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The guidelines Thyroid Cancer 2022 are prepared based on previous Polish recommendations updated in 2018. They consider international guidelines - American Thyroid Association (ATA) 2015 and National Comprehensive Cancer Network (NCCN); however, they are adapted according to the ADAPTE process. The strength of the recommendations and the quality of the scientific evidence are assessed according to the GRADE system and the ATA 2015 and NCCN recommendations. The core of the changes made in the Polish recommendations is the inclusion of international guidelines and the results of those scientific studies that have already proven themselves prospectively. These extensions allow de-escalation of the therapeutic management in low-risk thyroid carcinoma, i.e., enabling active surveillance in papillary microcarcinoma to be chosen alternatively to minimally invasive techniques after agreeing on such management with the patient. Further extensions allow the use of thyroid lobectomy with the isthmus (hemithyroidectomy) in low-risk cancer up to 2 cm in diameter, modification of the indications for postoperative radioiodine treatment toward personalized approach, and clarification of the criteria used during postoperative L-thyroxine treatment. At the same time, the criteria for the preoperative differential diagnosis of nodular goiter in terms of ultrasonography and fine-needle aspiration biopsy have been clarified, and the rules for the histopathological examination of postoperative thyroid material have been updated. New, updated rules for monitoring patients after treatment are also presented. The updated recommendations focus on ensuring the best possible quality of life after thyroid cancer treatment while maintaining the good efficacy of this treatment.

There is a significant correlation between elevated LDL cholesterol (LDL-C) levels sustained from childhood and future vascular disease. The study aimed to evaluate the effectiveness and safety of the therapy chosen for children with lipid disorders.The study group consisted of 37 children with increased LDL-C (13 boys) aged 8.99 ±4.03 years. After 6 months of behavioral treatment, study group was divided into G1 (n = 24) which continued non-pharmacological treatment supported by dietary supplements and G2 (n = 13) in which statin (5-10 mg/day) was added to non-pharmacological treatment. Analysis included: BMI Z-score, total cholesterol (TCh), LDL-C, HDL cholesterol (HDL-C) and triglycerides (TG) measured at several time points.The concentrations of TCh and LDL-C before treatment were significantly higher in G2 than in G1 (p0.001). Due to the treatment, these differences were no longer noticeable at the last visit. In G1 and G2 concentrations of TCh and LDL-C were reduced significantly, greater reduction after the treatment in TCh and LDL-C was observed in G2 than in G1. Moreover, in G1 we noticed reduction of TG after treatment (p0.05). The BMI Z-score did not change significantly through the treatment in both groups. G1 also showed a significant negative correlation between BMI Z-score and HDL-C before and after treatment (r = -0.57, p = 0.009; r = -0.52, p = 0.02). Same relationship was noticed also in G2 after treatment (r = 0.67, p = 0.05).In children with dyslipidemia, regardless of its background, statin therapy is the most effective in lowering LDL-C. However, therapy with lipids-lowering supplements seems to be safe and effective.Istnieje istotna korelacja pomiędzy zwiększonym stężeniem cholesterolu LDL (LDL-C) w dzieciństwie a chorobami naczyniowymi w przyszłości. Celem pracy jest ocena skuteczności i bezpieczeństwa wybranych terapii u dzieci z zaburzeniami gospodarki lipidowej.Do grupy badanej włączono 37 dzieci z podwyższonym stężeniem LDL-C (13 chłopców, 24 dziewcząt) w wieku 8.99 ±4.03 roku. Po 6 miesiącach leczenia behawioralnego, grupa została podzielona na G1 (n = 24), która była leczona niefarmakologicznie i suplementami diety i G2 (n =13), leczona niefarmakologicznie i statynami (5–10 mg/dziennie). Analizie poddano: BMI Z-score, cholesterol całkowity (TCh), LDL-C, cholesterol HDL (HDL-C) i trójglicerydy (TG), których stężenia były oceniane kilkukrotnie w trakcie obserwacji.Stężenia TCh i LDL-C przed leczeniem było istotnie wyższe w G2 niż w G1 (p0,001). Dzięki leczeniu różnice te nie były dłużej istotne na ostatniej wizycie. W G1 i G2 stężenia TCh i LDL-C spadły istotnie, istotnie większa redukcja stężenia TCh i LDL-C po leczeniu była obserwowana w G2 niż w G1. Co więcej, w G1 obserwowaliśmy również istotną redukcję stężenia TG po leczeniu (p0,05). BMI Z-score nie zmienił się istotnie w badanych grupach w trakcie leczenia. Ponadto w G1 stwierdzono istotną korelację pomiędzy BMI Z-score i HDL-C przed terapią i po leczeniu (r = –0,57, p = 0,009; r = –0,52, p = 0,02, odpowiednio). Taka korelacja była również obecna w G2 po leczeniu (r = –0,67, p = 0,05).U dzieci z dyslipidemią, niezależnie od jej przyczyny, leczenie statynami jest najbardziej efektywne w redukcji LDL-C. Aczkolwiek, leczenie suplementami diety wpływającymi na profil lipidowy wydaje się również skuteczne i bezpieczne.