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Medullary thyroid carcinoma (MTC) still remains a rare endocrine tumor. 20-25% of MTC cases are genetically determined. The detection of the RET proto-oncogene mutation in 1993 allowed to understand the unique genotype-phenotype relationships in hereditary medullary thyroid carcinoma (HMTC) and formed the basis for therapeutic decisions based on the molecular results. Currently, prophylactic thyroidectomy is a commonly adopted and accepted therapeutic method. The decision on the time and extent of surgery should be made based on the results of molecular examination, the assessment of calcitonin (Ct) concentration and family history. Treatment of patients with HMTC requires the cooperation of a multidisciplinary team of experts and should be done in specialized centers only. The study is a review of the current guidelines for surgical management in the MEN2 syndrome.

Recent studies provide evidence that anxiety disorders may be linked to malfunction of serotonin neurotransmission or impaired activity of enzymes metabolising the catecholamines. Functional polymorphisms in the MAO-A uVNTR promoter gene, the COMT gene (Val158Met) exon 4, and the 5-HTT promoter gene (44 bp ins/del) were investigated in 101 patients with phobic disorders of the anxiety spectrum and 202 controls matched to the patients for sex, age and ethnicity. There were no significant differences between controls and patients in the allele and genotype frequencies of the 5-HTT and COMT gene polymorphisms. The frequency of >3 repeat alleles of the MAO-A gene polymorphism was significantly higher in female patients suffering from anxiety disorders, specifically panic attacks and generalized anxiety disorder. There was also a trend for the more frequent presence of >3 repeat alleles in female patients with agoraphobia and specific phobia, in contrast to female patients with social phobia, who did not differ from controls. The results support a possible role of the MAO-A gene in anxiety disorders.

Atrial fibrillation belongs to the group of supraventricular arrhythmias. The episode begins with anxiety about the loss of health or life. Anxiety is accompanied by depressive disorders. The aim of this work was to study the intensity of depression in patients with atrial fibrillation.We used Beck Depression Inventory in 52 patients with atrial fibrillation hospitalized at the Department of Internal Medicine of the Poviat Hospital in Białogard. Correlations between the intensity of depression and age, gender, and education level were determined.The intensity of depression depended on age, gender, and education level. Mild depression was more common in women, moderate in men, and was very severe in 2 women. Patients between the age of 61 and 80 years and with incomplete primary and vocational education presented with all forms of depression.The intensity of depression correlates with episodes of atrial fibrillation and depends on such factors as age, gender, and education level (p0.05). Effective therapy of atrial fibrillation may help reduce the intensity of depression.

Atrial fibrillation is a common supraventrical arrhythmia. The onset of fibrillation is marked by fear of loss of health or life. Symptoms of depression occur concurrently. This study was undertaken to measure anxiety in patients with atrial fibrillation grouped according to gender, age, and education.The test anxiety inventory of C.D. Spielberger was administered to 52 patients aged 41 to 80 years, treated for atrial fibrillation at the Internal Ward of the District Hospital in Białogard.Anxiety as a state was observed more frequently in males and in patients with vocational and secondary education. Anxiety was not a trait of atrial fibrillation. Psychotherapeutic interventions used in cardiac rehabilitation are not recommended in atrial fibrillation. However, relaxation techniques could be of benefit in reducing the intensity of anxiety as a state.

In recent years, the increasing frequency of gastroesophageal reflux disease (GERD) occurrence has been observed. Gastroesophageal reflux disease may take the form of so called 'heart mask' (i.e., chest pain) imitating ailments typical for the myocardial ischemia. The aim of this work was to evaluate frequency of GERD symptoms and the oesophagitis among patients suffering from angiographically confirmed coronary artery disease. The patients mentioned above were ordered to undergo CABG.134 coronary artery disease (CAD) patients were observed. All patients underwent collection of medical history and gastrointestinal endoscopy.Gastroesophageal reflux disease symptoms were found in 46 patients diagnosed with CAD what constitutes 34% of the total number of patients (28.3 vs. 3.4%, p = 0.00006). It has to be mentioned that oesophagitis was found more often among patients suffering from GERD (i.e., among 24% of the total number of patients). According to the Los Angeles classification, type A of the reflux oesophagitis occurred more frequently than type B did (A = 15.3%, B = 10.9%). Barrett's oesophagus had been observed among 5.5% ofpatients. Other complications of GERD had not been found. It is worth to emphasize that there was a significant statistical correlation between GERD, hiatal hernia, myocardial infarction and smoking.Patients suffering from myocardial ischemia may often have GERD symptoms that are not accompanied by injury of oesophageal mucosae in most cases. Confirmation and explanation of the observed relation between the presence of hiatal hernia and infarction underwent require further research.

The aim of the study was to search for measurable, objective, and reproducible biological factors such as gene polymorphisms that increase the risk of an anxiety disorder, distinguishing personality traits predisposing to the anxiety disorder. The material comprised 103 patients fulfilling criteria of an anxiety disorder (panic disorders, generalized anxiety disorders, phobic disorders) and a control group of 100 subjects matched for age and free of neuropsychiaric disease.The genes studied were: COMT (catechol-oxygen-methyltransferase), MAO-A (monoamine oxidase A), and 5-HTT-LPR (serotonine transporter). Isolation of human genomic DNA, polymerase chain reaction (PCR) and electrophoresis on agarose gel were part of the study protocol. Anxiety disorders were diagnosed with the Composite International Diagnostic Interview (CIDI). The following psychometric tests were applied: TCI (R. Cloninger's Temperament and Character Inventory), R. B. Cattell's Inventory, C. D. Spielberger's questionnaire, and Beck's depression scale.There were no associations of COMT, MAO-A, and 5-HTT-LPR gene polymorphisms with anxiety disorders in the study and control groups. A higher level of anxiety as a "status" and as a "trait" were revealed in both groups (p0.001). TCI scales and subscales, as well as Cattell's personality factors, demonstrated significant differences between patients with anxiety disorders and controls. Depression was more severe in patients with anxiety disorders (p0.001). An association of COMT gene polymorphism with simple phobia (p0.004) was revealed. Mutation of 5-HTT-LPR carr tended to be more frequent (p0.07) among patients with generalized anxiety.Gene mutations that may account for increased risk of generalized anxiety, phobic disorder (simple and social), and agoraphobia were found, as well as gene variants determining temperament traits typical for patients with anxiety disorders. The depression level was higher in patients with anxiety disorders. TCI and Cattell's personality inventory distinguish personality traits typical for such patients.

The aim of the present study is a characterisation of the personality dimensions of patients with anxiety disorder.Personality of 103 patients with different mixed ICD-10 diagnosis of anxiety disorders (79 females, 24 males, mean age: 38 +/- 12 years) were studied and compared to 183 healthy controls (117 females, 66 males, mean age: 35 +/- 14) using the 16 PF Cattell's Questionnaire and Cloninger's TCI. Spielberger's State and Trait Anxiety Inventory and Self-evaluation of the Beck's Depression Scale were also applies.Levels of anxiety and depression were significantly higher in patients. It was found that patients with anxiety disorders scored higher in Cattell's following factors: O, Q4 and lower in: C, E, F, H, Q3 when compared to standard population norms. Following TCI scales differentiated the personality of patients when compared to the controls: A significant increase of all HA subscales, decrease of NS in females and NS1 in both female and male patients, increase in RD1 and decrease in RD3 in patients, decrease of P, SD, C (except C4 and C5 subscales) were observed.Both TCI and 16 PF describe similar traits in the personality of patients with anxiety disorders, and are helpful in the diagnosis and prognosis of therapy.