[Family planning is an exceptionally important question in multiple sclerosis, as women of childbearing age are the ones most often affected. Although it is proven that pregnancy does not worsen the long-term prognosis of relapsing-remitting multiple sclerosis, many patients are still doubtful about having children. This question is further complicated by the fact that patients – and often even doctors – are not sufficiently informed about how the ever-increasing number of available disease-modifying treatments affect pregnancies. Breastfeeding is an even less clear topic. Patients usually look to their neurologists first for answers concerning these matters. It falls to the neurologist to rationally evaluate the risks and benefits of contraception, pregnancy, assisted reproduction, childbirth, breastfeeding and disease modifying treatments, to inform patients about these, and then together come to a decision about the best possible therapeutic approach, taking the patients’ individual family plans into consideration. Here we present a review of relevant literature adhering to international guidelines on the topics of conception, pregnancy and breastfeeding, with a special focus on the applicability of approved disease modifying treatments during pregnancy and breastfeeding. The goal of this article is to provide clinicians involved in the care of MS patients with up-to-date information that they can utilize in their day-to-day clinical practice. ]

[The joint appearance of pregnancy and cancer is rare. It is highly recommended that the tumorous pregnant should be managed by a multidisciplinary team. The early diagnosis is very important, but it is not easy, because the symptoms of pregnancy and cancer are rather similar. Imaging diagnosis has to avoid ionizing radiation (e.g. PET/CT). The same is true for chemotherapy in the fi rst trimester, due to the increased risk of developmental abnormalities. Consequently, radiation therapy is not allowded throughout the pregnancy, and the chemotherapy in the fi rst trimester is a strong indication for the interruption of pregnancy. Surgery, with good practice, usually can be performed without complications. Chemotherapy, given in the second and third trimester generally follows the standard protocols with a low frequency of developmental errors. Early delivery should not be encouraged, except the delay has a hazardous effect on the mother and/or on the child. The pregnant should be informed about all steps to be an active part of the fi nal decision.]

[The effects of thyroid hormones on bone tissue are of fundamental importance.They are required for skeletal development and later for normal bone metabolism.Their action is dose-dependent and also depends on the degree of differentiation of the target tissue. In childhood, thyroid hypofunction manifests itself in growth retardation, whereas hyperfunction will accelerate bone maturation.The exact mechanism of action of thyroid hormones on bone in later years is poorly understood, and their clinical relevance on the risk of bone fracture, the most important complication, is also unclear. In adults with hypothyroidism, bone mineral density (BMD) remains unchanged or even becomes increased, but the risk of fractures is elevated. In hyperthyroidism the bone turnover is increased, which may lead to a decrease in BMD and a higher risk of fracture. However, the results are inconsistent for endogenous subclinical hyperthyroidism, where BMD may also decrease and fractures may occur more frequently.Treatment of hypothyroidism may temporarily result in increased fragility but this phenomenon seems to be only transient. During L-T4 replacement therapy the TSH level should be kept in the normal range, while with suppression, it should be set to the lower end of the normal range. During treatment of hyperthyroidism BMD temporarily increases and the risk of fractures decreases.The most effective way of preventing osteoporosis and bone fractures in all cases is the early recognition and treatment of thyroid diseases.The presence of other osteoporosis risk factors should always be considered. In some cases adjuvant therapy may be necessary to stop bone loss.]

[Various medical associations issue different recommendations for the prevention and treatment of vitamin D deficiency. These significant differences are partly explained by the different definition of normal vitamin D level and the use of completely different mathematical models to predict the increase in vitamin D level as a response to therapy. According to the Institute of Medicine, the target vitamin D level is 20 ng/ml, whereas the Endocrine Society recommends 30 ng/m as the minimum target value. These differences show that the two Society have different views on the risk of adverse effects. Screening, however, is not recommended by either society. In this review I summarize the role of the vitamin D supplementation in the prevention of infertility. Also, I suggest the protective effect of the vitamin D during the pregnancy. In my opinion screening program against D hypovitaminosis should be performed in case of infertility and in pregnancy, because data show a protective role of vitamin D against many disease of newborn. ]

[Even in the absence of clinically signifi cant co-morbidities, cancer care is a major challenge for both patients and healthcare professionals. Routine anticancer treatment may be complicated by special clinical situations such as pregnancy or organ transplantation. The dosage of certain oncotherapy agents may be further affected by impaired renal and hepatic function or diabetes mellitus. These days, given the improved prognosis of cancerous diseases and increased survival, personalized therapy and prevention of long-term side effects is becoming particularly important, especially in the above-mentioned oncological situations. In this summary, we review the anticancer treatments recommended by ESMO in specifi c clinical situations.]