Objective. Congenital hypothyroidism (CH) is one of the common preventable causes of intellectual disability in neonates, by early detection through neonatal screening. We present the 8-year experience of the National Institute for Mother and Child Health (INSMC) in using MEDILOG national registry for the neonatal screening of CH.Methods. Neonatal screening for CH, done by TSH measurement in dried blood spot, is organized in 5 regional centers, each with a reference laboratory.Results. In 2018 80% of all the newborns, from 80% of the maternity hospitals, were registered in MEDILOG. After re-testing of TSH and T4/FT4 from venous blood in positive cases, the incidence of confirmed CH in 2018 was 1/3576 -1/ 4746. In INSMC center (which includes 26 counties and Bucharest, out of 41 counties), in 2018 the incidence of positive CH cases at screening was 1/2094 (TSH cut-off ≥17 mIU/L) and of confirmed CH cases 1/3576 newborns. For positive screening cases, the median duration from birth to the INSMC laboratory result was 19 days: median of 9 days between screening and laboratory registration and 6 days between registration and test result.Conclusion. MEDILOG registry is a practical instrument for monitoring the steps of neonatal CH screening, the incidence of CH, the evolution of the diagnosed cases, for evaluation of iodine deficiency (by neonatal TSH), and also for research, with the aim of improving early disease detection and treatment.

BackgroundThis survey, part of the European Project JANPA ( Joint Actions for Nutritional and Physical Activities), aims to the evaluation of obesity prevalence in Romanian children versus obesity prevalence in children of six other European countries: Italy, Greece, Portugal, Slovenia, Croatia and Ireland.Material and methodA number of 13 surveys and researches developed in Romania at regional or national scale between 2010 and 2016 concerning prevalence of overweight and obesity in children, have been analysed. The results of these surveys were compared to similar epidemiologic surveys available in the six mentioned European countries.ResultsPrevalence of overweight and obesity in Romanian children varies between 17% and 30% and the condition affects more boys than girls and particularly school age children than teenagers.On the other hand the records in Portugal, Grece and Italy show higher levels of children overweight and obesity than in Romania, while in Slovenia and Croatia the prevalence of these conditions was similar to those in Romania for all age groups.Prevalence of overweight and obesity in pre-school and school age children was higher than in teenagers in all countries except Italy. In infants few surveys on this conditions are available: they show a reduced prevalence in Romania (5.4% following WHO standards) in contrast with Ireland where 24.8% of infants are overweight and 15.7% obese (following UK – WHO growth standards). In most of these countries the surveys show a higher prevalence of overweight and obesity in boys, with a particular situation in Italy where this prevalence is higher in school girls of 7 age group than in boys of 7 age group.ConclusionIn the selected coutries there are similarties and differencies as concerns prevalence, characteristics, gender associations and age-related evolutive aspects of overweight and obesity in children.

BackgroundPhenilketonuria (PKU) is a rare metabolic desease that in absence of an early dietary treatment introduced from the first month of life leads to ireversible neuro-cognitive disorders. In Romania this condition is diagnosed mostly by newborn screening and the prevalence is 1/10.000 births.Material and methodThe retrospective surwey included a number of 48 children with PKU of 1 to 12 years of age registered in Bucharest and Iasi regional screening centres. The age at diagnostic and at dietary treatment introduction, as well as the blood Phe average concentration within year 2016 were statistically established. The children were assesed as concerns the psychosomatic and growth status.ResultsA number of 43 children from total of 48 were early diagnosed by newborn screening at an average age of 26.13 days (range 11 to 112 days). The dietary treatment to these children was introduced at the average age of 42 days.At the end of year 2016 the weight of the children was out of the standard WHO±2 SD in 30% of cases and the height of the children was out of WHO standard in 42% of cases.The cognitive development is variable from normal to severe mental retardation.ConclusionThe dietary treatment only provides a normal growth in two thirds of the monitored PKU children. The early diagnostic, as well as a good compliance to dietary treatment and monitoring are key factors for a normal development of the affected children. All PKU children that were not diagnosed by newborn screening presented moderate to severe neurocognitive disorders.

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Diabetic retinopathy is a well-known complication of diabetes, a major cause of vision loss worldwide. Purpose. The present study investigates the correlation between hypertension and evolution of diabetic retinopathy in patients with type II diabetes. Materials and methods. We conducted a prospective study between June and December 2016, on 24 patients hospitalized in Ophthalmology Clinic, Emergency University Hospital Bucharest, with AO: diabetic retinopathy and arterial hypertension under medical treatment. Patients were evaluated at baseline, 2 months, 4 months and 6 months through comprehensive eye examination and measuring the value of blood pressure (BP). Comparative data were analyzed in patients with compensated hypertension (BP<150 mmHg) and subcompensated hypertension (BP> = 150 mmHg). Results. Of the 24 patients, 15 had values offset BP (group A) and 9 associated hypertension subcompensated (group B). In group A proportion of patients (at baseline) with diabetic retinopathy absent or nonproliferative was higher than patients in group B (47% vs. 22%, p = 0.052995019518117). Patients in group B had a higher tendency to record an evolution of diabetic retinopathy (in group B, 55.55% of patients had a progression, and in group A, only 26.66%). Conclusions. Incomplete therapeutic control of hypertension may affect the retinal microvasculature impacting the progression of diabetic retinopathy. Maintaining a strict control of systolic BP of permanent value bellow 140 mmHg should be part of the patient management guide of the diabetic patient in order to prevent ophthalmic complications with major risk of vision loss.

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