NEONATAL SCREENING FOR CONGENITAL HYPOTHYROIDISM IN ROMANIA: DATA FROM MEDILOG MEDICAL INFORMATION REGISTRY.

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.

Overweight and obesity in infants and pre-school children in the European Union: a review of existing data.

The objective of this study was to synthesize available information on prevalence and time trends of overweight and obesity in pre-school children in the European Union. Retrieval and analysis or re-analysis of existing data were carried out. Data sources include WHO databases, Medline and Google, contact with authors of published and unpublished documents. Data were analysed using the International Obesity Task Force reference and cut-offs, and the WHO standard. Data were available from 18/27 countries. Comparisons were problematic because of different definitions and methods of data collection and analysis. The reported prevalence of overweight plus obesity at 4 years ranges from 11.8% in Romania (2004) to 32.3% in Spain (1998-2000). Countries in the Mediterranean region and the British islands report higher rates than those in middle, northern and eastern Europe. Rates are generally higher in girls than in boys. With the possible exception of England, there was no obvious trend towards increasing prevalence in the past 20-30 years in the five countries with data. The use of the WHO standard with cut-offs at 1, 2 and 3 standard deviations yields lower rates and removes gender differences. Data on overweight and obesity in pre-school children are scarce; their interpretation is difficult. Standard methods of surveillance, and research and policies on prevention and treatment, are urgently needed.

[The treatment of inguinal hernias by the tension-free mesh-plug alloplastic technic]. / Tratamentul herniilor inghinale prin tehnica alloplastica "tension-free mesh-plug".

The treatment of inguinal hernia using conventional procedures is related with a relative high rate of recurrency, discomfort and postoperative complications. This is the reason, why, in the last 6 months we began to perform the tension-free mesh-plug technique, starting from the American authors idea of preserving the sphincters-like action of the internal ring and the "sling" & "shutter" mechanism of the inguinal canal. Also, the dissection being minimal, it importantly reduced the possibility of postoperative complications (hematoma, seroma, ischemic orchitis). According to the hernia type, after the high dissection & ligation of the sac, on or more plugs are placed into the internal ring or/and the defect of the inguinal floor, reinforcing it with a second piece of flat mesh, from the pubic tubercle and beyond the internal ring. Though one experience is still small and of recent date, the results are encouraging: we didn't have postoperative complications and the patients discomfort was minimal.

[Colonic tuberculosis]. / Tuberculoza colonica.

General improvement of life standard normally reduces tuberculous morbidity. However, the general surgeon is confronted with a significant rise of abdominal tuberculosis, especially the colonic form. Between 1990 and 1995, 6 patients with ileo-colonic tuberculosis were operated in the Surgical Department N. Gh. Lupu, of which 3 presented also the peritonitis form, and 2 patients had also a liver involvement. The clinical symptoms, the palpable abdominal mass in the right lower quadrant and the intraoperative aspect suggested usually a right colonic neoplasm. The diagnosis was established by histology. The management was right (ileo) hemicolectomy, followed by tuberculostatic treatment over one year. In conclusion, the diagnosis is still a matter of concern whenever a palpable abdominal mass is found, even in the absence of evolutive pulmonary tuberculosis. A frozen section from the resection piece is very important, because it enables early beginning of the tuberculostatic treatment.