ADIPONECTIN LEVELS IN GRAVES' DISEASE - SYSTEMATIC REVIEW AND META-ANALYSIS.

Context: Graves' disease is the most prevalent cause of hyperthyroidism worldwide. Adiponectin, the most abundant adipokine, plays a significant role in a cluster of prevalent diseases connected to metabolic disorders. Objective: Although the association between adiponectin and Graves' disease has been studied, the existing data is inconsistent. Therefore, we conducted this systematic review and meta-analysis to evaluate the relationship between adiponectin levels and Graves' disease. Methods: We performed a systematic electronic search on PubMed, EMBASE, Scopus and Cochrane Library using predefined keywords. We used the NHLBI quality assessment tools to assess the included studies. Results: There were 11 studies involving 781 subjects included in our qualitative synthesis, while 6 studies were included in our quantitative synthesis. We observed significantly increased adiponectin levels in Graves' disease patients compared to controls (MD 2.983 [95% CI 0.138-5.828]) and hypothyroidism patients (MD 3.389 [95% CI 1.332-5.446]). Nevertheless, no significant MD was observed when comparing Graves' disease patients with and without Graves' ophthalmopathy (MD -27.124 [95% CI -88.893 - 34.645]). Conclusions: Adiponectin levels were significantly higher in patients with Graves' disease compared to controls and hypothyroidism patients. However, patients with and without Graves' ophthalmopathy did not present a significant mean difference in adiponectin levels.

CARDIOVASCULAR RISK ASSESSMENT IN THE ADULT (AGED 40-79 YEARS) ROMANIAN POPULATION.

Atherosclerotic Cardiovascular Diseases are the leading cause of death worldwide. AIM: To estimate the prevalence of cardiovascular risk (CVR) categories in the adult population (aged 40-79 years) of Romania. DESIGN: The present study was part of the epidemiological, cross-sectional PREDATORR study (PREvalence of DiAbeTes mellitus, prediabetes, overweight, Obesity, dyslipidemia, hyperuricemia and chronic kidney disease in Romania). SUBJECTS AND METHODS: Exclusion criteria: age <40/or>79 years old and diagnosis of ischemic vascular disease. The CVR was evaluated using charts developed by the World Health Organization/ International Society of Hypertension (WHO/ISH) available for Europe B (epidemiological sub-region where Romania was included). The CVR was divided into 5 categories: <10%, 10-20%, 20-30%, 30-40%, > 40%. RESULTS: A total of 1631 subjects (57.0±10.7 years, 45.1% males) were included in the present study.The age and sex-adjusted prevalence of CVR >40% was 2.9% (95%CI 2.8-3.1%), CVR 30-40% was 1.85% (95%CI 1.8-1.9%), CVR 20-30% was 5.8% (95%CI 5.6-6.0%) and 13.0% (95%CI 12.8-13.3%) of the adult Romanian population has a 10-20% CVR, these CVR categories being more frequent in male and older age. Diabetes, overweight/obesity and smoking were associated with high CVR categories. CONCLUSION: Romania is one of the countries with high CVR, requiring CVD prevention measures.

LONG-TERM IMPROVEMENT OF GLUCOSE HOMEOSTASIS AND BODY COMPOSITION IN PATIENTS UNDERGOING LAPAROSCOPIC SLEEVE GASTRECTOMY.

CONTEXT: Laparoscopic sleeve gastrectomy (SG) has gained popularity as a metabolic procedure, but its long-term effectiveness for Romanian patients remains unclear. OBJECTIVES: To assess the long-term efficacy of SG for Romanian patients and to evaluate the differences between 5 years and 1 year follow-up. DESIGN: A longitudinal, prospective analysis of collected data from 68 patients undergoing SG between 2009 and 2014 was performed. Long-term outcomes at 5 years were analyzed in terms of total weight loss (%TWL), excess weight loss (%EWL), body composition and glucose homeostasis. SUBJECTS AND METHODS: All patients meeting the standard criteria for SG before inclusion were prospectively enrolled in the study. Of the 68 patients, eight were lost to follow-up, therefore, 60 patients (41.7±12.5 years, baseline body mass index [BMI] 44.6±9.9Kg/m2) were analyzed. RESULTS: The BMI decreased at 12 months with 30.7% from the preoperative BMI (p<0.001) and subsequently stabilized at 5 years.TWL and EWL were 30.6% and 83.1%, respectively at 1 year, with a slightly increase at 5 years.Therapeutic success rate (%EWL≥50) and diabetes remission rate (Buchwald criteria) were 93.3% and respectively 63.6% at 5 years. Insulin sensitivity index and metabolic clearance rate of glucose increased with 92.5% and 60.1% respectively, in the third month from baseline (p<0.001), while estimated second phase of insulin secretion decreased with 7.9% in the first month postoperatively (p=0.04), remaining stable afterwards. CONCLUSIONS: SG was effective in terms of %EWL, body composition and glucose homeostasis improvement for Romanian patients, the outcomes stabilizing after 1 year follow-up.

A comparison of the pharmacokinetics and safety of enzalutamide in subjects with hepatic impairment and matched healthy subjects.

WHAT IS KNOWN AND OBJECTIVE: Enzalutamide is an androgen receptor inhibitor approved for treatment of metastatic castration-resistant prostate cancer. Enzalutamide is highly protein bound and eliminated primarily by hepatic metabolism; therefore, it is important to understand whether enzalutamide pharmacokinetics is altered by hepatic impairment. METHODS: Pharmacokinetic data were obtained from two non-randomized, open-label, single-dose, phase 1 studies conducted in patients with mild (Child-Pugh class A, n = 6) or moderate (Child-Pugh class B, n = 8) hepatic impairment (NCT01901133) or severe (Child-Pugh class C, n = 8) hepatic impairment (NCT02138162) and their corresponding matched healthy controls; data from both studies are presented here. Subjects with hepatic impairment had liver cirrhosis (n = 19) or chronic hepatitis (n = 3). All subjects received a single oral dose of 160 mg enzalutamide under fasting conditions, with blood samples collected predose and up to 49 days post-dose. RESULTS AND DISCUSSION: Exposure to enzalutamide active moieties, based on the area under the curve of the sum of enzalutamide and N-desmethyl enzalutamide (an active metabolite with similar potency to enzalutamide), increased by 13%, 18% and 4% in subjects with mild, moderate and severe hepatic impairment, respectively, relative to matched controls. Compared with healthy controls, the mean maximum plasma concentration for enzalutamide active moieties was 24% higher in subjects with mild hepatic impairment and 11% and 41% lower in subjects with moderate and severe hepatic impairment, respectively. Enzalutamide was generally well tolerated, with no clinically significant trends in abnormal laboratory findings, vital signs or electrocardiograms. WHAT IS NEW AND CONCLUSIONS: No major differences in single-dose pharmacokinetics were observed in subjects with hepatic impairment vs. matched healthy controls. Therefore, these studies indicate that no initial dose adjustment is necessary when administering enzalutamide to patients with hepatic impairment.

EARLY COMPLICATIONS FOLLOWING ANATOMIC LUNG RESECTIONS--EXPERIENCE OF A THORACIC SURGICAL ONCOLOGY UNIT.

AIM: To analyze the medical and socioeconomic impact of the complications of anatomic lung resections performed at the Thoracic Surgery Unit of the Iasi Regional Cancer Institute. METHODS: This retrospective study included patients who underwent anatomic lung resections between January 2013 and August 2015. RESULTS: Over this interval a total of 172 major lung resections were performed: 31 (18.02%) pneumonectomies, 5 (2.91%) bilobectomies, and 136 (79.06%) lobectomies. Complications occurred in 36 patients, including bronchial stump fistula in 7 patients (4.06%), bronchopneumonia (9/5.23%), pleural empyema without bronchoscopically documented bronchial stump fistula (1/0.58%), chylothorax (1/0.58%), postoperative arrhythmia (3/1.74%), early postoperative stroke (1/0.58%), prolonged air leak (requiring hospital stay longer than 14 days) (11/6.38%), and postoperative hemothorax requiring reintervention (3/1.74%). Secondary to complications, a number of 3 (1.74%) patients died early postoperatively. CONCLUSIONS: The incidence of immediate and early postoperative complications is comparable to those reported by other authors.

PELVIC ACTINOMYCOSIS MIMICKING A LOCALLY ADVANCED PELVIC MALIGNANCY--CASE REPORT.

We present the case of a former user of an intrauterine contraceptive device (IUD) for 10 years, diagnosed with a bulky, fixed pelvic tumor involving the internal genital organs and the recto sigmoid, causing luminal narrowing of the rectum, interpreted as locally advanced pelvic malignancy, probably of genital origin. Intraoperatively, a high index of suspicion made us collect a sample from the fibrous wall of the tumor mass, large Actinomyces colonies were thus identified. Surgery consisted in debridement, removal of a small amount of pus and appendectomy, thus avoiding a mutilating and useless surgery. Specific antibiotic therapy was administered for 3 months, with favorable postoperative and long-term outcomes. Pelvic actinomycosis should always be considered in the differential diagnosis of pelvic tumors in women using an IUD. The association of long-term antibiotic treatment is essential to eradicate the infection and prevent relapses.

Prevalence of overweight/obesity, abdominal obesity and metabolic syndrome and atypical cardiometabolic phenotypes in the adult Romanian population: PREDATORR study.

PURPOSE: The objectives were to assess the prevalence of overweight/obesity, abdominal obesity and metabolic syndrome (MetS), and to evaluate the characteristics of the metabolically unhealthy lean (MUHL) and metabolically healthy overweight/obese (MHO) phenotypes in a Romanian population-based sample from the PREDATORR study. METHODS: PREDATORR was an epidemiological study with a stratified, cross-sectional, cluster random sampling design. Participants were classified into four cardiometabolic phenotypes based on the BMI, the cut-off value being 25 kg/m(2), and the presence of MetS (defined according to the Harmonization definition 2009): MUHL, MHO, metabolically healthy lean (MHL) and metabolically unhealthy overweight/obese (MUHO). RESULTS: Overall, 2681 subjects aged 20-79 years were included in the analysis. The overall age and sex-adjusted prevalence of obesity was 31.90 %, overweight was 34.7 %, abdominal obesity was 73.90 % and MetS was 38.50 %. The age- and sex-adjusted prevalence of MHO phenotype was 31.60 %, while MUHL phenotype prevalence was 3.90 %. MUHL and MHO participants had a cardiometabolic profile, kidney function and CVD risk intermediary between MHL and MUHO. MUHL had higher odds of being associated with CVD risk (OR 5.8; p < 0.001), abdominal obesity, prediabetes, diabetes, hypertriglyceridemia and hypo-HDL cholesterolemia than MHL, while MHO phenotype was associated with hypo-HDL cholesterolemia (OR 3.1; p = 0.002), prediabetes (OR 2.9; p < 0.001) and abdominal obesity. CONCLUSIONS: PREDATORR study showed a high prevalence of obesity/overweight, abdominal obesity and MetS in the adult Romanian population, and their association with kidney function and several cardiometabolic factors.

PALLIATIVE TREATMENT OF MALIGNANT ESOPHAGOPULMONARY FISTULAS WITH COVERED SELF-EXPANDABLE METALLIC STENTS (SEMSS). A SINGLE CENTER EXPERIENCE.

AIM: The aim of our study was to determine the efficiency of SEMSs in patients with esophagopulmonary fistulas, regarding fistula closure, enhancement of dysphagia scores and survival rates. MATERIALS AND METHODS: Between January 2004 and June 2014, from a total of 133 patients who underwent stent placement procedures, 26 were diagnosed with esophagopulmonary fistulas. In 19 cases the fistulas were caused by esophageal carcinomas and in 7 cases by bronchogenic ones. 16 patients developed aspiration pneumonia, 3 lung abscess and 7 subclinical fistulas. RESULTS: Complete fistula sealing occurred in 26 patients (100%). There were no immediate procedural complications except chest pain in 5 cases. After sealing of the fistulas and antibiotic treatment, pneumonia has regressed. After stent insertion, the dysphagic syndrome improved significantly (mean dysphagia scores decrease from 3.28 to 1.3 after stent insertion). The main goal of palliative therapy in patients with unresectable cancer and esophago-pulmonary fistulas is to close the fistulas, thus preventing the aspiration of saliva and food into the bronchus. Other goals include amelioration of dysphagia symptoms, maintenance of oral intake and improvement of quality of life. Ultimately covered expandable metal stents may increase survival rate as compared with other therapies. CONCLUSIONS: The endoscopic placement of covered SEMSs is the treatment of choice for malignant esophago-pulmonary fistulas.

POSTOPERATIVE ARTERIAL RELAXATION AND INTRAOPERATIVE VENOUS DILATION AS INTERCONNECTED PROGNOSTIC FACTORS FOR THE MATURATION OF ARTERIOVENOUS FISTULAS.

AIM: To investigate if immediate arterial distention can be used as a predictive factor for the development of a good fistula. MATERIAL AND METHODS: Over a 5-months period (January- May 2015) all the patients who underwent an arteriovenous fistula between the radial artery and the cephalic vein of the forearm at the Second Surgical Clinic of the Iasi Regional Cancer Institute and were willing to participate were enrolled in the study. The diameters of the vessels were measured 1 hour and 8 weeks after surgery. RESULTS: We found statistically significant differences for all measured diameter variations between the calcified artery and normal artery groups (p < 0.001 for the arterial distention at 1 hour and 8 weeks after surgery and p = 0.002 for the venous distention 8 weeks after surgery). A linear regression also showed that the degree of arterial distention immediately after surgery and the venous distention 8 weeks after surgery were statistically correlated. CONCLUSIONS: Arterial distention immediately after surgery and therefore the lack of it due to the presence of arterial calcifications can be used to predict whether or not a good fistula can be achieved at a 1% statistical significance level.

Corelation of lymphocytic infiltrates with the prognosis of recurrent colo-rectal cancer.

BACKGROUND: Recent studies are focusing on complementary prognostic and predictive markers that could complete the predictive TNM staging and one of the most promising directions is the study of tumor immune infiltrates. MATERIALS AND METHODS: Our 2-year retrospective study includes resection specimens from the primary tumors of 23 patients presenting to our clinic for a local or a distant relapse after colon or rectal cancer. From every primary tumor specimen we obtained immunohistochemically stained slides in order to assess cd3, cd4, cd8, cd45ro and cd68 infiltrates. Digital analysis assessed the density and percentage of positively stained cells in the normal peritumoral tissue, invasive margin and center of the tumor. RESULTS: A small density of cd8 positive cells in the peritumoral region was strongly correlated with a longer disease-free interval (p=0.009) and the Kaplan-Meier survival analysis showed that the percentage of cd8+ T cells could be used to stratify patients in terms of relapse risk (p=0.006). We found no correlation between invasion front infiltrates and intra tumoral infiltrates and the disease-free interval. CONCLUSION: Our study concludes that cytotoxic T-cell infiltrates in the normal peritumoral tissue could be used to predict a more aggressive tumor in terms of the relapse risk.

Laser microdissection--a novel approach for accessing the molecular basis of cancer.

BACKGROUND AND AIM: It has been known for quite a lot of time that tumours are cellular aggregates of different cells, mainly malignant cells but also immune cells--of which the most well-known are the tumour infiltrating lymphocytes (TIL) and the tumour associated macrophages (TAM). By observing hematoxylin--eosin stained or immunohistochemical stained slides belonging to different areas of the tumour it is clear that there are clusters of malignant cells within the tumour itself that seem to behave differently from the rest of the tumour. Another fact is that different areas of the tumour contain different inflammatory cells which may promote carcinogenesis or may help to confine it. Whereas different immune cells can be recognised by using immunohistochemistry, a satisfactory characterization of the molecular characteristics of the malignant clusters of the tumour cannot be made without further use of different molecular techniques such as different PCR techniques or microarray methods. Laser microdissection thus comes as a valuable aid in choosing exactly which cells will be analyzed further on. PRINCIPLE OF THE METHOD: Laser microdissection is based on using the energy of a focused laser beam to cut through the thickness of the tissue that is placed on a microscope slide in order to obtain cell samples previously selected by the pathologist through special software. CONCLUSIONS: To be able to cut the cells that you want and analyze them further without having them contaminated with other cells means that you can get more insight into the progression of the mutations that occur in these malignant cells, mutations that cause them to become more aggressive or multidrug-resistant. This could in time lead to the discovery of new molecular targets for cancer therapy.

Structure and magnetic properties of nanosized magnetite obtained by glass recrystallization.

We present the preparation, structural and magnetic properties of nanosized magnetite obtained by the crystallization of a series of Fe-containing borosilicate glasses. Several compositions with the ratio Fe2O3/SiO2 spanning from 0.37 to 0.67 were investigated as a function of two nucleators Cr2O3 and P2O5, respectively, and modifiers and intermediates (Al2O3 and MgO). Mössbauer spectroscopy revealed the degree, the type and the location of disorder induced by a specific composition and nucleators. In addition to magnetite, it was also revealed the presence of large amounts of Fe-rich paramagnetic phases. The magnetic response is analysed in relation with the amount of Fe ions which remain dispersed in the glassy matrix as noninteracting (paramagnetic) ions. We discuss the role of the nucleators on the disorder in both tetrahedral and octahedral sites of the magnetite.

[Assessment of visual function under treatment with topical antiglaucoma agents and systemic vasodilators. Clinical study on glaucoma patients]. / Evaluarea functiei vizuale sub tratament cu topice antiglaucomatoase si vasodilatatoare sistemice. Studiu clinic pe loturi de pacienti cu glaucom, asistati in Clinica a II-a Oftalmologie, Spitalul Clinic de Urgente Prof. Dr. N. Oblu Iasi.

UNLABELLED: The authors present some observations regarding the use of topical anti-glaucoma therapy and systemic vasodilators. MATERIAL AND METHODS: The study was carried out on a series of 996 glaucoma patients, of which 54.1% with primary open-angle glaucoma, 5.7% closed-angle glaucoma, and 17.6% with normal intraocular pressure. RESULTS: Intraocular pressure and visual field were assessed after the use of such therapeutic methods as carbonic anhydrase inhibitors (dorzolamide) and prostaglandin (latanoprost) and dorzolamide (cosopt) association. CONCLUSIONS: The favorable progression of glaucoma could be improved by using new etiopathogenic mechanisms and treatment approaches.

[Contributions to know the involvement of cardio-vascular diseases in glaucoma etiology, studied on a sample of 996 patients assisted in Clinic of Ophthalmology, "Prof. N. Oblu" Emergency Hospital, Iasi]. / Contributii la cunoasterea implicarii unor afectiuni cardiovasculare in aparitia glaucomului, observate pe 996 pacienti asistati in Clinica de Oftalmologie, a Spitalului de Urgenta "Prof. Dr. N. Oblu" Iasi.

MATERIAL AND METHOD: The authors present the results of clinical and epidemiological research on a sample of 8118 patients assisted in the Ophthalmology Clinic of the Hospital "Prof. Dr. N. Oblu", including 996 (12.1%) with glaucoma, of which 54.1% primary open angle glaucoma (POAG), 22.6%, normal tension glaucoma (NTG), 5.7% primary angle closure-glaucoma (PACG) and 17.6% secondary glaucoma, during 2006-2010. RESULTS: For patients with glaucoma authors assessed the prevalence of arterial hypertension (POAG: 33.1%; NTG: 32%; PACG: 8.7%, secondary: 8%), diabetes mellitus (POAG : 19.9%, TNG : 12.9%; PACG : 5.3%, secondary : 5.2%), atherosclerosis (POAG: 10.2%, TNG: 12%; PACG: 5.2%, secondary: 2.9%), vasospasm (POAG: 45 2%, TNG: 47.3%; PACG: 39.3%, secondary: 44.3%).

[CT and anatomo-pathologic examination in the diagnosis of cavernous sinus lesions]. / Aportul examenului CT si al examenului anatomo-patologic in diagnosticul leziunilor sinusului cavernos.

UNLABELLED: This study presents the CT imaging and histological aspects of a lot of cavernous sinus disease that include primary and secondary neoplastic processes, congenital lesions, infectious and inflammatory processes, and vascular abnormalities. MATERIAL AND METHODS: All 47 patients were CT explored with and without intravenous contrast, using specific protocols for orbit and brain. We studied the topography of the tumors, their impact to neighborhood regions and post-treatment results. For all patients we performed histological examination. RESULTS: We found 26 cases with sellar origin of the tumor and 21 cases of para-sellar origin, with a significant extension in 22 cases. The most frequent histologic type of tumors were represented by hypophyseal adenoma (17 cases), followed by meningiomas (9 cases) and cranio-pharyngiomas (5 cases). CONCLUSIONS: CT imaging allows a fast and accurate analysis of sellar and para-sellar tumors, with a tumor extension assessment. The clinical and imaging diagnosis is confirmed by histological examination.

[Clinical study on the tolerance and efficacy of piroxicam used in cataract surgery, compared with diclofenac and indomethacin]. / Studiul clinic privind toleranta si eficacitatea piroxicamului in chirurgia cataractei, comparativ cu diclofenacul si indometacinul.

The study was done on 75 patients diagnosed with cataract, treated with non-steroidal anti-inflammatory eye drops. This clinical trial recommends piroxicam 0.5% as a reliable alternative of diclofenac 0.1% and indomethacin 0.1%.

A role for kisspeptins in the regulation of gonadotropin secretion in the mouse.

Kisspeptins are products of the KiSS-1 gene, which bind to a G protein-coupled receptor known as GPR54. Mutations or targeted disruptions in the GPR54 gene cause hypogonadotropic hypogonadism in humans and mice, suggesting that kisspeptin signaling may be important for the regulation of gonadotropin secretion. To examine the effects of kisspeptin-54 (metastin) and kisspeptin-10 (the biologically active C-terminal decapeptide) on gonadotropin secretion in the mouse, we administered the kisspeptins directly into the lateral cerebral ventricle of the brain and demonstrated that both peptides stimulate LH secretion. Further characterization of kisspeptin-54 demonstrated that it stimulated both LH and FSH secretion, at doses as low as 1 fmol; moreover, this effect was shown to be blocked by pretreatment with acyline, a potent GnRH antagonist. To learn more about the functional anatomy of kisspeptins, we mapped the distribution of KiSS-1 mRNA in the hypothalamus. We observed that KiSS-1 mRNA is expressed in areas of the hypothalamus implicated in the neuroendocrine regulation of gonadotropin secretion, including the anteroventral periventricular nucleus, the periventricular nucleus, and the arcuate nucleus. We conclude that kisspeptin-GPR54 signaling may be part of the hypothalamic circuitry that governs the hypothalamic secretion of GnRH.

[A prevalence study of serum markers in hepatitis virus infection in the epidemiological anamnesis of the population]. / Studiul prevalentei markerilor serici ai infectiei cu virusurile hepatitelor în anamneza epidemiologica a populatiei.

Pandemic of the infections with hepatitis viruses is a priority in public health. In Romania, the very high acute and chronic morbidity by viral hepatitis demands the rapid implementation of a feasible preventive program. In the population of 5 districts from Transylvania we conducted a sero-epidemiological survey in order to find the real and specific characteristics of the prevalence of the infections with hepatitis viruses. The study was a cross-sectional study on the anamnestic presence of the infections in the population. The evolution of the cumulative prevalence of infections with HAV (74.3%) and HBV (31.7%) are proving a high endemoepidemicity. For the infections with HCV (4.9%) and HDV (1.7%) we observed an active process of endemicity. The high rate of persistent infections following HBV acute infections (19.1%) suggests a growing-up tendency of chronic hepatic diseases. In actual epidemiologic conditions, the rate of exposure to a potential hepatic viral infections in the population we studied could be 1.68 infections/person, during a period equal to life expectancy at birth.

Training needs of staff in Romanian institutions for young children.

In order to make adequate provision for staffing and staff training in leagane (long-term residential care institutions for preschool age children in Romania) a postal survey was conducted in the autumn of 1991 to ascertain the demographic characteristics, job titles and educational attainment of directors and staff, staffing needs and the kinds of positions currently filled, the numbers of directors and staff exposed to continuing education programmes within the last 2 years, and the opinions of directors and staff regarding their most important continuing educational needs. The bulk of the direct care workforce was less than 50 years old. Thirty-four per cent of the direct care staff had less than a high-school education. Sixty-seven per cent of the staff were health professionals or health care workers. There were few psychologists, physical therapists, teachers or social workers. In the last 2 years, directors and other physicians had been mostly exposed to courses in the areas of psycho-social care/management and paediatric medical care. Nurses had attended professional development courses. Infirmiera (nursing assistants) had also attended professional development courses such as those offered by foreign non-governmental organizations on the care of institutionalized children. Educators (teaching assistants) had attended courses in child development and rehabilitation. Directors and staff expressed clear opinions regarding their needs and preferences for additional training.

Management of hyperthyroidism due to Graves' disease: a retrospective analysis of 1,000 inpatient cards.

There are three different modalities to treat hyperthyroidism due to Grave's disease: anti-thyroid drugs (ATD), radioiodine and surgery, each of them having its own advantages and disadvantages. The option for one of the three therapeutical approaches has both subjective and objective components. In Europe, a screening on the therapeutical options in Graves' disease was performed at the European Thyroid Association (ETA) initiative, being based on a questionnaire. In the Thyroid Department of the Endocrinology Institute in Bucharest, w analysed the managements of hyperthyroidism due to Graves' disease on 1,000 cards of hyperthyroid patients admitted there during the last five years. In order to diagnose Graves' disease, in vivo tests radioiodine uptake (RIU) at 2 and 24 hrs, 93.39% scintigram (92.93%), thyroid ultrasonography (15%) and reflexogram (98.06%), were carried out. Out of the in vitro tests, PBI (protein bound iodine) was performed prioritarily, while T4, T3 (variable), TSH (13.91%) were performed according to the economic factors. For the patient with moderate hyperthyroidism, antithyroid therapy was alternative with the radioiodine one (51.61% and 48.35%, respectively). The age of the patient played a major role in the decision to take. The frequency of cases treated with radioiodine was considerably higher in the patients with recurrence and in the elderly. The initial dose of antithyroid treatment was high (50-60 mg), and was reduced according to the thyroid function. The therapy duration was not pre-determined. The ATD treatment was prolonged for a time-interval ranging between 2 and 5 years, depending of the clinical status (age, sex, goiter size, exophthalmic syndrome) and the social conditions.(ABSTRACT TRUNCATED AT 250 WORDS)