The International Journal of Romanian Society of Endocrinology / Registered in 1938

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  • Case Report

    Rosulescu R

    An Interesting Etiology of Ventricular Tachycardia

    Acta Endo (Buc) 2017 13(1): 115-118 doi: 10.4183/aeb.2017.115

    Intermittent hypoxia and ventilatory intermittence due to sleep disorders such as obstructive sleep apnea can lead to cardiac arrhythmia, coronary artery disease, conductance disturbances and cardiac failure. Sub-clinical and overt hypothyroidism is an important physiopathological complex that is linked with cardiovascular risk, alteration of lipidic profile promoting atherogenic mechanisms. The two pathologies combined can exponentially increase the cardiovascular event risk. This case report demonstrates a young patient with obesity and arterial hypertension accusing irregular heart beats. Despite a normal resting ECG and echocardiography the patient presented malignant ventricular arrhythmias revealed on the 24h Holter ECG. The Epworth scale was 20 and the patient presented numerous episodes of hypopnea with an increased apnea-hypopnea index associated with ventricular arrhytmias on the polisomnography. The endocrine profile of the patient revealed a sublinical hypothyroidism that untreated can lead to accelerated atherosclerosis and arrhytmic risk. CPAP treatment alongside the levothyroxine treatment at TSH levels above 10mUI/L have controlled the malignant arrhythmic events without complex antiarrhythmic drugs sustaining the pathogenic contributions of this two pathologies in arrhythmogenesis process.
  • Endocrine Care

    Rosu MM, Popa SG, Mota E, Popa A, Manolache M, Guja C, Bala C, Mota M

    Cardiovascular Risk Assessment in the Adult (Aged 40-79 Years) Romanian Population

    Acta Endo (Buc) 2018 14(2): 227-234 doi: 10.4183/aeb.2018.227

    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 subregion 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.
  • Book Review

    Rosulescu R

    Sleep Disorders Medicine: Basic Science, Technical Considerations, and Clinical Aspects

    Acta Endo (Buc) 2015 11(2): 264-267 doi: 10.4183/aeb.2015.264

  • General Endocrinology

    Serban V, Vlad A, Rosu M, Rosca A, Timar R, Sima A

    Decrease of pancreatic antibodies and fasting C peptide in Romanian children with type I diabetes mellitus is related to disease duration

    Acta Endo (Buc) 2008 4(4): 367-381 doi: 10.4183/aeb.2008.367

    The prerequisite for developing methods for type 1 diabetes mellitus prevention is to know its pathogenic mechanisms. The aim of this work was to characterize a group of children with type 1 diabetes mellitus regarding pancreatic antibody positivity and fasting C peptide concentrations. The study group enrolled 117 children, 61 boys (52.1%), mean age 12.7?3.1 years. Islet cell antibodies, glutamic acid decarboxylase antibodies (GADA), IA-2 antibodies (IA-2A) and fasting C peptide were measured. Sensitivity for GADA and IA-2A tests was 85% and 75%, respectively. Specificity for the tests was 87.1% and 98%, respectively. The threshold for pancreatic antibody positivity was considered the 97.5th percentile, and normal values for fasting C peptide were between the 5th and 95th percentiles from a control group (n=73), matched for age and gender. Thirty-nine patients (33.3%) were positive for 1 antibody, 10 (8.6%) were positive for 2 and 2 (1.7%) were positive for all 3 antibodies. The positivity for pancreatic antibodies and for islet cell antibodies was significantly lower in patients with diabetes duration>2 years, compared with the rest: 32% vs. 52.2% (p=0.03) and 6% vs. 20.9% (p=0.03), respectively. Mean fasting C peptide and the percentage of patients with normal C peptide decreased significantly one year after the diagnosis of diabetes: 0.20?0.40 ng/ml vs. 0.44?0.57 ng/ml (p=0.03) and 9.5% vs. 27.3% (p=0.02), respectively. In conclusion, in children with type 1 diabetes mellitus, pancreatic autoimmunity is more intense in the first two years of the disease and insulin secretion decreases one year after the diagnosis.
  • Actualities in medicine

    Rosulescu R

    The Role of Cortisol in Neurocognitive Performance in Obstructive Sleep Apnea Patients

    Acta Endo (Buc) 2016 12(3): 375-377 doi: 10.4183/aeb.2016.375

    Obstructive sleep apnea consists in recurrent episodes of partial obstruction of the upper airways which can determine cessation of breathing during sleep causing intermittent hypoxia. The obstructive sleep disorders are encountered predominantly in obese patients with or without metabolic syndrome, that can affect the quality of life and life expectancy by increasing the cardiovascular risk of coronary artery disease, conductance disturbances, malignant arrhythmias, promoting atherogenic processes, determining sudden death and impairing several domains of cognitive function.
  • Case Report

    Ognean L, Boanta O, Visa G, Grosu F, Sofariu C, Gafencu M, Matei C, Iurian S

    Hydrocephaly, Schizencephaly, Spondylocostal Dysplasia, and Hypoparathyroidism in an Infant of a Diabetic Mother

    Acta Endo (Buc) 2017 13(4): 494-501 doi: 10.4183/aeb.2017.494

    Context. Diabetes mellitus is the most frequent chronic complication in pregnancy and continues to contribute to increased perinatal morbidity and mortality in newborns. Macrosomia, respiratory distress syndrome, metabolic and electrolytic disturbances, and increased rates of congenital structural defects are well-known neonatal complications associated with maternal diabetes, even if well-controlled. Case report. A macrosomic infant born from an insulin-dependent mother, with uncontrolled diabetes and lack of adequate prenatal care, prenatally diagnosed with hydrocephaly showed a complicated postnatal course. Initial respiratory distress syndrome and transient hypoglycemia, rapidly corrected under treatment, were followed by persistent hypocalcemia and hyperphosphatemia due to hypoparathyroidism and evolving hydrocephaly. Ventriculoperitoneal shunting was followed by resolution of hypocalcemia, but seizures associated with schizencephaly and recurrent respiratory tract infections, aggravated by spondylocostal dysplasia, concurred to infant’s demise at the age of 5 months. Conclusions. The reported case is rare due to multiple aspects: persistent hypoparathyroidism, uncommon association of schizencephaly, and even rarely association with spondylocostal dysplasia, all these conditions requiring a multidisciplinary therapeutic approach. Also, the reported case is evocative for challenges associated with infants born from diabetic mothers.