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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.
RESUMO
PURPOSE: To investigate the role of reference height inter-test variability upon the variability of the stereometric parameters. MATERIALS AND METHOD: 204 glaucomatous patients underwent a complete ophthalmological exam, including Heidelberg Retina Tomography 3 (HRT-3). The exclusion criteria were optic disc or retinal pathology that might interfere with the detection of glaucoma progression, TSD >30µm. 4 sets of data were taken during the HRT-3 exam for each patient. RESULTS: RH variability ranged between -198 and 187. Correlation analysis revealed a linear dependence between the inter-test variability of RH and stereometric parameters change. The most powerful correlations were observed for: RNFL Thickness (r=0.756, p<0.001), Rim Area (r=0.662, p<0.001), C/D Area Ratio (r=-0.663, p<0.001). The least correlated were Height Variation Contour (r=0.31) and Cup Shape Measure (r=0.07, p=0.3). When RH variability did not exceed 25µm, the correlations with stereometric parameters change were not statistically significant (for Rim Area, r=0.21, p>0.05, for C/D Area Ratio, r=-0.13, p=0.22, for RNFL Thickness r=0.06, p=0.52). CONCLUSIONS: For values >25µm, the variability of the RH is a major factor determining test/retest variability for RNFL Thickness, Rim Area, C/D Area, Rim Volume and Linear C/D. Inter-test variability of RH <25µm is an important criterion for the clinical relevance of stereometric parameters changes.
