Search Results

You are looking at 1 - 10 of 12 items for

  • Author: Rucsandra Dănciulescu Miulescu x
Clear All Modify Search
Open access

Rucsandra Dănciulescu Miulescu and Andrada Doina Mihai

Abstract

Hypothyroidism is a pathologic condition generated by the thyroid hormone deficiency. The American Thyroid Association advises for the screening of hypothyroidism beginning at 35 years and thereafter every 5 years in people at high risk for this condition: females older than 60 years, pregnant women, patients with other autoimmune disease or patients with a history of neck irradiation. In pregnant women, hypothyroidism can been associated with adverse effect for both mother and child. The „Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and Postpartum“ recommends the treatment of maternal overt hypothyroidism: females with a thyrotropin (TSH) level higher than the trimester-specific reference interval and decreased free thyroxine (FT4), and females for which TSH level is higher than 10.0 mIU/L, irrespective of the FT4 value, with administration of oral levothyroxine. The goal of treatment of maternal overt hypothyroidism is to bring back the serum TSH values to the reference range specific for the pregnancy trimester. The Guidelines of the „European Thyroid Association for the Management of Subclinical Hypothyroidism in Pregnancy and in Children“ recommends treatment of pregnancy associated subclinical hypothyroidism with the following levothyroxine doses: „1.20 μg/kg/day for TSH≤4.2 mU/l, 1.42 μg/kg/day for TSH >4.2-10 and 2.33 μg/kg/day for overt hypothyroidism“. The „Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and Postpartum“ and the „European Thyroid Association for the Management of Subclinical Hypothyroidism in Pregnancy and in Children“ do not recommend the treatment of isolated hypothyroxinemia in pregnancy.

Open access

Carmen Dobjanschi and Rucsandra Dănciulescu Miulescu

Abstract

Women with gestational diabetes mellitus (GDM) have an increased lifetime risk of developing type 2 diabetes mellitus (T2DM). GDM has a substantial impact on maternal and foetal short and long-term health. Risk factors for GDM may be genetic or nongenetic and have been analysed in numerous studies. Researches in recent years allowed the identification of other risk factors for GDM except for those already known. Knowledge and identification of all risk factors for GDM allows the elaboration of a prevention strategy of T2DM, it may influence the screening, diagnosis, and, subsequently, treatment modalities for this disease.

Open access

Cristian Guja and Rucsandra Dănciulescu Miulescu

Open access

Rucsandra Dănciulescu Miulescu, Denisa Margină, Roxana Corina Sfetea, Diana Păun and Cătălina Poiană

Abstract

Background and Aims. Previous studies have shown that aging is an important risk factor for insulin resistance and type 2 diabetes. The beneficial effects of exercise on glucose metabolism are well known. Our goal was to examine whether physical activity improves insulin levels in older individuals. Material and Methods. Plasma glucose and insulin were measured in fasting state and 2 h after a 75-g oral glucose tolerance test in young lean, sedentary, non-diabetic subjects (n=34, age 25±2 years, body mass index- BMI 24.4±0.7 kg/m2) and older, lean, sedentary, non-diabetic subjects (n=36, age 75±3 years, BMI 24.8±0.4 kg/m2), before and after 8 weeks of aerobic exercise. Training consisted of exercise (such as cycling or fast walking) 5 days/week for approximately 30 min/day. Results. Fasting plasma insulin and 2-h serum insulin levels at baseline were significantly higher in older than young subjects (11.6 μU/ml vs 10.0 μU/ml, p=0.0001, 46.3 μU/ml vs 34.0 μU/ml, p=0.0001). Fasting and 2h plasma insulin levels were reduced after 8 weeks of aerobic exercise in older subjects, with no change in body weight. Conclusion. In our study the hyperinsulinemia associated with aging can be blunted significantly by aerobic exercise in older individuals independent of any changes in body composition

Open access

Marius Cristian Neamţu, Ştefania Crăiţoiu, Rucsandra Dănciulescu Miulescu and Denisa Margină

Abstract

Background and Aims. Previous studies have shown that hypochromia is a common finding in patients with chronic diseases. The aim of our study was to estimate the anthropometric and metabolic characteristics of patients with type 2 diabetes mellitus (T2DM) and hypochromia. Material and Methods. 30 patients with T2DM were recruited for this study. Patient demographics, relevant concomitant illnesses and medical history were recorded. Anthropometric, biochemical parameters (fasting plasma glucose - FPG, glycated hemoglobin -HbA1c, glomerular filtration rate - GFR) and morphology of blood smear were assessed. Patients diagnosed with diabetes and hypochromia constituted the study group and patients with type T2DM but without hypochromia constituted the control group. Results. The study showed no statistically significant differences on anthropometric and metabolic characteristics of patients with diabetes and hypochromia, compared with controls. Conclusions. We observed a high prevalence of hypochromia in diabetic patients (46.66%). Our findings suggest the need of screening for routine hematological tests in patients with T2DM.

Open access

Rucsandra Dănciulescu Miulescu, Suzana Dănoiu, Denisa Margină, Sorin Păun and Cătălina Poiană

Abstract

Objectives. Prostate-specific antigen (PSA) is the most used and validated marker of prostate cancer risk. The aim of this study was to assess PSA levels during treatment with testosteronum undecanoat in patients with type 2 diabetes (T2DM). Material and Methods. We evaluated 38 T2DM patients aged between 48 and 61 years with confirmed hypogonadism. 1000 mg testosterone undecanoate was injected intramuscular every 10 to 14 weeks. Total testosterone and PSA levels were assessed at baseline and after 6, 12, 24 months of treatment. Results. The average age was 55.03 ± 2.40 years and 3 patients (7.89%) had a family history of prostate cancer. Treatment with testosterone undecanoate generated significant changes in serum total testosterone (482.29±50.78 ng/dl vs. 246.66±51.50 ng/dl, p < 0.001) but not in serum PSA levels (2.11±.0.49 ng/ml vs. 2.09±0.47 ng/ml, p - NS). Conclusion. Testosterone replacement therapy may normalize serum androgen levels but appears to have little effect on PSA levels.

Open access

Rucsandra Dănciulescu Miulescu, Denisa Margină, Mirela Culman, Sorin Păun and Cătălina Poiană

Abstract

Background and Aims. Previous studies have shown that impaired glucose tolerance is present in patients with pheochromocytoma with a prevalence of 25- 75%. The aim of this study was to examine glucose tolerance in 12 patients with pheochromocytoma, before and after medical and surgical treatment. Material and

Methods. We evaluated 12 patients aged between 44 and 60 years with confirmed pheochromocytoma. Plasma insulin, fasting blood glucose and 2h glucose levels during the oral glucose tolerance test (OGTT) were measured before and three months after surgical removal of the tumor. Results. Surgical removal of the tumor generated significant changes in plasma and urinary metanephrines (plasma normetanephrine 191.15±13.22 pg/ml after treatment vs. 792.54±86.74 pg/ml at baseline, p<0.0001, plasma metanephrine 86.69±4.48 pg/ml vs. 363.62.±21.69 pg/ml, p<0.0001, urinary normetanephrine 718.54±37.59 μg/day after treatment vs. 1855.77±116.54 μg/day at baseline and urinary metanephrine of 258.31±34.00 μg/day vs. 745.38±65.14 μg/day, p<0.0001) but not in insulin, fasting and 2h glucose levels during OGTT. Conclusion. In our study, the prevalence of impaired glucose tolerance in patients with confirmed pheochromocytoma was 8.33% (1 patient with a previous family history of diabetes). After surgical removal of the tumor, normalization of mean glucose levels of OGTT was not achieved.

Open access

Anca Ungurianu, Rucsandra Dănciulescu Miulescu and Denisa Margină

Abstract

Introduction: Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are part of the routine blood tests and are usually used to assess liver or cardiac status. The most common disturbances are the mildly risen levels which are correlated with hepatic dysfunction and entail a wide variety of etiologies: viral, toxic, drug or are lifestyle related.

Case report: Routine blood tests revealed high AST and ALT levels in an otherwise healthy 40-years-old male. After a series of supplementary tests the cause remained undetermined, so more attention was paid to the patient’s daily routine. Recently he started an intense training program which led to extensive muscle damage causing an elevation of plasma transaminases’ levels.

Discussion: When dealing with a rise in AST and ALT levels in asymptomatic patients, physicians must carefully consider all aspects, from family and personal history, infectious diseases or toxins to medication and lifestyle, in order to avoid unnecessary tests and incorrect diagnoses or treatments.

Open access

Rucsandra Dănciulescu Miulescu, Marius Cristian Neamţu, Denisa Margină, Cătălina Poiană and Diana Loreta Păun

Abstract

Background and Aims. The interactions between kidney and thyroid functions are well established: thyroid hormones are necessary for the maintenance of electrolyte and water homeostasis and kidney is involved in the regulation of thyroid hormones metabolism. The aim of our study was to estimate the prevalence of thyroid dysfunction in patients with diabetes mellitus and chronic kidney disease (CKD). Material and Method. 23 patients with diabetes mellitus and CKD in pre-dialysis phase were recruited for this study. All subjects were investigated with thyroid ultrasound and laboratory tests to determine thyroid function, including: serum triiodothyronine (T3), free thyroxine (free T4), thyroid-stimulating hormone (TSH) and antithyroid peroxidase antibodies (ATPO). Results were compared with the same measurements in 21 patients with diabetes mellitus but without CKD. Results. The prevalence of goiter (52.17% vs. 19.04%, p<0.05), subclinical hypothyroidism (23.80% vs. 9.52%, p<0.05), hypothyroidism (8.69% vs. 4.76 %, p<0.05) and low T3 syndrome (23.80% vs. 0.00% p<0.05) were significant high in diabetic patients with CKD compared with patients with diabetes mellitus but without CKD. Conclusions. We observed high prevalence of thyroid morphology abnormalities and thyroid function disorders in diabetic patients with CKD. Low T3 syndrome and subclinical hypothyroidism are the most frequently thyroid function disorders in CKD patients.

Open access

Rucsandra Dănciulescu Miulescu, Denisa Margină, Anca Ungurianu, Roxana Irina Roșca, Alina Nicolau and Andrada Doina Mihai

Abstract

Background and Aims. Previous studies report the presence of cognitive impairment in patients with overt hypothyroidism. The thyroid hormones are essential for neurological and intellectual functions. Type 2 diabetes mellitus (T2DM) subjects are exposed to higher risk of cognitive function alteration compared to nondiabetic subjects. The aim of the present study was to analyze the cognitive function of T2DM subjects with overt hypothyroidism.

Materials and Methods. We performed an observational study between 2015-2017. A total of 12 patients (11 women and 1 men) with overt hypothyroidism and T2DM were recruited for this study. Their cognitive function was compared with that of subjects of a control group (16 patients - 12 women and 4 men with T2DM but without overt hypothyroidism). Cognitive function was evaluated using the Mini Mental State Examination (MMSE) test. Serum thyroid stimulating hormone (TSH) levels were measured by immunoradiometric assay, free thyroxine (FT4) by radioimmunoassay while fasting plasma glucose (FPG) levels were evaluated using automated devices.

Results. There were no significant differences between the two groups in respect of age and FPG. In the study group, mean TSH and FT4 levels were 11.76±4.43 mIU/L, resepectively 0.53±0.08 ng/dL while in the control group these were 2.60±0.40 mIU/L, respectively 1.12±0.19 ng/dL (p<0.001). Moderate cognitive impairment was present in 3 patients of the study group (25.00%) and in 2 subjects from the control group (12.50%). Mild cognitive impairment was present in 4 patients (33.33%) of the study group and in 2 subjects from the control group (12.50%).

Conclusion. This study showed that MMSE scores are significantly reduced in subjects with T2DM and hypothyroidism compared to subjects with T2DM without hypothyroidism (p<0.004). The study revealed a negative correlation between TSH and MMSE score in the study group.