Psychosocial aspects of disease duration and control in young adults with type I diabetes

Self-report questionnaires completed by young adults with Type I diabetes were examined to determine if individuals differing in recent metabolic control (Poor, Moderate or Very Good) or disease duration (Long, Short) also vary in either occurrence or type of life events during the past year or occurrence of recent emotional distress. Subjects in Poor control reported more positive and neutral life events during the past year, suggesting even those life changes individuals view benignly may be associated with metabolic control difficulties. Individuals in Poor control also reported more recent symptoms of depression, anxiety and hostility than did individuals in Moderate or Very Good control--symptomatology which may further impair their ability to adhere to a complex self-care regimen. Individuals with Long disease duration reported more positive and negative recent life experiences than did subjects with Short disease duration, but did not evidence concomitant disruptions in metabolic control. The role experience with a chronic disease may play in this finding was unclear, however. Although more research is required to clarify the exact relation of psychosocial variables and diabetic control, these findings suggest that clinically relevant subgroup parameters, subjects' perceptions of life change, and demographic variables may be important factors to assess.     

METHODS OF FETAL HEART RATE MONITORING DURING LABOR

A review of the history of fetal heart rate monitoring is followed by detailed analysis of eight randomized, controlled trials and of a recent prospective study of electronic fetal monitoring compared with intermittent auscultation. No significant differences between the methods were reported in perinatal mortality rates, neonatal infection rates, and Apgar scores. Mixed results were reported for length of labor, maternal analgesic use during labor, maternal genital tract infection rates, umbilical cord pH values, and admissions to neonatal intensive care units. Auscultation was associated in two trials with a significantly increased rate of neonatal seizures. Electronic fetal monitoring was correlated with a significantly increased cesarean delivery rate in the first four trials, and with a significantly increased rate of operative delivery (forceps plus cesarean delivery) in three later trials. A decision tree is presented to assist the clinician in selecting the appropriate fetal monitoring method for a given client.     

Aggressive angiomyxoma with gastrointestinal communication: a case report

We report the imaging findings of an abdominal aggressive angiomyxoma, which communicated with the gastrointestinal tract. The literature on this rare tumor is reviewed.     

Exocrine pancreatic function in mediastinal teratomata: an aid to preoperative diagnosis?

The diagnosis of teratoma may be made by demonstration of high amylase content in fluid aspirated from anterior mediastinal lesions. In 2 cases of mediastinal teratoma proteolytic enzyme activity was evident at the time of operation. A diagnosis of mediastinal teratoma was aided in 2 subsequent cases by demonstration of elevated amylase activity in the aspirated fluid before definitive operation.     

Heterotopic cervical salivary gland tissue in a family with probable branchio-otorenal syndrome

Heterotopic cervical salivary gland tissue was found in a 4-yr-old girl with branchial and otologic abnormalities. Her mother and sister also had heterotopic cervical salivary tissue in association with anomalies that suggest the branchio-otorenal (BOR) syndrome. Heterotopic cervical salivary gland tissue may result from abnormal branchial development.     

Intractable Diarrhea from Carbamazepine

Diarrhea has been reported as an early, mild, and uncommon complication of carbamazepine (CBZ) therapy. We report three cases of intractable diarrhea induced by CBZ necessitating discontinuation of the drug.