Effect of reward-based motivation on metabolic control in children and adolescents with type 1 diabetes mellitus

The aim of this study was to investigate the impact of reward-based motivation on metabolic control in children and adolescents with type 1 diabetes mellitus (DM). Forty-four children and adolescents (female/male: 21/23 and prepubertal/pubertal: 17/27) with type 1 diabetes mellitus with a mean age of 12.3?±?2.8 years (8–18 years) and a mean diabetes duration of 4.7?±?2.7 years (2–11 years) were enrolled in the study. Before the study, patients were informed that three patients who will have the best metabolic control at the end of 1 year would be rewarded. Number of control visits and hypoglycemic episodes, daily insulin requirement and mean hemoglobin A1c (HbA1c) values were compared before and 1 year after study. During the study period, a statistically significant decrease in the mean HbA1c value, number of hypoglycemic attacks, and daily insulin requirement were determined (p?<?0.05). Decrease in the mean HbA1c value was significant in both sexes and especially in the pubertal group (p?<?0.05). It was observed that the patients had more frequent control visits during the motivation study. While 56 % of the patients had regular control visits before the motivation activity, during the motivation period, regular follow-up ratio improved and increased up to 81 %. The positive impact of motivation has been maintained throughout 6 months after completion of the study. This study showed that motivating activities might provide significant improvement in the metabolic control of children and adolescents with type 1 DM with a more evident effect in the pubertal group.     

Effect of stanford pouch and ileal conduit urinary diversions on bone mineral density and metabolism

After urinary-intestinal diversions metabolic complications may occur in long term follow up. We aimed to evaluate bone metabolism changes in urinary diverted patients. Nineteen patients with urinary diversions (11 Stanford pouch and 8 ileal conduit) performed with diagnosis of locally invasive bladder cancer and 19 age-sex matched healthy subjects were enrolled in the study. Bone mineral density (BMD), arterial blood pH, bicarbonate and base excess as well as bone mineralisation parameters at urine and serum were evaluated for all groups. For statistical evaluation, nonparametric comparisons between groups were used. Comparison of ileal conduit and control groups displayed higher alkaline phosphatase and parathormone levels in the patient group though the difference was not significant. The mean BMD values of ileal conduit group were osteopenic, revealing a significant difference with the control group. Statistically significant differences between alkaline phosphatase, parathormone levels of Stanford pouch and control groups were apparent whereas BMD values were not significantly different. When the two patient groups were compared with each other, no difference in BMD or bone metabolism parameter values could be observed. Patients with urinary diversions are under risk of bone demineralisation and must be followed by BMDs, arterial blood analysis and bone mineral metabolism parameters.     

The shortened cochlea: its classification and histopathologic features

INTRODUCTION: The term 'Mondini dysplasia' has been used to describe virtually any congenital abnormality of the osseous labyrinth resulting in confusion and seemingly contradictory observations and conclusions about this type of deformity. The purpose of this study is to histopathologically classify and describe temporal bones whose cochleas have less than 2.5 turns. METHODS: Of the 1800 temporal bones in our collection, 21 from 12 cases were found to have cochleas with less than 2.5 cochlear turns. Ages ranged from stillborn to 50 years. Temporal bones were harvested at autopsy, processed and embedded in celloidin. Sections were cut at a thickness of 20 microm and every 10th section stained with hematoxylin-eosin and examined using light microscopy. The number of turns, length of cochlea, integrity of cochlear base, length of modiolus, abnormalities of the semicircular canals and vestibule, enlargement of the vestibular aqueduct and middle ears were documented. Twenty-one temporal bones from age-matched patients without cochlear deformities were used as controls for modiolar length measurements. RESULTS: Malformation of the shortened cochlea was histopathologically classified into three groups as follows: (1) Common cavity, cochlear dysplasia (one ear)--severe dysplasia of the cochlea without a complete basal turn; (2) Mondini dysplasia (11 ears)--1.5 cochlear turns, a complete basal turn, an incomplete or absent interscalar septum and a complete bone at the base of the modiolus; and (3) Mondini-like dysplasia type A (five ears)--2 turns to the cochlea including a complete basal turn and complete bone at the base of the modiolus; and type B (four ears)--1.5-2 turns to the cochlea, hypoplasia of or a missing bone at the base of the modiolus (either with or without a communication between the internal auditory canal and the cochlea) and a complete basal turn. CONCLUSION: The range of congenital malformations in short cochlea is highly variable. Fundamental to the accurate evaluation of a labyrinthine anomaly, malformations of the inner ear should be classified according to the findings in the labyrinth. We suggest the use of common cavity cochlear dysplasia, Mondini dysplasia and Mondini-like dysplasia to describe these variable anomalies.     

The potential of preoperative beta-hCG and progesterone levels to predict failure of laparoscopic linear salpingostomy in ectopic pregnancies

STUDY OBJECTIVE: To estimate the association between preoperative beta-human chorionic gonadotropin (hCG) and progesterone levels, and success of linear salpingostomy in treatment of tubal pregnancy. DESIGN: Retrospective case control study (Canadian Task Force classification II-1). SETTING: Women's general hospital. PATIENTS: Three hundred five women undergoing laparoscopic linear salpingostomy for ectopic pregnancy. INTERVENTION: Examination of risk factors for surgical failure of salpingostomy by analyzing corresponding receiver operating curves. MEASUREMENTS AND MAIN RESULTS: In 305 women, intervention was successful in 272 and failed in 33, as assessed by either postoperative hemorrhage (16) or rising beta-hCG values (14); 3 women had both. Of 295 patients in whom beta-hCG was evaluated preoperatively, 149 (50.5%) had values of 1000 mU/ml. or less; 75% had progesterone levels of 10 ng/ml or below. No association was found between preoperative beta-hCG and progesterone levels and the success of linear salpingostomy. CONCLUSION: Preoperative beta-hCG and progesterone levels are of no significance with regard to success of linear salpingostomy for treatment of tubal pregnancy.     

Benign fibrous histiocytoma: report of case

Benign fibrous histiocytoma is a rare and usually painless oral neoplasm found in adults that may affect either soft tissue or bone typically noted in their fifth decade. This case was found in a 32 year-old Caucasian male who presented with a fairly well circumscribed unilocular radiolucent lesion extending from the mandibular right first incisor to the left first premolar and reaching the inferior mandible on a panoramic radiograph. A bony window was created and the intrabony lesion was curetted. Multiple sections revealed a cellular tumor composed of uniform spindle-shaped cells arranged in a prominent whorled or storiform pattern. Scattered xanthoma cells, multinucleated giant cells, lymphocytes, and deposits of hemosiderin were noted throughout the lesional stroma. Although malignant fibrous histiocytoma of the bone is relatively well known, benign fibrous histiocytoma of the bone is very rare.     

A large glandular odontogenic cyst of the mandible: report of case

Glandular odontogenic cyst (GOC) is generally considered uncommon, but several investigators claim there is a more frequent occurrence than previously thought. However these case reports lacked confirming data to validate their claim. On the other hand, it is possible that cases of central mucepidermoid carcinoma or later periodontal cyst might be viewed as glandular odontogenic cyst. This is a report of a case of a 70-year old male who presented with a firm swelling in the right side of his edentulous mandible. Radiographic examination revealed a multilocular radiolucent lesion in the mandible extending from the right first premolar to the left second premolar and reaching the inferior mandible. Clinical findings, the health history, and microscopic examination of excised tissue confirmed the diagnosis of GOC. The lesion was excised and post-operative healing was uneventful.