Red Cell Distribution Width and Acute Complications of Diabetes

Context. Red cell distribution width (RDW) has been associated with type 2 diabetes (T2DM), however data in relation to diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar non-ketotic acidosis (HONK) remains unclear. Objective. The aim of this study was to evaluate the association between RDW, MCV, and RDW/MVC values and acute complications in T2DM. Patients and Methods. RDW was measured in 90 T2DM patients (30 DKA, 30 HONK and 30 T2DM without acute complications). Clinical variables were analyzed by One -Way ANOVA, Kruskal-Wallis and Pearson analysis with SPSS software. Diagnostic screening tests and ROC curve analysis determined the cut-off point of MCV,RDW and RDW/MCV values. Results. DKA patients had higher levels of plasma glucose (524.20 +/- 201.43mg/dL, p<0.001), HbA1c (10.73 +/- 2.29%, p<0.001), osmotic pressure (310.32 mosm/L, p<0.001), RDW (14.61 +/- 1.75g/L, p<0.01), and the RDW/MCV ratio (0.17 +/- 0.04%, p<0.01), compared to HONK patients. RDW/MCV cut-off value was 0.15 with 90% sensitivity 50% specifity these values for only MCV were 76.67%-70%, for only RDW were 76.67%-63.33% respectively. The area under curve values for the ability to reflect DKA for RDW and the RDW/MCV ratio were 0.708 and 0.766, respectively (p<0.001). Conclusions. RDW and RDW/MCV ratio were found associated with DKA and valuable in predicting DKA. However these parameters were not valuable in predicting HONK

Comparative study of the biochemical changes and volatile compound formations during the production of novel whey-based kefir beverages and traditional milk kefir

Cheese whey (CW) and deproteinised cheese whey (DCW) were investigated for their suitability as novel substrates for the production of kefir-like beverages. Lactose consumption, ethanol production, as well as organic acids and volatile compounds formation, were determined during CW and DCW fermentation by kefir grains and compared with values obtained during the production of traditional milk kefir. The results showed that kefir grains were able to utilise lactose from CW and DCW and produce similar amounts of ethanol (7.8–8.3 g/l), lactic acid (5.0 g/l) and acetic acid (0.7 g/l) to those obtained during milk fermentation. In addition, the concentration of higher alcohols (2-methyl-1-butanol, 3-methyl-1-butanol, 1-hexanol, 2-methyl-1-propanol, and 1-propanol), ester (ethyl acetate) and aldehyde (acetaldehyde) in cheese whey-based kefir and milk kefir beverages were also produced in similar amounts. Cheese whey and deproteinised cheese whey may therefore serve as substrates for the production of kefir-like beverages similar to milk kefir.The authors acknowledge the financial support from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES), CAPES-GRICES and Lactogal for supplying cheese whey powder

Collision sellar lesions: experience with eight cases and review of the literature

The concomitant presence of a pituitary adenoma with a second sellar lesion in patients operated upon for pituitary adenoma is an uncommon entity. Although rare, quite a great variety of lesions have been indentified coexisting with pituitary adenomas. In fact, most combinations have been described before, but an overview with information on the frequency of combined pathologies in a large series has not been published. We present a series of eight collision sellar lesions indentified among 548 transsphenoidally resected pituitary adenomas in two Neurosurgical Departments. The histological studies confirmed a case of sarcoidosis within a non-functioning pituitary adenoma, a case of intrasellar schwannoma coexisting with growth hormone (GH) secreting adenoma, two Rathke’s cleft cysts combined with pituitary adenomas, three gangliocytomas associated with GH-secreting adenomas, and a case of a double pituitary adenoma. The pertinent literature is discussed with emphasis on pathogenetic theories of dual sellar lesions. Although there is no direct evidence to confirm the pathogenetic relationship of collision sellar lesions, the number of cases presented in literature makes the theory of an incidental occurrence rather doubtful. Suggested hypotheses about a common embryonic origin or a potential interaction between pituitary adenomas and the immune system are presented

Mathematics Teachers\u27 Knowledge of Student Thinking and Its Evidences in Their Instruction

The aim of this case study is to examine mathematics teachers\u27 knowledge of students\u27 thinking and its evidences in their teaching. The participants were three secondary mathematics teachers. Data were gathered from interviews and observations. While analyzing the data, the framework about teachers\u27 knowledge of students\u27 thinking was used. The findings showed that each teacher mainly considered the knowledge of students\u27 thinking as knowing students\u27 prior knowledge. They expressed that they benefited from the questions to reveal students\u27 ideas, encouraged their students to use different solution ways for the problems, and had ideas on misconceptions and difficulties their students might be confronted. The participants also considered students\u27 prior knowledge in their lessons, but they did not tackle their difficulties, errors and misconceptions unless students asked questions to them. They had the limited approaches for building on students\u27 mathematical ideas, promoting students thinking mathematics, triggering and considering divergent thoughts, engaging students in mathematical learning, and motivating students learning.DOI: http://dx.doi.org/10.22342/jme.8.2.4144.199-21

Uterine preservation in early stage endometrial carcinoma or atypical complex hyperplasia under age of 40 [Kirk yaşin altindaki erken evre endometrium kanseri ya da atipik kompleks hiperplazide uterusun korunmasi]

Objective: Aim of this paper is to present, results obtained from one of the treatment option attempting uterine preservation, which is progesterone medication, in young patients with endometrial cancer or atypical complex hyperplasia (ACEH). Material and Methods: Our medical data of the last seven years concerning progesterone treatment were retrospectively investigated. Demographic features, success rates were evaluated. Myometrial invasion were examined using vaginal sonography or magnetic resonance. Additionally endometrial biopsy samples were reviewed by a pathologist specialized on gynecological oncology before starting the progesterone. Inclusion criterion of study were having myometrial invasion less than %50, having ACEH or endometrioid histology with grade 1 or 2, being younger than 40 years and wishing to be pregnant. Oral, 160 mg/day megestrol acetate was given and controls intervals of endometrial sampling were three months. Results: Ten patients were appropriate for study and three of them had ACEH. Mean values of age and body mass index were 28.1±4.9 (22-34) and 25.9±4.5 (18-35) respectively. Tumor was eliminated in six at the first control and one had pregnancy. Four patients had hysterectomy due treatment failure of progesterone. Patients having hysterectomy or who could preserve the uterus are well in follow-ups. Conclusion: In our era maternity is postponing to late ages. In endometrial cancer and its precursors which are caused by the unopposed estrogen effect made by the obesity, chronic anovulation and polycystic ovary syndrome; progesterone may be an option permitting to preserve the fertility and eliminate the cancer. Copyright © 2011 by Türkiye Klinikleri