Georgia-Nektaria Keskesiadou

Background: Menstrual cycle–related glycaemic fluctuations may persist despite automated insulin delivery (AID), yet evidence in adolescents remains limited. Our aim was to evaluate continuous glucose monitoring (CGM) metrics across five menstrual cycle phases and examine insulin delivery and meal-related parameters among AID users. Methods: Adolescents with type 1 diabetes (T1D), regular menstrual cycles, available CGM data, and menstrual cycle records were included. Glycaemic outcomes included Time in Range (TIR), Time Above Range (TAR), Time Below Range (TBR), and coefficient of variation across five predefined menstrual phases. In AID users, insulin delivery, meal announcements, and carbohydrate intake were also evaluated. Results: Twenty-nine adolescents with T1D (mean age:15.6±2.2 years) contributing 107 menstrual cycles were included. The mid-luteal phase showed the least favourable glycaemic profile, with lower TIR (67.4%) than the early follicular (69.5%), mid-follicular (73.1%), peri-ovulatory (71.3%), and late luteal (70.1%) phases. Compared with non-AID therapy, AID systems were associated with higher TIR throughout the menstrual cycle and significantly lower exposure to mild hypoglycaemia. Among AID users, the mid- and late luteal phases showed increased insulin delivery, higher bolus proportion, and greater carbohydrate intake. Conclusions: Glycaemic control varies across the menstrual cycle in adolescent girls with T1D. Although AID systems improve overall regulation, cycle-related variability persists, supporting individualized phase-specific insulin management strategies.

Background/Objectives: Orthognathic surgery has evolved with digital advancements, improving precision and predictability. Traditional free-hand techniques rely on surgeon expertise, often leading to variable outcomes. Fully guided approaches integrate computer-assisted surgery, including virtual surgical planning (VSP), CAD/CAM, and dynamic navigation, enhancing accuracy and efficiency. This review compares these approaches, assessing their impact on surgical accuracy, efficiency, and patient outcomes. Methods: A scoping review was conducted across PubMed, MEDLINE, Scopus, Cochrane Library, and Embase databases, focusing on clinical trials and cohort studies. Key parameters analyzed include surgical precision, operative efficiency, complication rates, and functional/aesthetic results. Results: Fully guided techniques achieve sub-millimetric accuracy with mean length deviations ranging from 1.3 mm to 2.4 mm and mean angular deviations between 2.29° and 3.51°. Moreover, these approaches markedly reduce operative time, averaging between 34 min and 1.7 h, and postoperative complications. Digital tools streamline workflow, improving reproducibility and aesthetic outcomes. Free-hand methods remain cost-effective but require greater surgical expertise, often resulting in longer recovery periods and higher variability. Conclusions: Computer-assisted orthognathic surgery enhances precision and efficiency, outperforming free-hand techniques in accuracy and predictability. While free-hand methods remain viable for simpler cases, fully guided approaches optimize surgical execution. Future research should explore hybrid strategies combining digital precision with manual adaptability to further refine surgical techniques.

Introduction: According to the Institute of Environmental Sciences, endocrine-disrupting chemicals (EDCs) are “natural or human-made chemicals that may mimic, block, or interfere with the body’s hormones, associated with a wide array of health issues”, mainly in the endocrine system. Recent studies have discussed the potential contribution of EDCs as risk factors leading to diabetes mellitus type 1 (T1DM), through various cellular and molecular pathways. Purpose: The purpose of this study was to investigate the correlation between the EDCs and the development of T1DM. Methodology: Thus, a 5-year systematic review was conducted to bring light to this research question. Using the meta-analysis and systematic review guideline protocol, a PRISMA flow diagram was constructed and, using the keywords (diabetes mellitus type 1) AND (endocrine-disrupting chemicals) in the databases PubMed, Scopus and ScienceDirect, the relevant data was collected and extracted into tables. Quality assessment tools were employed to evaluate the quality of the content of each article retrieved. Results: Based on the data collected and extracted from both human and animal studies, an association was found between T1DM and certain EDCs, such as bisphenol A (BPA), bisphenol S (BPS), persistent organic pollutants (POPs), phthalates and dioxins. Moreover, based on the quality assessments performed, using the Newcastle–Ottawa Scale and ARRIVE quality assessment tool, the articles were considered of high quality and thus eligible to justify the correlation of the EDCs and the development of T1DM. Conclusion: Based on the above study, the correlation can be justified; however, additional studies can be made focusing mainly on humans to understand further the pathophysiologic mechanism involved in this association.