Investigating the Effect of Selenium Nanoparticles on Mineral Trioxide Aggregates as a Promising Novel Dental Material.

Aim: To enhance mineral trioxide aggregate high plasticity (MTA HP), a commonly used dental calcium silicate cement, by incorporating selenium nanoparticles (SeNPs) known for their antioxidant and anti-inflammatory properties. The objectives included investigating the impact of SeNPs on the setting time and chemical properties of MTA HP. Materials and Methods: We performed a comprehensive study to formulate and profile SeNPs integrated into MTA HP. Diverse concentrations of SeNPs were introduced into MTA HP, and the commencement and culmination of the setting process were gauged employing a Gillmore needle cabinet. The chemical composition was validated using Fourier transform infrared spectroscopy with attenuated total reflectance and X-ray diffraction analysis. Results: The incorporation of SeNPs led to remarkable improvements. Notably, SeNPs positively affected the setting time of MTA HP, with faster setting times corresponding to higher SeNPs concentrations. Chemical analyses confirmed the successful integration of SeNPs with MTA HP. These enhancements make the material may be suitable for dental applications, especially due to its accelerated setting time. Conclusions: MTA HP incorporated with SeNPs represents a significant advancement in dental materials. Its faster setting time, combined with the antioxidant and anti-inflammatory properties of selenium, provides dental professionals with an efficient and time-saving option for complex treatments. This novel nanomaterial holds promise for improving dental procedures and patient outcomes.

Impacts of the COVID-19 pandemic on population management in AZA.

Soon after the onset of the COVID-19 pandemic, almost all Association of Zoos and Aquariums (AZA) facilities closed to the public. Resulting cost-saving and safety measures led some facilities to temporarily cease or reduce animal breeding and/or transfers. We surveyed AZA facilities and Species Survival Plan® (SSP) Coordinators for AZA's cooperative population management programs to evaluate how widespread these decisions were, if impacts varied by taxa, and how the AZA community navigated related challenges during the pandemic. We found that 60% of responding facilities did not suspend breeding and 22% did not suspend transfers. About 50% of responding zoos increased their reliance on ground transportation to move animals, while aquariums reported no change to transportation methods. SSP Coordinators reported the main reason why breeding decreased, regardless of taxa, was due to canceled or delayed transfers. The reasons transfers decreased differed by taxa, such as limited financial resources and lack of access to air transportation. The majority of respondents for both surveys stated transfers were the greatest challenge they faced. To address this, facilities utilized alternative transportation methods and worked closely with nearby zoos and aquariums for the movement of animals, while SSP Coordinators issued alternative transfer recommendations. If another pandemic or other widespread facility closure occurs, our research highlights the importance of communication, collaboration, and flexibility to fulfill breeding and transfer recommendations to maintain sustainable zoo and aquarium populations.

Caenorhabditis elegans as an In Vivo Model for the Discovery and Development of Natural Plant-Based Antimicrobial Compounds.

Antimicrobial resistance (AMR) due to the prevalence of multidrug-resistant (MDR) pathogens is rapidly increasing worldwide, and the identification of new antimicrobial agents with innovative mechanisms of action is urgently required. Medicinal plants that have been utilised for centuries with minor side effects may hold great promise as sources of effective antimicrobial products. The free-living nematode Caenorhabditis elegans (C. elegans) is an excellent live infection model for the discovery and development of new antimicrobial compounds. However, while C. elegans has widely been utilised to explore the effectiveness and toxicity of synthetic antibiotics, it has not been used to a comparable extent for the analysis of natural products. By screening the PubMed database, we identified articles reporting the use of the C. elegans model for the identification of natural products endowed with antibacterial and antifungal potential, and we critically analysed their results. The studies discussed here provide important information regarding "in vivo" antimicrobial effectiveness and toxicity of natural products, as evaluated prior to testing in conventional vertebrate models, thereby supporting the relevance of C. elegans as a highly proficient model for their identification and functional assessment. However, their critical evaluation also underlines that the characterisation of active phytochemicals and of their chemical structure, and the unravelling of their mechanisms of action represent decisive challenges for future research in this area.

Terahertz waveform synthesis in integrated thin-film lithium niobate platform.

Bridging the "terahertz gap" relies upon synthesizing arbitrary waveforms in the terahertz domain enabling applications that require both narrow band sources for sensing and few-cycle drives for classical and quantum objects. However, realization of custom-tailored waveforms needed for these applications is currently hindered due to limited flexibility for optical rectification of femtosecond pulses in bulk crystals. Here, we experimentally demonstrate that thin-film lithium niobate circuits provide a versatile solution for such waveform synthesis by combining the merits of complex integrated architectures, low-loss distribution of pump pulses on-chip, and an efficient optical rectification. Our distributed pulse phase-matching scheme grants shaping the temporal, spectral, phase, amplitude, and farfield characteristics of the emitted terahertz field through designer on-chip components. This strictly circumvents prior limitations caused by the phase-delay mismatch in conventional systems and relaxes the requirement for cumbersome spectral pre-engineering of the pumping light. We propose a toolbox of basic blocks that produce broadband emission up to 680 GHz and far-field amplitudes of a few V m-1 with adaptable phase and coherence properties by using near-infrared pump pulse energies below 100 pJ.

A human breast atlas integrating single-cell proteomics and transcriptomics.

The breast is a dynamic organ whose response to physiological and pathophysiological conditions alters its disease susceptibility, yet the specific effects of these clinical variables on cell state remain poorly annotated. We present a unified, high-resolution breast atlas by integrating single-cell RNA-seq, mass cytometry, and cyclic immunofluorescence, encompassing a myriad of states. We define cell subtypes within the alveolar, hormone-sensing, and basal epithelial lineages, delineating associations of several subtypes with cancer risk factors, including age, parity, and BRCA2 germline mutation. Of particular interest is a subset of alveolar cells termed basal-luminal (BL) cells, which exhibit poor transcriptional lineage fidelity, accumulate with age, and carry a gene signature associated with basal-like breast cancer. We further utilize a medium-depletion approach to identify molecular factors regulating cell-subtype proportion in organoids. Together, these data are a rich resource to elucidate diverse mammary cell states.

Deconstructing Commercial Wearable Technology: Contributions toward Accurate and Free-Living Monitoring of Sleep.

Despite prolific demands and sales, commercial sleep assessment is primarily limited by the inability to "measure" sleep itself; rather, secondary physiological signals are captured, combined, and subsequently classified as sleep or a specific sleep state. Using markedly different approaches compared with gold-standard polysomnography, wearable companies purporting to measure sleep have rapidly developed during recent decades. These devices are advertised to monitor sleep via sensors such as accelerometers, electrocardiography, photoplethysmography, and temperature, alone or in combination, to estimate sleep stage based upon physiological patterns. However, without regulatory oversight, this market has historically manufactured products of poor accuracy, and rarely with third-party validation. Specifically, these devices vary in their capacities to capture a signal of interest, process the signal, perform physiological calculations, and ultimately classify a state (sleep vs. wake) or sleep stage during a given time domain. Device performance depends largely on success in all the aforementioned requirements. Thus, this review provides context surrounding the complex hardware and software developed by wearable device companies in their attempts to estimate sleep-related phenomena, and outlines considerations and contributing factors for overall device success.

Assessing the Accuracy of Popular Commercial Technologies That Measure Resting Heart Rate and Heart Rate Variability.

Commercial off-the shelf (COTS) wearable devices continue development at unprecedented rates. An unfortunate consequence of their rapid commercialization is the lack of independent, third-party accuracy verification for reported physiological metrics of interest, such as heart rate (HR) and heart rate variability (HRV). To address these shortcomings, the present study examined the accuracy of seven COTS devices in assessing resting-state HR and root mean square of successive differences (rMSSD). Five healthy young adults generated 148 total trials, each of which compared COTS devices against a validation standard, multi-lead electrocardiogram (mECG). All devices accurately reported mean HR, according to absolute percent error summary statistics, although the highest mean absolute percent error (MAPE) was observed for CameraHRV (17.26%). The next highest MAPE for HR was nearly 15% less (HRV4Training, 2.34%). When measuring rMSSD, MAPE was again the highest for CameraHRV [112.36%, concordance correlation coefficient (CCC): 0.04], while the lowest MAPEs observed were from HRV4Training (4.10%; CCC: 0.98) and OURA (6.84%; CCC: 0.91). Our findings support extant literature that exposes varying degrees of veracity among COTS devices. To thoroughly address questionable claims from manufacturers, elucidate the accuracy of data parameters, and maximize the real-world applicative value of emerging devices, future research must continually evaluate COTS devices.

Depressive Symptoms and Trust of Healthcare Provider in Rural Adolescents: Relationships and Predictors.

The purpose of this study was to evaluate associations among depressive symptoms, trust of healthcare provider, and health behavior in adolescents who live in a rural area. Two hundred twenty-four adolescents aged 14-19 years old attending public high school in the Midwestern United States were surveyed. Results showed a diagnosis of depression, trust of healthcare provider, health awareness, and stress management predicted depressive symptoms in adolescents living in a rural area. Healthcare providers should take extra care to promote trust in the healthcare provider-patient relationship with adolescents and to follow guidelines for annual screening of adolescents for depressive symptoms. Nursing implications include adolescent psychoeducation to improve health awareness and stress management.

The current practice of using angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in diabetic hypertensive and non-hypertensive patients. Is there a room for vitamin D?

OBJECTIVES: To determine the current pattern of using angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) in diabetic nephropathy (DN), and assess physician awareness of using vitamin D in the prevention and treatment of DN. METHODS: A cross-sectional study implementing a validated questionnaire, which was distributed to physicians in the aforementioned specialties in 3 hospitals in Saudi Arabia (Almanee Hospital, King Saud Medical City [KSMC], and Riyadh Care Hospital [RCH]) between April 2019 and November 2019. We used IBM SPSS 26.0 to perform descriptive statistical analyses and comparisons were based on the Chi-square test. RESULTS: Forty-one physicians (30%) reported the use of combination therapy of ACEi and ARBs. Fifty-six (41%) physicians reported that they never used vitamin D in the treatment of DN, and 48% agreed that vitamin D can benefit patients with DN. 52% of the respondents reported the existence of guidelines. The vast majority (94%) recommended clearer guidelines on monitoring renal function in patients treated with ACEi or ARBs. CONCLUSION: There is a universal agreement among physicians regarding the use of ACEi and ARBs for the treatment of DN with limited awareness of the bene ts of using vitamin D. Hence, the development of specific guidelines for its use are recommended.

Preliminary validation of the NTM Module: a patient-reported outcome measure for patients with pulmonary nontuberculous mycobacterial disease.

INTRODUCTION: Nontuberculous mycobacteria (NTM) cause chronic, debilitating pulmonary disease. Patient-reported outcomes provide measures of symptoms, functioning and treatment response. Here we describe the preliminary validation of the recently developed NTM Module. METHODS: The study population included Northwest NTM Biobank patients in whom Mycobacterium avium complex (MAC) was isolated and who had ever met the 2007 American Thoracic Society/Infectious Diseases Society of America pulmonary disease criteria. The NTM Module was administered at enrolment and 12 months; a subset also completed the Quality of Life Questionnaire-Bronchiectasis (QOL-B). The NTM Module generates four domain scores (0-100; higher scores indicate better functioning) reflecting NTM-specific symptoms (NTM Symptoms, Body Image, Digestive Symptoms and Eating Problems). We described patient characteristics and mean scores, and evaluated psychometric properties, including response to treatment at 12 months, for each domain. RESULTS: Overall, 203 patients with pulmonary MAC disease were included. Average enrolment scores ranged from 76 (NTM Symptoms) to 84 (Eating Problems). Ceiling effects were observed for Body Image (26% of participants) and Eating Problems (52%). Internal consistency (Cronbach's alpha) ranged from 0.67 (Digestive Symptoms) to 0.89 (Eating Problems). The intraclass correlation for test-retest reproducibility (n=27) ranged from 0.72 (Body Image) to 0.94 (Eating Problems). Patients starting treatment (n=35) had statistically significant increases in scores for NTM Symptoms (+5, p=0.04), Digestive Symptoms (+7, p=0.002), Body Image (+7, p=0.03) and QOL-B Respiratory Symptoms (n=25, +10, p=0.006). NTM Symptoms scores increased by 15 points (p=0.002) in the 16 patients with scores ≤80 at enrolment. CONCLUSION: The NTM Module generally performs well as a valid patient-reported outcome for pulmonary MAC disease and was responsive to MAC treatment.

Two types of high inductive electromagnetic stimulation and their different effects on endothelial cells.

Effects of low-frequency electromagnetic fields (LF EMF) on the activation of different tissue recovery processes have not yet been fully understood. The detailed quantification of LF EMF effects on the angiogenesis were analysed in our experiments by using cultured human and mouse endothelial cells. Two types of fields were used in the tests as follows: the LF EMF with rectangular pulses, 340-microsecond mode at a frequency of 72 Hz and peak intensity 4 mT, and the LF EMF with sinusoidal alternating waveform 5 000 Hz, amplitude-modulated by means of a special interference spectrum mode set to a frequency linear sweep from 1 to 100 Hz for 6 s and from 100 Hz to 1 Hz return also for 6 s, swing period of 12 second. Basic parameters of cultured cells measured after the LF EMF stimulus were viability and proliferation acceleration. Both types of endothelial cells (mouse and human ones) displayed significant changes in the proliferation after the application of the LF EMF under conditions of a rectangular pulse mode. Based on the results, another test of the stimulation on a more complex endothelial-fibroblast coculture model will be the future step of the investigation.

High inductive magnetic stimuli and their effects on mesenchymal stromal cells, dendritic cells, and fibroblasts.

Effects of low-frequency electromagnetic fields (LF EMF) on the activation of different tissue recovery processes have already been fully understood. Preliminary recent data demonstrated that a special case of sinusoidal electromagnetic fields, known as amplitude-modulated currents (AMC) could have a potential to accelerate the cell metabolism or cell migration. An AMC generator was designed to generate sinusoidal induced electric currents with the amplitude modulation and the harmonic carrier frequency of 5,000 Hz was modulated by frequencies of 1 to 100 Hz. The magnetic field peak was 6 mT, electric field intensity 2 V/m and the current density of induced electrical currents was approximately 1 A/m(2). The coil of the generator was adapted to easy handling and safe integration into the shelf of the CO(2) incubator. The shelf with the coil was prepared for the introduction of cells in standard plastic in vitro chambers. The tests focused on cells with migratory capacity after injury or during immunological processes and thus, mesenchymal stromal cells (MSC), dendritic cells (DC), and fibroblasts were chosen. The tests involved exposures of the cells to LF EMF (180 min/day) every day, for a period of three days, before examining them for cell death, morphology changes, and CD markers. The samples were tested by using MTT assay and the effects on the intracellular concentration of reactive oxygen species were quantified. The cell migration was finally measured with the help of the transwell migration assay. None of the cell types showed any decrease in the cell viability after the LF EMF application and the cells displayed minimum changes in reactive oxygen species. Functional changes (acceleration of cell migration) after AMC exposure were statistically significant for the MSC samples only. The acceleration of MSCs is associated with the production of MMP by these cells. The EMF has a potential to be a safe, clinically applicable selective activator of MSC homing, MSC paracrine production, and subsequent regeneration processes.

The potential utility of urinary biomarkers for risk prediction in combat casualties: a prospective observational cohort study.

INTRODUCTION: Traditional risk scoring prediction models for trauma use either anatomically based estimations of injury or presenting vital signs. Markers of organ dysfunction may provide additional prognostic capability to these models. The objective of this study was to evaluate if urinary biomarkers are associated with poor outcomes, including death and the need for renal replacement therapy. METHODS: We conducted a prospective, observational study in United States Military personnel with traumatic injury admitted to the intensive care unit at a combat support hospital in Afghanistan. RESULTS: Eighty nine patients with urine samples drawn at admission to the intensive care unit were studied. Twelve patients subsequently died or needed renal replacement therapy. Median admission levels of urinary cystatin C (CyC), interleukin 18 (IL-18), L-type fatty acid binding protein (LFABP) and neutrophil gelatinase-associated lipocalin (NGAL) were significantly higher in patients that developed the combined outcome of death or need for renal replacement therapy. Median admission levels of kidney injury molecule-1 were not associated with the combined outcome. The area under the receiver operating characteristic curves for the combined outcome were 0.815, 0.682, 0.842 and 0.820 for CyC, IL-18, LFABP and NGAL, respectively. Multivariable regression adjusted for injury severity score, revealed CyC (OR 1.97, 95 % confidence interval 1.26-3.10, p = 0.003), LFABP (OR 1.92, 95 % confidence interval 1.24-2.99, p = 0.004) and NGAL (OR 1.80, 95 % confidence interval 1.21-2.66, p = 0.004) to be significantly associated with the composite outcome. CONCLUSIONS: Urinary biomarker levels at the time of admission are associated with death or need for renal replacement therapy. Larger multicenter studies will be required to determine how urinary biomarkers can best be used in future prediction models.

Early acute kidney injury in military casualties.

BACKGROUND: While acute kidney injury (AKI) has been well studied in a variety of patient settings, there is a paucity of data in patients injured in the course of the recent wars in Iraq and Afghanistan. We sought to establish the rate of early AKI in this population and to define risk factors for its development. METHODS: We combined the results of two studies performed at combat support hospitals in Afghanistan. Only US service members who required care in the intensive care unit were included for analysis. Data on age, race, sex, Injury Severity Score (ISS), first available lactate, and requirement for massive transfusion were collected. Univariate analyses were performed to identify factors associated with the subsequent development of early AKI. Multivariable Cox regression was used to adjust for potential confounders. RESULTS: The two observational cohorts yielded 134 subjects for analysis. The studies had broadly similar populations but differed in terms of age and need for massive transfusion. The rate of early AKI in the combined cohort was 34.3%, with the majority (80.5%) occurring within the first two hospital days. Patients with AKI had higher unadjusted mortality rates than those without AKI (21.7% vs. 2.3%, p < 0.001). After adjustment, ISS (hazard ratio, 1.02; 95% confidence interval, 1.00-1.03; p = 0.046) and initial lactate (hazard ratio, 1.16; 95% confidence interval, 1.03-1.31; p = 0.015) were independently associated with the development of AKI. CONCLUSION: AKI is common in combat casualties enrolled in two prospective intensive care unit studies, occurring in 34.3%, and is associated with crude mortality. ISS and initial lactate are independently associated with the subsequent development of early AKI. LEVEL OF EVIDENCE: Prognostic and epidemiologic study, level III.

Impact of psychological and cancer-related factors on HRQoL for Korean childhood cancer survivors.

PURPOSE: The purposes of this study were (1) to compare health-related quality of life (HRQoL) between Korean childhood cancer survivors and healthy controls and (2) to examine the impact of demographic, diagnosis/treatment, and psychological variables on physical and psychosocial health in survivors. METHODS: The HRQoL (PedsQL), Self-Concept Inventory, and Child Behavior Checklist were administered to childhood cancer survivors, age/gender-matched healthy counterparts, and their parents. Independent-samples t tests and hierarchical multiple regression analyses were conducted. RESULTS: Compared with healthy controls, childhood cancer survivors reported significantly lower scores across physical and psychosocial HRQoL. For survivors, demographic, diagnosis/treatment, current health status, and psychological variables explained more than 50 % of the variance in both subscales of HRQoL. Especially, self-concept, a psychological variable, explained a significant portion of the variance in physical and psychosocial HRQoL after controlling for cancer-related factors. Several cancer-related factors including time since treatment completion, having a history of allogeneic hematopoietic stem cell transplantation, multiple treatment modalities, and suffering from severe late effects also associated with specific dimension of HRQoL. CONCLUSIONS: Childhood cancer survivors do experience lower level of QoL and psychological factors, especially self-concept, should be considered when supporting the well-being of childhood cancer survivors.

Association of AKI with adverse outcomes in burned military casualties.

BACKGROUND AND OBJECTIVES: Although associated with increased morbidity and mortality, AKI has not been systematically examined in military personnel injured from combat operations in Iraq and Afghanistan. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: Patients evacuated from Iraq and Afghanistan to a burn unit were examined. AKI was classified by the Acute Kidney Injury Network (AKIN) and Risk-Injury-Failure-Loss-End Stage (RIFLE) schemas. Age, sex, percentage of total body surface area burned (TBSA), percentage of full-thickness burn, inhalation injury, and injury severity score were recorded. Additional data that could be associated with poor outcomes were recorded for patients with TBSA ≥20%. Multivariate logistic regression analyses were performed to determine factors associated with morbidity and mortality. RESULTS: AKI prevalence rates by the RIFLE and AKIN criteria were 23.8% and 29.9%, respectively. After logistic regression, RIFLE categories of risk (odds ratio [OR], 15.34; 95% confidence interval [CI], 1.75-134; P=0.01), injury (OR, 46.28; 95% CI, 5.02-427; P<0.001), and failure (OR, 126; 95% CI, 13.39->999; P<0.001); AKIN-2 (OR, 23.70; 95% CI, 2.32-242; P=0.008); and AKIN-3 (OR, 130; 95% CI, 13.38->999; P<0.001) were significantly associated with death. AKIN-3, injury, and failure remained significant in the subset of patients with ≥20% TBSA. There was also a strong interaction between TBSA and the stage of AKI with respect to ventilator and intensive care unit days. CONCLUSIONS: AKI is prevalent in military casualties with burn injury and is independently associated with morbidity and mortality after adjustment for factors associated with injury severity.

Elevated anti-Müllerian hormone (AMH) and inhibin B levels in prepubertal girls with type 1 diabetes mellitus.

OBJECTIVE: Elevated anti-Müllerian hormone (AMH) and adrenal androgen levels have been observed during childhood in girls at risk of developing polycystic ovarian syndrome (PCOS). The aim of this study was to evaluate ovarian function and adrenal steroid levels in prepubertal girls with type 1 diabetes mellitus (T1D). DESIGN: Cross-sectional study. PATIENTS/MEASUREMENTS: We evaluated hormonal and ultrasonographic characteristics in girls with T1D (N = 73) and compared them to characteristics found in a control group of healthy girls (N = 86). Data are reported as geometric means (95% CI). RESULTS: Prepubertal girls with T1D had higher levels of AMH (29·1 pmol/l (23·2-36·3) vs 20·9 pmol/l (16·6-26·1), P = 0·038), inhibin B (arithmetic mean: 16·7 pg/ml (11·6-21·7) vs 11·7 pg/ml (10·0-13·5), P = 0·044) and dehydroepiandrosterone sulphate (DHEAS) (0·3 nmol/l (0·2-0·6) vs 0·2 nmol/l (0·1-0·3)) than controls (P = 0·045). During puberty, decreasing AMH levels were observed in girls with T1D only (P < 0·0001). Girls with T1D in Tanner stages 4-5 had lower AMH levels than their paired healthy controls (10·1 pmol/l (7·4-13·9) vs 15·7 pmol/l (11·6-21·3), respectively, P = 0·047). CONCLUSIONS: Our observations indicate that prepubertal girls with T1D may exhibit similar endocrine findings to those of other girls at risk of developing PCOS. The elevated levels of AMH and inhibin B suggest that higher numbers of follicles are present in the ovary during childhood in these patients and that insulin treatment may act as a local growth factor. In addition, AMH levels differed in prepubertal and pubertal girls, suggesting that the effect of T1D on ovarian folliculogenesis changes once gonadotrophin levels rise during puberty.

Menstrual cycle irregularities and their relationship with HbA1c and insulin dose in adolescents with type 1 diabetes mellitus.

OBJECTIVE: To evaluate the prevalence and risk factors of menstrual cycle irregularities in adolescents with type 1 diabetes mellitus. DESIGN: Prospective diary of menstrual cycle. SETTING: Pediatric diabetes clinics and nearby schools. PATIENT(S): Adolescents with type 1 diabetes mellitus treated with multiple daily insulin doses (n = 56) and 56 healthy adolescents. MAIN OUTCOME MEASURE(S): Duration and variability of menstrual cycle. RESULT(S): Duration of the menstrual cycle was 48 ± 39 and 32 ± 7 days in girls with type 1 diabetes mellitus and controls, respectively. Oligomenorrhea (58.9% vs. 19.6%) and amenorrhea (10.7% vs. 1.8%) were more prevalent in girls with type 1 diabetes mellitus than in controls. Oligomenorrhea was observed in 53.3% of the girls with type 1 diabetes mellitus with optimal metabolic control. Girls with an HbA1c level of 7.6% to 8.9% exhibited increased cycle duration, menstrual cycle variability, and prevalence of oligomenorrhea compared with controls. Regression analysis showed that, for each point of increase in HbA1c, the menstrual cycle duration increased by 5.1 days. Cycle variability was associated with a higher daily insulin dose. CONCLUSION(S): Despite optimal metabolic control, a higher prevalence of oligomenorrhea was observed in girls with type 1 diabetes mellitus compared with controls. This is the first report to describe the high variability of the menstrual cycle in type 1 diabetes mellitus. HbA1c and insulin dose are important factors related to menstrual irregularities in type 1 diabetes mellitus.