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The objective of this study was to design the screens of a future gamified mobile application for self-management of type 1 diabetes in children based on the opinion of caregivers at the King Fahad Hospital Diabetes Center, Saudi Arabia. To achieve this objective, a questionnaire was designed and distributed among 100 caregivers through face-to-face communication and social media using a Google Forms link. 65% of the participants met the inclusion criteria. The main result of this study was the design of 13 screens of a gamified application for self-management of type 1 diabetes in children from Saudi Arabia. The key features of the screens were caring for a character; using a challenging friend; inclusion of points, level, and leaderboard as rewarding principles; use of reminders and notifications for doctor's appointments, insulin injection times, blood glucose readings; and tips for improving medication adherence, increasing blood glucose readings, supporting physical activities, and adopting healthy eating habits. It can be concluded that the practical implementation of the screens in a future mobile application can motivate children with type 1 diabetes to improve eating habits, physical exercise, and cognitive, emotional, and social behaviors to maintain a stable state of health. Also, the content of the designed screens can help to monitor blood glucose readings and comply with medication treatment. The designed screens are adapted to the Arab culture.A multicenter, randomized, controlled clinical trial and four postmarket user acceptance investigations were carried out to document the safety, performance, and user acceptance of Efemia Bladder Support, a novel vaginal inlay for the temporary reduction of stress urinary incontinence (SUI). The clinical investigation enrolled 97 women diagnosed with SUI, randomized 3  1 to either treatment or standard care (control). The primary endpoint was reduction of urine leakage, measured as change in pad weight baseline week compared with treatment week. Secondary endpoints were treatment success, calculated as the percentage of subjects with >70% reduction in pad weight, reduction in incontinence episodes, and quality of life (QoL). 75 women (77%) completed the clinical investigation. No serious adverse events occurred. The treatment group reached a 55% (p less then 0.001) mean reduction of total leakage compared to the control arm. A subanalysis, involving only leakage during provocation testing (coughing and jumping), showed a 67% (p less then 0.001) mean reduction of leakage. No significant effect on QoL could be observed. 51% of the women answered "yes" to the question if they would use the device to reduce SUI. The user acceptance of the device was further investigated in four postmarket studies, using an improved device design with a slimmer centerpiece and a thinner handle, while keeping the effect achieving parts of the device unchanged. An average of 74% of the 102 participants in the postmarket studies reported that they were likely to continue using Efemia. The highest user satisfaction was seen in the two studies evaluating the use of Efemia during exercise, where 83% and 88% of the women were likely to continue using Efemia. It can be concluded that Efemia is a safe, well-tolerated, and effective alternative for reducing SUI, both in everyday life and during physical exercise.

Takayasu's arteritis (TA) and inflammatory bowel disease (IBD) are chronic inflammatory granulomatous disorders that have rarely been concomitantly reported in case reports and small case series.

We report a series of seven cases of TA and IBD association in two referral centers with a comprehensive review of literature.

We analyzed retrospectively the electronic medical charts of TA-IBD patients at the University Hospital of São Paulo, Brazil, and at the Sheba Medical Center at Tel Aviv University, Israel.

Overall, five patients had Crohn's disease (DC) and two had ulcerative colitis (UC), and they were mostly female and non-Asian. All patients developed IBD first and, subsequently, TA. Two underwent colectomy and one ileocecectomy due to IBD activity, while three required cardiovascular surgery due to TA activity. Most patients are currently in clinical remission of both diseases with conventional drug treatment.

Although the coexistence of TA and IBD is uncommon, both seem to be strongly associated through pathophysiological pathways.

Although the coexistence of TA and IBD is uncommon, both seem to be strongly associated through pathophysiological pathways.A granuloma is defined as a localized inflammatory reaction or a hypersensitive response to a nondegradable product leading to an organized collection of epithelioid histiocytes. Etiologies of granulomatous disorders can be divided into two broad categories infectious and noninfectious (autoimmune conditions, toxins, etc.) causes. The endless list of causalities may prove challenging for gastroenterologists and pathologists to formulate a list of clearly defined differentials. This is true when distinguishing these etiologies based on various clinical presentations and endoscopic and histological findings. Saracatinib We aim to provide a comprehensive review of some of the frequent and rare infectious granulomatous diseases of the gastrointestinal tract documented in the literature to date. We provide an overview of each infectious pathology with an emphasis on epidemiology, clinical presentation, and endoscopic and histologic findings, in addition to treatment.

The study was to analyze the clinical manifestation variety and management choices of symptomatic Meckel's diverticulum in children.

From July 2008 to October 2018, 28 cases of Meckel's diverticulum with a variety of complications were admitted to our hospital. The clinical data included age, gender, symptoms and signs, investigations, intraoperative and pathological findings, and outcome.

The ratio of males to females was 2.5  1. The diagnoses were made by

Tc-pertechnetate scan (in 5 cases) and by exploratory laparotomy (in 2 cases). The initial diagnosis in the other cases includes intussusception (in 4 cases), acute appendicitis (in 5 cases), intestinal obstruction (unknown origin), peritonitis, and even shock in 12 cases. Laparoscopic surgery was performed in 8 cases; 18 cases underwent open surgery. Excision of partial bowel segment with diverticulum and primary anastomosis was done in 22 cases and wedge resection of diverticulum in 4 cases. Two other cases received nonoperative therapy and went to other hospitals to receive surgical management.

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