bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatial distribution and machine learning prediction of sexually transmitted infections and associated factors among sexually active men and women in Ethiopia, evidence from EDHS 2016
Authors: Kebede Kassaw Abdul-Aziz , Melese Yilma Tesfahun , Sebastian Yakub , Yeneneh Birhanu Abraham , Sharew Melaku Mequannent , Surur Jemal Sebwedin
Published: January 2023

Introduction

Sexually transmitted infections (STIs) are the major public health problem globally, affecting millions of people every day. The burden is high in the Sub-Saharan region, including Ethiopia. Besides, there is little evidence on the distribution of STIs across Ethiopian regions. Hence, having a better understanding of the infections is of great importance to lessen their burden on society. Therefore, this article aimed to assess predictors of STIs using machine learning techniques and their geographic distribution across Ethiopian regions. Assessing the predictors of STIs and their spatial distribution could help policymakers to understand the problems better and design interventions accordingly.

Methods

A community-based cross-sectional study was conducted from January 18, 2016, to June 27, 2016, using the 2016 Ethiopian Demography and Health Survey (EDHS) dataset. We applied spatial autocorrelation analysis using Global Moran’s I statistics to detect latent STI clusters. Spatial scan statics was done to identify local significant clusters based on the Bernoulli model using the SaTScan™ for spatial distribution and Supervised machine learning models such as C5.0 Decision tree, Random Forest, Support Vector Machine, Naïve Bayes, and Logistic regression were applied to the 2016 EDHS dataset for STI prediction and their performances were analyzed. Association rules were done using an unsupervised machine learning algorithm.

Results

The spatial distribution of STI in Ethiopia was clustered across the country with a global Moran’s index = 0.06 and p value = 0.04. The Random Forest algorithm was best for STI prediction with 69.48% balanced accuracy and 68.50% area under the curve. The random forest model showed that region, wealth, age category, educational level, age at first sex, working status, marital status, media access, alcohol drinking, chat chewing, and sex of the respondent were the top 11 predictors of STI in Ethiopia.

Conclusion

Applying random forest machine learning algorithm for STI prediction in Ethiopia is the proposed model to identify the predictors of STIs.
Effects of manipulations of oblique pulling on the biomechanics of the sacroiliac joint: a cadaveric study
Authors: Xu Zhun , Huang Zhiping , Zhang Zhaocong , Feng Ziyu , Yan Yiguo , Zhu Qingan , Li Yikai
Published: January 2023

Background

There are many reports on the treatment of sacroiliac joint dysfunction by manipulation of oblique pulling (MOP). However, the specific mechanism of MOP on the sacroiliac joint remains unclear. This study aimed to investigate the effect of MOP on the biomechanics of the sacroiliac joint and the effect of the anterior sacroiliac ligament on the stability of the sacroiliac joint.

Methods

First, MOP-F1 (F: force) and MOP-F2 were applied to nine cadaveric pelvises. Then, segmental resection of the anterior sacroiliac ligament was performed. The range of motion of the sacroiliac joint was observed in all procedures.

Results

Under MOP-F1 and F2, the average total angles were 0.84° ± 0.59° and 1.52° ± 0.83°, and the displacements were 0.61 ± 0.21 mm and 0.98 ± 0.39 mm, respectively. Compared with MOP-F1, MOP-F2 caused greater rotation angles and displacements of the sacroiliac joint (p = 0.00 and p = 0.01, respectively). In addition, the rotation angles and displacements of the sacroiliac joint significantly increased after complete resection of the anterior sacroiliac ligament (p = 0.01 and p = 0.02, respectively). The increase was mainly due to the transection of the upper part of the anterior sacroiliac ligament.

Conclusions

MOP-F2 caused greater rotation angles and displacements of the sacroiliac joint and was a more effective manipulation. The anterior sacroiliac ligament played an important role in maintaining the stability of the sacroiliac joint; the upper part of the anterior sacroiliac ligament contributed more to the stability of the joint than the lower part.
Development and external validation of prognostic scoring models for portal vein thrombosis: a multicenter retrospective study
Authors: Zhong Xuan , Li Shan , Hu Jiali , Lu Jinlai , Wang Wei , Hu Miao , Sun Qinjuan , Zhang Shuo , Yang Xiaoqing , Yang Changqing , Zhong Lan
Published: January 2023

Background

Portal vein thrombosis is a common complication of liver cirrhosis and hepatocellular carcinoma; however, few studies have reported its long-term clinical prognosis. This study aimed to establish and validate easy-to-use nomograms for predicting gastrointestinal bleeding, portal vein thrombosis resolution, and mortality of patients with portal vein thrombosis.

Methods

This multicenter retrospective cohort study included 425 patients with portal vein thrombosis who were divided into training (n = 334) and validation (n = 91) sets. Prediction models were developed using multivariate Cox regression analysis and evaluated using the consistency index and calibration plots.

Results

Predictors of gastrointestinal bleeding included a history of gastrointestinal bleeding, superior mesenteric vein thrombosis, red color sign observed during endoscopy, and hepatic encephalopathy. Meanwhile, predictors of resolution of portal vein thrombosis included a history of abdominal infection, C-reactive protein and hemoglobin levels, and intake of thrombolytics. Predictors of death included abdominal infection, abdominal surgery, aspartate aminotransferase level, hepatic encephalopathy, and ascites. All models had good discriminatory power and consistency. Anticoagulation therapy significantly increased the probability of thrombotic resolution without increasing the risk of bleeding or death.

Conclusions

We successfully developed and validated three prediction models that can aid in the early evaluation and treatment of portal vein thrombosis.
Dry synovitis, a rare entity distinct from juvenile idiopathic arthritis
Authors: De Somer Lien , Bader-Meunier Brigitte , Breton Sylvain , Brachi Sara , Wouters Carine , Zulian Francesco
Published: January 2023

Background

Dry synovitis (DS) is a rare entity as only a few cases have been reported to date. We describe the clinical features, radiological manifestations and course of DS in comparison with rheumatoid factor negative polyarticular juvenile idiopathic arthritis (RFneg-polyJIA).

Methods

We performed a multicenter retrospective collection of data of DS patients who presented with progressive joint limitations without palpable synovitis, absence of elevated acute phase reactants, negative ANA and RF, and imaging showing joint and/or osteochondral involvement. For comparative purposes, we included a cohort of RF neg-polyJIA patients.

Results

Twelve DS patients, 8F/4 M, with mean age at onset of 6.1 years, were included. Presenting signs comprised delayed motor development, functional limitations and/or progressive stiffness. Clinical examination showed symmetric polyarticular involvement with variable muscular atrophy. MRI showed mild, diffuse synovial involvement, without effusion. With time, signs of progressive osteochondral damage became evident, despite treatment. All patients were treated with low-dose corticosteroids and methotrexate. Anti-TNF agents were prescribed in five. The response was variable with limited joint mobility in 11/12, and need of joint replacement in 2. In comparison with a cohort of RFneg-polyJIA, DS patients presented higher number of joint involved (p = 0.0001) and contractures (p = 0.0001), less swelling (p = 0.0001) and prolonged diagnostic delay (p = 0.0001).

Conclusion

DS represents a unique juvenile-onset arthropathy, distinct from polyarticular JIA. Awareness among pediatricians is essential for early recognition and proper treatment. Further studies, including synovial pathology, immunology and genetics may contribute to a better understanding of this rare disorder of childhood.
Karst vegetation coverage detection using UAV multispectral vegetation indices and machine learning algorithm
Authors: Pan Wen , Wang Xiaoyu , Sun Yan , Wang Jia , Li Yanjie , Li Sheng
Published: January 2023

Background

Karst vegetation is of great significance for ecological restoration in karst areas. Vegetation Indices (VIs) are mainly related to plant yield which is helpful to understand the status of ecological restoration in karst areas. Recently, karst vegetation surveys have gradually shifted from field surveys to remote sensing-based methods. Coupled with the machine learning methods, the Unmanned Aerial Vehicle (UAV) multispectral remote sensing data can effectively improve the detection accuracy of vegetation and extract the important spectrum features.

Results

In this study, UAV multispectral image data at flight altitudes of 100 m, 200 m, and 400 m were collected to be applied for vegetation detection in a karst area. The resulting ground resolutions of the 100 m, 200 m, and 400 m data are 5.29, 10.58, and 21.16 cm/pixel, respectively. Four machine learning models, including Random Forest (RF), Support Vector Machine (SVM), Gradient Boosting Machine (GBM), and Deep Learning (DL), were compared to test the performance of vegetation coverage detection. 5 spectral values (Red, Green, Blue, NIR, Red edge) and 16 VIs were selected to perform variable importance analysis on the best detection models. The results show that the best model for each flight altitude has the highest accuracy in detecting its training data (over 90%), and the GBM model constructed based on all data at all flight altitudes yields the best detection performance covering all data, with an overall accuracy of 95.66%. The variables that were significantly correlated and not correlated with the best model were the Modified Soil Adjusted Vegetation Index (MSAVI) and the Modified Anthocyanin Content Index (MACI), respectively. Finally, the best model was used to invert the complete UAV images at different flight altitudes.

Conclusions

In general, the GBM_all model constructed based on UAV imaging with all flight altitudes was feasible to accurately detect karst vegetation coverage. The prediction models constructed based on data from different flight altitudes had a certain similarity in the distribution of vegetation index importance. Combined with the method of visual interpretation, the karst green vegetation predicted by the best model was in good agreement with the ground truth, and other land types including hay, rock, and soil were well predicted. This study provided a methodological reference for the detection of karst vegetation coverage in eastern China.
Suitability of skin traction combined with braces for treating femoral shaft fractures in 3–5 years old children
Authors: Wang Menglei , Su Yuxi
Published: January 2023

Background

In children aged 3–5 years, femoral fractures are common and are frequently treated using flexible intramedullary nails (FIN) or spica casting. Recently, more surgeons have been relying on FIN surgery because of the high rate of complications associated with spica casts, such as skin irritation and re-adjustment surgery. We aimed to evaluate the effect of skin traction combined with braces in 3–5 years old children at our hospital.

Methods

We retrospectively analyzed 125 children aged 3–5 years with femoral shaft fractures treated at our hospital between January 2010 and December 2020. We assigned 68 patients who underwent FIN surgery to Group A and 57 patients treated with skin traction and braces to Group B. Comparative analysis included the children’s age, sex, side of the affected limb, cause of fracture, function of the knee joint, healing time of the fracture, duration of hospitalization, cost of hospitalization, and complications. The complications evaluated included joint dysfunction, pain, infection, pressure ulcers, angular deformities, limb length differences, re-fractures, nonunion fractures, and delayed union.

Results

There were significant differences in and hospital costs (p = 0.001). Conversely, no statistically significant differences were observed in sex (p = 0.858), injury type (p = 0.804), age (p = 0.231), hospitalization time (p = 0.071), bone healing time (p = 0.212), and complications. Pressure ulcers, nonunion fractures, and delayed union did not occur in both groups.

Conclusion

Both methods had similar therapeutic effects and postoperative complications in children aged 3–5 years with femoral shaft fractures. Therefore, skin traction combined with braces is recommended for this population and for patients hospitalized in institutions where several beds are available, with a consequent possibility of prolonged hospitalization.

Level of Evidence: IV.
A distractions capture tool for cardiac surgery and lung transplantation: impact on outcomes
Authors: Arkley James , Ong Lay Ping , Gunaratnam Niranjan , Butt Tanveer , Clark Stephen Charles
Published: January 2023

Objectives

Surgical distractions are associated with worse patient outcomes. Lung transplantation and cardiac surgery’s multi-disciplinary nature, and their inherent complexities render them more vulnerable to distractions. We aim to use a novel distractions capture tool to evaluate the severity of distractions during cardiac surgery (CS) and lung transplantation (LTx) and assess its impact on post-operative complications.

Methods

A prospective ‘blinded’ study was undertaken by direct observation of distractions during CS and LTx. Events were identified using the Imperial College Error Capture tool (ICECAP). Number and severity of distractions were correlated with post-operative outcomes (ICU & hospital stay, bleeding and anastomotic complications).

Results

In LTx, we observed 2059 distractions within 287 h across 41 surgeries. In CS, we observed 1089 distractions within 192 h across 62 surgeries. Surgeons were consciously aware of 19.2% (LTx) and 21.3% (CS) of recorded events. Distractions consisted of procedure-independent pressures (61% LTx vs 56% CS), equipment problems (15% LTx vs 23%CS), communication (12% LTx vs 12% CS), technical problems or patient safety concerns (12% LTx vs 9% CS). In CS, 91% of procedure-independent pressures were non-operative distractions whilst LTx recorded 83%. Staff absences at a critical moment of surgery were recorded at 9% (LTx) and 7% (CS). The number and severity of distractions correlated with bleeding (CS p < 0.001, LTx p < 0.01), prolonged ICU stay (CS p = 0.002, LTx p = 0.002), hospital stay (CS p < 0.001) and anastomotic complications(LTx p < 0.03).

Conclusions

ICECAP as a novel surgical distractions capture tool was effective & applicable to both elective cardiac and urgent transplant surgeries. Surgeons were unaware of a large number of distractions & interruptions. Distractions were associated with longer ICU stay and higher rate of bleeding.
T7Max transcription system
Authors: Deich Christopher , Cash Brock , Sato Wakana , Sharon Judee , Aufdembrink Lauren , Gaut Nathaniel J. , Heili Joseph , Stokes Kaitlin , Engelhart Aaron E. , Adamala Katarzyna P.
Published: January 2023

Background

Efficient cell-free protein expression from linear DNA templates has remained a challenge primarily due to template degradation. In addition, the yields of transcription in cell-free systems lag behind transcriptional efficiency of live cells. Most commonly used in vitro translation systems utilize T7 RNA polymerase, which is also the enzyme included in many commercial kits.

Results

Here we present characterization of a variant of T7 RNA polymerase promoter that acts to significantly increase the yields of gene expression within in vitro systems. We have demonstrated that T7Max increases the yield of translation in many types of commonly used in vitro protein expression systems. We also demonstrated increased protein expression yields from linear templates, allowing the use of T7Max driven expression from linear templates.

Conclusions

The modified promoter, termed T7Max, recruits standard T7 RNA polymerase, so no protein engineering is needed to take advantage of this method. This technique could be used with any T7 RNA polymerase- based in vitro protein expression system.
Cytokine hemoadsorption with CytoSorb® in post-cardiac arrest syndrome, a pilot randomized controlled trial
Authors: Monard Céline , Bianchi Nathan , Poli Elettra , Altarelli Marco , Debonneville Anne , Oddo Mauro , Liaudet Lucas , Schneider Antoine
Published: January 2023

Background

Hemoadsorption (HA) might mitigate the systemic inflammatory response associated with post-cardiac arrest syndrome (PCAS) and improve outcomes. Here, we investigated the feasibility, safety and efficacy of HA with CytoSorb® in cardiac arrest (CA) survivors at risk of PCAS.

Methods

In this pilot randomized controlled trial, we included patients admitted to our intensive care unit following CA and likely to develop PCAS: required norepinephrine (> 0.2 µg/kg/min), and/or had serum lactate > 6 mmol/l and/or a time-to-return of spontaneous circulation (ROSC) > 25 min. Those requiring ECMO or renal replacement therapy were excluded. Eligible patients were randomly allocated to either receive standard of care (SOC) or SOC plus HA. Hemoadsorption was performed as stand-alone therapy for 24 h, using CytoSorb® and regional heparin–protamine anticoagulation. We collected feasibility, safety and clinical data as well as serial plasma cytokines levels within 72 h of randomization.

Results

We enrolled 21 patients, of whom 16 (76%) had out-of-hospital CA. Median (IQR) time-to-ROSC was 30 (20, 45) minutes. Ten were assigned to the HA group and 11 to the SOC group. Hemoadsorption was initiated in all patients allocated to the HA group within 18 (11, 23) h of ICU admission and conducted for a median duration of 21 (14, 24) h. The intervention was well tolerated except for a trend for a higher rate of aPTT elevation (5 (50%) vs 2 (18%) p = 0.18) and mild (100–150 G/L) thrombocytopenia at day 1 (5 (50%) vs 2 (18%) p = 0.18). Interleukin (IL)-6 plasma levels at randomization were low (< 100 pg/mL) in 10 (48%) patients and elevated (> 1000 pg/mL) in 6 (29%). The median relative reduction in IL-6 at 48 h was 75% (60, 94) in the HA group versus 5% (− 47, 70) in the SOC group (p = 0.06).

Conclusions

In CA survivors at risk of PCAS, HA was feasible, safe and was associated with a nonsignificant reduction in cytokine plasma levels. Future trials are needed to further define the role of HA after CA. Those studies should include cytokine assessment to enrich the study population.

Trial registration: NCT03523039, registered 14 May 2018.
Ventriculus terminalis cyst in an infant: a case report
Authors: Menezes Arnold H. , Sato Yutaka , Dlouhy Brian J. , Jones Karra A. , Moore Steven A.
Published: January 2023

Background

Filar cysts are frequently found on neonatal ultrasound and are physiologically involuting structures with natural resolution. Hence, there has been no previous histologic correlation. Ventriculus terminalis is a focal central canal dilation in the conus medullaris and usually not clinically significant. Extra-axial cyst at the conus–filum junction connected to ventriculus terminalis is extremely rare, especially when associated with tethered lipomatous filum terminale and with progressive cyst enlargement.

Case presentation

A Caucasian female neonate with abnormal gluteal cleft had ventriculus terminalis cyst with an extra-axial cyst at the conus–filar junction and taut lipomatous filum on ultrasound examination and magnetic resonance imaging. This persisted at 6-month follow up imaging. In light of the nonresolving extra-axial mass and thick taut lipomatous filum, the child underwent L1–L3 osteoplastic laminectomies. The extra-axial cyst expanded after bony decompression and furthermore on dural opening; visualized on ultrasound. It communicated with the central canal and was documented with intraoperative photomicrographs. It was excised and filum sectioned. Histological immunostaining of the cyst wall showed neuroglial and axonal elements. The child did well without deficits at 4-year follow up with normal urodynamics.

Conclusion

Progression dilation of ventriculus terminalis and extra-axial conofilar cyst with tethered lipomatous filum will likely progress to clinical significance and require surgical intervention. The embryologic basis for this pathology is discussed, with literature review.
Biopreservative efficacy of Enterococcus faecium-immobilised film and its enterocin against Salmonella enterica
Authors: Rashid Muzamil , Sharma Sunil , Kaur Arvinder , Kaur Amarjeet , Kaur Sukhraj
Published: January 2023

The growing awareness about the adverse health effects of artificial synthetic preservatives has led to a rapid increase in the demand for safe food preservation techniques and bio preservatives. Thus, in this study, the biopreservatives efficacy of enterocin-producing Enterococcus faecium Smr18 and its enterocin, ESmr18 was evaluated against Salmonella enterica contamination in chicken samples. E. faecium Smr18 is susceptible to the antibiotics penicillin-G, ampicillin, vancomycin, and erythromycin, thereby indicating that it is a nonpathogenic strain. Further, the enterocin ESmr18 was purified and characterised as a 3.8 kDa peptide. It possessed broad spectrum antibacterial activity against both Gram-positive and Gram-negative pathogens including S. enterica serotypes Typhi and Typhimurium. Purified ESmr18 disrupted the cell membrane permeability of the target cell thereby causing rapid efflux of potassium ions from L. monocytogenes and S. enterica. Chicken samples inoculated with S. enterica and packaged in alginate films containing immobilised viable E. faecium resulted in 3 log10 colony forming units (CFU) reduction in the counts of S. enterica after 34 days of storage at 7–8 °C. The crude preparation of ESmr18 also significantly (p < 0.05) reduced the CFU counts of salmonella-inoculated chicken meat model. Purified ESmr18 at the concentration upto 4.98 µg/ml had no cytolytic effect against human red blood cells. Crude preparation of ESmr18 when orally administered in fish did not cause any significant (p < 0.05) change in the biochemical parameters of sera samples. Nonsignificant changes in the parameters of comet and micronucleus assays were observed between the treated and untreated groups of fishes that further indicated the safety profile of the enterocin ESmr18.
Robotic-assisted revision total knee arthroplasty: a novel surgical technique
Authors: Ngim Hui-Ling Joanne , Van Bavel Dirk , De Steiger Richard , Tang Andrew W. W.
Published: January 2023

Background

Revision total knee arthroplasty is a challenging procedure. The robotic-assisted system has been shown to enhance the accuracy of preoperative planning and improve reproducibility in primary arthroplasty surgeries. The aim of this paper was to describe the surgical technique for robotic-assisted revision total knee arthroplasty and the potential benefits of this technique.

Method

This single-centre retrospective study included a total of 19 patients recruited from April 1, 2021 to April 30, 2022. Inclusion criteria were patients who had Mako™ robotic-assisted revision total knee arthroplasty done within the study period with a more than 6 months follow-up. Statistical analysis was done using Microsoft Excel 16.0.

Results

All 19 patients were followed up for 6 to 18 months. All patients in this study had uneventful recoveries without needing any re-revision surgery when reviewed to date.

Conclusion

With the development of dedicated revision total knee software, robot-assisted revision TKA can be a promising technique that may improve surgical outcomes by increasing the accuracy of implant placement, and soft tissue protection and achieving a better well-balanced knee.
Follicular fluid biomarkers for prediction of human IVF outcome in women with poor ovarian response
Authors: Barroso-Villa Gerardo , Valdespin-Fierro Carlos , Weiser-Smeke Ariane-Estrella , Machargo-Gordillo Ana-Paula , Flores-Pliego Arturo , Palma-Lara Icela , Oehninger Sergio
Published: January 2023

Background

The aim of controlled ovarian stimulation is to achieve an optimal number of mature oocytes to obtain good-quality embryos. High follicular fluid (FF) concentrations of FSH, hCG, and LH promote oocyte maturation and are associated with a higher probability of fertilization. LH concentrations in FF are consistently higher in follicles that will lead to a successful IVF outcome. The levels of some of these FF biomarkers may vary among different ovarian stimulation schemes; however, the effects of corifollitropin alfa, recombinant FSH (rFSH), LH (rLH), and highly purified urinary menotropins uhMG on these biomarkers are still unknown. The objective of this study was to characterize the profile of FF biomarkers (leptin, vascular endothelial growth factor (VEGF), metalloproteinases (MMPs), and NO2−/NO3−) according to three different protocols of controlled ovarian stimulation (COS) in poor ovarian responders (POR) and to evaluate the association between these profiles and clinical outcomes. Three groups of POR patients were examined according to the protocols used.

Results

Group C showed significant higher levels in all biomarkers (p < 0001). FF samples from Group B had the lowest levels of VEGF and Pro-MMP-9. Group A showed the lowest concentration of pro-MMP-2. The VEGF level and number of captured oocytes were positively correlated in Group C (r = 0.534, p = 0.01). MMP-9 and fertilization rate were negatively correlated in Group C (r = −0.476, p = 0.02). We found negative correlations between proMMP-2 and serum estradiol levels on the day of rhCG administration.

Conclusion

We found significant variations in the biomarker concentrations between the different controlled ovarian stimulation schemes used in POR patients. These differences can be potentially explained by the nature and composition of the gonadotropins. Our results support the hypothesis that some of these molecules should be thoroughly investigated as noninvasive predictors of egg quality.
Unresolving cyclic pelvic pain in young women due to rare structural uterine anomalies: a case series
Authors: Kandasamy Vignesh , Reghunath Anjuna , Gupta Swarna , Sharma Anuradha , Ghasi Rohini Gupta
Published: January 2023

Background

There are many causes for cyclic pelvic pain unresponsive to anti-spasmodic medications in young women. An uncommon, although significant, association in patients presenting with such symptoms is structural uterine anomalies with rudimentary functional cavities. Ultrasound is the first-line modality for the investigation of dysmenorrhea, and the radiologist may be the first person to identify such an underlying condition in the patient. However, transabdominal ultrasound may provide only limited information. Magnetic resonance imaging (MRI) is the imaging modality of choice in such situations due to its high soft tissue resolution and multiplanar capability. This case series is unique in that it primarily highlights the MR imaging of rare structural uterine anomalies in three young females suffering from severe dysmenorrhea, along with an imaging approach.

Case presentation

We present three cases of unresolving cyclic pain in young nulliparous females who were radiologically diagnosed with three rare uterine structural anomalies—accessory and cavitated uterine mass, Mayer–Rokitansky–Küster–Hauser syndrome, and functional non-communicating rudimentary horn in a hemiuterus or unicornuate uterus, which were treated with resection leading to symptom relief.

Conclusion

In young women with recurrent cyclic pelvic pain, uterine structural abnormalities with functioning cavities should be considered as an etiology and evaluated with MRI. Owing to the non-specific nature of causes of dysmenorrhea, a schematic approach to imaging is essential for identifying the various underlying gynecological conditions, thus aiding in the prompt management of the patient.
Comparative study between blind and ultrasound-guided steroid injection for carpal tunnel syndrome
Authors: Farfour Hesham , Hegab Sherif , El-Sherif Sherine , Abdel-Kerim Amr
Published: January 2023

Background

Carpal tunnel syndrome is the most common entrapment neuropathy. Local injections of corticosteroids have proven to be an effective treatment option. Injections are either blind (non-guided) or guided by ultrasound. The current study aimed to compare the efficiency of both approaches and determine which one yields better results.

Method

This study involved 30 patients (8 males, 22 females, aged 36–58 years, mean age 48.3 years) with 30 affected hands with mild or moderate carpal tunnel syndrome. Patients were randomly divided into two equal groups. Steroid injections were performed blindly in group 1 and ultrasound-guided in group 2. A mixture of 2 ml of triamcinolone and lidocaine was administered at both groups. Follow-up (using the Boston Carpal Tunnel Questionnaire and ultrasound assessment) was performed 4 weeks after the injection.

Results

The symptom severity scale, functional status scale, cross-sectional area, and flattening ratio were significantly reduced in both groups at 4 weeks after the procedure. The ultrasound-guided group showed a statistically significant improvement compared to the blindly injected group.

Conclusions

Local steroid injection is an effective method in the management of both idiopathic and secondary carpal tunnel syndrome. Although clinical and sonographic improvement was achieved with blind and guided steroid injections, better results were obtained when ultrasound was used.
A multi-agent-based symbiotic organism search algorithm for DG coordination in electrical distribution networks
Authors: Kawambwa Shamte , Mnyanghwalo Daudi
Published: January 2023

Metaheuristic algorithms have become popular in solving engineering optimization problems due to their advantages of simple implementation and the ability to find near-optimal solutions for complex and large-scale problems. However, most applications of metaheuristic algorithms consider centralized design, assuming that all possible solutions are available in one machine or controller. In some applications, such as power systems, especially DG coordination, centralized design may not be efficient. This work integrates a multi-agent system (MAS) into a metaheuristic algorithm for enhanced performance. In a proposed multi-agent framework, the agent implements a metaheuristic algorithm and uses shared information with neighbours as input to optimize the solutions. In this study, a new distributed Symbiotic Organism Search (SOS) algorithm has been proposed and tested in the proposed multi-agent framework. The proposed algorithm is termed a multi-agent-based symbiotic organism search algorithm (MASOS). The MASOS has been tested and compared with other proficient algorithms through statistical analysis using benchmark functions. The results show that the proposed MASOS solves the considered benchmark functions efficiently. Then MASOS was tested for DGs coordination considering load variations in the Tanzanian electrical distribution network. The results show that the coordination of DG using the proposed algorithm reduces power loss and improves the voltage profiles of the power system.
Prevalence and pattern of isolated fungi from bronchoalveolar lavage among patients with lung cancer: a prospective cross-sectional study
Authors: El-Badrawy Mohammad Khairy , Elsaied Amany Ragab , Ibrahim Asmaa Adel Metwally , Eladl Ahmed Elsayed , Elmorsey Rehab Ahmad
Published: January 2023

Background

Fungal colonization or infection has recently been reported in patients with lung cancer, and it is possible that it has a role in the pathogenesis of lung cancer or having an effect on treatment and outcome. Aim of work was to assess the prevalence and pattern of isolated fungi from patients with lung cancer at the time of diagnosis. In this prospective cross-sectional observational study, patients with suspected lung tumors were subjected to fiberoptic bronchoscopy (FOB) for biopsy, bronchoalveolar lavage (BAL) with its culture for fungal growth. After a pathological diagnosis, 100 cases of confirmed lung cancer were entered into the study analysis. The prevalence and type of isolated fungi have been determined and compared to the characteristics of the participants and cell types of lung cancer.

Results

Fungi were isolated from 68% of the studied lung cancer cases. The most common isolated fungi were Candida albicans (32%), Aspergillus niger (28%), and Aspergillus fumigatus (8%). Fungi were isolated with a higher frequency in lung cancer cases with the following characteristics: males (p = 0.008), current or ex-smokers (p = 0.002), and chronic obstructive pulmonary disease (COPD) association (p = 0.01). In comparison to lung cancer cases with negative fungal culture, detection of fungal colonization was more associated with increasing severity of clinical presentation: higher grades of dyspnea (grade 1 vs. grade 2, p 0.001), a higher cough score (score 1 versus score 3, p 0.001), a higher chest pain score (score 0 versus score 1, p 0.001), and higher scores of hemoptysis (score 0 versus score 3, p 0.001). Otherwise, no difference was detected regarding age, frequency of comorbidities, chest computed tomography (CT) findings, lung cancer cell type, and staging in lung cancer patients with fungal colonization (p > 0.05).

Conclusion

Fungi were isolated in more than two thirds of lung cancer cases at the time of diagnosis with higher frequency among males, smokers, and those having associated COPD. This may negatively affect the response to treatment and prognosis of lung cancer. ClinicalTrials.gov (NCT 05575388).
As low as diagnostically acceptable dose imaging in maxillofacial trauma: a reference quality approach
Authors: Widmann Gerlig , Schönthaler Hannes , Tartarotti Alexander , Degenhart Gerald , Hörmann Romed , Feuchtner Gudrun , Jacobs Reinhilde , Pauwels Ruben
Published: January 2023

Objectives:

As-low-as-diagnostically-acceptable (ALADA) doses are substantially lower than current diagnostic reference levels. To improve dose management, a reference quality approach was tested in which phantom quality metrics of a clinical ALADA dose reference protocol were used to benchmark potential ALADA dose protocols for various scanner models.

Methods:

Spatial resolution, contrast resolution, contrast-to-noise ratio (CNR) and subjective noise and sharpness were evaluated for a clinical ALADA dose reference protocol at 80 kV and 40 mA (CTDIvol 2.66 mGy) and compared with test protocols of two CT scanners at 100 kV and 35 mA (3.08–3.44 mGy), 80 kV and 54–61 mA (2.65 mGy), 80 kV and 40 mA (1.73–1.92 mGy), and 80 kV and 21–23 mA (1.00–1.03 mGy) using different kernels, filtered backprojection and iterative reconstructions. The test protocols with the lowest dose showing quality metrics non-inferior to the reference protocol were verified in a cadaver study by determining the diagnostic accuracy of detection of maxillofacial fractures and CNR of the optical nerve and rectus inferior muscle.

Results:

36 different image series were analysed in the phantom study. Based on the phantom quality metrics, potential ALADA dose protocols at 1.73–1.92 mGy were selected. Compared with the reference images, the selected protocols showed non-inferiority in the detection and classification of maxillofacial fractures and non-inferior CNR of orbital soft tissues in the cadaver study.

Conclusions:

Reference quality metrics from clinical ALADA dose protocols may be used to guide selection of potential ALADA dose protocols of different CT scanners.
Η δήμευση των προϊόντων νομιμοποίησης εσόδων από εγκληματικές δραστηριότητες
Authors: Κουτσουπιά Βικτωρία
Published: January 2023

Η παρούσα διδακτορική διατριβή πραγματεύεται το θέμα της δήμευσης των προϊόντων νομιμοποίησης εσόδων από εγκληματικές δραστηριότητες. Η νομιμοποίηση εσόδων από εγκληματικές δραστηριότητες δύναται χωρίς αμφιβολία να διαβρώσει την νόμιμη οικονομία, τους κυβερνητικούς μηχανισμούς και εν γένει την κοινωνική ευημερία και την ανάπτυξη μιας χώρας. Η δήμευση αποβλέπει στην ολική αποστέρηση των περιουσιακών στοιχείων του δράστη ή του τρίτου και την επαγωγή αυτών στο Δημόσιο κατά πρωτότυπο τρόπο. Ο σκοπός της διατριβής είναι να εξεταστούν όλες οι πτυχές της δήμευσης των προϊόντων νομιμοποίησης από εγκληματικές δραστηριότητες. Η παρούσα μελέτη διαρθρώνεται σε επτά κεφάλαια και αποβλέπει να προσεγγίσει σφαιρικά τα σχετικά με τη δήμευση των προϊόντων του εγκλήματος ζητήματα.Στο πρώτο κεφάλαιο γίνεται μια ιστορική αναδρομή της δήμευσης των προϊόντων του εγκλήματος. Στο δεύτερο κεφάλαιο περιγράφονται οι βασικές έννοιες και ζητήματα του ξεπλύματος βρώμικου χρήματος και της δήμευσης. Στο τρίτο κεφάλαιο εξετάζονται οι σχετικές νομοθετικές προβλέψεις τόσο στην Ελλάδα όσο και στην Ευρώπη. Γίνεται αναφορά και σε ορισμένες νομικές διατάξεις που περιλαμβάνονται σε διεθνείς συμβάσεις, σχετικά με τη δήμευση των εγκληματικών προϊόντων. Στο τέταρτο κεφάλαιο αναφέρονται διεθνή ζητήματα συντονισμού και συνεργασίας μεταξύ ευρωπαϊκών χωρών και διεθνώς σε διαδικασίες δήμευσης. Ακολούθως εξετάζονται οι προκλήσεις της σύγχρονης τεχνολογίες στο ξέπλυμα βρώμικου χρήματος και τη δήμευση των εγκληματικών προϊόντων. Τα κρυπτονομίσματα και τα κρυπτο- περιουσιακά στοιχεία χρησιμοποιούνται ως όχημα για ξέπλυμα παρανόμως κτηθέντων περιουσιακών στοιχείων και καθιστούν εξαιρετικά δύσκολη της δήμευση τους. Στο έκτο κεφάλαιο εξετάζονται ορισμένα ειδικά θέματα της δήμευσης όπως για παράδειγμα η δήμευση εις βάρος τρίτου, η δήμευση σε περίπτωση παραγραφής, δήμευση άνευ καταδικαστικής απόφασης καθώς και η χρήση των μαρτύρων δημοσίου συμφέροντος ως εργαλείου για την ενίσχυση της αποτελεσματικότητας της δήμευσης. Το τελευταίο κεφάλαιο αναφέρεται στην κοινωνική επαναχρησιμοποίηση των δημευθέντων εγκληματικών προϊόντων. Οι κοινωνίες μπορούν να επωφεληθούν σημαντικά από τα εγκληματικά προϊόντα σε περίπτωση όπου το κράτος αποφασίσει να εφαρμόσει ένα σχήμα κοινωνικής επαναχρησιμοποίησης. Ορισμένες χώρες παραδειγματικά εφαρμόζουν βέλτιστες πρακτικές επαναχρησιμοποίησης που θα μπορούσαν να αξιοποιηθούν ώστε να καταστρωθεί ένα συνεκτικό ευρωπαϊκό πλαίσιο κοινωνικής επαναχρησιμοποίησης.Μετά την ανάλυση όλων των ζητημάτων σχετικά με τη δήμευση των προϊόντων νομιμοποίησης εσόδων από εγκληματικές δραστηριότητες παρουσιάζεται μια σύνοψη των ανωτέρω και ορισμένα συμπεράσματα- προτάσεις.
Επαγγελματική ταυτότητα του Κοινωνικού Λειτουργού
Authors: Κομπότη Δέσποινα
Published: January 2023

Στην κοινωνική εργασία υπάρχουν διεθνείς, εθνικές και τοπικές διαστάσεις που συμβάλλουν στην ανάπτυξη μιας επαγγελματικής ταυτότητας, όπως ορισμοί, κώδικες δεοντολογίας, πρότυπα πρακτικής, επαγγελματικές ενώσεις και διαπιστευμένα εκπαιδευτικά προγράμματα. Μια επαγγελματική ταυτότητα κοινωνικής εργασίας βασίζεται στη βελτίωση των σχέσεων, στην επίτευξη περιβαλλοντικής βιωσιμότητας και στη διευκόλυνση της δίκαιης πρόσβασης σε ευκαιρίες. Η παρουσία και η ανάπτυξη της επαγγελματικής ταυτότητας είναι σημαντική στην άσκηση της κοινωνικής εργασίας. Η αντίληψη για την επαγγελματική ταυτότητα συντελεί στην ενίσχυση του ρόλου του ΚΛ , στην κινητοποίησή του, στη δέσμευσή του απέναντι στο επάγγελμα και στην ικανοποίηση που αντλεί μέσα από αυτό. Για την υλοποίηση του σκοπού αυτού πραγματοποιήθηκε εμπειρική έρευνα ώστε να διερευνηθούν και να καταγραφούν οι απόψεις των κοινωνικών λειτουργών, επί των παραμέτρων που συνθέτουν τις παραπάνω έννοιες. Η παρούσα μελέτη διερευνά το ζήτημα της διαμόρφωσης και έκφρασης της επαγγελματικής ταυτότητας μέσω μιας ερμηνευτικής φαινομενολογικής προσέγγισης επικεντρωμένη στη βιωμένη εμπειρία επαγγελματιών κοινωνικών λειτουργών οι οποίοι εργάζονται σε κοινωνικές υπηρεσίες σε ΟΤΑ στην Περιφέρεια Αττικής, χρησιμοποιώντας ημιδομημένη συνέντευξη και θεματική ανάλυση. Η μελέτη εντόπισε στοιχεία για μια αναδυόμενη επαγγελματική ταυτότητα, η οποία θα μπορούσε να περιγραφεί από την οπτική γωνία της επαγγελματικής συμπεριφοράς και της αυτοαντίληψης των ερωτηθέντων.Οι συμπεριφορές των ερωτηθέντων ήταν σε μεγάλο βαθμό συνεπείς με τον νέο επαγγελματισμό, την έμφαση που δίνεται στη σχέση χρήστη-παρόχου υπηρεσιών και θέματα εμπιστοσύνης, ενδυνάμωσης και ποιότητα εξυπηρέτησης. Αυτές οι συμπεριφορές αναδύθηκαν μέσω της προώθησης της ανεξαρτησίας, της αυτονομίας και της αυτοδιάθεσης των χρηστών των υπηρεσιών. Η αυτοαντίληψη των ερωτηθέντων για την επαγγελματική τους ταυτότητα τεκμηριώθηκε με ενισχυμένη αίσθηση ικανότητας και αύξηση της αυτοπεποίθησης που έφερναν στην καθημερινή τους εργασία και στις αλληλεπιδράσεις τους με συναδέλφους και άλλους επαγγελματίεςΗ έρευνα εντοπίζει μια σειρά επιρροών στην ανάπτυξη της επαγγελματικής ταυτότητας των εργαζομένων, συμπεριλαμβανομένων: εμπειριών ζωής πριν από την καριέρα·, περιβάλλον εργασίας, επιρροές από άλλους επαγγελματίες και συναδέλφους ,δια βίου μάθηση , επιρροή του προγράμματος επαγγελματικής εκπαίδευσης. Καθένας από αυτούς τους παράγοντες που επηρεάζουν μπορούν να αξιοποιηθούν θετικά ώστε να αναπτυχθεί μια ισχυρή επαγγελματική ταυτότητα κοινωνικής εργασίας προσανατολισμένη στις αξίες του επαγγέλματος και στην κοινωνική δικαιοσύνη. Η έρευνα έδειξε επίσης πολύ υψηλά επίπεδα δέσμευσης των εργαζομένων απέναντι στους χρήστες και αποκάλυψε την ανάγκη για ανάπτυξη δεξιοτήτων διαχείρισης συναισθημάτων στην καθημερινή εργασία, ενώ προτείνεται ότι αυτές οι πτυχές του ρόλου να αναγνωριστούν από εκπαιδευτικούς και εργοδότες. Τα ευρήματα της έρευνας μπορούν να βοηθήσουν στο σχεδιασμό προγραμμάτων υποστήριξης και ενίσχυσης της επαγγελματικής ταυτότητας των κοινωνικών λειτουργών στη Ελλάδα.
Μοριακοί μηχανισμοί ελέγχου της αυτοοργάνωσης και προσαρμοστικότητας στα φυτά
Authors: Τεμπλαλέξης Δημήτριος
Published: January 2023

Η πολική μεταφορά της αυξίνης ελέγχει την ανάπτυξη των φυτών και την ταχεία απόκρισή στα εξωτερικά ερεθίσματα. Ο μεταφορέας καλίου TINY ROOT HAIR 1 (TRH1)/ KUP4 ανήκει στην οικογένεια των μεταφορέων K+ uptake/ high-affinity potassium K+ /K+ transporter (KUP/HAK/KT) και είναι γνωστό ότι επηρεάζει την ομοιόσταση της αυξίνης στο ακρορίζιο ρυθμίζοντας τη μορφογένεση των ριζικών τριχιδίων και τον γεωτροπισμό της ρίζας. Ο μηχανισμός με τον οποίο όμως ένας μεταφορέας K+ σχετίζεται με τη διακίνηση μιας ορμόνης επηρεάζοντας την αρχιτεκτονική του ριζικού συστήματος παραμένει ακόμη άγνωστος. Στόχος της παρούσας διδακτορικής διατριβής ήταν να αποσαφηνίσει τις άγνωστες πτυχές λειτουργίας του συστήματος TRH1/KUP4.Για το σκοπό αυτό, αρχικά εφαρμόστηκε η προσέγγιση της ιστοειδικής έκφρασης του συστήματος TRH1/KUP4 υπό τον έλεγχο των προαγωγέων των γονιδίων PIN, η οποία κατάφερε να διαχωρίσει τις δυο στενά συνδεδεμένες ρυθμιζόμενες από την αυξίνη αναπτυξιακές αποκρίσεις της ρίζας. Η προσέγγιση αυτή αναδεικνύει τη σημασία της λειτουργίας του συστήματος TRH1/KUP4 στο ακροπεταλικό ρεύμα για το γεωτροπισμό της ρίζας, ενώ η τοποθέτηση του στο βασιπεταλικό ρεύμα φαίνεται ότι είναι καθοριστική για τη φυσιολογική μορφογένεση των ριζικών τριχιδίων. Η εφαρμογή αυξίνης ή αναλόγων της υποστηρίζει ότι το σύστημα TRH1/KUP4 ρυθμίζει κυρίως την εκροή αυξίνης. Η ανάλυση του μεταγραφώματος των διαγονιδιακών φυτών αποκάλυψε νέα γονίδια που φαίνεται να σχετίζονται με διάφορες βιολογικές διεργασίες, όπως η γονιδιακή έκφραση, τα οποία ρυθμίζουν την απόκριση της ρίζας στη βαρύτητα και τη μορφογένεση των ριζικών τριχιδίων, καθορίζοντας την αρχιτεκτονική του ριζικού συστήματος.Παράλληλα, δοκιμές σε όξινες συνθήκες αναδεικνύουν νέες πτυχές του συστήματος TRH1/KUP4 όσον αφορά την πλαστικότητα της ρίζας και την προσαρμογή της σε ακραίες συνθήκες. Σε χαμηλό pH τα φυτά αγρίου τύπου, εξαιτίας μεταβολής της ομοιόστασης της αυξίνης, εμφανίζουν τους φαινότυπους της μετάλλαξης trh1. Στις ίδιες όξινες συνθήκες τα φυτά της μετάλλαξης trh1 παρουσιάζουν υπερευαισθησία. Η απόκριση αυτή αναδεικνύει τη συμβολή του συστήματος TRH1/KUP4 στη μεταβολή του αναπτυξιακού προγράμματος της ρίζας ώστε να διασφαλιστεί η προσαρμογή της σε ακραίες εδαφικές συνθήκες. Η συνδυαστική ανάλυση των πειραμάτων παρατήρησης του pH της ριζόσφαιρας και της λειτουργικής κατάστασης των αντλιών πρωτονίων AHA στην κυτταροπλασματική μεμβράνη, αποκάλυψαν τη συνεισφορά του συστήματος TRH1/KUP4 στη διατήρηση της ιοντικής ισορροπίας των κυττάρων της ρίζας. Συγκεντρωτικά τα ευρήματα αναδεικνύουν μια ανεξερεύνητη πλευρά των μελών της οικογένειας μεταφορέων καλίου KUP/HAK/KT στα φυτά, υποστηρίζοντας ότι το σύστημα TRH1/KUP4 αποτελεί τον κύριο μηχανισμό αλκαλοποίησης της ρίζας, φαινόμενο το οποίο πρόσφατα συγκεντρώνει έντονο ερευνητικό ενδιαφέρον.
Τα διοικητικά ελεγκτικά σώματα στην Ελλάδα
Authors: Βάντζος Χρήστος
Published: January 2023

Η γοητεία του να ασχολείται κανείς σε επίπεδο έρευνας με τον έλεγχο είναι οι τόσο μεγάλων διαφορών πολυποίκιλες έννοιες που περικλείει. Παρεξηγημένη και άχαρη για πολλούς δραστηριότητα καθώς βρίσκεται πάντα είτε στο περιθώριο είτε στο τέλος μίας δραστηριότητας προκειμένου να προστατεύει τη φυσιολογική ροή αυτής καθώς και να αντλεί τα ζωτικά στοιχεία βελτιστοποίησης του όποιου σχεδιασμού, δεν είναι υπερβολή να ειπωθεί πως πρόκειται για τον αφανή ήρωα και το σημαντικότερο σκέλος κάθε πρωτοβουλίας, πόσο δε στον απαιτητικό τομέα της διοικητικής οργάνωσης και ιδιαίτερα της κρατικής. Πράγματι τα σώματα που έχουν αναλάβει το έργο της άκοπης δράσης για την εξεύρεση των όποιων φαινομένων διαφθοράς στο δημόσιο διοικητικό τομέα και τη γνωμοδότηση για χάραξη δράσεων που θα μετατρέψουν την πολύπαθη δημόσια υπηρεσία σε χρηστή και αποδοτική είναι ένα κομμάτι που δύσκολα κανείς μπορεί να φανταστεί πως είναι δυνατόν να απουσιάζει από τη συνολική κρατική λειτουργία. Ακριβώς για αυτούς τους λόγους έχει νόημα να αποσαφηνιστεί το κατά πόσο ο ρόλος του έχει αναγνωριστεί σε εγχώριο επίπεδο, το εάν η ίδια η απόδοση των ελεγκτικών σωμάτων σε επίπεδο διοίκησης έχει δικαιολογήσει το μέγεθος της αξίας τους ως διοικητικών εργαλείων και το ποια θα μπορούσε να είναι η περαιτέρω προοπτική του διοικητικού ελέγχου ως δράσης εντός του μανατζεριακού διοικητικού σχεδιασμού.
Μελέτη της συχνότητας εμφάνισης της Υπεργλυκαιμίας του stress σε παιδιατρικό πληθυσμό κατά τη νοσηλεία για οξέα συμβάντα και διερεύνηση των υπεύθυνων προγνωστικών παραγόντων
Authors: Αργυρόπουλος Θεόδωρος
Published: January 2023

Εισαγωγή: Ως Υπεργλυκαιμία του stress ,χαρακτηρίζεται η αύξηση των επιπέδων γλυκόζης αίματος ,επί απουσίας Σακχαρώδους διαβήτη, αλλά επί παρουσίας παραγόντων stress όπως λοίμωξη, τραύμα, έγκαυμα, χειρουργική επέμβαση, έμφραγμα μυοκαρδίου και σήψη. Αποτελεί απάντηση του οργανισμού στο βιολογικό stress που αναπτύσσεται στους ασθενείς κατά τη νοσηλεία τους.Σκοπός: Σκοπός της μελέτης ,είναι η καταγραφή του ποσοστού εμφάνισης της υπεργλυκαιμίας του stress σε αντιπροσωπευτικό πληθυσμό νοσηλευόμενων παιδιών ,τα οποία εισάγονται για νοσηλεία λόγω κάποιου οξέος συμβάντος και η διερεύνηση τυχόν αιτιολογικών παραγόντων.Υλικό-Μέθοδος: Υλικό της μελέτης αποτέλεσαν παιδιά ηλικίας 1-16 ετών που εισήχθησαν για νοσηλεία για διαφορετικά οξέα νοσήματα σε παιδιατρικό νοσοκομείο ή κλινική, χωρίς να νοσούν από Σακχαρώδη Διαβήτη.Διενεργήθηκε καταγραφή των ανθρωπομετρικών στοιχείων, των τιμών γλυκόζης, της χορηγούμενης φαρμακευτικής αγωγής και της διάρκειας νοσηλείας και διανεμήθηκε δομημένο ερωτηματολόγιο ,μέσω του οποίου, ελήφθησαν πληροφορίες για το ιατρικό και περιγεννητικό ιστορικό των γονέων.Αποτελέσματα: Μελετήθηκαν 1005 παιδιά με μέση ηλικία τα 6,48 έτη. Υπεργλυκαιμία (τιμές glu>126mg/dl) κατά την εισαγωγή στο νοσοκομείο, εμφάνισε ποσοστό 7,1 % των παιδιών ,ενώ κατά τη διάρκεια της νοσηλείας το 3,9 %.Ως προς το φύλο, παρατηρείται ελαφρά υπεροχή των κοριτσιών. Stress Υπεργλυκαιμία (τιμές Glu >140mg/dl), ανιχνεύθηκε σε, ποσοστό 2,29% επί του συνόλου των ασθενών .Παρατηρείται, στατιστικά σημαντική διαφορά στις μέσες τιμές γλυκόζης μεταξύ,των παιδιών που έκαναν χρήση κορτικοστεροειδών και εισπνεόμενων σαλβουταμόλης και αυτών που δεν έλαβαν ανάλογη αγωγή.Συμπεράσματα: Η χορήγηση κορτικοστεροειδών και Β2 διεγερτών, φαίνεται να συσχετίζεται με την εμφάνιση αυξημένων τιμών γλυκόζης. Η πλειοψηφία των παιδιών που ανέπτυξαν stress υπεργλυκαιμία ,νοσηλεύθηκε με εμπύρετες και αναπνευστικές λοιμώξεις. Η χορήγηση των αντιβιοτικών οποιασδήποτε κατηγορίας δε φαίνεται να σχετίζεται με την εμφάνιση υπεργλυκαιμίας. Η μέση τιμή γλυκόζης αυξάνεται παράλληλα με το χρόνο νοσηλείας των ασθενών.