bluuebunny/crossref_metadata_2025 huggingface dataset:
Survey of Urinary Aflatoxin Levels Among Residents of Makueni County, Kenya: A Follow-Up Study
Authors: Buuri Martin , Gicheru Michael , Mutiso Joshua , Mulakoli Festus
Published: April 2021

Although fungi are known to be less pathogenic and mostly saprophytic in their nature as compared to other groups of microbes, those that produce aflatoxin have been associated with severe human disease. An example of such disease is Aflatoxicosis caused by soil-borne pathogenic fungi of the species Aspergillus parasiticus and Aspergillus flavus. They produce a mycotoxin substance that is carcinogenic to the human liver with severe outcomes. The objective of this study was to determine urinary aflatoxin levels among the residents of Makueni County, previously affected by Aflatoxicosis.

This was a cross-sectional study that involved the use of primary data collected from 106 participants. The method for data collection included a structured questionnaire and the collection of the urine samples for aflatoxin M1 analysis at Bora Biotech Laboratories LTD. The urinary levels of AFM1 were detected by use of an ELISA kit. Data was entered in SPSS and analysed through Chi-Square for the association.

The study participants, including both male and female, had an age of between 15 and 91 years and with an average age of 41±18. Out of the 106 study participants, n=68 (72%) were females and n=26 (28%) were males. Majority of the study participants were with a median age of 24 years old. AFM1 levels were detected in 99.1% % of all urine samples at a range of 25-2337 pg./ml. The mean and median concentration of AFM1 in urine was 637.6 ± 512.7and 525 pg./mL, respectively.

The results of this study provide information on the current situation of aflatoxin exposure. From what is evident from our study a lot needs to be done to mitigate on the long-term effect of this high exposure.  Therefore, the study encourages the concerned ministry to have a broader focus on the extent of aflatoxin food contamination from this region plus other regions across the country.
La réception de la littérature classique grecque et latine du IXe au XIIe siècle. Une étude comparative
Authors: Olsen Birger Munk
Published: April 2021

O artigo se propõe a examinar a recepção da literatura clássica grega e latina dos séculos IX ao XII, baseando-se nos manuscritos e fragmentos conservados das obras de um corpus de cinqüenta autores gregos e cinqüenta autores latinos. Os resultados da pesquisa mostram que os testemunhos no Ocidente são singularmente mais numerosos que os de Bizâncio. Para as vinte e cinco obras mais conhecidas, assinalamos, por exemplo, cerca de três mil cópias de textos latinos contra aproximadamente duzentos textos gregos, o que torna problemático o estabelecimento de estatísticas signi?cativas para o domínio bizantino. Esse desvio pode ser explicado de muitas formas, antes de tudo pelo papel importante, no Ocidente, dos clássicos no ensino dos mosteiros, que fazem copiar em seus scriptoria coleções geralmente consideráveis de livros escolares. Em Bizâncio, ao contrário, os mosteiros, tendo uma concepção bem diversa da cultura monástica, parecem não ter tido nenhum papel na transmissão da literatura antiga. Assim sendo, os livros clássicos deviam encontrar-se essencialmente nas bibliotecas privadas dos amadores esclarecidos ou dos mestres, e eram menos estáveis e numerosas do que as pessoas morais do Ocidente.
Call For Paper _nº3_ Espacio público y tejido social_arte colaborativo en tiempos de crisis
Authors: López Moreno Ignacio , Tejeda Martín Isabel
Published: April 2021

El equipo editorial de Umática –Revista para el análisis de la imagen y la creación–y el proyecto de Investigación El barrio como escenario de pedagogías críticas y arte colaborativo (PGC2018-094351-B-C42), del Ministerio de Economía y Competitividad, invitan a investigadores/as y creadores/as a revisar las claves teóricas, metodológicas y prácticas asociadas al empuje que desde el impacto de la crisis de 2008 han recibido aquellas políticas participativas o colaborativas en la gestión y en la creación artística vinculadas al barrio como contexto específico. Con un amplio recorrido durante las últimas décadas, los esquemas de trabajo colectivo que han definido estas apuestas perfilan hoy más que nunca, en plena crisis sanitaria y económica producida por el COVID-19, nuestras posibilidades de respuesta artística o cultural.
The Concept of Waqf-Syirkah for Community Food Security
Authors: Wildana Muhammad Dandy Alif , Kafabih An’im
Published: April 2021

Food is essential for human survival, and ensuring its availability is critical. Waqf is present as one of supporting institutions that supports food security. This paper aims to see how waqf can contribute to the food security of a community. Waqf, in its sense is an Islamic philanthropic institution that focus on welfare of Muslim. As a Muslim, it is important to safeguard one’s life as stated in Maqasid As Shariah. This paper employs systematic literature review to see the contribution of waqf through syirkah (partnership) for community food security. Syirkah plays its role as a connector between waqf and food security, with farmers at its spearhead. Syirkah is chosen because it is compatible with farmer’s business and waqf may serve to their business sustainability in general, and farmer’s livelihood in particular. The ultimate goal of this concept is to achieve stability in the supply of staple food which leads to its price stability, hence staple food is available and accessible to all. Furthermore, the stability achieved will reduce the burden of government to provide staple food in times of crisis and to promote welfare and better social cohesion of a community.
Control of a Four-wire Hybrid Prosumer Converter for Balancing Utility Grids
Authors: Łukasz Kwaśny , Zieliński Dariusz
Published: April 2021

The paper presents the project of the power electronic AC/DC converter operating under a multiresonant control algorithm for prosumer applications. This design allows independent control of active and reactive power for any or each phase. Both the converter and its algorithm are based on a three-phase converter of four-wire topology (AC/DC 3p-4w) with a DC bus, which couple the converter to a renewable energy source and energy storage. Further, model and simulation tests were carried out in the Matlab-SIMULINK programming environment. The results obtained indicate that operation with deep unbalances and powers of opposite signs in individual phases results in current variations (oscillations) in the DC line, which is a significant limitation, and it can be concluded that the level of asymmetry should be limited to the level acceptable to the energy storage device.
Studi evaluasi kualitas visual lanskap koridor Jalan Sumbersari – Gajayana Kota Malang
Authors: Setyabudi Irawan , Budiyono Debora , Pernandes Fedrich
Published: April 2021

The corridor landscape that is on a commercial road with a lot of user activity can affect the visual quality of the road corridor landscape. The Sumbersari-Gajayana road corridor is one of the commercial roads that has centers of education to economic activities and services. The problem is the large number of community activities that are not supported by the width of the road resulting in congestion, the number of shop houses for businesses, the lack of parking space, narrow and disconnected pedestrians, the number of banners and billboards, so the combination of these facts disturbs the visual quality of the road corridors, however, some point is precisely the potential that must be preserved. This study used the analysis technique of Scenic Beauty Estimation (SBE) and Semantic Differential (SD) with 30 respondents who were students of Landscape Architecture. The evaluation results show that the corridor landscape of Jalan Sumbersari-Gajayana has high (T), medium (S), and low (R) aesthetic qualities which have a relationship between SBE and SD analysis techniques on the aesthetic elements of the road corridor landscape.
Trashed
Authors: Peoples Ashley , Stanley Caitlin , Labute Justine , Atherly Sacha , Turcon Beth
Published: April 2021

Our performance piece, entitled Trashed, initially grew from three central questions 1) What is the role of testimony in recording history and/or current affairs? 2) What role can theatre play in communicating personal testimony? and 3) How does a person (or people) perform testimony? To explore these questions, we took on the following personal testimony: A young man in high school was giving blood and 45 minutes in, the administrators re‐read his form, realized he had checked the box saying he had had sex with a man (since 1977) and promptly took his bag of blood and dropped it in a garbage can. We were all struck by this story and particularly by the image of blood in a garbage can; however, as five heterosexual women we were unsure if and how we could communicate the testimony to an audience. Working from the idea that our responsibility to the issue is our “ability to respond,” our performance piece became a manifestation of these abilities. We chose to use movement‐based clown to enter and explore the material from a neutral space—clown negates specific characteristics such as gender or social orientation. Combining objective fact with clown allowed us to visually represent the issue, our confusion surrounding the issue and our physical disconnect with the issue as performers. Our hope is to achieve a performance that serves the original testimony emotional justice while allowing an audience to engage with the related issue on multiple levels.
A Different Perspective on Canadian History: The Canadian Wing of the Art Gallery of Ontario’s New Design
Authors: Sevcik Jackie
Published: April 2021

The issue of representation within the grand Canadian historical narrative is a topic that re‐opens previous notions about the accepted version of the Art Historical canon. While there are many aspects of Canadian Art History that are celebrated as true notions of national identity, there are many indigenous groups and ideas that do not meet the criteria to be included in the canon and are thus, not represented. This paper examines the contemporary Canadian Wing at the Art Gallery of Ontario (AGO) and will focus on showing the changes made to the gallery and how this will help Canadians understand what it means to be Canadian. What is interesting about this newly renovated wing is that the curatorial staff has successfully managed to show Canadian history from a contemporary perspective. By choosing to recognize the importance of different aspects of Canadian history to the understanding of Canadian identity, the AGO takes old practices and turns them into new traditions.
4. Diatom‐based Paleolimnological Assessment of Long Term Water Quality Trends, Near Forrest Island, Lake of the Woods, Ontario
Authors: Jenkin Ashley
Published: April 2021

Lake of the Woods (LOW) is a large, international freshwater body that shares borders with Ontario, Manitoba, and Minnesota. Previous studies from the LOW have found that water quality is spatially variable in this complex lake. The current perception is that cyanobacterial blooms have increased in frequency and intensity, generating much interest in determining whether increased nutrients have resulted in water quality deterioration. To address this concern, paleolimnological techniques will be used to examine changes in diatom assemblage over the last ca. 200 years on a dated sediment core retrieved near Forrest Island, close to the city of Kenora, Ontario. Comparisons will be made to other LOW sites that are elevated in total phosphorous (TP) and experience algal blooms (impact sites) as well as a site with low TP that does not experience algal blooms (reference site). Based on the Forrest Island diatom shifts, the following questions will be examined: (1) What is the baseline condition of this site? (2) Have diatom assemblages and/or water quality changed over time? (3) If so, are these changes comparable to other LOW sites?; and (4)What are the potential mechanisms for these changes? To aid our interpretation, a diatom‐based inference model for TP will be applied downcore to examine whether TP concentrations have changed over the last few centuries. Additionally, other mechanisms such as recent warming will also be examined. Results from this study could have important implications related to the impacts of multiple stressors on the LOW
11. Exploring Various Factors and Sources in Relation to Environmental Contaminants in the Rideau Canal System
Authors: Lai Cynthia
Published: April 2021

The Rideau Canal has served several purposes since its establishment in 1832. Acting as a channel connecting Ottawa and Kingston, it was often used for the transport of commercial goods and lumber. Over time, its uses expanded to include recreational purposes such as: sport fishing, boating, cottaging, and tourism. This increased development and use has caused the Rideau Canal and its watersheds to become vulnerable to metal contamination. Studies within Dr. Linda Campbell’s Lab at Queen’s University have shown that cadmium (Cd), lead (Pb), chromium (Cr), zinc (Zn), mercury (Hg), arsenic (As), and copper (Cu), are in concentrations that have reached or exceeded the level of potential concern for both aquatic and human health. This study explores the potential sources as well as both natural and human factors which could be related to the influx in metal contaminants within the system. A literature review of both historical and recent documents was completed and supplemented with personal interviews with professionals and community members. Based on these investigations, the primary sources being reviewed are: atmospheric deposition, natural geological processes, and anthropogenic factors relating to residential development. While research is still ongoing preliminary analysis suggests that these are the primary sources of contamination within the area.
Sexual relationships and self-esteem: Why do Women Get the Short-End of the Stick?
Authors: Craig-Broadwith Morgan
Published: April 2021

My study will investigate sex differences in the relationship between number of sexual partners and self-esteem. Previous research has found a moderate positive relationship between number of sexual partners and self-esteem in men, while finding a strong negative relationship in women. Women who engage in more short-term sexual relationships are left feeling vulnerable, depressed, and have lower scores of self-esteem. Men on the other hand, appear to have an ego boost with the more short-term sexual partners they have. Why is this? My study, using an evolutionary psychological perspective, will investigate the relationship between number of sexual partners and self-esteem in hopes of piecing together why men and women are affected so differently.
Hematocrit Sign Elucidates Cause of Abdominal Pain
Authors: Lam Jeffrey , Montague Steven
Published: April 2021

A 78-year-old male with chronic kidney disease on peritoneal dialysis developed unprovoked bilateral pulmonary embolisms. He was started on IV unfractionated heparin, but shortly thereafter developed severe pain and a small firm abdominal nodule near his dialysis catheter site. The diagnosis was unknown, and the initial plan was watchful waiting, until point-of-care ultrasound (POCUS) was used. POCUS revealed an ovoid mass with hyperdensity in the gravity dependent regions with spontaneous movement. This appearance was classic for the hematocrit sign. When combined with the clinical presentation, this was concerning for a rectus sheath hematoma. An urgent CT of the abdomen confirmed this several hours later. POCUS allowed for rapid bedside diagnosis, which expedited appropriate care in a potentially life-threatening situation.
Evaluation of Diagnostic Imaging Capacity and the Role for Point-of-Care Ultrasound (POCUS) within the Zanzibar Health System
Authors: Fasina Abiola A. , Dean Anthony J. , Panebianco Nova L. , Shofer Frances S. , Ali Omar , Yahya Mwajuma , Ismail Salim , Henwood Patricia C.
Published: April 2021

Background: The Zanzibar Ministry of Health identified access to ultrasound (US) as a system priority due to limited diagnostic imaging capacity and consequent impact on patient care and requested a needs assessment in this regard. As a result, the objective of this study was to assess diagnostic imaging capacity focusing on ultrasound in Zanzibar, including health care providers’ (HCPs) current training, use, and barriers to implementation.  Methods: A previously published ultrasound needs assessment survey was modified and administered on-site at the eight public hospitals in Zanzibar among a convenience sample of HCPs. Demographics, perceived US needs, current training and practice, and availability of specialty support were assessed. HCPs also completed focused personal interviews (FPIs) to explore experience with training, interests, and barriers to ultrasound. On-site diagnostic imaging modalities were assessed.  Results: There were nine ultrasound machines present at six of the eight public hospitals assessed. All had x-ray, but only one had a CT scanner and a radiologist. There was no MRI capacity at the hospitals assessed at the time of the study. Survey data among 40 participants revealed that prior experience with POCUS was limited with only 10% reporting any prior ultrasound training or experience.  The majority of those surveyed (72%), indicated a ‘high’ interest in learning ultrasound.  Of those reporting interest in POCUS applications, obstetrics was the most often cited (70%). Lack of ultrasound machines (40%) and educators (28%) were identified as the greatest barriers. Conclusion: HCPs in Zanzibar have limited access to diagnostic imaging, including ultrasound, and expressed a high level of interest in learning point-of-care ultrasound. A shortage of machines and educators are the main barriers to widespread use. Obstetrics is the application for which ultrasound is currently most used and is the application HCPs are most interested in learning. Equipment and educational support for a POCUS program could improve care by increasing access to diagnostic imaging.
SOVIET REPRESSIONS AGAINST THE CLERGE OF THE GREEK CATHOLIC CHURCH IN 1944–1947 (ON THE EXAMPLE OF FR. IVAN KOTIV’S BIOGRAPHY)
Authors: Haliv Mykola , Ohar Anna
Published: April 2021

Summary. Based on the prosopographic approach and analysis of the Fr. Ivan Kotiv biography the article studies the forms and methods of Soviet repressions against the Greek Catholic clergy. The purpose of the article is on the example of the relations of the Soviet special bodies with Fr. Ivan Kotiv to analyze and cover the repressive activities against the Greek Catholic Church in 1944–1947. The research methodology is based on prosopographic approach, principles of historicism, scientific, authorial objectivity, application of general scientific (deduction, induction, analysis, synthesis, generalization) and special historical (historical-genetic, historical-systemic, historical-typological) methods. The novelty of the study is that for the first time in Ukrainian historical science an attempt has been made to shed light on the repressive activities of the Soviet authorities against the Greek Catholic clergy through the prism of a prosographic analysis of the activities of Fr. Ivan Kotiv, one of the informal leaders of the Greek Catholic clergy in the liquidation of the GCC. The Conclusions. Thus, on the example of the relations of the Soviet special bodies with Fr. Ivan Kotiv analyzed and covered the repressive activities against the GCC in 1944–1946. In our opinion, the repressive policy of the Soviet authorities towards the clergy of the GCC during the outlined period can be divided into several stages: 1) stage of "soft pressure" (August 1944 – March 1945), which was characterized by careful study and analysis of the internal situation of the GCC, personality traits of leading figures among the Greek Catholic clergy, gradual propaganda and intelligence training of the Union Church to join the ROC, dissemination of rhetoric individually and through the media and study the clergy the idea; 2) the stage of organizational and repressive pressure (April 1945 – March 1946), which was marked by the arrests of the top of the GCC, the creation and operation of the CIG, neutralization of opposition attempts led by K. Sheptytsky and I. Kotiv to conduct special operations to "reunite" churches; 3) the stage of total repressions against the clergy, which did not recognize the decisions of the Lviv Pseudo-Council (March 1946 – May 1947). In fact, all these stages are quite clearly traced in the relationship of Fr. I. Kotiv with the Soviet authorities, and thus his activity in the period under study is quite representative and prosopographically relevant for understanding the complexity of the GCC in the restoration of the Soviet totalitarian regime in the Western Ukraine in the first postwar years.
M.I. GAVRILENKO’S SCIENTIFIC PROGRESS IN 1940–50s
Authors: Rohozha Mariya
Published: April 2021

Summary. The purpose of the research is to reveal the peculiarities of the naturalist M.I. Havrylenko (1889‒1971) research work during the 40’s ‒ 50’s years of the twentieth century; to show his personal ability to study nature in terms of the tendency attitude to the scientist in the postwar period, due to the peculiarities of the biography. The research methodology is based on the principles of historical reliability, objectivity, systemcity, multifactoriality, scientificity and comprehensiveness; use of general scientific research methods (analytical, synthetic, logical, classification); historical (problem-chronological, comparative-historical, historical-genetic, retrospective) and interdisciplinary. The scientific novelty lies in the fact that it is the first time in modern history the scientific heritage of the zoologist M.I. Havrylenko on the basis of his published works during the 40’s ‒ 50’s years of the twentieth century is learned. It is established that, despite the negative attitude of society to the scientist, he continued working productively. To form scientifically reliable results of studying different classes of animals, he used the methods of zoology, as well as botany, anatomy, osteology, physiology, physical geography, geology, paleontology, ecology, biocenology and other sciences. Conclusions. After almost twenty years’ study of the vertebrate fauna of Poltava region, the scientist obtained several fundamental results: 1) identified changes in species quantity, 2) deepened the knowledge of little-known animal species, 3) studied the herpetofauna of Poltava region, thus expanding his own scientific interests, 4) clarified the issue of zoogeography of black grouse in historical retrospect, 5) conducted a comparative species analysis of birds of the genus Ocheretyanka for different ecotopes in the biogeocenosis, 6) conducted an analysis of new and little-known bird species in the Poltava region in the space-time continuum (1929‒1958), 7) continued the formation of a unique ornithological collection, importantly. In general, it is emphasized that the scientific progress of the zoologist M.I. Havrylenko during this period was productive and effective.
Analisis Pengaruh Komitmen Organisasi Terhadap Semangat Kerja Pegawai Kantor Dinas Pertanian Kota Bima
Authors: Wardimansyah Wardimansyah , Wulandari Wulandari
Published: April 2021

This study aims to determine the effect of organizational commitment on employee morale in the Agriculture Office of the City of Bima. The criteria set by the researcher as the sample in this study were the employees of the Civil Service Office (ANS) at the main service with a total of 61 people using purposive sampling technique, namely the method of selecting samples based on certain criteria. Based on the results of data processing using SPSS version 23.0, the following results were obtained: This type of research is associative with a population of 52 employees based on the Slovin formula. The constant value is positive at 22.559 and the oefficient of organizational commitment variable is 0.378, so the regression equation can be written: Y = 22.559 + 0.378X, and the correlation coefficient (R) = 0.222. This means that the variable organizational commitment (X) in explaining the morale variable (Y) is in the low category. R Square value of 0.049. This means that the contribution of the organizational commitment variable (X) to morale (Y) is 0.49%, while 46.5% is influenced by variables outside of this research model. For the t-test, two parties reject the alternative hypothesis (Ha) which states that organizational commitment has no effect on morale in the agricultural department of the city of Bima (H0 is accepted).
Formación emprendedora en alumnos del área económico-administrativa, complejo regional nororiental BUAP
Authors: Salazar Arriaga José Juan , Ortigoza Hernández Anita , Reyes Arellano Ana María , Hernández Ojeda Alicia
Published: April 2021

La educación para el emprendimiento ha cobrado mayor importancia en las Instituciones deEducación Superior, por lo que este trabajo de investigación se realizó con el objetivo deanalizar la formación para la actividad emprendedora de los alumnos del área económicoadministrativadel Complejo Regional Nororiental de la Benemérita Universidad Autónomade Puebla (BUAP) desde tres enfoques: 1.- educación y formación en la Universidad parael emprendimiento, 2.- actitudes y percepciones del alumno sobre el emprendimiento, 3.-formación y actividad emprendedora en la familia. El estudio fue de tipo exploratorio ydescriptivo, se basó en el instrumento para la recolección de datos del GlobalEntrepreneurship Monitor (GEM), los principales hallazgos son: satisfacción con losconocimientos y preparación adecuada y de calidad por parte de la Universidad y lalicenciatura que cursan, perciben como buena opción al emprendimiento, tienen planes para iniciar un negocio o empresa, consideran al emprendedurismo como una vía para gozar de un estatus social alto y se perciben como individuos con habilidades para crear una empresa, sin embargo existe otro porcentaje considerable de estudiantes con indecisión sobre la cultura del emprendimiento. Con relación a la formación y actividad emprendedora en la familia, más del 50% de los encuestados no poseen formación para la actividad del emprendimiento por la ausencia de negocio o empresa de tipo familiar, los padres de los alumnos de Contaduría Pública emprenden por oportunidad mientras que en el caso de Administración de Empresas lo hacen por una mezcla de necesidad y oportunidad y finalmente el perfil del emprendedor se caracteriza por una educación básica.
Stablecoin: una fuente de inversión en tiempos de crisis económicas
Authors: Ordóñez Sánchez Sergio Gabriel , Sánchez Ruanova Salvador , García Franco Cesar Alejandro , Padilla López Abner Noel
Published: April 2021

A medida que la situación económica a nivel global es afectada por la crisis económica provocada por el COVID-19, las empresas y usuarios del sistema financiero, buscan la mejor herramienta para reactivar sus fuentes de trabajo y obtener ingresos. La mayor problemática de los inversionistas es saber qué activos son los ideales para inyectar dinero y poder enfrentar esta situación, manteniendo su dinero en forma estable. El objetivo es determinar si las Stablecoin en el mercado de las Criptomonedas son viables como instrumento de inversión en tiempos de crisis, Se desarrolló una investigación exploratoria realizando consultas de manera documental además de aplicar un instrumento tipo encuesta y obtener los datos de usuarios que se desenvuelven en el sistema Blockchain, limitando el estudio a los tokens: DAI y TUSD (criptomonedas definidas como stablecons). Obteniendo viable utilizar las Stablecoin en tiempos de crisis como opción segura, ya que están respaldadas por dinero FIAT y Criptomonedas, obteniendo rendimientos competitivos.
Assessment of efficacy of laryngotracheal reconstruction with autogenous rib cartilage graft
Authors: Zawadzka-Głos Lidia , Jabłońska-Jesionowska Monika
Published: April 2021

Introduction. Subglottic stenosis may lead to respiratory failure, especially in newborns and small children. It is the most common indication for tracheostomy in order to maintain airway patency in this age group. Subglottic stenosis requires surgical treatment. Laryngotracheal reconstruction with autogenous rib cartilage graft is one of the many treatment methods. Aim. The aim of the study was to assess of efficacy of laryngotracheal reconstruction with autogenous rib cartilage graft. Material and methods. Clinical data of 8 children operated for subglottic stenosis has been analysed. The severity of stenosis was assessed during the endoscopic examination with the Myer?Cotton Grading System. The efficacy of treatment was understood as a possibility of decannulation. Results. The study group included 8 patients: 6 boys and 2 girls. All the children had been born prematurely between the 24th and 34th week of pregnancy and were intubated in the early neonatal period. In 5 cases, decannulation followed, and in 3 cases, the treatment proved to be not effective enough, as the children had additional health problems. Conclusions. Prematurely born children intubated in the early neonatal period are at risk of post-intubation subglottic stenosis. Laryngotracheal reconstruction with autogenous rib cartilage graft is an effective treatment method. Treatment outcomes are also dependent on the overall health status of the patient and coexisting tracheal lesions.
Ocular compications in ethmoiditis in children treated in a reference laryngological academic center
Authors: Drohobycka Iryna , Zawadzka-Głos Lidia
Published: April 2021

Introduction. One of the most commonly diagnosed upper respiratory diseases is sinusitis. A particular form of sinusitis in children is ethmoiditis. Due to the location of ethmoidal cells, their inflammation is associated with higher risk of complications compared with inflammation of other sinuses. Aim. The aim of the study was to assess the prevalence, severity and management of ocular complications of ethmoiditis in the retrospective material of the reference laryngological academic center. Material and Methods. The retrospective analysis included 41 patients with ocular complications of ethmoid sinusitis who were hospitalized in the Department of Pediatric Otolaryngology in the years 2012–2017. The analysis included the severity of complications on Chandler’s scale, management and results of culture of the material obtained during surgery. Results. The study included 25 boys (60%) and 16 girls (40%) aged from 3 months to 16 years. Mean age of the patients was 5.34 years (SD = 3.98). According to Chandler’s scale, retroseptal complications were diagnosed in 12 patients (29.27%), and anteroseptal complications – in 29 patients (70.73%). Surgical treatment was performed in 12 patients (29.27%), 8 of whom (66.7%) underwent external ethmoidectomy with orbital drainage, and 4 of whom (33.3%) underwent functional endoscopic sinus surgery (FESS). Consistent findings of CT scan with lesions found during surgical intervention were found in 10 patients (83.3%). Fifteen different pathogens were isolated from the material collected during the procedures. In more than half of the patients (53.3%), the pathogen was a staphylococcus. Al the patients with retroseptal ocular complications underwent combination therapy consisting of surgical management and two intravenous antibiotics targeted for the etiological factor. The most frequently used antibiotics included 3rd generation cephalosporins and clindamycin. Conclusions. In children with ethmoiditis treated in a reference laryngological academic center, anteroseptal complications occurred twice as often as retroseptal complications. Most cases did not require surgical intervention.
Corynebacterium pseudodiptheriticum – a dangerous respiratory pathogen. A case report
Authors: Michalik Michał , Podbielska-Kubera Adrianna , Samet Alfred , Dmowska-Koroblewska Agnieszka , Broda Marcin
Published: April 2021

We believe that an insufficient role is attributed to bacteria belonging to the genus Corynebacterium in the pathogenesis of chronic sinusitis. These strains are treated as contaminants in most cases. Meanwhile, Corynebacterium strains may be a clinically significant pathogenic agent, especially in cases where samples are collected from the lower respiratory tract in symptomatic patients. Corynebacterium strains can survive in the form of biofilms in hospitals and cause multi-resistant infections. We present a rare case of Corynebacterium pseudodiptheriticum infection. The patient was a 10-year-old girl who complained of recurrent rhinitis and sinusitis. Adenoidectomy and functional endoscopic sinus surgery were performed. The patient returned for a consultation after six months due to exacerbation of the disease symptoms lasting for 2 weeks (inflow of thick secretions difficult to expectorate). Corynebacterium pseudodiptheriticum and Staphylococcus epidermidis were cultured from swabs. The patient was treated with ciprofloxacin, and her condition improved. The described case points to the need to identify strains of a given species and to pay attention to species commonly considered as commensals that may contribute to serious complications.
Faciocranial complications of sinusitis
Authors: Michalik Michał , Podbielska-Kubera Adrianna
Published: April 2021

Sinusitis is one of the most common conditions. The aetiology of sinusitis has not been fully discovered; however, viruses and bacteria are usually the dominant causes. The chief symptoms include nasal congestion, profuse nasal discharge and a compromised sense of smell. Inflammation of any sinus can be the source of complications. Complications develop usually as a result of exacerbation of chronic sinusitis. Sinusitis may result in inflammation spreading inside the cranium and to the orbital area and in the development of osteomyelitis or superior sagittal sinus thrombosis. Due to the anatomical location and proximity of important structures, sphenoid sinusitis may lead to meningitis or subdural empyemas, temporal lobe abscesses and cavernous sinus thrombosis. Fungal sinusitis is very dangerous since it is characterised by a rapid course often complicated by intracranial and orbital spread. Invasive fungal paranasal sinusitis with orbital complications is a life-threatening emergency. If there is concern about possible orbital or intracranial complications of sinusitis or if there is no improvement after initial empirical therapy, the use of diagnostic imaging is necessary, including computed tomography and magnetic resonance imaging. Early diagnosis of sinusitis and multidisciplinary management involving a combination of antibiotic therapy and surgical treatment, including neurosurgery and maxillofacial procedures can be effective in the prevention of complications and may significantly reduce morbidity and mortality.
Adenoidectomy and adenotonsillotomy in patients treated in the Department of Paediatric Otorhinolaryngology of the Medical University of Warsaw in 2018 – a retrospective analysis
Authors: Lis Tomasz , Zawadzka-Głos Lidia
Published: April 2021

Introduction. Adenoidectomy and adenotonsillotomy are among the most common surgical procedures worldwide. Sleep-related breathing disorders and recurrent upper respiratory tract infections are two primary categories of indications for adenoidectomy and adenotonsillotomy. Aim. The aim of this study was to analyse selected adenoidectomy and adenotonsillotomy procedures performed in the Department of Paediatric Otorhinolaryngology of the Medical University of Warsaw in 2018. Material and methods. A total of 474 patients aged between 11 months and 18 years, who underwent adenoidectomy and adenotonsillotomy in the Department of Paediatric Otorhinolaryngology of the Medical University of Warsaw in 2018, were included in the study. Data on age, gender, length of hospital stay, as well as additional diagnoses in adenoid hypertrophy or adenoid and palatine tonsil hypertrophy were collected. Minor surgeries performed in addition to tonsillectomy were also evaluated. Results. A total of 472 patients underwent adenoidectomy and adenotonsillotomy in 2018. Adenotonsillotomy was almost twice more common. Tonsillar hypertrophy was accompanied by exudative otitis media in almost 1/3 of children, and ear ventilation tubes were needed in almost 1/5 of children. Mean hospital stay equaled 4.19 ± 1.44 days. Conclusions. We have shown that adenotonsillotomy was the most common procedure in the Department of Paediatric Otorhinolaryngology. Exudative otitis media was the most common concomitant diagnosis, and middle ear ventilation was the most common additional procedure. Hospital stay usually lasted 3 days.
Indications for tympanostomy tube insertion in children
Authors: Wolniewicz Maria , Zawadzka-Głos Lidia
Published: April 2021

Introduction. Tympanostomy tube insertion is one of the basic paediatric otolaryngological procedures. Otitis media with effusion (OME) is the primary indication for elective qualification for this procedure. Currently, there are no recommendations suggesting pharmacotherapy for effusion. In cases of recurrent otitis media or acute complications of otitis media, tube insertion is a method of choice to support systemic antibiotic therapy. Aim. The main aim of this study was to evaluate indications for tympanostomy tube insertion. Secondary aims included characteristics of the study population and an intraoperative assessment of the tympanic membrane. Material and methods. We conducted a retrospective analysis of ear tube placement procedures performed in the Department of Paediatric Otorhinolaryngology of the Medical University of Warsaw between January 1, 2018 and December 31, 2018. Results. A total of 213 children (aged between 2 months and 18 years) underwent tympanostomy tube insertion and a total of 368 tubes were placed due to otitis media with effusion in 2018 in the Department of Paediatric Otorhinolaryngology of the Medical University of Warsaw. Elective tube insertion accounted for 69.48% of procedures. Recurrent otitis media (22.07%), complications of acute otitis media and, most of all, acute mastoiditis (23.33% of urgent procedures) came second. In a large majority of cases, Mikolow tympanostomy tubes were placed; in isolated cases, long-term tympanostomy tubes were used (14 T-tubes, 7 Paparella tubes). Mucous effusion dominated (62.44%). Ear tube placement alone was performed in more than half of cases (62.44%), while in 1/3 of patients the procedure was combined with adenoidectomy. Microscopically confirmed tympanic lesions indicative of advanced inflammation were found in 28 patients (13.14%). Conclusions. Although commonly accepted, tympanostomy tube insertion is not devoid of negative consequences. Possible complications include persistent tympanic perforation, tympanosclerosis, premature extrusion of an ear tube, ear discharge, tube obstruction and, in some cases, the need for surgical tube removal. Therefore, the procedure requires permanent and systematic otolaryngological care.
Assessment of the utility of ultrasonography and microbiology in the treatment of peritonsillar abscess in children
Authors: Piotrowska Alicja M. , Frąckiewicz Magdalena , Zawadzka-Głos Lidia
Published: April 2021

Introduction. Peritonsillar abscess is the most common deep neck and head space infection. It mostly occurs in young adults and teenagers, usually during the infectious season; at the turn of November and December as well as April and May. The peak incidence coincides with the highest incidence of streptococcal pharyngitis. Aim. A clinical analysis was performed in patients with peritonsillar abscess symptoms to determine the role of ultrasound imaging as a diagnostic tool confirming this condition. Material and methods. A retrospective, non-randomised study conducted in a group of 20 patients aged between 1 and 17 years, who were hospitalised due to peritonsillar abscess or infiltration in the Department of Paediatric Otolaryngology. Ultrasonography of the neck was performed in all patients in the study group to assess the presence of a fluid reservoir on the symptomatic side. Results. Ultrasound imaging revealed the presence of fluid indicative of abscess in 12 cases. Incision and puncture were performed in all these patients. Purulent content was obtained in 11 cases. Conclusions. Ultrasound was found useful in detecting the presence of an abscess and differentiating between peritonsillar infiltration and abscess.
Trzyipółletni chłopiec z malformacją Chiariego typu I – opis przypadku
Authors: Worch Anna , Wielopolska Małgorzata
Published: April 2021

Chiari malformation is the most common structural defect of the posterior fossa and cerebellum, consisting of displacements of hindbrain inclination through the foramen magnum, often associated with syringomyelia. In the most common type I of this disease, only the cerebellar tonsils are descended. Chiari type I malformation may remain asymptomatic in early childhood, however a number of unspecific symptoms, such as: neck pains and headaches, vertigos, balance and sight disorders, may strengthen with age. Because of unspecificity and various exacerbation of symptoms the disease is often misdiagnosed or undiagnosed. We describe a case of a 3.5-year old boy with whom his mother visited a pediatrician because of a chronic cough. During the examination mother of the patient informed that all infections start with vomiting and the patient is not able to stand up from horizontal position without turning first to the side and then to the abdomen. During the examination, a large head circumference was noticed (56 cm, > 97 percentile). MRI showed elongated cerebellar tonsils descended below the foramen magnum (left 14 mm, right 11 mm). Chiari malformation type I with associated syringomyelia was diagnosed. The patient was reffered to neurosurgery consultation.
Nowoczesna tomografia komputerowa w diagnostyce wybranych wad wrodzonych żył płucnych
Authors: Roik Danuta , Brzewski Michał , Werner Bożena
Published: April 2021

An excellent spatial and temporal resolution of computed tomography (CT) provides for precise evaluation of congenital cardiac malformation in selected group of patients. CT allows for quick, simultaneous assessment of all chest structures, such as pulmonary vessels, lung parenchyma and bones. Recent advances in CT hardware and software result in fast scanning of large anatomic ranges with a single lamp rotation without the need for patient's sedation and breath hold. The only limitation of CT is nowadays the exposure to ionizing radiation but with the new generation of scanners equipped with iterative reconstruction it is possible to reduce applied radiation dose while maintaining image quality. CT evaluation of pulmonary venous anomalies is well described, accurate for determining the site of anatomic obstruction in anomalous pulmonary venous return and has been shown to be highly specific when compared to operative findings. This article presents short review on current possibilities of CT diagnostic management of selected congenital pulmonary venous malformations.
Diagnostyka radiologiczna artropatii hemofilowej
Authors: Bokwa-Dąbrowska Katarzyna , Łaguna Paweł , Matysiak Michał , Brzewski Michał
Published: April 2021

Hemophilia is a genetic bleeding disorder which leads to numerous complications including arthropathy. Early diagnosis makes it possible to implement early prophylactic treatment and may be a chance to avoid permanent disability. The aim of this study was to discuss all imaging methods helpful in hemophilia diagnostics. The discussion includes indications, contraindications and limitations of each imaging method. Apart from plain radiographs and ultrasound, 3T MRI was discussed closely. It is impossible to predict the severity of hemarthrosis or the complications in hemophilia in children. Marked injuries do not result from each bleeding episode, but no rule may be indicated here. Early radiological assessment of the joint facilitates a clear identification of visible injuries. MRI diagnostics is becoming more accessible, it is thought that such examinations should be performed on a routine basis in patients with hemophilia in order to complement primary prophylaxis.
Guz lewej komory serca u nastolatka
Authors: Prowotorow-Iwaniukowicz Anna , Kucińska Beata , Godlewski Krzysztof , Brzewski Michał , Werner Bożena
Published: April 2021

Asymptomatic 17-years-old boy with a suspicion of the heart tumor was admitted to the Cardiology Department for further investigation. Due to the murmur over the heart echocardiography was performed revealing a bright mass near the left ventricular apex. He was in a good physical condition, no symptoms like chest pain, shortness of breath, syncope, palpitations were reported. On physical examination diminished heart sounds and systolic murmur 2-3/6 in the Levin’s scale over the heart were found. Laboratory data including troponin T, CK, CK-MB, NSE, urea acid, marker were within normal limits. On ECG abnormalities of the repolarization were recorded (ST segment depression and T waves inversion in the II, III, aVF leads). Transthoracic echocardiogram revealed a 4.7 x 5.8 cm tumor within the postero-lateral wall of the left ventricle, without left ventricular inflow nor outflow obstruction. Based on cardiac magnetic resonance hemangioma supplied from the right coronary artery was suspected. Cardiac catheterization was performed, the left ventricular mass with supply from vascular network of the right coronary artery was confirmed. No abnormalities of the central nervous system in magnetic resonance were found. Full-body positron emission tomography showed cardiac mass without any evidence of extra-cardiac fluorodeoxyglucose-avid disease. Cardiac hemangioma was recognized. Pharmacological treatment with propranolol was introduced without any impact on the tumor size during 6 months follow-up.
Pierwotna małopłytkowość immunologiczna u dzieci
Authors: Dusza Anna , Matysiak Michał
Published: April 2021

In this article we present current investigation on primary immune thrombocytopenia in children. There are described pathomorphology, clinical symptoms, diagnosis and treatment. We also present current data from literature about genetic tests and latest data on treating options in children. Primary immune thrombocytopenia (ITP) is one of the most frequent hematological disorders in pediatric population. Although the majority of children have a self-limited and short duration of the disease. However, approximately 20-30% of those patients can develop chronic ITP, which can cause significant complications and higher mortality and reduced quality of life. Especially regarding to long-term immunosupression or surgical interventions, such like splenectomy and restrictions on daily activities to avoid trauma. Over the past decades a lot of informations has been reported about pathogenic features of ITP. Nowdays, we know that it is not only caused by increased platet destruction and decreased platet production, but also complex, multifactorial immune dysregulation, like loss of immune tolerance and generation of platelet autoantibodies. In this article we present current investigation on ITP including clinical symptoms, diagnosis, pathomorphology and latests options on treatment in children. We also present current data about genetic biomarker, such as Vanin-1 (VNN-1) which has been suggested as one of predictors of chronic disease and potentially can offer early prognosis estimation.