bluuebunny/crossref_metadata_2025_split huggingface dataset:
Voisinage stratégique de l'Union européene
Authors: Dupuy Emmanuel 
Published: September 2013

Alors que le livre blanc sur la défense et la sécurité vient consacrer la notion de « profondeur stratégique », la France reste néanmoins en retard, en comparaison de ses partenaires orientaux de l’UE, dans son approche globale de la zone Mer Noire-Causase-Asie centrale. C’est pourtant là que s’y joue un nouveau « Grand Jeu », expression d’une Realpolitik réaffirmée, sur fond de sécurité énergétique, de proximité avec les foyers de crise que sont la Syrie, l’Iran et l’Afghanistan et « d’orientalisation » des relations internationales et de balancement diplomatique, économique et militaire vers l’Asie. D’où l’urgente nécessité pour l’UE de redécouvrir les vertus de l’ Ostpolitik .
Le « Printemps arabe » et la nouvelle donne de l'énergie
Authors: Simonet Loïc 
Published: September 2013

Au-delà de l’impact immédiat des évènements de ces deux dernières années sur le niveau de production des hydrocarbures en Afrique du Nord et au Moyen-Orient et sur les prix, le « Printemps arabe » a également généré un bouleversement de fonds de la donne énergétique, qui pourrait affecter, dans les années qui viennent, les relations entre États producteurs de la région et États consommateurs. Le phénomène est également observé de près par l’Iran et la Turquie, préoccupés tous deux de sauvegarder leur position de carrefour énergétique et dépendants pour ce faire de leurs voisins arabes.
Corruption, mode d'emploi
Authors: Pons Noël 
Published: September 2013

Cet article présente le cadre général des montages et des typologies corruptrices récurrentes : la petite et la moyenne corruption qui se matérialisent dans un échange direct entre corrupteur et corrompu ; la grande corruption ou la corruption des riches ou des élites qui relève d’une situation de rente ; la corruption dite des ingénieurs et du secteur privé, et enfin la corruption criminelle et le blanchiment. L’importance donnée aux manifestations matérielles de la corruption est due au fait que chaque montage est en premier lieu causé par une décision personnelle et qu’elle ne peut se développer sans la présence d’artifices comptables ou juridiques. Il faut donc savoir reconnaître les situations qui sont susceptibles de présenter des risques de corruption avant de s’engager dans toute autre analyse.
Chimeric Anti-CD14 IGG2/4 Hybrid Antibodies for Therapeutic Intervention in Pig and Human Models of Inflammation
Authors: Lau Corinna , Gunnarsen Kristin S. , Høydahl Lene S. , Andersen Jan Terje , Berntzen Gøril , Pharo Anne , Lindstad Julie K. , Ludviksen Judith K. , Brekke Ole-Lars , Barratt-Due Andreas , Nielsen Erik Waage , Stokes Christopher R. , Espevik Terje , Sandlie Inger , Mollnes Tom Eirik 
Published: September 2013

Abstract
CD14 is a key recognition molecule of innate immune responses, interacting with several TLRs. TLR signaling cross-talks extensively with the complement system, and combined CD14 and complement inhibition has been proved effective in attenuating inflammatory responses. Pig models of human diseases have emerged as valuable tools to study therapeutic intervention, but suitable neutralizing Abs are rare. Undesired Fc-mediated functions, such as platelet activation and IL-8 release induced by the porcine CD14-specific clone Mil2, limit further studies. Therefore, an inert human IgG2/IgG4 hybrid C region was chosen for an rMil2. As revealed in ex vivo and in vivo pig experiments, rMil2 inhibited the CD14-mediated proinflammatory cytokine response similar to the original clone, but lacked the undesired Fc-effects, and inflammation was attenuated further by simultaneous complement inhibition. Moreover, rMil2 bound porcine FcRn, a regulator of t1/2 and biodistribution. Thus, rMil2, particularly combined with complement inhibitors, should be well suited for in vivo studies using porcine models of diseases, such as sepsis and ischemia-reperfusion injury. Similarly, the recombinant anti-human CD14 IgG2/4 Ab, r18D11, was generated with greatly reduced Fc-mediated effects and preserved inhibitory function ex vivo. Such Abs might be drug candidates for the treatment of innate immunity-mediated human diseases.
Anterior communicating artery aneurysm presenting with vision loss
Authors: Shukla Dhaval P , Bhat Dhananjaya I , Devi Bhagavatula I 
Published: September 2013

ABSTRACTAnterior communicating artery aneurysm rarely presents with symptoms of compression of anterior visual pathways. We report a case of 65 years old man, who had complete loss of vision in right eye and temporal hemianopsia in left eye due to giant anterior communicating artery aneurysm.
Sensory profile and its impact on quality of life in patients with painful diabetic polyneuropathy
Authors: Kulkantrakorn Kongkiat , Lorsuwansiri Chakraphong 
Published: September 2013

ABSTRACT
Context: Painful diabetic polyneuropathy (PDN) is common and causes significant disability. The sensory profile in each patient is different and affects quality of life. Aim: To describe the demographic, details of sensory profile and its impact on quality of life in patients with PDN. Settings and Design: A cross-sectional survey in patients with PDN who were treated in a University Hospital. Materials and Methods: They were interviewed with standard questionnaires, which included neuropathic pain scale (NPS), a short-form McGill Pain Questionnaire (SF-MPQ) and a short form-36 quality of life survey (SF-36). Statistical Analysis Used: Descriptive statistics were used in demographic data. Student′s t test was used to analyze continuous data. Multiple comparisons for proportions and correlations were made using Fisher Exact test and Pearson′s coefficient of correlation, respectively. Results: Thirty three patients were included in this study. In NPS, sharp pain was the most common symptom and itching was the least common. Almost all patients had more than one type of pain. The mean VAS was 53 mm. In SFMPQ, the sensory score, affective score and the present pain score fell in the moderate range. In SF-36, physical functioning was the most affected and social function was the least affected. Conclusions: PDN significantly affects patients′ quality of life, especially physical function and role limitation due to a physical problem. Almost all patients have many types of pain and sharp pain is the most common.
Thoracic extraosseous, epidural, cavernous hemangioma: Case report and review of literature
Authors: Sharma Manish S , Borkar Sachin A , Kumar Amandeep , Sharma M. C. , Sharma Bhawani S , Mahapatra Ashok K 
Published: September 2013

ABSTRACTA 40-year-old male presented with mid-thoracic backache and progressive, ascending, spastic, paraparesis for one year. Magnetic resonance imaging demonstrated an extraosseous, extradural mass, without any bone invasion at the T2-T4 vertebral levels, located dorsal to the thecal sac. The spinal cord was compressed ventrally. The lesion was totally excised after a T2-T4 laminectomy. Histopathological examination revealed a cavernous hemangioma. The authors reported this case and reviewed the literature, to explain why extraosseous, extradural, cavernous hemangiomas should be considered in the differential diagnosis of extradural thoracic compressive myelopathy.
The “Skull Flap” a new conceived device for decompressive craniectomy/cranioplasty: Feasibility study on cadaver specimen
Authors: Chibbaro Salvatore , Tigan L , Marsella M , George B , Galzio R , Kehrli P , Vicaut E , Diemidio P 
Published: September 2013

ABSTRACT
Background: Decompressive craniectomy (DC) is a procedure that is currently performed with increasing frequency. The reason is that its indications have become much broader. This procedure may be associated with the relevant morbidity in the postoperative stage due to the creation of a large bone defect. On the other hand, cranioplasty is associated too with some of the common complications related to any reconstructive head surgery. The authors present a newly developed device: The “Skull Flap” (SF). This new device allows the surgeon to complete a DC, yet providing at the same time a cranial reconstruction that will not require the patient to undergo a second reconstructive procedure. Materials and Methods: Different size and location craniectomies were carried out on four human cadaveric heads; the bone flaps were then repositioned in a more elevated position with respect to the skull edges. The flaps were placed at a distance of 12 and 15 mm from the skull edges using the SF system. Crash tests were conducted on each flap while in open and closed positions to assess its reliability and efficacy. Results: SF was shown to be a strong fixation device that allows satisfactory brain decompression by keeping the original bone flap away from the swollen brain; at the same time, in a later stage, it allows cranial reconstruction in a simple way. Conclusion: The SF device was shown to be very easy to use, adaptable, and practical to apply; thus, allowing both satisfactory brain decompression as well as bone flap repositioning at a later time after the brain swelling has subsided.
Uncontrolled seizures resulting from cerebral venous sinus thrombosis complicating neurobrucellosis
Authors: Faraji Fardin , Didgar Farshid , Talaie-Zanjani Afsoon , Mohammadbeigi Abolfazl 
Published: September 2013

ABSTRACTCerebral venous sinus thrombosis is a rare form of stroke caused by thrombosis in venous sinuses of the brain. In this study, we reported on a patient with venous sinus thrombosis and brucellosis who presented with uncontrolled seizure despite being treated with anti-epileptic drugs at high doses. The case was a 33-year-old woman with a history of controlled complex partial seizure who presented with headache, asthenia, and uncontrolled seizure for one month. She was febrile and a brain CT scan indicated hemorrhagic focus in the left posterior parietal and the temporal lobe. Magnetic resonance imaging and magnetic resonance venography also proved venous sinus thrombosis in the left transverse sinus. Besides [In addition], a laboratory assessment confirmed brucellosis. Following the treatment with anti-coagulant, anti-brucellosis, and anti-epileptic agents, the patient was discharged in good condition with medical orders. Clinical suspicion and accurate evaluation of a patient′s history is the most important clue in diagnosis and treatment of brucellosis and cerebral venous sinus thrombosis, especially in uncontrolled seizure in patients who had previously been under control.
Endovascular treatment of acute ischemic stroke
Authors: Singh Paramdeep , Kaur Rupinderjeet , Kaur Amarpreet 
Published: September 2013

ABSTRACTEarly recanalization of the occluded artery leads to better clinical outcomes in patients with acute ischemic stroke (AIS) through protection of the time-sensitive penumbra. Intravenous administration of pharmacologic thrombolytic agents has been a standard treatment for AIS. To get better rates of recanalization, enhance the time window, and diminish the possibility of intracranial hemorrhage, endovascular thrombectomy was launched, with first authorization of the Merci clot retriever, a corkscrew-like apparatus, followed by approval of the Penumbra thromboaspiration system. Both devices lead to a high rate of recanalization. On the other hand, time to recanalization was on an average of 45 minutes, with most of the patients attaining only partial recanalization. More lately, retrievable stents have shown promise in decreasing the time to recanalization, and attaining a superior rate of complete clot resolution. The retrievable stent can be released within the clot to engage it within the struts of the stent, and afterwards it is taken back by pulling it under flow arrest. Neurointerventional techniques have a persistently ever-increasing and stimulating role in the management of AIS, as indicated by the advent of several important techniques. Stent retrievers have the capability to be ascertained as the most important approach to endovascular stroke treatment.
Hypothalamic glioma masquerading as craniopharyngioma
Authors: Vyas Sameer , Prabhakar Nidhi , Tewari Manoj Kumar , Radotra Bishan Dass , Khandelwal Niranjan 
Published: September 2013

ABSTRACTHypothalamic glioma account for 10-15% of supratentorial tumors in children. They usually present earlier (first 5 years of age) than craniopharyngioma. Hypothalamic glioma poses a diagnostic dilemma with craniopharyngioma and other hypothalamic region tumors, when they present with atypical clinical or imaging patterns. Neuroimaging modalities especially MRI plays a very important role in scrutinizing the lesions in the hypothalamic region. We report a case of a hypothalamic glioma masquerading as a craniopharyngioma on imaging along with brief review of both the tumors.
Nosocomial Escherichia coli meningitis in adults: Report of four cases and literature review
Authors: Khan Fahmi Yousef , Abukhattab Mohammed , Anand Deshmukh 
Published: September 2013

ABSTRACTWe report four cases of nosocomial E. coli meningitis, in male patients with accidental and neurosurgical trauma. The interval between accidents/neurosurgical procedures and the onset of meningitis was 2-15 days (mean 6.25 days). The most consistent clinical features were fever and deterioration of consciousness level. Emergence of extended spectrum beta lactamase E. coli strains had been observed in two (50%) of our cases and the mean duration of antimicrobial treatment was 16.5 days (range: 6-24 days). Two of the four patients (50%) died in the hospital.
Twelfth cranial nerve involvement in Guillian Barre syndrome
Authors: Nanda Subrat Kumar , Jayalakshmi Sita , Ruikar Devashish , Surath Mohandas 
Published: September 2013

ABSTRACTGuillian Barre Syndrome (GBS) is associated with cranial nerve involvement. Commonest cranial nerves involved were the facial and bulbar (IXth and Xth). Involvement of twelfth cranial nerve is rare in GBS. We present a case of GBS in a thirteen years old boy who developed severe tongue weakness and wasting at two weeks after the onset of GBS. The wasting and weakness of tongue improved at three months of follow up. Brief review of the literature about XIIth cranial nerve involvement in GBS is discussed.
Absence status seen in an adult patient
Authors: Hasan H , Demir Caner F , Cura Hasan S 
Published: September 2013

ABSTRACTAbsence status epilepticus (ASE) is a type of nonconvulsive status epilepticus in which continuous or recurrent generalized epileptiform discharges are associated with a varying grade of consciousness impairment. Absence status epilepticus may be obtained during progress of many epileptic syndromes, in several metabolic disturbances and related to use of several drugs. Absence status epilepticus is generally seen in childhood; rarely it can be seen in adulthood. In this paper, the case which has never diagnosed until now in spite of many absence seizures for years, applied for absence seizures to our clinic and diagnosed for juvenile absence epilepsy, has been discussed.
Factores de Riesgo para el Desarrollo de Complicaciones en las Toracostomías Cerradas por Trauma
Authors: Díaz Rocío I , Andrade-Alegre Rafael 
Published: September 2013

RESUMEN

Introducción
La toracostomía cerrada es un procedimiento quirúrgico considerado sencillo y ampliamente utilizado en pacientes con trauma torácico. Al ser un procedimiento realizado a ciegas, posee mayor probabilidad de complicaciones. En nuestro hospital se colocan alrededor de 315 tubos de tórax por trauma al año. El objetivo de nuestro estudio es determinar, de manera prospectiva, los factores de riesgo para el desarrollo de complicaciones en las toracostomías cerradas por causas traumáticas.

Metodología
Se trata de un estudio prospectivo, observacional tipo cohorte, de corte longitudinal. Durante un periodo de 7 meses, se incluyeron pacientes consecutivos con diagnóstico de trauma torácico cerrado o penetrante y a los que se les colocó un tubo de tórax por esta causa. La muestra consistió de 152 casos. Los datos se recolectaron utilizando el expediente clínico. Las variables fueron analizadas con un nivel de confianza del 95%.

Resultados
Predominó el sexo masculino (86.8%) y la edad promedio fue de 29 años. Un 37.5% de los pacientes presentó un Injury Severity Score mayor o igual a 16. Cuarenta y dos pacientes tuvieron algún tipo de complicación, lo que representa un 27.6% de la muestra. De este grupo, solo 14 pacientes requirieron un segundo drenaje pleural o una toracotomía abierta. La presencia de hemotórax resultó estadísticamente significativa para el desarrollo de complicaciones (p = 0.041), al igual que la incorrecta colocación del tubo de tórax (p = 0.006).

Conclusión
La toracostomía cerrada por trauma tiene una significativa morbilidad. La presencia de hemotórax es un factor de riesgo estadísticamente significativo para el desarrollo de complicaciones al igual que la incorrecta colocación del tubo de tórax. Proponemos la elaboración de un estudio prospectivo utilizando el ultrasonido como guía para la adecuada colocación del tubo de tórax y así determinar su utilidad en la disminución de complicaciones.
Impact of Low Fibrinogen Levels in the Puzzle of Traumainduced Coagulopathy: Is This the Missing Link?
Authors: Meade Peter , Duchesne Juan C , Park Timothy S , Simms Eric , Hoffman Jordan RH , Bock Jiselle M , Wascom Julie , Barbeau James , Jr Norman E McSwain 
Published: September 2013

ABSTRACT

Background
Patients with severe tissue injury and tissue hypoperfusion can present with low fibrinogen levels and signs of hyperfibrinolysis. The role of damage control resuscitation (DCR) in addressing the hyperfibrinolytic aspect of trauma induced coagulopathy (TIC) is unknown. We hypothesize a survival advantage when DCR is used in TIC patients with severe tissue injury and low fibrinogen levels.

Materials and methods
This is a 2 years prospective observational study of TIC patients who received DCR. TIC was defined as initial base deficit = –6 in combination with ISS = 12. Low fibrinogen was considered when serum level <200 mg/dl. Patients were stratified into those with an injury severity score (ISS) <20, and those with an ISS = 20. Variables analyzed between groups included: initial serum fibrinogen, INR, base deficit, intraoperative FFP: PRBC ratio and mortality.

Results
Of 67 patients with TIC, 29 (43.2%) had ISS < 20, and 38 (56.7%) an ISS ≥ 20. Mean ISS was 13.9 vs 32.8 (p < 0.0001) for the ISS < 20 group vs the ISS ≥ 20 group respectively. Mean initial fibrinogen levels for the ISS < 20 group vs the ISS ≥ 20 group was 357.4 mg/dl vs 148.5 mg/dl (p = 0.0007). Intraoperative DCR with FFP: PRBC for the ISS < 20 group vs the ISS ≥ 20 group showed no statistical difference: 1 to 1.12 vs 1 to 1.3 (p = 0.12). Overall mortality after controlling for DCR in the ISS < 20 group was 29 and 73% in the ISS ≥ 20 group (p = 0.0007). In a stepwise logistic regression, low fibrinogen levels was associated with mortality, p = 0.01; OR 1.01 (1.23-11.55) with area under the receiver operating characteristic curve of 0.701. The correlation coefficient for ISS vs initial fibrinogen level was –0.5635 (p = 0.0001).

Conclusion
Overall mortality was significantly increased in patients who had an ISS . 20 with low fibrinogen level despite effective DCR. Given the correlated decrease in fibrinogen levels in patients with severe tissue injury, further investigation regarding potential benefits of antifibrinolytic agents in DCR needs further validation.

How to cite this article
Duchesne JC, Guidry C, Park TS, Simms E, Hoffman JRH, Bock JM, Wascom J, Barbeau J, Meade P, McSwain NE Jr. Impact of Low Fibrinogen Levels in the Puzzle of Trauma-induced Coagulopathy: Is This the Missing Link? Panam J Trauma Critical Care Emerg Surg 2013;2(2): 74-79.
Penetrating Pelvic Injury: Cases Analysis
Authors: Díaz-Rosales Juan de Dios , Enriquez-Dominguez Lenin , Díaz-de-Sandi Ricardo , Jasso-de-León Antonio 
Published: September 2013

ABSTRACT

Background
Although, selective nonoperative management of penetrating pelvic injuries is a feasible, safe and effective alternative; lack of advanced imaging studies in developing countries to assess these patients, force us to perform more invasive procedures to treat them.

Study design
Cases analysis performing with patients with penetrating pelvic trauma underwent to laparotomy in General Hospital of Juarez City (Mexico), during January to December 2012.

Results
Among 44 patients with penetrating pelvic injuries and underwent laparotomy were included. There were 27 therapeutic laparotomies, 9 nontherapeutic laparotomies, 8 damage control laparotomies. Small bowel was the most affected organ, follow by both colon and rectum organ. Hypovolemic shock was the major cause of death and surgical site infections were the most common complications.

Conclusion
Despite, that nonoperative management is safe, penetrating wounds with transpelvic trajectory continue having an absolute indication for laparotomy in medical units in developing world.

How to cite this article
de Dios Díaz-Rosales J, Enriquez- Dominguez L, Díaz-de-Sandi R, Jasso-de-León A. Penetrating Pelvic Injury: Cases Analysis. Panam J Trauma Critical Care Emerg Surg 2013;2(2):80-82.
Effects of Methylprednisolone on Femoral Bone Marrow: Age-Dependent Susceptibility
Authors: Chan Wing P. , Kuo Tzong-Fu , Lin Yun-Ho , Chen Chia-Chun , Yang Shu-Ru , Huang Sydney , Jiang Ching-Chuan 
Published: September 2013

Purpose: We aimed to test our primary hypothesis that the effects of methylprednisolone on bone marrow in chickens are age-sensitive and increase with prolonged treatment and our secondary hypothesis that the effects of methylprednisolone on bone marrow can have individual effects. Methods: Sixteen control (group A) and 29 methylprednisolone-treated (group B) chickens were categorised by age: pubertal chicks (subgroups A1, B1), young hens (A2, B2), and adult hens (A3, B3). Histologic evaluation 12 to 50 weeks after the start of methylprednisolone treatment included fat cell proliferation, trabecular bone loss, necrosis of bone and marrow, and new bone formation in the femoral head, neck, and intertrochanteric area. Results: There were significant differences between groups A1 and B1 in new bone formation in the femoral neck (P = 0.048) and fat cell proliferation in the femoral head (P = 0.008) and neck (P = 0.048). New bone formation in the femoral head was also significantly different (P = 0.023) between groups A2 and B2. No differences were noted between groups A3 and B3 (all P>0.05). Necrosis of bone and marrow was observed in four control and three methylprednisolone-treated chickens (P>0.05). Significant new bone formation and fat cell proliferation in pubertal and young chickens occurred 12 to 19 weeks after administration of high-dose methylprednisolone. Conclusions: Younger animals may be more susceptible to methylprednisolone, and responses to methylprednisolone in femoral marrow may vary among individuals.