bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progressive restoration of spinal sagittal balance after surgical correction of lumbosacral spondylolisthesis before skeletal maturity
Authors: Thomas Diala , Bachy Manon , Courvoisier Aurélien , Dubory Arnaud , Bouloussa Houssam , Vialle Raphaël 
Published: January 2015

OBJECT
Spinopelvic alignment is crucial in assessing an energy-efficient posture in both normal and disease states, such as high-displacement developmental spondylolisthesis (HDDS). The overall effect in patients with HDDS who have undergone local surgical correction of lumbosacral imbalance for the global correction of spinal balance remains unclear. This paper reports the progressive spontaneous improvement of global sagittal balance following surgical correction of lumbosacral imbalance in patients with HDDS.

METHODS
The records of 15 patients with HDDS who underwent surgery between 2005 and 2010 were reviewed. The treatment consisted of L4–sacrum reduction and fusion via a posterior approach, resulting in complete correction of lumbosacral kyphosis. Preoperative, 6-month postoperative, and final follow-up postoperative angular measurements were taken from full-spine lateral radiographs obtained with the patient in a standard standing position. Radiographic measurements included pelvic incidence, sacral slope, lumbar lordosis, and thoracic kyphosis. The degree of lumbosacral kyphosis was evaluated by the lumbosacral angle. Because of the small number of patients, nonparametric tests were considered for data analysis.

RESULTS
Preoperative lumbosacral kyphosis and L-5 anterior slip were corrected by instrumentation. Transient neurological complications were noted in 5 patients. Statistical analysis showed a significant increase of thoracic kyphosis on 6-month postoperative and final follow-up radiographs (p < 0.001). A statistically significant decrease of lumbar lordosis was noted between preoperative and 6-month control radiographs (p < 0.001) and between preoperative and final follow-up radiographs (p < 0.001).

CONCLUSIONS
Based on the authors' observations, this technique resulted in an effective reduction of L-5 anterior slip and significant reduction of lumbosacral kyphosis (from 69.8° to 105.13°). Due to complete reduction of lumbosacral kyphosis and anterior trunk displacement associated with L-5 anterior slipping, lumbar lordosis progressively decreased and thoracic kyphosis progressively increased postoperatively. Adjusting the sagittal trunk balance produced not only pelvic anteversion, but also reciprocal adjustment of lumbar lordosis and thoracic kyphosis, creating a satisfactory level of compensated global sagittal balance.
Outcomes following surgical intervention for impending and gross instability caused by multiple myeloma in the spinal column
Authors: Zadnik Patricia L. , Goodwin C. Rory , Karami Kristophe J. , Mehta Ankit I. , Amin Anubhav G. , Groves Mari L. , Wolinsky Jean-Paul , Witham Timothy F. , Bydon Ali , Gokaslan Ziya L. , Sciubba Daniel M. 
Published: January 2015

OBJECT
Multiple myeloma is the most common primary tumor of the spine and is the most common primary malignant tumor of bone. Although spinal myeloma is classically a radiosensitive lesion, clinical or radiographic signs of instability merit surgical intervention. The authors present the epidemiology, surgical indications, and outcome data of a series of consecutive cases involving 31 surgically treated patients with diagnoses of multiple myeloma and plasmacytoma of the spine (the largest such series reported to date).

METHODS
Surgical instability was the criterion for operative intervention in this patient cohort. The Spinal Instability Neoplastic Score (SINS) was used to make this assessment of instability. The cases were analyzed using location of the lesion, spinal levels involved, Frankel score, adjuvant therapy, functional outcome, and patient survival.

RESULTS
All patients undergoing surgical intervention were determined to have indeterminate or gross spinal column instability according to SINS criteria. The median survival was 78.9 months. No significant difference in survival was seen for patients with higher SINS scores or for older patients (> 55 years). There was a statistically significant difference in survival benefit observed for patients receiving chemotherapy and radiation versus radiation alone as an adjuvant to surgery (p = 0.02).

CONCLUSIONS
In this 10-year analysis, the authors report outcomes of surgical intervention for patients with indeterminate or gross spinal instability due to multiple myeloma and plasmacytoma of the spine with improved neurological function following surgery and low rates of instrumentation failure.
Complications of Tonsillectomy, Adenoidectomy and Adenotonsillectomy in Chittagong Medical College Hospital
Authors: Chowdhury Abdul Qayum , Mojumder Dhanenjoy , Deb Nath Jishu 
Published: January 2015

It is a prospective study is done with materials of 100 cases of Tonsillectomy patient giving Proper attention to age, sex, Indication of operation, Clinical Presentation, Duration of Operation, Post operative complications. Altogether 100 Patients of whom 54 were male and 46 female, collected for a period of 6 months from 16th July 2001 to 15th January 2002 with maximum age group 48% were of 20+years and a sex ratio of Male: female 1.17:1 were included in the series the commonest indication is Recurrent tonsillitis was 83%. Among them clinical presentation, Patients presented with recurrent pain in throat (85%), History of Fever in 62% and difficulty in swallowing in 46%. Regarding duration of operation 40% Patients were operation within 30 to 39 minutes, 31% patients were operated within 40 to 49 minutes. In this Series, Complications that encountered after operation were hemorrhages both reactionary and secondary 1% and 2% respectively, operative local trauma in 4% cases and local infection in tonsillar bed in 6% cases. In this Series one patient needed second time general anaesthesia.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21047
Relationship of Various Prognostic Factors with Outcome of Treatment of Chronic Duodenal Ulcer Perforation Patients
Authors: Khan Sakhawat Mahmud , Alam Meer Mahbubul , Akhter Shahin , Alam Didarul 
Published: January 2015

Background: In acute abdominal conditions, chronic duodenal ulcer perforation is a very common surgical emergency that overwhelm the surgical ward throughout the year. Especially in the tropics and more in our country, peptic ulcer disease causes a major health problem. Objectives: To assess the usefulness of the prognostic factors in terms of morbidity and mortality in the treatment of perforated duodenal ulcer patient. Methods: This was a prospective study during the period from January 2003 to December 2003 in M.A.G. Osmani Medical College Hospital, Sylhet. The study included 100 cases of perforated chronic duodenal ulcer. Patients were randomly collected from all surgical units of SOMCH, Sylhet. Operation was done by simple closure with omental graft in all cases. Data analyzed by appropriate statistical method (Mean, SD & l2 test). Results: Highly significant relationship was found between increased age (>50 years) of patients with perforated duodenal ulcer and mortality (p<0.001). Lethality rate was higher in patients operated after 24 hours of onset of symptom in relation to patients operated within 24 hours of onset of symptom, (p<0.05). Different postoperative complications were prevalent in patients operated after 24 hours of onset of symptom, on the other hand complication rate was low in patients operated within 24 hours (p<0.001). There was also longer hospital stay in lately operated patients (more above median) than patients operated within 24 hrs (p<0.001). Mortality was higher in cases of purulent peritoneal fluid, where as it was nil in case of billous and serosanguinous fluid (p<0.001). More complications were developed in patients with purulent peritoneal fluid in comparison to billous and serosanguinous nature (p<0.001). There was more mortality in patients with preoperative shock in comparison with no features of shock (p<0.001). More complications were noted in patients with preoperative shock than in patients with no features of shock (p<0.01). Conclusion: Delayed operation, preoperative shock, more age and gross peritoneal sepsis bear a direct relationship with outcome of treatment chronic duodenal ulcer perforation patients.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21060
Clinical Presentation & Operative Treatment of Leiomyoma of Uterus and its Outcome
Authors: Das Rinku , Jafrin Rummana , Biswas Banita , Nahar Nazmun , Biswas Rajat Sanker Roy 
Published: January 2015

Introduction: Uterine leiomyoma is remarkably common, however only a subset of women have their fibroids clinically detected, symptomatic, or warrant surgical treatment. Mode of treatment depends on age of the patients, number, size and site of the myoma and also fertility status of the patients. Materials & methods: To evaluate the sociodemographic, clinical characteristics, management outcome and its determinants in BSMMU, Dhaka, Bangladesh, the study was carried out. 50 patients of diagnosed leiomyoma admitted in the BSMMU, Dhaka was selected for the study. Clinical profile, type of surgery and postoperative follow up findings were noted. Data was analyzed by computer based software SPSS  18.Results: The common complaints among the 50 patients were progressive menorrhagia (70%), abdominal swelling (50%), infertility (24%), weight in pelvis (38%), weakness/dizziness or syncopal attack after menstrual period (26%) and recurrent miscarriages (12%). The average uterine size at presentation was 15±9.7 weeks. The majority (70%) of the women presented with multiple leiomyomata. The commonest anatomical position of the myomas were multiple positions and intramural(80%). Total abdominal hysterectomy with or without bilateral sulphingo ophorectomy according to age was the commonest surgical procedure performed in thirty two (64%) cases. Myomectomy was done in 12(24%) cases and laparoscopic assisted vaginal hysterectomy was done in also 6(12%) of patients. Postoperative complications occurred in 24%(12) of the women. The most common complications were postoperative pyrexia 12%, blood loss warranting transfusion 8%, wound infection 10% and prolonged hospital stay 6%.Conclusion: Uterine fibroid is common in our environment and most of the patients had regular menstrual cycle with progressive menorragia. Its removal is commonly associated with post-operative pyrexia, blood loss, and anemia and wound infection. Preoperative correction of anemia appropriate use of antibiotics and strict hemostasis and asepsis can reduce these complications.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21061
Complimentary Feeding Practices in Under-2 Children
Authors: Paul Shanjoy Kumar , Islam Quazi Rakibul , Roy Sunirmal , Rudra Pranab Kumar 
Published: January 2015

Background: Complimentary feeding (CF) practices are quiet frustating in our country. Innaproprite foods in first two years of life have detrimental impact on health and growth of children. The aim of the study was to see the present pattern of CF practices, to identify wrong practices and to develop awareness among medical professionals so that they may encourage appropriate practices more vigorously for reducing child mortality and morbidity.Methods: A cross-sectional study was conducted from October, 2011 to December, 2011 in the Pediatric department (indoor and outdoor) of Sir Salimullah Medical College Mitford Hospital, Dhaka and in a private chamber of a district town of Bangladesh. Four hundred motherchild pairs were selected by non-random convenience sampling method. 6-24 months old children and children under six months (if was on complimentary feeding) were included. Data was collected from the mothers/caregivers of the children in a pretested semi-structured data collection sheet and analyzed by SPSS version 12. Appropriate statistical tests were done. Statistical significance was considered if p value was <0.05. Results: Early initiation was very high (49.25%). Most common first complimentary food was rice gruel with milk (26.56%). Most common current main complimentary food (25.52%) and most common main complimentary food fed in last 24 hours (26.82%) was also rice gruel with milk. Amount of complimentary food per feed was inappropriate in most cases. Frequency of CF was not appropriate in many cases. Fast foods and commercial cereal were given to 54.8% & 33.33% children respectively. Only 1% mothers/caregivers had sound knowledge about CF. Positive support from family regarding practicing appropriate CF was found in 24.75% cases. Feeding practices were mostly influenced by relatives (25%).Conclusion: CF practices are still not ideal in our country. So, all possible interventions should be applied to improve it and thus to improve child survival.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.21020
Iron Status in Malnourished Children : A Cross Sectional Study
Authors: Ferdousi Shormin Ara , Biswas Rajat Sanker Roy , Paul Nayan Kanti , Karim Mohammed Rezaul 
Published: January 2015

Objectives: Malnutrition is a common condition among children and iron status varies in different types of malnutrition. So the present study is aimed to find the different iron status among severe malnourished children in our context. Methods: A hospital based cross sectional study was done in the Paediatrics ward Chittagong Medical College Hospital in a period of 6 months from January to July 2013 among the 50 cases of malnourished children of age range between 1 to 5 years and Weight for Height Z score(WHZ) was <-2 SD. Sampling technique was continuous purposive sampling. Venous blood was collected to assay the different iron profile mainly serum iron level, total iron binding capacity(TIBC) and transferrin saturation(TSAT). Data was analyzed after correction by SPSS-19. Results: Among the 50 study children of different age groups 15 patients were 1 to 2 years, 18 patients were 2 to 3 years, 10 patients were 3 to 4 years and 7 patients were at 4-5 years of age groups. Among the patients, 29 (58%) of patients were female and 21(42%) of the patients were male. Most of the children were from the families of low socioeconomic status 38(76%). 2(4%) children were from upper middle class who had step mother. Among the selected patients the dominating clinical features were anemia was found among 45(90%) of patients which was mild(66.6%), moderate(26.6%) and severe(6.6%). Skin changes(32%), eye changes (10%) and hair changes(48%) were also found. Among the 50 study subjects prelacteal feeding was given among 43(86%) children, breast feeding was given 45(90%), exclusive breast feeding was given to 24(48%) of children and complementary feeding after 6 months was given to 29(58%) patients. Among the 50 patients -2 to -3 SD weight for height was found in 20(40%) patients and <-3 SD was found in 30(60%) patients. Most of the children was found to have Mid Upper Arm Circumference (MUAC) 115-125 mm(50%). Iron status was measured among all patients where serum iron level was found 77.72 ± 11.22 mcgm/dl, TIBC was found 340.07 ± 22.67 mcgm/dl and transferrin saturation was found 22.38 ± 2.9 %. Iron status were measured among the different types of malnutrition where serum iron level and transferrin saturation was high among all patients with malnutrition while TIBC was lower than standard level in all patients. Different biochemical status were measured among the different types of malnutrition where serum total protein, serum albumin, Hb% were lower than standard level in all patients.Conclusion: Change in different iron status is a common findings in malnourished children. Screening of all children for anemia and providing iron and folic acid (IFA) or multiple micronutrients (MMN) supplements to children and Infant and Young Child Feeding (IYCF) should be addressed at all level to overcome the situation.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.21024
Self-Reported Need for Psychotherapy Predicts Interferon-Induced Depression in Hepatitis C: Stratification for Interferon-Free Treatment
Authors: Staufer Katharina , Scherzer Thomas-Matthias , Miehsler Wolfgang , Reichhold Daniel , Kienbacher Christian , Ferenci-Förster Daniela , Hagmann Michael , Ferenci Peter , Moser Gabriele 
Published: January 2015

Background Interferon (IFN)-induced depression occurs in approximately 30% of chronic hepatitis C (CHC) patients undergoing pegylated (PEG)-IFN-based antiviral therapy. While IFN-free therapy has been developed, it is not accessible to all CHC patients due to the high costs of treatment. This study evaluated the Assessment of Demand for Additional Psychological Treatment (ADAPT) questionnaire as a screening tool for patients at risk of IFN-induced depression, in order to identify patients who may uniquely benefit from IFN-free regimens. Methods In this prospective study, consecutive patients being treated for CHC with PEG-IFN-based antiviral therapy were examined for the occurrence of depression during a 12-week treatment period. Using univariate and multivariate regression models, the value of the ADAPT questionnaire, in comparison to the Hospital Anxiety and Depression Scale (HADS), and the patients’ psychiatric history was analysed. Results A total of 103 patients (59% male; median age 42) were included, of whom 25% (26/103) developed IFN-induced depression during the study period. HADS-Depression (D) subscale (OR=1.187, P=0.003; area under the curve [AUC]=0.690) and ADAPT-Psychotherapy (PT) subscale (OR=1.020, P=0.006; AUC=0.695) showed the highest accuracy for identification of patients at risk for depression. A HADS-D score of ≥7 and an ADAPT-PT score of ≥37.8 showed a similar sensitivity (61.5% versus 57.7%), whereas ADAPT-PT showed a more favourable specificity (68.9% versus 77.4%). Conclusions The ADAPT-PT subscale effectively identifies patients at risk for IFN-induced depression and should therefore be taken into account when allocating patients to IFN-free antiviral treatment regimens.
A Novel Ritonavir Paediatric Powder Formulation is Bioequivalent to Ritonavir Oral Solution with a Similar Food Effect
Authors: Salem Ahmed Hamed , Chiu Yi-Lin , Valdes Joaquin M , Nilius Angela M , Klein Cheri E 
Published: January 2015

Background A novel ritonavir oral powder formulation has been developed to eliminate the alcohol and propylene glycol contents in the current ritonavir oral solution for paediatric use. Two clinical studies were conducted to assess the bioequivalence of the powder formulation to the marketed oral solution and to evaluate the effect of food and vehicles on bioavailability. Methods Study 1 was a randomized, partial-crossover, 4-period study in 48 subjects. Regimens included: oral solution under moderate-fat conditions, powder formulation in water under fasting, moderate-fat or high-fat conditions, and powder formulation in chocolate milk or pudding under moderate-fat conditions. Study 2 was a randomized, crossover, 4-period study in 24 subjects. Subjects were randomized to a sequence of the oral solution and powder formulation in water, infant formula and apple sauce, all under moderate-fat conditions. Bioavailability comparisons were assessed by the 90% CIs for the geometric least-squares mean ratios. Results Ritonavir powder formulation in water was found to be bioequivalent to the marketed oral solution. Ritonavir powder formulation administered in chocolate milk, pudding, infant formula or apple sauce was bio-equivalent to the powder formulation administered in water. Compared with fasting conditions, moderate-fat and high-fat meals were associated with approximately 25–40% and 35–50% reduction in ritonavir concentrations, respectively. Conclusions The novel ritonavir powder formulation is bioequivalent to marketed ritonavir oral solution under moderate-fat conditions with a similar effect of meals. None of the vehicles tested negatively affected the bioavailability, which suggests the potential for use of a broad range of vehicles for dose preparation.
Maigrir à l'adolescence : d'un processus de décontenance du corps familial à un enveloppement institutionnel
Authors: Sanahuja Maria de la Almudena , Schwailbold Marie-Anne , Cuynet Patrice 
Published: January 2015

Cet article soulève la difficulté majeure que rencontrent certaines institutions spécialisées dans le traitement de l’obésité pédiatrique pour travailler avec les familles. Ces familles sont au cœur de la problématique de ces jeunes : la séparation de l’enfant d’avec ses proches est la base thérapeutique, mais la dépendance est forte et la séparation d’avec les parents, la mère en particulier, difficile. Dans une perspective psychodynamique, les auteurs, chercheurs en psychologie, partent du postulat que l’obésité d’un individu serait révélatrice de conflits intrapsychiques, intersubjectifs, mais aussi d’un symptôme familial transgénérationnel impactant la contenance du groupe. L’institution pourrait alors assurer une fonction substitutive de contenance auprès de ces familles en fragilité d’enveloppes psychiques. À partir d’un exemple clinique institutionnel, l’article montre l’impact dynamique de divers dispositifs thérapeutiques sur l’évolution de l’accompagnement des familles en souffrance de séparation.
Formes électorales et conception de la communauté dans les communes italiennes (12 e -14 e siècle)
Authors: Keller Hagen , Renault Didier , Sintomer Yves 
Published: January 2015

L’article livre une synthèse de l’évolution des formes électorales et de la conception de la communauté dans les communes italiennes du 12 e au 14 e siècle. Celles-ci firent preuve d’une étonnante inventivité politique. Elles multiplièrent les « votes de compromis » à plusieurs échelons, furent avec l’Église l’un des foyers de l’introduction du vote majoritaire et, à partir du 13 e siècle, eurent massivement recours au tirage au sort. Dans cette dynamique s’entrecroisaient des conflits sociaux, des débats procéduraux et une conception normative qui pensait les modes de scrutin en fonction de l’objectif de désignation des candidats les plus impartiaux, les plus justes et les plus utiles pour l’harmonie communale – une logique fort différente des élections dans les démocraties modernes.
La classe dirigeante de Florence au tournant du 14 e et 15 e siècle
Authors: De Angelis Laura , Boutier Jean 
Published: January 2015

L’article s’attache aux dynamiques du pouvoir politique à l’intérieur de la Florence de la première Renaissance lorsque, à l’intérieur d’un cadre institutionnel pourtant presque inchangé par rapport aux grandes réformes des premières décennies du 14 e siècle, la conduite de la cité et de l’État fut assurée avec force par une classe dirigeante toujours plus unie autour des familles d’ancienne tradition citadine. Cette classe dirigeante, définie dans son extension numérique et dans ses caractéristiques de représentation sociale, promut une figure nouvelle de « professionnel » de la politique, qui concernait peut-être près d’un dixième de la population mâle adulte de la cité au début du 15 e siècle.
Le régime de Côme de Médicis au moment de son arrivée au pouvoir (1434)
Authors: Fubini Riccardo , Saint-Upéry Marc 
Published: January 2015

En 1434, Côme de Médicis rentra à Florence après un an d’exil à Venise. Ce retour marqua le début d’un processus majeur de changement politico-institutionnel, qui aboutit à terme à l’instauration d’un principat (1530-1532). Ce « moment 1434 » ne fait pas pour autant l’objet d’un consensus historiographique. Le pouvoir médicéen reposait toujours sur le même groupe de citoyens privilégiés, base du pouvoir politique depuis les années 1380 ; il n’opéra dans un premier temps aucun changement constitutionnel, mais instaura un recours régulier à l’extraordinaire, qui transforma de fait la réalité des pratiques politiques. À partir d’une relecture critique de la vie politique florentine des années 1380 aux années 1450, l’article pose la question essentielle des fondements du constitutionalisme florentin.