bluuebunny/crossref_metadata_2025_split huggingface dataset:
Overview of University Sport in Iran
Authors: Mirsafian Hamidreza , Mohamadinejad Azadeh 
Published: November 2011

Overview of University Sport in IranThis article focuses on the structure and management systems of sport at Iranian universities. The method of this research was through an analysis of documents. Sport in the system of Iranian universities is divided into three different categories. The physical education department of the Ministry of Science, Research and Technology of Iran is responsible for sport at universities in the country, and managing sport affairs. Authority was granted to secretariats in the various regions so that decision making would be decentralized due to the large size of the country and the large number of universities in the various geographical regions. Due to this great geographical diversity, universities should continue their activities under the supervision of sport secretariats in their given regions. The participation of students in sport activities at Iranian universities was calculated in three categories; students with different interests and skills can participate in various numbers of sports, championships, and sport festivals. At this time, with regards to the scientific attitudes towards sport and physical activities and the expanding culture of sport at Iranian universities, the number of participants in sport activities is increasing. In the conclusion it is stated that improving the knowledge and attention of students regarding the importance of sport in different aspects of education and life, as well as the recognition of present barriers and support of campus volunteers, could help to increase the participation of students in sport activities. Moreover, the allocation of more power and authority to each region, as well as holding different local and traditional sport festivals, could help to improve the development of sport at Iranian universities.
Magnetic Resonance Imaging: Fundamental Safety Issues
Authors: Durbridge Gail 
Published: November 2011

Synopsis Medical practitioners have a variety of imaging modalities at their disposal. The exquisite soft tissue delineation available with magnetic resonance imaging (MRI) has resulted in the rising utilization of this particular modality. Increasingly, physical therapists around the world are actively involved in not only referring patients with musculoskeletal conditions for MRI but also in the acquisition of MRI data in both the clinical and research arenas. The MRI process involves the use of a very strong static magnetic field, time-varying (gradient) fields, and radiofrequency energy. To ensure the well-being of patients, staff, and visitors, an understanding of the primary hazards of this environment and the rigorous safety procedures that must be followed is imperative to the clinician. This paper describes the basic components of an MRI system, discusses various MRI safety issues, and presents the screening procedure necessary prior to using MRI. Primary hazards associated with the imaging process are also reviewed. J Orthop Sports Phys Ther 2011;41(11):820–828. doi:10.2519/jospt.2011.3906
Effective surgical treatment of cerebral cavernous malformations: a multicenter study of 79 pediatric patients
Authors: Hugelshofer Michael , Acciarri Nicola , Sure Ulrich , Georgiadis Dimitrios , Baumgartner Ralf W. , Bertalanffy Helmut , Siegel Adrian M. 
Published: November 2011

Object
Cerebral cavernous malformations (CCMs) are common vascular lesions in the brain, affecting approximately 0.5% of the population and representing 10%–20% of all cerebral vascular lesions. One-quarter of all CCMs affect pediatric patients, and CCMs are reported as one of the main causes of brain hemorrhage in this age group. Symptoms include epileptic seizures, headache, and focal neurological deficits. Patients with symptomatic CCMs can be treated either conservatively or with resection if lesions cause medically refractory epilepsy or other persistent symptoms.

Methods
The authors retrospectively analyzed 79 pediatric patients (41 boys and 38 girls) from 3 different centers, who were surgically treated for their symptomatic CCMs between 1974 and 2004. The mean age of the children at first manifestation was 9.7 years, and the mean age at operation was 11.3 years. The main goal was to compare the clinical outcomes with respect to the location of the lesion of children who preoperatively suffered from epileptic seizures.

Results
Of these patients, 77.3% were seizure free (Engel Class I) after the resection of the CCM. Significant differences in the outcome between children who harbored CCMs at different locations were not found.

Conclusions
Resection seems to be the favorable treatment of symptomatic CCMs not only in adults but also in children.
Treatment practices for Chiari malformation Type I with syringomyelia: results of a survey of the American Society of Pediatric Neurosurgeons
Authors: Rocque Brandon G. , George Timothy M. , Kestle John , Iskandar Bermans J. 
Published: November 2011

Object
The purpose of this study was to report the results of a survey of the American Society of Pediatric Neurosurgeons (ASPN) on treatment of Chiari malformation Type I (CM-I) with syringomyelia.

Methods
A questionnaire was circulated during the 2006 meeting of the ASPN, in which surgeons were surveyed on their management of patients with CM-I and syringomyelia. The survey consisted of questions about 4 clinical scenarios, common causes of surgical failures, and complications.

Results
There were 72 respondents, representing more than 90% of attendees at the 2006 ASPN meeting and approximately half of the society's members. The majority of respondents (85%) reported that they perform posterior fossa decompression as first-line treatment for CM-I with syringomyelia. Seven percent perform bony decompression alone, 36% open the dura, and 27% shrink the tonsils. Very few respondents indicated that they offer syrinx drainage as first-line therapy (< 3%). Although all respondents reported that they treat symptomatic CM-I/syringomyelia patients surgically, 15% of respondents indicated that they do not operate on asymptomatic patients. Finally, respondents stated that their most common complications are pseudomeningocele and chemical meningitis.

Conclusions
This survey, given to a representative group of experienced North American pediatric neurosurgeons, confirms that posterior fossa decompression is still the preferred treatment modality in children with CM-I and syringomyelia, regardless of symptoms. Although most surgeons open the dura, preferred techniques for decompression vary. In contrast to the results of past surveys, conservative follow-up is now only used by a minority of respondents and only in the asymptomatic patient, and primary syrinx drainage seems to have lost popularity. A multicenter trial of surgical outcomes has been designed based on the information from this survey.
Left thorascopic sympathectomy for refractory long QT syndrome in children
Authors: Hwang Steven W. , Thomas Jonathan G. , Whitehead William E. , Curry Daniel J. , Dauser Robert C. , Kim Eugene S. , Luerssen Thomas G. , Jea Andrew 
Published: November 2011

Congenital long QT syndrome (LQTS) is a rare genetic ion transmembrane disorder that has been associated with multiple various genetic mutations including life-threatening cardiac arrhythmias and sudden death. Left thorascopic sympathectomy is an effective treatment for patients who are refractory to medical therapy or who need frequent epicardial internal cardiodefibrillator intervention. Although there is substantial literature about this therapy in adults, few reports detail the outcomes in children who undergo left thorascopic sympathectomies to treat LQTS.
The authors report the successful use of a left thoracic sympathectomy for the treatment of an 11-year-old girl who had persistently symptomatic LQTS, even after implantation of an automatic cardioverter-defibrillator. The patient remained clinically stable without arrhythmias through 6 months' of follow-up.
The authors also reviewed the relevant literature and found that it suggests that 77% of patients will have immediate resolution of their symptoms/arrhythmias after the procedure. When the outcome definition was broadened to include patients who had only 1 or 2 cardiac episodes in the follow-up period, 88% of cases were considered successful. The results of this case study and literature review suggest that left thorascopic sympathectomy is a safe and effective approach for treating pediatric patients with LQTS.
Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus: validation of a success score that predicts long-term outcome
Authors: Durnford Andrew J. , Kirkham Fenella J. , Mathad Nijaguna , Sparrow Owen C. E. 
Published: November 2011

Object
The goal of this study was to externally validate the proposed Endoscopic Third Ventriculostomy Success Score (ETVSS), which predicts successful treatment for hydrocephalus on the basis of a child's individual characteristics.

Methods
The authors retrospectively identified 181 cases of consecutive endoscopic third ventriculostomy (ETV) performed in children at a single neurosurgery center in the United Kingdom. They compared actual success at both 6 and 36 months, with mean predicted probabilities for low, moderate, and high chance of success strata based on the ETVSS. Long-term success was calculated using Kaplan-Meier methods and comparisons were made by means of unpaired t-tests.

Results
Overall, 166 primary ETVs were performed; ETV success was 72.9% at 6 and 64.5% at 36 months. At long-term follow-up, the mean predicted probability of success was significantly higher in those with a successful ETV (99 patients) than in those with a failed ETV (67 patients) (p = 0.001). The ETVSS accurately predicted outcome at 36 months; the low, medium, and high chance of success strata had mean predicted probabilities of success of 82%, 63%, and 36%, and actual success of 76%, 66%, and 42%, respectively. The overall complication rate was 6%.

Conclusions
The ETVSS closely predicted the overall long-term success rates in high-, moderate-, and low-risk groups. The results of this study suggest that the ETVSS will aid clinical decision making in predicting outcome of ETV.
Direct surgical repair of spondylolysis in athletes: indications, techniques, and outcomes
Authors: Drazin Doniel , Shirzadi Ali , Jeswani Sunil , Ching Harry , Rosner Jack , Rasouli Alexandre , Kim Terrence , Pashman Robert , Johnson J. Patrick 
Published: November 2011

Object
Athletes present with back pain as a common symptom. Various sports involve repetitive hyperextension of the spine along with axial loading and appear to predispose athletes to the spinal pathology spondylolysis. Many athletes with acute back pain require nonsurgical treatment methods; however, persistent recurrent back pain may indicate degenerative disc disease or spondylolysis. Young athletes have a greater incidence of spondylolysis. Surgical solutions are many, and yet there are relatively few data in the literature on both the techniques and outcomes of spondylolytic repair in athletes. In this study, the authors undertook a review of the surgical techniques and outcomes in the treatment of symptomatic spondylolysis in athletes.

Methods
A systematic review of the MEDLINE and PubMed databases was performed using the following key words to identify articles published between 1950 and 2011: “spondylolysis,” “pars fracture,” “repair,” “athlete,” and/or “sport.” Papers on both athletes and nonathletes were included in the review. Articles were read for data on methodology (retrospective vs prospective), type of treatment, number of patients, mean patient age, and mean follow-up.

Results
Eighteen articles were included in the review. Eighty-four athletes and 279 nonathletes with a mean age of 20 and 21 years, respectively, composed the population under review. Most of the fractures occurred at L-5 in both patient groups, specifically 96% and 92%, respectively. The average follow-up period was 26 months for athletes and 86 months for nonathletes. According to the modified Henderson criteria, 84% (71 of 84) of the athletes returned to their sports activities. The time intervals until their return ranged from 5 to 12 months.

Conclusions
For a young athlete with a symptomatic pars defect, any of the described techniques of repair would probably produce acceptable results. An appropriate preoperative workup is important. The ideal candidate is younger than 20 years with minimal or no listhesis and no degenerative changes of the disc. Limited participation in sports can be expected from 5 to 12 months postoperatively.
Cerebral aneurysms with intrasellar extension: a systematic review of clinical, anatomical, and treatment characteristics
Authors: Hanak Brian W. , Zada Gabriel , Nayar Vikram V. , Thiex Ruth , Du Rose , Day Arthur L. , Laws Edward R. 
Published: November 2011

Object
Intrasellar aneurysms are rare lesions that often mimic pituitary tumors, potentially resulting in catastrophic outcomes if they are not appropriately recognized. The authors aimed to characterize the clinical and anatomical details of this poorly defined entity in the modern era of neuroimaging and open/endovascular neurosurgery.

Methods
A PubMed literature review was conducted to identify all studies reporting noniatrogenic aneurysms with intrasellar extension, as confirmed by CT or MR imaging and angiography. Clinical, anatomical, and treatment characteristics were analyzed.

Results
Thirty-one studies reporting 40 cases of intrasellar aneurysms were identified. Six patients (15%) presented with aneurysmal rupture. Patients with unruptured aneurysms presented with the following signs and symptoms: headache (61%), visual field cuts/decreased visual acuity (61%), endocrinopathy (57%), symptomatic hyponatremia (21%), and cranial nerve paresis (other than optic nerve) (18%). The most common endocrine abnormalities were hyperprolactinemia and hypogonadism. Eight aneurysms (20%) were diagnosed in conjunction with a pituitary adenoma. Aneurysms could be categorized into 2 primary anatomical groups as follows: 1) cavernous/clinoid segment internal carotid artery (ICA) (infradiaphragmatic) aneurysms with medial extension into the sella; and 2) suprasellar (supradiaphragmatic) aneurysms originating from the ophthalmic segment of the ICA or from the anterior communicating artery, with inferomedial extension into the sella. The mean diameters of infradiaphragmatic and supradiaphragmatic aneurysms were 14.5 and 21.8 mm, respectively. Infradiaphragmatic aneurysms were much more likely to present with endocrinopathy, whereas supradiaphragmatic ones presented more commonly with visual disturbances. Aneurysms with infradiaphragmatic growth were generally treated using either endovascular techniques or surgical trapping and bypass, while supradiaphragmatic aneurysms were more often treated by surgical clipping.

Conclusions
Aneurysms with intrasellar extension typically present due to mass effect on surrounding structures, and they can be classified as infradiaphragmatic cavernous or clinoid segment ICA aneurysms, or supradiaphragmatic ophthalmic ICA or anterior communicating artery aneurysms. Varying approaches exist for treating these complex aneurysms, and intervention strategies depend substantially on the anatomical subtype.
Cost per quality-adjusted life year gained of laminectomy and extension of instrumented fusion for adjacent-segment disease: defining the value of surgical intervention
Authors: Adogwa Owoicho , Parker Scott L. , Shau David N. , Mendenhall Stephen K. , Devin Clinton J. , Cheng Joseph S. , McGirt Matthew J. 
Published: November 2011

Object
Over the past decade, there has been a dramatic increase in the number of spinal fusions performed in the US and a corresponding increase in the incidence of adjacent-segment disease (ASD). Surgical management of symptomatic ASD consists of decompression of neural elements and extension of fusion. It has been shown to have favorable long-term outcomes, but the cost-effectiveness remains unclear. In this study, the authors set out to assess the cost-effectiveness of revision surgery in the treatment of ASD over a 2-year period.

Methods
Fifty patients undergoing neural decompression and extension of fusion construct for ASD-associated back and leg pain were included in the study. Two-year total back-related medical resource utilization, missed work, and health state values (quality-adjusted life years [QALYs], calculated from the EQ-5D with US valuation) were assessed. Two-year resource use was multiplied by unit costs based on Medicare national allowable payment amounts (direct cost), and patient and caregiver workday losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). Mean total 2-year cost per QALY gained after revision surgery was assessed.

Results
The mean (± SD) interval between prior fusion and revision surgery for ASD was 3.07 ± 2.02 years. A mean cumulative 2-year gain of 0.76 QALYs was observed after revision surgery. The mean total 2-year cost of extension of fusion constructs was $47,846 ± $32,712 (surgery cost: $24,063 ± $300; outpatient resource utilization cost: $4175 ± $3368; indirect cost: $19,607 ± $32,187). Revision decompression and extension of fusion was associated with a mean 2-year cost per QALY gained of $62,955.

Conclusions
In the authors' practice, revision decompression and extension of fusion provided a significant gain in health state utility for patients with symptomatic ASD, with a 2-year cost per QALY gained of $62,995. When indicated, revision surgery for ASD is a valuable treatment option for patients experiencing back and leg pain secondary to ASD. The findings provide a value measure of surgery that can be compared with future cost-per-QALY-gained studies of medical management or alternative surgical approaches.
Vaginal Reconstruction with Pudendal Thigh Flap- an early experience in Shaheed Sohrawardi Medical College Hospital
Authors: Kalam MA , Rahman SA 
Published: November 2011

The surgical management of the absence of the vagina is a complex problem and constitutes a significant technical challenge. The aim is to create a neovagina that is satisfactory both functionally and aestheticaly using a technique that is simple, reliable, and applicable to most patients. Earlier techniques used were skin grafts, or local skin flaps with various degrees of success. Tissue expanders and vascularized flaps like gracilis myocutaneous flaps were used for more extensive reconstruction. In 1989 Wee and Joseph introduced a new technique using bilateral pudendal thigh flaps based on post labial artery; a branch of perineal artery, which itself is the continuation of the internal pudendal artery. A 16 year old girl with congenital vaginal stenosis in whom previous two attempts of vaginal recanalization have failed, a neovagina was created using the bilateral pudendal thigh flaps, the lining of the cavity was made by the fasciocutaneous flap with the blood supply from the posterior labial artery, a branch of perineal artery. There was no per-operative or post operative complications. Follow-up shows no significant contractions, the reconstructed vagina is expansible and post operative stenting or dilatation was not required. There is good sensation in the wall of the constructed vagina because sensory nerves run through the flaps. Key words: Vaginal stenosis; Neo-vagina; Pudendal Thigh Flaps. DOI: http://dx.doi.org/10.3329/bdjps.v1i2.8798 BDJPS 2010; 1(2): 3-9
Breast Implant Surgery in Bangladesh: An Experience of 126 cases
Authors: Siddiky SA , Quader F , Rahman MH 
Published: November 2011

Augmentation mammoplasty is one of the common plastic surgical operations in the western countries. The procedure has received particular attention among patients with hypo-plastic breasts. The first silicone breast implant was performed in 1963 by Cronin and Gerow, and at present more than 250,000 breast implants are done every year in the USA alone. Due to skepticism and ignorance this surgery took a very long time to become popular in Bangladesh. We started breast implant surgery in Bangladesh in September 2001. Since then it gradually became popular and is now a rather common procedure in our centre. In spite of our conservative culture and religious taboos, women in Bangladesh are no longer lagging behind in deriving the benefit of this wonderful procedure. The study was done at a private hospital from September 2001 to September 2008. A total of 126 cases were done, 125 being females and 1 male. Complications were minimal and the overall results very encouraging. The result of the present work evidenced that silicone breast implants can boost confidence by alleviating depression in women of different age groups with hypoplastic breasts. Research studies have further revealed that silicone implant does not impair lactation. Key words: Silicone implant; augmentation mammoplasty DOI: http://dx.doi.org/10.3329/bdjps.v1i2.8799 BDJPS 2010; 1(2): 10-13
Microtia reconstruction: our experiences of first 10 cases in Bangladesh
Authors: Khondoker MS , Awwal R , Sarker MM , Khundkar SH 
Published: November 2011

Varying degrees of congenital ear deformity (microtia) occurs 1 in about 8000 to 10,000 live births. One of the greatest challenges in plastic surgery is total auricular reconstruction as it demands precise technique as well as artistic creativity. In Bangladesh, recent advancement in the technique of carving and sculpting rib cartilage and better training for achieving finer anatomic details has given a break through in the surgical management of deformed ear. Between January 2009 and January 2010, total ear reconstruction was done with a two-stage method using autogenous costal cartilage in the Department of Plastic Surgery, Dhaka Medical College Hospital, Dhaka. In the first stage, lobule rotation, fabrication of the cartilage framework and its implantation were performed. In the second stage, elevation of the auricle and formation of the tragus were done. A total of 10 cases with microtia comprising different age group have been operated. All of them underwent stage I operation; among them 8 patients went through stage II procedure while the other 2 are waiting for the same. Results: 10 patients, ranging in age between 8 and 25 years, were operated on using autogenous costal cartilage between 2009 and 2010. Six patients were males and four were females. Unilateral microtia was present in all of these patients (7 right, 3 left). Eight cases were with Grade III microtia; the remaining 2 cases presented with Grade II microtia. The follow-up period was one month to one year. Seven among 8 cases presented acceptable ear contour after second stage ear reconstruction. The cranioauricular angle of the reconstructed ears was also similar to that of the opposite ears. Unfavourable result was deformation of the constructed helix which occurred in one case. Though it is impossible to reconstruct an ear that appears exactly as the opposite one, the new ears which were made were of correct size and in normal position with impressive finer three dimensional details that achieved patients satisfaction as well as surgeons professional gratification.Key words: Microtia; Two stage auricular reconstruction; Autologous costochondral cartilageBDJPS 2010; 1(2): 14-19