bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fatty Liver, Insulin Resistance, and Features of Metabolic Syndrome
Authors: Sung Ki-Chul , Wild Sarah H. , Kwag Hyon Joo , Byrne Christopher D. 
Published: July 2012

OBJECTIVE
Nonalcoholic fatty liver disease (NAFLD) coexists with insulin resistance (IR), but it is uncertain whether NAFLD and IR contribute independently to atherosclerosis. We tested whether fatty liver, IR, and metabolic syndrome (MetS) features (waist, glucose, triglyceride, HDL cholesterol [HDL-C], and blood pressure) were associated with a marker of atherosclerosis (coronary artery calcium [CAC] score &gt;0), independently of cardiovascular risk factors and cardiovascular disease (CVD).

RESEARCH DESIGN AND METHODS
Data were analyzed from a South Korean occupational cohort of 10,153 people who all received ultrasound measurements of fatty liver and a cardiac computed tomography CAC score. IR was defined by homeostasis model assessment of IR (HOMA-IR) ≥75th percentile. Odds ratios (ORs) (95% CIs) for the presence of a CAC score &gt;0 were estimated using logistic regression.

RESULTS
There were 915 people with a CAC score &gt;0. MetS features were increased (glucose, blood pressure, triglyceride, and waist) or decreased (HDL-C) among people with a CAC score &gt;0 (all comparisons against CAC score ≤0; P &lt; 0.0001). Of subjects with a CAC score &gt;0, 55% had fatty liver and 33.7% were insulin resistant. Fatty liver (OR 1.21 [95% CI 1.01–1.45]; P = 0.04) and HOMA-IR (1.10 [1.02–1.18]; P = 0.02) were associated with CAC score &gt;0, independently of all MetS features, conventional cardiovascular risk factors, and prior evidence of CVD. The presence of IR and fatty liver combined was associated with CAC score &gt;0 (1.53 [1.20–1.95]; P = 0.001).

CONCLUSIONS
Fatty liver and HOMA-IR are both associated with a CAC score &gt;0 (independently of each other), features of MetS, conventional cardiovascular risk factors, and existing CVD.
Cement Spacer as Definitive Management for Postoperative Ankle Infection
Authors: Ferrao Paulo , Myerson Mark S. , Schuberth John M. , McCourt Michael J. 
Published: July 2012

Background: Postoperative infection can be a devastating complication of ankle replacement and arthrodesis surgery. Management consists of eradication of the infection and either, revision of the initial surgery or some form of salvage procedure. There are instances however when the patient is asymptomatic, medically unfit, or the local tissue is too tenuous to warrant performing additional surgery. We conducted a retrospective review of the outcome of the use of an antibiotic impregnated cement spacer as the definitive procedure in this kind of patient. Methods: There were nine patients with post operative deep ankle infection following surgery who did not undergo subsequent revision surgery. The initial surgeries were either total ankle replacement (TAR) ( n = 6) or ankle arthrodesis ( n = 3). The indications for the retention of the cement spacer were patients who were asymptomatic following insertion of the cement spacer, did not desire further surgery, or were medically unfit for further surgery. The patients all underwent removal of hardware or implants, debridement, and insertion of an antibiotic impregnated cement spacer. Six weeks of intravenous antibiotics were administered according to culture sensitivity results. Patients were followed up closely for complications (wound dehiscence, spacer migration, bone loss), resolution of infection, functionality, and satisfaction. Results: The average time of cement spacer retention was 20.1 months, ranging from 6 to 62 months. The most common infecting organisms were Staph. Aureus ( n = 3) and Staph. Epidermidis ( n = 3). One patient had wound complications, possibly due to the proximity of the cement spacer to the anterior skin surface. One patient had a repeat infection at 52 months. The most common co-morbidities were rheumatoid arthritis ( n = 3) and diabetes ( n = 2). At final followup, seven patients still had a retained cement spacer and two had subsequent below knee amputations (BKA) performed as a result of delayed complications. Review of the X-rays revealed two patients with loosening and migration of the cement spacer. No patients had signs of excessive bone loss. All patients with a retained antibiotic cement spacer were mobile and able to perform basic activities of daily living with minimal discomfort. Conclusion: The long-term use of antibiotic impregnated cement spacers following postoperative ankle infection is a reasonable option in the low demand patient with surgical or medical co-morbidities. Level of Evidence: IV; Retrospective Case Series
Porous Tantalum as a Structural Graft in Foot and Ankle Surgery
Authors: Sagherian Bernard H. , Claridge Richard J. 
Published: July 2012

Background: Structural bone grafts are often used in foot and ankle surgery to fill gaps, maintain height, length or correction. Bone graft, whether autograft or allograft, has limitations and disadvantages. With porosity and mechanical properties similar to native bone, porous tantalum has been used successfully in hip and knee applications. This study investigates the potential advantages of porous tantalum as a substitute for conventional bone graft in foot and ankle surgery. Methods: A retrospective review of 27 arthrodesis procedures was performed of foot and ankle procedures using Trabecular Metal™ porous tantalum over a period of 5 years. Twenty-five patients were involved. Mean age at the time of surgery was 63 (range, 41 to 80) years. All the patients had pathologies in the foot and ankle that required arthrodesis with structural graft. Average followup was 27 (range, 12 to 72) months. Results: At final followup the mean American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot / Midfoot score improved from 40.6 (range, 16 to 64) preoperatively to 86.3 (range, 57 to 100) postoperatively ( p < 0.001). When the pain component of the AOFAS was examined, the score improved from a mean of 8.2 (range, 0 to 20) to 35.2 (range, 20 to 40), ( p < 0.001). At the time of last followup, 56% of patients reported no pain, 40% reported mild occasional pain, and 4% reported moderate pain. Conclusion: Porous tantalum therefore, was found to be a viable alternative to conventional bone graft when structural support was required. Level of Evidence: IV; Retrospective Case Series
Midfoot Arthrodesis following Multi-Joint Stabilization with a Novel Hybrid Plating System
Authors: Filippi Jorge , Myerson Mark S. , Scioli Mark W. , Den Hartog Bryan Dale , Kay David B. , Bennett Gordon L. , Stephenson Kenneth A. 
Published: July 2012

Background: Several methods for fixation have been described for midfoot arthrodesis. Multi-joint arthrodesis at this level can be challenging because of bone loss and deformity, making it difficult to obtain a stable construct. We present the results of a novel hybrid plating system that incorporates locked and non-locked compression screws for multi-joint arthrodesis of the midfoot. Method: A retrospective multicenter review of patients undergoing multi-joint arthrodesis with hybrid plating of the midfoot was performed to evaluate the time to radiographic arthrodesis. Hybrid plating was defined as a construct that incorporates locked and non-locked compression screws. Neuropathy was the only exclusion criteria. Radiographic arthrodesis was defined as bridging bone on one of the three standard foot radiographs in the absence of a joint gap on the other views, or by 50% or greater bridging bone on computed tomography. Etiology of the arthritis, presurgical comorbidities, body mass index, functional level and postoperative complications were evaluated. Results: Seventy-two patients were evaluated, and arthrodesis was obtained in 67 patients at 6 weeks in 27 patients, 9 weeks in 26, 12 weeks in 11, and at 16 weeks in three. In five patients at least one of the joints were not fused at 16 weeks and were considered a nonunion. Complications were present in 12 patients (17%). Conclusions: The healing rate and time to arthrodesis compared favorably to similar published studies. Based on these results, hybrid plating was a reliable and consistent alternative for fixation in midfoot arthrodesis, especially in multi-joint disease. Level of Evidence: IV; Retrospective Case Series
Intra-Articular Opening Medial Tibial Wedge Osteotomy (Plafond-Plasty) for the Treatment of Intra-Articular Varus Ankle Arthritis and Instability
Authors: Mann Haroon A. , Filippi Jorge , Myerson Mark S. 
Published: July 2012

Background: Although supramalleolar osteotomy with an opening medial wedge or a closing lateral wedge have been described for varus ankle deformity, these may be associated with failure due to persistence of the medial intra-articular defect, resulting in recurrent varus deformity. We report the results of a retrospective study assessing the outcome of an intra-articular opening wedge osteotomy of the distal medial tibia (plafond-plasty) for intra-articular varus ankle deformity associated with osteoarthritis and ankle instability. Method: The results of 19 plafond-plasties in 19 patients for correction of intra-articular varus osteoarthritis of the ankle associated with ankle instability were reviewed. Fourteen men and five women of a mean age of 47 (range, 32 to 63) years were treated. Followup ranged from 14 to 98 (mean, 59) months. Results: Lateral ligament reconstruction was done at the time of the surgery in 18 out of 19 patients. The radiographic parameters including the TAS and TAL showed no statistical significant improvement when compared pre and post operatively. The varus ankle tilt deformity improved from 18 degrees preoperatively to 10 degrees postoperatively ( p < 0.05). The pre- and postoperative AOFAS score improved significantly from 46 to 78, respectively ( p < 0.05). Two patients underwent ankle arthrodesis at 7 and 36 months, and two patients underwent ankle replacement at 30 and 48 months following the index procedure. Of the remaining 15 patients, 14 reported stable or very stable ankles, and 15 of the 19 were either satisfied or very satisfied with the outcome of treatment. Conclusions: These results demonstrate that plafond-plasty osteotomy associated with lateral ligament reconstruction may be a suitable for patients presenting with intra-articular varus ankle osteoarthritis associated with ankle instability, providing pain relief and better function and stability in most patients. Level of Evidence: IV, Retrospective Case Series
Neuropathic Symptoms following Continuous Popliteal Block After Foot and Ankle Surgery
Authors: Gartke Kathleen , Portner Oliver , Taljaard Monica 
Published: July 2012

Background: Continuous perineural blocks are increasingly popular for postoperative pain control. While the reported incidence of neuropathic symptoms has been low, the experience of the lead author suggested it may be much higher. The objectives of this study were to elucidate the incidence of patient-reported neuropathic symptoms following continuous popliteal block (CPB) for postoperative pain control in patients undergoing foot and ankle surgery, to characterize these symptoms and to identify preoperative risk factors. Methods A prospective cohort study of 147 surgical patients undergoing significant foot and ankle procedures was carried out. Patients were followed for 8 months post-surgery. Preoperative/perioperative questionnaires were completed by anesthesiologists. Patients completed questionnaires at 2, 6, 14, and 34 weeks. Multivariable logistic regression analysis using Generalized Estimating Equations (GEE) was used to examine risk factors for neuropathy. Results The prevalence of neuropathic symptoms at 2 weeks was 41% (95% CI, 33% to 49%) decreasing to 24% (95% CI, 15.4% to 32.5%) at 34 weeks. Multivariable analyses revealed that tourniquet placement, tourniquet time, use of prophylactic antibiotics, type of anesthesia, level of training in anesthesiology, patient history of chronic pain and patient age were not significantly associated with neuropathy. Smokers were more likely to report neuropathic symptoms (adjusted OR, 2.25; 95% CI, 0.96 to 5.33). Conclusion The incidence of neuropathic symptoms may be much higher than previously reported. Smoking may be a risk factor for the development of neuropathic symptoms. Level of Evidence: II, Prospective Cohort Study
Retrospective comparison between minimally invasive plate osteosynthesis and open plating for tibial fractures in dogs
Authors: Boero Baroncelli A. , Peirone B. , Winter M. D. , Reese D. J. , Pozzi A. 
Published: July 2012

SummaryObjectives: To compare fracture healing in diaphyseal tibial fractures stabilized using either minimally invasive plate osteosynthesis (MIPO) or open reduction and internal fixation (ORIF).Methods: Dogs in each group were matched for type of fracture, age and body weight. Stage of healing was measured blindly every four weeks postoperatively until complete healing. Outcome variables including fracture length, plate length, plate bridging ratio, plate working length, healing grading, and fracture reduction were compared between groups using the Mann-Whitney test. Significant difference was set at p <0.05.Results: Based on the definition of clinical union, at 30 days five out of eight dogs managed with MIPO had healed, while two of the eight of dogs managed with ORIF had healed. We did not find any significant differences in the other outcome measures. No complications were reported in the MIPO group whereas one major complication was reported in the ORIF group.Clinical significance: All dogs treated by MIPO healed rapidly without any complications, nevertheless the difference in radiographic healing between the two groups was not significant.
Correction of severe congenital flexural carpal deformities with semicircular external skeletal fixation system in calves
Authors: Ozak A. , Nisbet O. , Yardimci C. 
Published: July 2012

SummaryObjective: To present a novel technique for the treatment of severe congenital flexural forelimb deformities in calves.Methods: Thirteen calves of different breeds and sex with severe congenital flexural forelimb deformities were enrolled in the study. A semicircular external skeletal fixation system composed of 6-hole, 45° carbon-fiber arches, 6 mm threaded rods, half-pin fixation bolts, 6 mm hexagonal nuts, and negative profile end-threaded half-pins were used for pancarpal arthrodesis. Complications, time to first use of the limb, fixator removal time, preoperative and postoperative sagittal plane angles of the fused joints, and functional outcomes were evaluated clinically and radiographically. Final assessments were determined according to functional and cosmetic outcomes.Results: All of the surgically treated carpal joints obtained fusion. Seven of the calves started to use the limb immediately after recovering from anesthesia. In the other six calves, the time ranged from one to two days. Time to fixator removal ranged from 25 to 36 days (mean 30 days). Final outcome was excellent in 11 cases, and good in two cases.Clinical significance: The technique was found to be a useful method for the treatment of severe congenital flexural forelimb deformities in calves. The cost of the operation is negligible compared to the economic value of beef cattle.
L'adolescence face aux préjugés de la société
Authors: Birraux Annie 
Published: July 2012

Résumé Ce texte cherche à cerner les processus adolescents en les resituant dans le contexte actuel des préoccupations des parents et de la société à partir de la clinique des Maisons des Adolescents. Qu’est-ce qui détermine l’adolescence, hier et aujourd’hui ? Les changements physiques et sociétaux sont-ils suffisants pour définir cette période de la vie ? Nos adolescents sont-ils plus précoces ? Faut-il les considérer comme des adultes sous le seul prétexte qu’ils sont grands et forts et, par là même, renoncer à la part d’infantile constitutive de chacun ? Adolescence , 2012, 30 , 2, 297-306.
L'atelier maquillage
Authors: Manzano Laurence , Moro Marie Rose 
Published: July 2012

Résumé Cet article décrit une médiation originale utilisée dans une Maison des Adolescents : l’esthétique. L’activité, menée par une socio-esthéticienne professionnelle et un des membres de l’équipe institutionnelle, est très demandée par les adolescentes et permet d’importants changements dans les représentations que les adolescentes ont de leur propre corps. Par l’intermédiaire de modalités esthétiques adaptées à ce qu’elles désirent, demandent ou ont envie d’essayer, les adolescentes apprennent progressivement à se soucier d’elles-mêmes, de leurs désirs et de leur beauté. L’ensemble de ce qui est vécu par les adolescentes est repris et élaboré dans le cadre thérapeutique. Adolescence , 2012, 30 , 2, 411-419.
Le Mas des Alouettes
Authors: Sommantico Massimiliano 
Published: July 2012

Résumé À partir du film des frères Taviani Le Mas des Alouettes (2007), l’auteur propose une analyse de la question de la transmission de l’horreur aux descendants des situations de catastrophes génocidaires comme celle qui s’est abattue sur le peuple arménien. Dans ce but, il étudie plus particulièrement, à travers l’analyse de certaines séquences clés du film, les questions suivantes : que faire de cet héritage ? Comment lui donner un sens et une « forme féconde » ? Comment rendre possible le travail d’historisation et d’appropriation d’une histoire si traumatique ? Comment faire face à l’impossibilité des survivants de nommer la violence subie ? En référence à la notion d’alliance inconsciente défensive pathogène, l’auteur propose en conclusion une analyse du rapport entre espace individuel, espace familial et espace social en situation de catastrophe génocidaire.
Tarnation
Authors: Eiguer Alberto 
Published: July 2012

Résumé L’auteur avance que selon le film autobiographique Tarnation construit avec des fragments de films d’amateur, le cinéaste Jonathan Caouette se donne comme but d’œuvrer au rétablissement de sa mère en essayant de faire la lumière sur l’origine de sa psychose et, en même temps, de comprendre pour quoi le père l’(les) a abandonné(s). Le réalisateur dit lui-même qu’il aura du mal à se reconstruire aussi longtemps que sa mère ne pourra elle-même émerger. Son œuvre se met alors au service d’une quête sur les mystères de ses origines. Dans ce film très émouvant, des assertions avancées à un moment donné seront écartées ultérieurement. Plusieurs pistes envisagées se révéleront erronées. Le cinéaste nous fait partager les prises de conscience douloureuses qui émaillent ce parcours initiatique. L’auteur de l’article élabore à son tour ses hypothèses en examinant nombre de concepts et de notions : l’homosexualité, le travestisme, la création artistique, les fonctions parentales, la filiation, la nomination du sujet, l’après-coup et la construction-reconstruction. Il note que la réalisation du film permettra au cinéaste d’agir et finalement de se retrouver.
Clinique des traces traumatiques familiales chez l'enfant placé en institution
Authors: Derivois Daniel , Duperray Marie , Guillier Nathalie , Simon Audrey 
Published: July 2012

Résumé Le clinicien intervenant auprès de l’enfant placé en institution est souvent confronté à des traces familiales difficiles à décoder dans la psyché de l’enfant. À partir de deux vignettes cliniques, cet article interroge le statut et le trajet des traces du passé familial dans la psyché de l’enfant. Dans l’ici et maintenant de la rencontre clinique, une trace est coconstruite par le clinicien et l’enfant. Les auteurs l’appellent « trace habilitée ». Elle permet de suivre la « traçabilité » processuelle de l’expérience subjective vécue.
L'océan Indien, laboratoire de la géographie militaire américaine
Authors: Samaan Jean-Loup 
Published: July 2012

Longtemps, l’océan Indien fut considéré par l’armée américaine comme un espace géographique secondaire, à la différence des océans Atlantique et Pacifique. Or, depuis le milieu des années 2000, cette perception a changé. Cette nouvelle attention américaine est avant tout le résultat des appréhensions de Washington quant au rôle croissant de la Chine dans l’océan Indien. Toutefois, dans le contexte politique et financier actuel, les forces américaines ne devraient pas opérer de revirement spectaculaire vers l’océan Indien. Cependant, l’approche coopérative vis-à-vis de l’Inde ou de l’Australie qui anime la stratégie du Pentagone pour la zone préfigure des pratiques qui pourraient devenir structurantes pour les armées américaines. S’il est donc encore prématuré de faire de l’océan Indien le centre de gravité du XXI e siècle, il constitue indéniablement un laboratoire de la géographie militaire américaine de demain.
Idéologies religieuses et réseaux transnationaux à travers l'océan Indien
Authors: Germain Éric 
Published: July 2012

Peut-on considérer que le maillage de communautés diasporiques établies sur le pourtour de l’océan Indien induit une interdépendance sécuritaire qui autorise à considérer cette région comme un véritable « complexe de sécurité » ? Dans les pays riverains, l’importance du fait diasporique (indien, yéménite, somalien, philippin ou chinois) tout comme le développement de stratégies d’influence régionale (Inde, Iran, voire la Chine ou la Turquie) apportent une réelle cohérence à une vision d’une aire économique et culturelle propre et non plus d’un simple espace de transit maritime. Les menaces qui pèsent sur la sécurité de cette région ne peuvent pas être considérées indépendamment de ces flux et de ces réseaux transnationaux. Les idéologies légitimant le recours à la violence reposent aujourd’hui moins sur un socle national ou ethnique (à l’exemple des Tigres tamouls) que religieux. On assiste à la diffusion à une échelle régionale d’un type de violence essentiellement intermusulmans (antichiites ou anti-ahmadis), mais d’autres violences confessionnelles pourraient naître, particulièrement dans les zones où le rapport entre populations « autochtones » et « allogènes » demeure tendu.
L'imaginaire géographique du tourisme sexuel
Authors: Staszak Jean-François 
Published: July 2012

Résumé Cet article examine l’imaginaire géographique lié au tourisme sexuel. Il porte sur le corps, la rencontre sexuelle et le paysage, susceptibles d’être érotisés ou désérotisés selon le lieu. Les touristes sexuels occidentaux affirment être frustrés par les possibilités de rencontre dans les pays de provenance, en raison de la ré-affectation des rôles de genre liée à la libération de la femme depuis les années 1970. Ils trouveraient ailleurs, dans des destinations exotiques qui sont souvent d’anciennes colonies, des corps phantasmés comme plus érotiques et des possibilités de rencontre où l’homme blanc détient et exerce (encore) un pouvoir qu’il estime nécessaire à la satisfaction de ses pulsions sexuelles. Le paysage exotique est lui-même aphrodisiaque, non seulement pour le touriste sexuel mais aussi pour tous les touristes, ce qui conduit à reconsidérer la catégorie « tourisme sexuel ». L’imaginaire géographique des touristes sexuels serait le même que celui des autres touristes. Les tourismes sexuels féminin et homosexuel nuancent cet imaginaire, mais ne remettent pas en cause le cadre (néo)colonial dans lequel il s’inscrit.