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Biomedical subjects

A Benini

Publications and source records attributed to A Benini.

At least 19 recordsLinked to original sources
PubMed2004

[Computer-assisted surgery (CAS) in transpedicular lumbar fusion. Experiences of the Spinal Neurosurgery Department].

A well-known problem occurring with lumbar fusion is the incorrect placement of the pedicular screws. Previous studies have shown a rate of incorrect insertion of the screws ranging from 10 to 40%. An incorrectly inserted screw with medial perforation through the pedicle may cause an acute injury of the root passing medially to the pedicle. In case of wrong laterally placed screw the root exiting along the lateral wall of pedicle can be damaged. As a rule, a neurological deficit due to such an injury is irreversible. Vascular lesions are much rarer. Screws malposition, no matter in which direction the insertion should be wrong, leads very often to failed fusion. To reduce the rate of incorrectly placed transpedicular screws, computed tomography based navigation has been introduced. It allows the surgeon multidimensional control of the screw position in virtual reality and real time during insertion. The experience with the first 109 patients in which transpedicular lumbar fusion was performed this way in the Neurosurgical Dpt of the Spine Unit in the Schulthess Clinic in Zurich is described. The computed assisted surgery (CAS) takes slightly more time than the conventional procedure. The significantly increased accuracy of pedicle screw insertion repays this disadvantage generously.

Adult↗
PubMed2004

Surgical treatment of cervical myelopathy of unclear aetiology.

In some cases neither the clinical pattern nor the findings of magnetic resonance imaging (MRI) can help to determine the cause of a cervical myelopathy. The differential diagnosis of such cases as a rule includes spondylotic myelopathy, a solitary focus of multiple sclerosis and an intramedullary tumour in early stage. Worsening of signs and symptoms due to the circumscribed lesion of the spinal cord can require surgical treatment, even if no certain diagnosis could be stated thus far. The question is how to choose a surgical procedure which is beneficial for all three kinds of spinal cord pathology in their initial stage, which at the same time does not jeopardise spine and spinal cord and allows secondary surgery if needed after the precise nature of the lesion has been assessed. Ventral decompression and fusion with or without dorsal decompression seems to be a convincing procedure.

Adult↗
PubMed2003

Release of gentamicin and vancomycin from temporary human hip spacers in two-stage revision of infected arthroplasty.

AIM: Evaluation of the delivery of gentamicin and vancomycin from polymethylmethacrylate (PMMA) spacers before and after implantation for the treatment of total hip replacement infections. METHODS: Twenty industrially produced spacers containing gentamicin (1.9%) were utilized. Vancomycin (2.5%) mixed with PMMA cement was used to fill holes drilled in the cement of 14 of the 20 spacers immediately before implantation. The spacers were removed from 20 patients 3-6 months after implantation and then immersed in phosphate buffer at 37 degrees C for 10 days. Antibiotic concentrations were determined by fluorescence polarization immunoassay. RESULTS: Gentamicin and vancomycin were still present in all the spacers removed from the patients. The release of gentamicin alone and in combination with vancomycin was in the range 0.05%-0.4% of the initial amount present, whereas the release of vancomycin was in the range 0.8%-3.3%. The release kinetics showed a similar pattern for both drugs. After a high initial release of drug, a reduced, but constant, elution was observed over the next few days. CONCLUSIONS: The delivery of gentamicin and vancomycin from PMMA cement was high initially, with sustained release over several months. Incorporation of vancomycin into the surface of the spacers permitted spacers to be prepared with multiple antibiotics present and without adversely affecting the release kinetics of the agents. The gentamicin-vancomycin combination shows potential for the treatment of infection following total hip replacement in specific patients.

Aged↗
PubMed2002

[Clinical aspects, etiology, pathogenesis, diagnosis and therapy of aseptic bone necrosis--a current analysis of the literature].

With continuous proliferation of magnetic resonance imaging early detection of avascular bone necrosis becomes progressively important for treatment of early disease stages. The last decades intensified research on the field of ostoenecrosis has lead to different etiopathogenetic models and to new treatment options. Thereby long term results of known operative interventions are now available. Those can be used as a standard of treatment, new innovative techniques (e.g. mosaic arthoplasty or chondrocyte transplantation) might also be added. The goal of this paper is to give a comprehensive review about Osteonecrosis, Osteochondrosis and Osteochondritis dissecans. Respectively the latest literature results we are able to subordinate these to one unit with mechanical stress as a significant etiological factor in common. Knowledge derived form single literature marks are perhaps comprehended to general picture.

Bone and Bones↗
PubMed2002

Release of antibiotics from polymethylmethacrylate cement.

The increase in resistance rates to antibiotics of bacteria isolated from infected hip joints, particularly staphylococci, prompted us to investigate the usefulness of antibiotic combinations such as gentamicin plus vancomycin. Cylinder test specimens of polymethylmethacrylate (PMMA) cement (Cemex, Tecres) containing gentamicin alone, vancomycin alone and both drugs in combination, were studied. The antibiotic concentrations were determined using a microbiological method and fluorescence polarization immunoassay (FPIA). The release of gentamicin alone, vancomycin alone and in combination from PMMA cement was prompt. The combination revealed synergistic antimicrobial activity against Escherichia coli and Enterococcus faecalis. FPIA showed that gentamicin and vancomycin delivery rates from PMMA cement were different. Gentamicin alone and in combination with vancomycin presented similar release rates from PMMA cement (1.50%). Vancomycin release from PMMA cylinders impregnated with the combination was lower (0.51%) than that from cylinders with vancomycin alone (1.16%). Vancomycin showed a 34.1% loss of microbiological activity at 37 degrees C after 10 days of incubation; the reduction corresponded to 15.0% when measured by FPIA. Results obtained with test specimens are indicative for the preparation of antibiotic-impregnated cements for different human prostheses.

Anti-Bacterial Agents↗
PubMed1999

[Not Available].

Explore the source record for details and available documents.

Journal Article↗
PubMed1999

[Lumbago and radicular complaints: not always a herniated disk or degenerative stenosis of the spinal canal. A differential diagnosis of infrequent diseases].

Low back ache and pain in the legs are not always due to disc displacement and lumbar spinal degenerative changes. Some infrequent, but really not very rare diseases are presented in order to avoid mistakes which can have serious consequences for the patients. Degenerative changes of the lumbar spine are very common, not only in aged people. A superficial examination of the patient with back ache and/or pain in the legs can lead to a fallacious tie-up between such lesions and disturbances and complaints which are not connected to them.

Diagnosis, Differential↗
PubMed1998

[Pain as a biological phenomenon of consciousness].

Pain has not to be considered a false step of nature. On the contrary, it is an extremely effective warning mechanism through which the individual becomes aware of a danger to its own physical integrity from inside the body or from the environment. Pain therefore belongs to the biological devices for evading bodily danger. The conscious experience of pain is the most sophisticated stage of evolution of warning systems, whose simplest form is represented by an unicellular organism which moves away if it anticipates danger from an environmental state. Similar to all qualia, conscious experience of pain cannot be fully explained in terms of neurophysiological events. Conscious pain is a complex perceptual and affective experience influenced not by the amount of the bodily lesion alone, but also by the whole personality of the sufferer. This often makes surgical, medical and psychological treatment of pain difficult and disappointing.

Animals↗
PubMed1998

Anterior lumbar vertebral translation following translaminar screw fixation. A report of five cases.

Translaminar screw fixation is a good procedure for posterolateral spinal fusion of one or two motion segments. Anterior translation of the upper fused vertebra occurred in 5 of our patients following this procedure. A further fusion with pedicle screw fixation was needed in 2 of them. This complication has been previously reported after decompression operations on the lumbar spine. Translaminar screwing produces slight posterior distraction which pushes forward the upper vertebra. This procedure should be avoided in cases with even minimal anterior translation before operation. Translaminar screw fixation is an ideal technique for fusion of a degenerated segment when the upper vertebra has slipped posteriorly.

Back Pain↗
PubMed1998

The intestinal ecosystem in chronic functional constipation.

Chronic functional constipation is common in infants, and the bacterial composition of stools in this condition is not known. The study aims were to: (i) investigate the composition of the intestinal ecosystem in chronic functional constipation; (ii) establish whether the addition of the water-holding agent calcium polycarbophil to the diet induces an improvement in constipation; and (iii) determine the composition of the intestinal ecosystem after the use of this agent. In total, 42 children (20F, 22M; mean age: 8.6 +/- 2.9 y) were studied. Twenty-eight children with functional chronic constipation without anatomical disorders were treated double-blind in random sequence for 1 month with an oral preparation of calcium polycarbophil (0.62 g/twice daily) or placebo. Intestinal flora composition was evaluated by standard microbiological methods and biochemical assays on faecal samples collected before and after treatment. Fourteen healthy children were studied as controls. The results show that (i) the constipated children presented a significant increase in clostridia and bifidobacteria in faeces compared to healthy subjects--different species of clostridia and enterobacteriaceae were frequently isolated; no generalized overgrowth was observed; Clostridia outnumbered bacteroides and E. coli mean counts by 2-3log, while bacteroides and E. coli counts were similar (5-6 log10/g fresh faeces); these intestinal disturbances could be defined as a dysbiosis, i.e. a quantitative alteration in the relative proportions of certain intestinal bacterial species. (ii) Clinical resolution of constipation was achieved only in 43% of treated children and an improvement in 21% (one bowel movement every 2 d). (iii) Calcium polycarbophil treatment induced no significant changes in the composition of the intestinal ecosystem, nor in blood chemistry parameters.

Acrylic Resins↗