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Biomedical subjects

C Benaim

Publications and source records attributed to C Benaim.

15 recordsLinked to original sources
PubMed2005

Sagittal alignment of spine and pelvis regulated by pelvic incidence: standard values and prediction of lordosis.

Pelvis and spinal curves were studied with an angular parameter typical of pelvis morphology: pelvic incidence. A significant chain of correlations between positional pelvic and spinal parameters and incidence is known. This study investigated standards of incidence and a predictive equation of lordosis from selective pelvic and spinal individual parameters. One hundred and forty nine (78 men and 71 women) healthy adults, aged 19-50 years, with no spinal disorders, were included and had a full-spine lateral X-ray in a standardised upright position. Computerised technology was used for the measurement of angular parameters. Mean-deviation section of each parameter and Pearson correlation test were calculated. A multivariate selection algorithm was running with the lordosis (predicted variable) and the other spinal and pelvic parameters (predictor variables), to determine the best sets of predictors to include in the model. A low incidence (<44 degrees ) decreased sacral-slope and the lordosis is flattened. A high incidence (>62 degrees ) increased sacral-slope and the lordosis is more pronounced. Lordosis predictive equation is based on incidence, kyphosis, sacral-slope and +/-T9 tilt. The confidence limits and the residuals (the difference between measured and predicted lordosis) assessed the predicted lordosis accuracy of the model: respectively, +/-1.65 and 2.41 degrees with the 4-item model; +/-1.73 and 3.62 degrees with the 3-item model. The ability of the functional spine-pelvis unit to search for a sagittal balance depended both on the incidence and on the variation section of the other positional parameters. Incidence gave an adaptation potential at two levels of positional compensation: overlying state (kyphosis, T9 tilt), underlying state (sacral slope, pelvic tilt). The biomechanical and clinical conditions of the standing posture (as in scoliosis, low back pain, spondylisthesis, spine surgery, obesity and postural impairments) can be studied by comparing the measured lordosis with the predicted lordosis.

Adult↗
PubMed2005

[The assessment of autonomy in elderly people].

The assessment of autonomy in elderly people relies on various instruments that aim to evaluate and follow up patients, to measure the burden of care for the medical staff, or to properly distribute health budgets. In this article, we describe 3 clinical scales traditionally employed by gerontologists and specialists in geriatric rehabilitation. We intentionally left out generic scales such as the Barthel index and the Functional Independence Measure, which are well known by physiatrists. The Katz index is a scale of Activities of Daily Living, and the Lawton test is a scale of Instrumental Activities of Daily Living. We paid special attention to the AGGIR classification, which is the actual legal instrument for evaluating dependency in elderly in France, and whose first application is health resources management.

Activities of Daily Living↗
PubMed2005

[Assessment of idiopathic Parkinson's disease in physical medicine and rehabilitation].

Parkinson's disease (PD) is a chronic disease associated with motor impairments (bradykinesia, rigidity, tremor and postural disorders), cognitive disorders and dysautonomia. Most symptoms are greatly improved by dopatherapy during the first stages, then signs of treatment ineffectiveness or intolerance occur that signal the beginning of motor and cognitive decline. This evolution signified the need to develop an effective tool to measure the effectiveness of drugs or surgery in PD and has had the Movement Disorder Society to propose 20 years ago a tool to assess such patients: the Unified Parkinson's Disease Rating Scale (UPDRS). This scale has a good internal consistency and a good interrater reliability. Yet, some impairments, especially of cognitive origin, are evaluated too succinctly and need complementary scales. As well, other disorders such as bladder disorders are not included, nor is quality of life studied despite the impact of PD on daily life. Specific scales have been proposed. UPDRS may be well-adapted to PD follow-up in the physical medicine and rehabilitation context by measuring treatment effectiveness, detecting Dopa ineffectiveness or complications and assessing patients' handicap in daily activities. The evolution of UPDRS will improve the qualities of the scale and contribute to better determining the various stages of the disease.

Activities of Daily Living↗
PubMed2005

[Incidence, circumstances and consequences of falls in patients undergoing rehabilitation after a first stroke].

OBJECTIVES: To describe the incidence, circumstances, and consequences of falls in patients admitted in a rehabilitation ward after a stroke. METHODS: Prospective monitoring of falls over four years in a neurological rehabilitation unit. Use of fall registry. INCLUSION CRITERIA: age < 75 years, admission < 45 days after stroke onset, single stroke of 1 cerebral hemisphere (nonlacunar) or of the brain stem. Only falls due to loss of balance were considered; falls caused by a seizure or syncope were not considered. RESULTS: Of 217 consecutive patients with the inclusion criteria, 34 had fallen at least once (15.7%) and 10 twice (4.1%). Fall incidence, defined as the number of falls per patient per day was 2.2 per thousand. Half of the patients fell the first three weeks after admission. Most falls involved getting to or from the wheelchair or the bed; 1 patient had recovered minimal postural abilities at the gym but was not independent. Traumatic lesions were noted in 13 patients: they were minor in nine and severe in four, including three fractures. CONCLUSION: Falls due to loss of balance are a major problem in patients undergoing rehabilitation after a stroke. Getting to and from wheelchairs in the bedroom and bathroom by patients who are not allowed to do so play a key role in many falls. Prevention programs should consider this information.

Accidental Falls↗
PubMed1999

Assessment of hand after brain damage with the aim of functional surgery.

The semiology of the hand after brain damage is really rich. Its clinical evaluation remains quite difficult and must be integrated in the neuro-orthopedic and cognitive context. Deficiency, neuropsychological, analytic and functional status, must be assessed before any surgical decision aiming the improvement of prehension. Neuropsychological evaluation precise the hemispheric specialization: right hemisphere lesions conduct to unilateral spatial neglect while left hemispherical lesions determine language troubles and gesture impairment (apraxia). The analytical evaluation describes motor and sensitive function and assesses spasticity and pain. Concerning the functional assessment, the Enjalbert's score seems to be the most adapted to the upper limb. The assessment of hand deficiency and its origin is necessary to orientate the surgical decision and includes the Zancolli classification for the fingers and wrist and the House classification for the thumb. These classification used for cerebral palsy seems to be insufficient for all the different situations occurring after brain damage. A new classification is proposed based on 3 parameters: fingers extension, thumb abduction and supination. Surgical decision should be examined only after an adapted rehabilitation program.

Brain Diseases↗
PubMed1999

Validation of a standardized assessment of postural control in stroke patients: the Postural Assessment Scale for Stroke Patients (PASS).

BACKGROUND AND PURPOSE: Few clinical tools available for assessment of postural abilities are specifically designed for stroke patients. Most have major floor or ceiling effects, and their metrological properties are not always completely known. METHODS: The Postural Assessment Scale for Stroke patients (PASS), adapted from the BL Motor Assessment, was elaborated in concordance with 3 main ideas: (1) the ability to maintain a given posture and to ensure equilibrium in changing position both must be assessed; (2) the scale should be applicable for all patients, even those with very poor postural performance; and (3) it should contain items with increasing difficulty. This new scale has been validated in 70 patients tested on the 30th and 90th days after stroke onset. RESULTS: Normative data obtained in 30 age-matched healthy subjects are presented. The PASS meets the following requirements: (1) good construct validity: high correlation with concomitant Functional Independence Measure (FIM) scores (r=0.73, P=10(-6)), with lower-limb motricity scores (r=0.78, P<10(-6)), and with an instrumental measure of postural stabilization (r=0.48, P<10(-2)); (2) excellent predictive validity: high correlation between PASS scores on the 30th day and FIM scores on the 90th day (r=0.75, P<10(-6)); (3) high internal consistency (Cronbach alpha-coefficient=0.95); and (4) high interrater and test-retest reliabilities (average kappa=0.88 and 0.72). CONCLUSIONS: Our results confirm that the PASS is one of the most valid and reliable clinical assessments of postural control in stroke patients during the first 3 months after stroke.

Cerebrovascular Disorders↗
PubMed1998

[Static balance is controlled by a non-linear dynamic system].

Different techniques of stabilometric signal analysis have been used in order to study the adaptation of the fine postural control system to the wearing of corrective glasses with or without prisms. The comparison between the results obtained with conventional techniques and those obtained with non-linear dynamic methods demonstrates the better efficiency of the latter. These results confirm that the postural system behaves as a non-linear dynamical system and may explain the outstanding sensitivity of the fine postural system to small perturbations.

Adult↗
PubMed1997

Influence of sports discipline on shoulder rotator cuff balance.

Isokinetic shoulder rotational strength was evaluated in four groups of subjects as follows: 12 nonathletes, 12 runners, 15 tennis players, and 12 baseball players for a total of 51 subjects. The tests were performed in the seated 45 degrees abducted test position in the scapular plane at 60, 180, and 300 degrees.s-1 for both shoulders. Peak torque and mean power values were gathered, and from these values the internal/external rotation ratios were calculated. Intergroup comparison showed a progression of the ratio related to the sports discipline. The nonathletes and runners had ratios close to those reported for nonathletes (1.3 to 1.5). The tennis players had ratios close to 1.5, whereas the baseball players had ratios from 1.6 to 2.2. The comparison between dominant and nondominant side showed no significant differences in the tennis players and higher values for the dominant side in the nonathletes and runners under certain conditions (180 degrees.s-1 for the nonathletes and 300 degrees.s-1 for the runners). Regarding the baseball players, the ratio was systematically higher for the dominant side. These results raise questions about the influence of sports discipline on the internal/external rotator muscle ratio and indicate the need to establish normative values based on the characteristics of the population under study.

Adult↗
PubMed1996

Late contralateral hyperhidrosis in lateral medullary infarcts.

BACKGROUND AND PURPOSE: This study describes unilateral increases of sweating reactions observed in the months after contralateral medullary infarct; evaluation of sympathetic cutaneous response may help to explain sweating disorders. SUMMARY OF REPORT: After the discovery of the clinical phenomenon in one case, patients admitted between 1990 and 1993 were systematically evaluated clinically and electrophysiologically. In a group of five patients presenting with lateral or dorsal medullary lesions, two exhibited an increase of contralateral sweating reactions that appeared 6 to 8 months after stroke, were elicited by effort and exposure to heat and stress, and were more severe over the forehead, face, and upper trunk. In one case, this was clinically associated with an absence of sweating on the side of the lesion. During the late phase after stroke, in three patients presenting with lateral medullary lesions, electrophysiological evaluation revealed significant asymmetry of the sympathetic skin response, which was higher on the side contralateral to the lesion than on the ipsilateral side. In one patient, no response could be elicited by stimulations applied on the side of the lesion. CONCLUSIONS: Contralateral hyperhidrosis can be observed in the late phase after lateral medullary infarct and is likely due to lesion of the sympathetic pathway passing through the lateral medulla, which inhibits sudomotor neurons. Evaluation of sympathetic skin response may help to explain such clinical disorders.

Adult↗
PubMed1996

[Analysis and course of cognitive deficits after rupture of aneurysms of the anterior communicating artery].

The aim of this study is to investigate general intellectual and memory performances at the secondary (3 weeks to 4.5 months) and late (10 to 16 months) stages following rupture of anterior communicating artery aneurysms (AACA). Twenty one patients presenting with selective lesion within frontal, or cingulate, callosal, caudate, basal forebrain areas were evaluated. At the secondary stage, the analysis of the general intellectual capacities revealed a drop of performance, prominent on performance IQ, which was more severe than the learning deficit. Specific cognitive evaluations revealed increase of the execution time, but performance was relatively preserved: in the Stroop test, focused attention disorder was moderate: the modified Wisconsin Card Sorting test was correctly performed in most cases; significant deficits of verbal short-term memory, long-term verbal and visuo-spatial learning, and access to semantic memory were observed. At the late stage, general intellectual performance improved, but did not reached the estimated prelesional level in most cases; specific cognitive disorders had most often disappeared. Most performances were best explained by the severity of lesions in the left cingulate cortex and corpus callosum area. These results show that the cognitive profile of AACA patients is different from classical descriptions of the "amnesic syndrome", and is also different at the secondary and late stages; this evolution has to be taken into account in studies describing cognitive deficits of such patients, or comparing them with others presenting with "annesic syndrome".

Adult↗
PubMed1995

Cerebral blood flow in lateral medullary infarcts.

BACKGROUND AND PURPOSE: The aim of this study was to evaluate the diaschisis phenomenon in patients presenting with lateral medullary infarct (Wallenberg's syndrome). METHODS: We examined all patients admitted between 1991 and 1993. The localization of lesions was evaluated by MRI. Single-photon emission computed tomographic technique was used to assess cerebral blood flow by two methods (133Xe and hexamethylpropyleneamine oxime) on five slices of brain tissue. Flow values were calculated in 11 regions of interest in each cerebral hemisphere and in the cerebellum and were compared with those obtained in 20 control subjects. RESULTS: Three patients had selective lateral medullary infarct: Relative reduction of flow (133Xe) and of tracer uptake (HMPAO) were observed in one patient in the ipsilateral cerebellum and contralateral hemisphere; in two patients, hemispheric flow values were relatively low, without significant asymmetry. Two patients also presented with cerebellar infarct: Flow drop was severe in the ipsilateral cerebellum, and contralateral reduction in the brain hemisphere was observed in both cases. CONCLUSIONS: Lateral medullary infarct can be associated with ipsilateral reduction of flow in the cerebellum, but this phenomenon is inconstant. Severe flow drop suggests infarction in the territory of the posterior inferior cerebellar artery. Contralateral hemispheric flow reduction can also be observed. These phenomena of cerebellar and crossed hemispheric diaschisis are probably related to lesions of tracts from the olivary and reticular nuclei.

Adult↗
PubMed1995

[Deficit of verbal recall caused by left dorso-lateral thalamic infarction].

A case of amnesia with preferential disorder of verbal recall, associated to a limited infarct of the left superior, external and anterior thalamus, is reported. This lesion involved the anterior and middle dorso-lateral nuclei and the centrolateral nucleus, sparing most of the structures classically incriminated in diencephalic amnesia. At the initial stage, the patient presented discrete language impairment and severe deficit of semantic processing, which later recovered. At the late stage, the anterograde and retrograde amnesia principally concerned the recall of verbal information used in daily life, verbal learning using short-term and long-term recall, questionnaires evaluating retrograde memory and requiring the evocation of proper names. Verbal priming was also affected. Verbal recognition was preserved. Evocation of the most recent events of the personal life was also impaired. Confrontation of this case with others previously reported suggests that various thalamic amnesias may be described, associated to different cognitive deficits, in relation with the preferential situation of lesions.

Amnesia↗
PubMed1975

Microculture method for some viable airborne particles.

A microchamber has been developed for in situ culture of some airborne particles collected on the acrylic "I" rods of the Rotorod Air Sampler. The design of the chamber allows direct observation as well as the photography of microscopic airborne particles. Its use permits a rapid distinction between living and nonliving matter, as well as increased efficiency in sampling airborne particles.

Air Pollution↗