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Biomedical subjects

E R Benson

Publications and source records attributed to E R Benson.

At least 19 recordsLinked to original sources
PubMed2000

Particulate bone grafting of osteolytic femoral lesions around stable cementless stems.

The purpose of the current study was to evaluate the effect of particulate grafting for proximal femoral osteolysis in the presence of a well-fixed cementless femoral stem at the time of acetabular liner change or revision. Sixteen patients (17 hips) who averaged 51 years of age underwent curettage and packing of proximal femoral osteolytic lesions with cancellous allograft. Modular acetabular liners were changed in 11 patients, acetabular revisions were performed in six patients, and femoral heads were exchanged in all patients. The femoral component was retained in all patients. The majority of patients were asymptomatic before revision surgery. The size of the femoral osteolytic lesions was measured preoperatively and postoperatively with anteroposterior and Lauenstein lateral radiographs of the hip. Preoperatively, the average lesion was 41 x 16 mm on the anteroposterior view and 18 x 7 mm on the lateral view. The average clinical and radiographic followup was 39 and 32 months, respectively, with a minimum followup of 24 months. All but one patient remained asymptomatic during the followup period and no femoral stem showed evidence of loosening. The size of the femoral osteolytic lesion averaged 16 x 6 mm on the anteroposterior view and 6 x 2 mm on the lateral view at most recent followup. In 15 of 17 patients, the size of the femoral lesion had regressed. This technique seems to be a viable means of preventing progressive osteolysis and femoral loosening while preserving bone stock for future reconstruction.

Acetabulum↗
PubMed1999

Posttraumatic piriformis syndrome: diagnosis and results of operative treatment.

BACKGROUND: Posttraumatic piriformis syndrome is a rare disorder that is not clearly defined in the orthopaedic literature. We report on the specific diagnosis, operative treatment, and outcome of treatment of fifteen cases of piriformis syndrome (in fourteen patients), treated by one surgeon, in which the common etiology was blunt trauma to the buttock. We are unaware of any previously published report of this kind. METHODS: Fourteen patients (fifteen cases of piriformis syndrome), with an average age of thirty-eight years (range, twenty-four to fifty-six years), were managed with an operative release of the piriformis tendon and sciatic neurolysis. All fourteen patients had a history of a blow to the buttock, and all had pain in the buttock, intolerance to sitting, tenderness to palpation of the greater sciatic notch, and pain with flexion, adduction, and internal rotation of the hip. Eleven patients (twelve cases) had severe radicular pain in the affected lower limb. All fourteen patients failed to improve after a prolonged period of conservative treatment with nonsteroidal medication or physical therapy, or both. On the average, the patients had been evaluated by three physicians who were not orthopaedic surgeons and by two orthopaedic surgeons before they were referred to the senior one of us. They had had an average of 4.5 diagnostic tests and an average delay of thirty-two months (range, four to seventy-one months) between the time of the injury and the operation. Preoperative electromyograms revealed extrapelvic compression of the sciatic nerve in six of the eight patients who had this study. Intraoperative findings revealed adhesions between the piriformis muscle, the sciatic nerve, and the roof of the greater sciatic notch. RESULTS: Clinical examination at a minimum of twenty-four months (average, thirty-eight months) postoperatively revealed eleven excellent and four good results according our symptom-rating scale. All of the patients returned to work or to their usual daily activities at an average of 2.3 months postoperatively, and the time to maximum subjective improvement averaged 2.1 months. Complications included a seroma and an infected hematoma. CONCLUSIONS: Patients who have blunt trauma to the buttock and then have signs and symptoms that are suggestive of lumbar nerve-root compression may have posttraumatic piriformis syndrome. In our group of carefully selected patients, release of the piriformis tendon and sciatic neurolysis led to encouraging results with few complications.

Adult↗
PubMed1998

Results and morbidity in a consecutive series of patients undergoing spinal fusion for neuromuscular scoliosis.

STUDY DESIGN: A retrospective clinical and radiographic review. OBJECTIVES: To provide current data on the results and complications of patients who have undergone spinal fusion for neuromuscular scoliosis at a center with physicians experienced in these types of cases. SUMMARY OF BACKGROUND DATA: The reported complication rate in the management of neuromuscular scoliosis ranges from 44% to 62% in the recent literature. This literature is that of 1991 or earlier reflecting operative techniques of the mid-1980s, and it has been used to argue against the efficacy of neuromuscular spinal fusions. METHODS: A retrospective chart and radiographic review of 50 consecutive spinal fusions for neuromuscular scoliosis was performed at Connecticut Children's Medical Center between January 1990 and January 1994. The three most common diagnoses were spastic quadriplegic cerebral palsy (20 patients), myelomeningocele (13 patients), and muscle disease (8 patients). There were 38 posterior spinal fusions including two kyphectomies and 12 anteroposterior spinal fusions. The Luque-Galveston technique was used in 39 of 50 patients. The average age at surgery was 13 years and 6 months, with an average follow-up of 40 months (minimum, 24 months). RESULTS: Before surgery, the mean major scoliosis measured 72 degrees, with mean best bend or traction view of 35 degrees. At most recent follow-up, the mean scoliosis magnitude was 25 degrees (mean correction, 65%). There were 17 minor complications in 14 patients and three major complications (deep wound infections) in three myelomeningocele patients. Rod breakage was noted in two patients, one of whom had an asymptomatic pseudarthrosis. There were no neurologic complications or deaths, and none of the complications affected the final results. CONCLUSIONS: The data in the current study support the authors' belief that with current surgical techniques and perioperative management in an experienced center, the results for patients undergoing spinal fusion for neuromuscular scoliosis have been improved, and major complications have been minimized.

Adolescent↗
PubMed1998

Nucleocytoplasmic shuttling by protein nuclear import factors.

Protein nuclear import factors are not, in general, believed to function in the nuclear export of macromolecules and their reutilization therefore requires their recycling from the nucleus to the cytoplasm. Two possible mechanisms for recycling have been proposed. On the one hand, protein import factors such as importin beta and transportin (Trn) could continuously shuttle between cytoplasm and nucleoplasm. On the other hand, these proteins could penetrate into the nucleus only as far as the inner surface of the nuclear pore complex and then directly return to the cytoplasm. In this manuscript, we have used microinjection analysis in human cells, and in vitro nuclear assays, to demonstrate that importin beta, transportin and importin alpha are all nucleocytoplasmic shuttle proteins that efficiently enter and exit the cell nucleoplasm. In the case of transportin, we have mapped sequences required for nucleocytoplasmic shuttling to the carboxy-terminal 270 amino acids of this 890 amino acid import factor, thus demonstrating that nuclear export is independent of the amino-terminal Ran-binding domain of Trn. We further show that Trn shuttling is independent of nuclear RNA transcription. Overall, these data suggest that nucleocytoplasmic shuttling is likely to be a general attribute of protein nuclear import factors.

Binding Sites↗
PubMed1998

Functional outcome of arthrodesis for failed total knee arthroplasty.

To establish the ability of a salvage procedure to restore an independent lifestyle, the SF-36 functional outcome instrument and the pain, mobility, and physical activity subscales of the Arthritis Impact Measurement Scale (AIMS) was used to assess patient function. Nine patients (10 knees) who had undergone arthrodesis for failed total knee arthroplasty were compared with a control group of successful primary total knee arthroplasty patients. Average clinical follow-up was 42 months (minimum: 24 months). For six of the eight SF-36 categories, the average scores for the arthrodesis and arthroplasty groups were similar. The average global scores for the two groups were nearly identical. The arthroplasty patients scored better on the AIMS physical activity and mobility subscales than the arthrodesis group, although the latter group fared better on the pain subscale. Overall, global scores favored the arthroplasty patients. The only subscales to show a statistically significant difference between the arthrodesis and arthroplasty groups were the SF-36 physical functioning and the AIMS physical activity subscales. This pilot study demonstrated the ability of a salvage procedure to allow for an independent lifestyle with minimal complications. Furthermore, despite its popularity, the SF-36 does not appear as sensitive as the AIMS to differences in functional status or health outcomes between total knee arthroplasty and arthrodesis patients.

Activities of Daily Living↗
PubMed1994

When third party payment determines service: the elderly at risk.

Third party reimbursement policies have created barriers to coordinated health services. They have had the effect of compromising the nature and quality of the delivery of nursing service to the elderly in the home setting, thereby posing health risks to older adults. The practice of holistic nursing requires a total commitment to the advocacy role in order to reduce risks to elderly clients and to provide them with quality care.

Aged↗
PubMed1992

On the other side of the battle: Russian nurses in the Crimean War.

One redeeming feature that emerged from the horrors of the Crimean War was the skilled and compassionate nursing care provided by women. The work of Florence Nightingale and her nurses with the British forces is a familiar story. What is less well-known is that the fighting forces on the other side of the battle lines also had their contingent of nurses who helped to alleviate the suffering of their sick and wounded. This paper discusses the events leading up to the organization of Russia's volunteer nurses who provided care on their side of the battle.

History of Nursing↗
PubMed1992

Jewish women and nursing: an overview of early history.

This paper seeks to fill a gap in nursing historiography by presenting an overview of the historical presence of Jewish women in nursing. The topic is viewed within the context of women's history and of nursing history. The authors identify several illustrious Jewish women whose contributions to nursing have earned them a place in the annals of the profession. It is hoped that this article will inspire studies about Jewish women in nursing today.

Europe↗