Sixteen optimal trajectories were placed and 8 intentional cortical breaches. Each pedicular drill hole was examined using a 360 ultrasound transducer and CT scanning. The ultrasonographic images were reviewed by 3 independent investigators who were blinded to the CT findings. In addition, 20 screw holes were placed intraoperatively in 3 patients, and equally assessed by intraoperative intraosseous ultrasonography and postoperative CT scanning.
Results. Ultrasonographic images of pedicle screw holes in postmortem human spine specimen were correctly interpreted in 99% of PF-562271 concentration cases. No cortical breech was missed, i.e., no false-negatives occurred. Intraoperative
findings closely matched the experimental data. None of the intraoperative ultrasound scans demonstrated a cortical breach, a finding confirmed by postoperative CT. The intraoperative time required for the ultrasonographic analysis of each pedicle was about 1 minute
and the interpretation of the resulting images was judged SRT2104 intuitive by the evaluating neurosurgeons.
Conclusion. Intraosseous ultrasound is a highly reliable technique for the intraoperative assessment of pedicle screw holes before pedicle screw placement. Additional expenses with respect to procedure time and manpower are minimal.”
“Background: In patients treated with TNF-antagonists, incident cases of tuberculosis (TB) after a negative screening have been reported, leading to the suggestion that improved TB testing is necessary.
Aim: The aim of the current study is to establish the incidence of TB and its characteristics in patients with inflammatory bowel disease (IBD) under BI 2536 cost TNF antagonists to design improved prevention strategies.
Methods: IBD patients from a single center treated with anti-TNF therapy between January 2000 and September 2011 were identified through a
database that prospectively records clinical data, treatments and adverse events.
Results: During the study period 423 patients received anti-TNF therapy. Screening for latent TB infection (LTBI) previous to anti-TNF treatment was positive in 30 patients (6.96%). Seven patients (1.65%) developed TB while under anti-TNF treatment. Six patients (five under imnnunosuppressant treatment) had a negative LTBI screening. TST was positive in one patient not receiving immunosuppressants, and was treated with isoniazid before starting anti-TNF therapy. In 4 patients TB was diagnosed within the first 16 weeks after starting anti-TNF therapy. Three cases had pulmonary TB and 4 extrapulmonary disease.
Conclusions: In the IBD population under study, incidence of TB infection associated with anti-TNF therapy is higher than that reported in controlled trials and occurs early after treatment initiation. False negative results of LTBI despite appropriate measures may occur, suggesting that more effective screening strategies are needed. (C) 2012 European Crohn’s and Colitis Organisation. Published by Elsevier B.V. All rights reserved.