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Biomedical subjects

E E Specht

Publications and source records attributed to E E Specht.

At least 19 recordsLinked to original sources
PubMed1981

The risk of hip fracture in postmenopausal females with or without estrogen drug exposure.

This study estimated the risk of hip fracture among postmenopausal females with and without estrogen drug exposure. The Kaiser-Permanente Medical Care Program in Portland, Oregon served as the setting and medical records the source of data. A retrospective case-control method that matched each female member hospitalized with a hip fracture (N = 168) between 1965-1975 with two control female members hospitalized for reasons other than a hip fracture was used. The estrogen exposure rate of cases was 29.2 per cent and of controls 36.0 per cent. The risk of hip fracture was reduced with postmenopausal and prefracture estrogen exposure (RML = 0.72, 95 per cent CL: 0.48-1.09). However, the number of cases was sufficient only to detect a reduction in risk of about 50 per cent or greater. A possible protective effect from estrogens was also suggested with oral estrogen exposure and with longer lengths of estrogen exposure.

Activities of Daily Living↗
PubMed1980

Hip fracture, skeletal fragility, osteoporosis and hormonal deprivation in elderly women.

Fractures of the hip have been shown to have a significant personal and societal impact in Western countries; this impact is largely borne by elderly women, and represents a substantial health care commitment in modern society. For many people a fracture of the proximal end of the femur represents a preterminal event of considerable cost, both in economic loss and psychosocial well-being. These fractures are generally recognized as a clinical complication of osteoporosis, and are one index of general skeletal fragility which is also manifested in fractures of the vertebrate and of the distal radius (Colles fracture). There is increasing evidence that hormonal deprivation in elderly women is directly related to loss of skeletal integrity and consequent fragility. There is also increasing evidence that hormonal substitution is effective in preventing this structural loss and fragility. Unfortunately, a therapeutic dilemma has arisen in that the preparation that seems to give optimal protection, conjugated estrogens, has also been reported to cause an increased incidence of endometrial carcinoma. The search for a preparation or dosage regimen of estrogens which simultaneously prevents skeletal atrophy and fragility and avoids the increased risk of malignancy must be a long-term goal.

Aged↗
PubMed1979

Osseous lesions and pathologic fractures in congenital cytomegalic inclusion disease: report of a case.

A newborn infant with congenital cytomegalic inclusion disease had spontaneous fractures of the distal radii bilaterally, and involvement of the metaphyseal portions of the humeri, ulnas, femurs, and tibias. The fractures healed promptly without complications under ordinary management. At the present time, one can only speculate on the cause of these lesions. Viral osteomyelitis, osteomalacia secondary to hepatitis and malabsorption and a disturbance of endochondral ossification are all possibilities. There is a need for additional cases with histologic and biochemical studies of the bone lesions in congenital cytomegalic inclusion disease.

Bone Diseases↗
PubMed1977

Juvenile aponeurotic fibroma.

Juvenile aponeurotic fibroma is an uncommon benign tumor which occurs mostly in the hands and wrists of young children. It has a tendency to recur, especially in younger individuals, and this, combined with a rather cellular microscopic appearance, has led to mistaken diagnoses of malignancy. No instances of metastasis have been reported. Conservative therapy, consisting of excisional biopsy without sacrifice of vital structures, is indicated.

Adolescent↗
PubMed1977

Evaluation of a computerised image analyser for studying alterations in radiographic bone density in the rat.

A computerised image analyser has been used experimentally to determine its possible usefulness in quantifying bone density. Rats were prepared for this purpose and ash weight/volume readings were obtained on femora which had been radiographed and studied to estimate radiographic density by means of the image analyser. The findings indicated that rats can be prepared by administering oestradiol or by allowing an additional week's growth, both of which give a statistically significant increase of bone density. The computerised image analyser was able to detect these differences but the correlations, although real and linear, between ash weight/volume and radiographic density were not large. Further refinements in techniques will be needed before the system is applied clinically.

Aminopropionitrile↗
PubMed1976

Conservative management of low back pain.

With the apparent indefinite postponement of the release of chymopapain for lumbar disk disorders, it seems appropriate to review critically the proliferation of proposed methods of management of this common complaint, particularly the numerous exercise regimens which have been set forth as helpful. A critical review of these regimens quickly reveals that the majority are propounded with considerably more confidence than statistical proof of their efficacy. The following is a delineation of the results of a critical review of the literature, with emphasis on those few studies which have been statistically validated. The physician has an obligation to attempt conservative management of discogenic disease with methods of demonstrated efficacy before recommending invasive procedures such as laminectomy or chemonucleolysis.

Adult↗
PubMed1976

Congenital dislocation of the hip.

Congenital dislocation or subluxation of the hip (congenital acetabular dysplasia) is a complete or partial displacement of the femoral head out of the acetabulum. The physical signs essential for diagnosis are age related. In newborns the tests for instability are the most sensitive. After the neonatal period, and until the age of walking, tightness of the adductor muscles is the most reliable sign. Early diagnosis is vital for successful treatment of this partially genetically determined condition. Various therapeutic measures, ranging from abduction splinting to open reduction and osteotomy, may be required. Following diagnosis in the first month of life, the average treatment time in one recent series was only 2.3 months from initiation of therapy to attainment of a normal hip. When the diagnosis was not made until 3 to 6 months of age, ten months of treatment was required to achieve the same outcome. When the diagnosis is not made, or the treatment is not begun until after the age of 6, a normal hip will probably not develop in any patient.

Age Factors↗
PubMed1975

Congenital paralytic vertical talus. An anatomical study.

Dissections of the feet of a three-month-old infant with paralytic congenital vertical talus secondary to lumbar myelomeningocele were compared with a dissection of a normal foot. The major differences appeared to be absence of the plantar intrinsic muscles and dorsal dislocation of the talonavicular joint. It is postulated that the pathological process begins as a failure of the intrinsic muscles to oppose the unbalanced, active dorsiflexion forces of the anterior crural muscles. This imbalance then allows disruption of the talonavicular joint, mechanically the least stable joint in the mid-part of the foot. All dorsiflexion forces acting on the ankle then become ineffective and plantar flexion forces serve only to pull the calcaneus and talus into equinus, causing a "vertical" talus. Treatment must be directed at reducing the talonavicular dislocation, correcting the equinus deformity of the hind part of the foot, and substituting for the undeveloped plantar intrinsic muscles.

Flatfoot↗
PubMedDate not supplied

Brachial plexus palsy in the newborn. Incidence and prognosis.

The problem of the accuracy of current data regarding prognosis of brachial plexus palsy in the newborn infant was studied by means of a retrospective review of hospital records, letters to parents of affected infants, and follow-up examinations of available children. Only 11 cases of mild upper plexus injuries were found in a review of 19,314 newborn infants' charts, an incidence of 0.57 per 1,000 live births. Four cases were available for examination and 4 others were evaluated from follow-up records. Three were lost to follow-up. No instance of permanent paralysis was found, thus raising the possibility that while permanent paralysis is still seen, it may now represent a diminishing minority of the total, at least in the United States with modern obstetrical care. This is in contrast to the opinion one might formulate from a review of the orthopedic literature on this subject.

Brachial Plexus↗
PubMedDate not supplied

Hypochondroplasia.

Hypochondroplasia is a hereditary form of short-limbed dwarfism which somewhat resembles achondroplasia, but which is clinically, roentgenographically, and genetically distinct. The pertinent findings in 6 new cases are: moderate rhizomelic shortness of stature; normal craniofacial appearance and hand configuration; and later recognition of the presence of the abnormality than in achondroplasia (which can be recognized at birth). A review of the 35 previously described cases in the literature reveals a preponderance of affected females and a high incidence of spontaneous mutation, although when once evident the trait is passed as an autosomal dominant. Two of our patients had seizures, and mental deficiency may be an associated finding although it is by no means usually present. Orthopedists should be aware of this entity, which may be somewhat more common than has been thought, because of the different implications for ultimate height, which is greater in hypochondroplasia than in achondroplasia, the lack of cauda equina compression findings, and the need for genetic counseling.

Adolescent↗