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Biomedical subjects

A E Brodsky

Publications and source records attributed to A E Brodsky.

18 recordsLinked to original sources
PubMed2001

Perceptions of parenting: individual differences and the effect of community.

Neighborhood norms are an important determinant of beliefs and attitudes about parenting, and measuring changes in community norms is an important component of evaluating community-based programs for improving child outcomes. The purpose of this study was to determine whether or not a survey of community residents' perceptions of parenting could be used to measure community parenting norms and whether these perceptions differed by individual or community characteristics. Two community surveys with 870 and 914 respondents, respectively, were conducted in 3 low-income neighborhoods. Results indicated that perceptions of parenting could be measured reliably at the community level although it is important to consider the presence of multiple norms when using such measures. Furthermore, differences in perceptions of parenting associated with individual characteristics were markedly decreased when neighborhood characteristics were considered, suggesting that the association of individual characteristics with perceptions of parenting is confounded by neighborhood characteristics.

Adult↗
PubMed1999

"Making it": the components and process of resilience among urban, African-American, single mothers.

In contrast to the bulk of research on urban single mothers that focuses on risk and negative outcomes, this qualitative study of ten resilient mothers living in risky neighborhoods uses the women's own words to conceptualize resilience as an ongoing process of balancing risk and protective factors in eight domains. The findings question current assumptions about the universality of risk and protective factors, and point to new directions for program and policy.

Adaptation, Psychological↗
PubMed1992

Repair of symptomatic pseudoarthrosis of anterior cervical fusion. Posterior versus anterior repair.

Thirty-four patients with symptomatic pseudarthrosis of anterior cervical fusion were treated. There were 16 men and 18 women. Eighteen patients had pseudarthrosis at 1 level; 14 at 2 levels; and 2 at 3 levels, with C5-6 and C6-7 levels most commonly involved. Anterior repair of pseudarthrosis was done in 17 patients, which resulted in 76% radiologic fusion. Of 17 patients repaired posteriorly, 94% achieved radiologic fusion. Average follow-up was 60 months, with a minimum of 24 months. "Excellent" or "Good" results were achieved in 59% of anterior repair and 88% of posterior fusion group. This study demonstrates that posterior cervical fusion is the more effective method for repairing symptomatic pseudarthrosis of anterior cervical fusion.

Bone Transplantation↗
PubMed1991

Correlation of radiologic assessment of lumbar spine fusions with surgical exploration.

Although inspection of posterolateral lumbar fusion is the best method of determining its solidity, routine exploration of the fusion is somewhat impractical because of the morbidity and expense involved. Removal of internal fixation devices or implantable batteries or reoperation for failed back surgery enabled the exploration and assessment of lumbar spine fusions in 214 operations on 175 patients. The preoperative radiologic assessment (plain roentgenographs, polytomography, bending films, and computed tomographic scans) were correlated with surgical findings. This study indicated a significant percentage of inaccuracy of all radiologic modalities used. Noncorrelations were present in 36% of plain roentgenographs, 41% of polytomograms, 38% of bending films, and 43% of computed tomographic scans. Radiologic inaccuracy was manifest on both the positive and negative sides. Computed tomographic scanning presented the lowest percentage of inaccuracy (22%) and bending films the highest percentage (27%). Based on these findings, there exists the need for more accurate noninvasive methods to determine the solidity of spine fusions.

Adult↗
PubMed1989

Segmental ("floating") lumbar spine fusions.

A traditional teaching in orthopaedic surgery has been that, in cases of fusion for L4-5 discopathy or instability, one must include the lumbosacral joint. There is nothing in the literature to support this time-honored dictum. The senior author, among others, has rejected this concept; and, the authors are, therefore, in a position to present a 32-year experience with segmental or "floating" fusion. Two hundred six floating fusions were performed, of which 184 were available for follow-up. Of these, 83.7% achieved "Excellent" or "Good" results; 15.2% were rated "Fair"; and 2% were rated "Poor." Only five patients (2.7%) had subsequent disc herniation at the lumbosacral level necessitating discectomy and extension of fusion to incorporate the sacrum.

Adult↗
PubMed1988

A reassessment of Holt's data on: "The question of lumbar discography".

This paper is a detailed critique of Holt's study entitled "The Question of Lumbar Discography." His finding of a 37% false positive rate in asymptomatic volunteers has been used to discredit lumbar discography as a valid diagnostic study in the investigation of low back pain patients with nonprolapsing disc disease of the lumbar spine. The authors show why Holt's paper should no longer be used as scientific and authoritative evidence against the use of discography by today's standards.

Back Pain↗
PubMed1987

Talar compression syndrome.

Ballet dancers frequently stand on the tips of their toes in the en pointe and demi-pointe positions, resulting in compression of the posterior structures of the ankle during repeated plantar flexion of the foot, producing the talar compression syndrome. This mechanism may result in posterior block or impingement of an os trigonum or Stieda's process. When the dancer attempts to force the foot into plantar flexion, the os trigonum or the Stieda's process may be impinged between the calcaneus and the posterior edge of the tibia. Pain and tenderness are localized at the posterolateral aspect of the ankle behind the peroneal tendons. In nondancing members of the population, these conditions are usually asymptomatic. It is the requirement of the classical dance for a well-pointed foot that produces symptoms. We are reporting up to 7 years follow-up of six professional ballet dancers in whom we removed the os trigonum for symptomatic talar compression syndrome, caused by the trauma of the en pointe position of toe dancing. Two patients had bilateral operations. All six patients returned to professional dancing within a few months and remained asymptomatic. The anatomy of this condition is reviewed, as well as the diagnosis and treatment.

Adolescent↗
PubMed1985

Cervical angina. A correlative study with emphasis on the use of coronary arteriography.

A total of 438 patients with cervical angina were evaluated from 1966 to 1979. Of these 88 were treated surgically. This article emphasizes the inadequacy of established noninvasive diagnostic criteria for coronary disease and the importance of coronary arteriography. Statistics are presented for coronary diagnostic criteria for decision-making for surgery, for levels of surgery, choice of surgical procedures, and results of surgery. A total of 78.2 percent who underwent cervical spine surgery were rated as excellent; 16.1 percent fair; 2.3 percent poor; and 3.4 percent had inadequate length of follow-up.

Adult↗
PubMed1978

Cauda equina arachnoiditis. A correlative clinical and roentgenologic study.

A series of 93 consecutive patients whose myelograms were reported as showing arachnoiditis were studied, and correlations between the radiographic appearance and the clinical and surgical findings were tabulated. All but 1 patient had had either lumbar disc surgery and/or Pantopaque myelography. The study led to a classification of such roentgenogram changes which revealed that the majority of patients studied did not have the usual adhesive arachnoiditis, but the picture they projected was more commonly due to spinal stenosis, extraarachnoid dye injection, extradural scar, etc. Only 1 patient of the 93 presented the classic severely disabling paraparesis, intractable pain, and loss of bowel and bladder functions commonly ascribed to adhesive arachnoiditis. The presence of such myelographic changes need not deter necessary surgery for coexisting disc pathology, nerve root entrapment, or spinal stenosis. In only a small percentage of these patients could the symptoms be attributed to the arachnoiditis changes seen in the myelogram.

Adult↗
PubMedDate not supplied

Talar compression syndrome.

Ballet dancers frequently stand on the tips of their toes in the en pointe and demi pointe positions, resulting in compression of the posterior structures of the ankle during repeated plantar flexion of the foot, producing the talar compression syndrome. This mechanism may result in posterior block or impingement of an os trigonum or Stieda's process. When the dancer attempts to force the foot into plantar flexion, the os trigonum or the Stieda's process may be impinged between the calcaneus and the posterior edge of the tibia. Pain and tenderness are localized at the posterolateral aspect of the ankle behind the peroneal tendons. In nondancing members of the population, these conditions are usually asymptomatic. It is the requirement of the classical dance for a well-pointed foot that produces symptoms. We are reporting up to 7 years' followup of six professional ballet dancers in whom we removed the os trigonum for symptomatic talar compression syndrome, caused by the trauma of the en pointe position of toe dancing. Two patients had bilateral operations. All six patients returned to professional dancing within a few months and remained asymptomatic. The anatomy of this condition is reviewed, as well as the diagnosis and treatment.

Adult↗
PubMedDate not supplied

Post-laminectomy and post-fusion stenosis of the lumbar spine.

On the basis of a 9-year experience with 231 patients with post-laminectomy and post-spinal fusion stenosis of the lumbar spinal canal, we emphasize the importance of recognizing and adequately decompressing such lesions. In the majority of such patients pain relief has been achieved, but some of the failures can be attributed to technical reasons. Most failures are due to associated lesions and to functional factors. A special surgical techniy be advisable. The indications for fusion however were few and require further investigation and evaluation. The significant failure rate points to the need for continuing research into the causes of low back pain and adequate management programs for the patient with the "multiple operated back" who still has disabling pain and drug dependence.

Constriction, Pathologic↗
PubMedDate not supplied

Lumbar discography. Its value in diagnosis and treatment of lumbar disc lesions.

Lumbar discography has been performed in over 1500 patients at St. Luke's Episcopal Hospital, and a report concerning 683 cases has been previously published. The authors review an additional 199 cases, finding that decision making was influenced by discography in 155 cases (78%). A positive discogram was surgically confirmed in 111 patients (56%). In 14(7%) the disc was found to be normal at surgery. One hundred six patients (53%) had positive discograms with negative or equivocal myelogram. In 36 patients with a positive myelogram, the discogram was corroborative, although most patients with positive myelograms did not have discography. Sixty-nine patients (35%) did not have surgery.

Adult↗