Biomedical subjects

H Ehrengruber

Publications and source records attributed to H Ehrengruber.

At least 19 recordsLinked to original sources

PubMed1992

Diffuse idiopathic skeletal hyperostosis (DISH) of the elbow: a cause of elbow pain? A controlled study.

Elbow pain is a common complaint and elbow hyperostosis a frequent radiological condition. However, little is known about the association between the clinical and radiological findings. To evaluate the relationship between spinal and extraspinal hyperostotic features and the clinical relevance of elbow hyperostosis we have performed the first controlled, double-blinded study of 85 hospitalized probands, 33 with and 52 without thoracospinal hyperostosis on lateral chest X-ray. Elbow and shoulder hyperostosis were graded on bilateral standard radiographs. Elbow pain was assessed by an interviewer using a standardized questionnaire and extraskeletal causes of elbow pain were recorded. The prevalence of elbow hyperostosis was increased in cases with thoracospinal hyperostosis compared to controls (82% versus 58%, chi 2 = 5.32, P less than 0.025, n = 85, olds ratio (OR) 3.30 (95% CI 1.16-9.35)). Similarly, the prevalence of elbow hyperostosis was increased in cases with shoulder hyperostosis compared to controls (83% versus 60%, chi 2 = 4.51, P less than 0.05, n = 84, OR = 3.20 (95% CI 1.06-9.66)), emphasizing the multifocal nature of hyperostotic features. Elbow pain was only slightly more prevalent in cases with elbow hyperostosis compared to controls (21% versus 13%, chi 2 = 0.75, NS, OR = 1.84 (95% CI 0.46-7.44)). We conclude that elbow hyperostosis is a radiological finding of doubtful clinical relevance.

Aged↗

PubMed1992

The prevalence of palpable finger joint nodules in diffuse idiopathic skeletal hyperostosis (DISH). A controlled study.

The presence of clinically palpable finger joint nodules (Heberden's and Bouchard's nodes) was documented in 123 consecutive cases with diffuse idiopathic skeletal hyperostosis (DISH) of the thoracic spine and 191 matched DISH negative controls. The prevalence of palpable finger joint nodules was almost twice as frequent in cases with spinal DISH compared to controls (46% versus 31%, chi 2 = 7.67, P less than 0.01; multivariate adjusted odds ratio OR = 1.84; 95% CI: 1.14-2.98). This increase was most marked at the proximal interphalangeal joint, in males and in patients up to the age of 65 years. In addition and independent of other variables such as hyperostotic features, age and sex, the prevalence of palpable finger joint nodules was about twice as high in probands with a history of physically heavy work compared to those without (43% versus 26%, chi = 9.18, P less than 0.005; multivariate adjusted odds ratio OR = 2.10; 95% CI: 1.26-3.52). From these results we conclude that DISH should be considered as an independent risk factor in the development of finger joint nodules.

Aged↗

PubMed1990

Diffuse idiopathic skeletal hyperostosis (DISH) of the shoulder: a cause of shoulder pain?

Shoulder pain is a common complaint and shoulder hyperostosis a frequent radiological condition. However, little is known about the association between the clinical and radiological findings. To evaluate the clinical relevance of shoulder hyperostosis we performed a controlled, blind study of 99 hospitalized probands with and without thoracospinal hyperostosis on lateral chest X-rays. The study included grading of the shoulder hyperostosis on the basis of three bilateral standard radiographs, assessing shoulder pain in a standardized way by an interviewer and recording extraskeletal causes of shoulder pain. The prevalence of shoulder hyperostosis was doubled in probands with thoracospinal hyperostosis compared to controls (chi 2 = 5.90, P less than 0.025, n = 99). Shoulder hyperostosis, irrespective of thoracospinal hyperostosis, predisposed to shoulder pain (40% versus 18%, chi 2 = 4.06, P less than 0.05, n = 74). Shoulder hyperostosis in combination with thoracospinal hyperostosis (shoulder DISH) predisposed to shoulder pain to an even greater extent (46% versus 12%, chi 2 = 6.64, P less than 0.01, n = 47). We conclude that shoulder hyperostosis is a radiological finding of potential clinical relevance.

Arthrography↗

PubMed1989

Diffuse idiopathic skeletal hyperostosis (DISH) of the spine: a cause of back pain? A controlled study.

This is the first controlled study of the frequency of back pain in a European caucasian population with diffuse idiopathic skeletal hyperostosis (DISH). Elderly patients admitted to hospital for reasons other than back pain were assessed for the presence of spinal DISH using the routine lateral chest radiograph films. A total of 106 probands (82 males, 24 females) with a mean age of 70 years fulfilled the criteria for DISH as defined previously. One hundred and seventy-eight patients (117 males, 61 females) not meeting these criteria were used as controls. The prevalence of back pain was assessed by a blinded interviewer using a structured questionnaire. Our primary hypothesis was that spinal DISH positive probands had not had back pain more often than controls. This controlled study showed no statistically significant difference in pain frequency between spinal DISH positive probands and controls at any spinal level. We conclude that back pain does not occur more often in radiographically defined DISH positive probands than in controls. The radiological finding of spinal DISH, as far as it does not lead to stenosis of the spinal canal or dysphagia, thus seems to be a finding without clinical relevance.

Aged↗

PubMed1986

[Preoperative prediction of the character of strumas].

We analyzed prospectively collected preoperative data of 278 goiter patients in order to determine predictors of goiter dignity. Aspiration-biopsy-cytology (ABC) revealed to be a good predictor as a result of a regression analysis. Its predictive value could not be improved significantly by combining ABC-data with other preoperative data. Patients with malignant goiters significantly differed from those with benign goiters with respect to age distribution, growth duration of the goiter and its function and texture, whereas sex distribution, nodularity and scintigraphic appearance did not differ significantly in the two groups.

Adenocarcinoma↗

PubMed1985

[Hospital mortality of acute myocardial infarct in Switzerland according to VESKA (Swiss Hospital Association) diagnosis statistics 1970, 1975 and 1981].

During the period spanned by the years 1970, 1975 and 1981, in-hospital mortality from acute myocardial infarction in Swiss hospitals fell by a total of 30%. The decrease was most marked in small and medium sized hospitals, in which mortality was highest in 1970. At the same time, the average length of hospital stay declined by some 50%. The possible causes of this development are discussed.

Adult↗

PubMed1982

[Evaluation of the Swiss Hospital Association diagnostic and surgical statistics].

Number of admissions, days of care and the average length of stay are presented by age, sex and other criteria for Swiss short stay hospital. Persons 60 and over consumed more than 50 percent of all days of care. On the average, females of all age groups, except from 5 to 54 years of age, were hospitalized longer than males. Principal factors influencing the length of stay are: age, diagnosis and mode of discharge. The increase in the number of persons 65 and over admitted to medical departments corresponds to the demographic development, while it exceeds the demographic increase for surgical departments.

Adolescent↗

PubMed1982

Measurement of the optical density of the optic nerve head I: the pallor of the papilla in artificial ocular hypertension.

The pallor of the optic disc during acute raise of intraocular pressure can be shown on the negatives of orthochromatic film and is measured by a photoscanner. When raising intraocular pressure from normal values to ablut 40 mm Hg, ten young persons showed an increase in optical density from 0.28 log units +/- 0.04 SEM to 0.38 log units +/- 0.04 SEM. When raising IOP to 65 mm Hg, the optical density was 0.43 log units +/- 0.04; with 110 mm Hg the optical density was 0.44 log units +/- 0.04 SEM. Above values of 40 mm Hg IOP, the pallor does not remain constant but may also decrease in some cases. The higher the intraocular pressure, the more contradictory the response. The phenomenon may be shown on various parts of the rim simultaneously. The amount of maximum pallor is directly related to the value of optical density with normal intraocular pressure. After restoring IOP to normal values, optical density decreases again, the amount of decrease being related to initial value. The contradictory response with higher IOP may be due to autoregulation of the capillaries of the optic nerve head.

Humans↗

PubMed1982

Measurement of the optical density of the optic nerve head II: short-time fluctuations of the optical density of the nerve head.

The fluctuation of pallor with increasing IOP could be due to either insufficient reliability of the method or to an unrecognized pulsating phenomenon. A better arrangement should eliminate imperfection of the method. Coupling the release with the ECG should reveal a relationship to the arterial pulse rate. Neither condition could be demonstrated as the reason for the fluctuation. The connection of the fluctuation and its possible relationship to central venous pressure is discussed. The margin of error is shown, which is 9% on average.

Electrocardiography↗

PubMed1979

[Prognostic criteria and clinical prerequisites of curative therapy of esophageal cancer by radiotherapy alone (author's transl)].

Survey of 289 patients with squamous cell carcinoma of the esophagus treated solely by irradiation between 1961 and 1973. All patients fit for radiotherapy -- uniformly without further selection -- received a local dose of at least 6500 rads. This resulted in a 18% one year survival rate; only one patient lived more than five years. All patients were compared using different criteria to correlate the initial findings at the time of diagnosis with the type of therapy and the prognosis. Three treatment plans were established according to the initial clinical findings: a) palliative therapy, b) locally curative therapy and c) radical curative therapy. The treatment plan which seems to show the best results consists of preoperative irradiation with adjuvant chemotherapy followed by surgical removal of the tumor. This plan should be pursued in all appropriate patients.

Adult↗

PubMed1975

[Proceedings: The evaluation of the mixed venous O2-saturation in the oxymetric determination of heart minute volume and shunt size].

An investigation has been conducted into three groups of patients without intracardiac shunt (A: 59 adults without anesthesia, B: 58 children in anesthesia, C: 53 children without anesthesia). Oxygen saturation in the pulmonary artery was plotted against saturation in both venae cavae or against saturation in only one of them. The resulting 9 equations can be used as formulas to calculate the saturation of mixed venous blood in patients with an intracardiac shunt. Furthermore, mixed venous saturation can be estimated from "subclavian catheter" blood samples in patients without shunt.

Arteriovenous Anastomosis↗

PubMed1975

Effect of oral thyrotrophin-releasing hormone on serum thyroxine in growth hormone deficient and normal children.

Oral administration of synthetic TRH in a dose of 80 mg/1-73 m-2 at 0 and 12 h to normal and constitutionally small children caused a significant increase of total serum thyroxine (T4) within 6-24 h. The mean maximal T4 increment was +3-7 plus or minus 1-1 and +3-8 plus or minus 1-2 mug/dl (mean plus or minus 1 SD) respectively in the two groups. Of seventeen euthyroid GH deficient children, fifteen showed a normal and two patients a slightly subnormal response. Of fifteen hypothyroid GH deficient children nine had a prompt and normal increase of serum T4 indicating primary TRH deficiency. Two had a delayed T4 response and four had no response, even after prolonged stimulation. The localization of the primary defect in these latter subjects with severe hypothyroidism can not be made by measuring T4 only, since the thyroid gland may become unresponsive to TSH after longstanding TSH deficiency. TSH measurements are necessary in these circumstances for a clear localization of the primary defect. One GH deficient patient with hypothalamic TRH deficiency was treated with high oral TRH doses for 7 months and showed no side effects.

Administration, Oral↗

PubMed1975

[Computation of mixed venous oxygen saturation in intracardial shunts and its dependence on age, anesthesia and premedication].

In patients with an intracardiac shunt, the oxygen saturation of the mixed venous blood cannot be measured, but it must be estimated from the oxygen saturation in the superior and in the inferior vena cava. We have evaluated the results of patients who had definitively no shunt and who had been catheterized for other reasons. Based on statistical principles we developed formulas to calculate the oxygen saturation of the mixed venous blood. We examined three group of patients: a) Children up to 11 years catheterized during general anaesthesia (58 patients) b) Children up to 11 years catheterized after premedication but without general anaesthesia (53 patients) c) Adults catheterized without general anaesthsia (59 patients) We found that the formulas from the patients who had been catheterized during general anaesthesia were quite different from those without anaesthesia. In the patients without an anaesthesia the superior vena cava was coupled with a much higher factor than the inferior vena cava; in patients with anaesthesia, the contribution of the inferior vena cava was stronger. The age of the patients had no significant influence on our formulas.

Adolescent↗

PubMed1974