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Biomedical subjects

J C Drennan

Publications and source records attributed to J C Drennan.

At least 19 recordsLinked to original sources
PubMed2000

Evaluation and treatment of swallowing impairments.

Swallowing disorders are common, especially in the elderly, and may cause dehydration, weight loss, aspiration pneumonia and airway obstruction. These disorders may affect the oral preparatory, oral propulsive, pharyngeal and/or esophageal phases of swallowing. Impaired swallowing, or dysphagia, may occur because of a wide variety of structural or functional conditions, including stroke, cancer, neurologic disease and gastroesophageal reflux disease. A thorough history and a careful physical examination are important in the diagnosis and treatment of swallowing disorders. The physical examination should include the neck, mouth, oropharynx and larynx, and a neurologic examination should also be performed. Supplemental studies are usually required. A videofluorographic swallowing study is particularly useful for identifying the pathophysiology of a swallowing disorder and for empirically testing therapeutic and compensatory techniques. Manometry and endoscopy may also be necessary. Disorders of oral and pharyngeal swallowing are usually amenable to rehabilitative measures, which may include dietary modification and training in specific swallowing techniques. Surgery is rarely indicated. In patients with severe disorders, it may be necessary to bypass the oral cavity and pharynx entirely and provide enteral or parenteral nutrition.

Age Distribution↗
PubMed2000

The ethics of the introduction of gene therapy into orthopaedic practice.

Gene therapy has the potential to transform musculoskeletal medicine. Orthopaedists have been ready to incorporate innovations in medicine and engineering into their surgical practice, frequently before having full information. There is no reason to doubt the rapid acceptance of gene therapy by the orthopaedic profession. Caution is needed in incorporating gene therapy into standard practice because of the lack of knowledge and risks that are greater than for previous innovations.

Ethics, Medical↗
PubMed1991

Myelomeningocele.

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Foot Deformities↗
PubMed1989

Long-term results of triple arthrodesis in Charcot-Marie-Tooth disease.

We evaluated sixteen patients who had Charcot-Marie-Tooth disease and had had a total of thirty triple arthrodeses. The average age at the time of operation was fifteen years, and the average length of follow-up was twenty-one years. Of the thirty feet, the result in two (7 per cent) was rated excellent; in five (17 per cent), good; in nine (30 per cent), fair; and in fourteen (47 per cent), poor. Each of the fourteen feet that had a poor result had severe impairment of function and needed an orthosis. Six limbs had an arthrodesis of the ankle for degenerative joint disease. Progressive muscle imbalance resulted in recurrent cavovarus deformity in seven feet that initially had had satisfactory alignment. Degenerative changes of the ankle and joints of the mid-part of the foot were noted radiographically in twenty-three feet. The large number of unsatisfactory long-term results in these patients who had had a triple arthrodesis for deformity of the foot secondary to progressive peripheral neuropathy differs from those in earlier reports on patients who had poliomyelitis, who retained normal sensation and had a permanent, stable muscle imbalance. We believe that triple arthrodesis should be considered only as a salvage procedure in patients who have progressive peripheral neuropathy and should be limited to those who have severe, rigid deformity.

Adolescent↗
PubMed1985

Foot and ankle deformities in arthrogryposis multiplex congenita.

When 51 patients with arthrogryposis multiplex congenita followed an average of 12 years were reviewed, talipes equinovarus was the most common foot and ankle deformity. The best results were obtained by talectomy. The majority of tendo Achillis lengthenings, posteromedial releases, and triple arthrodeses were unsuccessful and were associated with a high complication rate. Congenital convex pes valgus was the second most common deformity. Surgical treatment by open reduction generally resulted in unsuccessful outcomes. Ambulation was achieved in 46 patients. Residual foot deformity was the primary reason for persistent difficulties in walking.

Achilles Tendon↗
PubMed1982

Physiological bowing and tibia vara. The metaphyseal-diaphyseal angle in the measurement of bowleg deformities.

The metaphyseal-diaphyseal angle is the angle created by the intersection of a line through the transverse plane of the proximal tibial metaphysis with a line perpendicular to the long axis of the tibial diaphysis. This angle represents the degree of deformity of the proximal end of the tibia in a patient with clinical bowleg deformity and permits early differentiation between infantile tibia vara and physiological bowleg, before the appearance of the radiographic changes of tibia vara. In twenty-nine of thirty affected extremities with an initial metaphyseal-diaphyseal angle of more than 11.0 degrees, radiographic changes of tibia vara later developed. However, only three of fifty-eight extremities with a metaphyseal-diapyseal angle of 11.0 degrees or less had any of the diagnostic changes. In addition, the ratio of the metaphyseal-diaphyseal angle (proximal tibial metaphyseal deformity) to the tibiofemoral angle (deformity of the entire extremity) showed that approximately 60 per cent of the deformity in tibia vara originates in the proximal metaphysis, whereas only 20 per cent of the deformity in physiological bowing originates there. The metaphyseal-diaphyseal angle allows accurate early diagnosis of bowleg deformity, as well as accurate assessment of its progression.

Bone Diseases, Developmental↗
PubMed1981

Case report 157.

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Adolescent↗
PubMed1981

Functional classification and orthopaedic management of spinal muscular atrophy.

The majority of patients with chronic infantile and juvenile forms of spinal muscular atrophy survive to adult life. Forty-four patients have been reviewed at an average of 17 years after diagnosis. The subdivision of patients into four groups, based on the maximal physical function developed by the individual, correlates well with the onset and severity of secondary deformity of the limbs and spine. This information allows anticipation of the problems and plans for their treatment to be made from early childhood. After analysis of the orthotic and surgical treatment received by these patients, a specific programme of care is recommended for each of the functional groups.

Adolescent↗
PubMed1978

"Body-brace" oesophagitis, a complication of kyphoscoliosis therapy.

Oesophagitis developed in 4 patients, 3 of whom had scoliosis braces and 1 a body cast after surgery for kyphoscoliosis. Symptoms varied from chronic epigastric pain to gastrointestinal haemorrhage. Prophylaxis of oesophageal disease in children undergoing correction of scoliosis may prevent severe oesophagitis.

Adolescent↗
PubMed1977

Denver: a metropolitan public school scoliosis survey.

A successful method for screening pupils for scoliosis in a metropolitan public school system is outlined. The incidence of scoliosis increased to greater than 3% in the seventh-grade population. Approximately 15% of the patients with established diagnoses required active management.

Adolescent↗