Estrogen therapy.

PIP: A continuing education examination of estrogen therapy is discussed. The most common indication of estrogen therapy is for replacement in menopausal women. Estrogens can also be used in the treatment of certain types of cancer such as prostatic cancer. A diagnosis of estrogen deficiency must be established first and then estrogen therapy must be selectively used. Psychoemotional problems must be ruled out. Perimenopausal patients may be treated somewhat differently than postmenopausal patients. 1 of the major controversies surrounding estrogen therapy, other than cancer and osteoporosis, is its implication to coronary heart disease. The evidence indicates that estrogen in some way contributes to endometrial carcinoma. Estrogen administration does not seem to show a correlation to breast cancer. Actual treatment must be individualized, and which estrogen, how much, and how long it should be used is still not clear.^ieng

Idiopathic scoliosis: an electromyographic study.

Thirty-one patients from 12 to 19 years of age having idiopathic scoliosis underwent electromyography of the paraspinal musculature using a Teflon-coated monopolar electrode. The studies conducted with the patients both prone and standing revealed no abnormalities on electrode insertion suggestive of a neuropathic process. In the prone position 29 patients had electrical silence on both the concave and convex side of the curvature. In the standing position most of the patients had asymmetrical activity with a preponderance of activity on the convex side. However, 33% of the patients in whom the spinal musculature was silent in the standing position had balanced curves. This observed correlation between a balanced curve and electrical silence warrants further study.

Primary subacute pyogenic osteomyelitis in long bones of children.

Ten cases of primary subacute osteomyelitis illustrate its clinical resemblance to various bone neoplasms. Diagnosis was established by open biopsy. Treatment with curettage, cast immobilization, and antibiotics, when indicated, resulted in radiographic healing and resolution of symptoms.

Multifocal subacute pyogenic osteomyelitis in a child. A case report.

The clinical features of multifocal subacute pyogenic osteomyelitis are: insidious onset; the absence of toxic reaction; radiographic appearance of a bone neoplasm. In a 14-year-old boy, immobilization and appropriate antibiotics produced symptomatic improvement and radiographic evidence of healing reactive bone above both bone lesions.