92172829 The accuracy of self-report of fractures in elderly women: Evidence from a prospective study

257 with estriol suppositories. All had symptoms of vaginal atrophy and urinary incontinence. Endometrial samples were taken after 8-10 years of therapy. Estriol had induced slight proliferative changes in the endomethm in 7 of 48 patients studied by endometrial sampling. 75%of the women reported significant subjective improvement of stress incontinence. Estriol supplementation did not produce any significant change in urethral pressure, functional length, or cystometric parameters. However, a significant increase in pressure transmission ratio to the proximal urethra was noted after vaginal medication with estriol. Replacement therapy in post menopausal women must take into account the patients perception of risks and benefits. The risk of estriol treatment is insignificant. 92172829 ~raryof~~~of~~ise~~w~:Evideeeefrolra~ve~y Nevitt M.C.; Cummings S.R.; Browner W.S.; Seeley D.G.; Cauley J.A.; Vogt T.M.! Black D.M. Division of Clinical Epiahiology, University of California, 74 New Montgomery St., San Francisco, CA 94105 AM. J. EPIDEMIOL. 1992 13515(490-499) The authors compared self-reports of non-spine fractures in a cohort of elderly white women with radiologic reports and medical records. Subjects (n = 9,784) were recruited between 1986 and 1988 in Baltimore, Pittsburgh, Minneapolis, and Portland, Oregon. Eleven percent (95% confIdewe interval 913%) of self-reports of fracture were false-positive (radiographs were negative) and a total of 20% (18-23%) could not be confirmed (radiographs were negative, uncertain, or not available). Report by proxy respondent was more accurate than self-report. There were no contInned fractures in the medical records of a random sample of 283 participants who did not report a fracture. The percent of falsepositives varied by the site of the injury and was low for self-reported fractures of the shoulder or upper arm (5%; l-13%), wrist (8%; 4-l I%), and hip (11%; 5-N%), but was high for hand or finger (20%; 12-30%), rib (23%; 15-32%), and face or skull (33%; 17-54%). Having a college education was associated with increased accuracy, while a history of falls and self-reported osteoporosis were associated with decreased accumcy. The authors conclude that elderly women overreport fractures, but that self- report is relatively accurate for several important osteoporotic fractures, including those of the hip, wrist, and humerus. Self-report of ‘any’ fracture, rib, distal extremity, and head fracture, and fractures in women with a tendency to fall or with osteoporosis should be verified by a radiologic diagnosis. 92179856 l?4mgead~Asblyofaporhl~aad-nceptor~in~oateoartMtkkllea Tsai C.L.; Liu T.K.; Chen T.J. Department of Orthopaedic Surgery, School of Medicine. National Taiwan University, Taipei BIOCHEM. BIOPHYS. RES. COMMUN. 1992 183/3 (1287-1291) Estrogen appears to be a risk factor in knee osteoarthritis (OA). Results from 21 patients revealed that synovial estradiol level was highly related to the severity of OA. Increased estradiol receptor bindings in the medial compartment of the femoral condylar and tibia plateau cartilages were observed, the increase was significantly higher in the medial than in the lateral compartment (P < 0.05). Although the synovial estradiol level was significantly lower in women with OA than in men with OA (P < O.Ol), postmenopausal women were hypothesimd to be more susceptible to OA, since the possible existence of synovial testosterone might counteract the high estradiol synoviai level in men, which results in a lower incidence of knee OA in men than in postmenopausal women. We suggest that excessive synovial estradiol and higher estradiol receptor bindings may be involved in the development of knee OA, particularly in postmenopausal women. 92179864 pregnMqasriskfactar!?forrhemMtoidarrJwf&lm& Amexam&thnoftherokoffemlelwmooesd 8makpa@atbnaseentrdgoap Pritchard M.H. Department of Rheumatology, University Hospital of Wales, Cardiff CF4 4XW