ABSTRACT
Aneurysmal dilation of arteriovenous fistulae used for haemodialysis is a recognised complication but its clinical significance is a contentious issue. Our aims were to describe aneurysmal fistulae morphologically and clinically.Sixty patients underwent duplex scanning to measure the maximum diameter and skin thickness of their fistula. Haemodialysis function and bleeding risk were assessed clinically.The 75th percentile of maximum diameter was 2.05 cm. In addition to conventional diameter measurement, we describe a novel volume measurement technique which may be of value. No relationship was found between maximum diameter or volume and function, skin thickness or bleeding.Some studies define aneurysm at 2 cm (75th percentile); however, this definition and other arbitrary definitions lack clinical significance. This work suggests that fistula dilation should be considered together with clinical issues when determining the clinical significance of an aneurysm. Our finding that haemodialysis function, skin thickness and bleeding were not associated with diameter needs further study.
Subject(s)
Aneurysm/diagnostic imaging , Arteriovenous Shunt, Surgical/adverse effects , Renal Dialysis , Ultrasonography, Doppler, Color , Adult , Aged , Aged, 80 and over , Aneurysm/etiology , Aneurysm/physiopathology , Dilatation, Pathologic , Female , Humans , Male , Middle Aged , Pilot Projects , Postoperative Hemorrhage/etiology , Predictive Value of Tests , Prognosis , Risk Factors , Scotland , Skin/diagnostic imaging , Time FactorsSubject(s)
Histiocytosis, Langerhans-Cell/diagnosis , Administration, Cutaneous , Aged , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use , Diagnosis, Differential , Histiocytosis, Langerhans-Cell/drug therapy , Histiocytosis, Langerhans-Cell/pathology , Humans , Male , Thorax , Triamcinolone/administration & dosage , Triamcinolone/therapeutic useABSTRACT
Mediastinal fat necrosis (MFN) or epipericardial fat necrosis, as it is commonly referred to in the literature, is a rare self-limiting cause of chest pain of unclear etiology. MFN affects previously healthy individuals who present with acute pleuritic chest pain. Characteristic computed tomography (CT) findings include a fat attenuation lesion with intrinsic and surrounding increased attenuation stranding. There is often associated thickening of the adjacent pericardium and/or pleural effusions. We present two cases of MFN manifesting as ovoid fat attenuation lesions demarcated by a soft tissue attenuation rim with intrinsic and surrounding soft tissue attenuation stranding and review the clinical and pathologic features of these lesions. Knowledge of the clinical presentation of patients with MFN and familiarity with the characteristic imaging findings of these lesions should allow radiologists to prospectively establish the correct diagnosis and suggest conservative management and follow-up.
ABSTRACT
Although uncommon, "brain cancer" is one of the most feared diseases that afflict human beings. While still regarded as one of the most deadly forms of primary malignant brain neoplasm, recent advances in the treatment of Glioblastoma Multiforme (GBM) have offered new hope for patients, families and clinicians. In the first part of this two-part evidence-based review, we focused on the multidisciplinary advances that have established the current standard of care practice in the management of GBM. The second part discusses ongoing research efforts, both ongoing clinical trial efforts as well as some of the newer technologies that are forming the promise of the future.
Subject(s)
Brain Neoplasms/therapy , Glioblastoma/therapy , Medical Oncology/trends , Standard of Care/trends , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/pharmacokinetics , Blood-Brain Barrier/drug effects , Combined Modality Therapy/trends , Glioblastoma/immunology , Humans , Immunotherapy/methods , Immunotherapy/trends , Injections, Intra-Arterial , Molecular Targeted Therapy , Radiation Oncology/trendsABSTRACT
Although uncommon, "brain cancer" is one of the most feared diseases that afflict human beings. While still regarded as one of the most deadly forms of primary brain neoplasm, recent advances in the treatment of glioblastoma (GBM) have offered new hope for patients, families, and clinicians. In the first part of this two-part review, we will focus on the multidisciplinary advances that have established the current treatment approach in the management of GBM. In the second part of this review, ongoing research will be presented including current clinical trials as well as some of the newer technologies that are forming the promise of the future.
