Republished: Bilateral carotid and vertebral rete mirabile with vein of Galen aneurysmal malformation: an unreported association

Rete mirabile is a fine meshwork of anastomosing vessels that replace the parent artery. A 30-year-old woman complained of slurring of speech, right eye proptosis, recurrent vomiting, and loss of bladder and bowel control, followed by drowsiness lasting 30–40 min, for the past 6 months. On cross sectional imaging and angiography, the patient was found to have a vein of Galen aneurysmal malformation, with bilateral carotid and vertebral rete mirabile. The patient was offered both endovascular and open surgical options but she refused any form of surgical treatment and opted for conservative management. At the 6 month follow-up, she continued to have occasional episodes of headache and vomiting but was otherwise normal. We describe the clinical, cross sectional, and angiographic features of this patient. A comparison with other patients with bilateral carotid and vertebral rete mirabile is also reported.

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State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair

VASA ◽

10.1024/0301-1526/a000324 ◽

2014 ◽

Vol 43 (1) ◽

pp. 6-26 ◽

Cited By ~ 12

Author(s):

Fabian Rengier ◽

Philipp Geisbüsch ◽

Paul Schoenhagen ◽

Matthias Müller-Eschner ◽

Rolf Vosshenrich ◽

...

Keyword(s):

Aortic Valve ◽

Transcatheter Aortic Valve Replacement ◽

Surgical Repair ◽

Imaging Modality ◽

Open Surgical Repair ◽

Cross Sectional ◽

Transcatheter Aortic Valve ◽

Cross Sectional Imaging ◽

Sectional Imaging

Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

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Cross-Sectional Imaging of Small Bowel Malignancies

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2010.10.001 ◽

2012 ◽

Vol 63 (3) ◽

pp. 215-221 ◽

Cited By ~ 8

Author(s):

Dellano D. Fernandes ◽

Ram Prakash Galwa ◽

Najla Fasih ◽

Margaret Fraser-Hill

Keyword(s):

Small Bowel ◽

Accurate Diagnosis ◽

Imaging Features ◽

Cross Sectional ◽

Conventional Endoscopy ◽

Cross Sectional Imaging ◽

Pretreatment Staging ◽

Sectional Imaging ◽

Histologic Subtypes

Small bowel malignancies are rare neoplasms, usually inaccessible to conventional endoscopy but detectable in many cases by cross-sectional imaging. Modern multidetector computed tomographies permit accurate diagnosis, complete pretreatment staging, and follow-up of these lesions. In this review, we describe the cross-sectional imaging features of the most frequent histologic subtypes of the small bowel malignancies.

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The relationship between disability and suicide: prospective evidence from the Ten to Men cohort

Journal of Public Health ◽

10.1093/pubmed/fdy197 ◽

2018 ◽

Vol 41 (4) ◽

pp. 707-713 ◽

Cited By ~ 2

Author(s):

Allison Milner ◽

Anne-Marie Bollier ◽

Eric Emerson ◽

Anne Kavanagh

Keyword(s):

Mental Health ◽

Logistic Regression ◽

Regression Model ◽

Logistic Regression Model ◽

People With Disabilities ◽

Cross Sectional ◽

Longitudinal Cohort ◽

The Past ◽

The Relationship

Abstract Background People with disabilities often face a range of social and economic adversities. Evidence suggests that these disadvantages result in poorer mental health. Some research also indicates that people with disabilities are more likely experience thoughts about suicide than people without disability, although most of this research is based on small cross-sectional samples. Methods We explored the relationship between self-reported disability (measured at baseline) and likelihood of reporting thoughts of suicide (measured at follow up) using a large longitudinal cohort of Australian males. A logistic regression model was conducted with thoughts of suicide within the past 12 months (yes or no) as the outcome and disability as the exposure. The models adjusted for relevant confounders, including mental health using the SF-12 MCS, and excluded males who reported thoughts of suicide at baseline. Results After adjustment, there was a 1.48 (95% CI: 0.98–2.23, P = 0.063) increase in the odds of thoughts of suicide among men who also reported a disability. The size of association was similar to that of being unemployed. Conclusions Males reporting disability may also suffer from thoughts of suicide. We speculate that discrimination may be one explanation for the observed association. More research on this topic is needed.

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Drug Use Changes at the Individual Level: Results from a Longitudinal, Multisite Survey in Young Europeans Frequenting the Nightlife Scene

European Addiction Research ◽

10.1159/000520118 ◽

2021 ◽

pp. 1-6

Author(s):

Meryem Grabski ◽

Jon Waldron ◽

Tom P. Freeman ◽

Claire Mokrysz ◽

Ruben J.J. van Beek ◽

...

Keyword(s):

Drug Use ◽

Online Survey ◽

Prescription Opioids ◽

Alkyl Nitrates ◽

Cross Sectional ◽

Individual Level ◽

The Past ◽

Frequency Of Use ◽

The Individual

Background: Monitoring emerging trends in the increasingly dynamic European drug market is vital; however, information on change at the individual level is scarce. In the current study, we investigated changes in drug use over 12 months in European nightlife attendees. Method: In this longitudinal online survey, changes in substances used, use frequency in continued users, and relative initiation of use at follow-up were assessed for 20 different substances. To take part, participants had to be aged 18–34 years; be from Belgium, Italy, the Netherlands, Sweden, or the UK; and have attended at least 6 electronic music events in the past 12 months at baseline. Of 8,045 volunteers at baseline, 2,897 completed the survey at both time points (36% follow-up rate), in 2017 and 2018. Results: The number of people using ketamine increased by 21% (p < 0.001), and logarithmized frequency of use in those continuing use increased by 15% (p < 0.001; 95% CI: 0.07–0.23). 4-Fluoroamphetamine use decreased by 27% (p < 0.001), and logarithmized frequency of use in continuing users decreased by 15% (p < 0.001, 95% CI: −0.48 to −0.23). The drugs with the greatest proportion of relative initiation at follow-up were synthetic cannabinoids (73%, N = 30), mephedrone (44%, N = 18), alkyl nitrites (42%, N = 147), synthetic dissociatives (41%, N = 15), and prescription opioids (40%, N = 48). Conclusions: In this European nightlife sample, ketamine was found to have the biggest increase in the past 12 months, which occurred alongside an increase in frequency of use in continuing users. The patterns of uptake and discontinuation of alkyl nitrates, novel psychoactive substances, and prescription opioids provide new information that has not been captured by existing cross-sectional surveys. These findings demonstrate the importance of longitudinal assessments of drug use and highlight the dynamic nature of the European drug landscape.

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A Tour of the Thymus: A Review of Thymic Lesions with Radiologic and Pathologic Correlation

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2013.09.003 ◽

2015 ◽

Vol 66 (1) ◽

pp. 5-15 ◽

Cited By ~ 13

Author(s):

Alan J. Goldstein ◽

Isabel Oliva ◽

Hedieh Honarpisheh ◽

Ami Rubinowitz

Keyword(s):

Imaging Studies ◽

Dynamic Changes ◽

Cross Sectional ◽

Radiographic Diagnosis ◽

Imaging Characteristics ◽

Pathologic Features ◽

Cross Sectional Imaging ◽

Pathologic Lesions ◽

Periods Of Stress

The thymus is routinely encountered on cross-sectional imaging studies of the chest. It has a variable appearance, undergoes dynamic changes during periods of stress, and demonstrates numerous different pathologic lesions. Understanding the imaging characteristics of these different lesions facilitates accurate radiographic diagnosis and can prevent unnecessary follow-up imaging and intervention. This article will review normal thymic anatomy and development, thymic hyperplasia and associated medical conditions, and the imaging and pathologic features of various benign and malignant thymic lesions.

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P357 Long-term outcomes of biologic therapy in Crohn’s disease complicated with internal fistulizing disease: BIOSCOPE study from GETECCU

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.481 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S377-S378

Author(s):

I Rodríguez-Lago ◽

A Fernández-Clotet ◽

F Mesonero ◽

F J García-Alonso ◽

M J Casanova ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Biologic Agent ◽

Fistula Closure ◽

Biologic Drugs ◽

Biologic Treatment ◽

Cross Sectional ◽

Urinary Fistulas ◽

Cross Sectional Imaging

Abstract Background The prevalence of penetrating disease in Crohn’s disease (CD) increases progressively over time, and evidence on the medical treatment of this complication is limited. The aim of this study was to evaluate the efficacy of biologic agents in CD complicated with internal fistulising disease. Methods A retrospective analysis of all adult patients from the ENEIDA registry (>68,000 patients) with CD who received at least one biologic agent -anti-TNF, ustekinumab or vedolizumab- for penetrating disease was performed. Exclusion criteria comprised treatment for perianal disease, enterocutaneous, anastomotic or periostomal fistula tracts. The main outcomes were fistula-related surgery and fistula closure on cross-sectional imaging. Preestablished secondary outcomes included the rate of abdominal abscess, the need for percutaneous drainage, the changes in the number of fistula tracts, fistula closure rates, and the safety profile.The baseline characteristics were analyzed by means of descriptive statistics and were compared by non-parametric tests. Predictive factors associated with surgery and fistula closure were evaluated by a multivariable logistic regression and survival analyses. Results A total of 710 patients (median age 38 years [IQR, 28-48], 59% male, 55% L3) receiving 791 biologic treatments were included at 53 sites (701 anti-TNF, 71 ustekinumab, and 19 vedolizumab). Patients had a median of 1 (range 1-5) fistula tracts, 49% of them entero-enteric followed by entero-colic (28%). After a median follow-up of 59 months (IQR, 27-105), 244 patients (31%) required surgery due to internal fistulising complications after 8.5 months (IQR, 3-24). Patients with ileocolonic disease (OR 1.99 [1.22-3.23]), entero-urinary fistulas (OR 2.35 [1.17-4.73]), or with a stricture distal to the fistula (OR 2.1 [1.31-3.36]) showed a higher risk of surgery, with no differences between biologic drugs (Figure 1). Combination therapy reduced the risk of surgery (HR 0.58 [0.37-0.90]). Fistula closure was observed in 24% of patients after a median of 15 months (IQR, 7.5-27). Patients with a lower number of fistula tracts showed a higher probability of closure (OR 1.72 [1.09-2.7]). Conclusion A high proportion of patients with internal fistulizing CD benefit from biologic treatment after a median of 5 years. During this follow-up, around two thirds of patients are free of surgery and one in every four patients achieves fistula closure.

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Simple vs ugly adnexal lesions: is ultrasonography alone good enough?

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20193389 ◽

2019 ◽

Vol 7 (8) ◽

pp. 3020

Author(s):

Rahul Dev Chauhan ◽

Yashvir Mathur

Keyword(s):

Histopathological Examination ◽

Imaging Modality ◽

Cross Sectional Study ◽

Colour Doppler ◽

Benign Lesions ◽

Cross Sectional ◽

Adnexal Masses ◽

Cross Sectional Imaging ◽

Ovarian Masses

Background: Ultrasound (USG) is easily available and effective imaging modality for adnexal lesions. A simple looking lesion on ultrasound is usually benign and an ugly looking adnexal lesion is either benign or malignant. This study aims to evaluate the varied appearance of simple and ugly benign adnexal lesions on USG and to find out any additional role of colour Doppler in such suspected benign lesions. The confirmation of diagnosis was done either by follow up appearance of lesions on USG or by histopathological evaluation.Methods: A total of 55 consecutive female patients with age between 18 to 50 years were enrolled in this prospective cross sectional study. USG and colour Doppler for all the lesions were done. The patients found to have malignant lesions on histopathological examination, were later excluded from the analysis. Follow up USG was done for all the cases. Those cases wherein there was no resolution of lesions even after 08 weeks, were given an option to undergo laparoscopy as next management step.Results: Out of 50 benign adnexal masses, 88% masses were ovarian in origin and 12% were tubal masses. Ovarian masses included hemorrhagic cysts, endometriosis, simple cysts, serous cystadenomas and ovarian dermoid. All extra-ovarian masses were hydrosalpinx. Colour Doppler did not add any additional finding. Some of the patients underwent diagnostic laparoscopy followed by excision of masses in majority of them.Conclusions: Benign adnexal lesions can have varied appearance ranging from simple to ugly on USG. Ultrasonographic features of benign lesions on USG can be appreciated very well even without further use of colour Doppler or cross sectional imaging. Follow up USG remains key modality for benign adnexal masses in absence of MRI.

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The aetiology, epidemiology, clinical features, and investigation of kidney cancer

10.1093/med/9780199659579.003.0083 ◽

2017 ◽

Author(s):

Nilay Patel ◽

David Cranston ◽

Mark Sullivan

Keyword(s):

Renal Cancer ◽

Mortality Rates ◽

Small Renal Masses ◽

Renal Masses ◽

Cross Sectional ◽

The Past ◽

Urological Malignancies ◽

Number Of Patients ◽

Cross Sectional Imaging ◽

Sectional Imaging

Over 270,000 patients worldwide are diagnosed with renal cancer every year. It is the most lethal of all urological malignancies, with 33–44% of patients dying as a result of the disease. The past three decades has seen the incidence of renal cancer increasing by approximately 2% per year. This increased incidence has predominantly been within localized tumours, detected incidentally due to the increased use of cross-sectional imaging in medical practice. Despite an increase in the number of patients undergoing surgery for renal cancer, mortality rates have continued to rise. There is some evidence to suggest this may be a consequence of the overdiagnosis and overtreatment of small renal masses. At present, there is no justification for national screening programmes for renal cancer.

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