Determining patient risk factors associated with accelerated growth of popliteal artery aneurysms

Objective

The objective of this study was to determine the natural progression of popliteal artery aneurysms (PAAs) and clinical variables associated with their accelerated growth.

The Carotid Artery as an Alternative Site to the Middle Cerebral Artery for Reproducible Estimates of Autoregulation Index

Temporal insonation is not always possible for the middle cerebral artery (MCA) for blood flow velocity (BFV) measurements, to estimate cerebral autoregulation. We compared BFV and cerebral autoregulation estimates from the common-carotid (CCA) and internal-carotid arteries (ICA) with the MCA. BFV was measured at the CCA, ICA and MCA, synchronously with blood pressure, heart rate and end-tidal CO₂ and was recorded onto a data acquisition system. The autoregulation index (ARI) estimated using the Tiecks model. Eleven healthy volunteers (7 women, 33 ± 9 years old) were recruited. BFVs in the MCA, CCA and ICA were 60.3 ± 8.9, 64.4 ± 6.5 and 69.2 ± 4.8 cm/s, respectively. ARI estimates were not significantly different (5.6 ± 0.8, 6.0 ± 1.1 and 5.9 ± 0.5, respectively). Good reproducibility over repeated measurements was evidenced by low coefficient of variation of standard error of measurement for BFV and ARI. The CCA and ICA are alternatives to the MCA, where insonation is impossible, because of an absent trans-temporal window or where it cannot be tolerated, such as in patients with head injury.     

Clinical characteristics and comparative study of different modalities of treatment of pseudocyst pinna

The aims of the article were to study the clinical characteristic of patients with pseudocysts and to compare different common modalities of treatment and introduce the concept of observation in pseudocyst management. Twenty-eight patients were diagnosed with pseudocyst of the auricle between June 2009 and June 2011 in a medical college hospital. The patients were divided into four groups each of seven patients on the basis of primary treatment offered. Four primary treatments offered were simple aspiration, aspiration with intralesional steroid, incision and drainage with removal of anterior cartilage leaflet with buttoning, and lastly, simple observation and reassurance. All 28 patients were male with involvement of right side more than left and no one had bilateral involvement. Adults in the age group of 30–40 were commonly affected. Most of the patients had history of significant trauma by security forces. Most common site of involvement was scaphoid and triangular fossa. The best form of treatment with minimum recurrence was incision and drainage with removal of anterior cartilage leaflet with buttoning. Simple observation as a treatment option was found to be as good as intralesional steroids. Pseudocyst of the pinna is a benign condition of unknown etiology affecting the pinna, commonly encountered in middle-aged men. It is a rare condition and is hardly encountered in routine ENT practice. Bilateral diseases are uncommon. Most common site of occurrence is triangular and scaphoid fossa. Many modalities of treatment have been recommended in literature with varied recurrence and failure rates. The best treatment is surgical deroofing followed by buttoning with minimum recurrences. An option of simple observation for 2–3?months should be discussed with each patient and was found to be as good as intralesional steroids.