Lipohemarthrosis of the knee: a review of recent experiences

The radiographs of 268 patients with knee trauma were retrospectively reviewed. In 15 patients with intraarticular fracture, the images demonstrated fat-fluid levels. In 28 other patients with intraarticular fracture, only joint effusion without a fat-fluid level was depicted. The presence of a fat-fluid level in the knee indicated fracture in all patients in whom it was seen. The absence of such a level, however, did not exclude intraarticular fracture.     

A 12-year follow-up of ANNA/C-TRUS image-targeted biopsies in patients suspicious for prostate cancer

Purpose

PSA screening has been rehabilitated. PSA is not specific and can be elevated by benign reasons. Additionally, a subgroup of patients with prostate hyperplasia may harbor prostate cancer (PCa). During monitoring, the clinician aims to detect significant tumors in time, submitting patients to minimal psychological and physical burden, especially in men with high serum PSA and repeat biopsies. We aimed to determine long-term outcomes with respect to ANNA/C-TRUS ability to detect PCa with six targeted biopsies.

Methods

A subset of 71 patients were enrolled. During monitoring, they were subjected to primary, secondary, or even multiple prostate biopsies when needed. Protocol monitoring included PSA measurements, digital rectal examination (DRE) and imaging.

Results

The median follow-up was 12 years. Forty-one patients had a history of negative systematic random biopsies (1–3 sessions). Their age ranges 62–85 years, PSA 0.5–47.3 ng/ml, and the median prostate volume 11–255 cc. During monitoring, 15 patients were diagnosed with PCa. Only two harbored aggressive tumors. The median time to diagnosis was 6 years. All PCa patients are free from biochemical relapse. From the remaining 56 patients, 11 did not have any biopsies, 12 had one, 13 had two, and 20 had three or more biopsy sessions.

Conclusions

ANNA/C-TRUS is a useful method monitoring patients with a risk of PCa. 50–75% of the usually performed biopsy cores could be spared and, after 12 years, 97% of the patients were either without evidence of a PCa or were diagnosed with a good prognosis tumor.

     

Coronary CT angiography (CCTA) and advances in CT plaque imaging

The goal of this review is to highlight current advances in the non-invasive detection of clinically significant atherosclerotic disease including the so-called vulnerable plaque with computed tomography. Atherosclerotic disease encompasses stages of plaque progression, stabilization, and even regression. Traditionally, the focus of diagnostic imaging has been the detection of lumen-occluding atheroma. However, advances in our understanding of the pathophysiology of atherosclerotic plaque have shown that, in certain stages of plaque progression, plaque is “vulnerable” and able to cause acute coronary syndromes despite “non-significant” vascular occlusion at baseline. This provides a rationale to improve our non-invasive imaging technology. Presented here are improvements in soft-tissue resolution with technical advancements as well as contrast-enhancement and lately even nanotechnology-based technology which are geared to detect the clinically elusive vulnerable plaque and provide an opportunity for preventative therapy.     

Schilddrüsenunterfunktion und -überfunktion

Approximately one-third of women suffer from dysfunction of the thyroid gland. However, in the majority of cases the dysfunction is not recognized. Symptoms of thyroid dysfunction are multifactorial and can range from symptom-free conditions to hypertensive crisis or severe depressive episodes. Iodine deficiency is the main reason for thyroid dysfunction. Gynaecological aspects are often underestimated and include effects on the menstrual cycle, increased tendency for miscarriage, fertility disorders and endocrine effects such as hyperprolactinemia. Other effects on basal metabolic rate and cardiac arrhythmia also need to be considered before gynaecological surgery. This article gives an introduction to special aspects on thyroid dysfunction in females.     

Family presence during resuscitation and invasive procedures

The practice of allowing family to be present during patient resuscitation or invasive procedures (Family Presence) is gaining acceptance in North America and the United Kingdom in controlled circumstances. Research into Family Presence has demonstrated multiple benefits for the patient, family and health care team. These advantages include helping the family to understand the severity of the illness/trauma and to see that appropriate attempts were undertaken to save their loved one. Family Presence can also facilitate improved communication between the health care team and family. In spite of evidence supporting Family Presence as a useful practice for patient, family and health care team, the use of Family Presence is uncommon within Australian emergency departments and hospitals. Clear expectations at organisational, governmental and professional levels are essential to effectively implement this approach. To be supported in the clinical area, the success of a Family Presence program requires an inclusive approach to program development. A critical component of a successful Family Presence program is a family facilitator who is adequately prepared for the role and committed to supporting the family during resuscitation or invasive procedures. Research exploring Family Presence in Australia is lacking and highlights the need for context specific research in this area.     

MR three-dimensional molecular imaging of intramural biomarkers with targeted nanoparticles.

In this study, porcine carotid arteries were subjected to balloon overstretch injury followed by local delivery of paramagnetic nanoparticles targeted to alphavbeta3-integrin expressed by smooth muscle cells or collagen III within the extracellular matrix. Carotid T1-weighted angiography and vascular imaging was performed at 1.5T. While MR angiograms were indistinguishable between control and targeted vessel segments, alphavbeta3-integrin-and collagen Ill-targeted nanoparticles spatially delineated patterns and volumes of stretch injury. In conclusion, MR molecular imaging with alphavbeta3-integrin or collagen Ill-targeted nanoparticles enables the non-invasive, three-dimensional characterization of arterial pathology unanticipated from routine angiography.     

Indomethacin induced corneal deposits (author's transl)]

After a summary of corneal changes, caused by drugs (gold, Chloroquine, Phenothiazines, Amiodaron), a personal case of indomethacin induced deposits is described. The chief characteristic was was a ring-shaped formation of the grey-whitish lines in the epithelium. A retinopathy was not present.