Subject(s)
Bone Density Conservation Agents , Denosumab , Metatarsal Bones , Osteoporosis, Postmenopausal , Humans , Female , Denosumab/adverse effects , Metatarsal Bones/injuries , Bone Density Conservation Agents/adverse effects , Osteoporosis, Postmenopausal/drug therapy , Fractures, Bone , Aged , Middle Aged , East Asian PeopleSubject(s)
Cardiomyopathies/diagnostic imaging , Heart Defects, Congenital/diagnostic imaging , Heart Failure/diagnostic imaging , Heart Ventricles/diagnostic imaging , Adolescent , Cardiomyopathies/complications , Female , Heart Defects, Congenital/complications , Heart Failure/etiology , Humans , Magnetic Resonance ImagingSubject(s)
Diverticulum/complications , Diverticulum/diagnostic imaging , Urinary Bladder/abnormalities , Urinary Retention/etiology , Diagnosis, Differential , Humans , Male , Middle Aged , Spontaneous Perforation , Tomography, X-Ray Computed , Urinary Bladder/diagnostic imaging , Urinary Bladder DiseasesABSTRACT
Bortezomib-based regimens have significant activities in multiple myeloma (MM). In this study, we tested the efficacy of a total therapy with a staged approach where newly diagnosed MM patients received vincristine/adriamycin/dexamethsone (VAD). VAD-sensitive patients (> or =75% paraprotein reduction) received autologous hematopoietic stem cell transplantation (auto-HSCT), whereas less VAD-sensitive patients (<75% paraprotein reduction) received bortezomib/thalidomide/dexamethasone (VTD) for further cytoreduction prior to auto-HSCT. On an intention-to-treat analysis, a progressive increase of complete remission (CR) rates was observed, with cumulative CR rates of 48% after HSCT. Seven patients progressed leading to three fatalities, of which two had central nervous system disease. The 3-year overall survival and event-free survival were 75.1% and 48.3%, respectively. Six patients developed oligoclonal reconstitution with new paraproteins. In the absence of anticoagulant prophylaxis, no patients developed deep vein thrombosis. The staged application of VAD+/-VTD/auto-HSCT resulted in an appreciable response rate and promising survivals. Our approach reduced the use of bortezomib without compromising the ultimate CR rate and is of financial significance for less affluent communities.
Subject(s)
Antineoplastic Agents/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Boronic Acids/therapeutic use , Hematopoietic Stem Cell Transplantation , Multiple Myeloma/diagnosis , Multiple Myeloma/therapy , Pyrazines/therapeutic use , Thalidomide/therapeutic use , Adult , Aged , Angiogenesis Inhibitors/therapeutic use , Antibiotics, Antineoplastic/therapeutic use , Bortezomib , Dexamethasone/therapeutic use , Disease Progression , Disease-Free Survival , Doxorubicin/therapeutic use , Female , Humans , Immunoglobulins/blood , Male , Middle Aged , Multiple Myeloma/pathology , Multiple Myeloma/physiopathology , Treatment Outcome , Vincristine/therapeutic useABSTRACT
Intra-abdominal cystic lesions are increasingly recognized in the newborn because of the advent of routine antenatal ultrasonography. As these lesions are often asymptomatic or non-specific in clinical presentation in the newborn, imaging by ultrasonography has an important role in diagnosis. We present a pictorial review of the commonly encountered intra-abdominal cystic lesions in the newborn, with emphasis on ultrasonographic features that can aid differentiation between the various lesions.
Subject(s)
Abdomen/diagnostic imaging , Cysts/diagnostic imaging , Choledochal Cyst/diagnostic imaging , Diagnosis, Differential , Female , Gastrointestinal Diseases/diagnostic imaging , Humans , Infant, Newborn , Meconium/diagnostic imaging , Mesenteric Cyst/diagnostic imaging , Ovarian Cysts/diagnostic imaging , UltrasonographyABSTRACT
Enhanced computed tomography (CT) is frequently performed for possible bowel ischaemia. It has the distinct advantage of possible detection of the causes of ischaemia. Radiologists therefore need to be familiar with the spectrum of diagnostic CT signs. We present the CT imaging findings in surgically proven cases of small bowel ischaemia. In addition to signs pertaining to the underlying aetiological pathology, bowel dilatation, bowel wall thickening, mural gas, occlusion of mesenteric vessels, ascites and infarct of other abdominal organs were observed.
Subject(s)
Abdomen, Acute/diagnostic imaging , Intestinal Diseases/diagnostic imaging , Ischemia/diagnostic imaging , Mesenteric Vascular Occlusion/diagnostic imaging , Adult , Aged , Aged, 80 and over , Contrast Media , Female , Humans , Intestinal Diseases/etiology , Intestinal Diseases/physiopathology , Intestines/blood supply , Ischemia/etiology , Male , Mesenteric Arteries/diagnostic imaging , Middle Aged , Pain/etiology , Retrospective Studies , Thromboembolism/complications , Thromboembolism/diagnostic imaging , Tomography, X-Ray Computed/methodsABSTRACT
AIM: To report two cases of intense and persistent adrenal enhancement on computed tomography (CT) examinations of the abdomen. MATERIALS AND METHODS: Two patients presented with septic shock, one due to pyogenic liver abscess and the other strangulated obturator hernia with gangrenous bowel. Both patients were resuscitated with fluid before undergoing unenhanced and enhanced CT. RESULTS: In both patients intravascular volume was not reduced as evident by normal calibre of the aorta and inferior vena cava. One patient had abnormal enhancement pattern in the liver and kidneys, suggesting hypoperfusion. The other patient had normal enhancement pattern of the other abdominal viscera. Both patient subsequently died with multi-organ failure. CONCLUSION: We propose that adrenal enhancement may be a sign of hyperperfusion in early stage of shock due to the crucial role of the adrenal glands in this clinical situation. This may not persist with further circulatory compromise due to vasoconstriction. If confirmed, its recognition has potential value of identifying a therapeutic window before irreversible shock set in.