Biomedical subjects

M R Cesarone

Publications and source records attributed to M R Cesarone.

At least 91 records · Page 5Linked to original sources

PubMed1998

[Edema tester. Assessment of edema of the legs].

BACKGROUND: The aim of this study was the clinical evaluation of an original device produced to evaluate edema in a semi-quantitative way, the ACI Medical, Edema Tester (ET). ET1, is a soft plastic plate characterised by two parallel conic pyramidal protrusions. One side of the protrusion is rounded while the other side has an angular edge. The two protrusions are placed on the plate in inverse decreasing height. ET2 is characterised by two lines of 7 holes placed in the plate. The ET is applied at the internal perimalleolar region with the conic pyramidal protrusions in contact with the skin. A standard sphygmomanometer cuff is applied over the area and pressure is maintained at 50 mmHg for a period between 1 an 3 minutes. The cuff is then removed. ET1: skin marks are usually just visible in normal subjects without edema and disappear in a few minutes. When edema is moderate some half of each protrusion is visible as a skin mark. In limbs with severe edema the whole length of the protrusion is clearly visible. ET2: skin marks are usually just visible in normal limbs without edema and disappear in a few minutes. In limbs with edema the number of holes visible on the skin is increased and in severe edema all holes are visible. METHODS: To evaluate semi-quantitatively the level of edema the length of the two skin marks can be measured and for the ET2 the numbers of visible holes can be counted, as they are generally proportional to the degree of edema. The ET testers were evaluated in 22 normal subjects, 19 limbs with varicose veins, 22 patients with CVI and lipodermatosclerosis, 5 patients with initial primary lymphedema and in 8 subjects with severe, chronic, lymphedema and skin alterations. RESULTS: The results showed a significant difference between normal limbs an patients. CONCLUSIONS: In conclusion, the method of evaluating edema with ET can be used to supplement the clinical and noninvasive evaluation. In general practice the presence of edema measurable with ET indicate the need for treatment. The several degrees of skin marks visibility and disappearance time may be used as a general guideline to indicate the need for different types and length of treatment.

Adult↗

PubMed1997

Epidemiology and costs of venous diseases in central Italy. The San Valentino Venous Disease Project.

The Prevalence of Early Atherosclerosis study aims to define the prevalence of subclinical atherosclerosis in a typical population of central Italy. A concomitant study evaluates the prevalence of venous diseases. The prevalence of superficial and deep venous disease, the prevalence of venous thrombosis and pulmonary embolism, and the prevalence of the most common venous malformations were studied through use of medical history, a questionnaire, and noninvasive investigations. The costs of venous problems were also considered. Of some 2000 inhabitants, 746 (379 women; mean age 46.3 +/- 7 years; range eight to ninety-four) have been screened. No significant difference in trend increase of the relationship age/percent of subjects with venous problems was observed for superficial venous disease. The increase in the proportion of subjects with lipodermatosclerosis and venous ulcerations appeared to be correlated with age (r = 0.543). Evidence accepted for pulmonary embolisms was pulmonary angiogram or evidence on ventilation+perfusion lung scans. According to these criteria the number of documented deep vein thromboses and pulmonary embolisms was very limited with a larger number of suspected disease entities. There was no significant correlation between age and pulmonary embolism or deep venous thrombosis distribution. The number of venous and/or arteriovenous malformations was comparable along the age axis in the different age groups. Only a limited number of these malformations (in less that 1% of subjects) had caused a clinical problem. The treatments used for venous problems have been reported in a questionnaire and subdivided into occasional treatments and chronic treatments (when used for periods longer than twelve months). The percent of subjects using different treatment was also studied. Treatments were divided in: (1) over-the-counter products (or any treatment not requiring prescription); (2) specialized drug (for venous diseases); (3) compression; (4) surgery (any type of surgical treatment); (5) sclerotherapy; (6) combined treatments (ie, sclerotherapy and surgery); (7) alternative treatments (herbal products etc). Finally, the average costs per year for treatment, for investigations, and the costs due to lost working days were recorded. In conclusion some 12% of the evaluated population sample (male population 46%) had or had been affected in the past by a venous problem and 50% of them had received some type of treatment.

Adolescent↗

PubMed1997

[Prevalence of venous diseases. The San Valentino screening and prevalence study].

The PAP/PEA (Prevalence of Early Atherosclerosis) study aims to define the prevalence of subclinical atherosclerosis in a typical population of central Italy. A concomitant study evaluates the prevalence of venous diseases. The first group of 850 patients evaluated, indicated the prevalence of superficial ve-nous disease, the prevalence of deep venous thrombosis and pulmonary embolism and the prevalence of the most common venous malformations. Also the costs of venous problems was considered. In conclusion some 12% of the evaluated population sample (male population 46%) had or had been affected in the past by a venous problem and 50% of them had been under some form of treatment.

Adolescent↗

PubMed1997

Circadian pattern of post-surgical fatal pulmonary embolism.

BACKGROUND: The circadian distribution of fatal pulmonary thromboembolism in general surgical patients is unknown. PATIENTS AND METHODS: One hundred consecutive cases of pulmonary embolism, with reliable clinical notes and data, were studied (67 men and 33 women; mean age 71 years). Only post-surgical cases were considered in this analysis. Patients had undergone elective (78%) or emergency abdominal surgery (22%). Correct prophylaxis (according to the Windsor Consensus Statement) had been used in 12%. Cases were grouped according to the time of onset of signs and symptoms related to pulmonary embolism at one hour intervals. RESULTS: The maximum incidence of fatal pulmonary embolism was between 7.00 a. m. and 1.00 p. m. with the highest peaks at 9.00 and 11.00 a. m. 9% of deaths) (P < 0.02). When results from this study were compared to a previous study no significant difference was observed between the distribution profile of cases from general medical wards and surgical wards. CONCLUSION: It appears that in surgical patients there is a circadian pattern in pulmonary embolism as already documented in medical patients.

Aged↗

PubMed1997

[Prevention of the extension of distal deep venous thrombosis. A randomized controlled trial with a 6-month follow-up].

BACKGROUND: Deep venous thrombosis (DVT) of distal veins of the legs is important for its frequency and its potential proximal extension. The incidence of embolization in distal DVT is limited and treatment still undefined. METHODS: After diagnosing with duplex scanning a distal DVT patients were included in a 24-week follow-up. All subjects used elastic compression (stockings TED = thromboembolic deterrent) for 24 weeks after DVT. In the 4 groups the following prophylaxis for 8 weeks were used: A: oral anticoagulant (INR 2.5). B: subcutaneous calcium heparin 0.2 ml bid (8.00 and 20.00). C: subcutaneous calcium heparin (0.5 ml at 20.00). D was the control group (only elastic TED stockings). heparin 0.2 ml bid (5000 IU) and 0.5 ml once daily (12.500 IU) were used for individuals with weight range between 65 and 90 kg. No patient was admitted into hospitals. Initially 106 patients were included. There were 17 (9.6%) drop outs and after 8 weeks 177 patients completed the study. No pulmonary embolisation or side effects were observed. In one patient (control group) an important extension of the thrombus to the femoral and iliac veins was observed. RESULTS: The percentage of thrombus reduction was higher in the treatment groups than in controls (p < 0.05). No significant differences were found among the 3 treatment groups. At 8 weeks 88.6% of patients treated with oral anticoagulant showed improvement (stability/reduction in size of the thrombus; the percentage was 88.4% in subjects treated with subcutaneous heparin bid and 93.2% in those treated with a single dosage). In the control group thrombus increase was observed in 78.3% of patients (this difference was significant in comparison with the treatment groups; p < 0.05). At the 24-week control in 97.6% of patients in group A thrombosis was reduced/stable. This percentage was 97.7% in the ca-heparin double-dose group (B) and 100% in the single dose group (C), significantly lower than in group D (75%; p < 0.05). CONCLUSIONS: Results indicate that untreated subjects with distal DVT are at risk of thrombus extension. In this study treatments were clinically equivalent. However one single dose of subcutaneous heparin is as effective as the double dose, is better tolerated, does not require haematological monitoring and has a lower cost.

Administration, Oral↗

PubMed1996

Doppler ultrasonography of the central retinal artery by duplex scanning.

PURPOSE: To present duplex scanning of the central retinal artery, which the authors have termed duplex scanner imaging, as an alternative to color Doppler imaging in the evaluation of retinal blood flow velocity, and to show the difference in measurements obtained with the two different techniques. METHODS: The high-resolution ATL-Ultramark 4 duplex scanner (Advanced Technology Laboratories, Bothell, WA) with the variable focus access probe was used to measure blood flow velocity of the central retinal artery in the eyes of 48 healthy volunteers. RESULTS: Using this technique the peak systolic flow velocity (+/- standard deviation [SD]) of the central retinal artery was 36.6 +/- 10.8 cm/sec, and the end diastolic flow velocity was 12.6 +/- 3.7 cm/sec. CONCLUSION: The flow velocity measurements of the central retinal artery obtained with this technique were much higher than those obtained by other authors using color Doppler imaging (9.6 cm/sec for the peak systolic flow velocity, and 4.7 cm/sec for the end diastolic flow velocity). The authors propose duplex scanner imaging as an alternative to color Doppler imaging for evaluating retinal blood flow velocity. The duplex scanner also can be used to measure the flow velocity of orbital vessels.

Adult↗

PubMed1996

Ultrasound morphology classification of the arterial wall and cardiovascular events in a 6-year follow-up study.

A 6-year follow-up based on an arterial morphology classification defined with an ultrasound assessment of carotid and femoral artery bifurcations was conducted on 2322 asymptomatic subjects. Four morphology classes were considered. When 2000 subjects (86% of total subjects; 1124 males, 876 females) completed a 6-year follow-up, the study was terminated. At 6 years, no cardiovascular events were observed in subjects who were in class I (80.05% of the population sample) at inclusion; there were 69 events in classes II, III, and IV (19.95% of the population; incidence, 17.3%); 59 events, including the five deaths, occurred in classes III and IV (10.85% of the population), producing an event incidence of 27.2%. The increased event rate in classes II, III, and IV was significant (log-rank test; P < .05, P < .025, and P < .025, respectively). Thus, the arterial morphology classification identified 19.95% of the population (subjects in classes II, III, and IV) in which all events occurred. There was a higher (P < .05) rate of progression of altered arterial morphology in 6 years in classes III (26.5% of subjects progressed) and IV (41.9% progressed) than in classes I and II. The total number of cigarette-years was higher (P < .05) in classes II, III, and IV than in class I. In conclusion, the ultrasound-based arterial classification was useful in selecting from the population sample 80.05% of subjects (class I) who remained event-free for 6 years. All events occurred in class II, III, and IV subjects (19.95%), and all five deaths (0.25% of the population) occurred in classes III and IV (10.85% of the sample).

Adult↗

PubMed1996

Laser Doppler flux in normal and arteriosclerotic carotid artery wall.

The perfusion of the arterial wall was evaluated in vivo in normal sections of the carotid artery, in sections with fibrotic plaques and in sections with plaques and diffuse calcifications using laser Doppler flowmetry. Patients with carotid plaques undergoing carotid endarterectomy were studied. Using intra-operative ultrasound three different levels of atherosclerosis involvement of the arterial wall were defined: normal arterial wall where all components (intima, media and adventitia) were clearly separated and intact; wall with intima-media thickening and fibrotic plaques (without calcifications); sections with diffusely calcified plaques. In 20 patients 20 normal sections, 20 sections with fibrotic plaques and 20 sections with large plaques and diffuse calcifications were studied. Diabetic and hypertensive patients were excluded. Wall flux was measured on the external surface of the common carotid artery before complete dissection for endarterectomy. Measurements were recorded when at least 3/4 of the adventitia was intact for a length of at least 4 cm. The average flux in normal sections was higher (p < 0.05) than in sections with fibrotic plaques and in sections with calcified plaques. A significant difference in flux (p < 0.05) between fibrotic (decreased flux) and calcified areas (very low flux) was recorded. In conclusion a higher wall perfusion was observed in normal arterial sections in comparison with sections with plaques. Sections with diffuse calcifications and larger plaques had a very low flux.

Aged↗

PubMed1996

Vasa vasorum visualised by power-Doppler in normal and arteriosclerotic carotid arteries.

Vasa vasorum and the perfusion of the carotid wall in normal arteries and in arteries with arteriosclerotic plaques was evaluated in-vivo using power-Doppler. Two types of arteries were studied using high-resolution ultrasound. These were arteries with a normal wall (intima, media and adventitia clearly separated) and arteries with intima-media thickening and plaques without calcification. In 10 normal subjects and in 10 patients with early plaques vasa vasorum were visualised. On power-Doppler they appeared as distinct, glomerular-like perfusion units, regularly placed along the course of normal arteries and at similar distance (2 to 4 mm from the lumen-wall interface, within the adventitia and periadventitia layers). In arteriosclerotic vessels the distribution of vasa vasorum units was more irregular, often concentrated in one spot with some perfusion units more distant from the lumen (between 2.5 and 5 mm) and their pulsatility was reduced. Flow velocity complex in most vasa vasorum was comparable, in lower scale to the pattern observed in the carotid lumen without significant differences between normal and arteriosclerotic arteries. The average peak systolic flow velocity was 15: +/-4 cm/sec and the average diastolic velocity was 6 +/- 4 in normal arteries with a median pulsatility index of 1.8 (range 2.2-1.05); in arteriosclerotic arteries velocities were 13 +/- 4 (peak systolic) and 3 +/- 2 (end diastolic) with a median pulsatility index of 1.71 (range 2.1-1.1). In conclusion a different, apparent distribution of vasa vasorum was observed in normal carotids and in carotids with arteriosclerotic lesions.

Adult↗

PubMed1996

[Laser-doppler flowmetry in vivo and reactivity of the normal and abnormal venous wall].

Venous wall flux was measured using laser-Doppler flowmetry on the external surface of 24 normal veins, partially dissected during the preparation of the vein for aortocoronary bypass grafting. Measurements were performed before the final dissection of the vein when at least 3/4 of the adventitia and periadventitia tissue was still intact for a length of 3 cm. The segment of vein (10 cm) proximal to the sapheno-femoral junction was studied. Measurements were repeated on 22 varicose veins before stripping or ligation of the sapheno-femoral junction. Flux was measured with a Laserflo (Vasamedics) flowmeter. A Delrin (polycarbonate) spacer was placed between the probe and the vein wall surface. Measurements shown are the average of three minutes recording. Preliminary analysis indicates that flux appears to be lower in varicose veins in comparison with flux in the normal vein wall. However the variability of results and technical problems in flux measurements indicate the need of a larger measurement sample before confirming the observation of a decreased perfusion of the varicose venous wall.

Adult↗

PubMed1996

Laser-Doppler flux in the normal and atherosclerotic carotid artery wall in normotensive and hypertensive subjects.

UNLABELLED: The aim of this study was to evaluate in vivo the perfusion of the arterial wall in normal sections of the carotid artery, in sections with fibrotic plaques and in sections with plaques and heavy calcifications using laser-Doppler flowmetry. Patients with carotid plaques undergoing carotid endarterectomy were studied. Using intraoperative ultrasound three different levels of atherosclerosis involvement of the arterial wall were defined: normal arterial wall where all components (intima, media and adventitia) were clearly separated and intact; wall with intima-media thickening and fibrotic plaques (no calcification); sections with diffusely calcified plaques. In 20 patients 20 normal sections, 20 sections with fibrotic plaques and 20 sections with large plaques and heavy calcifications were studied. Diabetic patients were excluded. Also the carotid wall of 10 patients with essential hypertension were evaluated. Wall flux was measured on the external surface of the common carotid artery before endarterectomy. Measurements were recorded when at least 3/4 of the adventitia was intact for a lenght of at least 4 cm. RESULTS: The average flux in normal sections was higher (p < 0.05) than in sections with fibrotic plaques and in sections with calcified plaques. A significant difference in flux (p < 0.05) between fibrotic (decreased flux) and calcified areas (very low flux). In hypertensive subjects flux measurements were significantly lower than in non-hypertensive patients (p < 0.05). In conclusions a higher wall perfusion was observed in normal arterial sections in comparison with sections with plaques. Sections with calcifications and large plaques had a markedly low flux. In hypertensive subjects all sections had a significantly lower flux.

Aged↗

PubMed1995

Doppler ultrasonography of the central retinal artery in patients with diabetes and vascular disease treated with topical timolol.

Using high-resolution duplex scanning it is possible to evaluate the blood flow velocity in the central retinal artery of the eye. Four different patient groups were studied with this technique: normals, diabetics with a decreased flow, diabetics with an increased flow and vascular patients with a decreased flow. The eyes of these patients were then treated with topical timolol and the flow measured again. An increase in the flow was found in three of the four groups. This increased flow velocity may be due to a vasodilatory effect of timolol. The results are presented and discussed.

Administration, Topical↗

PubMed1995

Laser Doppler and transcutaneous oximetry: modern investigations to assess drug efficacy in chronic venous insufficiency.

During chronic venous insufficiency (CVI), microcirculatory changes, e.g. a decrease in transcutaneous oxygen pressure (tcpO2) and an increase in transcutaneous carbon dioxide pressure (tcpCO2), are implicated in the pathophysiology of trophic disorders leading ultimately to venous ulcers. Daflon 500 mg1, a micronized purified flavonoid fraction, has been shown to improve venous tone, capillary permeability and resistance, and lymphagogue activity at a daily dose of 2 tablets. To assess the effects of Daflon 500 mg on microcirculatory parameters by means of laser Doppler fluxmetry and transcutaneous oxiketry, a 3-month, double-blind, randomized, parallel-group study was carried out in 104 patients divided into 3 groups according to the daily dose: 1 tablet (group 1, n = 34), 2 tablets (group 2, n = 33), on 4 tablets (group 3, n = 37). All patients (mean age 43.7 +/- 13.1 years; 100 females, 4 males) included in the study were affected by mild CVI. They were followed for 90 days with visits at 1 month (day 28) and 3 months (day 90). At inclusion, there were no significant differences between groups as regards biometric data, mean tcpO2 (group 1, 62.7 +/- 4.5 mm Hg; group 2, 64.0 +/- 3.3 mm Hg; group 3, 64.1 +/- 3.5 mm Hg), mean tcpCO2 (group 1, 40.7 +/- 2.5 mm Hg; group 2, 39.3 +/- 2.9 mm Hg; group 3, 40.0 +/- 2.5 mm Hg) and laser Doppler parameters. Fourteen patients withdrew from the study (group 1, n = 4; group 2, n = 3; group 3, n = 7): 9 for reasons not related to treatment, 3 for adverse events, 2 because they were lost to follow-up. From day 0 to day 90, mean tcpO2 significantly increased (p < 0.001) in each group (group 1, 3.0 +/- 2.1 mm Hg; group 2, 2.9 +/- 2.1 mm Hg; group 3, 2.5 +/- 1.6 mm Hg), mean tcpCO2 significantly decreased (p < 0.001) in each group (group 1, 2.6 +/- 2.0 mm Hg; group 2, 1.7 +/- 1.9 mm Hg; group 3, 2.2 +/- 1.5 mm Hg). No significant differences were observed between groups. Laser Doppler parameters remained unchanged from day 0 to day 90 in the 3 groups. Symptoms (discomfort, pain, heaviness, burning sensation) and signs (oedema) of CVI as well as perimetric measurements of calf and supramalleolar area were significantly improved in the 3 groups. In conclusion, during this 3-month study, Daflon 500 mg improved oximetric measurements and did not alter laser Doppler parameters. These data suggest that Daflon 500 mg, at the early stages of CVI, acts favourably on the microcirculatory disturbances also involved in the pathophysiology of more severe stages of CVI.

Adult↗

PubMed1995

[Lymphedema. New non-invasive methods for diagnosis and follow up].

Lymphedema is still a difficult clinical problem, poorly investigated and new methods of evaluation are needed to improve the understanding of its pathophysiology. Lymphoscintigraphy is diagnostic but cannot be repeated frequently in the follow-up. In this study we have evaluated four new methods of evaluation of lymphedema which may be used to quantify the problem and to follow-up patients. These methods are: A. the evaluation of the ratio between the concentration of lymphatic fluid proteins and plasma proteins concentration (CL/CP); B. the test of the spontaneous clearance of a haematoma; C. high-resolution ultrasound imaging of low density spaces (SBD) in the subcutaneous tissue, possibly corresponding to dilated lymphatic spaces; D. the combination of imaging and CL/CP ratio. Comparable groups of normal subjects, patients with primary lymphedema diagnosed with lymphoscintigraphy and patients with chronic venous insufficiency have been evaluated. The four methods appeared useful to differentiate normal subjects from those with lymphedema. However the separation between lymphedema and chronic venous insufficiency was less evident. Edema due to systemic causes (cardiac failure, nephrotic syndrome or chronic venous insufficiency) is also differentiated from lymphedema. In conclusion these tests may be useful to evaluate lymphedema (particularly in the early phases, when the clinical presentation is unclear), to follow-up its evolution and possibly to evaluate the effects of treatments.

Chronic Disease↗

PubMed1995

Microcirculation in high perfusion microangiopathy.

Using laser-Doppler flowmetry in association with other noninvasive microcirculatory techniques such as transcutaneous PO2 and PCO2 and capillary filtration measurements it is possible to define two major types of microangiopathy. Low perfusion microangiopathy (LPM) is observed in peripheral vascular disease, essential hypertension, Raynaud's disease etc. High perfusion microangiopathy (HPM) is observed in venous hypertensive microangiopathy and diabetic microangiopathy. In both these conditions there is an increased skin flux, decreased venoarteriolar response and increased capillary filtration leading to edema formation. In HPM elastic compression and drugs acting on capillary filtration effectively reduce skin flux and the increased capillary leakage and edema formation.

Bandages↗

PubMed1995

Progression of subclinical atherosclerosis in 6 years. Ultrasound evaluation of the average, combined femoral and carotid bifurcation intima-media thickness.

The intima-media complex thickness (IMT) was evaluated in 472 asymptomatic subjects in a 6-year follow-up study. Four age groups were included (40-45, 46-50, 51-55 and 56-60) with the aim of obtaining a random equal number of men and women sample. The baseline IMT ranged from 0.42 to 2.12 mm (mean 0.63 mm, SD 0.14 mm). In 4.66% subjects completing the 6-year follow-up, the IMT decreased by more than 0.1 mm and in 18% there was no significant IMT change (> 0.1 mm). In the remaining individuals (77.33%) the IMT increased by at least 0.1 mm. The IMT increase in the 56-60 age group was significantly higher than in the remaining age groups (p < 0.02). A significantly higher percentage of smokers was also observed in the 56-60 age group (p < 0.05). However, the IMT increase in the smoker subgroups was not significantly different from the mean IMT increase observed in the whole group or from the IMT increase observed in the non-smoker group. Blood pressure variations were not associated with change of IMT over six years. The main difference between the four groups was an average weight 5.7% higher in the oldest age group at the end of the study (4.44% higher at inclusion). In conclusion the increase in IMT appeared to be greater in older subjects and the effect of smoking did not apparently affect IMT increase. The method of IMT measurements is able to demonstrate the age-related evolution of intima-media in a population.

Adult↗

PubMed1994

Effects of trandolapril on 24-h ambulatory blood pressure in patients with mild-to-moderate essential hypertension.

The effects of trandolapril on 24-h blood pressure in mild-to-moderate hypertensive patients of both sexes were investigated by conventional (clinic) and ambulatory recording in a double-blind study at two dosages, 1 mg (n = 14) and 2 mg (n = 13) once daily for 2 weeks. Both methods of measurement showed significant end-of-treatment decreases (p < 0.01 in all cases) in diastolic and systolic pressure in the 1- and 2-mg groups. Although intergroup differences were not significant, inspection of the mean changes from baseline in the eight 3-h periods constituting the 24-h profile showed that reductions were consistently greater in the 2-mg than in the 1-mg group, by 2 mm Hg diastolic blood pressure and 6 mm Hg systolic blood pressure. Values in the last segment of the placebo washout (46-48 h after the last active dose) showed that these reductions were well maintained, notably in the 2-mg group, with a minimal tendency to drift toward pretreatment levels. No effect was observed on the normal circadian blood pressure rhythm. Both doses were well tolerated. In conclusion, trandolapril is an effective, well-tolerated antihypertensive agent for once-daily dosing at either 1 or 2 mg.

Adult↗

PubMed1994

Doppler ultrasonography in giant cell arteritis.

A patient with biopsy negative giant cell arteritis was examined and treated by our group. Since in some cases the visual loss in this disease is due to a central retinal artery occlusion, a technique to evaluate the blood flow velocity in this artery would be useful. The Duplex scanner was utilized by us in this patient to study the blood flow velocity of the central retinal artery. The flow velocity was reduced. The patient was treated with systemic steroids which lead to clinical and symptomatic improvement. After the treatment with steroids the Duplex scanner was again used to study the flow velocity of the central retinal artery. The blood flow velocity improved. We think that Doppler ultrasonography may be useful in the diagnosis of and in monitoring the treatment of some cases of giant cell arteritis.

Aged↗