The radiocephalic arteriovenous fistula remains the method of choice for haemodialysis access. In order to assess their suitability for fistula formation, the radial arteries and cephalic veins were examined preoperatively by ultrasound colour flow scanner in conjunction with a pulse-generated run-off system. Intraoperative blood flow was measured after construction of the fistulae. Post-operative follow-up was performed at various intervals to monitor the development of the fistulae. Radial artery and cephalic vein diameter less than 1.6 mm was associated with early fistula failure. The intraoperative fistula blood flow did not correlate with the outcome of the operation probably due to vessel spasm from manipulation. However, blood flow velocities measured non-invasively 1 day after the operation were significantly lower in fistulae that failed early compared with those that were adequate for haemodialysis. Most of the increase in fistula diameter and blood flow occur within the first 2 weeks of surgery.

Patient knowledge of the acetaminophen content of commonly used analgesic medications and its maximum recommended daily dose is limited. This may contribute to unintentional repeated supratherapeutic ingestion (RSTI) of acetaminophen, or overdose.

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Condensing osteitis of the clavicle was first described as a disease entity in 1974. There is painful localised swelling of the clavicle of undetermined origin, with increased radio-density, but an infective aetiology has not been excluded by previous authors. We report three children with the clinical and radiological findings of 'condensing osteitis'. Two of them had raised levels of antistaphylolysin titres and all responded to antibiotic therapy. We conclude that condensing osteitis is due to low-grade staphylococcal osteomyelitis; biopsy and treatment by antibiotics is recommended.

This study is concerned with an assessment of the quality of the blood vessels used in the construction of radiocephalic arteriovenous fistulae for haemodialysis vascular access in 20 patients. Following non-invasive preoperative assessment of the cephalic vein by means of a colour Doppler scanner, input impedance was determined intraoperatively from blood flow and blood pressure measured about 2 cm downstream of the anastomosis. The patients were re-assessed 1 day and 2, 4, 6 and 12 weeks after surgery, and the diameter and the flow through the fistulae, the location of major branches, and the presence and severity of stenoses in the cephalic veins were determined non-invasively. Five fistulae failed within the 12 weeks period following surgery, mainly due to thrombosis. In a further 3 patients, the fistulae were patent but did not achieve an adequately high blood flow and dilate sufficiently for haemodialysis and were therefore considered to be essentially failed. The impedance moduli from 0 to 10 Hz as well as the average impedance modulus of successful fistulae were significantly lower than those of fistulae that subsequently failed. An attempt was made to locate the presence of reflection sites (i.e. stenoses and branches) from the minima in the impedance modulus spectra. Their locations were compared with those of the reflection sites detected by ultrasound 2 weeks after surgery. However, not all reflection sites detected 2 weeks after surgery were located by the impedance method. It is recommended that both preoperative examination and intraoperative haemodynamic measurements be made to improve the accuracy of the assessment.