Opportunistic screening for AAA in men undergoing clinically indicated abdominal ultrasonography is easy, productive, without discernible cost, and discloses a prevalence of AAA comparable with that of population screening programmes. Routine opportunistic measurement of aortic diameter during abdominal ultrasonography in the at risk group would allow 12-15% of men aged 65-74 to be screened for AAA within five years without the need for any additional resources.
We report two cases of patients with analgesic nephropathy presenting with the symptoms of hypercalcaemia, and who were found to have transitional cell carcinomas of the renal pelvis. On removal of the tumours, calcium levels fell to normal, indicating that a humoral factor produced by the tumour caused the hypercalcaemia. We suggest that hypercalcaemia in a patient with analgesic nephropathy may indicate a malignant change, and that serum calcium should be assessed when such patients are reviewed.
Cerebral venous sinus thrombosis is a rare condition, which is difficult to diagnose. It has not previously been reported following surgery to the cervical spine . We report such a case in a 45-year-old man after cervical disc replacement. A high index of suspicion, with early imaging of the brain and prompt treatment, can produce a favourable outcome, albeit not in this case.
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