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(L.) Migeotte Les finances des cités grecques: aux périodes classique et hellénistique. Paris: Les Belles Lettres, 2014. Pp. 770. €59. 9782251444918.
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- Janet Powell
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- The Journal of Hellenic Studies / Volume 135 / 2015
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- 22 October 2015, p. 244
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- 2015
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(H.) Van Wees Ships and Silver: A Fiscal History of Archaic Athens (Library of Classical Studies). London: I.B. Tauris, 2013. Pp x + 213. £56. 9781780766867.
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- Janet Powell
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- The Journal of Hellenic Studies / Volume 135 / 2015
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- 22 October 2015, pp. 209-211
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- 2015
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F. Hobden and C. Tuplin EdsXenophon: Ethical Principles and Historical Enquiry (Mnemosyne Supplements 348). Leiden and Boston: Brill, 2012. Pp. 791. €221/$307. 9789004224377.
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- Janet Powell
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- The Journal of Hellenic Studies / Volume 134 / 2014
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- 02 October 2014, pp. 167-168
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- 2014
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(E.M.A.) Bissa Governmental Intervention in Foreign Trade in Archaic and Classical Greece (Mnemosyne Supplements: History and Archaeology of Classical Antiquity 312). Leiden and Boston: Brill, 2009. Pp. xiv + 266. €93/$138. 9789004175044.
- Janet Powell
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- Journal:
- The Journal of Hellenic Studies / Volume 131 / November 2011
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- 25 November 2011, pp. 204-205
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- November 2011
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13 - Pharmacological treatment of aneurysms
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- By Janet Powell, St George's Hospital, London, UK, Matthew Thompson, St George's Hospital, London, UK
- Robert Fitridge, University of Adelaide, Matthew Thompson, St George's Hospital Medical School, London, UK
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- Book:
- Mechanisms of Vascular Disease
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- The University of Adelaide Press
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- 05 June 2012
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- 01 June 2011, pp 247-254
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Summary
BACKGROUND
Abdominal aortic aneurysms (AAAs) are present in 5 to 10% of men over the age of 65, and elective surgical intervention has long been the mainstay of treatment. There is widespread consensus that operative repair is the treatment of choice in larger AAAs, where the risk of rupture increases with the size of the aneurysm. However, even elective operations carry a significant mortality risk, and the UK small aneurysm trial has shown that for smaller aneurysms (between 4 and 5.5cm) there is no difference in outcome between operation and no intervention. Currently such patients are treated with best medical therapy, but there has been considerable research into finding a pharmacological treatment to prevent aneurysm expansion and rupture.
SCREENING PROGRAMMES
A major obstacle to the prevention of mortality and morbidity associated with aneurysms has been the fact that the majority are asymptomatic, and therefore often remain undetected. Abdominal aortic aneurysms have tended to present either as emergencies or as a result of their increasing size, and it has been shown that larger aneurysms grow more rapidly than their smaller counterparts and are at greater risk of rupture. These patients would therefore benefit most from operative repair rather than medical intervention. In order for a medical treatment to be of benefit, it needs to be targeted at aneurysms that are small and asymptomatic. The most obvious way of doing this would be the initiation of a mass screening programme, and indeed, the Multicentre Aneurysm Screening Study (MASS) has shown that as many as 88% of screen-detected aneurysms are below the threshold for surgery.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. 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Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
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- 20 September 2010, pp xi-xliv
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14 - Abdominal aortic aneurysm
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- By Janet T. Powell, Department of Vascular Surgery, Imperial College School of Medicine, London
- Edited by Beverley J. Hunt, University of London, Lucilla Poston, University of London, Michael Schachter, Imperial College of Science, Technology and Medicine, London, Alison W. Halliday, St George's Hospital, London
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- An Introduction to Vascular Biology
- Published online:
- 07 September 2009
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- 25 July 2002, pp 318-326
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Summary
Introduction
The aorta has to withstand the load imposed by arterial blood pressure for a lifetime. The microanatomy of the aorta reflects this burden and the media is thick, composed of numerous concentric lamellae of elastic connective tissue and smooth muscle cells. In youth and health elastin is the principal load-bearing component of the aorta with collagen fibres only being recruited at the highest loads (Burton, 1954). Other microfibrils, including fibrillin-rich fibrils, also contribute to load bearing. The abdominal aorta, distal to the renal arteries, is the aortic segment with least elastin and least nutrient vasa vasorum in the adventitia. With ageing this segment of the aorta is vulnerable to weakening and fusiform aneurysmal dilatation: abdominal aortic aneurysms (AAAs) are present in approximately 5% of men aged 65 years or older.
Definition of an abdominal aortic aneurysm
The normal diameter of the infrarenal aorta is 1.5–2.2 cm, with taller patients tending to have wider aortas. The infrarenal aorta is conveniently assessed by ultrasonography. A localized fusiform dilation is clearly evidenced when the proximal and distal aortic diameters are much smaller than the maximum diameter. One suggested definition of an AAA is when the ratio of maximum diameter to infrarenal diameter exceeds 1.5 cm. However, the resolution and visualization of the suprarenal aorta by ultrasonography are poor. A more convenient and widely accepted definition of an aneurysm is when the maximum anterior–posterior diameter exceeds 3 cm.