SARS-CoV-2 breakthrough infections among vaccinated individuals with rheumatic disease: results from the COVID-19 Global Rheumatology Alliance provider registry.

Objective: While COVID-19 vaccination prevents severe infections, poor immunogenicity in immunocompromised people threatens vaccine effectiveness. We analysed the clinical characteristics of patients with rheumatic disease who developed breakthrough COVID-19 after vaccination against SARS-CoV-2.

Methods: We included people partially or fully vaccinated against SARS-CoV-2 who developed COVID-19 between 5 January and 30 September 2021 and were reported to the Global Rheumatology Alliance registry.

Analytical Considerations in Nanoscale Flow Cytometry of Extracellular Vesicles to Achieve Data Linearity.

Background:  Platelet microparticles (PMPs) and their abundance in the blood are a prognostic biomarker in thrombotic disorders and cancer. Nanoscale flow cytometry (nFC) is ideal for high-throughput analysis of PMPs but these clinical assays have not been developed previously.

Objective:  This article demonstrates that nFC is a suitable technology to enumerate PMPs present in plasma samples in a clinical setting.

Intraoperative digital specimen mammography: rapid, accurate results expedite surgery.

Introduction: Specimen mammography during image guided breast surgery is a daily occurrence. The process of specimen travel, imaging and reporting may take 20-30 minutes. An intraoperative method to obtain digital specimen mammograms may expedite the process.

Intraoperative digital specimen mammography: prompt image review speeds surgery.

Specimen mammograms are often a time-consuming event for image-guided surgery. The use of an intraoperative imaging device may improve the speed of surgery, but comparison must be made to ensure accuracy is maintained. One hundred fifty consecutive image localized patients underwent both intraoperative digital specimen mammogram (in the operating room) and standard specimen mammogram (in radiology).

Digital documentation of the physical examination: moving the clinical breast exam to the electronic medical record.

Background: Documentation of the clinical breast examination (CBE) has consisted of simple hand-drawings and stick figures without a common lexicon. There is a need for a device that can accurately depict the CBE in digital format while being objective, reproducible over time, and useable in the electronic medical record. This new device is called palpation imaging (PI).

Inferior vena cava filling defects on CT and MRI.

Objective: The purpose of this article is to describe the appearance and causes of inferior vena cava (IVC) filling defects, how such findings may be accurately characterized, and the clinical significance of IVC filling defects. Filling defects in the IVC observed at MDCT and MRI may be a result of flow artifacts, anatomic variants, or bland or malignant thrombus.

Conclusion: Familiarity with anatomy and flow effects is critical for distinguishing true from false filling defects in the IVC.

Stereotactic core breast biopsy of malignant calcifications: diagnostic yield of cores with and cores without calcifications on specimen radiographs.

Purpose: To retrospectively compare core biopsy diagnosis with final diagnosis at surgical excision in cores with and cores without calcification on specimen radiographs.

Materials And Methods: One hundred thirteen consecutive patients underwent vacuum-assisted 11- or 14-gauge needle stereotactic core biopsy for calcifications with malignant histologic results in core samples from 116 lesions. For each lesion, calcification was identified in at least one core at specimen radiography.

Do simultaneous bilateral tunneled infusion catheters in patients undergoing bone marrow transplantation increase catheter-related complications?

Purpose: Secure venous access with multiple lumens is necessary for the care of allogeneic hematopoietic stem cell transplant (HSCT) recipients. The outcomes associated with simultaneous bilateral tunneled internal jugular infusion catheter placement in the HSCT recipient population were investigated in an attempt to determine whether simultaneous introduction of these catheters compounds or magnifies the risks (infection, venous thrombosis) associated with tunneled catheters.

Materials And Methods: Patients undergoing HSCT and receiving bilateral tunneled infusion catheters in a single procedure were identified using a quality assurance data base.

Metallic marker placement after stereotactic core biopsy of breast calcifications: comparison of two clips and deployment techniques.

Objective: Two methods of deployment of metallic clips at the site of stereotactic core biopsy for breast calcifications are compared retrospectively.

Materials And Methods: One hundred nineteen clips deployed through an 11-gauge vacuum-assisted biopsy probe at core biopsy sites were compared with 109 vascular ligating clips deployed at biopsy sites using an 18-gauge spinal needle. The distance of each clip from the position of the target calcification was assessed using stereotactic coordinates in 52 sequential cases and was measured on mammograms before and after biopsy in 108 clips deployed through an 11-gauge probe and 98 clips deployed using an 18-gauge needle.

Encircling guidewire facilitates complete excision of image-localized breast lesions.

Background: An innovative encircling guidewire defines three sides of a target lesion with a single puncture to achieve negative margins.

Methods: Twenty-five patients requiring image-guided surgery were localized with an encircling guidewire. Although the deployed wire is circular, it is straight when placed, using a straight outer needle.

Intraoperative ultrasonography guidance is accurate and efficient according to results in 100 breast cancer patients.

Background: The frequency of nonpalpable breast cancer has doubled in the last 10 years. Surgical use of high quality portable ultrasound units has made it possible to evaluate the time-saving method of intraoperative ultrasonography localization.

Methods: Ultrasonography localization in the operating room immediately prior to definitive surgery was performed by the surgeon.

Detachable balloon-modified reducing stent to treat hepatic insufficiency after transjugular intrahepatic portosystemic shunt creation.

A patient developed severe hepatic insufficiency after creation of a transjugular intrahepatic portosystemic shunt, which was treated unsuccessfully with a constrained Wallstent ("reducing stent"). After a failed attempt at occluding the shunt with an occlusion balloon, a detachable balloon was placed at the portal end of the constrained stent. This balloon-modified reducing stent reduced flow while maintaining shunt patency, and the patient's hepatic insufficiency improved.

Intraoperative ultrasound facilitates surgery for early breast cancer.

Background: Mammogram-directed wire localization for nonpalpable cancer requires surgeon's time and coordination and some patient discomfort. Up to half of these nonpalpable lesions can be visualized by ultrasound. Use of intraoperative ultrasound streamlines the process of image-guided surgery.