High Prevalence of New Clinically Significant Findings in Patients With Embolic Stroke of Unknown Source Evaluated by Cardiac Magnetic Resonance Imaging.

Background: Embolic stroke of unknown source (ESUS) accounts for 1 in 6 ischemic strokes. Current guidelines do not recommend routine cardiac magnetic resonance (CMR) imaging in ESUS, and beyond the identification of cardioembolic sources, there are no data assessing new clinical findings from CMR in ESUS. This study aimed to assess the prevalence of new cardiac and noncardiac findings and to determine their impact on clinical care in patients with ESUS.

Cross-Training Pharmacy Professionals as Community Health Workers.

Community health workers (CHWs) are health professionals that connect the populations they serve to health services. They play a valuable role in assessing patients' needs, linking patients with health and human resources, educating patients toward achieving optimal health, and advocating for their patients to have accessible resources to improve their health and wellbeing. Pharmacies are readily accessible and frequently utilized health locations that could employ CHWs.

Atrial CARdiac Magnetic resonance imaging in patients with embolic stroke of unknown source without documented Atrial Fibrillation (CARM-AF): Study design and clinical protocol.

Background: Initiation of anticoagulation therapy in ischemic stroke patients is contingent on a clinical diagnosis of atrial fibrillation (AF). Results from previous studies suggest thromboembolic risk may predate clinical manifestations of AF. Early identification of this cohort of patients may allow early initiation of anticoagulation and reduce the risk of secondary stroke.

Impact of catheter ablation versus medical therapy on cognitive function in atrial fibrillation: a systematic review.

Purpose: Atrial fibrillation is associated with an increased risk of cognitive impairment. It is unclear whether the restoration of sinus rhythm with catheter ablation may modify this risk. We conducted a systematic review of studies comparing cognitive outcomes following catheter ablation with medical therapy (rate and/or rhythm control) in atrial fibrillation.

Biochar and compost equally improve urban soil physical and biological properties and tree growth, with no added benefit in combination.

Soil compaction can be a major impediment to tree growth as it damages soil physical and biological properties and reduces plant available water. This may result in trees that are more vulnerable to seasonal water stress. Improving soil physical and biological properties by increasing soil organic matter content may lead to improved tree establishment.

Effects of deep tillage and municipal green waste compost amendments on soil properties and tree growth in compacted urban soils.

Large trees are often seen as a means of offsetting negative consequences of growing urban densification. To increase the tree canopy cover of dense urban landscapes, developers, planners and urban tree managers are often forced to plant into damaged and compacted sites. Compacted urban soils can hinder the establishment and growth of deep rooted, woody plants by: 1) impeding root exploration and development which is critical for water and nutrient acquisition; 2) reducing infiltration of water into the soil and the availability of water to plants; and 3) reducing gas exchange and the balance between anaerobic and aerobic conditions.

Changing homelessness services: revanchism, 'professionalisation' and resistance.

This paper argues that the increasing international salience of homelessness can be partially explained by reference to the revanchist thesis (involving processes of coerced exclusion and abjection), but the situation on the ground is more complex. It reports on interviews with 18 representatives of 11 homelessness service providers in one city in England. As Cloke et al.

Evaluation of malignant breast lesions in the diagnostic setting with cone beam breast computed tomography (Breast CT): feasibility study.

To investigate the feasibility of noncontrast and contrast-enhanced cone beam breast Computed Tomography (CT) in demonstrating malignant breast lesions in the diagnostic setting. This Institutional Review Board approved, Health Information Portability and Accountability Act compliant, prospective study enrolled BI-RADS four and five patients from 2008 to 2010. Eighty-seven subjects had noncontrast breast CT, 42 had contrast-enhanced breast CT (CE-breast CT) with 70 pathologically confirmed cancer diagnoses.

Comparison of breast cancers diagnosed in screening patients in their 40s with and without family history of breast cancer in a community outpatient facility.

Objective: The purpose of this study was to compare invasive breast cancer in patients in their 40s with and without a family history of breast cancer as well as the lymph node meta-static rate and mastectomy rate.

Materials And Methods: From 2000 to 2011, a total of 793,827 examinations were performed; 221,541 (28%) were women between 40 and 49 years old. A total of 6965 cancers were found in 6511 patients.

Clinical experience with elasticity imaging in a community-based breast center.

Objectives: The aim of this study was to evaluate compression elasticity imaging in combination with standard B-mode imaging for assessment of benign versus malignant breast lesions and correlation with needle biopsy.

Methods: Institutional Review Board approval was obtained, and patients were prospectively enrolled from 2007 to 2011. A total of 221 patients yielding 230 elastograms recommended for biopsy were the basis of this analysis.

Underestimation of papillary breast lesions by core biopsy: correlation to surgical excision.

Background: The purpose of this study was to evaluate papillary lesions of the breast diagnosed at needle core biopsy and the outcomes of follow-up imaging and surgical findings.

Methods: Retrospective review of 13,806 needle core biopsies performed from 2004 to 2010 revealed 352 patients with 368 papillary lesions; 137 of these lesions underwent surgical excision and 215 had a minimum of 2 year imaging follow-up. Outcomes of imaging follow-up and underestimation of carcinoma by comparison to surgical excision, as applicable, were determined.

Management of patients diagnosed with lobular carcinoma in situ at needle core biopsy at a community-based outpatient facility.

Objective: The objective of our study was to show the importance of surgical excision after the diagnosis of lobular carcinoma in situ (LCIS) based on needle core biopsy.

Materials And Methods: Retrospective evaluation of all cases of LCIS diagnosed at needle core biopsy from 2000 to 2011 was performed; 60 patients with 64 diagnoses of LCIS comprise the cohort. Data recorded included patient demographics, patient presentation, breast density, personal and family histories of breast cancer, lesion characteristics, biopsy method, and correlation of core results with surgical pathology or follow-up imaging.

A review of breast imaging following mastectomy with or without reconstruction in an outpatient community center.

Despite developments in surgical technique, radiation treatment, and chemotherapeutic agents, tumor recurrence and distant disease have remained a major concern in breast cancer management. Breast imaging after mastectomy in the screening arena remains a controversial topic for breast imagers. Many feel the yield of finding a recurrent cancer with imaging in the asymptomatic patient is too low to be beneficial; others believe imaging should be performed on these patients as the risk of recurrence exists.

Rates of pathological underestimation for 9 and 12 gauge breast needle core biopsies at surgical excision.

Background: The clinical implementation of needle core biopsies has given radiologists an invaluable tool for the diagnostic evaluation of suspicious breast lesions. Despite improvements made to the technology of breast biopsy, the underestimation of disease in tissue samples retrieved continues. This can be attributed to many factors, including variability between different needle gauges.

Perceived sufficiency of full-field digital mammograms with and without irreversible image data compression for comparison with next-year mammograms.

Problems associated with the large file sizes of digital mammograms have impeded the integration of digital mammography with picture archiving and communications systems. Digital mammograms irreversibly compressed by the novel wavelet Access Over Network (AON) compression algorithm were compared with lossless-compressed digital mammograms in a blinded reader study to evaluate the perceived sufficiency of irreversibly compressed images for comparison with next-year mammograms. Fifteen radiologists compared the same 100 digital mammograms in three different comparison modes: lossless-compressed vs 20:1 irreversibly compressed images (mode 1), lossless-compressed vs 40:1 irreversibly compressed images (mode 2), and 20:1 irreversibly compressed images vs 40:1 irreversibly compressed images (mode 3).

Hypocomplementaemic immune complex tubulointerstitial nephritis.

We report a rare cause of rapidly progressive renal failure associated with low complement, positive ANA but negative anti DS-DNA. A renal biopsy demonstrated tubulointerstitial nephritis with positive immunoglobulin staining involving the interstitium and tubular basement membrane but glomerular sparing. A review of the literature and differential diagnosis are discussed.

Computer-aided detection of breast carcinoma in standard mammographic projections with digital mammography.

Purpose: A retrospective evaluation of the ability of computer-aided detection (CAD) ability to identify breast carcinoma in standard mammographic projections.

Materials And Methods: Forty-five biopsy proven lesions in 44 patients imaged digitally with CAD applied at examination were reviewed. Forty-four screening BIRADS category 1 digital mammography examinations were randomly identified to serve as a comparative normal/control population.

Community-based practice experience of unsuspected breast magnetic resonance imaging abnormalities evaluated with second-look sonography.

Objective: The purpose of this study was to assess the utility and efficacy of second-look breast sonography in the evaluation of abnormalities identified on presurgical breast magnetic resonance imaging (MRI) examinations.

Methods: A retrospective review was performed of 152 presurgical breast MRI examinations having 196 unsuspected abnormalities to identify findings that underwent subsequent breast sonography. Eligible examinations had a suspicious abnormality identified on presurgical MRI and documentation of the location and size of the finding on MRI and subsequent second-look sonography.

Anticoagulation and bleeding risk after core needle biopsy.

Objective: The objective of our study was to compare the bleeding complication rates after core needle biopsy in patients receiving anticoagulation therapy and those who had not to assess the safety of performing core needle breast biopsy in anticoagulated patients.

Materials And Methods: Core needle biopsy was performed at 1,144 sites in 1,055 women from August 2004 to May 2007. A retrospective study of these cases was performed.

Full-field digital mammography on LCD versus CRT monitors.

Objective: Our purpose was to determine if the display of full-field digital mammograms on a 5-megapixel liquid crystal display (LCD) monitor is at least equivalent to the display of the same on a 5-megapixel cathode ray tube (CRT) monitor.

Materials And Methods: Five radiologists evaluated normal anatomy and features of 61 abnormalities in 48 full-field digital mammograms. A 9-point Likert scale was used to compare images on two identical soft-copy review workstations, one equipped with two 5-megapixel CRTs and the other with two 5-megapixel LCDs.

Hypocalcemic tetany and metabolic alkalosis in a dialysis patient: an unusual event.

The case is described of a 29-year-old man with renal failure and recurrent hyperparathyroidism who 3 weeks postparathyroidectomy developed hypocalcemic tetany because he was taking one-half the prescribed dose of calcitriol. He interpreted his symptoms as those of potassium intoxication and self-administered almost 1,500 mEq sodium bicarbonate. The increase in plasma sodium and osmolarity led to increased fluid intake, and at presentation he had an ionized calcium of 0.