scholarly journals Emergency Breast Imaging, What Radiologists Need To Know

2021 ◽  
Vol 4 ◽  
pp. 4
Author(s):  
Abdelmohsen Radwan Hussien ◽  
Monaliza El-Quadi ◽  
Rola Shaheen ◽  
Mohamed Elfar ◽  
Avice O’Connell
Keyword(s):  
Breast Imaging ◽  
Severe Infection ◽  
The Past ◽  
General Radiologist ◽  
Breast Radiologist

Awareness by the general radiologist of the various emergent conditions of the breast would enable a better management and appropriate referral, rather than postponing management till a breast radiologist is available for consultation. Early referrals are essential to prevent deterioration of complications including severe infection and even sepsis. There has been a lack of consensus in the past regarding appropriate management and delays in treatment have resulted in worse outcomes which could have been avoided.

scholarly journals Traces of SARS-CoV-2 RNA in the Blood of COVID-19 Patients

2020 ◽  
Author(s):  
Ahmed Moustafa ◽  
Ramy K Aziz
Keyword(s):  
Mononuclear Cells ◽  
Sequence Data ◽  
Severe Infection ◽  
Multiple Organ ◽  
Respiratory Complications ◽  
Peripheral Blood Mononuclear ◽  
Human Organs ◽  
The Third ◽  
The Past ◽  
Virus Rna

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the third virus that caused coronavirus-related outbreaks over the past 20 years. The outbreak was first reported in December 2019 in Wuhan, China, but rapidly progressed into a pandemic of an unprecedented scale since the 1918 flu pandemic. Besides respiratory complications in COVID-19 patients, clinical characterizations of severe infection cases showed several other comorbidities, including multiple organ failure (liver, kidney, and heart) and septic shock. To better understand COVID-19 pathogenesis in different human organs, we interrogated the presence of the virus in the blood, or any of its components, which might provide a form of trafficking or hiding to the virus. By computationally analyzing high-throughput sequence data from patients with active COVID-19 infection, we found evidence of only traces of SARS-CoV-2 RNA in peripheral blood mononuclear cells (PBMC), while the virus RNA was abundant in bronchoalveolar lavage specimens from the same patients. We also devised a "viral spike-to-actin" RNA normalization, as a metric to compare across various samples and minimize errors caused by intersample variability in human RNA. To the best of our knowledge, the presence of SARS-CoV-2 RNA in the PBMC of COVID-19 patients has not been reported before, and this observation could suggest immune presentation, but discounts the possibility of extensive viral infection of lymphocytes or monocytes.

scholarly journals Candida parapsilosis, an Emerging Fungal Pathogen

2008 ◽  
Vol 21 (4) ◽  
pp. 606-625 ◽  
Author(s):  
David Trofa ◽  
Attila Gácser ◽  
Joshua D. Nosanchuk
Keyword(s):  
Candida Parapsilosis ◽  
Molecular Genetic ◽  
Hydrolytic Enzymes ◽  
Severe Infection ◽  
Therapeutic Approaches ◽  
Indwelling Catheters ◽  
Prosthetic Devices ◽  
The Past ◽  
New Therapeutic Approaches ◽  
Care Workers

SUMMARY Candida parapsilosis is an emerging major human pathogen that has dramatically increased in significance and prevalence over the past 2 decades, such that C. parapsilosis is now one of the leading causes of invasive candidal disease. Individuals at the highest risk for severe infection include neonates and patients in intensive care units. C. parapsilosis infections are especially associated with hyperalimentation solutions, prosthetic devices, and indwelling catheters, as well as the nosocomial spread of disease through the hands of health care workers. Factors involved in disease pathogenesis include the secretion of hydrolytic enzymes, adhesion to prosthetics, and biofilm formation. New molecular genetic tools are providing additional and much-needed information regarding C. parapsilosis virulence. The emerging information will provide a deeper understanding of C. parapsilosis pathogenesis and facilitate the development of new therapeutic approaches for treating C. parapsilosis infections.

scholarly journals Visual search in breast imaging

2019 ◽  
Vol 92 (1102) ◽  
pp. 20190057 ◽  
Author(s):  
Ziba Gandomkar ◽  
Claudia Mello-Thoms
Keyword(s):  
Visual Search ◽  
Eye Tracking ◽  
Diagnostic Accuracy ◽  
Breast Imaging ◽  
Diagnostic Errors ◽  
Digital Breast Tomosynthesis ◽  
Imaging Modalities ◽  
Radiology Workflow ◽  
Breast Tomosynthesis ◽  
The Past

Breast cancer is the most common cancer among females worldwide and large volumes of breast images are produced and interpreted annually. As long as radiologists interpret these images, the diagnostic accuracy will be limited by human factors and both false-positive and false-negative errors might occur. By understanding visual search in breast images, we may be able to identify causes of diagnostic errors, find ways to reduce them, and also provide a better education to radiology residents. Many visual search studies in breast radiology have been devoted to mammography. These studies showed that 70% of missed lesions on mammograms attract radiologists’ visual attention and that a plethora of different reasons, such as satisfaction of search, incorrect background sampling, and incorrect first impression can cause diagnostic errors in the interpretation of mammograms. Recently, highly accurate tools, which rely on both eye-tracking data and the content of the mammogram, have been proposed to provide feedback to the radiologists. Improving these tools and determining the optimal pathway to integrate them in the radiology workflow could be a possible line of future research. Moreover, in the past few years deep learning has led to improving diagnostic accuracy of computerized diagnostic tools and visual search studies will be required to understand how radiologists interact with the prompts from these tools, and to identify the best way to utilize them. Visual search in other breast imaging modalities, such as breast ultrasound and digital breast tomosynthesis, have so far received less attention, probably due to associated complexities of eye-tracking monitoring and analysing the data. For example, in digital breast tomosynthesis, scrolling through the image results in longer trials, adds a new factor to the study’s complexity and makes calculation of gaze parameters more difficult. However, considering the wide utilization of three-dimensional imaging modalities, more visual search studies involving reading stack-view examinations are required in the future. To conclude, in the past few decades visual search studies provided extensive understanding about underlying reasons for diagnostic errors in breast radiology and characterized differences between experts’ and novices’ visual search patterns. Further visual search studies are required to investigate radiologists’ interaction with relatively newer imaging modalities and artificial intelligence tools.

scholarly journals ACTUAL ISSUES OF MODERN EPIDEMIOLOGY OF MELIOIDOSIS: A LITERATURE REVIEW AND ANALYSIS OF IMPORTED CASES TO NON-ENDEMIC REGIONS

2018 ◽  
Vol 23 (3) ◽  
pp. 126-133
Author(s):  
Irina B. Zakharova
Keyword(s):  
Southeast Asia ◽  
Burkholderia Pseudomallei ◽  
Fatal Outcome ◽  
Severe Infection ◽  
Northern Australia ◽  
The Past ◽  
The Pacific ◽  
Imported Cases ◽  
Infection Disease ◽  
The Caribbean

Introduction. Melioidosis is a severe infection disease with the high mortality rate due to saprophytic bacterium Burkholderia pseudomallei. For the time present, the area of the distribution of the pathogen is much wider than in the case of the traditionally endemic Southeast Asia and Northern Australia and covers the humid tropics and subtropics of all continents. Methods. The search for data and analysis of disease cases in non-endemic areas for the period from 2003 to April 2017. Results. Over the past 15 years, 120 cases of melioidosis in non-endemic countries were described, that is 5,5 times higher than in the same previous period. There is no direct dependence of infection probability on the age and risk factors, but the presence of diabetes or chronic diseases doubles the risk of a fatal outcome of melioidosis. Southeast Asia still prevails as the origin of infection (62.5% of cases), however, the number of imported cases of melioidosis from Mexico, the Caribbean, South America, East Africa, Madagascar, China and the Pacific region begins to increase.

Characteristics of young women enrolled in a high-risk breast cancer screening program

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 1512-1512
Author(s):  
S. Tierney ◽  
J. C. Delli Carpini ◽  
M. L. Gemignani
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Young Women ◽  
Breast Imaging ◽  
Screening Program ◽  
Inclusion Criteria ◽  
Risk Screening ◽  
The Past ◽  
High Risk Screening

1512 Background: Young women at higher risk for breast cancer may benefit from enrollment in a dedicated surveillance program to ensure that their unique needs for examination, imaging, and risk modification are met. Though these programs do exist, little information is known about their effectiveness. In this pilot study, we sought to characterize the patients enrolled in our high-risk screening program. Methods: The Special Surveillance Breast Program (SSBP) at the Memorial Sloan-Kettering Cancer Center (MSKCC) was initiated in 1992 and enrolls patients in four categories: known and probable genetic mutation carriers, atypia, LCIS, and positive family history. Data is collected prospectively in an IRB-approved database and reviewed retrospectively. Patients enrolled from 1992 to March 2008 were included. Inclusion criteria included age under 40 and at least one follow-up visit. Data was validated with the patients’ medical records. Results: Four hundred and thirteen patients met inclusion criteria. The median age at enrollment was 33. The median duration of enrollment was 41 months. Defining continued participation as having a follow up visit in 2008, 193 patients (48%) were retained. At enrollment, 247 patients (60%) had ever undergone screening breast imaging. Of these, 216 patients (52%) had undergone screening in the past 2 years. At the most recent visit, 394 patients (95%) had ever undergone screening breast imaging and 376 patients (91%) had undergone screening in the past 2 years. Of the patients who had not had any radiologic screening, 18 patients (78%) were under the age of 35 at the most recent visit. Two hundred and ninety one patients (70%) reported performing self-breast exams. Two patients were diagnosed with cancer during their participation. An additional six patients underwent prophylactic surgery at MSKCC. Conclusions: Enrollment in a high-risk screening program was associated in an increase in any utilization of radiologic screening from 60% to 95%. It is unknown how this would compare to similar high-risk populations not enrolled in any program. Considering their voluntary enrollment and return for follow-up, these women are likely highly motivated regarding their health care. Further prospectively collected survey data from patients, including those who did not return after their initial visit, is planned. No significant financial relationships to disclose.

A Proposal to Define Three New Breast Calcification Shapes: Square, Sandwich, and Teardrop, Pill & Capsule

2019 ◽  
Vol 1 (3) ◽  
pp. 186-191
Author(s):  
Jay A Baker ◽  
Lars J Grimm ◽  
Karen S Johnson
Keyword(s):  
Breast Imaging ◽  
Interobserver Variability ◽  
Institutional Review Board ◽  
Observer Variability ◽  
Preliminary Assessment ◽  
Clinical Value ◽  
Institutional Review ◽  
Index Study ◽  
Breast Radiologist ◽  
Breast Calcification

Abstract Objective To define and illustrate three new descriptors for microcalcification morphology on mammography, and provide a preliminary assessment of their potential clinical value. Methods The institutional review board approved this retrospective study and waived the requirement for informed consent. One thousand consecutive biopsy-proven cases of microcalcifications were retrospectively reviewed by the index study observer, a fellowship-trained breast radiologist blinded to histologic outcome. Each case was evaluated for traditional Breast Imaging Reporting and Data System (BI-RADS) morphology descriptors, as well as for the presence of one of three proposed new calcification morphology descriptors: (1) square, (2) sandwich, and (3) teardrop, pill & capsule. Positive predictive value (PPV) for each proposed shape was calculated. Interobserver variability was calculated on a subset of 200 cases, which were evaluated by two additional breast radiologists blinded to the interpretation of the index observer. Results Of 1000 cases, 702 (70.2%) were benign, and 298 (29.8%) were malignant. There were 51 (5.1%) square and 60 (6.0%) sandwich calcification cases, which were all benign at biopsy (PPV, 0%). Of the 106 (10.6%) cases that included teardrop, pill & capsule calcifications, 90 were malignant (PPV, 84.9%). Interobserver variability for the traditional BI-RADS morphology descriptors (κ = 0.40) was comparable to observer variability of the proposed new morphologies: square (κ = 0.39), sandwich (κ = 0.47), and teardrop, pill & capsule (κ = 0.49). Conclusion The proposed calcification descriptors square and sandwich-shaped had a PPV of 0%, and they may represent new typically benign morphologies. In contrast, teardrop, pill & capsule–shaped calcifications indicate a higher likelihood of malignancy than that of previously established descriptors.

One-minute Preceptors in Action: Breast Radiologists and the Medical Student General Radiology Elective

2020 ◽  
Author(s):  
Sheila S Lee ◽  
Gary L Beck Dallaghan ◽  
Jorge D Oldan ◽  
Sheryl G Jordan
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Learning Styles ◽  
Breast Imaging ◽  
Positive Impact ◽  
Teaching Strategy ◽  
Learning Experiences ◽  
High Yield ◽  
Yield Learning ◽  
Breast Radiologist

Abstract Breast imaging, with its unique patient-facing, multimodality, and multidisciplinary workflow, offers opportunities to engage medical students enrolled in a general radiology rotation and to highlight the role of the radiologist in patient care. At a time when breast radiologists face unprecedented challenges in delivering safe and efficient imaging services, however, accommodating larger numbers of medical students can overwhelm reading rooms, dilute meaningful learning experiences for the student, and place further demands on faculty. In order to meet the students’ and clinician educators’ needs, Neher’s one-minute preceptor teaching strategy is used to create a high-yield learning environment in a short amount of time. In this model, the breast radiologist weaves together multiple impactful and varied learning experiences in only 8 to 12 total hours of structured student exposure during the 160-hour general radiology course. We describe our adaptation of this technique and the positive impact that a short breast imaging component had on our general radiology medical student rotation. This standardized curriculum is easily adapatable to a variety of learning styles. It contributes to medical students’ understanding of the various facets of radiology through direct participation and exceeds education goals set forth by the Alliance of Medical Student Educators in Radiology. Students’ evaluations of the general radiology rotation demonstrated a sharp uptick in the year following the adoption of the technique, and students’ rotation final examination mean scores on the breast questions were higher for students who participated at least eight hours on service in the breast radiology clinic.

Prevalence of Burnout in Breast Imaging Radiologists

2020 ◽  
Vol 2 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Jay R Parikh ◽  
Jia Sun ◽  
Martha B Mainiero
Keyword(s):  
Breast Imaging ◽  
Maslach Burnout Inventory ◽  
The United States ◽  
Personal Accomplishment ◽  
Physician Burnout ◽  
The Past ◽  
High Prevalence ◽  
Related Stress ◽  
Job Related Stress ◽  
E Mail

Abstract Objective Burnout is defined as a psychological syndrome arising as a response to chronic prolonged interpersonal job-related stress. Physician burnout has been increasingly recognized over the past decade as an epidemic within the United States. The goal of this study was to ascertain the prevalence of burnout amongst practicing breast imaging radiologists. Methods A survey contained demographic questions based on workforce surveys carried out by the American College of Radiology and a validated condensed version of the Maslach Burnout Inventory (MBI) evaluating the three aspects of burnout. The radiologist members of the Society of Breast Imaging (SBI) received the survey internally from the SBI as a weekly e-mail with a web link to the survey from February 19, 2019, to March 13, 2019. The link allowed respondents to complete the survey anonymously. The authors were blinded to the SBI mailing list and the SBI was blinded to the responses. Results A total of 370 breast imaging radiologists from the SBI responded to the survey. Overall, 290 out of 370 (78.4%) were highly burned out in at least 1 measured dimension of burnout; 197 out of 362 (54.4%) were highly burned out in at least 2 dimensions of burnout; and 27 out of 362 (7.5%) were highly burned out in all 3 dimensions of burnout. However, rates of personal accomplishment were high, with only 8.8% experiencing high burnout in the dimension of personal accomplishment. Conclusion Our study demonstrates a high prevalence of burnout amongst breast imaging radiologists. Burnout rates were highest in the youngest breast imaging radiologists.

scholarly journals CAD and AI for breast cancer—recent development and challenges

2020 ◽  
Vol 93 (1108) ◽  
pp. 20190580 ◽  
Author(s):  
Heang-Ping Chan ◽  
Ravi K. Samala ◽  
Lubomir M. Hadjiiski
Keyword(s):  
Artificial Intelligence ◽  
Machine Learning ◽  
Patient Care ◽  
Breast Imaging ◽  
Medical Image Analysis ◽  
Response Assessment ◽  
Cancer Staging ◽  
Lesion Detection ◽  
Clinical Workflow ◽  
The Past

Computer-aided diagnosis (CAD) has been a popular area of research and development in the past few decades. In CAD, machine learning methods and multidisciplinary knowledge and techniques are used to analyze the patient information and the results can be used to assist clinicians in their decision making process. CAD may analyze imaging information alone or in combination with other clinical data. It may provide the analyzed information directly to the clinician or correlate the analyzed results with the likelihood of certain diseases based on statistical modeling of the past cases in the population. CAD systems can be developed to provide decision support for many applications in the patient care processes, such as lesion detection, characterization, cancer staging, treatment planning and response assessment, recurrence and prognosis prediction. The new state-of-the-art machine learning technique, known as deep learning (DL), has revolutionized speech and text recognition as well as computer vision. The potential of major breakthrough by DL in medical image analysis and other CAD applications for patient care has brought about unprecedented excitement of applying CAD, or artificial intelligence (AI), to medicine in general and to radiology in particular. In this paper, we will provide an overview of the recent developments of CAD using DL in breast imaging and discuss some challenges and practical issues that may impact the advancement of artificial intelligence and its integration into clinical workflow.

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