"Cell blocking" the parasitic imposter: In a rare case of isolated pulmonary cysticercosis.

Isolated pulmonary cysticercosis is a rare manifestation of human cysticercosis which mainly affects central nervous system, skeletal muscles, eyes and subcutaneous tissues. Pulmonary involvement is usually a part of disseminated disease and mainly presents as bilateral pulmonary nodules. We report a rare case of isolated pulmonary cysticercosis presenting as lung cyst with pleural effusion. The diagnosis was made on pleural fluid cytology and cell block preparation. Herein we wish to recapitulate the importance of cell block as a diagnostic aid for parasitic infections, where morphological features and architectural patterns are as clearly discernable as in histopathology.

Pirated Manuscripts From Radiology's Most Impactful Journals: An International Analysis of Copyright-Infringing Downloads.

OBJECTIVES: The world's largest scholarly literature pirate website, Sci-Hub, permits readers to bypass journal paywalls, thus facilitating no-cost copyright-infringing article downloads. We studied download characteristics of internationally pirated radiology journal articles. METHODS: All download request events between September 2015 and February 2016 were retrieved from Sci-Hub's public server logs. Focusing on high-impact factor radiology journals, we targeted uniquely identifiable diagnostic imaging and radiation oncology journals with a 2015 Thompson Reuters impact factor of ≥2. Pirated article download characteristics were assessed at the individual article, journal, and geographic level. RESULTS: Of all 27,819,965 pirated article downloads, 105,075 (0.4%) were from 49 radiology journals with high impact factor. Total monthly radiology downloads ranged from 6,715 to 24,449. Downloads were most frequent for papers from Radiology (10,357 of 105,075; 9.9%), NeuroImage (10,121; 9.6%), and the International Journal of Radiation Oncology Biology (8,025; 7.6%). The most downloaded articles were published in European Radiology, RadioGraphics, and NeuroImage. By country, download requests were most frequent from China (17,975 of 105,075; 17.1%), India (7,969; 7.6%), and Iran (7,327; 7.0%), but on a per capita basis, were most common in Portugal (210.8 per 1,000,000 population), Chile (135.4), and Tunisia (113.8). Only 4,450 (4.2%) of download requests were from the United States. CONCLUSIONS: Copyright-infringing downloading of pirated radiology journal articles occurs frequently across the world and impacts nearly all top impact-factor journals. New publisher pricing and business models, akin to those for digital music, may be necessary to disincentivize pirating and ensure journal financial sustainability.

Mammography Patient Information at Hospital Websites: Most Neither Comprehensible Nor Guideline Supported.

OBJECTIVE: Ongoing controversy regarding screening mammography guidelines has created confusion for many patients. Given recommendations that patient educational material be prepared at or below the 7th grade reading level of average Americans, the purpose of this study was to assess the readability of online mammography information offered by hospitals nationwide. MATERIALS AND METHODS: During 2015, online mammography patient educational materials were identified for all Medicare-recognized hospitals nationwide for which screening mammography metrics were publicly available. Patient educational materials were assessed using six validated readability score algorithms. All references to official screening guidelines were captured. RESULTS: Of 4105 hospitals nationwide, 3252 had websites and confirmable screening mammography services. Of those, 1753 (54%) offered mammography information material online. Only 919 (28%) referenced any professional society guidelines. After excluding information not formatted in HTML and shorter than 100 words (to improve algorithm reliability), 1524 hospital mammography webpages were assessed for grade level scores. Nationally, the mean of each readability score for all hospitals varied between the 10th and 14th grade levels, all higher than the recommended 7th grade level (p < 0.001). At the individual hospital level, only 14 hospitals (0.4%) had mean scores at or below the 7th grade level. CONCLUSION: Of U.S. hospitals that offer screening mammography and have websites, only 54% provide online mammography educational material. Of those, only 0.4% present information at a reading level comprehensible to average Americans, and only 28% offer specific information to help patients reconcile conflicting guidelines. Health systems offering mammography should strive to better meet women's health information and literacy needs.

Magnetic resonance imaging features of osteochondral lesions of the talus.

BACKGROUND: Osteochondral lesions of the talus (OLT) traditionally have been thought to occur anterolaterally or posteromedially. Recent studies utilizing magnetic resonance imaging (MRI) have questioned this teaching. The purpose of this study was to use MRI to describe the location, frequency, and morphology of OLT and determine if any correlations exist between lesion location and other data points. METHODS: The location, frequency, and size of OLT based on a nine-zone grid were recorded on 77 MRI examinations. Lateral ligaments were inspected for evidence of injury. Stability of the lesions was assessed based on four MRI criteria: presence or absence of cartilage defects, edema-like signal abnormality, T2 bright rim, and/or subchondral cysts. Demographic data including patient age, injury mechanism, and chronicity were recorded. An ANOVA model was used to determine if statistical differences existed between lesion size and location. Pearson correlation coefficients were used to examine any association between lesion location and demographic data. RESULTS: Most of the lesions were located medially and centrally on the talar dome (54.5%), with the second highest frequency found laterally and centrally (31.2%). With the numbers available there was no statistical difference between the size of the lesions based on location. No strong correlations were found between lesion location and demographic data. CONCLUSION: This study refutes traditional teachings regarding the location of OLT and supports recent studies showing that most lesions are located medially and centrally on the talar dome.

The use of bioabsorbable implants in the spine.

BACKGROUND CONTEXT: Bioabsorbable implants are commonplace in sports medicine surgeries, especially in shoulder and knee ligamentous reconstruction. Their use is now expanding to the realm of spinal reconstructive surgery. Newer polymers offer reduced incidence of the side effects of aseptic sterile sinus formation and have appropriate resorption time parameters for spine use. These new bioabsorbable materials confer initial and intermediate-term stability that is adequate for stable bony healing in various applications. The majority of human clinical applications in the spine that have been documented involve bone graft harvest site reconstruction, posterior spinal graft containment, anterior interbody reconstruction and anterior cervical and lumbar spine tension band plating. PURPOSE: The purpose of this review article is to highlight the indications and outcomes of the use of bioabsorbable implants in specific spinal applications. STUDY DESIGN: A comprehensive literature review of the English and non-English literature on bioabsorbable implant technology. METHODS: A comprehensive literature review was performed to gather basic science, animal and human data on the use of bioabsorbable implants in spinal surgery. RESULTS: Bioabsorbable implants have demonstrated strength and resorption characteristics commensurate with the physiologic and biomechanical requirements of the human spinal axis. Histologic sampling has demonstrated successful time-patterned resorption accompanied by bony replacement and remodeling of intervertebral cage devices in the animal model. CONCLUSION: Bioresorbable compounds appear to have a role in specific spinal reconstructive procedures. Their radiolucent nature improves image assessment of fusion healing, and their time-engineered resorption characteristics allow controlled dynamization in interbody and plate applications. Their widespread use and acceptance may increase dramatically as further research and clinical studies report on their safety and efficacy.