Design, Creation, and 13-Month Performance of a Novel, Web-Based Activity for Education in Primary Cardiology Palliative Care.

Cardiovascular disease (CVD) clinicians who care for seriously ill patients frequently report that they do not feel confident nor adequately prepared to manage patients' palliative care (PC) needs. With the goal, therefore, of increasing PC knowledge and skills amongst interprofessional clinicians providing CVD care, the ACC's PC Workgroup designed, developed, and implemented a comprehensive PC online educational activity. This paper describes the process and 13-month performance of this free, online activity for clinicians across disciplines and levels of training, "Palliative Care for the Cardiovascular Clinician" (PCCVC). A key component of PCCVC is that it is tailored to the lifelong learner; users can choose and receive credit for the activities that meet their individual learning needs. This webinar series was well-subscribed, and upon completion of the modules, learners reported better self-perceived abilities related to palliative care competencies. We propose PCCVC as a model for primary PC education for clinicians caring for individuals with other serious or life-shortening illnesses.

Neurocognitive sequelae of a giant arachnoid cyst: case study.

We conducted a comprehensive neuropsychological evaluation of a normally functioning man with a giant arachnoid cyst encompassing much of the space normally occupied by the left hemisphere. Although of solidly average intellectual ability, the patient demonstrated neurocognitive deficits only revealed upon neuropsychological assessment. Despite the remarkable left hemisphere lesion, the pattern of cognitive dysfunction suggested right hemisphere pathology. We review the arachnoid cyst literature and discuss the possibility of a crowding phenomenon by which language function relocates to the more viable hemisphere. This case illustrates striking preservation of higher cognition in the presence of substantial structural abnormality.

Hormonal variations in the vascularity of breast tissue.

OBJECTIVE: The purpose of this study was to determine whether there are sonographically detectable variations in breast glandularity and vascularity due to hormonal changes during the course of a normal menstrual cycle. METHODS: Gray scale and color and power Doppler sonographic evaluations were performed on 7 premenopausal patients over the course of 1 menstrual cycle. Progesterone and estradiol levels were measured from saliva collected from the patients. Vascularity was measured by mean color level, area covered by color pixels, and color-weighted fractional area. RESULTS: Of the 5 volunteers not taking oral contraceptives, 4 had peaks in vascularity correlating with midcycle peak hormonal levels (50%-320% from baseline) on power Doppler sonography. On color Doppler sonography, 3 of 5 patients also had peaks in vascularity (60%-190% from baseline). The 2 patients taking oral contraceptives did not have any peaks in vascularity. CONCLUSIONS: Vascularity changes in normal breast tissue that correlated with peak hormonal levels were detected in most of the volunteers. Therefore, hormonal variations in breast vascularity should be considered when evaluating breast lesions by sonography.

Microcalcifications in breast tissue phantoms visualized with acoustic resonance coupled with power Doppler US: initial observations.

Calcium carbonate particles embedded in gelatin and turkey breast tissues were visualized with acoustic resonance imaging and power Doppler ultrasonography. Sonography revealed that the region of color level detection corresponded to the location of the calcium carbonate particles. Correlation between color level detection and the location of the particles was confirmed on radiographs of the specimens obtained at core needle biopsy performed through the region of color level detection.