Core needle biopsy causing a pseudoaneurysm in the breast.

Core needle biopsy (CNB) is the first-choice method of sampling suspicious, focal breast lesions for histological analysis. Here we present the case of a 65-year-old woman who was recalled for evaluation of the left breast following a screening mammogram. An ultrasound-guided biopsy was performed using a disposable core biopsy needle and 3 weeks later a magnetic resonance imaging scan showed a distended vessel with adjacent sac measuring 17 × 15mm2. A Doppler ultrasound scan confirmed pseudoaneurysm. A review of the literature was made on breast pseudoaneurysm following CNB, and over the past 20 years there were few other reports. Pseudoaneurysms in the breast are a rare but serious complication of CNBs. They may spontaneously thrombose, but often require intervention, so it is essential that clinicians are aware of the risk.

Very low birth weight infants and their families during the first year of life: comparisons of medical outcomes based on after care services.

OBJECTIVE: To evaluate factors contributing to optimal medical outcomes during the first year following discharge of very low birth weight infants from tertiary neonatal intensive care units. STUDY DESIGN: This was a prospective investigation of the health and development of 81 very low birth weight infants following discharge from two tertiary neonatal intensive care units in Los Angeles. Infants were assigned to four groups receiving a variety of after care services in their homes. Analyses of variance were computed to examine differences between groups for a variety of outcomes. RESULTS: No statistically significant differences were seen between after care groups on use of hospital emergency rooms (ER) rehospitalization rates, or child abuse and neglect. Highest overall rates of optimal outcomes were seen in the group receiving the highest intensity of after care services. Those groups receiving long-term home visiting services had significantly higher rates of up-to-date immunizations. CONCLUSION: There was no significant impact on infant mortality and morbidity of early discharge, regardless of the system of after care used. However, those infants who received the highest level of after care services had the most optimal health outcomes and were most likely to be receiving well-baby care. It is likely that the comprehensive, clinic-based system of health care available to all study infants was a significant factor in low rates of morbidity.

Very low birth weight infants and their families during the first year of life: comparisons of psychosocial outcomes based on after-care services.

OBJECTIVE: To evaluate psychosocial outcomes in families of very low birth weight infants during the first year postdischarge. STUDY DESIGN: This was a prospective investigation of family functioning in families of 81 very low birth weight infants discharged from two tertiary care neonatal intensive care units in Los Angeles, CA. Infants were assigned to four groups receiving a variety of after-care services in their homes. Analyses of variance and t-tests were used to examine differences in outcomes, including parental involvement with infant, maternal depression, and family adaptation and cohesion over time. RESULTS: During the first year following discharge, there were no differences between after-care groups in levels of maternal depression as measured by the Center for Epidemiologic Studies Depression Scale or family cohesion and adaptability as measured by the Family Adaptability and Cohesion Evaluation Scales II. Significant between-group differences were seen on measures of home environment at both 6 and 12 months and self-reports of satisfaction with parenting at 6 months. CONCLUSION: Results of this study indicate that types of after-care services do not change basic maternal or family characteristics. However, long-term home-visiting services appear to impact the way mothers interact with their high-risk infants. Furthermore, such services seem to influence a mother's perception of satisfaction with her role.