Predictors of in-hospital appendiceal perforation in patients with non- perforated acute appendicitis with appendicolithiasis at presentation.

Introduction: Appendicolithiasis is a risk factor for perforated acute appendicitis. There is limited inpatient data on predictors of progression in appendicolithiasis-associated non-perforated acute appendicitis.

Methods: We identified adults presenting with appendicolithiasis-associated non-perforated acute appendicitis (on computed tomography) who underwent appendectomy.

The First COVID-19 Pandemic Wave and the Effect on Health Care Trainees: A National Survey Study.

Background: This study observes the trends and patterns among trainees during the coronavirus disease 2019 (COVID-19) pandemic and their response to resident education and hospital/program support.

Methods: An anonymous online 31-question survey was distributed to medical students and postgraduate year residents. Topics included were demographics, clinical responsibilities, educational/curricula changes, and trainee wellness.

Warfarin Use Is Associated with Increased Mortality at One Year in Patients with Idiopathic Pulmonary Fibrosis.

Objectives: We studied the safety and efficacy of warfarin compared to direct acting oral anticoagulant use in patients with IPF.

Methods: We conducted a retrospective cohort study of all patients with IPF who were prescribed warfarin or direct acting oral anticoagulants (DOACs) for cardiac or thromboembolic indications and followed at our institute for their care. Univariate tests and multivariable logistic regression analyses were used for assessing association of variables with outcomes.

Rapidly growing sclerosing angiomatoid nodular transformation of the spleen.

Sclerosing angiomatoid nodular transformation (SANT) of the spleen is a rare benign vascular lesion with unknown pathogenesis and no definitive pathognomonic radiological features. The majority of patients with SANT are asymptomatic, and the lesion is an incidental finding on cross-sectional imaging performed for unrelated reasons or during intra-abdominal surgery. However, in the symptomatic minority, abdominal pain is the most commonly reported symptom.

Patients with idiopathic pulmonary fibrosis have poor clinical outcomes with COVID-19 disease: a propensity matched multicentre research network analysis.

Introduction: Outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with pre-existing idiopathic pulmonary fibrosis (IPF) remain understudied, and it is unknown if IPF is an independent predictor of worse disease course. Herein, we report the clinical outcomes in a large cohort of 251 patients with COVID-19 in the setting of known IPF. Outcomes were compared with a propensity matched cohort of patients with COVID-19 without IPF.

Adenocarcinoma arising at ileostomy sites: Two cases and a review of the literature.

Total colectomy with ileostomy placement is a treatment for patients with inflammatory bowel disease or familial adenomatous polyposis (FAP). A rare and late complication of this treatment is carcinoma arising at the ileostomy site. We describe two such cases: a 78-year-old male 30 years after subtotal colectomy and ileostomy for FAP, and an 85-year-old male 50 years after colectomy and ileostomy for ulcerative colitis.

Radiologic case study. Dialysis-related amyloidosis.

A 59-year-old woman presented with worsening bilateral hip pain for 6 months. She had been receiving hemodialysis for 12 years.

Readmission within 30 days of discharge after hip fracture care.

The Affordable Care Act currently requires hospitals to report 30-day readmission rates for certain medical conditions. It has been suggested that surveillance will expand to include hip and knee surgery-related readmissions in the future. To ensure quality of care and avoid penalties, readmissions related to hip fractures require further investigation.

Use of an "antibiotic plate" for infected periprosthetic fracture in total hip arthroplasty.

Periprosthetic fracture and infection are dreaded complications after total hip arthroplasty. We present the case of a 50-year-old man who suffered an early postoperative Vancouver B1 periprosthetic fracture, which was further complicated by concurrent infection after open reduction and internal fixation. We report the novel use of an antibiotic-impregnated cement coated locking plate during the staged treatment of concomitant periprosthetic fracture and chronic total hip arthroplasty infection.

Distal third femur fractures treated with retrograde femoral nailing and blocking screws.

Retrograde femoral nailing is a widely used treatment for fractures involving the distal third of the femur. Angular malunion of these fractures after retrograde intramedullary nailing is a known complication. We report our surgical technique and experience using blocking screws to aid in reduction and augment the stability of the fixation when using a retrograde intramedullary nail for distal femoral fractures.

Increased mortality associated with a clonal outbreak of ceftazidime-resistant Klebsiella pneumoniae: a case-control study.

Objectives: To determine risk factors for ceftazidime-resistant Klebsiella pneumoniae infection and the effect of ceftazidime-resistant K. pneumoniae infection on mortality during an isolated outbreak.

Design: Case-control investigation using clinical and molecular epidemiology and prospective analysis of infection control interventions.

Extent of initial corneal injury as the mechanistic basis for ocular irritation: key findings and recommendations for the development of alternative assays.

Currently, there are no recognized alternative tests to eliminate the use of animals in ocular irritation testing. A major reason no replacement alternatives have been developed is that the current in vivo data set provides no perspective regarding the critical cellular and molecular changes involved in initial ocular injury, subsequent responses, and repair processes in standard in vivo tests. Without this perspective, mechanistically based replacement tests cannot be developed and validated.