An observational study of patients' attitudes to tattoos and piercings on their physicians: the ART study.

Introduction: Perceptions regarding body art change over time as societal norms change. Previous research regarding patients' perceptions of physicians with exposed body art have been hampered by flaws in design methodology that incorporate biases into patient responses. This study was performed to determine whether emergency department (ED) patients perceived a difference in physician competence, professionalism, caring, approachability, trustworthiness and reliability in the setting of exposed body art.

A seven-center examination of the relationship between monthly volume and mortality in trauma: a hypothesis-generating study.

Introduction: The relationship between trauma volumes and patient outcomes continues to be controversial, with limited data available regarding the effect of month-to-month trauma volume variability on clinical results. This study examines the relationship between monthly trauma volume variations and patient mortality at seven Level I Trauma Centers located in the Eastern United States. We hypothesized that higher monthly trauma volumes may be associated with lower corresponding mortality.

The infected heart: ventriculoseptal abscess and intracardiac fistulization.

Infective endocarditis is a rare but potentially deadly infection of the endocardial layer, which can involve the valves of the heart among other structures. The extraordinarily rare complication seen in this case involves extensive damage manifesting in an aortic root abscess resulting in an abnormal communication between the aorta and the atrium known as an aortocavitary fistula (Eur Heart J 2005;26:288-297; Pediatr Cardiol 2011;32:1057-1059; J Am Coll Cardiol 1991;18:663-667). As the disease progresses, wading through the complex symptoms, which may seem unrelated, represents a key challenge in diagnosis.

Extensive retroperitoneal air, pneumomediastinum, and subcutaneous air secondary to stercoral perforation.

Stercoral perforation is an uncommon cause of large intestinal perforation that is typically the result of chronic constipation. Historically, this disease process has a devastatingly high mortality rate, and recent evidence questions the incidence of the disease, once thought to be scarce. We report the case of an elderly woman presenting with symptoms related to mediastinal and soft tissue air in the neck from dissection of air retroperitoneally from stercoral perforation.