Inverted Appendix in a Patient With Weakness and Occult Bleeding.

Background: Appendiceal mucinous neoplasms (AMNs) are rare adenomatous primary tumors of the appendix. Although of low malignant potential, these neoplasms can cause serious potentially fatal complications such as bowel obstruction and pseudomyxoma peritonei, making prompt identification and removal of utmost importance. AMNs often present with nonspecific gastrointestinal symptoms or are asymptomatic and found incidentally.

Constipation and Postprandial Pain in a Patient With Shortness of Breath.

Incidental image findings may be important for resolving seemingly unrelated symptoms at presentation.

Left-Sided Amyand Hernia: Case Report and Review of the Literature.

Left-sided Amyand hernia is a rare condition that requires a high degree of clinical suspicion to correctly diagnose.

Evaluating the Impact of Provider Type and Patient Diagnosis on Patient No-Shows to Vascular Clinic.

Background: No-shows are a source of burden that lead to wasted resources. While prior research has established that many patient-level affect impact no-show rates, the impact of referring provider-level factors, in particular the type of referring provider-and specific diagnosis are still largely unknown.

Materials And Methods: Retrospective chart review examining new patient consults scheduled for outpatient vascular surgery clinic from August 1, 2014 through February 28, 2015 was conducted.

Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19.

Background: Coronavirus disease 2019 (Covid-19) may disproportionately affect people with cardiovascular disease. Concern has been aroused regarding a potential harmful effect of angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) in this clinical context.

Methods: Using an observational database from 169 hospitals in Asia, Europe, and North America, we evaluated the relationship of cardiovascular disease and drug therapy with in-hospital death among hospitalized patients with Covid-19 who were admitted between December 20, 2019, and March 15, 2020, and were recorded in the Surgical Outcomes Collaborative registry as having either died in the hospital or survived to discharge as of March 28, 2020.

Incidence of Catheter-Associated Urinary Tract Infections With Compliance With Preventive Guidelines.

This study describes the incidence of catheter-associated urinary tract infections in a large academic medical center and shows that even with prevention guideline adherence, catheter-associated urinary tract infections cannot truly be a .

Small Bowel Obstruction in a Surgically Naïve Abdomen.

Finding the cause of small bowel obstructions can lead to the discovery of important and treatable underlying disease.

Progesterone for Prevention of Preterm Birth: Shortcomings and Unintended Consequences of the Orphan Drug Act.

Preterm birth is a problem of major public health significance that continues to plague our country despite the existence of a therapy, 17α-hydroxyprogesterone caproate, with known efficacy in reducing the risk of spontaneous preterm birth among high-risk women. Over the past several years, the Louisiana Department of Health has undertaken a robust, multifaceted initiative to improve access to 17α-hydroxyprogesterone caproate, which resulted in a 3.5-fold increase in the percentage of eligible high-risk pregnant women in the Medicaid program who received the therapy between 2013 and 2016.

Eliminating Critical Incident Tracking Network Patient Safety Events at a Veterans Affairs Institution Through Crew Resource Management Training.

The objective of this study was to determine whether rates of Critical Incident Tracking Network (CITN) patient safety adverse events change after implementation of crew resource management (CRM) training at a Veterans Affairs (VA) hospital. CRM training was conducted for all surgical staff at a VA hospital. Compliance with briefing and debriefing checklists was assessed for all operating room procedures.

Decreasing 30-day surgical mortality in a VA Medical Center utilizing the ACS NSQIP Surgical Risk Calculator.

Background: The Overton Brooks VA Medical Center Surgical Service had a high mortality. In an effort to reduce surgical mortality, we implemented a series of quality improvement interventions, including utilization of the ACS Surgical Risk Calculator to identify high-risk surgical patients for discussion in a multidisciplinary Pre-Operative Consultation Committee.

Methods: Retrospective study describing the implementation of a risk stratification intervention incorporating the ACS Surgical Risk Calculator Tool and a multidisciplinary Pre-Operative Consultation Committee to target high-risk patients.

Improving staff perception of a safety climate with crew resource management training.

Background: Communication failure is one of the top root causes in patient safety adverse events. Crew resource management (CRM) is a team building communication process intended to improve patient safety by improving team dynamics. First, to describe implementation of CRM in a Veterans Affair (VA) surgical service.

Gas Gangrene of the Diabetic Foot.

A 67-year old man presented with a painful left foot and a putrid odor. His past medical history was significant for poorly controlled diabetes mellitus, coronary artery disease, and peripheral vascular disease. His surgical history included a prior right below-knee amputation for a diabetic foot infection three years prior, and a left third toe amputation for osteomyelitis one month ago.

Carotid Body Tumor.

A 46-year-old woman noted a right-sided neck lump one year ago. A CT scan demonstrated a right-sided 2 cm mass located between the external and internal carotid arteries that enhanced with contrast and caused splaying of the carotid bifurcation, suggesting a carotid body tumor (Figure A). She had no neurological symptoms.