A Cohort Study of Lt. Col. Luke J. Weathers VA Medical Center Patients with Positive FIT and Incomplete GI Evaluation during the COVID-19 Pandemic.

Objectives: The reasons for and incidence of delay in screening colonoscopies during the coronavirus disease 2019 (COVID-19) pandemic are of major public health interest. The risks and reasons for delay likely vary between public and private institutions. This research sought to analyze data regarding the completion of screening colonoscopies after a positive fecal immunochemical test (FIT) before and during the COVID-19 pandemic and the reasons for a delay in obtaining these results at the Lt.

Axillary Contact Dermatitis: An Update on Potential Allergens and Management.

The differential diagnosis of dermatoses in the axillae is broad. Contact dermatitis-both irritant and allergic-represents common etiologies. Axillary contact dermatitis can develop following exposure to a variety of irritants and/or allergens.

Exploring Communication about Fall Risk and Prevention between Internal Medicine Residents and Geriatric Patients: A Needs Assessment.

Objectives: In the United States, falls are the leading cause of fatal and nonfatal injuries for geriatric patients. With a growing aging population, medical trainees must gain experience with geriatric assessments, including fall risk and prevention. To the authors' knowledge, no prior studies have explored who most often initiates fall discussions between Internal Medicine (IM) residents and geriatric (age 65 years and older) patients.

Analysis of over 2 decades of colon injuries identifies optimal method of diversion: Does an end justify the means?

Introduction: Conflicting evidence exists regarding the definitive management of destructive colon injuries. Although diversion with an end ostomy can theoretically decrease initial complications, it mandates a more extensive reversal procedure. Conversely, anastomosis with proximal loop ostomy diversion, while simplifying the reversal, increases the number of suture lines and potential initial morbidity.

Effect of concussion and blast exposure on symptoms after military deployment.

Objective: To examine whether blast exposure alone and blast-associated concussion result in similar neurologic and mental health symptoms.

Methods: A 14-item questionnaire was administered to male US Marines on their return from deployment in Iraq and/or Afghanistan.

Results: A total of 2,612 Marines (median age 22 years) completed the survey.

Upper Lip Reconstruction.

Reconstruction of an aesthetically acceptable and functional upper lip requires a careful consideration of the transverse and vertical soft tissue, muscle, and skin deficiency. This review focuses on the reconstructive aspects of the upper lip. The functional anatomy of the upper lip is considerably complex and includes paired muscles in addition to the orbicularis, elevators of both the upper lip and commissure.

Impact of venous thromboembolism chemoprophylaxis on postoperative hemorrhage following operative stabilization of spine fractures.

Background: Prophylactic anticoagulation may decrease the risk of venous thromboembolism (VTE) in patients with spine fractures following blunt trauma but comes with the threat of postoperative bleeding in patients requiring stabilization of these fractures. The purpose of this study was to evaluate the impact of preoperative anticoagulation on VTE and bleeding complications in patients with blunt spine fractures requiring operative stabilization.

Methods: All patients with blunt spine fractures requiring operative stabilization over a 6-year period were identified.

Good news, bad news: An analysis of 11,294 gunshot wounds (GSWs) over two decades in a single center.

Introduction: Gun violence is a substantial public health problem accounting for significant physical, psychological, and financial costs. Although aggregate data sources demonstrate decreasing rates of firearm violence, analyses from individual trauma centers have shown that mortality and injury severity from gunshot wounds (GSWs) are increasing. To evaluate the evolving characteristics of gun violence in our region, we studied all GSWs admitted to our trauma center over a 20-year period.

Precision Oncology: Who, How, What, When, and When Not?

Precision oncology, defined as molecular profiling of tumors to identify targetable alterations, is rapidly developing and has entered the mainstream of clinical practice. Genomic testing involves many stakeholders working in a coordinated fashion to deliver high-quality tissue samples to high-quality laboratories, where appropriate next-generation sequencing (NGS) molecular analysis leads to actionable results. Clinicians should be familiar with the types of genomic variants reported by the laboratory and the technology used to determine the results, including limitations of current testing methodologies and reports.

The Future of Plastic Surgery Resident Education.

The challenge of the current graduate medical education environment requires in plastic surgery acceptance of those contemporary pressures that cannot be substantially modified and address of those that can be successfully met. To do so implies an examination of conference didactics, intraoperative teaching, and a valid assessment of resident performance.

Limitations of A1c Interpretation.

Hemoglobin A1c is the measurement of glycated hemoglobin and can aid in both the diagnosis and continued management of diabetes mellitus. Accurate glycosylated hemoglobin A1c (A1c) measurements are an essential part of decision making in the diagnosis and treatment of type 2 diabetes mellitus. Although national standards exist to eliminate technical error with A1c testing, multiple patient conditions can falsely decrease or elevate the A1c.

Effect of Body Weight on Dose of Vitamin K Antagonists.

Objectives: Numerous factors are well documented to affect the response to vitamin K antagonists (VKA), including dietary vitamin K, other drugs, age, pharmacogenetics, and disease states. Body weight is perhaps not as well known as a variable affecting VKA dose. Our aim was to review the literature regarding body weight and VKA dose requirements.

Lack of Validity of the American College of Surgeons National Surgical Quality Improvement Program Database for Alloplastic Immediate Postmastectomy Reconstruction.

Background: The American College of Surgeons National Surgical Quality Improvement Program is an outcomes-based program with the objective of improving quality of surgical care. With its size and validity, the database has been mined by both general and plastic surgery clinical researchers to provide information for possible risk reduction strategies and patient counseling. However, the 30-day window of the program's database may be inappropriately brief in documentation of complications for some operative procedures.