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Pediatric Metabolic and Bariatric Surgery: Evidence, Barriers, and Best Practices
https://pediatrics.aappublications.org/content/early/2019/10/24/peds.2019-3223
Pediatrics Armstrong, S. et. al.

Oct 27th, 2019 - Severe obesity among youth is an “epidemic within an epidemic” and portends a shortened life expectancy for today’s children compared with those of their parents’ generation. Severe obesity has outpaced less severe forms of childhood obesity in prevalence, and it disproportionately affects adolescents. Emerging evidence has linked severe obesity to the development and progression of multiple co...

Chronic inflammatory liver diseases and coffee intake
https://journals.lww.com/co-clinicalnutrition/Abstract/publishahead/Chronic_inflammatory_liver_diseases_and_coffee.99131.aspx
Current Opinion in Clinical Nutrition & Metabolic Care; Contaldo, F. et. al.

Jun 17th, 2019 - Purpose of review To review the healthy protective effects of coffee against several metabolic diseases and some types of cancer. In this short review, the possible preventive and/or therapeutic actions of coffee on liver function is focused. Recent findings The protective mechanisms of coffee are various and because of several components with anti-inflammatory and antioxidant properties in ...

FDA approves ramucirumab for hepatocellular carcinoma
https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-ramucirumab-hepatocellular-carcinoma

May 9th, 2019 - On May 10, 2019, the Food and Drug Administration approved ramucirumab (CYRAMZA®, Eli Lilly and Company) as a single agent for hepatocellular carcinoma (HCC) in patients who have an alpha fetoprotein (AFP) of ≥ 400 ng/mL and have been previously treated with sorafenib.

Guidelines Insights: Hepatobiliary Cancers, Version 2.2019
https://jnccn.org/view/journals/jnccn/17/4/article-p302.xml
Benson, A. et. al.

Mar 31st, 2019 - Incidence and mortality rates for cancer overall are declining, but both incidence and mortality rates for hepatocellular carcinoma (HCC) are increasing.1,2 Risk factors for development of HCC include infection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV), and cirrhosis of the liver (eg, alcohol cirrhosis).3 Metabolic disorders (ie, obesity, diabetes, impaired glucose metabolism,...

Appendicitis - StatPearls
https://www.ncbi.nlm.nih.gov/books/NBK493193/

Feb 21st, 2019 - Appendicitis is inflammation of the vermiform appendix. This is a hollow organ located at the tip of the cecum, usually in the right lower quadrant of the abdomen.

Hepatitis, Nonalcoholic Steatohepatitis
https://www.ncbi.nlm.nih.gov/books/NBK470243/
Sharma, B. et. al.

Jan 31st, 2019 - Nonalcoholic, fatty liver disease (NAFLD) is defined as the ectopic accumulation of fat in the liver (hepatic steatosis) when no other causes of secondary, liver fat accumulation are present. As minor deposition of fat can occur in healthy adults, deposition of fat in at least 5% of hepatocytes is considered pathologic. Nonalcoholic steatohepatitis (NASH) is diagnosed via a liver biopsy when th...

Ramucirumab After Sorafenib in Patients With Advanced HCC and Increased α-Fetoprotein Concentrations
https://www.practiceupdate.com/c/78793/2/1
Grothey, A.

Jan 22nd, 2019 - The landscape of systemic therapy of hepatocellular carcinoma (HCC) has dramatically changed in the last 5 years with the introduction of various active agents into clinical pathways. The latest addition of agents with proof-of-efficacy in HCC is ramucirumab, an antibody against VEGF-R2. The published results of the REACH-2 trial in patients with prior sorafenib therapy demonstrate increased ov...

Ramucirumab after sorafenib in patients with advanced hepatocellular carcinoma and increased α-fetoprotein concentrations (REACH-2): a randomised, double-blind, placebo-controlled, phase 3 trial
https://www.thelancet.com/action/showPdf?pii=S1470-2045%2818%2930937-9
Zhu, A. et. al.

Jan 17th, 2019 - Patients with advanced hepatocellular carcinoma and increased α-fetoprotein concentrations have poor prognosis. We aimed to establish the efficacy of ramucirumab in patients with advanced hepatocellular carcinoma and α-fetoprotein concentrations of 400 ng/mL or higher.

Direct-Acting Antiviral Therapy not Associated with Recurrence of Hepatocellular Carcinoma in a Multicenter North American Cohort Study
https://www.gastrojournal.org/article/S0016-5085(19)30057-5/pdf
Singal, A. et. al.

Jan 16th, 2019 - Background & Aims There is controversy over the effects of direct-acting antiviral (DAA) therapies for hepatitis C (HCV) infection on hepatocellular carcinoma (HCC) recurrence and tumor aggressiveness. We compared HCC recurrence patterns between DAA-treated and untreated HCV-infected patients who had achieved a complete response to HCC treatment in a North American cohort.

Appendicitis - Merck Manual
https://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/appendicitis

Nov 30th, 2018 - Appendicitis is acute inflammation of the vermiform appendix, typically resulting in abdominal pain, anorexia, and abdominal tenderness. Diagnosis is clinical, often supplemented by CT or ultrasonography. Treatment is surgical removal of the appendix

ASMBS updated position statement on bariatric surgery in class I obesity (BMI 30–35 kg/m2)
https://asmbs.org/app/uploads/2018/08/PIIS1550728918302934-Low-BMI.pdf

Jul 31st, 2018 - The American Society for Metabolic and Bariatric Surgery (ASMBS) issued a position statement on the role of bariatric surgery in class I obesity in 2012 [1]. That statement was developed in response to inquiries made to the ASMBS by society members, physicians, patients, hospitals, health insurance payers, policymakers, and the media regarding the safety and efficacy of bariatric surgery f...

Improved Bariatric Surgery Pathways Could Reduce Health Care Burden, Costs in Canada
https://www.medscape.com/viewarticle/924044

Jan 22nd, 2020 - NEW YORK (Reuters Health) - A shorter time to bariatric surgery and better postop care could save money and years of obesity-related comorbidities in Canadian patients, an economic modeling study suggests. "For adults cleared for surgical treatment of obesity, there can be delays to receiving surgery and, in many cases, poor weight loss trajectories afterwards," Dr. Jason Davis of Coreva Scient...

Lower Hepatoma Risk With Earlier ALT Normalization During HBV Treatment
https://www.medscape.com/viewarticle/923929

Jan 20th, 2020 - NEW YORK (Reuters Health) - Earlier normalization of alanine aminotransferase (ALT) levels during treatment of chronic hepatitis B is independently associated with a reduced risk of hepatocellular carcinoma (HCC), researchers from South Korea report. In previous studies of the natural course of chronic hepatitis B, normalization of ALT levels, marked decreases in HBV DNA, and hepatitis B e anti...

Bariatric surgery is most effective early in the diabetes trajectory
https://www.mdedge.com/jcomjournal/article/215581/obesity/bariatric-surgery-most-effective-early-diabetes-trajectory?channel=302
Doug Brunk

Jan 15th, 2020 - LOS ANGELES – In the clinical experience of Kurt GMM Alberti, DPhil, FRCP, FRCPath, bariatric surgery should be used earlier in the course of diabetes to yield the most benefit. The problem is, far fewer people with diabetes are being referred for the surgery than would benefit from it.

Unique T cell populations pinpointed in hepatocellular carcinoma tissue
https://www.mdedge.com/fedprac/avaho/article/215285/gastroenterology/unique-t-cell-populations-pinpointed-hepatocellular?channel=263
Andrew D. Bowser

Jan 9th, 2020 - Hepatocellular carcinoma (HCC) tissue contains several unique populations of tumor infiltrating cells, including some exhausted effector T cells that regain normal function when treated with the immunotherapy drug nivolumab, according to researchers. The unique populations of recently activated CD4+, CD8+, and CD4-CD8 double-negative cells identified in the tumors expressed specific activation.

Evidence builds for bariatric surgery’s role in cancer prevention
https://www.mdedge.com/fedprac/avaho/article/215262/obesity/evidence-builds-bariatric-surgerys-role-cancer-prevention?channel=263
Mitchel L. Zoler

Jan 9th, 2020 - LAS VEGAS – The ability of bariatric surgery and substantial subsequent weight loss to cut the incidence of a variety of obesity-related cancers and other malignancies received further confirmation in results from two studies reported at a meeting presented by the Obesity Society and the American Society for Metabolic and Bariatric Surgery. Mitchel L.

Bariatric surgery candidates show high prevalence of thrombophilia
https://www.mdedge.com/surgery/article/215197/obesity/bariatric-surgery-candidates-show-high-prevalence-thrombophilia?channel=39313
Mitchel L. Zoler

Jan 8th, 2020 - LAS VEGAS – More than half the patients seeking laparoscopic sleeve gastrectomy at a pair of large U. S.

Score predicts bariatric surgery’s benefits for obesity, type 2 diabetes
https://www.mdedge.com/jcomjournal/article/215184/obesity/score-predicts-bariatric-surgerys-benefits-obesity-type-2?channel=302
Mitchel L. Zoler

Jan 8th, 2020 - LAS VEGAS – Researchers have devised a risk calculator for patients with obesity and type 2 diabetes that can estimate their 10-year risk for death and cardiovascular disease events if their clinical status continues relatively unchanged, or if they opt to undergo bariatric surgery. Mitchel L.

Deep Vein Thrombosis Risk Declines After Bariatric Surgery
https://www.medscape.com/viewarticle/923221

Dec 30th, 2019 - NEW YORK (Reuters Health) - Bariatric surgery is associated with a significant decrease in the long-term risk of venous thromboembolic events (VTEs), principally deep vein thrombosis (DVT), according to findings from the UK Clinical Practice Research Datalink (CPRD). Obesity is associated with a 2- to 3-fold increased risk of VTEs, including pulmonary embolism and DVT. Surgery is also a risk fa...

Bariatric Surgery Linked to Greater Colon-Cancer Risk
https://www.medscape.com/viewarticle/922576

Dec 16th, 2019 - NEW YORK (Reuters Health) - Obese adults who undergo bariatric surgery may face a greater risk of colon cancer than their peers who don't have weight-loss surgery, a new study in a large Nordic cohort suggests. "Individuals with obesity have an increased risk of colon cancer. While bariatric surgery results in substantial weight loss in a majority of patients with obesity, our study suggests th...

Bariatric surgery tied to fewer cerebrovascular events
https://www.mdedge.com/clinicianreviews/article/213981/stroke/bariatric-surgery-tied-fewer-cerebrovascular-events?channel=53
Mitchel L. Zoler

Dec 10th, 2019 - PHILADELPHIA – Obese people living in the United Kingdom who underwent bariatric surgery had a two-thirds lower rate of major cerebrovascular events than that of a matched group of obese residents who did not undergo bariatric surgery, in a retrospective study of 8,424 people followed for a mean of just over 11 years. Mitchel L.

No Survival Difference Between Re-Resection, Percutaneous RFA in Recurrent HCC
https://www.medscape.com/viewarticle/922296

Dec 8th, 2019 - NEW YORK (Reuters Health) - In patients with early-stage recurrent hepatocellular carcinoma (HCC), long-term survival does not differ between repeat hepatectomy and percutaneous radiofrequency ablation (RFA), a randomized trial in China suggests. Dr. Feng Shen of Second Military Medical University in Shanghai and Dr. Wan Yee Lau of the Chinese University of Hong Kong and colleagues enrolled 240...

Weight-loss surgery between pregnancies tied to better outcomes
https://www.reuters.com/article/us-health-pregnancy-bariatric-surgery/weight-loss-surgery-between-pregnancies-tied-to-better-outcomes-idUSKBN1YA2LD

Dec 6th, 2019 - (Reuters Health) - Obese women who have weight-loss surgery between pregnancies may be less likely to experience complications like high blood pressure and preterm births in their second pregnancy, a recent study suggests. Researchers examined hospital records from 2002 to 2014 for more than 1.6 million women 15 to 45 years old in New South Wales, Australia. The study focused on 326 women who h...

Bariatric Surgery Improves Outcomes for Mom, Infant
https://www.medscape.com/viewarticle/922209

Dec 4th, 2019 - Bariatric surgery may improve obesity-related pregnancy and birth outcomes, a study has found. Women who had bariatric surgery after their first pregnancy showed significant reductions in pregnancy hypertension, spontaneous preterm birth, a large-for-gestational-age neonate, and admission to the neonatal intensive care unit (NICU) with their second child.  Ibinabo Ibiebele, PhD, MIPH, from the ...

Bariatric surgery should be considered in individuals with class 1 obesity
https://www.mdedge.com/clinicianreviews/article/213577/diabetes/bariatric-surgery-should-be-considered-individuals-class-1?channel=205
Noel N. Deep, MD

Dec 4th, 2019 - Mitchel L. Zoler’s article on Abstract A105, presented at Obesity Week 2019, addresses an important health concern and is timely.

Recent Bariatric Surgery Linked to More Complications After Joint Arthroplasty
https://www.medscape.com/viewarticle/921924

Dec 3rd, 2019 - NEW YORK (Reuters Health) - Rather than benefitting from bariatric surgery, obese patients who undergo such a procedure less than two years before total joint arthroplasty (TJA) are more likely to experience postoperative complications, according to a new study. Immediate hospital costs were also higher in those with a history of bariatric surgery, as was the likelihood of postoperative transfu...

HCV Screening of Baby Boomers Continues to Lag in U.S. Safety-Net Clinics
https://www.medscape.com/viewarticle/922043

Dec 3rd, 2019 - NEW YORK (Reuters Health) - Even with help, safety-net primary care clinics serving low-income and uninsured populations in the U.S. often fall short in screening baby boomers for hepatitis C virus (HCV), as recommended by the U.S. Preventive Services Task Force, according to a new study. The study evaluated the Screen, Treat, Or Prevent Hepatocellular Carcinoma (STOP HCC) program, conducted in...

Pilonidal Disease Clinical Practice Guidelines (2019)
https://www.medscape.com/viewarticle/922019

Dec 2nd, 2019 - Guidelines on the management of pilonidal disease were released by the American Society of Colon and Rectal Surgeons.[1] Initial Evaluation Perform a disease-specific history and physical examination, with particular attention paid to risk factors, symptoms, and presence of secondary infection. Nonoperative Therapy & Adjuncts As a primary or adjunctive treatment, shaving or laser epilation may ...

Improved Survival Seen in Hepatoma Patients After HCV Cure
https://www.medscape.com/viewarticle/921838

Nov 27th, 2019 - NEW YORK (Reuters Health) - Cure of hepatitis C virus (HCV) infection with direct-acting antivirals is associated with increased survival in patients with HCV-related hepatocellular carcinoma (HCC), researchers report. "The survival benefit was observed even in patients with fairly advanced HCC, patients who only received palliative care, and patients with advanced liver disease with cirrhosis,...

Roche Says Tecentriq Cocktail Helps Liver Cancer Patients Live Longer
https://www.medscape.com/viewarticle/921741

Nov 25th, 2019 - ZURICH, Nov 22 (Reuters) - Swiss drugmaker Roche on Friday said its immunotherapy Tecentriq combined with its Avastin medicine helped people with the most common form of liver cancer to live longer than with an older drug from Germany's Bayer. Median overall survival for patients with unresectable hepatocellular carcinoma (HCC), or that which cannot be surgically removed, getting Tecentriq and ...

Roche says Tecentriq cocktail helps liver cancer patients live longer
https://www.reuters.com/article/us-roche-tecentriq/roche-says-tecentriq-cocktail-helps-liver-cancer-patients-live-longer-idUSKBN1XW1XK

Nov 22nd, 2019 - FILE PHOTO: The logo of Swiss drugmaker Roche is seen at its headquarters in Basel, Switzerland February 1, 2018. REUTERS/Arnd Wiegmann/File Photo ZURICH (Reuters) - Swiss drugmaker Roche on Friday said its immunotherapy Tecentriq combined with its Avastin medicine helped people with the most common form of liver cancer to live longer than with an older drug from Germany’s Bayer. Median overall...

Obese Teens' QOL Improves After Bariatric Surgery
https://www.medscape.com/viewarticle/921662

Nov 21st, 2019 - (Reuters Health) - Obese teens who have surgery to lose weight report better quality of life, less joint pain and fewer physical limitations after their operations than before, a new study suggests. Researchers followed 242 obese teens who had bariatric surgery at a mean age of 17 and with a median body mass index (BMI) of at least 50. Two-thirds had musculoskeletal pain and joint pain and half...

Obese teens' quality of life improves after weight loss surgery
https://www.reuters.com/article/us-health-teens-obesity-surgery/obese-teens-quality-of-life-improves-after-weight-loss-surgery-idUSKBN1XU2V0

Nov 20th, 2019 - (Reuters Health) - Obese teens who have surgery to lose weight report better quality of life, less joint pain and fewer physical limitations after their operations than before, a new study suggests. Researchers followed 242 obese teens who had so-called metabolic and bariatric surgery to lose weight over three years, starting when they were 17 years old, on average. Prior to surgery, half of th...

Sleeve Gastrectomy Beneficial at Lower BMI; Call to Lower Threshold
https://www.medscape.com/viewarticle/921543

Nov 18th, 2019 - LAS VEGAS — In a state-wide registry study of patients who had sleeve gastrectomy, less obese individuals — those with an initial body mass index (BMI) < 35 kg/m2 — had similar and even sometimes better early outcomes compared to patients with a BMI ≥ 35 kg/m2, researchers report.   At 1 year, more than half of patients in both groups discontinued medications for diabetes, hypertension, or hype...

Bariatric Surgery Improves Long-Term Health—but Not Long-Term Health Care Costs
https://www.mdedge.com/fedprac/article/212415/obesity/bariatric-surgery-improves-long-term-health-not-long-term-health-care?channel=94
Jan Dyer

Nov 15th, 2019 - Veterans have some of the highest rates of overweight and obesity in the country: 78%, compared with 35% of American adults overall. So bariatric surgery can be a boon to many veterans.

Nivolumab-ipilimumab combo has ‘robust’ clinical benefit in sorafenib-treated HCC patients
https://www.mdedge.com/fedprac/avaho/article/212354/oncology/nivolumab-ipilimumab-combo-has-robust-clinical-benefit?channel=263
Andrew D. Bowser

Nov 14th, 2019 - BOSTON – The combination of nivolumab and ipilimumab provided a “robust” clinical benefit and had manageable hepatic adverse events in a phase 2 study of sorafenib-treated patients with advanced hepatocellular carcinoma (HCC), an investigator said at the annual meeting of the American Association for the Study of Liver Diseases. Dr.

Over half of NASH patients have improvement in liver fibrosis after bariatric surgery
https://www.mdedge.com/internalmedicine/article/212231/hepatology/over-half-nash-patients-have-improvement-liver-fibrosis?channel=53
Will Pass

Nov 13th, 2019 - BOSTON – For almost half of patients with nonalcoholic steatohepatitis (NASH), bariatric surgery does not resolve severe fibrosis, even after significant weight loss and resolution of multiple metabolic comorbidities, according to investigators. Dr.

Cirrhosis Patients Skimp on Cancer Screening Because of Cost
https://www.medscape.com/viewarticle/921290

Nov 12th, 2019 - Concern about cost often means that patients with cirrhosis, who are at high risk for liver cancer, delay seeking medical care, including recommended screening, results from a new survey show. "This is one of the reasons this cancer is often found at late stages and continues to be deadly" for many patients, said Amit Singal, MD, from the UT Southwestern Medical Center in Dallas. Previous resea...

Direct-acting antiviral treatment linked to lower mortality in patients with HCC history
https://www.mdedge.com/fedprac/avaho/article/212167/oncology/direct-acting-antiviral-treatment-linked-lower-mortality?channel=263
Andrew D. Bowser

Nov 12th, 2019 - BOSTON – For patients with a complete response following treatment for hepatitis C virus (HCV)–related hepatocellular carcinoma (HCC), treatment with direct-acting antiviral therapy was linked to significantly reduced mortality compared with no such treatment, according to results of a large cohort study. UT Southwestern Medical Center Dr.

CRISPR Used to Silence Crucial Hepatitis B Gene
https://www.medscape.com/viewarticle/921151

Nov 11th, 2019 - The CRISPR gene-editing tool can be used to silence an important hepatitis B virus gene, a proof-of-concept in vitro study suggests. "It's the first time we've seen CRISPR editing done in a hepatitis B model," said Douglas Dieterich, MD, director of the Institute of Liver Medicine and professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City. Hepatitis B can lead to ...

Evidence Mounts for Bariatric Benefit in Obesity-Related Cancer
https://www.medscape.com/viewarticle/921110

Nov 11th, 2019 - LAS VEGAS — Two studies that provide further support for a potential benefit of a reduced risk of obesity-related cancers post-bariatric surgery were presented here at Obesity Week 2019. Camila Ortiz Gomez, MD, reported that a snapshot of data from the National Inpatient Sample (NIS) shows obese patients with no prior bariatric surgery were 21% more likely to have an obesity-related cancer than...

Bariatric surgery as safe in adolescents as it is in adults
https://www.mdedge.com/jcomjournal/article/212048/obesity/bariatric-surgery-safe-adolescents-it-adults?channel=302
Mitchel L. Zoler

Nov 11th, 2019 - LAS VEGAS – Bariatric surgery in adolescents was about as safe as it was in adults in the largest U. S.

Level of hepatitis B core–related antigen is risk factor for hepatocellular carcinoma
https://www.mdedge.com/internalmedicine/article/211943/hepatitis/level-hepatitis-b-core-related-antigen-risk-factor?channel=39313
Amy Karon

Nov 8th, 2019 - A high level of hepatitis B core–related antigen (HBcrAg) was a complementary risk factor for hepatocellular carcinoma, according to the results of a retrospective cohort study of more than 2,600 noncirrhotic adults with untreated hepatitis B virus (HBV) infection with a median of 16 years of follow-up. SOURCE: AMERICAN GASTROENTEROLOGICAL ASSOCIATION “Patients with an intermediate viral load a.

Bariatric surgery shows metabolic benefits in lower-BMI patients
https://www.mdedge.com/surgery/article/211869/obesity/bariatric-surgery-shows-metabolic-benefits-lower-bmi-patients?channel=39313
Mitchel L. Zoler

Nov 7th, 2019 - LAS VEGAS – It’s time to take bariatric out of bariatric surgery. “The way forward is to not call it bariatric surgery or weight-loss surgery but surgery to treat diabetes, hypertension, hyperlipidemia, and other metabolic diseases,” said Oliver A.

More evidence that statins reduce HCC risk
https://www.mdedge.com/fedprac/avaho/article/211723/preventive-care/more-evidence-statins-reduce-hcc-risk?channel=263
Bruce Jancin

Nov 6th, 2019 - SAN ANTONIO – The evidence that statin therapy reduces the risk of developing hepatocellular carcinoma, while not rising to the highest-level 1A strata, is nonetheless sufficiently persuasive at this point that consideration should be given to prescribing a statin in all patients with risk factors for the malignancy, regardless of their cardiovascular risk profile, Muhammad Talal Sarmini, MD, a.

Calculator Predicts Events With or Without Weight Loss Surgery
https://www.medscape.com/viewarticle/920910

Nov 5th, 2019 - LAS VEGAS — Researchers have developed a calculator to predict the 10-year risk of a major cardiovascular event (MACE) or death in those with type 2 diabetes and obesity, depending on whether or not the patient decides to undergo bariatric surgery. The risk calculator is available on the Cleveland Clinic website and will soon be available as an app (BariatricCalc), Ali Aminian, MD, a bariatric ...

Liver Cancer Rates Tripled Over 20 Years in England
https://www.medscape.com/viewarticle/920826

Nov 4th, 2019 - GLASGOW — Both the incidence and mortality rates of hepatocellular carcinoma (HCC) have risen dramatically in England in the 20 years up to 2016, say UK experts who found that patients often do not receive potentially curative treatment. Anya Burton, a cancer epidemiologist at Public Health England, and colleagues examined national cancer data on HCC epidemiology, including diagnosis, treatment...

Obesity Ties to Cancer, Diabetes Showcased in Vegas Meeting
https://www.medscape.com/viewarticle/920787

Nov 3rd, 2019 - LAS VEGAS — In this glitzy city where lady luck lurks, it is a sure bet that attendees at Obesity Week 2019, this year's joint meeting of The Obesity Society and American Society for Metabolic and Bariatric Surgery (ASMBS), will learn new things from the latest scientific evidence in the field. Medscape Medical News interviewed the ASMBS president and two program planners from The Obesity Socie...

'I Have Had My Eyes Gouged': What We Heard This Week
https://www.medpagetoday.com/emergencymedicine/emergencymedicine/83101

Nov 1st, 2019 - "I have had my eyes gouged; I have been shoved and punched. I have seen one intern literally knocked out cold by someone who sucker-punched him." -- Ken Marriott, MD, of the University of Texas Health Science Center, commenting on a study suggesting violence against emergency department staff is a global problem. "Our kids, our nation, and our world face a grim future." -- Christopher Bolling, ...