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Patients who present to the emergency department unable to provide a medical history are particularly challenging to health care workers and clinicians. In this case, we present a trauma patient who tested positive for Coronavirus Disease 2019 (COVID-19). The case highlights that in the midst of the COVID-19 pandemic: (1) personal protective equipment for health care personnel is crucial at all levels of patient contact until testing performed and (2) persistent fever, thrombocytopenia, elevated transaminases, and diarrhea could be early findings, while leukopenia and hypoxemia may be delayed. [ABSTRACT FROM AUTHOR]

Liver-directed therapy for hepatic metastases includes: intra-arterial techniques such as trans-arterial chemoembolization (TACE) and yttrium-90 resin (90Y) microsphere radioembolization and ablative technologies: cryoablation, radiofrequency ablation, and microwave ablation. Combining embolization techniques with liver ablation may enhance the therapeutic benefit of each and result in improved patient survival. We retrospectively reviewed our experience with combined intra-arterial therapies and ablation for unresectable hepatic colorectal metastases from 1996 to 2011. Patient demographics, tumor characteristics, specific liver-directed treatments, procedure-related morbidity and mortality, and overall survival were recorded. There were 17 (53%) males and 15 (47%) females. Average age for the group was 74.1 years (median, 75.5 years). Fifteen patients (46.9%) had a single hepatic metastasis. Eleven (34%) patients had bilobar tumor distribution and seven (22%) patients had vascular invasion of the portal vein or hepatic/caval venous structures. Seven (21%) tumors were greater than 5 cm in diameter. Twenty-seven (84.4%) patients received TACE and five (15.6%) received 90Y. Fourteen (43%) were embolized before any ablation. Fifty-three per cent of patients required multiple hepatic ablation sessions. Median length of hospital stay was 1 day. There were no procedure-related mortalities and complications occurred in six (18.8%) patients. Mean follow-up for the group was 33 months. Kaplan-Meier 1-, 3-, and 5-year estimated survival was 93.8, 50.0, and 10.1 per cent, respectively. Median survival for the group was 46 months. Hepatic ablation and embolization techniques can be combined safely with minimal morbidity. In our series, we observed 5-year survival in 10 per cent of patients. [ABSTRACT FROM AUTHOR]

A biography of surgeon and Nobel Prize winner Emil Theodor Kocher is presented. He was born on August 25, 1841 in Bern, Switzerland and studied in several countries before graduating summa cum laude from medical school. He received the Nobel Prize in Physiology or Medicine in 1909 for his pioneering work in pathophysiology and surgery of the thyroid gland.

A biography of Christian Albert Theodor Billroth, founding father of abdominal surgery, is presented. Billroth was born in Norway on April 26, 1829. He attended medical school at the University of Griefswald, and became the Associate Professor of Surgery in 1856 in Berlin, Germany. He accomplished his greatest surgical achievements in Vienna, Australia, including performing the first ever esophagectomy and a successful gastrectomy. Billroth died of congestive heart disease on February 6, 1894.