Concomitant abdominal exploration with durable left ventricular assist device implantation.
A 45-year-old male presented in decompensated heart failure from nonischemic cardiomyopathy and was implanted with a right transaxillary intra-aortic balloon pump. He was listed for heart transplantation but after 9 days, he developed abdominal pain with evidence of embolization on computed tomography scan despite a well-positioned balloon pump. He underwent concomitant abdominal exploration with small bowel resection and durable left ventricular assist device implantation. He recovered well and was discharged home. This case highlights the challenges of decision-making in the current era where intra-aortic balloon pumps are being utilized more frequently as a bridge to heart transplantation.Stacy Koltiska was forced to take back hot lunches from students whose parents owed over $25 on overdrawn accounts, replacing meals with cheese sandwiches

Stacy Koltiska loved working in the Wylandville elementary school cafeteria in western Pennsylvania. The hours were perfect – the two-and-a-half-hour shift allowed her to get her youngest daughter on and off the bus every day – and she enjoyed working with kids and seeing their excitement over school lunch every day.

But last Thursday, Koltiska resigned over what she considers a “lunch shaming” school policy. She said she was forced to take away hot lunches from two students because their parents owed more than $25 on the account used to pay for their school lunches.

The policy, according to the Canon-McMillan school district’s website, states that when