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https://www.readbyqxmd.com/read/29334144/acute-gastrointestinal-bleeding-from-appendiceal-diverticulitis-diagnosed-preoperatively-by-combined-short-interval-computed-tomography-and-colonoscopy-a-case-report
#1
Yutaro Ogawa, Naoki Asayama, Shinji Nagata
Colonic diverticular bleeding is the most common cause of lower gastrointestinal bleeding1,2 . Appendiceal diverticulosis is an uncommon clinical entity, with an incidence of 0.004%-2% in surgical pathologic specimens3,4 . Appendiceal diverticulitis in symptomatic patients should be treated with early resection, because of the risk of perforation and peritonitis; the rate of perforation is higher in appendicitis (27%) with diverticulosis than in appendicitis alone (6.6%)5 . Untreated appendiceal diverticulitis can also lead to massive gastrointestinal hemorrhage and abscess formation, and has a potential role in the development of pseudomyxoma peritonei...
January 15, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29331965/right-iliac-fossa-pain-treatment-rift-study-protocol-for-an-international-multicentre-prospective-observational-study
#2
Dmitri Nepogodiev
INTRODUCTION: Patients presenting with right iliac fossa (RIF) pain are a common challenge for acute general surgical services. Given the range of potential pathologies, RIF pain creates diagnostic uncertainty and there is subsequent variation in investigation and management. Appendicitis is a diagnosis which must be considered in all patients with RIF pain; however, over a fifth of patients undergoing appendicectomy, in the UK, have been proven to have a histologically normal appendix (negative appendicectomy)...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331260/multifaceted-behavior-of-meckel-s-diverticulum-in-children
#3
Qingjiang Chen, Zhigang Gao, Lifeng Zhang, Yuebin Zhang, Tao Pan, Duote Cai, Qixing Xiong, Qiang Shu, Yunzhong Qian
PURPOSE/BACKGROUND: Meckel's diverticulum (MD) is one of the most common congenital malformations of gastrointestinal tract in children. However, the nonspecific clinical manifestations of MD often cause a diagnostic as well as therapeutic challenge to pediatric surgeon. This study aimed to review our experience in managing this disease while evaluating the management strategies. METHODS: We retrospectively analyzed the clinical data of all patients diagnosed with MD admitted to our center between January 2010 and December 2015...
December 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29328796/eappendicitis-diagnostic-uncertainty-in-appendicitis-and-the-role-of-ehealth-does-it-help
#4
Jeremy Batt, James Kynaston, James Oliver
The availability of medical information on the World Wide Web has grown as information technology has become more accessible. Patients seeking online information may be able to selfselect conditions having been adequately informed. This study evaluates the effect of eHealth information on those presenting to hospital with a suspected appendicitis and its effect on their management and clinical outcome. Patients who had performed online reading were more likely to go to theatre but were less likely to have a confirmed histological diagnosis of appendicitis...
November 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29327916/self-assembly-of-pseudorotaxane-structures-from-a-dicopper-ii-molecular-cage-and-dicarboxylate-axles
#5
Valeria Amendola, Ana Miljkovic, Laura Legnani, Lucio Toma, Daniele Dondi, Simone Lazzaroni
In this work, we employed for the first time a dinuclear bis[tris(2-aminoethyl)amine] cryptate to obtain the self-assembly of pseudorotaxane structures in an aqueous solution. The goal was achieved by exploiting the well-known affinity of the dicopper azacryptate with diphenyl spacers for the terephthalate anion. In particular, a series of molecular threads were synthesized by appending either alkyl or polyoxyethylene chains on both sides of the terephthalate benzene ring. The obtained dicarboxylic acids were precipitated as sodium salts, and their affinity toward the dicopper azacryptate was determined in a methanol/water mixture (pH 7)...
January 12, 2018: Inorganic Chemistry
https://www.readbyqxmd.com/read/29327290/the-diagnostic-performance-of-reduced-dose-ct-for-suspected-appendicitis-in-paediatric-and-adult-patients-a-systematic-review-and-diagnostic-meta-analysis
#6
Hee Mang Yoon, Chong Hyun Suh, Young Ah Cho, Jeong Rye Kim, Jin Seong Lee, Ah Young Jung, Jung Heon Kim, Jeong-Yong Lee, So Yeon Kim
OBJECTIVE: To evaluate the diagnostic performance of reduced-dose CT for suspected appendicitis. METHODS: A systematic search of the MEDLINE and EMBASE databases was carried out through to 10 January 2017. Studies evaluating the diagnostic performance of reduced-dose CT for suspected appendicitis in paediatric and adult patients were selected. Pooled summary estimates of sensitivity and specificity were calculated using hierarchical logistic regression modelling...
January 11, 2018: European Radiology
https://www.readbyqxmd.com/read/29324635/diagnostic-value-of-serum-urokinase-type-plasminogen-activator-receptor-in-children-with-acute-appendicitis
#7
Mustafa Onur Oztan, Aysegul Aksoy Gokmen, Fatma Demet Arslan, Ebru Cakir, Ali Sayan, Elif Abay, Selçuk Kaya, Gokhan Koyluoglu
OBJECTIVES: Acute appendicitis (AA) is the most common surgical emergency in children. The accurate and timely diagnosis of AA in children can be challenging, and delayed diagnosis rates have been reported to range from 5.9% to 27.6%. Although combining clinical history and repeated physical examination with laboratory tests and radiographic imaging modalities help reach the diagnosis, novel biomarkers can support the surgeons' decision as well. The aims of this study were to evaluate a new plasma marker, urokinase-type plasminogen activator receptor (uPAR), to improve diagnostic accuracy in AA patients, and to determine a cutoff value of uPAR, which can safely include/exclude the diagnosis of AA...
January 11, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29324631/pediatric-appendicitis-association-of-chief-complaint-with-missed-appendicitis
#8
Zachary Drapkin, Jennifer Dunnick, Troy E Madsen, Matthew Bryce, Jeff E Schunk
OBJECTIVES: We evaluated the association between the emergency department (ED) triage chief complaint and rate of missed appendicitis in children. METHODS: We performed a retrospective chart review of patients who presented to a pediatric ED and were diagnosed with appendicitis over 5 years (July 1, 2009 to June 30, 2014). We reviewed the medical record for any additional ED visits in the 7 days preceding the diagnosis of appendicitis. Triage chief complaints were classified as "suggestive of appendicitis" (abdominal pain, right lower quadrant pain, or rule out appendicitis) or "nonspecific" (fever, vomiting, dehydration, etc)...
January 11, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29324630/perforated-meckel-diverticulum-a-rare-cause-of-acute-abdomen-in-children
#9
Saurabh Talathi, David Kelly, Scott Anderson, Yoginder Vaid, Jose Mestre
Meckel diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract and the most common cause of gastrointestinal bleeding in children. Although it usually follows the rule of 2's, exceptions to this rule are reported in the literature. Often asymptomatic, MD is commonly an incidental finding during surgical interventions. When symptomatic, the most common presentation of this condition is painless rectal bleeding. A myriad of other nonspecific symptoms are however possible, especially in adults, thus making this diagnosis difficult...
January 11, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29324373/abdominal-ct-aided-diagnosis-of-acute-appendicitis-in-the-presence-of-mobile-cecum-a-case-report
#10
Kentaro Yazawa, Yuki Azuma, Tomohiro Kurokawa, Yuichiro Yoshioka, Giichiro Tsurita, Masaru Shinozaki
INTRODUCTION: A mobile cecum is a frequently encountered congenital anomaly. It is important to recognize this atypical position of the cecum as it may interfere with an accurate diagnosis of acute appendicitis. PRESENTATION OF CASE: A 48-year-old man presented with abdominal pain, anorexia, and fever. He had mild lower abdominal discomfort, and rebound tenderness in the suprapubic region, but no guarding or right lower quadrant findings. Laboratory tests identified an elevated white blood cell count (12350 cells/mL) and C-reactive protein level (4...
December 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29322168/patient-preferences-for-surgery-or-antibiotics-for-the-treatment-of-acute-appendicitis
#11
Alexis L Hanson, Ross D Crosby, Marc D Basson
Importance: Studies have compared surgical with nonsurgical therapy for acute uncomplicated appendicitis, but none of these studies have a patient-centered perspective. Objectives: To evaluate how patients might choose between surgical and nonsurgical therapy for acute uncomplicated appendicitis and to identify targets to make antibiotic treatment more appealing. Design, Setting, and Participants: This study comprised an online survey and an in-person sensitivity analysis survey...
January 10, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29321951/utility-of-the-phenacyl-protecting-group-in-traceless-protein-semisynthesis-through-ligation-desulfurization-chemistry
#12
Maria Matveenko, Stefanie Hackl, Christian F W Becker
Semisynthesis of proteins via expressed protein ligation is a widely applicable method, even more so because of the possibility of ligation at non-cysteine sites using β-mercapto amino acids that can be converted to the corresponding native amino acids by desulfurization. A drawback of this ligation- desulfurization approach is the removal of any unprotected native cysteine residues within the ligated protein segments. Here, we show that the phenacyl (PAc) moiety can be successfully used to protect cysteines within recombinantly generated protein segments...
January 2018: ChemistryOpen
https://www.readbyqxmd.com/read/29318226/controllable-supramolecular-polymerization-via-a-chain-growth-mechanism
#13
Deep Sankar Pal, Haridas Kar, Suhrit Ghosh
A naphthalene-diimide appended carboxylic acid either spontaneously self-assembles (P) by an open-chain H-bonding or can be arrested in an intra-molecularly H-bonded monomeric state (M) depending on the sample preparation method. Sonication of P produces a seed (S) that triggers controllable supramolecular polymerization (SP) of M via a chain growth route with first order kinetics, a tunable mesoscopic structure and a living nature as demonstrated by the chain-extension up to three cycles. SP of an achiral M, initiated by a chiral S, illustrates chiral amplification by the "sergeant and soldiers" effect...
January 10, 2018: Chemical Communications: Chem Comm
https://www.readbyqxmd.com/read/29316352/transformations-in-chemically-responsive-copper-calixarene-architectures
#14
Edmundo Percástegui, Carlos Reyes-Mata, Marcos Flores-Alamo, Beatriz Quiroz-García, Ernesto Rivera, Ivan Castillo
Self-assembly of bis-picolyl-appended calix[4]arene (L) with Cu(I) or Cu(II) salts resulted in a collection of multinuclear architectures capable of expressing structural reconfigurations in response to various chemical stimuli: addition of copper salt, solvents, or oxidation. Coordination of L to CuX (X = Br, I) selectively yielded dinuclear macrocycles Cu(I)₂L₂Br₂ (1) and Cu(I)₂L₂I₂ (3) that were transformed into tetranuclear assemblies Cu(I)₄L₂Br₄ (2) and Cu(I)₄L₂I₄ (4) upon further addition of CuX...
January 9, 2018: Chemistry, An Asian Journal
https://www.readbyqxmd.com/read/29315613/the-learning-curve-in-diagnosing-acute-appendicitis-with-emergency-sonography-among-novice-emergency-medicine-residents
#15
Jeehyun Kim, Kipum Kim, Jungwan Kim, Jungwoo Yoo, Wonjoon Jeong, Sunguk Cho, Kihyuk Joo, Yongchul Cho, Jinwoong Lee, Seung Ryu, Yeonho Yoo
PURPOSE: Ultrasonography (US) has good accuracy for diagnosing appendicitis when it is performed by emergency physicians. This study aimed to determine the amount of experience that is required to achieve competency in this field. METHODS: Three novice emergency medicine residents completed a 1-day training course regarding the US diagnosis of appendicitis. Then, they performed appendix US in the emergency department on patients complaining of right lower quadrant pain...
January 5, 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29314749/laparoscopic-appendectomy-during-the-third-trimester-case-presentation-and-literature-review
#16
Sena Iwamura, Hiroki Hashida, Tomoaki Yoh, Shoichi Kitano, Motoko Mizumoto, Koji Kitamura, Masato Kondo, Hiroyuki Kobayashi, Satoshi Kaihara, Ryo Hosotani
Acute appendicitis is the most common general surgical problem encountered during pregnancy. Laparoscopic appendectomy (LA) is widely accepted as a minimally invasive procedure for acute appendicitis. However, LA during the third trimester is associated with problems, including technical difficulty, risk of preterm delivery, and fetal loss. We successfully managed three cases of LA during the third trimester between 2011 and 2016. None of the cases required conversion to an open procedure, and none of the patients had postoperative complications and/or fetal loss...
January 4, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29310444/safety-of-galcanezumab-in-patients-with-episodic-migraine-a-randomized-placebo-controlled-dose-ranging-phase-2b-study
#17
Tina Marie Myers Oakes, Vladimir Skljarevsuki, Qi Zhang, William Kielbasa, Michael E Hodsdon, Holland C Detke, Angelo Camporeale, Joel R Saper
Background Safety findings from a Phase 2b study of galcanezumab, a humanized monoclonal antibody against calcitonin gene-related peptide, for prevention of migraine (NCT02163993) are reported here. Methods Patients aged 18-65 years with episodic migraine were evaluated in this multicenter, double-blind, randomized study. After randomization, 410 patients were administered 5, 50, 120 or 300 mg of galcanezumab or placebo subcutaneously once every 4 weeks for 12 weeks, followed by a post-treatment off-drug period lasting 12 weeks...
January 1, 2018: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29310437/maleimide-and-cyclooctyne-based-hexakis-adducts-of-fullerene-multivalent-scaffolds-for-copper-free-click-chemistry-on-fullerenes
#18
Javier Ramos-Soriano, Jose Juan Reina, Beatriz M Illescas, Javier Rojo, Nazario Martín
The synthesis of multivalent systems based on hexakis-adducts of [60]fullerene employing a biocompatible copper-free click chemistry strategy has been accomplished. A symmetric hexakis-adduct of fullerene bearing 12 maleimide units 3 is reported and it has been employed to carry out the thiol-maleimide Michael addition. To achieve orthogonal click addition, an asymmetric derivative bearing one maleimide and ten cyclooctynes has been synthesized. The sequential and one-pot transformations of the two clickable groups have been explored, finding the best results in the case of the one-pot experiment...
January 9, 2018: Journal of Organic Chemistry
https://www.readbyqxmd.com/read/29310273/identification-and-classification-of-cathinone-unknowns-by-statistical-analysis-processing-of-direct-analysis-in-real-time-high-resolution-mass-spectrometry-derived-neutral-loss-spectra
#19
Kristen L Fowble, Jason R E Shepard, Rabi A Musah
An approach to the rapid determination of the structures of novel synthetic cathinone designer drugs, also known as bath salts, is reported. While cathinones fragment so extensively by electron impact mass spectrometry that their mass spectra often cannot be used to identify the structure, collision-induced dissociation (CID) direct analysis in real time-high resolution mass spectrometry (DART-HRMS) experiments furnished spectra that provided diagnostic fragmentation patterns for the analyzed cathinones. From this data, neutral loss spectra, which reflect the presence of specific chemical moieties, could be acquired...
March 1, 2018: Talanta
https://www.readbyqxmd.com/read/29306977/acute-appendicitis-in-childhood-oral-contrast-does-not-improve-ct-diagnosis
#20
Crystal R Farrell, Adam D Bezinque, Jared M Tucker, Erica A Michiels, Bradford W Betz
INTRODUCTION: We compared the diagnostic accuracy of CT performed without and with oral contrast for suspected appendicitis in children. METHODS: In this retrospective cohort study, we reviewed abdomen/pelvis CT scans with IV contrast performed between 2011 and 2015 for suspected appendicitis. Oral contrast was used routinely before August 2013 and eliminated from the CT protocol thereafter. Diagnostic accuracy of CT was compared with operative/pathology reports, and included a 30-day follow-up period for non-surgical patients...
January 6, 2018: Emergency Radiology
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