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Antibiotic using in appendicitis

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https://www.readbyqxmd.com/read/28535960/nonoperative-management-in-children-with-early-acute-appendicitis-a-systematic-review
#1
REVIEW
Jane Xu, Susan Adams, Yingrui Cyril Liu, Jonathan Karpelowsky
PURPOSE: Appendectomy has remained the gold standard treatment of acute appendicitis for more than 100years. Nonoperative management (NOM) has been shown to be a valid treatment alternative for acute uncomplicated appendicitis in adults. A systematic review of available evidence comparing operative management (OM) and NOM in children with acute uncomplicated appendicitis was performed. METHODS: Systematic searches of MedLine, Embase, and a clinical trial register (https://clinicaltrials...
May 11, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28494476/effect-of-the-shorter-stays-in-emergency-departments-time-target-policy-on-key-indicators-of-quality-of-care
#2
MULTICENTER STUDY
Peter Jones, James Le Fevre, Alana Harper, Susan Wells, Joanna Stewart, Elana Curtis, Papaarangi Reid, Shanthi Ameratunga
AIM: To determine whether implementation of a national health target called Shorter Stays in Emergency Departments impacted on clinical markers of quality of care. METHOD: A retrospective pre- and post-intervention study from 2006 to 2012 examined quality of care metrics for five different indicators at different sites in relation to the implementation of the target using a general linear model for times to treatment. Explanatory variables included period (pre- or post-target), ethnicity, age, deprivation and severity of condition...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28477257/control-of-emerging-contaminants-by-the-combination-of-electrochemical-processes-and-membrane-bioreactors
#3
Benny Marie B Ensano, Laura Borea, Vincenzo Naddeo, Mark Daniel G de Luna, Vincenzo Belgiorno
This study investigates the removal of selected pharmaceuticals, as recalcitrant organic compounds, from synthetic wastewater using an electro-membrane bioreactor (eMBR). Diclofenac (DCF), carbamazepine (CBZ), and amoxicillin (AMX) were selected as representative drugs from three different therapeutic groups such as anti-inflammatory, anti-epileptic, and antibiotic, respectively. An environmentally relevant concentration (10 μg/L) of each compound was spiked into the synthetic wastewater, and then, the impact of appending electric field on the control of membrane fouling and the removal of conventional contaminants and pharmaceutical micropollutants were assessed...
May 5, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28468685/a-neglected-risk-for-sparganosis-eating-live-tadpoles-in-central-china
#4
Jing Cui, Ye Wang, Xi Zhang, Xi-Meng Lin, Hong-Wei Zhang, Zhong-Quan Wang, Jia-Xu Chen
A 29-year-old farmer from central China was sent into the Emergency Department of the Affiliated Hospital of Zhengzhou University. He had a 15-day history of persistent high fever, abdominal distention and pain. The patient was clinically diagnosed as appendicitis and peritonitis, and treated with antibiotics in a local hospital, did not improve. On exploratory laparotomy, the appendicular perforation and peritonitis were seen; appendicectomy were performed, and antibiotics were given. However, high fever and abdominal pain still persisted; intestinal adhesion and obstruction, ascites appeared...
May 4, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28423177/comparison-of-appendectomy-outcomes-between-senior-general-surgeons-and-general-surgery-residents
#5
Baha Siam, Abbas Al-Kurd, Natalia Simanovsky, Haitham Awesat, Yahav Cohn, Brigitte Helou, Ahmed Eid, Haggi Mazeh
Importance: In some centers, the presence of a senior general surgeon (SGS) is obligatory in every procedure, including appendectomy, while in others it is not. There is a relative paucity in the literature of reports comparing the outcomes of appendectomies performed by unsupervised general surgery residents (GSRs) with those performed in the presence of an SGS. Objective: To compare the outcomes of appendectomies performed by SGSs with those performed by GSRs...
April 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28346589/comparison-of-antibiotic-therapy-and-appendectomy-for-acute-uncomplicated-appendicitis-in-children-a-meta-analysis
#6
Libin Huang, Yuan Yin, Lie Yang, Cun Wang, Yuan Li, Zongguang Zhou
Importance: Antibiotic therapy for acute uncomplicated appendicitis is effective in adult patients, but its application in pediatric patients remains controversial. Objective: To compare the safety and efficacy of antibiotic treatment vs appendectomy as the primary therapy for acute uncomplicated appendicitis in pediatric patients. Data Sources: The PubMed, MEDLINE, EMBASE, and Cochrane Library databases and the Cochrane Controlled Trials Register for randomized clinical trials were searched through April 17, 2016...
May 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28338596/operation-versus-antibiotics-the-appendicitis-conundrum-continues-a-meta-analysis
#7
Joseph V Sakran, Konstantinos S Mylonas, Alexandros Gryparis, Stanislaw P Stawicki, Christopher J Burns, Maher M Matar, Konstantinos P Economopoulos
BACKGROUND: Acute appendicitis continues to constitute a diagnostic and therapeutic challenge. The aim of this study was to synthesize evidence from randomized controlled trials (RCTs) comparing nonoperative versus surgical management of uncomplicated acute appendicitis in adult patients. METHODS: A systematic literature search of the PubMed, Cochrane, and Scopus databases was performed with respect to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement (end-of-search date: January 29, 2017)...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28284517/antibiotics-first-strategy-for-uncomplicated-acute-appendicitis-in-adults-is-associated-with-increased-rates-of-peritonitis-at-surgery-a-systematic-review-with-meta-analysis-of-randomized-controlled-trials-comparing-appendectomy-and-non-operative-management
#8
REVIEW
Mauro Podda, Nicola Cillara, Salomone Di Saverio, Antonio Lai, Francesco Feroci, Gianluigi Luridiana, Ferdinando Agresta, Nereo Vettoretto
BACKGROUND: Acute appendicitis is the most common surgical diagnosis in young patients, with lifetime prevalence of about 7%. Debate remains on whether uncomplicated AA should be operated or not. Aim of this meta-analysis of randomized controlled trials was to assess current evidence on antibiotic treatment for uncomplicated AA compared to standard surgical treatment. METHODS: Systematic literature search was performed using PubMed, EMBASE, Medline, Google Scholar and Cochrane Central Register of Controlled Trials databases for randomized controlled trials comparing antibiotic therapy (AT) and surgical therapy-appendectomy (ST) for uncomplicated AA...
March 8, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28248876/obturator-externus-abscess-in-a-9-year-old-child-a-case-report-and-literature-review
#9
Charlotte de Bodman, Dimitri Ceroni, Justine Dufour, Pierre-Alex Crisinel, Aline Bregou-Bourgeois, Pierre-Yves Zambelli
RATIONALE: Obturator pyomyositis is a rare condition in children. Diagnosis is often delayed because of its rarity, and the vagaries of its presentation cause it to be easily be missed. Physicians should therefore familiarize themselves with this condition and consider it as a possible differential diagnosis in patients presenting with an acutely painful hip. Inflammatory syndrome is also frequent among sufferers and the MRI is a very sensitive diagnostic tool for obturator pyomyositis...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28210834/conservative-treatment-in-uncomplicated-acute-appendicitis-reassessment-of-practice-safety
#10
Zvi Steiner, Genady Buklan, Rodica Stackievicz, Michael Gutermacher, Ita Litmanovitz, Guy Golani, Shmuel Arnon
The success rate of conservative treatment for children with uncomplicated appendicitis was prospectively evaluated among 197 children. All who received intravenous antibiotics for 3-5 days, and if symptoms resolved, were discharged home on oral antibiotics for 5 days. Failure rate, symptoms, laboratory signs, and sonographic findings were evaluated for prognostic markers of treatment failure. Children were followed for 18 months. The success rate of conservative treatment was 87%, with shorter hospital stays compared to children who eventually needed surgery (72 [60-84] vs...
February 16, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28174759/-infectious-supercarelessness-in-discussing-antibiotic-resistant-bacteria
#11
Neil S Greenspan
Many bacterial pathogens are exhibiting resistance to increasing numbers of antibiotics making it much more challenging to treat the infections caused by these microbes. In many reports in the media and perhaps even in discussions among physicians and biomedical scientists, these bacteria are frequently referred to as "bugs" with the prefix "super" appended. This terminology has a high potential to elicit unjustified inferences and fails to highlight the broader evolutionary context. Understanding the full range of biological and evolutionary factors that influence the spread and outcomes of infections is critical to formulating effective individual therapies and public health interventions...
October 2016: Pathogens & Immunity
https://www.readbyqxmd.com/read/28162864/use-of-computed-tomography-to-determine-perforation-in-patients-with-acute-appendicitis
#12
Cameron E Gaskill, Vlad V Simianu, Jonathan Carnell, Daniel S Hippe, Puneet Bhargava, David R Flum, Giana H Davidson
PURPOSE: Urgent appendectomy has long been the standard of care for acute appendicitis. Six randomized trials have demonstrated that antibiotics can safely treat appendicitis, but approximately 1 in 4 of these patients eventually requires appendectomy. Overall treatment success may be limited by complex disease including perforation. Patients׳ success on antibiotic therapy may depend on preoperative identification of complex disease on imaging. However, the effectiveness of computed tomography (CT) in differentiating complex disease including perforated from nonperforated appendicitis remains to be determined...
December 7, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28133355/-usefulness-of-transumbilical-laparoscopic-assisted-appendectomy-for-a-suspected-case-of-hydrops-processus-vermiformis
#13
Hiroki Kobayashi, Noriaki Koizumi, Tsuyoshi Takagi, Kanehisa Fukumoto
A-77-year-old man presented to our hospital with high fever and lower abdominal pain. Enhanced CT of the abdomen revealed swelling of the appendix with wall thickening and fluid collection. We diagnosed appendicitis with abscess formation and performed transumbilical laparoscopic-assisted appendectomy after the inflammation improved in response to antibiotics. Operative findings revealed a cystic lesion ofthe appendix and strong adhesion ofthe appendix to the terminal ileum. Based on these operative findings, we changed the operative procedure to a single-incision laparoscopic assisted ileocecal resection because ofthe possibility ofhydrops processus vermiformis...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28112705/antibiotics-alone-for-uncomplicated-acute-appendicitis-in-high-operative-risk-adult-patients-analytical-review-of-rcts-and-proposal-of-evidence-based-treatment-decision
#14
Hariscine Keng Abongwa, G Cervellin, A Tarasconi, G Perrone, G Baiocchi, N Portolani, F Catena
BACKGROUND: Clinical trials have so far shown controversial results as regards the standard of care for treating uncomplicated acute appendicitis (uC-AA). High operational risk adult patients (HORAP) could represent selected patients where primary antibiotic conservative therapy (pACT or A) could be indicated. METHODS: We carried a comprehensive search of the PubMed searching engine in the English language scientific literature from 1995 to 2015, using medical subject headings "antibiotics", "uncomplicated appendicitis", "appendicectomy", "conservative treatment", "surgery" and "randomized clinical trial"...
January 16, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28092251/-acute-appendicitis-surgical-and-non-surgical-treatment
#15
Luis Manuel Souza-Gallardo, José Luis Martínez-Ordaz
Appendicitis represents a common disease for the surgeon with a relative risk between 7-8%. It was thought that if more time passed between diagnosis and treatment, the risk for complications, such as perforation or abscess formation, was higher; nevertheless; the evolution is variable, making necessary the development of different strategies such as antibiotic use only, interval surgery or endoscopic treatment. The purpose of this study is to make a revision in the management of appendicitis comparing conservative and surgical treatment...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28063718/second-date-appendectomy-operating-for-failure-of-nonoperative-treatment-in-perforated-appendicitis
#16
Marco Lotti
BACKGROUND: Nonoperative treatment of acute appendicitis is embraced by many surgical teams, driven by low to moderate quality randomized studies that support noninferiority of antibiotics versus appendectomy for treatment of acute uncomplicated appendicitis. Several flaws of these studies have emerged, especially in the recruitment strategy and in the diagnostic criteria that were used. The growing confidence given to antibiotics, together with the lack of reliable criteria to distinguish between uncomplicated and perforated appendicitis, exposes patients with perforated appendicitis to the likelihood to be treated with antibiotics instead of surgery...
January 2, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28049113/update-on-pediatric-overuse
#17
Eric R Coon, Paul C Young, Ricardo A Quinonez, Daniel J Morgan, Sanket S Dhruva, Alan R Schroeder
As concerns over health care-related harms and costs continue to mount, efforts to identify and combat medical overuse are needed. Although much of the recent attention has focused on health care for adults, children are also harmed by overuse. Using a structured PubMed search and manual tables of contents review, we identified important articles on pediatric overuse published in 2015. These articles were evaluated according to the quality of the methods, the magnitude of clinical effect, and the number of patients potentially affected and were categorized into overdiagnosis, overtreatment, and overutilization...
February 2017: Pediatrics
https://www.readbyqxmd.com/read/28039865/sonographic-differentiation-of-complicated-from-uncomplicated-appendicitis-implications-for-antibiotics-first-therapy
#18
Yingding Xu, R Brooke Jeffrey, Stephanie T Chang, Michael A DiMaio, Eric W Olcott
OBJECTIVES: To evaluate sonographic findings as indicators of complicated versus uncomplicated appendicitis in the setting of known appendicitis, a necessary distinction in deciding whether to proceed with antibiotic therapy or with appendectomy. METHODS: With Institutional Review Board approval and Health Insurance Portability and Accountability Act compliance, appendiceal sonograms of 119 patients with histopathologically proven appendicitis were retrospectively blindly reviewed to determine the presence or absence of the normally echogenic submucosal layer, the presence of mural hyperemia, periappendiceal fluid, appendicoliths, and hyperechoic periappendiceal fat and to determine the maximum outside diameter...
December 31, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28003294/acute-uncomplicated-appendicitis-study-rationale-and-protocol-for-a-multicentre-prospective-randomised-controlled-non-inferiority-study-to-evaluate-the-safety-and-effectiveness-of-non-operative-management-in-children-with-acute-uncomplicated-appendicitis
#19
Jane Xu, Yingrui Cyril Liu, Susan Adams, Jonathan Karpelowsky
INTRODUCTION: This article presents an overview of a prospective randomised controlled non-inferiority study designed to evaluate the safety and effectiveness of non-operative management (NOM) with operative management in children with acute uncomplicated appendicitis (AUA). Here, we present the study protocol for this APRES study, a multicentre Australian study. The rationale and details of future analysis, in particular, non-inferiority calculations, cost-effectiveness, feasibility and acceptability of each intervention...
December 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27871681/postoperative-antibiotic-use-and-the-incidence-of-intra-abdominal-abscess-in-the-setting-of-suppurative-appendicitis-a-retrospective-analysis
#20
Esther Bae, Ahmed Dehal, Vanessa Franz, Michael Joannides, Nicholas Sakis, Joshua Scurlock, Patrick Nguyen, Farabi Hussain
BACKGROUND: Although guidelines exist for postoperative antibiotic use in acute appendicitis that is perforated, gangrenous, or simple/uncomplicated, there are less data about its use in suppurative appendicitis. Here, we targeted this subgroup of patients to determine whether postoperative antibiotic administration affects incidence of intra-abdominal abscess formation. METHODS: We retrospectively examined 1,192 patients who underwent laparoscopic appendectomy for acute appendicitis at Kaiser Permanente Fontana Hospital between August 2010 and August 2013...
December 2016: American Journal of Surgery
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