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Antibiotics appendicitis

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https://www.readbyqxmd.com/read/28213607/efficacy-and-safety-of-nonoperative-treatment-for-acute-appendicitis-a-meta-analysis
#1
REVIEW
Roxani Georgiou, Simon Eaton, Michael P Stanton, Agostino Pierro, Nigel J Hall
CONTEXT: Nonoperative treatment (NOT) with antibiotics alone of acute uncomplicated appendicitis (AUA) in children has been proposed as an alternative to appendectomy. OBJECTIVE: To determine safety and efficacy of NOT based on current literature. DATA SOURCES: Three electronic databases. STUDY SELECTION: All articles reporting NOT for AUA in children. DATA EXTRACTION: Two reviewers independently verified study inclusion and extracted data...
February 17, 2017: Pediatrics
https://www.readbyqxmd.com/read/28210834/conservative-treatment-in-uncomplicated-acute-appendicitis-reassessment-of-practice-safety
#2
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
#3
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
#4
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/28161124/are-antibiotics-a-feasible-therapeutic-option-for%C3%A2-appendicitis
#5
EDITORIAL
Anupam B Kharbanda, David J Schmeling
No abstract text is available yet for this article.
January 19, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28151844/impact-of-percutaneous-drainage-on-outcome-of-intra-abdominal-infection-associated-with-pediatric-perforated-appendicitis
#6
William Bonadio, Miriam Langer, Julie Cueva, Astrid Haaland
BACKGROUND: Perforated appendicitis can result in potentially serious complications requiring prolonged medical care. The optimal approach to successfully managing this condition is controversial. METHODS: Review of 80 consecutive cases of pediatric acute perforated appendicitis with intra-abdominal infection [IAI] medically managed with parenteral antibiotics and percutaneous drainage [PD] during a 7-year period. RESULTS: All patients received broad spectrum parenteral antibiotic therapy...
January 31, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28133355/-usefulness-of-transumbilical-laparoscopic-assisted-appendectomy-for-a-suspected-case-of-hydrops-processus-vermiformis
#7
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/28127129/recurrent-epiploic-appendagitis-mimicking-appendicitis-and-cholecystitis
#8
Claudia Lorente, Christopher B Hearne, Jorge Taboada
Epiploic appendagitis (EA) is a rare cause of acute abdominal pain caused by inflammation of an epiploic appendage. It has a nonspecific clinical presentation that may mimic other acute abdominal pathologies on physical exam, such as appendicitis, diverticulitis, or cholecystitis. However, EA is usually benign and self-limiting and can be treated conservatively. We present the case of a patient with two episodes of EA, the first mimicking acute appendicitis and the second mimicking acute cholecystitis. Although recurrence of EA is rare, it should be part of the differential diagnosis of acute, localized abdominal pain...
January 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28121030/the-gut-microbiome-and-the-mechanism-of-surgical-infection
#9
REVIEW
J C Alverdy, S K Hyoju, M Weigerinck, J A Gilbert
BACKGROUND: Since the very early days of surgical practice, surgeons have recognized the importance of considering that intestinal microbes might have a profound influence on recovery from surgical diseases such as appendicitis and peritonitis. Although the pathogenesis of surgical diseases such as cholelithiasis, diverticulosis, peptic ulcer disease and cancer have been viewed as disorders of host biology, they are emerging as diseases highly influenced by their surrounding microbiota...
January 2017: British Journal of Surgery
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
#10
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/28099380/predicting-appendiceal-tumors-among-patients-with-appendicitis
#11
Tyler J Loftus, Steven L Raymond, George A Sarosi, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Scott C Brakenridge, Alicia M Mohr, Janeen R Jordan
BACKGROUND: As non-operative management of appendicitis gains popularity, vigilance for appendiceal tumors becomes increasingly important. We hypothesized that among patients presenting with acute appendicitis, those with advanced age, multiple comorbidities, atypical presentation, and complicated appendicitis would be more likely to have underlying appendiceal tumors. METHODS: We performed a 4-year retrospective cohort analysis of 677 consecutive adult patients who underwent appendectomy for appendicitis at our tertiary care center...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28092251/-acute-appendicitis-surgical-and-non-surgical-treatment
#12
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
#13
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
#14
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
#15
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
#16
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/27987280/abdominal-pain-learning-when-not-to-intervene
#17
Niranjan Tachamo, Bidhya Timilsina, Salik Nazir, Saroj Lohani
Epiploic appendagitis (EA) is an uncommon cause of abdominal pain. It is a benign condition but may mimic other serious causes of acute abdomen such as appendicitis, diverticulitis, and gynecological emergency in severe cases. Knowledge of this condition in the differential diagnosis of abdominal pain can save unnecessary hospital admission, antibiotics, and surgery. In this article, we present the case of a 43-year-old female who presented to our hospital with a 2-day history of right lower quadrant abdominal pain and diarrhea...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27974169/antibiotics-first-versus-surgery-for-appendicitis-a%C3%A2-us-pilot-randomized-controlled-trial-allowing-outpatient-antibiotic-management
#18
David A Talan, Darin J Saltzman, William R Mower, Anusha Krishnadasan, Cecilia M Jude, Ricky Amii, Daniel A DeUgarte, James X Wu, Kavitha Pathmarajah, Ashkan Morim, Gregory J Moran
STUDY OBJECTIVE: Randomized trials suggest that nonoperative treatment of uncomplicated appendicitis with antibiotics-first is safe. No trial has evaluated outpatient treatment and no US randomized trial has been conducted, to our knowledge. This pilot study assessed feasibility of a multicenter US study comparing antibiotics-first, including outpatient management, with appendectomy. METHODS: Patients aged 5 years or older with uncomplicated appendicitis at 1 US hospital were randomized to appendectomy or intravenous ertapenem greater than or equal to 48 hours and oral cefdinir and metronidazole...
December 11, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27916376/factors-predictive-of-complicated-appendicitis-in-children
#19
Xuan-Binh D Pham, Veronica F Sullins, Dennis Y Kim, Blake Range, Amy H Kaji, Christian M de Virgilio, Steven L Lee
BACKGROUND: The ability to predict whether a child has complicated appendicitis at initial presentation may influence clinical management. However, whether complicated appendicitis is associated with prehospital or inhospital factors is not clear. We also investigate whether hyponatremia may be a novel prehospital factor associated with complicated appendicitis. MATERIALS AND METHODS: A retrospective review of all pediatric patients (≤12 y) with appendicitis treated with appendectomy from 2000 to 2013 was performed...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27873747/atypical-presentation-of-appendicitis
#20
Oliver Beaumont, Robert Miller, Richard Guy
A woman aged 64 years presented as an emergency with a mass in the right iliac fossa, clinically within the abdominal wall, but an otherwise soft abdomen. Systemically, she was quite well with normal vital signs. Blood tests revealed raised inflammatory markers, and an abdominal CT scan demonstrated a perforated appendix with associated large subcutaneous abscess. This represents a rare presentation of a common condition, demonstrating how appendicitis can still be a challenging problem for the clinician...
November 10, 2016: BMJ Case Reports
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