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Pediatric appendicitis

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https://www.readbyqxmd.com/read/28637571/workforce-issues-in-pediatric-surgery
#1
Don K Nakayama
High salaries indicate a demand for pediatric surgeons in excess of the supply, despite only a slight growth in the pediatric-age population and a sharp increase in numbers of trainees. Top-level neonatal intensive care units require 24-hour-7-day pediatric surgical availability, so hospitals are willing to pay surgeons a premium and engage high-priced locum tenens surgeons to fill vacancies in coverage. With increased supply comes an erosion of the numbers of cases performed by trainees and surgeons in practice...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28635516/concentration-of-uhcl1-in-the-serum-of-children-with-acute-appendicitis-before-and-after-surgery-and-its-correlation-with-crp-and-prealbumin
#2
Ewa Matuszczak, Marzena Tylicka, Wojciech Dębek, Anna Tokarzewicz, Ewa Gorodkiewicz, Adam Hermanowicz
Ubiquitin-mediated protein degradation plays a crucial role in various cellular processes, including signal transduction, cell differentiation, and stress response. Ubiquitin C-terminal hydrolase 1 (UCHL1) is a unique deubiquitinating enzyme that has both hydrolase and ligase activities. The aim of this study was the determination of UCHL1 concentration in serum of children with appendicitis, before and after the surgery. MATERIAL AND METHODS: 42 children with acute appendicitis, who were managed at the Pediatric Surgery Department, between 2013 and 2014, were randomly included into the study (age 9 months up to 14 years, mean age 2...
February 27, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28631157/performance-characteristics-of-magnetic-resonance-imaging-without-contrast-agents-or-sedation-in-pediatric-appendicitis
#3
Ryne A Didier, Katharine L Hopkins, Fergus V Coakley, Sanjay Krishnaswami, David M Spiro, Bryan R Foster
BACKGROUND: Magnetic resonance imaging (MRI) has emerged as a promising modality for evaluating pediatric appendicitis. However optimal imaging protocols, including roles of contrast agents and sedation, have not been established and diagnostic criteria have not been fully evaluated. OBJECTIVE: To investigate performance characteristics of rapid MRI without contrast agents or sedation in the diagnosis of pediatric appendicitis. MATERIALS AND METHODS: We included patients ages 4-18 years with suspicion of appendicitis who underwent rapid MRI between October 2013 and March 2015 without contrast agent or sedation...
June 19, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28628705/time-to-appendectomy-and-risk-of-complicated-appendicitis-and-adverse-outcomes-in-children
#4
Stephanie K Serres, Danielle B Cameron, Charity C Glass, Dionne A Graham, David Zurakowski, Mahima Karki, Seema P Anandalwar, Shawn J Rangel
Importance: Management of appendicitis as an urgent rather than emergency procedure has become an increasingly common practice in children. Controversy remains as to whether this practice is associated with increased risk of complicated appendicitis and adverse events. Objective: To examine the association between time to appendectomy (TTA) and risk of complicated appendicitis and postoperative complications. Design, Setting, and Participants: In this retrospective cohort study using the Pediatric National Surgical Quality Improvement Program appendectomy pilot database, 2429 children younger than 18 years who underwent appendectomy within 24 hours of presentation at 23 children's hospitals from January 1, 2013, through December 31, 2014, were studied...
June 19, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28610706/ultrasound-guided-bilateral-rectus-sheath-block-vs-conventional-local-analgesia-in-single-port-laparoscopic-appendectomy-for-children-with-nonperforated-appendicitis
#5
Caroline Maloney, Michelle Kallis, Ibrahim Abd El-Shafy, Aaron M Lipskar, John Hagen, Michelle Kars
INTRODUCTION: Despite its minimally invasive approach, laparoscopic surgery can cause considerable pain. Regional analgesic techniques such as the rectus sheath block (RSB) offer improved pain management following elective umbilical hernia repair in the pediatric population. This effect has not been examined in laparoscopic single-incision surgery in children. We sought to compare the efficacy of bilateral ultrasound-guided RSB versus local anesthetic infiltration (LAI) in providing postoperative pain relief in pediatric single-incision transumbilical laparoscopic assisted appendectomy (TULA) with same-day discharge...
June 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28609109/accuracy-and-radiation-dose-reduction-of-limited-range-ct-in-the-evaluation-of-acute-appendicitis-in-pediatric-patients
#6
Michael Jin, Thomas R Sanchez, Ramit Lamba, Ghaneh Fananapazir, Michael T Corwin
OBJECTIVE: The purpose of this article is to determine the accuracy and radiation dose reduction of limited-range CT prescribed from the top of L2 to the top of the pubic symphysis in children with suspected acute appendicitis. MATERIALS AND METHODS: We performed a retrospective study of 210 consecutive pediatric patients from December 11, 2012, through December 11, 2014, who underwent abdominopelvic CT for suspected acute appendicitis. Two radiologists independently reviewed the theoretic limited scans from the superior L2 vertebral body to the top of the pubic symphysis, to assess for visualization of the appendix, acute appendicitis, alternative diagnoses, and incidental findings...
June 13, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28591014/is-an-rct-the-best-way-to-investigate-the-effectiveness-of-nonoperative-management-of-pediatric-appendicitis
#7
Peter C Minneci, Katherine J Deans
No abstract text is available yet for this article.
July 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28578474/differentiating-perforated-from-non-perforated-appendicitis-on-contrast-enhanced-magnetic-resonance-imaging
#8
Daniel G Rosenbaum, Gulce Askin, Debra M Beneck, Arzu Kovanlikaya
BACKGROUND: The role of magnetic resonance imaging (MRI) in pediatric appendicitis is increasing; MRI findings predictive of appendiceal perforation have not been specifically evaluated. OBJECTIVE: To assess the performance of MRI in differentiating perforated from non-perforated appendicitis. MATERIALS AND METHODS: A retrospective review of pediatric patients undergoing contrast-enhanced MRI and subsequent appendectomy was performed, with surgicopathological confirmation of perforation...
June 3, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28574593/early-versus-delayed-appendicectomy-for-appendiceal-phlegmon-or-abscess
#9
REVIEW
Yao Cheng, Xianze Xiong, Jiong Lu, Sijia Wu, Rongxing Zhou, Nansheng Cheng
BACKGROUND: Appendiceal phlegmon and abscess account for 2% to 10% of acute appendicitis. People with appendiceal phlegmon or abscess usually need an appendicectomy to relieve their symptoms and avoid complications. The timing of appendicectomy for appendiceal phlegmon or abscess is controversial. OBJECTIVES: To assess the effects of early versus delayed appendicectomy for appendiceal phlegmon or abscess, in terms of overall morbidity and mortality. SEARCH METHODS: We searched the Cochrane Library (CENTRAL; 2016, Issue 7), MEDLINE Ovid (1950 to 23 August 2016), Embase Ovid (1974 to 23 August 2016), Science Citation Index Expanded (1900 to 23 August 2016), and the Chinese Biomedical Literature Database (CBM) (1978 to 23 August 2016)...
June 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28554816/a-pre-operative-clinical-scoring-system-to-distinguish-perforation-risk-with-pediatric-appendicitis
#10
William Bonadio, Syeda Shahid, Lior Vardi, Carly Buckingham, Allison Kornblatt, Chloe Free, Peter Homel
IMPORTANCE: Appendicitis is a common, potentially serious pediatric disease. An important factor in determining management strategy [whether/when to perform appendectomy, duration of antibiotic therapy/hospitalization, etc.] and predicting outcome is distinguishing whether perforation is present. OBJECTIVE: The objective was to determine efficacy of commonly assessed pre-operative variables in stratifying perforation risk in children with appendicitis. DESIGN: A retrospective analysis of consecutive cases was performed...
May 22, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28550935/looped-suture-versus-stapler-device-in-pediatric-laparoscopic-appendectomy-a-comparative-outcomes-and-intraoperative-cost-analysis
#11
Punam P Parikh, Jun Tashiro, Amy E Wagenaar, Miosotys Curbelo, Eduardo A Perez, Holly L Neville, Anthony R Hogan, Juan E Sola
BACKGROUND: Appendiceal ligation during pediatric laparoscopic appendectomy (LA) may be performed using looped suture versus stapler. Controversy regarding the utility of either method exists. Clinical outcomes and cost analysis of LA with both methods were compared. METHODS: All pediatric LA were performed from fiscal years 2013 and 2014 by two pediatric surgeons. While one surgeon used looped suture, the other used stapler exclusively. chi-Square tests were performed to analyze associations...
May 20, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28528712/timing-of-antimicrobial-prophylaxis-and-infectious-complications-in-pediatric-patients-undergoing-appendectomy
#12
Cristen N Litz, Jessica B Asuncion, Paul D Danielson, Nicole M Chandler
PURPOSE: Antibiotic administration within one hour prior to incision is a common quality metric; however, antibiotics are typically started at the time of diagnosis in pediatric patients with acute appendicitis. The purpose was to determine if antibiotic administration within one hour prior to incision reduces the incidence of surgical site infections (SSI) in pediatric patients with acute appendicitis started on parenteral antibiotics upon diagnosis. METHODS: A retrospective review was performed of 478 patients aged 0-18years who underwent appendectomy for acute appendicitis from 7/2013 to 4/2015...
May 11, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28486259/appendicitis-in-a-neutropenic-patient-a-multicentric-retrospective-study
#13
Alberto A Scarpa, Géraldine Hery, Arnaud Petit, Benoit Brethon, Irène Jimenez, Virginie Gandemer, Samuel Abbou, Stéphanie Haouy, Jean Breaud, Marilyne Poiree
To study the management of acute appendicitis in neutropenic patients, we retrospectively reviewed cases of acute appendicitis in neutropenic children treated for cancer. The patients' demographics, medical records, and outcomes were tracked. We compared nonoperative treatment versus emergency or delayed surgery. The cases of 30 patients with a mean age of 8.8 years in 12 French departments of Pediatric Hematology/Oncology between 1995 and 2013 were studied. Most patients (90%) were treated for hematological malignancies...
July 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28472969/perforated-acute-appendicitis-with-no-peritonitis-in-a-premature-baby-a-case-report
#14
Fayza Haider, Barrak Ayoub, Mariam Al Kooheji, Mona Al Juffairi, Safa Al-Shaikh
BACKGROUND: Acute appendicitis in a neonate and premature baby is still considered a rare entity as diagnosis is always made after surgical exploration for acute abdominal findings mimicking necrotizing enterocolitis. Our reported case is a premature baby who had a perforated appendix with no evidence of peritonitis. CASE PRESENTATION: We describe the case of a premature Bahraini girl born at 29 weeks of gestation by spontaneous vaginal delivery to a 39-year-old G6P5 mother...
May 5, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28472016/laparoscopic-appendectomy-in-children-with-perforated-appendicitis-a-meta-analysis
#15
Shun Zhang, Tao Du, Xiaohua Jiang, Chun Song
BACKGROUND: The purpose of this meta-analysis was to compare the influence of different surgical procedures on perforated appendicitis in pediatric population. MATERIALS AND METHODS: Studies were identified through a computerized literature search of Pubmed, Embase, Ovid, the Cochrane Colorectal Cancer Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials, the Cochrane Library database, and Web of Science. Two reviewers independently assessed the quality of each study and abstracted outcome data...
May 3, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28465653/predictors-of-hospitalization-among-children-on-art-in-ethiopia-a-cohort-study
#16
Abraham Haileamlak, Tesfalem Hagos, Workeabeba Abebe, Loko Abraham, Henok Asefa, Alula M Teklu
BACKGROUND: Substantial progress has been made in the management of pediatric HIV infection in Ethiopia with the implementation of mother-to-child-prevention programs. Since the introduction of HAART in 2005, mortality among HIV-infected children has reduced while the rate of hospitalization was expected to rise. The purpose of this study, therefore, was to assess predictors of hospitalization in children on ART in seven university referral hospitals in Ethiopia. METHODS: A prospective cohort study design was employed on children age 0-18 years as part of a multisite observational study...
February 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28424822/rapid-non-contrast-magnetic-resonance-imaging-for-post-appendectomy-intra-abdominal-abscess-in-children
#17
Megan H Lee, Eric P Eutsler, Elizabeth F Sheybani, Geetika Khanna
BACKGROUND: Acute appendicitis, especially if perforated at presentation, is often complicated by postoperative abscess formation. The detection of a postoperative abscess relies primarily on imaging. This has traditionally been done with contrast-enhanced computed tomography. Non-contrast magnetic resonance imaging (MRI) has the potential to accurately detect intra-abdominal abscesses, especially with the use of diffusion-weighted imaging (DWI). OBJECTIVE: To evaluate our single-center experience with a rapid non-contrast MRI protocol evaluating post-appendectomy abscesses in children with persistent postsurgical symptoms...
April 20, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28408075/effect-of-hospital-type-on-the-treatment-of-acute-appendicitis-in-teenagers
#18
Cristen N Litz, David J Ciesla, Paul D Danielson, Nicole M Chandler
BACKGROUND: Teenagers receive appendicitis care at both adult and pediatric facilities. The purpose of this study was to evaluate outcomes following treatment of acute appendicitis in teenagers based on the type of hospital facility. METHODS: Patients aged 13-17years with acute appendicitis who were discharged from acute care hospitals from 2009 to 2014 were identified using a statewide discharge dataset. Hospitals were classified as pediatric or adult and outcomes were compared...
April 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28393502/-peripherally-inserted-central-catheters-savings-comfort-many-advantages
#19
A Y Molina Caballero, M Martínez Merino, A Pérez Martínez, L Ayuso González, S Hernández Martín, J Pisón Chacón
INTRODUCTION: Peripherally inserted central catheters are indicated when an intravenous treatment is expected for more than 6 days or less if phlebotoxic medication is used. We report our recent experience. METHODS: Retrospective study from 2014 to 2015 including patients to whom a catheter was placed either, in the operating room after surgery and before awakening the patient, or in the Pediatric ICU by direct or ultrasound guidance venipuncture. We reviewed patient characteristics, underlying disease, line catheterization procedure, type and duration of venous line, intravenous treatment and complications...
July 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28363470/time-driven-activity-based-costing-a-dynamic-value-assessment-model-in-pediatric-appendicitis
#20
Yangyang R Yu, Paulette I Abbas, Carolyn M Smith, Kathleen E Carberry, Hui Ren, Binita Patel, Jed G Nuchtern, Monica E Lopez
OBJECTIVES: Healthcare reform policies are emphasizing value-based healthcare delivery. We hypothesize that time-driven activity-based costing (TDABC) can be used to appraise healthcare interventions in pediatric appendicitis. METHODS: Triage-based standing delegation orders, surgical advanced practice providers, and a same-day discharge protocol were implemented to target deficiencies identified in our initial TDABC model. Post-intervention process maps for a hospital episode were created using electronic time stamp data for simple appendicitis cases during February to March 2016...
June 2017: Journal of Pediatric Surgery
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