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appendicitis in children

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https://www.readbyqxmd.com/read/29155269/influence-of-time-to-appendectomy-and-operative-duration-on-hospital-cost-in-children-with-uncomplicated-appendicitis
#1
Stephanie K Serres, Dionne A Graham, Charity C Glass, Danielle B Cameron, Seema P Anandalwar, Shawn J Rangel
BACKGROUND: The goal of this study was to examine the influence of time to appendectomy (TTA) and operative duration (OD) on hospital cost as surrogate measures of perioperative efficiency. STUDY DESIGN: Retrospective cohort analysis of 2,116 children undergoing appendectomy for uncomplicated appendicitis at 16 children's hospitals from 1/2013 to 12/2014. TTA (emergency department presentation to incision) and OD were obtained from the NSQIP-Pediatric Appendectomy Pilot Database and merged with cost data from the Pediatric Health Information System Database...
November 16, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29148199/five-lessons-in-uncomplicated-appendicitis-can-we-remove-the-surgery
#2
Andrew Read, Jane Xu, Susan Adams, Jonathan Karpelowsky
Appendicectomy has remained the treatment of choice for appendicitis for over a century and is the most commonly performed emergency operation in children. However, emerging evidence suggests that appendicectomy may not always be necessary in uncomplicated appendicitis, with early paediatric trials demonstrating that antibiotic-only therapy can be safe and effective. Further rigorously designed and appropriately powered studies are necessarily to establish the place of non-operative management of uncomplicated appendicitis in the future...
November 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29146647/initial-non-operative-management-of-uncomplicated-appendicitis-in-children-a-protocol-for-a-multicentre-randomised-controlled-trial-apac-trial
#3
Max Knaapen, Johanna H van der Lee, Roel Bakx, Sarah-May L The, Ernst W E van Heurn, Hugo A Heij, Ramon R Gorter
INTRODUCTION: Based on epidemiological, immunological and pathology data, the idea that appendicitis is not necessarily a progressive disease is gaining ground. Two types are distinguished: simple and complicated appendicitis. Non-operative treatment (NOT) of children with simple appendicitis has been investigated in several small studies. So far, it is deemed safe. However, its effectiveness and effect on quality of life (QoL) have yet to be established in an adequately powered randomised trial...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29135899/new-oxidative-stress-markers-useful-in-the-diagnosis-of-acute-appendicitis-in-children-thiol-disulfide-homeostasis-and-the-asymmetric-dimethylarginine-level
#4
Bahri Elmas, Turan Yildiz, Hayrullah Yazar, Zekeriya İlçe, Ceylan Bal, Betül Özbek, Yusuf Yürümez
OBJECTIVES: The aim of this study was to evaluate 2 new oxidative stress markers, thiol/disulfide homeostasis status and the asymmetric dimethylarginine (ADMA) level, in children with acute appendicitis (AA) and to evaluate their diagnostic utility. METHODS: This case-control study included 45 patients with AA and 35 healthy children. Age, sex, white blood cell count, neutrophil-to-lymphocyte ratio, high-sensitivity C-reactive protein (hs-CRP) level, ultrasonographic findings, thiol/disulfide homeostasis parameters (native and total thiol levels, native thiol/total thiol ratios [antioxidant parameters], and disulfide, disulfide/native thiol, and disulfide/total thiol ratios [oxidant parameters]), and the ADMA level were compared between the 2 groups...
November 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29131879/time-to-appendectomy-and-risk-of-complicated-appendicitis-and-adverse-outcomes-in-children-reply
#5
Shawn J Rangel
No abstract text is available yet for this article.
November 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29131877/time-to-appendectomy-and-risk-of-complicated-appendicitis-and-adverse-outcomes-in-children
#6
William Bonadio
No abstract text is available yet for this article.
November 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29112539/correlating-abdominal-wall-thickness-and-body-mass-index-to-predict-usefulness-of-right-lower-quadrant-ultrasound-for-evaluation-of-pediatric-appendicitis
#7
Jeannie K Kwon, Nowice Trexler, Joan Reisch, Cory M Pfeifer, Jason Ginos, Jerry Allen Powell, Jennifer Veltkamp, Alvin Anene, Neil Fernandes, Li Ern Chen
OBJECTIVES: To inform selective and efficient use of appendix ultrasound (US) beyond adult parameters of body mass index (BMI) of less than 25 kg/m, we correlate abdominal wall thickness (AWT) with age and BMI to generate parameters for male and female children. Information presented in chart format can aid in the decision to utilize US for the evaluation of appendicitis. METHODS: In this observational study, 1600 pediatric computed tomography scans of the abdomen and pelvis were analyzed to obtain measurements of AWT in the right lower quadrant...
November 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29103787/a-prospective-same-day-discharge-protocol-for-pediatric-appendicitis-adding-value-to-a-common-surgical-condition
#8
Yangyang R Yu, Carolyn M Smith, Kimberly K Ceyanes, Bindi J Naik-Mathuria, Sohail R Shah, Adam M Vogel, Kathleen E Carberry, Jed G Nuchtern, Monica E Lopez
PURPOSE: Standardized clinical pathways for simple appendicitis decrease length of stay and result in cost savings. We performed a prospective cohort study to assess a same day discharge (SDD) protocol for children with simple appendicitis. METHODS: All children undergoing laparoscopic appendectomy for simple appendicitis after protocol implementation (February 2016 to January 2017) were assessed. Length of stay (LOS), 30-day resource utilization (ED visits and hospital readmissions), patient satisfaction, and hospital accounting costs for SDD were compared to non-SDD patients...
October 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29103784/expanding-the-inclusion-criteria-for-nonoperative-management-of-uncomplicated-appendicitis-outcomes-and-cost
#9
Steven L Lee, Lara Spence, Kyle Mock, James X Wu, Huan Yan, Daniel A DeUgarte
BACKGROUND: Carefully selected children with early appendicitis may be managed nonoperatively. However, it is unknown whether nonoperative management (NOM) is applicable to all patients with uncomplicated appendicitis. The purpose of this study was to evaluate the outcomes of NOM of uncomplicated appendicitis with expanded inclusion criteria. METHODS: A prospective, nonrandomized patient-preference study comparing NOM versus laparoscopic appendectomy (LA) was performed in children with radiographic/clinical evidence of uncomplicated appendicitis...
October 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29066523/non-operative-management-of-appendicitis-in-children
#10
REVIEW
Nigel J Hall, Simon Eaton
While appendicectomy has been considered the mainstay of treatment for children with acute appendicitis for many decades, there has been a great deal of recent interest in non-operative treatment (NOT) with antibiotics alone. Initial results suggest that many children with appendicitis can indeed be safely treated with NOT and can be spared the surgeon's knife. Many as yet unanswered questions remain, however, before NOT can be considered a realistic and reliable alternative to surgery. This review summaries current knowledge and understanding of the role of NOT in children with appendicitis and outlines and discusses the outstanding knowledge gaps...
October 24, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29064344/low-infection-related-re-admission-rates-in-a-retrospective-of-4725-children-with-appendicitis-using-a-clinical-pathway-in-a-tertiary-care-pediatric-center
#11
Nikolas E Marino, Kate Davenport, Mary Hilfiker, Simone Langness, Timothy Fairbanks, Erin Stucky Fisher, Robert Newbury, Allyson Andrews, Alan Wells, Juan D Chaparro, John S Bradley
BACKGROUND: Standardization of antibiotic management of appendicitis in tertiary care pediatric centers has been associated with improved outcomes. Rady Children's Hospital-San Diego implemented an appendicitis clinical pathway in 2005. We evaluated infection-related re-admission risk factors since 2010, when an electronic medical record was established, with the aim to optimize the clinical pathway. METHODS: Between January 2010 and August 2015, 4725 children with a diagnosis of appendicitis were evaluated for demographic data, pathology diagnoses, culture results, and inpatient and oral step-down antibiotic therapy regimens...
October 24, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29044790/acute-appendicitis
#12
REVIEW
Mark D Stringer
Acute appendicitis is the most common reason for abdominal surgery in children. Luminal obstruction of the appendix progresses to suppurative inflammation and perforation, which causes generalised peritonitis or an appendix mass/abscess. Classical features include periumbilical pain that migrates to the right iliac fossa, anorexia, fever, and tenderness and guarding in the right iliac fossa. Atypical presentations are particularly common in preschool children. A clinical diagnosis is possible in most cases, after a period of active observation if necessary; inflammatory markers and an ultrasound scan are useful investigations when the diagnosis is uncertain...
October 17, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29032983/early-versus-late-surgical-management-of-complicated-appendicitis-in-children-a-statewide-database-analysis-with-one-year-follow-up
#13
Saurabh Saluja, Tianyi Sun, Jialin Mao, Shaun A Steigman, P Stephen Oh, Heather L Yeo, Art Sedrakyan, Demetri J Merianos
BACKGROUND: Complicated appendicitis is common in children, yet the timing of surgical management remains controversial. Some support initial antibiotics with delayed operation whereas others support immediate operation. While a few randomized trials have evaluated this question, they have been small, single-center trials with limited follow-up. We present a database analysis of outcomes in early versus late surgical management of complicated appendicitis with one-year follow-up. METHODS: We conducted a retrospective review of children with complicated appendicitis presenting between 2000 and 2013, utilizing a New York State database...
October 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29016242/early-predictors-of-abscess-development-after-perforated-pediatric-appendicitis
#14
Catherine M Dickinson, Nathan A Coppersmith, Francois I Luks
BACKGROUND: Approximately one-third of children with appendicitis present with advanced disease or perforation. Whereas this increases the risk for post-operative complications and re-admission, it is not yet possible to predict early on who will develop an abdominal abscess. We sought to identify specific risk factors for this complication, in an attempt to streamline post-operative care. PATIENTS AND METHODS: We reviewed the records of all cases of perforated appendicitis over a 12-month period at a tertiary children's hospital...
October 10, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28988188/enterobius-vermicularis-pinworm-infestation-in-a-child-presenting-with-symptoms-of-acute-appendicitis-a-wriggly-tale
#15
Louise Dunphy, Zoe Clark, Mazhar H Raja
Acute appendicitis is the most common surgical emergency worldwide. However, it can still present a challenging diagnosis especially in the young, elderly and those individuals of reproductive age, thus encompassing a wide spectrum of varied clinical presentations. Parasitic infections of the appendix are a rare cause of acute appendicitis. However, they must be considered in children presenting with abdominal pain. We report a case of Enterobius vermicularis infestation mimicking the features of acute appendicitis in a 10-year-old girl...
October 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28985855/safety-of-perioperative-ketorolac-administration-in-pediatric-appendectomy
#16
Hibbut-Ur-Rauf Naseem, Robert Michael Dorman, George Ventro, David H Rothstein, Kaveh Vali
BACKGROUND: Recent studies in adults undergoing gastrointestinal surgeries show an increased rate of complications with the use of ketorolac. This calls into question the safety of ketorolac in certain procedures. We sought to evaluate the impact of perioperative ketorolac administration on outcomes in pediatric appendectomy. METHODS: The Pediatric Health Information System database was queried for patients aged 5-17 y with a primary diagnosis of appendicitis and a primary procedure of appendectomy during the period 2010-2014...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28963916/case-based-simulation-in-mri-for-suspected-appendicitis-in-children
#17
Hansel J Otero, Anilawan Smitthimedhin, Crystal C Wang, Mark D Heitzmann
PURPOSE: To establish the effect on diagnostic confidence of a simulation setting, in which radiologists re-interpret anonymized pediatric MRI cases. MATERIALS: In this IRB-approved study, participants completed surveys rating confidence before and after interpreting 10 MRI cases for suspected appendicitis in children. RESULTS: 18 radiologists (4 faculty, 5 fellows, and 9 residents) correctly identified an average of 7.44 cases (range 5-9)...
September 22, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28958280/differences-in-the-management-of-perforated-appendicitis-in-children-by-race-and-insurance-status
#18
Randi L Lassiter, Robyn M Hatley
This study was conducted to assess whether race and socioeconomic status influence the management method used to treat pediatric perforated appendicitis. Nonelective pediatric admissions with a primary diagnosis of appendicitis were analyzed using data from the 2001-2010 Nationwide Inpatient Sample. Bivariate and multivariate analyses were used to determine the association between race, insurance status, median household income, rural/metropolitan location, and the risk adjusted odds of undergoing surgery, laparoscopic appendectomy, percutaneous drainage, or neither surgery nor percutaneous drainage...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28952357/nonoperative-management-of-appendicitis
#19
Andrew Scott, Steven L Lee, Daniel A DeUgarte, Stephen B Shew, James C Y Dunn, Shant Shekherdimian
We evaluated the outcomes for nonoperative management (NOM) of all children with suspected nonperforated appendicitis, including those patients with an appendicolith. Parents of all children with suspected nonperforated appendicitis were offered NOM versus laparoscopic appendectomy. NOM included administration of intravenous antibiotics and hospital admission. If no improvement within 24 hours, laparoscopic appendectomy was performed. Primary outcomes were initial success rate and recurrence rate. Fifty patients selected NOM...
March 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28951011/biomarkers-to-estimate-the-probability-of-complicated-appendicitis
#20
Meghan C Daly, Daniel von Allmen, Hector R Wong
BACKGROUND: The conventional paradigm that all children with appendicitis require an appendectomy is being challenged by the idea that some patients may be successfully managed non-operatively. The study aimed to determine if matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinase (TIMPs) are candidate biomarkers for estimating the probability of complicated appendicitis in pediatric patients. METHODS: The study was a single-institution, prospective cohort study...
September 9, 2017: Journal of Pediatric Surgery
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