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https://www.readbyqxmd.com/read/28214369/diagnostic-accuracy-of-history-physical-exam-laboratory-tests-and-point-of-care-ultrasound-for-pediatric-acute-appendicitis-in-the-emergency-department-a-systematic-review-and-meta-analysis
#1
Roshanak Benabbas, Mark Hanna, Jay Shah, Richard Sinert
BACKGROUND: Acute appendicitis (AA) is the most common surgical emergency in children. Accurate and timely diagnosis is crucial but challenging due to atypical presentations and the inherent difficulty of obtaining a reliable history and physical examination in younger children. OBJECTIVES: To determine the utility of history, physical exam, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department-Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients...
February 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28213364/safety-and-antitumor-activity-of-apalutamide-arn-509-in-metastatic-castration-resistant-prostate-cancer-with-and-without-prior-abiraterone-acetate-and-prednisone
#2
Dana E Rathkopf, Emmanuel S Antonarakis, Neal D Shore, Ronald F Tutrone, Joshi J Alumkal, Charles J Ryan, Mansoor Saleh, Ralph J Hauke, Rajesh Bandekar, Edna Chow Maneval, Carla J de Boer, Margaret K Yu, Howard I Scher
PURPOSE: To evaluate the efficacy of apalutamide before or after treatment with abiraterone acetate and prednisone (AAP) in patients with progressive metastatic castration-resistant prostate cancer (mCRPC). EXPERIMENTAL DESIGN: Two cohorts were studied: AAP-naïve and post-AAP patients who had received ≥6 months of AAP. Patients had progressive mCRPC per rising prostate-specific antigen (PSA) and/or imaging, without prior chemotherapy exposure. All received apalutamide 240 mg/day...
February 17, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28212279/do-mothers-benefit-from-a-child-focused-cognitive-behavioral-treatment-cbt-for-childhood-functional-abdominal-pain-a-randomized-controlled-pilot-trial
#3
Claudia Calvano, Martina Groß, Petra Warschburger
While the efficacy of cognitive-behavioral treatment (CBT) approaches for childhood functional abdominal pain (FAP) is well-established for child outcomes, only a few studies have reported on parent-specific outcomes. This randomized controlled pilot trial analyzed effects of a group CBT on maternal variables (i.e., pain-related behavior, worries and self-efficacy, as well as general psychosocial strain). Methods: The sample constituted of 15 mothers in the intervention group (IG) and 14 mothers in the waitlist control group (WLC)...
February 15, 2017: Children
https://www.readbyqxmd.com/read/28211278/endoscopic-removal-of-multiple-sharp-gastro-duodenal-foreign-bodies
#4
Samuel Costa, Raquel Gonçalves, Carla Rolanda
A 45 years old female,with bipolar disorder,was brought to the Emergency Department with abdominal pain. The patient was hemodynamically stable,with no signs of respiratory distress. On abdominal examination she had pain in the upper quadrants,without peritoneal irritation. The successful endoscopic removal decreases if delayed approach, beyond 12 h, and sharp objects. Moreover in case of sharp objects, even if already into the stomach or duodenum, they should be retrieved endoscopically if it can be accomplished safely, because the risk of a complication during its natural exteriorization is as high as 35%...
February 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28210350/use-of-physician-in-triage-model-in-the-management-of-abdominal-pain-in-an-emergency-department-observation-unit
#5
John R Marshall, Robert Katzer, Shahram Lotfipour, Bharath Chakravarthy, Siri Shastry, Jessica Andrusaitis, Craig L Anderson, Erik D Barton
INTRODUCTION: Given the nationwide increase in emergency department (ED) visits it is of paramount importance for hospitals to find efficient ways to manage patient flow. The purpose of this study was to determine whether there is a significant difference in success rates, length of stay (LOS), and other demographic factors in two cohorts of patients admitted directly to an ED observation unit (EDOU) under an abdominal pain protocol by a physician in triage (bypassing the main ED) versus those admitted via the traditional pathway (evaluated and treated in the main ED prior to EDOU admission)...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28208932/spontaneous-rupture-of-the-main-pancreatic-duct-synchronous-with-a-multi-focal-microscopic-pancreatic-adenocarcinoma-a-case-report
#6
Shirly Shohat, Katerina Shulman, Boris Kessel, Oren Gal, Abdel Rauf Zeina
Pancreatic cancer is one of the most lethal types of malignant tumours, commonly diagnosed at an advanced stage. The only curative treatment for this fatal disease is surgery and early diagnosis is the key to a better outcome and prognosis. In this case report we present a 57-year-old woman presenting to the emergency room with abdominal pain and weight loss. Computer Tomography (CT) imaging showed a rupture of the main pancreatic duct and a peri-pancreatic fluid collection with no evidence of a pancreatic mass...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207574/laparoscopic-and-open-surgical-treatment-in-gastroduodenal-perforations-our-experience
#7
Rita Laforgia, Giovanni Balducci, Giuseppe Carbotta, Antonio Prestera, Maria Grazia Sederino, Giulia Casamassima, Marina Minafra, Pierluca Sallustio, Nicola Palasciano
INTRODUCTION: Peptic ulcer perforation (PPU) is a common surgical emergency and the mortality rate ranges 10% to 40%, especially in elderly patients. Laparoscopic repair achieved encouraging results. MATERIALS AND METHODS: We enrolled patients performing surgical repair for PPU from January 2007 to December 2015 in our surgical unit. The aim of this retrospective observational study was to compare the results of PPU laparoscopic repair with open technique. The following characteristics of patients were evaluated: age, sex and American Society of Anesthesiologists classification...
February 15, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28203466/idiopathic-renal-infarction-mimicking-appendicitis
#8
Marco Di Serafino, Rosa Severino, Chiara Gullotto, Francesco Lisanti, Enrico Scarano
Renal infarction is a rare cause of referral to the emergency department, with very low estimated incidence (0.004%-0.007%). Usually, it manifests in patients aged 60-70 with risk factors for thromboembolism, mostly related to heart disease, atrial fibrillation in particular. We report a case of idiopathic segmental renal infarction in a 38-year-old patient, presenting with acute abdominal pain with no previous known history or risk factors for thromboembolic diseases. Because of its aspecific clinical presentation, this condition can mimic more frequent pathologies including pyelonephritis, nephrolithiasis, or as in our case appendicitis...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28195246/cellular-fibroma-in-the-douglas-cavity-mimicking-a-malignant-neoplasia-fibroma-fibrosarcoma-or-mitotically-active-cellular-fibroma
#9
A Di Lorito, P Viola, S Rosini, G Lattanzio
INTRODUCTION: Ovarian fibroma is a benign stromal tumour composed of spindle/ovoid fibroblastic cells producing collagen. Approximally 10% of fibromas are densely cellular with small amount of collagen. In these cases, if mild nuclear atypia is present, they are best addressed as cellular fibroma. However cellular fibroma may show a greater mitotic activity and therefore they should be referred as mitotically active cellular fibromas. Mostly benign, it is necessary to differentiate them from malignant tumours such as fibrosarcomas...
March 2016: Pathologica
https://www.readbyqxmd.com/read/28194327/dysuria-an-uncommon-presentation-in-emergency-department-following-bladder-neck-disruption
#10
Ali Pourmand, Assya Abdallah, Hamid Shokoohi, Mindy Park, Marie White, Francis O'Connell
Prostate cancer is the most common life-threatening cancer diagnosed in men. Complications of prostatectomies vary and often include urinary incontinence, erectile dysfunction and pain, while other complications go unreported. While emergency physicians are already familiar with the more common post-operative complications presenting to their departments, including urinary retention, ileus, surgical site infections, venous thromboembolisms and urinary tract infections, they must have a high index of suspicion for rarer complications...
February 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28188511/non-occlusive-mesenteric-ischemia-localized-in-the-transverse-colon-a-case-report
#11
Koji Murono, Soichiro Ishihara, Kazushige Kawai, Manabu Kaneko, Kazuhito Sasaki, Koji Yasuda, Kensuke Otani, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Hiroaki Nozawa, Akimasa Hayashi, Tetsuo Ushiku, Masashi Fukayama, Toshiaki Watanabe
BACKGROUND: Non-occlusive mesenteric ischemia (NOMI) is ischemia of the mesentery that is caused by hypoperfusion or vasospasm without any thrombosis. NOMI is difficult to diagnose by physical examination alone. Although angiographic examination of the superior mesenteric artery (SMA) is the usual diagnostic method used, it is an invasive examination. Usually, a long range of the bowel becomes discontinuously necrotic in NOMI. Here, we report a rare case of NOMI localized in the transverse colon that was diagnosed by computed tomography (CT) angiography which is a minimally invasive examination...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28186860/traumatic-rib-injury-patterns-imaging-pitfalls-complications-and-treatment
#12
Brett S Talbot, Christopher P Gange, Apeksha Chaturvedi, Nina Klionsky, Susan K Hobbs, Abhishek Chaturvedi
The ribs are frequently affected by blunt or penetrating injury to the thorax. In the emergency department setting, it is vital for the interpreting radiologist to not only identify the presence of rib injuries but also alert the clinician about organ-specific injury, specific traumatic patterns, and acute rib trauma complications that require emergent attention. Rib injuries can be separated into specific morphologic fracture patterns that include stress, buckle, nondisplaced, displaced, segmental, and pathologic fractures...
February 10, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28183241/metronidazole-and-norfloxacin-induced-generalized-fixed-drug-eruptions-in-an-adult-male-patient-a-case-report
#13
Nidhi S Patel, Bhavesh C Chavada, Viren N Naik, Hiteshkumar N Patel, C B Tripathi
INTRODUCTION: Fluoroquinolones are most widely used for empirical treatment of gastrointestinal disease due to emergence of drug resistant strains to other antimicrobials. They are also indulged in cutaneous adverse drug reactions with varying form of severity. CASE PRESENTATION: A 43 year old male patient developed fixed drug eruptions after administration of tablet norfloxacin and metronidazole for treatment of colicky abdominal pain with diarrhoea. Erythematous rashes involved whole body including buccal mucosa...
February 9, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28181896/-a-woman-with-abdominal-pain-and-absence-of-defaecation
#14
E B Deerenberg, H El Addouli, J J B van Lanschot
A 62-years-old female presented to the Emergency Department with abdominal pain and absence of defaecation for two days. CT revealed an ileus with a change in the diameter of the small intestine and a segment without contrast in the intestinal wall. Laparotomy confirmed that a segment of the ileum was ischaemic.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28179982/spontaneous-biloma-due-to-an-intrahepatic-cholangiocarcinoma-an-extremely-rare-case-report-with-long-term-survival-and-literature-review
#15
Georgios K Georgiou, Athina Tsili, Anna Batistatou, Alexandra Papoudou-Bai, Georgios Papadopoulos, Michalis Fatouros, Georgios K Glantzounis
Cholangiocarcinomas are tumors that arise from the ductal epithelium of the intrahepatic or extra-hepatic bile ducts. Patients are usually asymptomatic or may present with weight loss, fatigue, loss of appetite and abdominal pain (intrahepatic cholangiocarcinomas) or jaundice (extra-hepatic cholangiocarcinomas). Subcapsular bile vessel rupture, due to intrahepatic cholangiocarcinoma, is an extremely rare clinical presentation, which is an emergent and potentially life-threatening complication. We report the case of a 79-year-old female patient suffering from an intrahepatic cholangiocarcinoma that completely obliterated the left main hepatic duct...
February 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28179200/laparoscopic-management-of-abdomininal-pregnancy
#16
Francesco Cosentino, Cristiano Rossitto, Luigi Carlo Turco, Salvatore Gueli Alletti, Carmine Vascone, Lavinia Di Meglio, Giovanni Scambia, Mario Malzoni
CASE REPORT OBJECTIVE: To show the surgical management in laparoscopy of a particular localization of an extra-uterine pregnancy misunderstood until 12 week of EG complicated by hemoperitoneum and abortion. BACKGROUND: The prevalence of ectopic pregnancy among women who go to an emergency department with first trimester bleeding, pain, or both ranges from 1 to 16 percent [1]. The most common localization of ectopic pregnancy are the Fallopian tubes while abdominal pregnancy represent at least 1 percent of extra-uterine pregnancies...
February 4, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28177973/monomicrobial-klebsiella-pneumoniae-necrotizing-fasciitis-with-liver-abscess-a-case-report-and-literature-review
#17
Ching-En Chen, Yu-Chung Shih
BACKGROUND: Necrotizing fasciitis is one of the most life-threatening soft tissue infections and usually follows a major or minor trauma. Published reports regarding single microorganism liver abscess caused by Klebsiella pneumoniae in Taiwan indicate a septic metastasis rate about 12%. Although a hematogenous origin of necrotizing fasciitis from a liver abscess is rare in Taiwan, it remains possible in our clinical practice. CASE PRESENTATION: A 75-year-old man with a history of diabetes and liver abscess had a status of postdrainage 5 years earlier...
February 8, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28174034/perihepatic-pulmonary-and-renal-abscesses-due%C3%A2-to%C3%A2-spilled-gallstones
#18
Jacob Lentz, Maria A Tobar, Caleb P Canders
BACKGROUND: Spilled gallstones are common during laparoscopic cholecystectomy; however, they rarely lead to postoperative complications. Perihepatic abscesses develop in < 0.1% of patients with spilled gallstones and are typically contained within the peritoneal cavity. CASE REPORT: We present a 57-year-old man with history of cholecystectomy 2 years prior who presented with cough and flank pain and was discovered to have a perihepatic abscess invading his lung and kidney secondary to a spilled gallstone...
February 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28171688/diagnostic-value-and-effect-of-bedside-ultrasound-in-acute-appendicitis-in-the-emergency-department
#19
Faruk Gungor, Taylan Kilic, Kamil Can Akyol, Gizem Ayaz, Umut Cengiz Cakir, Mehmet Akcimen, Cenker Eken
OBJECTIVE: Early and accurate diagnosis of acute appendicitis (AA) with ultrasound can minimize the morbidity and mortality of the patients. In this regard, ultrasound can help to the emergency physicians (EPs) in the diagnosing process and clinical decision making for AA. Therefore, we primarily aimed to evaluate the effectiveness of point of care ultrasound (POCUS) in clinical decision making of EPs for the diagnostic evaluation for AA in the emergency department (ED). METHODS: The study sample consisted of patients aged >18 years that presented to the ED with an abdominal pain and underwent diagnostic evaluation for AA...
February 7, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28166589/gastrointestinal-basidiobolomycosis-an-emerging-and-a-confusing-disease-in-children-a-multicenter-experience
#20
Khalid Shreef, Mervat Saleem, Mayssa Adballah Saeedd, Mohamed Eissa
Introduction Gastrointestinal basidiobolomycosis (GIB) is an emerging fungal infection in children that leads to diagnostic confusion. Aim Our study aim was twofold: a systematic review of published literature and an update of some Saudi Arabia hospital series to analyze their as well as our own experience in diagnosis and management of GIB. Material and Methods This clinical study included 18 children whose final diagnosis was GIB. The patients, who ranged in age from 5 to 10 years, were admitted between November 2009 and November 2015 with vague abdominal pains with or without abdominal masses for further investigation...
February 6, 2017: European Journal of Pediatric Surgery
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