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appendicitis, timing of treatment

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https://www.readbyqxmd.com/read/28538626/the-capacity-of-icd-10-cm-pcs-to-characterize-surgical-care
#1
Garth H Utter, Kevin M Schuster, Preston R Miller, Nathan T Mowery, Suresh K Agarwal, Robert J Winchell, Marie L Crandall
The International Classification of Diseases, 10th edition, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS) have been in effect since October 1, 2015 and offer much greater capacity than previous classifications to characterize the nature and treatment of surgical conditions. However, the diagnosis codes of ICD-10-CM are unevenly specific across the spectrum of surgical conditions and currently do not adequately allow description of important distinctions in disease severity for many common surgical conditions...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28528712/timing-of-antimicrobial-prophylaxis-and-infectious-complications-in-pediatric-patients-undergoing-appendectomy
#2
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/28515697/trpa1-channels-modify-trpv1-mediated-current-responses-in-dorsal-root-ganglion-neurons
#3
Takayoshi Masuoka, Makiko Kudo, Yuka Yamashita, Junko Yoshida, Noriko Imaizumi, Ikunobu Muramatsu, Matomo Nishio, Takaharu Ishibashi
The transient receptor potential vanilloid 1 (TRPV1) channel is highly expressed in a subset of sensory neurons in the dorsal root ganglia (DRG) and trigeminal ganglia of experimental animals, responsible for nociception. Many researches have revealed that some TRPV1-positive neurons co-express the transient receptor potential ankyrin 1 (TRPA1) channel whose activities are closely modulated by TRPV1 channel. However, it is less investigated whether the activities of TRPV1 channel are modulated by the presence of TRPA1 channel in primary sensory neurons...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28494476/effect-of-the-shorter-stays-in-emergency-departments-time-target-policy-on-key-indicators-of-quality-of-care
#4
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/28433247/outpatient-laparoscopic-appendectomy-feasible-in-a-public-county-hospital
#5
David R Rosen, Kenji Inaba, Paul J Oh, Adam C Gutierrez, Aaron M Strumwasser, Subarna Biswas, Melody Cala, Glenn T Ault
BACKGROUND: Outpatient laparoscopic appendectomy is being used increasingly as a treatment option for acute, uncomplicated appendicitis. This was a prospective validation study in a large, urban, public safety-net hospital. STUDY DESIGN: From 2014 to 2016, all patients undergoing laparoscopic appendectomy for acute, uncomplicated appendicitis were enrolled in a prospective observational trial. Standard baseline perioperative practice (control group) was documented for 1 year...
March 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28423177/comparison-of-appendectomy-outcomes-between-senior-general-surgeons-and-general-surgery-residents
#6
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/28409666/evaluating-the-feasibility-of-single-incision-laparoscopic-appendectomy-performed-by-a-resident-based-on-propensity-score-matching
#7
Sung Min Lee, Dong Jin Park, Jong Hee Yoon, Soon Young Tae, Song Soo Yang, Yeong Cheol Im
PURPOSE: Conventional laparoscopic appendectomy (CLA) has been considered the standard for the treatment of acute appendicitis. Recently, single incision laparoscopic appendectomy (SILA) has become an alternative option. There are few reports on the results of SILA performed by residents during the training period. The present study, we report our residents' experience. MATERIALS AND METHODS: We reviewed clinical characteristics and outcomes of 1005 patients who underwent appendectomy between October 2013 and April 2016...
April 14, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28347529/resource-savings-and-outcomes-associated-with-outpatient-laparoscopic-appendectomy-for-nonperforated-appendicitis
#8
Lori A Gurien, Jeffrey M Burford, Patrick C Bonasso, Melvin S Dassinger
BACKGROUND: Postoperative admission for acute appendicitis utilizes health care system resources. We evaluated outcomes and hospital charges for children with nonperforated appendicitis who underwent outpatient laparoscopic appendectomy. METHODS: A retrospective chart review was performed for patients ≤18years old who underwent laparoscopic appendectomy for acute appendicitis in 2015. Patients were categorized into discharge from postanesthesia care unit (PACU) (outpatient), admission for <24-h, and admission for >24-h...
March 19, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28341916/long-term-results-following-antibiotic-treatment-of-acute-appendicitis-in-adults
#9
K Lundholm, J Hansson-Assarsson, C Engström, B-M Iresjö
BACKGROUND: Antibiotic treatment of acute appendicitis has gained interest and inquiries. Reports have demonstrated both safety and high resolution of symptoms and inflammation following antibiotic treatment of appendicitis, but information on long-term results is required. Our present aim was therefore to evaluate long-term recurrence rate of initial antibiotics-alone treatment for suspected acute appendicitis. METHODS: Patients with favourable response to antibiotics in earlier randomized (RCT, n = 97) and population-based (PBT, n = 342) studies as well as subsequently treated non-randomized (Non-R, n = 271) patients are evaluated for long-term risk to relapse demanding surgical appendectomy; altogether 710 patients...
March 24, 2017: World Journal of 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
#10
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/28276643/single-incision-versus-conventional-three-incision-laparoscopic-appendectomy-a-meta-analysis-of-randomized-controlled-trials
#11
Li-Hui Deng, Jun-Jie Xiong, Qing Xia
BACKGROUND: Conventional three-incision laparoscopic appendectomy (CTLA) is considered the new golden standard for the treatment of acute appendicitis. However, single-incision laparoscopic appendectomy (SILA) can further reduce the number of abdominal incisions and visible scars. METHODS: Major databases were researched for randomized clinical trials (RCTs) comparing SILA and CTLA for acute appendicitis from January 1983 and to March 2015. The technical feasibility, effectiveness, and safety between SILA and CTLA were compared...
November 15, 2016: Journal of Evidence-based Medicine
https://www.readbyqxmd.com/read/28214369/diagnostic-accuracy-of-history-physical-examination-laboratory-tests-and-point-of-care-ultrasound-for-pediatric-acute-appendicitis-in-the-emergency-department-a-systematic-review-and-meta-analysis
#12
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: The aim of this study was to determine the utility of history, physical examination, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients...
May 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28119094/regenerative-treatment-for-tympanic-membrane-perforation-using-gelatin-sponge-with-basic-fibroblast-growth-factor
#13
Kaoru Omae, Shin-Ichi Kanemaru, Eiji Nakatani, Hideaki Kaneda, Tsutomu Nishimura, Risa Tona, Yasushi Naito, Atsuhiko Kawamoto, Masanori Fukushima
OBJECTIVE: The objective of this study was to evaluate safety and efficacy of regenerative treatment using gelatin sponge with basic fibroblast growth factor (bFGF) in patients with tympanic membrane perforation (TMP). METHODS: The current study was a prospective, multicenter, open-label, single-arm, and exploratory clinical trial to evaluate the safety and efficacy of the TM regeneration procedure (TMRP). Myringotomy was used to mechanically disrupt the edge of the TMP, and a gelatin sponge immersed in bFGF was then placed over the perforation...
January 21, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28092251/-acute-appendicitis-surgical-and-non-surgical-treatment
#14
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/28074461/acute-appendicitis-during-pregnancy-case-series-of-20-pregnant-women
#15
İlker Murat Arer, Songül Alemdaroğlu, Hasan Yeşilağaç, Hakan Yabanoğlu
BACKGROUND: Acute appendicitis (AA) is the most common cause of acute abdomen during pregnancy. Most of the signs of appendicitis are also found during normal pregnancy period, however, and diagnosis of appendicitis during pregnancy remains challenging. The aim of the current study was to report our clinical experience of AA during pregnancy and investigate optimal management of this difficult situation. METHODS: Records of 20 pregnant women with diagnosis of AA who underwent appendectomy between 2005 and 2015 were included in this study...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
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/27974169/antibiotics-first-versus-surgery-for-appendicitis-a%C3%A2-us-pilot-randomized-controlled-trial-allowing-outpatient-antibiotic-management
#17
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/27880929/a-complicated-case-of-amyand-s-hernia-involving-a-perforated-appendix-and-its-management-using-minimally-invasive-laparoscopic-surgery-a-case-report
#18
Wisam Al-Ramli, Yahya Khodear, Muyiwa Aremu, Abdel Basset El-Sayed
INTRODUCTION: Amyand's hernia is a rare condition of inguinal hernia in which the appendix is incarcerated within the hernia sac through the internal ring. Complications include acute appendicitis and perforated appendicitis, which are rare in incidence, accounting for about 0.1% of cases.(1) These complications prove a diagnostic challenge due to their vague clinical presentation and atypical laboratory and radiological findings. Until recently, open appendectomy was the mainstay of treatment...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27846185/single-incision-laparoscopic-appendectomy-by-surgical-trainees
#19
Sang Gyun Suh, Hee Joo Sohn, Beom Gyu Kim, Joong-Min Park, Yoo-Shin Choi, Yong Keum Park, Seung Eun Lee
BACKGROUND: Single-incision laparoscopic appendectomy (SILA) is one of the most commonly performed single port surgeries in the world. However, there are few publications documenting a young resident's experience. The purpose of this study is to investigate clinical outcomes of SILA performed by a surgical trainee and to evaluate its feasibility and safety compared with conventional three-port laparoscopic appendectomy (TPLA) when performed by a surgical trainee and SILA by surgical staff...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27807602/management-treatment-and-outcomes-of-acute-appendicitis-in-an-elderly-population-a-single-center-experience
#20
O Cohen-Arazi, K Dabour, M Bala, A Haran, G Almogy
INTRODUCTION: Only 5-10% of cases of acute appendicitis (AA) are diagnosed above the age of 60 years. Complicated AA is more common in the elderly, who also have more comorbidities. The goals of this study were to describe our experience with elderly patients and identify predictors of increased morbidity. MATERIAL AND METHODS: Patients ≥65 years who were treated for AA between 2006 and 2013 were selected. The control consisted of patients aged 20-45 years, who were randomly selected from a pool of 900 patients...
November 2, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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