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appendicitis, timing of treatment

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https://www.readbyqxmd.com/read/29217323/noninvasive-monitoring-of-physiologic-compromise-in-acute-appendicitis-new-insight-into-an-old-disease
#1
Young Mee Choi, David Leopold, Kristen Campbell, Jane Mulligan, Greg Z Grudic, Steven L Moulton
INTRODUCTION: Physiologic compromise in children with acute appendicitis has heretofore been difficult to measure. We hypothesized that the Compensatory Reserve Index (CRI), a novel adjunctive cardiovascular status indicator, would be low for children presenting with acute appendicitis in proportion to their physiological compromise, and that CRI would rise with fluid resuscitation and surgical management of their disease. METHODS: Ninety-four children diagnosed with acute appendicitis were monitored with a CipherOx CRI™ M1 pulse oximeter (Flashback Technologies Inc...
November 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29180169/sarcopenia-in-children-with-perforated-appendicitis
#2
Joseph J López, Jennifer N Cooper, Brett Albert, Brent Adler, Denis King, Peter C Minneci
BACKGROUND: Decreased skeletal muscle mass, or sarcopenia, has been shown to be associated with worse postoperative recovery and a higher risk of complications in adult surgical patients. We hypothesized that pediatric patients with complicated appendicitis may experience sarcopenic changes over the course of their treatment. METHODS: The medical records and computed tomography scans of 36 pediatric complex appendicitis patients who had both preoperative and postoperative computerized tomography scans at our hospital were reviewed...
December 2017: Journal of Surgical Research
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
#3
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/29019885/two-incision-laparoscopic-appendectomy-for-a-severe-hemophilia-a-child-patient-with-coagulation-factor-vii-deficiency-case-report-and-review-of-literature
#4
Jin Peng He, Jie Xiong Feng
RATIONALE: The main complication of patients with severe hemophilia is recurrent bleeding events that usually affected musculoskeletal contractures. And replacement therapy methods were continuously improved to minimize adverse impacts brought by those complications. However, only several cases reported about the appendectomy for hemophilia A. We report a case of acute appendicitis treated by two-incision laparoscopy in a boy with hemophilia A and coagulation factor VII deficiency for the first time...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29016242/early-predictors-of-abscess-development-after-perforated-pediatric-appendicitis
#5
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/28941724/operative-versus-non-operative-management-in-the-care-of-patients-with-complicated-appendicitis
#6
Thomas S Helling, Douglas F Soltys, Samantha Seals
BACKGROUND: The approach to complicated appendicitis is unclear. We have sought to determine factors which may persuade surgeons to non-operative management and whether such treatment affects outcome. METHODS: All adult patients admitted over a five-year period 2009-2014 with a diagnosis of appendicitis were reviewed. Patients were grouped into uncomplicated and complicated presentations and stratified by age, gender, ethnicity, socio-economic status, and time to presentation...
September 18, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28940383/immunoproteasome-in-the-blood-plasma-of-children-with-acute-appendicitis-and-its-correlation-with-proteasome-and-uchl1-measured-by-spr-imaging-biosensors
#7
E Matuszczak, A Sankiewicz, W Debek, E Gorodkiewicz, R Milewski, A Hermanowicz
The aim of this study was to determinate the immunoproteasome concentration in the blood plasma of children with appendicitis, and its correlation with circulating proteasome and ubiquitin carboxyl-terminal hydrolase L1 (UCHL1). Twenty-seven children with acute appendicitis, managed at the Paediatric Surgery Department, were included randomly into the study (age 2 years 9 months up to 14 years, mean age 9·5 ± 1 years). There were 10 girls and 17 boys; 18 healthy, age-matched subjects, admitted for planned surgeries served as controls...
September 23, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28935397/standardization-of-care-for-pediatric-perforated-appendicitis-improves-outcomes
#8
Yasmine Yousef, Fouad Youssef, Michael Homsy, Trish Dinh, Kartikey Pandya, Hayden Stagg, Robert Baird, Jean-Martin Laberge, Dan Poenaru, Pramod Puligandla, Kenneth Shaw, Sherif Emil
BACKGROUND: The treatment of perforated appendicitis in children is characterized by significant variability in care, morbidity, resource utilization, and outcomes. We prospectively studied how minimization of care variability affects outcomes. METHODS: A clinical pathway for perforated appendicitis, in use for three decades, was further standardized in May 2015 by initiation of a disease severity classification, refinement of discharge criteria, standardization of the operation, and establishment of criteria for use of postoperative total parenteral nutrition, imaging, and invasive procedures...
September 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28884300/what-every-radiologist-should-know-about-adnexal-torsion
#9
Guillaume Ssi-Yan-Kai, Anne-Laure Rivain, Caroline Trichot, Marie-Chantal Morcelet, Sophie Prevot, Xavier Deffieux, Jocelyne De Laveaucoupet
Adnexal torsion is the fifth most common gynecologic surgical emergency, requiring clinician and radiologist awareness. It involves the rotation of the ovarian tissue on its vascular pedicle leading to stromal edema, hemorrhagic infarction, and necrosis of the adnexal structures with the subsequent sequelae. Expedient diagnosis poses a difficult challenge because the clinical presentation is variable and often misleading. Adnexal torsion can mimic malignancy as it can take a subacute, intermittent, or chronic course, and thereby can be complicated to diagnose...
September 7, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28876621/the-absolute-number-of-repeat-operations-for-complex-intra-abdominal-sepsis-is-not-a-useful-predictor-of-non-survival
#10
M F Scriba, G L Laing, J L Bruce, D L Clarke
BACKGROUND: When multiple repeat laparotomies are required to manage intra-abdominal sepsis, questions about futility of treatment frequently arise. This study focuses specifically on patients who required two or more repeat laparotomies and describes the spectrum of disease necessitating multiple repeat laparotomies and the associated outcomes in the hope of clarifying the issue. METHOD: This study was conducted over a 20-month period (December 2012 - July 2014) at Greys Hospital in Pietermaritzburg, South Africa...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28812175/a-prospective-non-randomized-controlled-multicenter-trial-comparing-appendectomy-and-conservative-treatment-for-patients-with-uncomplicated-acute-appendicitis-the-actuaa-study
#11
Mauro Podda, Fernando Serventi, Lorenzo Mortola, Stefano Marini, Danilo Sirigu, Michela Piga, Marcello Pisano, Massimiliano Coppola, Ferdinando Agresta, Francesco Virdis, Salomone Di Saverio, Nicola Cillara
PURPOSE: Acute appendicitis (AA) is among the most common causes of lower abdominal pain and admissions to the emergency department. Over the past 20 years, there has been a renewed interest in the conservative management of uncomplicated AA, and several studies demonstrated that an antibiotic-first strategy is a viable treatment option for uncomplicated AA. The aim of this prospective non-randomized controlled, multicenter trial is to compare antibiotic therapy and emergency appendectomy as treatment for patients with uncomplicated AA confirmed by US and/or CT or MRI scan...
November 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28808675/acute-appendicitis-in-pregnancy-and-the-developing-world
#12
Tika Ram Bhandari, Sudha Shahi, Sarita Acharya
BACKGROUND: Acute appendicitis is the commonest nonobstetric surgical emergency during pregnancy. The aim of the study was to compare perioperative outcomes of acute appendicitis in pregnant and nonpregnant patients. METHODS: A retrospective review of medical records of 56 pregnant patients between 2011 and 2016 who were compared with 164 nonpregnant women of reproductive age who underwent open appendectomy between 2014 and 2016 for acute appendicitis. The patient's demographics and perioperative data were analyzed...
2017: International Scholarly Research Notices
https://www.readbyqxmd.com/read/28796014/comparison-of-superficial-surgical-site-infection-between-delayed-primary-versus-primary-wound-closure-in-complicated-appendicitis-a-randomized-controlled-trial
#13
Boonying Siribumrungwong, Anuwat Chantip, Pinit Noorit, Chumpon Wilasrusmee, Winai Ungpinitpong, Pradya Chotiya, Borwornsom Leerapan, Patarawan Woratanarat, Mark McEvoy, John Attia, Ammarin Thakkinstian
OBJECTIVE: To compare superficial surgical site infection (SSI) rates between delayed primary wound closure (DPC) and primary wound closure (PC) for complicated appendicitis. BACKGROUND: SSI is common in appendectomy for complicated appendicitis. DPC is preferentially used over PC, but its efficacy is still controversial. METHODS: A multicenter randomized controlled trial was conducted in 6 hospitals in Thailand, enrolling patients with gangrenous and ruptured appendicitis...
August 4, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28780543/electroacupuncture-to-alleviate-postoperative-pain-after-a-laparoscopic-appendectomy-study-protocol-for-a-three-arm-randomised-controlled-trial
#14
Seunghoon Lee, Dongwoo Nam, Minsoo Kwon, Won Seo Park, Sun Jin Park
BACKGROUND: The purpose of this study is to evaluate the efficacy and safety of electroacupuncture (EA) for postoperative pain after laparoscopic appendectomy compared with sham electroacupuncture (SEA) and no acupuncture treatment. METHODS AND ANALYSIS: This study is a protocol for a three-arm, randomised, patient-assessor-blinded (to the type of acupuncture treatment), controlled, parallel trial. 138 participants diagnosed with appendicitis and scheduled for laparoscopic appendectomy will be randomly assigned to the EA group (n=46), SEA group (n=46) or control group (n=46)...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28752336/acute-appendicitis-in-children-can-surgery-be-postponed-short-term-results-in-a-cohort-of-225-children
#15
Clemens-Magnus Meier, Helge Latz, Jens Kraemer, Stefan Wagenpfeil, Stefan Graeber, Matthias Glanemann, Arne Simon
PURPOSE: To our knowledge, there is no German study, which has examined the relationship between a postponement of surgery (from emergency service to standard working time) and the corresponding risk of postoperative complications in children and adolescents with acute appendicitis. The aim of this study is to examine if surgery of acute appendicitis in childhood can be postponed from night shift to the next working day without negative effects for the patient. METHODS: In a retrospective analysis (September 2001 to June 2007), the files of 225 paediatric surgical patients with acute appendicitis have been analysed concerning history, histology, course of treatment and development of complications...
July 27, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28677879/economic-evaluation-of-antibiotic-therapy-versus-appendicectomy-for-the-treatment-of-uncomplicated-acute-appendicitis-from-the-appac-randomized-clinical-trial
#16
RANDOMIZED CONTROLLED TRIAL
S Sippola, J Grönroos, R Tuominen, H Paajanen, T Rautio, P Nordström, M Aarnio, T Rantanen, S Hurme, P Salminen
BACKGROUND: An increasing amount of evidence supports antibiotic therapy for treating uncomplicated acute appendicitis. The objective of this study was to compare the costs of antibiotics alone versus appendicectomy in treating uncomplicated acute appendicitis within the randomized controlled APPAC (APPendicitis ACuta) trial. METHODS: The APPAC multicentre, non-inferiority RCT was conducted on patients with CT-confirmed uncomplicated acute appendicitis. Patients were assigned randomly to appendicectomy or antibiotic treatment...
September 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28673696/appendicitis-following-blunt-abdominal-trauma
#17
Travis Cobb
Appendicitis is a frequently encountered surgical problem in the Emergency Department (ED). Appendicitis typically results from obstruction of the appendiceal lumen, although trauma has been reported as an infrequent cause of acute appendicitis. Intestinal injury and hollow viscus injury following blunt abdominal trauma are well reported in the literature but traumatic appendicitis is much less common. The pathophysiology is uncertain but likely results from several mechanisms, either in isolation or combination...
September 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28657380/non-specific-abdominal-pain-remains-as-the-most-common-reason-for-acute-abdomen-26-year-retrospective-audit-in-one-emergency-unit
#18
Anne Fagerström, Paavo Paajanen, Heidi Saarelainen, Mirella Ahonen-Siirtola, Mika Ukkonen, Pekka Miettinen, Hannu Paajanen
OBJECTIVE: Distribution of diagnoses causing acute abdominal pain (AAP) may change because of population aging, increased obesity, advanced diagnostic imaging and changes in nutritional habits. Our aim was to evaluate the diagnoses causing AAP during a 26-year period. MATERIALS AND METHODS: This was a retrospective cross-sectional cohort study in one emergency department (ED) covering population about 250,000. All patients admitted to the ED in 1986, 2003 and 2012 were evaluated from hospital electronic database...
June 28, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28649377/a-bibliometric-analysis-of-the-citation-classics-of-acute-appendicitis
#19
REVIEW
Manvydas Varzgalis, Dermot J Bowden, Ciaran K Mc Donald, Michael J Kerin
INTRODUCTION: Acute appendicitis is one of the most commonly encountered emergency surgical conditions. An understanding of the most highly cited research works in this field is key to good evidence based clinical practice. AIMS: To perform a bibliometric analysis on the 100 most frequently cited articles in the field of acute appendicitis. METHODS: The database of the Institute for Scientific Information (ISI) Web of Science Expanded citation index was searched to identify the 100 most frequently cited articles in the field of acute appendicitis...
July 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28631985/effect-of-a-standardized-protocol-of-antibiotic-therapy-on-surgical-site-infection-after-laparoscopic-surgery-for-complicated-appendicitis
#20
Hyoung-Chul Park, Min Jeong Kim, Bong Hwa Lee
BACKGROUND: Although it is accepted that complicated appendicitis requires antibiotic therapy to prevent post-operative surgical infections, consensus protocols on the duration and regimens of treatment are not well established. This study aimed to compare the outcome of post-operative infectious complications in patients receiving old non-standardized and new standard antibiotic protocols, involving either 5 or 10 days of treatment, respectively. METHODS: We enrolled 1,343 patients who underwent laparoscopic surgery for complicated appendicitis between January 2009 and December 2014...
August 2017: Surgical Infections
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