A feasibility randomised controlled trial to evaluate the role of computed tomography in adults with atypical right iliac fossa pain.

CONCLUSION: A large randomised trial to evaluate the use of unenhanced computed tomography in atypical right iliac fossa pain appears feasible and justified. PMID: 31219315 [PubMed - as supplied by publisher]
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research

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By STEPHEN BORSTELMANN, MD Occasionally, you get handed a question you know little about, but it’s clear you need to know more.  Like most of us these days, I was chatting with my colleagues about the novel coronavirus. It goes by several names: SARS-CoV-2, 2019-nCoV or COVID-19 but I’ll just call it COVID.  Declared a pandemic on March 12, 2020 by the World Health Organization (WHO), COVID is diagnosed by laboratory test – PCR.  The early PCR test used in Wuhan was apparently low sensitivity (30-60%), lengthy to run (days), and in short supply.  As CT scanning was relatively availa...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: COVID-19 Hospitals Medical Practice Physicians coronavirus CT scans Imaging infecton control Pandemic Radiology Stephen Borstelmann Source Type: blogs
The ability to sense visceral pain during appendicitis is diminished with age leading to delay in seeking health care and poorer clinical outcomes. To understand the mechanistic basis of this phenomenon, we examined visceral nociception in aged mouse and human tissue. Inflamed and noninflamed appendixes were collected from consenting patients undergoing surgery for the treatment of appendicitis or bowel cancer. Supernatants were generated by incubating samples in buffer and used to stimulate multiunit activity in intestinal preparations, or single-unit activity from teased fibres in colonic preparations, of young and old m...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
ConclusionOur proof-of-concept study demonstrated the diagnostic potential of saliva LRG for appendicitis in children. The distinct advantage of saliva LRG assays is that the procedure is simple, pain-free, and requires no specialized skill. Further study with a larger cohort is needed to verify our results.
Source: Pediatric Surgery International - Category: Surgery Source Type: research
Authors: Guaitoli E, Gallo G, Cardone E, Conti L, Famularo S, Formisano G, Galli F, Giuliani G, Martino A, Pasculli A, Patini R, Soriero D, Pappalardo V, Casoni Pattacini G, Sparavigna M, Meniconi R, Mazzari A, Barra F, Orsenigo E, Pertile D Abstract Background: Acute appendicitis (AA) is one of the most common causes of abdominal pain requiring surgical intervention. Approximately 20% of AA cases are characterized by complications such as gangrene, abscesses, perforation, or diffuse peritonitis, which increase patients' morbidity and mortality. Diagnosis of AA can be difficult, and evaluation of clinical signs, la...
Source: Journal of Investigative Surgery - Category: Surgery Tags: J Invest Surg Source Type: research
Journal of Gynecologic Surgery, Ahead of Print.
Source: Journal of Gynecologic Surgery - Category: OBGYN Authors: Source Type: research
A 17-year-old boy presented with a 6-day history of abdominal pain and fever. Physical examination revealed an ill-looking patient with right lumbar/flank abdominal pain and minimal tenderness. Laboratory results showed leukocytosis (C-reactive protein, 236 mg/L). Urinalysis had no abnormalities. Ultrasound demonstrated a 4-cm collection contiguous to the upper pole of the right kidney. Computed tomography (Fig 1) revealed an air-fluid collection in the perinephric space (arrows) with 2 calcified images (appendicoliths, arrowheads), the upper one within the renal fascia; the kidney exhibited normal parenchyma.
Source: Surgery - Category: Surgery Authors: Source Type: research
T, Tez M Abstract BACKGROUND: Acute appendicitis (AA) is one of the major causes of acute abdomen pain. Various laboratory markers have been studied for diagnosis of AA, but none of them have shown superiority to physical examination or imaging. GCP-2/CXCL6 is a chemokine expressed by macrophages and epithelial and mesenchymal cells during inflammation. The present study aims to investigate the diagnostic role of GCP-2/CXCL6 in AA patients. METHODS: In this cross-sectional study, the serum level of GCP-2/CXCL6 was measured in 56 AA patients and 32 healthy control subjects. Also, hs-CRP and white blood cell c...
Source: Turkish Journal of Trauma and Emergency Surgery : TJTES - Category: Emergency Medicine Authors: Tags: Ulus Travma Acil Cerrahi Derg Source Type: research
Although acute appendicitis (AA) is one of the commonest causes of right lower quadrant abdominal pain (RLQP), there are numerous other conditions in the abdomen and pelvis that can simulate the clinical presentation of AA for which imaging is essential in detection. We discuss the approach to evaluation of patients presenting with acute onset RLQP and the choice of various imaging modalities that can be utilized. Although CT remains the workhorse in evaluation, US and MRI, given lack of radiation, play an important ancillary role, particularly in the pediatric and pregnant patients.
Source: Clinical Imaging - Category: Radiology Authors: Tags: Body Imaging Source Type: research
ConclusionsThe triple inflammatory markers have limited diagnostic value when interpreted individually, but are strong discriminators of pediatric appendicitis when combined. Their high sensitivity and negative predictive value could potentially help patients avoid unnecessary admissions or costly imaging studies, and reduce negative appendectomy rates. In addition, their objective nature confers an advantage over existing clinical scoring systems which comprise subjective elements.
Source: Pediatric Surgery International - Category: Surgery Source Type: research
The objective of this study was to evaluate whether early administration of ORC in children with abdominal pain receiving abdominal CT for possible appendicitis obscures subsequent abdominal US image quality.Methods: We designed a prospective observational study of children
Source: Western Journal of Emergency Medicine - Category: Emergency Medicine Source Type: research
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