MedWorm: Appendicitis

Importance of Histologic Subtype in the Staging of Appendiceal Tumors

Annals of Surgical Oncology — Fri, 03 Feb 2012 07:21:18 +0100

Conclusions Histologic subtype is an important predictor of disease-specific survival and overall survival in patients with appendiceal neoplasms. Addition of the histologic subtype to the TNM staging is simple and may improve prognostication. Content Type Journal ArticleCategory Regional Cancer TherapiesPages 1-7DOI 10.1245/s10434-012-2238-1Authors Kiran K. Turaga, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USASam G. Pappas, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USAT. Clark Gamblin, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA Journal Annals of Surgical OncologyOnline ISSN 1534-4681Print ISSN 1068-9265 (Source: Annals of Surgical Oncology)

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Combined Diffusion-Weighted and Gadolinium-Enhanced MRI Can Accurately Predict the Peritoneal Cancer Index Preoperatively in Patients Being Considered for Cytoreductive Surgical Procedures

Annals of Surgical Oncology — Fri, 03 Feb 2012 07:21:17 +0100

Conclusions Combined diffusion-weighted and gadolinium-enhanced peritoneal MRI accurately predicts the PCI before surgery in patients undergoing evaluation for cytoreductive surgery. Content Type Journal ArticleCategory Regional Cancer TherapiesPages 1-8DOI 10.1245/s10434-012-2236-3Authors Russell N. Low, Department of Radiology, Sharp Memorial Hospital, San Diego, CA, USARobert M. Barone, Department of Surgical Oncology, Sharp Memorial Hospital, San Diego, CA, USA Journal Annals of Surgical OncologyOnline ISSN 1534-4681Print ISSN 1068-9265 (Source: Annals of Surgical Oncology)

Increased levels of deleted in malignant brain tumours 1 (DMBT1) in active bacteria‐related appendicitis

Histopathology — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Our data demonstrate that bacteria‐related active inflammation results in a sharp increase of DMBT1 levels in enterocytes. These findings substantiate the view that DMBT1 is of functional relevance for host defence and modulation of the course of intestinal bacteria‐related inflammatory responses. (Source: Histopathology)

Fusobacterium nucleatum infection is prevalent in human colorectal carcinoma [RESEARCH]

Genome Research — Wed, 01 Feb 2012 05:00:00 +0100

An estimated 15% or more of the cancer burden worldwide is attributable to known infectious agents. We screened colorectal carcinoma and matched normal tissue specimens using RNA-seq followed by host sequence subtraction and found marked over-representation of Fusobacterium nucleatum sequences in tumors relative to control specimens. F. nucleatum is an invasive anaerobe that has been linked previously to periodontitis and appendicitis, but not to cancer. Fusobacteria are rare constituents of the fecal microbiota, but have been cultured previously from biopsies of inflamed gut mucosa. We obtained a Fusobacterium isolate from a frozen tumor specimen; this showed highest sequence similarity to a known gut mucosa isolate and was confirmed to be invasive. We verified overabundance of Fusobacter...

Depersonalization in the ER

Psychology Today Anxiety Center — Mon, 30 Jan 2012 04:50:58 +0100

The mental disorder of depersonalization could hide itself behind presentations of alarming medical emergency with seemingly physical disturbances that could lead to the ER. This type of depersonalization is known as vital depersonalization and closely connected to anxiety and pain.read more (Source: Psychology Today Anxiety Center)

Educational and training aspects of new surgical techniques: experience with the endoscopic–laparoscopic interdisciplinary training entity (ELITE) model in training for a natural orifice translumenal endoscopic surgery (NOTES) approach to appendectomy

Surgical Endoscopy — Sat, 28 Jan 2012 06:43:05 +0100

Conclusions This study was able to establish face and construct validity for the ELITE model with a large group of surgeons. The ELITE model seems to be well suited for the training of NOTES as a new surgical technique in an established gastrointestinal surgery skills course. Content Type Journal ArticleCategory Endoluminal SurgeryPages 1-7DOI 10.1007/s00464-012-2165-zAuthors Sonja Gillen, Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyJörn Gröne, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, GermanyFritz Knödgen, Research Group MITI, Minimally Invasive Therapy and Intervention, Munich, GermanyPetra Wolf, Institute of Medical Statistics and Epidemiology, Techn...

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Endoloop versus endostapler closure of the appendiceal stump in pediatric laparoscopic appendectomy.

Canadian Journal of Surgery — Fri, 27 Jan 2012 16:01:45 +0100

Conclusion: Our data suggest that in most cases of PA, the appendiceal stump can be safely controlled with EL. Within the PA group, the higher rates of IAA seen in ES patients may be attributable to the quality of the appendiceal stump rather than the technique of closure. PMID: 22269300 [PubMed - in process] (Source: Canadian Journal of Surgery)

Laparoscopic resection of a retroperitoneal schwannoma

Asian Journal of Endoscopic Surgery — Fri, 27 Jan 2012 11:25:39 +0100

AbstractHerein is a report of a case of a 34‐year‐old man whose chief complaint was right lower abdominal pain. He was diagnosed with acute appendicitis. Additionally, an abdominal CT scan found retroperitoneal tumor approximately 5 cm in size, with an imaging effect, located adjacent to the dorsal side of the inferior vena cava. For this suspected neurogenic tumor, laparoscopic appendectomy and retroperitoneal tumorectomy were performed after conservative treatment of appendicitis. The retroperitoneal tumor was 5.5 × 3.5 cm in size, had a capsule, smooth surface and soft elasticity, and the divided face was solid white. The histopathological work‐up revealed that the tumor was a benign mixed‐type schwannoma, in which spindle cells were arranged. The patient's postoperativ...

Time is the Currency of Self-Esteem

Psychology Today Parenting Center — Wed, 25 Jan 2012 03:24:56 +0100

"How do I give my child a self-esteem?" "If my child doesn't get a [fill in with sticker, souvenir, lollipop, trophy etc] won't that damage his self-esteem?" People ask me lots of questions about self-esteem as if it's an entity or unit that can be measured. Yet "the self-esteem" doesn't sit in some mysterious place in our minds or bodies.read more (Source: Psychology Today Parenting Center)

Subcutaneous abdominal wall masses: radiological reasoning.

Pain Physician — Tue, 24 Jan 2012 19:48:22 +0100

CONCLUSION: Integrating salient imaging findings with clinical history is crucial when approaching the diagnosis of subcutaneous soft-tissue masses. The diagnosis of endometriosis should be entertained when soft-tissue masses are seen in the distribution of a cesarean section scar in a woman of reproductive age. Pain, particularly with a cyclic pattern, is highly suggestive of endometriosis. If endometriosis is suspected on CT or ultrasound, MRI can be performed for further evaluation. Definitive diagnosis is made with biopsy. Because subcutaneous nodules are so amenable percutaneous biopsy, imaging features, although of interest, are somewhat ancillary to the diagnostic workup. PMID: 22268204 [PubMed - in process] (Source: Pain Physician)

Comparison of Outcomes of Laparoscopic Versus Open Appendectomy in Children: Data from The Nationwide Inpatient Sample (NIS), 2006–2008

World Journal of Surgery — Tue, 24 Jan 2012 07:55:24 +0100

Conclusions LA is safe in children with acute perforated and nonperforated appendicitis, and is associated with shorter hospital stay than OA. The laparoscopic approach is associated with lower morbidity and mortality in perforated cases. However, in nonperforated cases, these benefits are modest and are associated with higher hospital charges. Content Type Journal ArticlePages 1-6DOI 10.1007/s00268-011-1417-8Authors Hossein Masoomi, Department of Surgery, University of California, Irvine, Medical Center, 333 City Blvd. West, Suite 700, Orange, CA 92868, USASteven Mills, Department of Surgery, University of California, Irvine, Medical Center, 333 City Blvd. West, Suite 700, Orange, CA 92868, USAMatthew O. Dolich, Department of Surgery, University of California, Irvi...

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[Intussusception of the appendix : A rare cause of acute abdominal pain in childhood.]

Der Chirurg — Sat, 21 Jan 2012 05:00:00 +0100

We report the case of a 12-year-old girl with right-sided abdominal pain and concomitant peranal bleeding. Preoperative abdominal ultrasound showed partial appendicular intussusception which was confirmed by laparotomy. Appendectomy was carried out including a wide peripheral cecal ring. Peranal bleeding restarted 7 weeks after discharge and colonoscopy revealed ulcerative colitis. The etiology, clinical manifestations, diagnostic and therapeutic approaches for appendicular intussusception are discussed. PMID: 22271057 [PubMed - as supplied by publisher] (Source: Der Chirurg)

Remote CT reading using an ultramobile PC and web-based remote viewing over a wireless network

Journal of Telemedicine and Telecare — Fri, 20 Jan 2012 05:00:00 +0100

We developed a new type of mobile teleradiology system using an ultramobile PC (UMPC) for web-based remote viewing over a wireless network. We assessed the diagnostic performance of this system for abdominal CT interpretation. Performance was compared with an emergency department clinical monitor using a DICOM viewer. A total of 100 abdominal CT examinations were presented to four observers. There were 56 examinations showing appendicitis and 44 which were normal. The observers viewed the images using a UMPC display and an LCD monitor and rated each examination on a five-point scale. Receiver operating characteristics (ROC) analysis was used to test for differences. The sensitivity and specificities of all observers were similarly high. The average area under the ROC curve for readings per...

Intraductal Papillary Mucinous Neoplasm (IPMN) with Extra-Pancreatic Mucin: A Case Series and Review of the Literature

Journal of Gastrointestinal Surgery — Thu, 19 Jan 2012 06:48:11 +0100

Conclusions At this time, there is scant reporting and consensus for the treatment of IPMN with extra-pancreatic mucin. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s11605-012-1823-8Authors Laura H. Rosenberger, Department of Surgery, University of Virginia Health System, Medical Research Building #4, Room 3116, P.O. Box 801359, Charlottesville, VA 22908, USALouis H. Stein, Department of Surgery, Yale–New Haven Hospital, New Haven, CT, USAAgnieszka K. Witkiewicz, Department of Pathology, Thomas Jefferson University, Philadelphia, PA, USAEugene P. Kennedy, Department of Surgery, and the Jefferson Pancreas, Biliary and Related Cancer Center, Thomas Jefferson University, Philadelphia, PA, USACharles J. Yeo, Department of Surgery, and the Jeff...

Subcutaneous Abdominal Wall Masses: Radiological Reasoning

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. Integrating salient imaging findings with clinical history is crucial when approaching the diagnosis of subcutaneous soft-tissue masses. The diagnosis of endometriosis should be entertained when soft-tissue masses are seen in the distribution of a cesarean section scar in a woman of reproductive age. Pain, particularly with a cyclic pattern, is highly suggestive of endometriosis. If endometriosis is suspected on CT or ultrasound, MRI can be performed for further evaluation. Definitive diagnosis is made with biopsy. Because subcutaneous nodules are so amenable percutaneous biopsy, imaging features, although of interest, are somewhat ancillary to the diagnostic workup. (Source: American Journal of Roentgenology)

Appendicitis racial disparities mostly unexplained

Reuters: Health — Wed, 18 Jan 2012 18:15:33 +0100

NEW YORK (Reuters Health) - Poverty and unfavorable health insurance account for only a small portion of the gap in the number of white versus Hispanic or black children who end up with a burst appendix, according to a new study. (Source: Reuters: Health)

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Appendicitis Racial Disparities Mostly Unexplained

MedlinePlus Health News — Wed, 18 Jan 2012 18:15:23 +0100

Poverty and unfavorable health insurance account for only a small portion of the gap in the number of white versus Hispanic or black children who end up with a burst appendix, according to a new study.Source: Reuters Health Related MedlinePlus Pages: Appendicitis, Health Disparities (Source: MedlinePlus Health News)

Access to Care Not Prime Reason for Burst Appendix (CME/CE)

MedPage Today Pediatrics — Tue, 17 Jan 2012 22:06:47 +0100

(MedPage Today) -- Children in economically disadvantaged ethnic groups have higher appendicitis perforation rates than white children, but healthcare access cannot be completely blamed for the disparities, researchers said. (Source: MedPage Today Pediatrics)

Editorial comment: Left ureteral replacement with appendix in pediatric renal transplantation

Pediatric Transplantation — Tue, 17 Jan 2012 05:00:00 +0100

(Source: Pediatric Transplantation)

Appendicitis Perforation Rates Are A Misleading Indicator Of Health Care Access

Health News from Medical News Today — Mon, 16 Jan 2012 21:00:00 +0100

A study published in the January issue of the Archives of Surgery suggests that using appendicitis perforations rates as an indicator of access to healthcare is misleading and inappropriate. The research finds that only a small percentage of the disparity in rates of perforation between minority and white children can be explained by their socioeconomic or health insurance status. Previous analysis indicated that higher perforation rates are found among poor and minority patients, or those who have an insufficient amount of access to health care. The study, led by Edward H... (Source: Health News from Medical News Today)

Little Effect of Insurance Status or Socioeconomic Condition on Disparities in Minority Appendicitis Perforation Rates [Original Article]

Archives of Surgery — Mon, 16 Jan 2012 05:00:00 +0100

Conclusions A very small amount of the gap between minority and white children's appendicitis rates is explained by the proxy factors for health insurance and poverty status that might relate to health care access. Appendicitis perforation rates are not an appropriate indicator of health care access. (Source: Archives of Surgery)

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Factors Driving Imaging Modality Choice in Children with Appendicitis

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:13 +0100

(Source: Journal of Surgical Research)

Gangrenous Appendicitis in Children: A Prospective Evaluation of Definition, Bacteriology, Histopathology, and Outcomes

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:13 +0100

(Source: Journal of Surgical Research)

The Effects of Irrigation on Outcomes in Cases of Perforated Appendicitis in Children

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:13 +0100

(Source: Journal of Surgical Research)

Appendicitis: is CT Imaging Essential for Diagnosis?

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:12 +0100

(Source: Journal of Surgical Research)

Time of Symptoms of Appendicitis and Perforation Risk

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:05 +0100

(Source: Journal of Surgical Research)

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Who's Guarding Whom? the Changing of the Guard: A Study of Pediatric Abdominal Examinations

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:48 +0100

Conclusions: An unacceptable degree of variability and disagreement exists in pediatric abdominal examination, which may contribute to excessive diagnostic testing and radiation exposure, as well as diagnostic delay and potential patient morbidity. Guarding should be documented as voluntary or involuntary, and rebound tenderness should probably not be elicited in a child. These results suggest that closer scrutiny of fundamental principles in pediatric abdominal physical examination may be warranted in medical school and residency curricula, and additional multidisciplinary training may be needed in this specific area. (Source: Journal of Surgical Research)

Progression of Acute Appendicitis to Perforation: Examination of a Two-Variant Disease Model in 683,590 Patients

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:23 +0100

Introduction: Recent studies have suggested that acute appendicitis may represent two discrete disease entities, one associated with frequent early perforation and the other associated with a low overall likelihood of perforation. One implication of this two-variant disease model has been greater emphasis by some authors on entirely nonsurgical management of non-perforated appendicitis. The present study examines the clinical evolution of acute appendicitis - from the time of hospital admission until appendectomy - to assess rates of perforation as they relate to the delay preceding appendectomy in a nationwide sample. Methods: A cross-sectional descriptive analysis was performed using the National Inpatient Sample (NIS) and Kids' Inpatient Database (KID) data from 1988-2008. Patients were...

Warm Humidified Carbon Dioxide Gas Insufflation for Laparoscopic Appendicectomy in Children: A Double-Blinded Randomised Controlled Trial

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:19 +0100

Conclusions: Warm humidified CO2 gas insufflation for laparoscopic appendicectomy has no short-term clinical benefits in paediatric patients. (Source: Journal of Surgical Research)

Outcomes for Interval Appendectomy After Non-Operative Management of Perforated Appendicitis: What Are the Operative Risks and Luminal Patency Rates?

Journal of Surgical Research — Sat, 14 Jan 2012 22:28:54 +0100

(Source: Journal of Surgical Research)

Response to “The Physics and Technology of Radiation Therapy Book Review” (Int J Radiat Oncol Biol Phys 2011;80:637

International Journal of Radiation Oncology * Biology * Physics — Sat, 14 Jan 2012 19:43:02 +0100

To the Editor: We thank Dan Odero for his review of our book The Physics and Technology of Radiation Therapy in the June 2011 issue . When reviewing an 850-page book, it is usually not practical to read the entire volume. We believe that this has led to some misunderstandings. We have been criticized for leaving some things out of the book that are, in fact, in the book. Regarding the reference to the “Mevalac” linear accelerator (linac), we are criticized because “there exists no such linac or manufacturer.” The book clearly and repeatedly states (on Pages 12.5, 15.2, 15.5, and 15.23, as well as in the index [Page I.10]) that this is a fictitious linac. We give detailed dosimetry data for this fictitious machine in Appendix C. The title page to the appendix again states that this ...

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Percutaneous drainage of intra-abdominal abscess in children with perforated appendicitis

Pediatric Radiology — Fri, 13 Jan 2012 16:54:41 +0100

Conclusion PCD can be effective for managing perforated appendicitis in children. Children with large and ill-defined abscess might be at increased risk for complication or recurrence. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00247-011-2337-3Authors Michael F. McNeeley, Department of Radiology, University of Washington, Seattle Children’s Hospital, Seattle, WA, USANghia Jack Vo, Department of Radiology, University of Washington, Seattle Children’s Hospital, Seattle, WA, USASomnath J. Prabhu, Department of Radiology, University of Washington, Seattle Children’s Hospital, Seattle, WA, USAJason Vergnani, Department of Radiology, University of Washington, Seattle Children’s Hospital, Seattle, WA, USADennis W. Shaw, Department of ...

The "BASE-FIRST" technique in laparoscopic appendectomy

Journal of Minimal Access Surgery — Fri, 13 Jan 2012 05:00:00 +0100

Conclusion : We recorded only one intraoperative haemorrhage, one bladder perforation due to trocar insertion and no conversion. Our goal is to standardize and simplify the laparoscopic approach in order to give any surgeon, even non-expert ones, a simple way to remove the viscum especially in complicated pictures. (Source: Journal of Minimal Access Surgery)

Mucosal invasion by fusobacteria is a common feature of acute appendicitis in Germany, Russia, and China

The Saudi Journal of Gastroenterology — Thu, 12 Jan 2012 05:00:00 +0100

Conclusions: Acute appendicitis is a polymicrobial infectious disease in which F. nucleatum and other Fusobacteria play a key role. (Source: The Saudi Journal of Gastroenterology)

Comparison of non-invasive fibrosis markers and classical liver biopsy in chronic hepatitis C

European Journal of Clinical Microbiology and Infectious Diseases — Tue, 10 Jan 2012 06:48:38 +0100

Abstract The aim of this study was to compare the results of nine non-invasive serum biomarkers with liver biopsies to predict liver fibrosis stage. HCV-RNA-positive, HCV genotype 1, treatment-naive patients with chronic HCV infections were included from 14 centers (n = 77). The platelet count, AST/ALT ratio (AAR), cirrhosis discriminate score (CDS), FIB4, AST/platelet ratio index (APRI), age-platelet (AP) index, Göteborg University cirrhosis index (GUCI), FibroTest, and ActiTest were calculated and compared to histologic findings. All serum biomarkers, except AAR, were weakly or moderately correlated with liver biopsy results (ISHAK fibrosis score). The mean scores of FibroTest, FIB4, APRI, and AP index were significantly different between F0-F2 and F3-F4 groups and ...

Incidental appendectomy ‐ Standard or unnecessary additional trauma in surgery for colorectal cancer? A retrospective analysis of histological findings in 380 specimens

Colorectal Disease — Tue, 10 Jan 2012 05:00:00 +0100

Conclusion: Incidental appendectomy is a safe procedure and can be integrated in surgery for colorectal carcinoma to avoid future complications. Pathological findings of the appendix, including neoplasm, are frequent but clinical relevance remains questionable. (Source: Colorectal Disease)

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Computed tomography characteristics of isolated caecal ischaemia.

Radiologia — Sat, 07 Jan 2012 05:00:00 +0100

CONCLUSIONS: The combination of caecal wall thickening with oedematous characteristics, with no changes in the appendix, ileum and colon, suggest the diagnosis of caecal ischaemia, particularly with the presence of pneumatosis. PMID: 22230554 [PubMed - as supplied by publisher] (Source: Radiologia)

I knew instantly the previous pain had gone

The Irish Times - Health — Thu, 05 Jan 2012 10:17:08 +0100

MY HEALTH EXPERIENCE:Having your appendix out in your mid-40s is a bit unusual, writesSYLVIA THOMPSON (Source: The Irish Times - Health)

Novel Serum and Urine Markers for Pediatric Appendicitis

Academic Emergency Medicine — Thu, 05 Jan 2012 05:00:00 +0100

Conclusions: Plasma calprotectin and serum/urine LRG are elevated in pediatric appendicitis. No individual marker performed as well as the WBC count. (Source: Academic Emergency Medicine)

Diagnostic Characteristics of S100A8/A9 in a Multicenter Study of Patients With Acute Right Lower Quadrant Abdominal Pain.

Accident and Emergency Nursing — Thu, 05 Jan 2012 05:00:00 +0100

Conclusions: In patients presenting with acute right lower quadrant abdominal pain, we found the investigational enzyme-linked immunosorbent assay (ELISA) test for S100A8/A9 to perform with high sensitivity but very limited specificity. We found that shipping effect and delay in analysis resulted in a subsequent rise in test values, thereby increasing the sensitivity and decreasing the specificity of the test. Further investigation with hospital-based laboratory analyzers is the next critical step for determining the ultimate clinical utility of the ELISA test for S100A8/A9 in ED patients presenting with acute right lower quadrant abdominal pain. PMID: 22221415 [PubMed - as supplied by publisher] (Source: Accident and Emergency Nursing)

Novel Serum and Urine Markers for Pediatric Appendicitis.

Accident and Emergency Nursing — Thu, 05 Jan 2012 05:00:00 +0100

Conclusions: Plasma calprotectin and serum/urine LRG are elevated in pediatric appendicitis. No individual marker performed as well as the WBC count. PMID: 22221321 [PubMed - as supplied by publisher] (Source: Accident and Emergency Nursing)

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Correction: Can Tweets Predict Citations? Metrics of Social Impact Based on Twitter and Correlation with Traditional Metrics of Scientific Impact

Journal of Medical Internet Research — Wed, 04 Jan 2012 05:00:00 +0100

Discussion). The original decision to cite them as references was made for the sake of convenience for our readers, to prevent them from having to look up the references in a separate file or by DOI. JMIR has no space limitations and prefers to cite references in the article rather than in an Appendix; for readers downloading a PDF file it is more convenient to have all references in a single file rather than having to download a separate Appendix. The decision to now move these references into a Multimedia Appendix was made after a reader pointed out that citing these articles may increase JMIR’s impact factor. Although none of the two peer-reviewers, both experts in scientometrics, were originally concerned about citing the included articles as references, and even though any potential...

Actinomycosis in urachal remnants: A rare cause of pseudotumor

Indian Journal of Urology — Wed, 04 Jan 2012 05:00:00 +0100

We present one such case of urachal actinomycosis that mimicked a tumor. A 28-year-old man presented with abdominal pain of 20 days duration. Per abdominal palpation revealed a firm mass with ill-defined borders in the suprapubic region. Computed tomography and magnetic resonance imaging scans of the pelvis showed an irregular lesion in the urinary bladder extending to the umbilicus, giving the impression of urachal remnants with inflammation. Peroperatively, an irregular, hard mass measuring 6 x 5 cm, involving the anterior and posterior bladder walls, the appendix, the terminal ileum and sigmoid colon, was seen, which was suspicious for a malignancy. Frozen sections from the mass showed extensive inflammation and a florid fibroblastic proliferation, giving the impression of an inflammato...

Pelvic Pain: Ultrasound of the Bowel

Ultrasound Clinics — Sun, 01 Jan 2012 05:00:00 +0100

This article includes a review of the anatomy of the gastrointestinal tract and bowel wall in addition to the techniques used to perform a thorough evaluation of the bowel with ultrasound. Gastrointestinal causes of pelvic pain are discussed, including appendicitis, diverticulitis, inflammatory bowel disease, epiploic appendagitis, omental infarction, and infection. (Source: Ultrasound Clinics)

Evaluation of intestinal viability using 3–charge coupled device image enhancement technology in a pediatric laparoscopic appendectomy model

Journal of Pediatric Surgery — Sun, 01 Jan 2012 05:00:00 +0100

Conclusion: We have demonstrated proof of principle for the determination of bowel ischemia using 3-CCD image enhancement. By quantitatively identifying areas of ischemia, this technique has the potential to significantly change the management of ischemic bowel in the future. (Source: Journal of Pediatric Surgery)

Splenic rupture in a patient with pelvic abscess and sepsis.

Singapore Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

Authors: John AK Abstract A 49-year-old man underwent appendicectomy through a Lanz incision for necrotic appendicitis. He subsequently developed pelvic abscess in the postoperative period, which was drained under computed tomography (CT) guidance. The bacteriology of pus swabs taken during appendicectomy and abscess drainage revealed coliforms. Six days after appendicectomy, the patient had an acute collapse due to rupture of the spleen, which was treated by splenectomy. CT of the abdomen at the time of abscess drainage had confirmed a normal spleen. Histopathological examination of the spleen revealed nonspecific acute splenitis - red pulp congested and infiltrated with neutrophils complicated by rupture. We postulate the abdominal source of sepsis and associated inflammatory res...

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Outbreak of porcine epidemic diarrhea in suckling piglets, china.

Emerging Infectious Diseases — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Sun RQ, Cai RJ, Chen YQ, Liang PS, Chen DK, Song CX Abstract TO THE EDITOR: Beginning in October 2010, porcine epidemic diarrhea (PED), caused by a coronaviral infection affecting pigs, emerged in China in an outbreak characterized by high mortality rates among suckling piglets. The outbreak overwhelmed >10 provinces in southern China, and >1,000,000 piglets died. This outbreak was distinguished by ≈100% illness among piglets after birth (predominantly within 7 days and sometimes within only a few hours) and death rates of 80%-100% (Technical Appendix Table 1). Few sows or boars showed any clinical signs during the outbreak, which is not consistent with a recent report from Thailand (1). In that outbreak during late 2007, pigs of all ages were affected, exhibiting ...

A case of congenital fistula from an accessory parotid gland: Diagnosis and treatment.

Ear, Nose and Throat Journal — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Pinto FR Abstract The author reports a case of congenital fistula from an accessory parotid gland and describes its diagnosis and treatment. The patient was referred to the author's clinic for evaluation of a continuous serous discharge from a small orifice in the left cheek near the angle of the mouth. A left preauricular appendix was also noted. Fistulography detected an aberrant duct leading to an accessory parotid gland. The main parotid gland and its duct were normal. The anomalous duct was dissected in continuity with a small ellipse of skin and sutured to the buccal mucosa. The patient's recovery was uneventful. The author also discusses the embryologic origin of this rare anomaly. PMID: 22278868 [PubMed - in process] (Source: Ear, Nose and Throat Journal)

A fish bone causing ileal perforation in the terminal ileum.

Turkish Journal of Trauma and Emergency Surgery : TJTES — Sun, 01 Jan 2012 05:00:00 +0100

We report the case of a 69-year-old woman who experienced severe pain in the right iliac fossa. The presumptive diagnosis was acute purulent appendicitis or diverticulitis. Multidetector computed tomography (MDCT) imaging showed the fish bone perforation of the terminal ileum. A high index of suspicion should always be maintained in order for the correct diagnosis to be made. PMID: 22290059 [PubMed - in process] (Source: Turkish Journal of Trauma and Emergency Surgery : TJTES)

Is neopterin a diagnostic marker of acute appendicitis?

Turkish Journal of Trauma and Emergency Surgery : TJTES — Sun, 01 Jan 2012 05:00:00 +0100

CONCLUSION: This study was an experimental animal study; however, it provides valuable clues useful in clinical assessment. Neopterin seems to have great potential as a new diagnostic marker for the diagnosis of acute appendicitis. PMID: 22290042 [PubMed - in process] (Source: Turkish Journal of Trauma and Emergency Surgery : TJTES)

A Case of Squamous Cell Carcinoma of Conjunctiva as Initial Sign of Systemic Cancers

Journal of Biomedicine and Biotechnology — Thu, 29 Dec 2011 16:36:22 +0100

The purpose of this report is to present the findings in a case of squamous cell carcinoma (SCC) of the conjunctiva which was the initial sign of systemic cancers. A 94-year-old woman without known systemic diseases developed a mass in her right conjunctiva. She was referred to our hospital 5 months after the onset. She was diagnosed with conjunctival SCC by biopsy. Systemic CT before the surgery revealed multiple liver lesions, lung legions, and a large mass surrounding the appendix. The patient requested the surgery, and the main aim of the surgery was cosmesis. Histopathological examinations of the specimen led us to the final diagnosis as SCC. She did not receive any other therapy because of her age. As no other surgical procedures were undertaken, it is uncertain as to whether the con...

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ENETS Consensus Guidelines for the Management of Patients with Neuroendocrine Neoplasms from the Jejuno-Ileum and the Appendix Including Goblet Cell Carcinomas

Neuroendocrinology — Wed, 28 Dec 2011 23:00:00 +0100

Neuroendocrinology 0;0:0–0 (DOI:10.1159/000335629) (Source: Neuroendocrinology)

Role of colonoscopy in the diagnosis of acute appendicitis

Digestive Endoscopy — Wed, 28 Dec 2011 12:34:02 +0100

(Source: Digestive Endoscopy)

The Alvarado score for predicting acute appendicitis: A systematic review

BMC Medicine — Wed, 28 Dec 2011 05:00:00 +0100

Conclusions: The Alvarado score is a useful diagnostic 'rule out' score at a cut point of 5 for all patient groups. The score is well calibrated in men, inconsistent in children and over-predicts the probability of appendicitis in women across all strata of risk. (Source: BMC Medicine)

Appendix constrictor ring: a rare cause of intestinal obstruction.

Cirugia eEspanola — Wed, 28 Dec 2011 05:00:00 +0100

Authors: Curado Soriano A, López Ruiz JA, Martín Pérez B, Reyes Díaz ML, Oliva Mompeán F PMID: 22208677 [PubMed - as supplied by publisher] (Source: Cirugia eEspanola)

Open to laparoscopic conversion in hemoperitoneum of unknown origin

European Journal of Trauma and Emergency Surgery — Tue, 27 Dec 2011 16:50:19 +0100

Conclusions For selected cases, the conversion of an open procedure to a laparoscopic approach offers a real benefit for the patient, avoiding a large laparotomy and its associated morbidity. Content Type Journal ArticleCategory Tips&TricksPages 1-3DOI 10.1007/s00068-011-0173-7Authors S. Paun, General Surgery Department, Carol Davila University of Medicine and Pharmacy, Emergency Hospital of Bucharest, Bucharest, RomaniaI. Negoi, General Surgery Department, Carol Davila University of Medicine and Pharmacy, Emergency Hospital of Bucharest, Bucharest, RomaniaR. Ganescu, General Surgery Department, Carol Davila University of Medicine and Pharmacy, Emergency Hospital of Bucharest, Bucharest, RomaniaM. Beuran, General Surgery Department, Carol Davila University of Medicin...

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Increased risk of Parkinson's disease in individuals hospitalized with conditions related to the use of methamphetamine or other amphetamine-type drugs

Drug and Alcohol Dependence — Sat, 24 Dec 2011 06:09:53 +0100

Conclusion: These data provide evidence that meth/amphetamine users have above-normal risk for developing PD. (Source: Drug and Alcohol Dependence)

Appendectomy and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries

Langenbeck's Archives of Surgery — Fri, 23 Dec 2011 06:47:46 +0100

Conclusions Large variations in the classification of appendectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons and national DRG authorities should consider how other countries’ DRG systems classify appendectomy patients in order to optimize their DRG system and to ensure fair and appropriate reimbursement. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00423-011-0877-5Authors Wilm Quentin, Department of Health Care Management, Technische Universität (TU) Berlin, Straße des 17, Juni 135, H80, 10623 Berlin, GermanyDavid Scheller-Kreinsen, Department of Health Care Management, Technische Universität (TU) Berlin, Straße des 17, Juni 135, H80, 10623 Berlin, GermanyAlexander...

Ovarian vein thrombosis mimicking acute abdomen: A case report and literature review

World Journal of Emergency Surgery — Fri, 23 Dec 2011 05:00:00 +0100

Conclusions: OVT is a rare condition, usually in the postpartum period. A high index of suspicion is required for the prompt diagnosis and management especially in cases that mimic acute abdomen. (Source: World Journal of Emergency Surgery)

A structured approach to Exposure Based Waiving of human health endpoints under REACH developed in the OSIRIS project.

Regulatory Toxicology and Pharmacology : RTP — Fri, 23 Dec 2011 05:00:00 +0100

Authors: Marquart H, Meijster T, Van de Bovenkamp M, Ter Burg W, Spaan S, Van Engelen J Abstract Exposure Based Waiving (EBW) is one of the options in REACH when there is insufficient hazard data on a specific endpoint. Rules for adaptation of test requirements are specified and a general option for EBW is given via Appendix XI of REACH, allowing waiving of repeated dose toxicity studies, reproductive toxicity studies and carcinogenicity studies under a number of conditions if exposure is very low. A decision tree is described that was developed in the European project OSIRIS (Optimised Strategies for Risk Assessment of Industrial Chemicals through Integration of Non-Test and Test Information) to help decide in what cases EBW can be justified. The decision tree uses specific criter...

Reassessment of CT images to improve diagnostic accuracy in patients with suspected acute appendicitis and an equivocal preoperative CT interpretation

European Radiology — Thu, 22 Dec 2011 12:51:13 +0100

Conclusions Knowledge of the identified CT findings was found to improve diagnostic accuracy for acute appendicitis in patients with equivocal CT findings. Key Points • Numerous patients with clinically equivocal appendicitis do not have acute appendicitis • Computed tomography (CT) helps to reduce the negative appendectomy rate • CT is not always infallible and may also demonstrate indeterminate findings • However knowledge of significant CT variables can further reduce negative appendectomy rate • An equivocal CT interpretation of appendicitis should be reassessed with this knowledge Content Type Journal ArticleCategory GastrointestinalPages 1-8DOI 10.1007/s00330-011-2362-5Authors Hyun Cheol Ki...

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Postoperative adhesive intestinal obstruction: The role of intestinal stenting

Journal of Indian Association of Pediatric Surgeons — Thu, 22 Dec 2011 05:00:00 +0100

Conclusions: Use of an intraluminal tube stent in preventing recurrent small bowel obstruction due to adhesions is safe and effective when used on appropriately selected patients. (Source: Journal of Indian Association of Pediatric Surgeons)

Laboratory diagnosis in neurology

Neuromuscular Disorders — Thu, 22 Dec 2011 05:00:00 +0100

The Editors suggest this book is suitable for laboratory medical staff and clinicians and should be seen as a supplement to other books on laboratory diagnosis and neurology. The book is presented in four sections: Basics, Analysis, Clinical Pictures and an Appendix and the bias is very much toward analytical methodology. (Source: Neuromuscular Disorders)

Usefulness of ultrasonography in children with right iliac fossa pain.

Radiologia — Wed, 21 Dec 2011 05:00:00 +0100

Authors: Raposo Rodríguez L, Anes González G, García Hernández JB, Torga Sánchez S Abstract Acute pain in the right iliac fossa is common in children. It can arise from a wide variety of gastrointestinal and genitourinary processes that make up the differential diagnosis with acute appendicitis. In this article, we describe the most representative findings of these processes on ultrasonography. We emphasize the characteristics that enable these processes to be differentiated from acute appendicitis. PMID: 22195569 [PubMed - as supplied by publisher] (Source: Radiologia)

The Alzheimer’s Family: Helping Caregivers Cope

Psych Central — Tue, 20 Dec 2011 20:23:31 +0100

If you were asked to name a terminal illness, it is likely that Alzheimer’s would not be your first choice. However, from my own perspective, when you consider that there is no cure for this horrible disease, how can it be called anything else but terminal? When someone is diagnosed with Alzheimer’s disease, a family becomes focused on learning more about the illness, how it will affect their loved one, and what kind of care will be necessary. If they have no previous exposure to Alzheimer’s with other family members or even friends, what they may fail to realize is the extent to which each member of the family will be affected by the disease. “Helping the family face their grief and work through the accompanying emotions of sadness, anxiety, anger, guilt, ...

Matrix metalloproteinase levels in peritoneal effluents were increased in a patient with appendicitis undergoing continuous ambulatory peritoneal dialysis

Clinical and Experimental Nephrology — Tue, 20 Dec 2011 16:48:11 +0100

Abstract A differential diagnosis of common bacterial peritonitis and appendicitis is difficult in continuous ambulatory peritoneal dialysis (CAPD) patients, and thus the definite diagnosis of appendicitis is often delayed. In this case, a 60-year-old man undergoing CAPD was at first diagnosed with bacterial peritonitis but not appendicitis, and antibiotics were administered. The number of leukocytes in the peritoneal effluent decreased mildly, but the level of C-reactive protein continued to be high and the pain aggravated. When the catheter was removed, suppurative appendicitis was confirmed for the first time. Levels of matrix metalloproteinase (MMP)-2 and -9 in peritoneal effluents were markedly high. Appendicitis should be diagnosed as early as possible because MMPs d...

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Isolated ruptured appendicitis presenting as pneumatosis intestinalis in a premature neonate

Pediatric Surgery International — Tue, 20 Dec 2011 16:47:34 +0100

We report a novel case of ruptured appendicitis in a premature neonate which radiographically mimicked necrotizing enterocolitis with free intraperitoneal air. On exploratory laparotomy, both the large and small intestines were normal. Content Type Journal ArticleCategory Case ReportPages 1-3DOI 10.1007/s00383-011-3042-xAuthors Vaneet Kumar Kalra, Division of Neonatology, Department of Pediatrics, Children Hospital of Michigan, 3901 Beaubien St, #4C19, Detroit, MI 48201, USAGirija Natarajan, Division of Neonatology, Department of Pediatrics, Children Hospital of Michigan, 3901 Beaubien St, #4C19, Detroit, MI 48201, USAJanet Poulik, Department of Pediatric Pathology, Children Hospital of Michigan, Detroit, MI, USAPrem Arora, Division of Neonatology, Department of Pediatrics, Childre...

Detailed Assessment of Stomal Incontinence After Malone Antegrade Continence Enema: Development of a New Grading Scale

The Journal of Urology — Mon, 19 Dec 2011 05:00:00 +0100

Conclusions: We reviewed the spectrum of stomal incontinence following Malone antegrade continence enema in 75 patients and developed a new grading scale to help standardize this complication. Imbrication provided stomal continence in all patients. Without imbrication almost 90% had no stomal incontinence or grade 1 leakage after long-term followup. (Source: The Journal of Urology)

Schistosomiasis may contribute to Goblet Cell Carcinoid of the Appendix.

The Journal of Parasitology — Fri, 16 Dec 2011 05:00:00 +0100

Authors: Jiang Y, Long H, Li T, Wang W, Liu H, Zhang X Abstract Abstract To investigate whether schistosomiasis can contribute to appendiceal goblet cell carcinoid, appendix samples were obtained from 3 patients with combined appendiceal schistosomiasis and goblet cell carcinoid (CSG), 6 patients with goblet cell carcinoid only (GCC), 12 patients with appendiceal schistosomiasis only (ASO), and 12 cases with normal appendix (NA) of similar gender ratio and age distributions. Hematoxylin and eosin (H&E) stained sections were studied in 3 CSGs and 12 ASOs to diagnose schistosomiasis by detecting schistosome eggs. H&E and alcian blue/PAS stained sections, and immunohistochemistry of CgA and CEA were employed to establish the diagnosis of goblet cell carcinoid (GCC) in the 3 C...

Endorphin plays traffic cop to organs

ScienceDaily Headlines — Thu, 15 Dec 2011 19:10:10 +0100

Spleen to the left, appendix to the right: In order for the body to sort itself out properly, two substances have to trigger a complex chain reaction, according to new research findings. (Source: ScienceDaily Headlines)

External validation of Lintula score in Turkish acute appendicitis patients

International Journal of Surgery — Thu, 15 Dec 2011 05:00:00 +0100

Conclusion: Lintula score seems to be useful method to diagnose acute appendicitis among Turkish patients and may reduce the rate of negative appendectomy. (Source: International Journal of Surgery)

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Epiploic Appendagitis: Is There Need for Surgery to Confirm Diagnosis in Spite of Clinical and Radiological Findings?

World Journal of Surgery — Wed, 14 Dec 2011 06:55:59 +0100

Conclusions In patients with localized abdominal pain without other symptoms, diagnosis of EA should be considered. Recognizing the US and CT features of EA may allow an accurate diagnosis and avoid unnecessary surgery. Content Type Journal ArticlePages 1-6DOI 10.1007/s00268-011-1382-2Authors Mustafa Hasbahceci, Department of General Surgery, Umraniye Education and Research Hospital, Hirka-i Serif M Kececi Cesmesi S Doktorlar S B Bl 6/7, Fatih, 34291 Istanbul, TurkeyCengiz Erol, Department of Radiology, Selcuk University, Selcuklu Faculty of Medicine, Konya, TurkeyMehmet Seker, Department of Radiology, 29 May Hospital, Istanbul, Turkey Journal World Journal of SurgeryOnline ISSN 1432-2323Print ISSN 0364-2313 (Source: World Journal of Surgery)

JLS saved my daughter's life: Mother reveals how music tracks and meeting pop idols helped sick teen pull through

the Mail online | Health — Tue, 13 Dec 2011 12:48:14 +0100

Leah Price from Greater Manchester came close to death after she was treated for suspected appendicitis. But she pulled through thanks to support from her favourite boy band. (Source: the Mail online | Health)

Imaging the pregnant patient with abdominal pain

Abdominal Imaging — Mon, 12 Dec 2011 17:12:03 +0100

Abstract Imaging of pregnant patients with non-obstetric abdominal pain is reviewed, with an accompanying pictorial essay of cases with concentration on magnetic resonance imaging. Non-obstetric causes of abdominal pain during pregnancy are similar to those of non-pregnant patients. The most common causes are appendicitis and cholecystitis. Other causes are myriad and include biliary, gastrointestinal, infectious, inflammatory, and malignant etiologies, among others. The approach to imaging in pregnant patient is unique, as it is imperative to minimize potentially harmful radiation exposures to the fetus. Ultrasound and MRI are the primary modalities for evaluation of the pregnant patient with abdominal pain. The use of intravenous contrast is discouraged, except in highly...

Effect of the increase in "alcopops" tax on alcohol-related harms in young people: a controlled interrupted time series.

Med J Aust — Mon, 12 Dec 2011 05:00:00 +0100

CONCLUSIONS: The increase in the tax on alcopops was not associated with any reduction in alcohol-related harms in this population in a unique tourist and holiday region. A more comprehensive approach to reducing alcohol harms in young people is needed. PMID: 22171867 [PubMed - in process] (Source: Med J Aust)

Hantavirus and acute appendicitis—The diagnosis behind the diagnosis?

Journal of Clinical Virology — Mon, 12 Dec 2011 05:00:00 +0100

Abstract: A 33-year-old man with a history of acute lower abdominal pain was admitted to the emergency room. After laparoscopic appendectomy and pathological confirmed acute appendicitis the patient developed thrombocytopenia and acute renal failure. Serological testing for hantaviruses revealed a positive result for PUUV IgG and IgM. Immunohistochemical work-up detected PUUV antigen in endothelial cells of capillaries and larger vessels. The high percentage of patients with hantavirus infection and severe abdominal pain is remarkable and, up to now, unexplained. To our knowledge this is the first report demonstrating PUUV antigen in the human intestine. Further studies are warranted whether hantaviruses are setting the stage for a secondary bacterial infection or cause an inflammation its...

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Gallbladder and appendix surgery safe in pregnancy

Reuters: Health — Fri, 09 Dec 2011 20:17:57 +0100

NEW YORK (Reuters Health) - Pregnant women are at no greater risk of developing an infection or other complication after having their gallbladder or appendix removed than their non-pregnant counterparts, researchers report in a new study. (Source: Reuters: Health)

Gallbladder and Appendix Surgery Safe in Pregnancy

MedlinePlus Health News — Fri, 09 Dec 2011 20:17:53 +0100

Pregnant women are at no greater risk of developing an infection or other complication after having their gallbladder or appendix removed than their non-pregnant counterparts, researchers report in a new study.Source: Reuters Health Related MedlinePlus Pages: Health Problems in Pregnancy, Surgery (Source: MedlinePlus Health News)

Mucinous Tumors of the Ovary: Diagnostic Challenges at Frozen Section and Clinical Implications.

Gynecologic Oncology — Fri, 09 Dec 2011 05:00:00 +0100

CONCLUSIONS: Our study showed a 34% rate of discordance between FS and final diagnosis. Given that 5 cases (7%) were of GI origin, intraoperative assessment of the appendix should be performed in all mucinous ovarian tumors. PMID: 22155795 [PubMed - as supplied by publisher] (Source: Gynecologic Oncology)

NHS Outcomes Framework – renewed focus on improving patient results

NHS Networks — Thu, 08 Dec 2011 05:00:00 +0100

The NHS will be measured against a number of areas including whether a patient’s treatment was successful, whether they were looked after well by NHS staff and whether they recovered quickly after treatment. The updated NHS Outcomes Framework describes the changes made since the December 2010 edition. The first framework sets out the outcomes that the NHS Commissioning Board will be held to account for delivering, with corresponding indicators. The updated version recaps the purpose of the NHS Outcomes Framework and how it will work in the wider system; and highlights the main indicator changes. It also contains a technical appendix which provides detailed information about each of the indicators in the framework. (Source: NHS Networks)

Handheld Device Review of Abdominal CT for the Evaluation of Acute Appendicitis

Journal of Digital Imaging — Wed, 07 Dec 2011 10:51:05 +0100

Abstract Advances in handheld computing now allow review of DICOM datasets from remote locations. As the diagnostic ability of this tool is unproven, we evaluated the ability to diagnose acute appendicitis on abdominal CT using a mobile DICOM viewer. This HIPAA compliant study was IRB-approved. Twenty-five abdominal CT studies from patients with RLQ pain were interpreted on a handheld device (iPhone) using a DICOM viewer (OsiriX mobile) by five radiologists. All patients had surgical confirmation of acute appendicitis or follow-up confirming no acute appendicitis. Studies were evaluated for the ability to find the appendix, maximum appendiceal diameter, presence of an appendicolith, periappendiceal stranding and fluid, abscess, and an assessment of the diagnosis of acute a...

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Ureteral replacement with appendix in pediatric renal transplantation

Pediatric Transplantation — Wed, 07 Dec 2011 05:00:00 +0100

Corbetta JP, Weller S, Bortagaray JI, Durán V, Burek C, Sager C, Lopez JC. Ureteral replacement with appendix in pediatric renal transplantation.  Pediatr Transplantation 2011: © 2011 John Wiley & Sons A/S.Abstract: Ureteral necrosis is an uncommon complication following RT which can adversely affect outcome. Even though authors agree that the native ureter ought to be preserved, there are cases in which graft function can only be salvaged by ureteral substitution. The scant references in the literature on the use of the appendix for left ureteral replacement in children prompted us to report the following two cases in whom the technique was employed and to assess the evolution of graft function in these patients. (Source: Pediatric Transplantation)

Patient Reported Outcomes and Their Importance in the Development of Novel Surgical Techniques.

Surgical Innovation — Wed, 07 Dec 2011 05:00:00 +0100

Discussion. The patient perspective on health care is an important aspect of health care quality assessment. This is especially important with regard to the development of novel surgical techniques such as SILS and NOTES. With these techniques, the potential benefits are most likely to be found in the realms of reduced scarring and improved patient satisfaction. The findings from this study demonstrate the public's interest in these new techniques and thus give further support to continued research and development in this area. PMID: 22158844 [PubMed - as supplied by publisher] (Source: Surgical Innovation)

The Use of a Single Hem-o-lok Clip in Securing the Base of the Appendix During Laparoscopic Appendectomy

Journal of Laparoendoscopic — Tue, 06 Dec 2011 21:44:31 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Intracorporeal Knotting Versus Metal Endoclip Application for the Closure of the Appendiceal Stump During Laparoscopic Appendectomy in Uncomplicated Appendicitis

Journal of Laparoendoscopic — Tue, 06 Dec 2011 21:37:57 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

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The value of telephone triage for patients with appendicitis

Journal of Telemedicine and Telecare — Tue, 06 Dec 2011 05:00:00 +0100

Although it has been assumed that telephone triage can directly benefit patients by facilitating early diagnosis and treatment, this potential benefit has not been well documented. Using appendicitis cases ascertained from claims data, we compared telephone triage recommendations with what the callers originally intended to do. Over a two-year period, there were 20,230 calls to a telephone triage centre in the US where insurance information was available. Of these, 12,709 calls (63%) had insurance claims made within seven days of the call. Among these calls, 46 had a diagnosis of appendicitis. In 72% of calls concerning appendicitis, the telephone triage recommendation was for a more rapid evaluation than the caller originally intended (P < 0.0001). In 91% of the appendicitis cases, tri...

[Evidence for the Digital Rectal Examination in the Emergency Assessment of Acute Abdominal Pain.]

Zentralblatt fur Chirurgie — Mon, 05 Dec 2011 05:00:00 +0100

Conclusion: The recommendation of generally applying DRE in the emergency room needs to be questioned critically. No evidence for the necessity and significance was found in the reviewed literature. Independently, these findings do not touch on the unequivocal indication of the DRE as a tool for assessing other specific conditions as well as screening for prostate or rectal cancer. PMID: 22144138 [PubMed - as supplied by publisher] (Source: Zentralblatt fur Chirurgie)

Correction to Shepherd and Kay (2011).

Journal of Personality and Social Psychology — Mon, 05 Dec 2011 05:00:00 +0100

Authors: Abstract Reports an error in "On the perpetuation of ignorance: System dependence, system justification, and the motivated avoidance of sociopolitical information" by Steven Shepherd and Aaron C. Kay (Journal of Personality and Social Psychology, Advanced Online Publication, Nov 7, 2011, np). The images were omitted from Appendix A. (The following abstract of the original article appeared in record 2011-25736-001.) How do people cope when they feel uninformed or unable to understand important social issues, such as the environment, energy concerns, or the economy? Do they seek out information, or do they simply ignore the threatening issue at hand? One would intuitively expect that a lack of knowledge would motivate an increased, unbiased search for information, thereby f...

Ore. woman gives birth, didn't know she was pregnant: Common?

Health News: CBSNews.com — Fri, 02 Dec 2011 18:27:39 +0100

Mother-of-two Kim Nelson went to hospital thinking her appendix had burst, was in for a surprise (Source: Health News: CBSNews.com)

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Cecal diverticulitis as a continuing diagnostic and management dilemma: a report of two cases in children

Pediatric Surgery International — Fri, 02 Dec 2011 17:30:47 +0100

We report two cases of cecal diverticulitis, and discuss the diagnosis and management of this disease, with a review of the literature. Content Type Journal ArticleCategory Case ReportPages 1-4DOI 10.1007/s00383-011-3035-9Authors Elaine Cheng, Department of Surgery, Weill Cornell Medical College, New York, USALeslie Cohen, Department of Surgery, Weill Cornell Medical College, New York, USASelom Gasinu, Department of Surgery, Weill Cornell Medical College, New York, USACalvin Sy, Department of Radiology, Weill Cornell Medical College, New York, USADebra Beneck, Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, USANitsana Spigland, Department of Surgery, Weill Cornell Medical College, New York, USA Journal Pediatric Surgery International...

Prophylactic use of a recombinant activated factor VII in delivery haemorrhage by caesarean in a woman with major factor VII deficiency: a case report.

Annales de Biologie Clinique — Thu, 01 Dec 2011 05:00:00 +0100

We report here the haemorrhagic prophylaxis of delivery by recombinant activated FVII (rFVIIa) in a 27-year-old women, gravida 1, para 0, with major deficiency FVII by missense mutation (p.Arg337Cys). Her parents, first germen, presented a FVII deficiency. She has four brothers and three sisters, of which only one brother has major FVII deficiency with hemorrhagic diathesis in childhood (hematochezia). At her birth, because of dystocia, a right sterno-cleido-mastoid muscle hematoma and left clavicle fracture occurred. The FVII concentration was 0.08 U/mL. At the age of fifteen, a surgery of appendicitis was performed with substitution by FVII from plasma donors without any haemorrhagic complication. Because of anatomic specificity (bifid uterus and vagina), caesarean was planned. After r...

The “all-in-one” appendectomy: quick, scarless, and less costly

Journal of Pediatric Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: We conclude that the all-in-one laparoscopic appendectomy technique is quick, scarless, and less costly than conventional multi-port techniques. Wider application of the all-in-one technique seems indicated. (Source: Journal of Pediatric Surgery)

Does age affect the outcomes and management of pediatric appendicitis?

Journal of Pediatric Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: Although older children had a higher risk of abscess drainage, younger children were more likely to have perforated appendicitis, be readmitted, and have longer LOH. Management of appendicitis differed according to age. Laparoscopic appendectomy was more frequently performed in older children, whereas the youngest children were more likely to be treated nonoperatively. (Source: Journal of Pediatric Surgery)

Outcomes of perforated appendicitis in obese and nonobese children

Journal of Pediatric Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: Obese children undergoing laparoscopic appendectomy for perforated appendicitis experience longer operative times and suffer worse outcomes. (Source: Journal of Pediatric Surgery)

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Diagnostic Characteristics of S100A8/A9 in a Multicenter Study of Patients With Acute Right Lower Quadrant Abdominal Pain

Academic Emergency Medicine — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: In patients presenting with acute right lower quadrant abdominal pain, we found the investigational enzyme‐linked immunosorbent assay (ELISA) test for S100A8/A9 to perform with high sensitivity but very limited specificity. We found that shipping effect and delay in analysis resulted in a subsequent rise in test values, thereby increasing the sensitivity and decreasing the specificity of the test. Further investigation with hospital‐based laboratory analyzers is the next critical step for determining the ultimate clinical utility of the ELISA test for S100A8/A9 in ED patients presenting with acute right lower quadrant abdominal pain. (Source: Academic Emergency Medicine)

Male Gender Is a Risk Factor for Recurrent Appendicitis following Nonoperative Treatment: Reply

World Journal of Surgery — Wed, 30 Nov 2011 18:52:30 +0100

Content Type Journal ArticlePages 1-2DOI 10.1007/s00268-011-1371-5Authors Wan-Ching Lien, Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan, ROCChien-Jen Chen, Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC Journal World Journal of SurgeryOnline ISSN 1432-2323Print ISSN 0364-2313 (Source: World Journal of Surgery)

MDCT for suspected appendicitis in the elderly: diagnostic performance and patient outcome

Emergency Radiology — Wed, 30 Nov 2011 18:43:31 +0100

Abstract Elderly adults are at increased risk for complications related to both delayed diagnosis of appendicitis and to unnecessary appendectomy. We assessed the diagnostic performance of computed tomography (CT) in a consecutive elderly cohort with clinically suspected appendicitis. CT findings and clinical outcomes were analyzed for 262 consecutive adult patients age 65 and older (mean 75.6 ± 7.5 years; range 65–94; M/F 111:151) referred for clinically suspected appendicitis at a single medical center between January 2000 and December 2009. The overall prevalence of proven acute appendicitis in this elderly cohort with clinically suspected appendicitis was 16.8% (44/262). CT sensitivity, specificity, PPV, and NPV for acute appendicitis were 100% (44/44), 99....

Royal College of Nursing publishes guidance on sharps safety

NeLM - News — Wed, 30 Nov 2011 05:00:00 +0100

Source: King?s Fund Health Management and Policy Alert Area: News The Royal College of Nursing (RCN) has published guidance on sharps safety, to support implementation of the EU Directive (2010/32/EU) on the prevention of sharps injuries in the health care sector. The guidance covers the law on sharps injuries, including the European Directive 2010/32/EU and its underlying principles as well as its requirements on health care providers. It goes on to look at how the guidance should be implemented, including the introduction of risk assessments, selection and evaluation of safety-engineered devices and what employers should be doing to comply with the directive. The Appendix includes a checklist to help safety representatives assess organisational and ward/department...

Dentists Question If Removing Wisdom Teeth Is Necessary

Mon, 28 Nov 2011 23:03:14 +0100

BOSTON (CBS) – Getting your wisdom teeth removed is one of the most common surgical procedures around. But some dentists are now questioning if the procedure is really necessary. When Tara Kwilecki’s dentist originally suggested her wisdom teeth come out, she resisted. “I really didn’t want tot have them taken out because they weren’t hurting me,” says Tara. WBZ-TV’s Paula Ebben reports var videoCanvas = new WNVideoWidget("WNVideoCanvas", "wnVideo_6495732");videoCanvas.SetWidth(320);videoCanvas.SetHeight(240);videoCanvas.SetVariable("clipId", "6495732");videoCanvas.SetReportingKeywords("CBS.BOSTON");videoCanvas.SetAdvertisingZone("CBS.BOSTON/worldnowplayer");videoCanvas.SetVariable("offFaceColor", "afaeae");videoCanvas.SetVariable("overFaceColor", "ffffff"...

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"A psychometric analysis of the Positive and Negative Affect Schedule for Children-Parent Version in a school sample": Correction to Ebesutani et al. (2011).

Psychological Assessment — Mon, 28 Nov 2011 05:00:00 +0100

Reports an error in "A psychometric analysis of the Positive and Negative Affect Schedule for Children–Parent Version in a school sample" by Chad Ebesutani, Kelsie Okamura, Charmaine Higa-McMillan and Bruce F. Chorpita (Psychological Assessment, 2011[Jun], Vol 23[2], 406-416). There was an error in the Appendix caption (pg. 416). The corrected caption is provided in the erratum. (The following abstract of the original article appeared in record 2011-04634-001.) The current study was the 1st to examine the psychometric properties of the Positive and Negative Affect Schedule for Children–Parent Version (PANAS-C-P) using a large school-based sample of children and adolescents ages 8 to 18 (N = 606). Confirmatory factor analysis supported a 2-factor (correlated) model of positive affect (P...

Imaging of abdominal pain in pregnancy.

Radiologic Clinics of North America — Sun, 27 Nov 2011 21:30:32 +0100

This article reviews the evolving radiology and clinical literature on imaging of suspected common and relatively common maternal nonobstetric conditions of the abdomen and pelvis, including appendicitis, urolithiasis, and biliary disease, as well as on trauma to the maternal abdomen and pelvis and to the fetus. Recommendations for imaging these conditions, based on the literature to date and on the authors' experiences at two tertiary-care institutions with busy obstetric services, are proposed. The potential and theoretical fetal and maternal risks from such imaging are also reviewed. PMID: 22099493 [PubMed - in process] (Source: Radiologic Clinics of North America)

The Natural Medicine Guide to Bipolar Disorder

Psych Central — Sat, 26 Nov 2011 19:57:13 +0100

Having a special interest in how diet & physical activity help ease the symptoms of mood disorders, I was excited to review Stephanie Marohn’s book The Natural Medicine Guide to Bipolar Disorder. This review covers the 2011 edition, which is a fully revised version of the original 2003 book. Ms. Marohn has also written several other Natural Medicine Guides. She is an energy worker with a B.S. in Dance Therapy, and has a varied list of professionals who helped her with the information for her book. This book offers alternatives, or complements, to the pharmaceuticals that have become the go-to treatment for much of the treatment of mental illness today. The information in this book goes beyond the typical diet, exercise, and lifestyle advice normally presented as the natural w...

Effects of changing work patterns on general surgical training over the last decade

Postgraduate Medical Journal — Fri, 25 Nov 2011 05:00:00 +0100

Conclusions The proportion of operating performed by SpRs and SHOs has fallen over the last decade, coinciding with implementation of structural changes to training, the advent of minimally invasive techniques, and the drive for a consultant led health service. Trainees may therefore require increased supervision as well as protected theatre sessions to balance operative training with ward based duties. Education must be integrated into working practice in order for trainees to achieve expected competencies and ultimately produce adequately experienced consultants. (Source: Postgraduate Medical Journal)

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Appendix A: Examples of Recommended Approaches to Specifying and Reporting Irradiations

Journal of the ICRU — Wed, 23 Nov 2011 05:00:00 +0100

(Source: Journal of the ICRU)

Schistosomiasis may contribute to Goblet Cell Carcinoid of the Appendix.

The Journal of Parasitology — Tue, 22 Nov 2011 05:00:00 +0100

BMJ Analysis: How evidence based is English public health policy?

NeLM - News — Mon, 21 Nov 2011 05:00:00 +0100

Source: BMJ Area: News The authors of this article analyse the government's white paper 'Healthy Lives, Healthy People' and find that many of the proposed interventions lack evidence of effectiveness, and in some cases have even been shown not to work. Reviewers searched systematically for evidence relating to the 51 statements describing specific interventions to improve population health set out in the white paper. Expert advisers were asked to review the completeness and accuracy of the evidence assessments (full details are included in the article's appendix, with important findings highlighted in the analysis). The article discusses the main findings relating to interventions of the following categories: early years; physical ...

Maternal Microchimerism in Hirschsprung’s Disease

American Journal of Perinatology — Mon, 21 Nov 2011 05:00:00 +0100

Amer J PerinatolDOI: 10.1055/s-0031-1295645Hirschsprung’s disease (HD) presents with severe constipation due to absent ganglion cells in the distal rectum. We sought to determine whether maternal chimeric cells are present in aganglionic bowel. We hypothesize that chimeric cells are part of the unfavorable microenvironment that leads to the destruction of enteric neurons in HD. Intestinal biopsies and resections from seven male patients with HD were compared with four male patients with chronic constipation and six with bowel atresia. Fluorescence in situ hybridization was used to identify chimeric cells based on male/female (XX/XY) differences. The location and immunophenotype of chimeric cells were also studied. Chimeric cells were present more often in the small intestine and rectum, ...

Vision-Related Quality of Life in Patients with Ocular Chemical Burns [Cornea]

Investigative Ophthalmology — Mon, 21 Nov 2011 05:00:00 +0100

Conclusions. Ocular chemical burns have a significant and extensive impact on patients' visual function outcomes and vision-related quality of life. (Source: Investigative Ophthalmology)

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Appendectomy versus antibiotic treatment for acute appendicitis.

Cochrane Database of Systematic Reviews — Sun, 20 Nov 2011 22:06:03 +0100

CONCLUSIONS: The upper bound of the 95% CI of ABT for cure within two weeks without major complications crosses the 20% margin of appendectomy, so the outcome is inconclusive. Also the quality of the studies was low to moderate, for that reason the results should be interpret with caution and definite conclusions cannot be made. Therefore we conclude that appendectomy remains the standard treatment for acute appendicitis. Antibiotic treatment might be used as an alternative treatment in a good quality RCT or in specific patients or conditions were surgery is contraindicated. PMID: 22071846 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Teaching critical appraisal skills in healthcare settings.

Cochrane Database of Systematic Reviews — Sun, 20 Nov 2011 22:06:03 +0100

CONCLUSIONS: Low-intensity critical appraisal teaching interventions in healthcare populations may result in modest gains. Improvements to research examining the effectiveness of interventions in healthcare populations are required; specifically rigorous randomised trials employing interventions using appropriate adult learning theories. PMID: 22071800 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Septic Mesenteric Venous Thrombophlebitis: A Rare Complication of Acute Appendicitis

PPAR Research — Sun, 20 Nov 2011 07:53:48 +0100

Mesenteric venous thrombophlebitis represents a very rare complication of acute appendicitis. Based on the findings of a 45-year-old patient with mesenteric venous thrombophlebitis due to acute appendicitis, we herein describe the diagnostic difficulties and therapeutic options in this uncommon disease. The treatment in our case consisted of simple appendectomy and perioperative anticoagulation therapy. (Source: PPAR Research)

Mood and anxiety in the medically ill.

Advances in Psychosomatic Medicine — Sat, 19 Nov 2011 03:24:55 +0100

Authors: Bech P Abstract In this review on rating scales for anxiety and depression, only instruments considered to be quantifiable, analogue to the measurement of hypertension in the medical setting, have been selected. The clinimetric method for validating these rating scales is the item response theory model in which the individual items are rank ordered on the dimensions of anxiety or depression, resulting in their total score being a sufficient statistic. The measurement of anxiety and mood on their respective dimensions of severity implies that we can speak of primary and secondary anxiety or depression in the same way as we speak about primary hypertension (without a medical explanation) and secondary hypertension (when caused be various medical conditions). Both clinician-r...

Fatal case of perforated appendicitis in an elderly CAPD patient

International Urology and Nephrology — Wed, 16 Nov 2011 16:44:51 +0100

Content Type Journal ArticleCategory Nephrology - Letter to the EditorPages 1-2DOI 10.1007/s11255-011-0074-zAuthors Johnny Sayegh, Service de Néphrologie-Dialyse-Transplantation, CHU d’Angers, 4 rue Larrey, 49933 Angers cedex 9, FranceStéphanie Lanoiselée, Service de Néphrologie-Dialyse-Transplantation, CHU d’Angers, 4 rue Larrey, 49933 Angers cedex 9, FranceVirginie Besson, Service de Néphrologie-Dialyse-Transplantation, CHU d’Angers, 4 rue Larrey, 49933 Angers cedex 9, FranceGabriel Balit, Expansion Centres d’Hémodialyse de l’Ouest, Angers, FranceJean-François Subra, Service de Néphrologie-Dialyse-Transplantation, CHU d’Angers, 4 rue Larrey, 49933 Angers cedex 9, FranceJean-François Augusto, Service de Néphrologie-Dialyse-Transplantation, CHU d’Angers, 4 rue L...

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Role of Clinical Judgment and Tissue Harmonic Imaging Ultrasonography in Diagnosis of Paediatric Acute Appendicitis

World Journal of Emergency Surgery — Wed, 16 Nov 2011 05:00:00 +0100

The objective of this study was to investigate the hypothesis that the use of a modified clinical practice and harmonic ultrasonographic grading scores (MCPGS) may improve the accuracy in diagnosing acute appendicitis in the pediatric population.Patients & Methods:Main outcome measures: Sensitivity, specificity, and accuracy of the modified scoring system. Five hundred and thirty patients presented with suspected diagnosis of acute appendicitis during the period from December 2000 to December 2009 were enrolled in this study. Children's data that have already been published of those who presented with suspected diagnosis of acute appendicitis- to whom a special clinical practice grading scores (CPGS) incorporating clinical judgment and results of gray scale ultrasonography (US) was applied...

Management and outcome of appendicitis among octogenarians in an English hospital over a five year period

International Journal of Surgery — Mon, 14 Nov 2011 05:00:00 +0100

Conclusion: Appendicitis in the elderly can result in significant morbidity due to the atypical presentation causing an unnecessary delay in treatment. If indicated, age should not be a contraindication for an appendicectomy. The increased likelihood for these patients to have a post-operative complication should be at the forefront of their care. (Source: International Journal of Surgery)

Appendix stump closure with titanium clips in laparoscopic appendectomy

Langenbeck's Archives of Surgery — Sat, 12 Nov 2011 06:48:04 +0100

Conclusion This study suggests that the presented titanium DS-Clip is a safe and cost-effective technique for securing the appendix base in laparoscopic appendectomy. The application is easy and can be learned quickly, making it a good option also for teaching hospitals. Content Type Journal ArticleCategory How-I-Do-It ArticlePages 1-5DOI 10.1007/s00423-011-0869-5Authors Alexander Rickert, Department of Surgery, University Hospital Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, GermanyRoderich Bönninghoff, Department of Surgery, University Hospital Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, GermanyStefan Post, Department of Surgery, University Hospital Mannheim, University of Heidelberg, Theodor-Kutzer...

Headache Among Patients With HIV Disease: Prevalence, Characteristics, and Associations

Headache: The Journal of Head and Face Pain — Fri, 11 Nov 2011 05:00:00 +0100

Conclusions.— Problematic headache is highly prevalent among patients with HIV/AIDS, most of which conform to the semiology of chronic migraine, although with some atypical features such as bilateral location and pressing/tightening quality. A low frequency of identifiable secondary causes is likely attributable to reduced frequency of opportunistic infections in the current era of HAART. Disease severity is strongly predictive of headache, highlighting the importance of physician attention to headache symptoms and of patient adherence to treatment. (Source: Headache: The Journal of Head and Face Pain)

Amyand Hernia Diagnosed With Sonography: A Case Study

Journal of Diagnostic Medical Sonography — Fri, 11 Nov 2011 05:00:00 +0100

Individually, inguinal hernias and acute appendicitis are common, but the combination of the two, acute appendicitis within an inguinal hernia or Amyand hernia (AH), is rare. The overwhelming majority of AH cases are in males and discovered during surgery. To date, only three case reports in the literature of this pathology have been diagnosed with sonography. This is a report of an AH diagnosed in a woman with sonography. (Source: Journal of Diagnostic Medical Sonography)

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Headache Among Patients With HIV Disease: Prevalence, Characteristics, and Associations.

Headache — Fri, 11 Nov 2011 05:00:00 +0100

Conclusions.- Problematic headache is highly prevalent among patients with HIV/AIDS, most of which conform to the semiology of chronic migraine, although with some atypical features such as bilateral location and pressing/tightening quality. A low frequency of identifiable secondary causes is likely attributable to reduced frequency of opportunistic infections in the current era of HAART. Disease severity is strongly predictive of headache, highlighting the importance of physician attention to headache symptoms and of patient adherence to treatment. PMID: 22077887 [PubMed - as supplied by publisher] (Source: Headache)

The Disappearing Spoon by Sam Kean – review

Guardian Unlimited Science — Thu, 10 Nov 2011 12:33:00 +0100

A hectic celebration of the periodic table of chemical elements through 'true tales of madness, love, and the history of the world'Enter our competition to win all six books shortlisted for this year's Royal Society Winton Prize for Science BooksAt the heart of Sam Kean's book is a refreshing idea: to tell the story of the periodic table almost entirely in terms of material oddity, instructive folly, elemental greed and partisan obsession.The field is large, one might say universal. Some of the stories have already been told many times (no historian, however eccentric, could omit Mendeleev or Rutherford or Pierre and Marie Curie) but Kean searches for stuff of rarer substance. Naturally, he goes (or rather, does not: the notes suggest that a friend in pursuit of another book about the elem...

Medication overuse headache: A silent pandemic

Pain — Thu, 10 Nov 2011 05:00:00 +0100

It is now 60years since it was first reported in the medical literature that those patients with episodic headache who habitually overused acute headache medication (ergotamine) developed chronic headache . The subsequent worsening of the headache disorder could be relieved by withdrawal of this medication. Many terms have since been coined to describe this entity (analgesic abuse headache, medication misuse headache, drug-induced headache) but in 2004 the Classification Committee of the International Headache Society labelled it Medication Overuse Headache (MOH) and produced diagnostic criteria . The difficulties in defining the problem (and differentiating it from chronic migraine) were reflected in new appendix criteria which were published in 2006 . It is now recognised that MOH can be...

Imaging of acute right lower quadrant abdominal pain: differential diagnoses beyond appendicitis

Emergency Radiology — Wed, 09 Nov 2011 17:44:55 +0100

Abstract Evaluation of acute right lower quadrant pain remains a common and challenging clinical scenario for emergency medicine physicians due to frequent nonspecific signs, symptoms, and physical examination findings. Therefore, imaging has evolved to play a pivotal role in the emergency setting. While appendicitis is a common cause for acute pain, there are numerous other important differential considerations with which the radiologist must be aware. The purpose of this review is to list an anatomy-based, encompassing differential diagnosis in addition to acute appendicitis for right lower quadrant pain; demonstrate the key imaging findings of numerous differential considerations; and describe helpful imaging and clinical features useful in narrowing the differential di...

Pilot Study of the Vesicocutaneous Continent Catheterizable Stoma (Mitrofanoff) in Adults—High Complication Rates

Urology — Wed, 09 Nov 2011 05:00:00 +0100

Conclusion: Continent catheterizable stomas have been a continuous challenge for adults who have had multiple abdominal surgeries, making a typical appendix, ureter, or small bowel Mitrofanoff difficult. We looked at our experience with a cutaneous Mitrofanoff (an extraperitoneal procedure often done in pediatrics but never before in adults) as an alternative but found complication rates of 100%. These included stenosis and dehiscence eventually requiring reoperation, with some even requiring conversion to an ileal or appendiceal Mitrofanoff. Although there are high complication rates in the standard Mitrofanoff, we conclude that a vesicocutaneous Mitrofanoff is not an effective alternative. (Source: Urology)

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[Appendicitis in Hungary through the eyes of a health insurance specialist].

Orvosi Hetilap — Tue, 08 Nov 2011 21:09:08 +0100

Conclusions: In Hungary, there are large regional differences in the proportion of surgery. Orv. Hetil., 2011, 152, 1843-1848. PMID: 22030361 [PubMed - in process] (Source: Orvosi Hetilap)

An Observational Study of the Etiology, Clinical Presentation and Outcomes Associated with Peritonitis in Lilongwe, Malawi

World Journal of Emergency Surgery — Tue, 08 Nov 2011 05:00:00 +0100

IntroductionPeritonitis is a life-threatening condition with a multitude of etiologies that can vary with geographic location. The aims of this study were to elucidate the etiology, clinical presentation and outcomes associated with peritonitis in Lilongwe, Malawi. Methods: All patients admitted to Kamuzu Central Hospital (KCH) who underwent an operation for treatment of peritonitis during the calendar year 2008 were eligible. Peritonitis was defined as abdominal rigidity, rebound tenderness, and/or guarding in one or more abdominal quadrants. Subjects were identified from a review of the medical records for all patients admitted to the adult general surgical ward and the operative log book. Those who met the definition of peritonitis and underwent celiotomy were included. Results: 190 sub...

Methamphetamine Use and Schizophrenia: A Population-Based Cohort Study in California.

The American Journal of Psychiatry — Tue, 08 Nov 2011 05:00:00 +0100

Conclusions:Study limitations include difficulty in confirming schizophrenia diagnoses independent of drug intoxication and the possibility of undetected schizophrenia predating drug exposure. The study's findings suggest that individuals with methamphetamine-related disorders have a higher risk of schizophrenia than those with other drug use disorders, with the exception of cannabis use disorders. The elevated risk in methamphetamine users may be explained by shared etiological mechanisms involved in the development of schizophrenia. PMID: 22193527 [PubMed - as supplied by publisher] (Source: The American Journal of Psychiatry)

MRI Proves Cost-Effective for Diagnosing AppendicitisMRI Proves Cost-Effective for Diagnosing Appendicitis

Medscape Today Headlines — Sat, 05 Nov 2011 00:18:38 +0100

A new cost study adds to known advantages of MRI for appendicitis. Medscape Medical News (Source: Medscape Today Headlines)

Appendicular Perforation at the base of the Caecum, a Rare Operative Challenge in Acute Appendicitis, A Literature Review

World Journal of Emergency Surgery — Fri, 04 Nov 2011 04:00:00 +0100

Conclusion: There are limited studies to compare these two surgical options in the literature. A larger prospective study is needed to compare both approaches and long term outcome. (Source: World Journal of Emergency Surgery)

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More Than 700 HIV/AIDS-Related Terms Defined in New Edition of AIDSinfo Glossary

Fri, 04 Nov 2011 04:00:00 +0100

AIDSinfo is pleased to introduce the English-language 7th edition of the popular AIDSinfo Glossary of HIV/AIDS-Related Terms. The glossary provides people affected by HIV/AIDS with a comprehensive guide to the vocabulary used to describe HIV/AIDS, including its treatment, prevention, and ongoing research. From absolute contraindication to X4-tropic virus, the updated glossary contains definitions for more than 700 HIV/AIDS-related terms. Definitions, developed on the basis of health information from trusted government sources, are presented in concise, easy-to-understand language. Highlights of the 7th edition of the glossary include the following: 151 new terms and accompanying definitions. Addition of several new terms and changes to existing terms on the basis of the most...

Cecal Bascule With Concurrent Acute AppendicitisCecal Bascule With Concurrent Acute Appendicitis

Medscape Today Headlines — Thu, 03 Nov 2011 10:20:20 +0100

In this unusual case, two common entities--cecal volvulus and appendicitis--occurred concurrently. What did the imaging studies show? Applied Radiology (Source: Medscape Today Headlines)

Creation of a Guide for the Transfer of Care of the Malignant Hyperthermia Patient from Ambulatory Surgery Centers to Receiving Hospital Facilities.

Anesthesia and Analgesia — Thu, 03 Nov 2011 04:00:00 +0100

Authors: Larach MG, Hirshey Dirksen SJ, Belani KG, Brandom BW, Metz KM, Policastro MA, Rosenberg H, Valedon A, Watson CB Abstract Clinical Problem:Volatile anesthetics and/or succinylcholine may trigger a potentially lethal malignant hyperthermia (MH) event requiring critical care crisis management. If the MH triggering anesthetic is given in an ambulatory surgical center (ASC), then the patient will need to be transferred to a receiving hospital. Before May 2010, there was no clinical guide regarding the development of a specific transfer plan for MH patients in an ASC.Mechanism by which the statement was generated:A consensual process lasting 18 months among 13 representatives of the Malignant Hyperthermia Association of the United States, the Ambulatory Surgery Foundation, the S...

Author reply

Ophthalmology — Tue, 01 Nov 2011 04:00:00 +0100

We thank Marcus Ang, Jodhbir S. Mehta, Frank J.H.M. van den Biggelaar, Yanny Y.Y. Cheng, and Rudy M.M.A. Nuijts for their generous comments and additional observations. The 9 pages of our manuscript, as well as the 35 pages of the supplemental online appendix (both published in Ophthalmology) were extensively revised and shortened. Specifically, 2 of the deleted sections addressed applications of deep anterior lamellar keratoplasty (DALK) that Ang and Mehta identify. These applications were deemed to be somewhat peripheral to the objectives of the ophthalmic technology assessment, but are reprinted here. “Therapeutic indications, or the removal of infected corneal tissue when medical therapy alone has failed to stabilize the eye, have also been managed with DALK. This includes treatment ...

Increased use of pre-operative imaging and laparoscopy has no impact on clinical outcomes in patients undergoing appendicectomy.

Annals of the Royal College of Surgeons of England — Tue, 01 Nov 2011 04:00:00 +0100

CONCLUSIONS: This study shows that significant increase in the use of pre-operative imaging and laparoscopy in the management of patients with acute appendicitis failed to reduce negative appendicectomy, perforation and complications rates. The patient's age was the only predictor of negative appendicectomy and perforation. PMID: 22041239 [PubMed - in process] (Source: Annals of the Royal College of Surgeons of England)

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ACR Appropriateness Criteria® Right Lower Quadrant Pain—Suspected Appendicitis

Journal of the American College of Radiology : JACR — Tue, 01 Nov 2011 04:00:00 +0100

The diagnostic imaging of patients presenting with right lower quadrant pain and suspected appendicitis may be organized according to age and gender and to the presence or absence of “classic” signs and symptoms of acute appendicitis. Among adult patients presenting with clinical signs of acute appendicitis, the sensitivity and specificity of CT are greater than those of ultrasound, with improved performance when CT is performed with intravenous contrast. The use of rectal contrast has been associated with decreased time in the emergency department. Computed tomography has also been shown to reduce cost and negative appendectomy rates. Both CT and ultrasound are also effective in the identification of causes of right lower quadrant pain unrelated to appendicitis. Among pediatric patien...

Neonatal acute appendicitis: a proposed algorithm for timely diagnosis

Journal of Pediatric Surgery — Tue, 01 Nov 2011 04:00:00 +0100

We report 3 cases of NA seen at our institution during this period.Results: All 3 infants were previously well, born at term, and presented with signs consistent with abdominal sepsis. The first 2 diagnoses were not made until autopsy. The third case survived after having an urgent computed tomographic scan, exploratory laparotomy, and appendectomy.Discussion: The literature summarizing common presenting features of NA is reviewed. We present an algorithm to guide the workup of these neonates to facilitate earlier diagnosis and potentially improve outcomes. (Source: Journal of Pediatric Surgery)

The effect of surgical training and hospital characteristics on patient outcomes after pediatric surgery: a systematic review

Journal of Pediatric Surgery — Tue, 01 Nov 2011 04:00:00 +0100

Conclusions: Existing evidence is largely observational and potentially subject to selection bias, but general pediatric surgery outcomes were clearly dependent on operative volumes. Published evidence suggests that (1) pediatric appendicectomy should not be centralized because children can be managed effectively by general surgeons; (2) pyloromyotomy need not be centralized but should be carried out in children's units by appropriately trained surgeons who expect to see more than 4 cases per year. (Source: Journal of Pediatric Surgery)

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Journal of Pediatric Surgery — Tue, 01 Nov 2011 04:00:00 +0100

Acute mesenteric lymphadenitis in children has a clinical presentation very similar to that of acute appendicitis. The aim of this study was to evaluate whether it is possible to clinically differentiate between acute appendicitis and acute mesenteric lymphadenitis in children. (Source: Journal of Pediatric Surgery)

Incidental findings on computed tomography scans for acute appendicitis: prevalence, costs, and outcome.

The American Surgeon — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Ozao-Choy J, Kim U, Vieux U, Menes TS Abstract CT scan is increasingly being used to diagnose appendicitis due to its specificity and literature suggesting its cost-effectiveness. CT scans are associated with incidental findings. We sought to investigate the rates of incidental findings identified on CT scans, the follow-up of these findings, and the added cost associated with this follow-up. A retrospective review of patients who underwent appendectomies for acute appendicitis between 2003 and 2005 was completed at Elmhurst Hospital Center (Elmhurst, NY). Incidental findings were grouped into low and high significance, based on workup or follow-up needed. The diagnostic workup and cost of each incidental finding was ascertained. For patients who did not receive a workup d...

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Subhepatic appendicitis.

The American Surgeon — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Oakenful C, Lambrianides AL, Brown J PMID: 22196645 [PubMed - in process] (Source: The American Surgeon)

Ingested foreign body lodged in the appendix

Journal of Indian Association of Pediatric Surgeons — Mon, 31 Oct 2011 04:00:00 +0100

Vipul D YagnikJournal of Indian Association of Pediatric Surgeons 2011 16(4):174-174 (Source: Journal of Indian Association of Pediatric Surgeons)

Oophorectomy for whom and at what age? Primum non nocere

Maturitas — Mon, 31 Oct 2011 04:00:00 +0100

Medical and surgical practices have evolved during history as a result of the transformation of medical concepts and theories. Bilateral oophorectomy performed electively at the time of hysterectomy for a benign indication is now under scrutiny and critical reappraisal because long-term risks may outweigh the benefits in the majority of women. Like the removal of any other healthy organ for the prevention of possible future diseases (e.g., appendix, tonsils, or breasts), bilateral oophorectomy must follow the principle “primun non nocere, or first do no harm.” (Source: Maturitas)

Automated Detection of Critical Results in Radiology Reports

Journal of Digital Imaging — Sat, 29 Oct 2011 05:48:54 +0100

Abstract The goal of this study was to develop and validate text-mining algorithms to automatically identify radiology reports containing critical results including tension or increasing/new large pneumothorax, acute pulmonary embolism, acute cholecystitis, acute appendicitis, ectopic pregnancy, scrotal torsion, unexplained free intraperitoneal air, new or increasing intracranial hemorrhage, and malpositioned tubes and lines. The algorithms were developed using rule-based approaches and designed to search for common words and phrases in radiology reports that indicate critical results. Certain text-mining features were utilized such as wildcards, stemming, negation detection, proximity matching, and expanded searches with applicable synonyms. To further improve accuracy, t...

Autonomic nervous system and lipid metabolism: findings in anxious-depressive spectrum and eating disorders

Lipids in Health and Disease — Fri, 28 Oct 2011 04:00:00 +0100

Conclusions: Lipid metabolism and autonomic functioning seem to be related to the discussed psychiatric disorders. LI, in addition, could represent a new possible biomarker to be considered. (Source: Lipids in Health and Disease)

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Diagnostic accuracy of magnetic resonance imaging: A prospective evaluation of patients with suspected appendicitis (Diamond)

Journal of Magnetic Resonance Imaging — Thu, 27 Oct 2011 04:00:00 +0100

Conclusion:Abdominal MRI in the evaluation of patients with suspected appendicitis and equivocal clinical findings is safe, reliable, and cost‐effective. It should be considered an important alternative to computed tomography. J. Magn. Reson. Imaging 2011;. © 2011 Wiley Periodicals, Inc. (Source: Journal of Magnetic Resonance Imaging)

'Cyberchondria' gives doctors a pain

L.A. Times - Health — Wed, 26 Oct 2011 17:14:00 +0100

Physicians frustrated by patients who increasingly use the Internet to self-diagnose — and sometimes 'find' a serious illness that isn't thereA woman called her doctor to say she had been online and determined she had appendicitis. Knowing the woman wouldn't be talking calmly if she were truly in the throes of the condition, Brown set up an appointment for the next day. It turns out the woman had a groin injury. (Source: L.A. Times - Health)

Mystery bird: Mikado pheasant, Syrmaticus mikado | @GrrlScientist | Punctuated Equilibrium

Guardian Unlimited Science — Sun, 23 Oct 2011 16:30:01 +0100

This endangered species is revered as the national bird of Taiwan, where it is endemic (includes video) Mikado pheasant, Syrmaticus mikado Ogilvie-Grant, 1906 (protonym, Calophasis mikado), also known as the Taiwan long-tailed pheasant, photographed near Taichung, central Taiwan, China. Image: Marie-Louise Ng, 4 May 2011 (with permission) [velociraptorize]. Question: This striking Taiwanese mystery bird is a popular avicultural subject in both the United States and Europe -- a good thing since this bird is listed as CITES Appendix I (endangered), although IUCN red-lists this species as being "near threatened". Can you tell me a little about this bird's colouration and what that may suggest about this species' evolutionary origin? Can you identify this bird's taxonomic family and species? R...

Flexible-Tip Laparo-Endoscopic Surgery: A Bridge to Single Port Appendicectomy in Children

European Journal of Pediatric Surgery — Fri, 21 Oct 2011 04:00:00 +0100

We report the first series of children who were treated with a reduced incision technique for appendicectomy using flexible-tip laparo-endoscopic surgery (FLES).FLES was set up using one 11-mm and 2×5-mm bladeless ports (Ethicon XCEL™) via umbilical and low left iliac fossa incisions. A 10-mm flexible-tip laparo-endoscope was utilized. Tip angulation ensured visibility while minimising instrument clashing. A database of children undergoing FLES was kept prospectively. Demographic and peri-operative information and complications were recorded. Data are presented as medians with ranges.Between March and June 2010, 5 children (4 females) aged 9 (4–13) years underwent FLES for right iliac fossa pain. 2 procedures were performed by the admitting consultant, 3 by a supervised inexperienced ...