Seasonal variation of acute appendicitis and fecaliths in children

Abstract Purpose A higher incidence of acute appendicitis (AA) in summer has been reported. The reason of this observation is uncertain. The purpose of this study is to analyze the difference of the clinical findings between summer and non-summer AA. Methods We reviewed the clinical data of 171 patients who had an appendectomy from 2013 to 2016. The patients were under 18 years of age by the time of surgery. Laboratory data, CT scans, pathologic reports and operative records were reviewed. Results More appendectomies were performed in summer than non-summer months (101 patients vs 70 patients). There is no significant difference of laboratory results between the summer and non-summer patients. The percentage of AA patients with a fecalith is significantly lower in the summer (33.6%) than non-summer months (55.7%). There was no significant difference in appendiceal perforation/abscess between summer and non-summer months. Conclusions We observed a lower percentage of AA with a fecalith in summer. To our knowledge, this observation has not been reported in literature. The increase of AA in summer may be a result of more lymphoid hyperplasia in summer. This may correlate with the yearly outbreak of enteroviral infections in this area.

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Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

10.21203/rs.2.14801/v2 ◽

2019 ◽

Author(s):

Yao-Jen Hsu ◽

Yu-Wei Fu ◽

Taiwai Chin

Keyword(s):

Acute Appendicitis ◽

Laboratory Data ◽

Lymphoid Hyperplasia ◽

Clinical Findings ◽

Enterovirus Infection ◽

Number Of Patients ◽

Computed Tomography Scans ◽

Laboratory Results ◽

Pathology Reports ◽

Surgical Condition

Abstract Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. Laboratory data, computed tomography scans, pathology reports and operative records were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

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Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

BMC Pediatrics ◽

10.1186/s12887-019-1824-9 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Yao-Jen Hsu ◽

Yu-Wei Fu ◽

Taiwai Chin

Keyword(s):

Acute Appendicitis ◽

Medical Records ◽

Laboratory Data ◽

Lymphoid Hyperplasia ◽

Clinical Findings ◽

Number Of Patients ◽

Computed Tomography Scans ◽

Pathology Reports ◽

Operative Notes ◽

Surgical Condition

Abstract Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

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Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

10.21203/rs.2.14801/v4 ◽

2019 ◽

Author(s):

Yao-Jen Hsu ◽

Yu-Wei Fu ◽

Taiwai Chin

Keyword(s):

Acute Appendicitis ◽

Medical Records ◽

Laboratory Data ◽

Lymphoid Hyperplasia ◽

Clinical Findings ◽

Number Of Patients ◽

Computed Tomography Scans ◽

Pathology Reports ◽

Operative Notes ◽

Surgical Condition

Abstract Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

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Can Clinical Findings Prevent Negative Laparotomy in Parasitosis Mimicking Acute Appendicitis?

Advances in Emergency Medicine ◽

10.1155/2016/8313604 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5

Author(s):

Musa Zorlu ◽

İbrahim Tayfun Şahiner ◽

Ahmet Çınar Yastı ◽

Ethem Zobacı ◽

Ramazan Kocabaş ◽

...

Keyword(s):

Acute Appendicitis ◽

Rural Areas ◽

Young Patients ◽

Diagnostic Value ◽

Lymphoid Hyperplasia ◽

Clinical Findings ◽

City Centre ◽

Negative Laparotomy ◽

Number Of Patients ◽

Significant Difference

Objectives. Rates of negative laparotomy (NL) for acute appendicitis have been reported as 15% and parasitosis contributed to 2%. This study was planned to reduce the rates of NL by preoperative determination of parasitosis. Methods. In retrospective examination of 2730 appendectomy specimens in Hitit University Department of General Surgery between 2008 and 2012, 55 patients were determined with parasitosis and compared with 102 age-matched randomly selected patients with lymphoid hyperplasia. Results. The parasite group comprised 63.6% females with a mean age of 15.1 years. The number of patients in the parasitosis group increased from city centre to rural areas of towns and villages (p<0.001). While a lower rate of sonographic findings was found in the parasitosis group, the findings of inflammation in the histopathological evaluation were significantly low (p=0.014, p=0.0011, resp.). A significant difference was determined between groups in respect of the eosinophil and haematocrit values. In the differentiation of patients with parasites, eosinophil of >2.2% was determined as a diagnostic value. Conclusion. It is important to determine parasitosis to prevent NL. When acute appendicitis is considered for young patients living in rural areas, the observation of high eosinophil together with negative sonographic findings should bring Enterobius vermicularis parasitosis to mind and thereby should prevent NL.

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Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

10.21203/rs.2.14801/v5 ◽

2019 ◽

Author(s):

Yao-Jen Hsu ◽

Yu-Wei Fu ◽

Taiwai Chin

Keyword(s):

Acute Appendicitis ◽

Medical Records ◽

Laboratory Data ◽

Lymphoid Hyperplasia ◽

Clinical Findings ◽

Number Of Patients ◽

Computed Tomography Scans ◽

Pathology Reports ◽

Operative Notes ◽

Surgical Condition

Abstract Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

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Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

10.21203/rs.2.14801/v3 ◽

2019 ◽

Author(s):

Yao-Jen Hsu ◽

Yu-Wei Fu ◽

Taiwai Chin

Keyword(s):

Acute Appendicitis ◽

Medical Records ◽

Laboratory Data ◽

Lymphoid Hyperplasia ◽

Clinical Findings ◽

Number Of Patients ◽

Computed Tomography Scans ◽

Pathology Reports ◽

Operative Notes ◽

Surgical Condition

Abstract Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

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Infertile bulls versus steers: III. Carcass characteristics

The Journal of Agricultural Science ◽

10.1017/s0021859600024473 ◽

1971 ◽

Vol 77 (2) ◽

pp. 317-323 ◽

Cited By ~ 3

Author(s):

M. A. Price

Keyword(s):

Muscle Growth ◽

Weight Ratio ◽

Carcass Characteristics ◽

Carcass Composition ◽

Lower Percentage ◽

Nutritional Conditions ◽

Significant Difference ◽

Kidney Fat ◽

The Difference ◽

The One

SummaryThe carcass characteristics of a total of 43 infertile bulls were oompared with those of 42 steers from five independent trials. In most cases there was no significant difference between the bulls and the steers for dressing percentage, or fleshing index. Bulls were generally found to have greater hide percentages than steers, the difference being very highly significant (P < 0·001) in one of the trials and significant (P < 0·05) in another. Eye musole area expressed relative to caroass weight was greater in the bulls, the difference being significant (P < 0·05) in three of the trials. The depth of fat over the eye musole and the hind to fore-quarter weight ratio were greater in the steer carcasses. Head weights were found to be significantly greater (P < 0·05) and caul and kidney fat weights less (P < 0·05) in bulls than in steers in the one trial where these parameters could be measured.Carcass composition was estimated by the three-rib sample joint teohnique in four of the trials, and in these the bulls had a greater percentage of bone and muscle, but a lower peroentage of fat than the steers, the differences being significant in most oases. In the fifth trial composition was estimated by half carcass dissection. This, too, showed bulls to have a greater percentage of bone and muscle and a lower percentage of fat, the differences being highly significant (P < 0·01) and very highly significant (P < 0·001) respectively. On a fat-corrected basis the estimated retail value of the carcasses favoured the bulls by about $20.00 each.The studies, conducted over a range of nutritional conditions, showed that non-castration favoured muscle growth while suppressing fat deposition, and that this advantage was more pronounced when growth rates were high.

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Impact of grafting type on Esca foliar symptoms

OENO One ◽

10.20870/oeno-one.2016.50.4.1408 ◽

2017 ◽

Vol 51 (2) ◽

Author(s):

Séverine Mary ◽

Coralie Laveau ◽

Pascal Lecomte ◽

Marc Birebent ◽

Jean-Philippe Roby

Keyword(s):

The Other ◽

Lower Percentage ◽

Cabernet Sauvignon ◽

Climatic Regions ◽

Foliar Symptoms ◽

Significant Difference ◽

The Difference ◽

First Time

Aim: The aim of the survey was to investigate if the grafting type influences the foliar expression of Esca during summer.Methods and Results: Observations were conducted on plots distributed in two French winegrowing regions (two different climatic regions) with two varieties (Cabernet-Sauvignon in the Bordeaux region and Mourvèdre in Provence). Three grafting types were compared: Omega graft, Whip and Tongue graft, and full cleft graft. For both varieties, we found a significant effect of the type of grafting on the foliar development of Esca symptoms. Full cleft grafted plots showed a significantly lower percentage of Esca foliar symptoms than the other two modalities, which were not significantly different from one another. Concerning Omega grafted plots, a significant difference in the rate of Esca foliar symptoms was highlighted compared to full cleft grafted plots, with a higher rate on Omega grafted plots, but these plots were also younger.Conclusions: The study established, for the first time, the difference between full cleft field grafted plots and Omega and Whip and Tongue grafted plots, revealing a higher incidence of Esca on the latter types of grafting.Significance and impact of the study: The spread of mechanical graft could be one of the factors explaining the increasing incidence of Esca in vineyard.

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Comparative Therapeutic Efficacy and Safety of Remdesivir monotherapy and its Combination of Lopinavir/Ritonavir in COVID-19 Patients

10.22541/au.161884638.86969340/v1 ◽

2021 ◽

Author(s):

Marian Boshra ◽

haitham saeed ◽

Ahmed E. Abou Warda ◽

Rania Sarhan

Keyword(s):

Therapeutic Efficacy ◽

Laboratory Data ◽

Efficacy And Safety ◽

Once Daily ◽

Infection Treatment ◽

Significant Difference ◽

Before And After ◽

The Difference ◽

Severity Of The Disease ◽

Enzyme Elevation

Objectives: The treatment of COVID-19 infection remains a challenge because till now, there is no approved therapy for it. This study aimed to estimate the difference in the therapeutic efficacy and safety between remdesivir as monotherapy and its use in combination with lopinavir/ritonavir provided with standard supportive care. Methods: This is a prospective randomized cohort study included 1043 adult patients with confirmed moderate and severe COVID-19 infection. Treatment of all patients followed Egyptian Ministry of Health COVID-19 protocol as the first group received IV remdesivir 200 mg on day 1, followed by 100 mg once daily, for 5 days while the second group received lopinavir/ritonavir 400/100 mg twice daily, for 5 days with the same remdesivir regimen in the first group. All laboratory and clinical parameters were assessed before and after treatment duration. Results: There was no significant difference related to improvement parameters such as laboratory data and improvement time between the two groups. On the other hand, hepatotoxicity of the second group (combination) was significantly higher compared with that of the first one. The elevation on liver enzymes was affected by the severity of the disease, the severe cases showed a high enzyme elevation rate. Conclusion: Remdesivir as monotherapy and its use in combination with lopinavir/ritonavir is effective in the management of moderate COVID 19 subjects than severe cases. The combination of remdesivir with lopinavir/ritonavir is not recommended due to the increased hepatotoxicity effect.

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Should registrars be reporting after-hours CT scans? A calculation of error rate and the influencing factors in South Africa

Acta Radiologica ◽

10.1258/ar.2011.110103 ◽

2012 ◽

Vol 53 (1) ◽

pp. 61-68 ◽

Cited By ~ 9

Author(s):

Owen D Terreblanche ◽

Savvas Andronikou ◽

Linda T Hlabangana ◽

Taryn Brown ◽

Pieter E Boshoff

Keyword(s):

South Africa ◽

Influencing Factors ◽

Error Rate ◽

The Body ◽

Ct Scans ◽

Body Region ◽

Body Regions ◽

Significant Difference ◽

After Hours ◽

The Difference

Background There is a heavy reliance on registrars for after-hours CT reporting with a resultant unavoidable error rate. Purpose To determine the after-hours CT reporting error rate by radiology registrars and influencing factors on this error rate. Material and Methods A 2-month prospective study was undertaken at two tertiary, level 1 trauma centers in Johannesburg, South Africa. Provisional CT reports issued by the registrar on call were reviewed by a qualified radiologist the following morning and information relating to the number, time and type of reporting errors made as well as the body region scanned, indication for the scan, year of training of the registrar, and workload during the call were recorded and analyzed. Results A total of 1477 CT scans were performed with an overall error rate of 17.1% and a major error rate of 7.7%. The error rate for 2nd, 3rd, and 4th year registrars was 19.4%, 15.1%, and 14.5%, respectively. A significant difference was found between the error rate in reporting trauma scans (15.8%) compared to non-trauma scans (19.2%) although the difference between emergency scans (16.9%) and elective scans (22.6%) was found to be not significant, a finding likely due to the low number of elective scans performed. Abdominopelvic scans elicited the highest number of errors (33.9%) compared to the other body regions such as head (16.5%) and cervical, thoracic, or lumbar spine (11.7%). Increasing workload resulted in a significant increase in error rate when analyzed with a generalized linear model. There was also a significant difference noted in the time of scan groups which we attributed to a workload effect. Missed findings were the most frequent errors seen (57.3%). Conclusion We found an increasing error rate associated with increasing workload and marked increase in errors with the reporting of abdominopelvic scans. There was a decrease in the error rate when looking an increasing year of training although this there was only found to be significant difference between the 2nd and 3rd year registrars.

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