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Journal of Medical Case Reports Jun 2024Schistosomiasis is one of the endemic parasitic diseases in many developing countries. Despite this, appendicitis secondary to schistosomiasis is an uncommon condition...
BACKGROUND
Schistosomiasis is one of the endemic parasitic diseases in many developing countries. Despite this, appendicitis secondary to schistosomiasis is an uncommon condition even in some endemic areas. Schistosomal appendicitis, an incidentally discovered appendicitis associated with schistosomiasis histological findings, affects young males predominantly. Timely diagnosis and treatment, including appendectomy and anti-helminthic therapy, are crucial.
CASE REPORT
A 24-year-old Sudanese male patient presented with abdominal pain. Diagnosed with acute appendicitis, he underwent appendectomy, revealing appendix inflammation with Schistosoma ova in histopathology. Abdominal ultrasound detected no complications. Weakly positive Schistosoma serology was noted, but stool and urine analysis showed no infection evidence. Prescribed praziquantel, patient had 3-year post-op follow-up without complications.
CONCLUSIONS
This case report underscores the significance of including schistosomiasis in the differential diagnosis of appendicitis, particularly in regions where the disease is endemic. It underscores the necessity of histopathological evaluations for accurate diagnosis, emphasizing the potential implications for clinical practice in similar settings.
Topics: Humans; Appendicitis; Male; Young Adult; Praziquantel; Appendectomy; Anthelmintics; Schistosomiasis; Diagnosis, Differential; Abdominal Pain; Ultrasonography; Animals; Treatment Outcome; Appendix
PubMed: 38890741
DOI: 10.1186/s13256-024-04610-3 -
Gastroenterology Report 2024This article presents an overview of endoscopic retrograde appendicitis therapy (ERAT), an innovative and minimally invasive treatment for appendicitis with an... (Review)
Review
This article presents an overview of endoscopic retrograde appendicitis therapy (ERAT), an innovative and minimally invasive treatment for appendicitis with an appendix-preserving manner. Since its initial application in 2009, ERAT has gained significant popularity in China, due to its rapid recovery and minimal risk of complications. The ERAT procedures comprise several steps, including appendiceal orifice access and intubation, appendiceal lumen imaging, decompression and irrigation, fecalith removal, and stenting. ERAT has been used in various forms of complicated appendicitis, such as in pregnant women and children, with continuous improvements in both technique and safety. It has the potential to become the preferred diagnostic and treatment method for appendicitis. Until 2023, over 10,000 ERAT procedures have been successfully conducted in China, and the technique has gained more attention worldwide. However, challenges remain, including training, standardization of ERAT practice, research and technology improvement, enhancing public awareness, and fostering international collaboration. In summary, ERAT can be the standard treatment for appendicitis treatment, which represents a paradigm shift in the conventional clinical practice.
PubMed: 38887595
DOI: 10.1093/gastro/goae037 -
BMC Emergency Medicine Jun 2024Acute Appendicitis (AA) is one of the most common surgical emergencies worldwide. This study aims to investigate the predictive performances of 6 different Machine...
BACKGROUNDS
Acute Appendicitis (AA) is one of the most common surgical emergencies worldwide. This study aims to investigate the predictive performances of 6 different Machine Learning (ML) algorithms for simple and complicated AA.
METHODS
Data regarding operated AA patients between 2012 and 2022 were analyzed retrospectively. Based on operative findings, patients were evaluated under two groups: perforated AA and none-perforated AA. The features that showed statistical significance (p < 0.05) in both univariate and multivariate analysis were included in the prediction models as input features. Five different error metrics and the area under the receiver operating characteristic curve (AUC) were used for model comparison.
RESULTS
A total number of 1132 patients were included in the study. Patients were divided into training (932 samples), testing (100 samples), and validation (100 samples) sets. Age, gender, neutrophil count, lymphocyte count, Neutrophil to Lymphocyte ratio, total bilirubin, C-Reactive Protein (CRP), Appendix Diameter, and PeriAppendicular Liquid Collection (PALC) were significantly different between the two groups. In the multivariate analysis, age, CRP, and PALC continued to show a significant difference in the perforated AA group. According to univariate and multivariate analysis, two data sets were used in the prediction model. K-Nearest Neighbors and Logistic Regression algorithms achieved the best prediction performance in the validation group with an accuracy of 96%.
CONCLUSION
The results showed that using only three input features (age, CRP, and PALC), the severity of AA can be predicted with high accuracy. The developed prediction model can be useful in clinical practice.
Topics: Humans; Appendicitis; Machine Learning; Female; Male; Retrospective Studies; Adult; Middle Aged; Severity of Illness Index; C-Reactive Protein; ROC Curve; Algorithms; Adolescent; Acute Disease; Young Adult; Aged
PubMed: 38886641
DOI: 10.1186/s12873-024-01023-9 -
Case Reports in Surgery 2024Multiple types of fistulas associated with the appendix have been reported; however, duodenal fistula resulting from perforated acute appendicitis has only been...
Multiple types of fistulas associated with the appendix have been reported; however, duodenal fistula resulting from perforated acute appendicitis has only been documented in one previous case. In this report, we present the case of an 18-year-old male patient who was diagnosed to have a complicated appendicitis in its normal position with abscess formation. He was started on IV antibiotics and underwent a CT-guided drainage of the abscess with drain placement. Two days later due to biliary output from the drain, CT fistulography and diagnostic laparoscopy were performed that revealed the presence of a duodenal fistula. The potential for duodenal fistula formation in patients with complicated appendicitis must always be taken into consideration. Consequently, it is crucial to establish an appropriate management plan aimed at preventing additional serious complications arising from duodenal perforation.
PubMed: 38883267
DOI: 10.1155/2024/8269752 -
Cureus May 2024Gastrointestinal stromal tumors (GISTs) are a type of mesenchymal tumor of the gastrointestinal tract that originate anywhere in the gastrointestinal tract, with the...
Gastrointestinal stromal tumors (GISTs) are a type of mesenchymal tumor of the gastrointestinal tract that originate anywhere in the gastrointestinal tract, with the colon and appendix being the least recorded sites of occurrence. The following case report is that of a colonic GIST in a 53-year-old male and its histologic type. Included are notes on the recent additions and updates in the risk stratification of GISTs occurring in unusual sites with the relevant immunohistochemistry.
PubMed: 38883081
DOI: 10.7759/cureus.60383 -
Cureus May 2024Inguinal hernia is common. However, only a few cases have been reported in the literature of inguinal interparietal hernia, in which the herniated sac exits the...
Inguinal hernia is common. However, only a few cases have been reported in the literature of inguinal interparietal hernia, in which the herniated sac exits the intraperitoneal cavity through the deep inguinal ring and then protrudes into one of the anatomical planes of the anterior abdominal wall. Only one of the reported inguinal interparietal hernia cases was managed laparoscopically. We report the case of a right inguinal interparietal hernia in a young, healthy adult with a herniated cecum, terminal ileum, and appendix. He presented with right iliac fossa pain. On investigation, he was found to have an interparietal hernia in the inguinal region. Diagnostic laparoscopy showed a clear herniated cecum through the internal inguinal ring into the anterior abdominal wall. The patient was treated with regular laparoscopic hernioplasty and was discharged on the second postoperative day with no complications. Although the diagnosis might be difficult for interparietal hernias, laparoscopic diagnosis and management provide precise assessment and less invasive management.
PubMed: 38883002
DOI: 10.7759/cureus.60448 -
Cureus May 2024The purpose of this study was to assess the awareness of ototoxicity among medical doctors in Arar City, Saudi Arabia.
OBJECTIVES
The purpose of this study was to assess the awareness of ototoxicity among medical doctors in Arar City, Saudi Arabia.
METHODS
This is a cross-sectional study based on a pre-formed validated questionnaire (Appendix) that included three sections covering participants' demographic data (three questions), their attitudes (five questions), and knowledge (13 questions) regarding drug-induced ototoxicity.
RESULTS
After obtaining their informed consent, 213 physicians from government and private sector health facilities in Arar were enrolled in the study. Interns and general practitioners represented 57.8% of the participants; consultants represented 17.8%. Only 71.8% of participants were interested in drug-induced ototoxicity, while 26.3% considered ototoxicity a rare complication. Approximately 90% of the participants were knowledgeable about the adverse effects of drugs on the vestibulocochlear system, and 26.7% reported having experienced cases of drug-induced ototoxicity in their practice. Participants showed an overall knowledge score about ototoxicity of 9.3±3.27 (out of 14). The knowledge score was significantly higher (p-value=0.0007) for participants with more years of clinical experience. The most widely known ototoxic drug for participants was frusemide (72.3%), followed by aminoglycoside (68.5%), while acetaminophen (44.1%) ototoxicity was the least known among participants.
CONCLUSION
Awareness of drug-induced ototoxicity is satisfactory among physicians in the Northern Borders region. However, workshops about all types of drugs with ototoxic effects and the main lines for the management of drug-induced ototoxicity are recommended to increase awareness.
PubMed: 38882992
DOI: 10.7759/cureus.60429 -
Journal of Food Protection Jun 2024The 2021 FSIS Stabilization Guidelines for Meat and Poultry Products (Appendix B) Option 1.2 limits Phase 1 cooling from 48.8 to 26.7 °C in uncured meats to 1 h....
The 2021 FSIS Stabilization Guidelines for Meat and Poultry Products (Appendix B) Option 1.2 limits Phase 1 cooling from 48.8 to 26.7 °C in uncured meats to 1 h. However, this time restriction is impractical to achieve in large-diameter whole-muscle products. The objective of this study was to compare the inhibitory effect of commercial dry vinegars (DVs) and cultured sugar-vinegar blends (CSVs) on Clostridium perfringens and Bacillus cereus in uncured beef and poultry products during extended cooling. Treatments (beef: 72-73% moisture, pH 6.2-6.3, 0.85-0.95% NaCl; turkey: 76-77% moisture, pH 6.5-6.7, 1.3-1.6% NaCl) included Controls without antimicrobials, and four DV and four CSV, each tested at 0.75 and 1.25%. Batches were inoculated with 2.5-log C. perfringens or B. cereus spores, vacuum-packaged, and cooked to 73 °C. Packages were cooled from 48.8 to 27 °C (Phase 1) in 3, 4, or 5 h; Phase 2 (27-12.8 °C) and Phase 3 (12.8-4 °C) were standardized for 5-h cooling each. Pathogens were enumerated on selective agar in triplicate samples assayed at precook, postcook, and at the end of Phase 1, 2, and 3 cooling. Experiments were conducted twice. B. cereus did not grow (<0.5-log increase) in any treatment when Phase 1 cooling was extended to 5 h. C. perfringens grew rapidly (2.5 to >4.5 log) in Control treatments when Phase 1 cooling was extended to ≥3 h. All 1.25% DV ingredients limited C. perfringens growth to ≤1-log when Phase 1 cooling was extended to 3 h but supported a >1-log increase when Phase 1 cooling was extended to 5 h. All 1.25% CSV inhibited growth under 3-h Phase 1 cooling; 1.25% CSV-A and ≥0.75% CSV-D inhibited growth in turkey during 5-h Phase 1 cooling, but inhibition with 1.25% CSV-C was inconsistent in beef. This study revealed that formulating uncured meats with 1.25% DV or certain CSV can extend Phase 1 cooling to 3 h. Although all ingredients inhibited growth when used at 0.75% or greater compared to a control, greater variability of inhibition was observed among CSV than for DV.
PubMed: 38878899
DOI: 10.1016/j.jfp.2024.100317 -
The Journal of Thoracic and... Jun 2024Lung cancers that present as radiographic subsolid nodules represent a subtype with distinct biological behavior and outcomes. The objective of this document is to...
OBJECTIVE
Lung cancers that present as radiographic subsolid nodules represent a subtype with distinct biological behavior and outcomes. The objective of this document is to review the existing literature and report consensus among a group of multidisciplinary experts, providing specific recommendations for the clinical management of subsolid nodules.
METHODS
The American Association for Thoracic Surgery Clinical Practice Standards Committee assembled an international, multidisciplinary expert panel composed of radiologists, pulmonologists, and thoracic surgeons with established expertise in the management of subsolid nodules. A focused literature review was performed with the assistance of a medical librarian. Expert consensus statements were developed with class of recommendation and level of evidence for each of 4 main topics: (1) definitions of subsolid nodules (radiology and pathology), (2) surveillance and diagnosis, (3) surgical interventions, and (4) management of multiple subsolid nodules. Using a modified Delphi method, the statements were evaluated and refined by the entire panel.
RESULTS
Consensus was reached on 17 recommendations. These consensus statements reflect updated insights on subsolid nodule management based on the latest literature and current clinical experience, focusing on the correlation between radiologic findings and pathological classifications, individualized subsolid nodule surveillance and surgical strategies, and multimodality therapies for multiple subsolid lung nodules.
CONCLUSIONS
Despite the complex nature of the decision-making process in the management of subsolid nodules, consensus on several key recommendations was achieved by this American Association for Thoracic Surgery expert panel. These recommendations, based on evidence and a modified Delphi method, provide guidance for thoracic surgeons and other medical professionals who care for patients with subsolid nodules.
PubMed: 38878052
DOI: 10.1016/j.jtcvs.2024.02.026 -
Ear, Nose, & Throat Journal Jun 2024Laryngocele, an abnormal dilation of the appendix of the laryngeal ventricle filled with air, is a rare condition predominantly presenting unilaterally. However,...
Laryngocele, an abnormal dilation of the appendix of the laryngeal ventricle filled with air, is a rare condition predominantly presenting unilaterally. However, bilateral occurrences are exceedingly rare. In this article, we present a case of bilateral laryngocele along with a comprehensive literature review. A 57-year-old male presented with dyspnea, stridor, and bilateral neck masses. His medical history included chronic cough and intermittent hoarseness. Over a 3 month period, the neck masses progressively enlarged, resulting in respiratory distress. Interestingly, he denied experiencing weight loss, decreased appetite, or fever. Clinical examination revealed sizable, soft masses on both sides of the neck, obstructing lymph node assessment. Computed tomography (CT) imaging confirmed the presence of a left combined laryngopyocele and a right combined laryngocele. Subsequently, the patient underwent tracheostomy. Benign biopsy results excluded malignancy. Surgical excision of bilateral laryngoceles resulted in an uneventful recovery. The term "laryngocele" was introduced by Virchow in 1867 to describe the abnormal dilation of the saccule associated with Morgagni's ventricle. Diagnosis involves a thorough patient history, physical examination, and radiological imaging, notably CT, to differentiate laryngoceles from other conditions. Typically asymptomatic, they are often incidentally discovered around age 50, although symptoms such as voice changes or breathing difficulties can manifest. A review of the literature identified 77 documented cases, primarily in males, exhibiting various symptoms and treatment modalities. This case underscores the rarity of bilateral combined laryngocele, emphasizing the importance of timely diagnosis and surgical intervention for favorable outcomes. Comprehensive research reveals diverse clinical aspects, highlighting the necessity for continued investigation to enhance management strategies.
PubMed: 38877649
DOI: 10.1177/01455613241261455