Abstract:
:This study aimed (1) to develop a simple scoring system incorporating ultrasound (US) examination and clinical or laboratory predictors for increasing diagnostic accuracy in acute appendicitis (AA), and (2) to evaluate the performance of the scoring system as compared to that of previous models. Fifteen variables including US assessment for patients admitted with suspected AA were considered in multivariate analysis using the finding of AA at operation as the end point (internal study). The new score, together with 11 previous ones, was applied to a prospective independent population of subjects with suspected AA, and the respective performances were compared (external validation study). Among 303 patients (170 males, mean age 28.3 +/- 13.3 years) of the internal study, 161 went on to surgery, and 130 had AA at operation. Four independent correlates of AA were identified and used for the derivation of the following integer-based scoring system: number of points = 6 for US demonstrating AA + 4 for tenderness in the right lower quadrant + 3 for rebound tenderness + 2 for leukocyte count >12,000/microl. In the external study (201 subjects, 105 males, mean age 28.7 +/- 11.9 years, 109 operated, 87 with AA), when the cut-off of >/or = 8 points for AA was used, sensitivity, specificity, accuracy, and area under the curve of the proposed score were 95.4%, 97.4%, 96.5%, and 93%, respectively, exceeding noticeably the previous models. The proposed scoring system introduces a quantitative combination of the clinical evaluation with US imaging and a marker of inflammatory response, which may enhance the diagnostic accuracy for subjects with suspected AA especially in geographical areas where CT scanning is not readily available on a 24-hour basis.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Tzanakis NE,Efstathiou SP,Danulidis K,Rallis GE,Tsioulos DI,Chatzivasiliou A,Peros G,Nikiteas NIdoi
10.1007/s00268-005-7853-6keywords:
subject
Has Abstractpub_date
2005-09-01 00:00:00pages
1151-6, discussion 1157issue
9eissn
0364-2313issn
1432-2323journal_volume
29pub_type
杂志文章abstract::Organ transplantation continues to be hindered by a limited supply of organs. A significant percentage of potential organ donors are lost to either medical failure or inability to obtain consent for donation. In a surgical intensive care unit (ICU) we have refocused our efforts toward aggressive resuscitation, directe...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/pl00012362
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Surgery for Graves' disease (GD) is usually performed after adequate control with medical treatment. Occasionally, rapid pre-operative optimization is required. The primary objective was to compare the outcomes of patients undergoing elective surgery for well-controlled GD with those undergoing rapid pre-ope...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05125-5
更新日期:2019-12-01 00:00:00
abstract::In 1947, a patient with metastatic islet cell tumor was treated for intractable ulcer disease at the University of Chicago Medical Center. Eight years later, in retrospect, it was recognized that he and another patient had the Zollinger-Ellison syndrome (ZE). From 1947 until the present, 30 patients with the ZE syndro...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658530
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:Medullary thyroid carcinoma (MTC) originates from calcitonin-producing cells of the thyroid. In 2009, we published our first report on the biological characteristics and prognosis of 118 MTC patients. Herein, we enrolled a larger number of patients with longer follow-up periods to further study the biologica...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4738-z
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:There is increasing interest in provision of essential surgical care as part of public health policy in low- and middle-income countries (LMIC). Relatively simple interventions have been shown to prevent death and disability. We reviewed the published literature to examine the cost-effectiveness of simple su...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2243-y
更新日期:2014-01-01 00:00:00
abstract::The hypervascular nature of carcinoid tumors and their metastases allows a more aggressive role by the radiologist in diagnosis and interventional management. Double-contrast gastrointestinal studies still best define the primary neoplasms. Appendiceal tumors, the most frequent site of carcinoids, frequently escape ra...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689900023
更新日期:1996-02-01 00:00:00
abstract::It is difficult to evaluate precisely the effects of one individual on an entire discipline such as surgery. Indeed, it is impossible to do so when such a discipline spans so vast a country as the United States of America. Nevertheless, as a mountain peak can be seen from afar, so may one perceive the influence of man...
journal_title:World journal of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1007/s002689900357
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate and investigate the complications of carotid endarterectomy (CEA) and carotid artery stenting (CAS) by performing a meta-analysis based on prospective randomized controlled trials (RCTs). METHODS:We performed a search of multiple electronic databases for RCTs containing...
journal_title:World journal of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00268-008-9862-8
更新日期:2009-03-01 00:00:00
abstract::It is a fundamental clinical observation that wounds do not heal in tissue that does not bleed, and they almost always heal in tissue that bleeds extensively. Continuous supply of oxygen to the tissue through microcirculation is vital for the healing process and for resistance to infection. Evaluation of tissue perfus...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-003-7398-5
更新日期:2004-03-01 00:00:00
abstract::During the past four decades, especially in recent years, various active adjuvant therapies combined with surgery have improved the outcome in cases of cancer of the esophagus. However, no optimum adjuvant therapy has been determined. From 1981 to 1992, 341 patients with regional and distant node metastasis who underw...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00316819
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:There is a proven relationship between obesity and several cancers including breast, endometrium, colorectal, and esophagus. With the increasing incidence of both obesity and thyroid cancer, we designed the present study to investigate a causal relationship between leptin, which is one of the well known adip...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2634-8
更新日期:2014-10-01 00:00:00
abstract::The surgical management of pancreatic islet cell carcinomas poses a complicated set of questions resulting from their rare occurrence and the difficulty in establishing a diagnosis in early cases or, conversely, the problems inherent in dealing with metastatic disease. However, because their biologic behavior is rathe...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01655109
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:The survival impact of distal pancreatectomy (DP) with celiac axis resection for locally advanced pancreatic body/tail cancer remains unclear. METHODS:A total of 16 patients underwent DP with celiac axis resection, while 76 underwent standard DP for pancreatic body/tail cancer. The indications for DP with c...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3670-3
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:The goal of the present study was to evaluate the effects of preoperative oral carbohydrate supplementation (OCH) on the postoperative metabolic stress response of patients undergoing elective abdominal surgery. METHODS:The study was designed as a controlled, prospective, cohort study including 38 patients ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1590-4
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Intra-abdominal adhesions constitute between 49% and 74% of the causes of small bowel obstruction. Traditionally, laparotomy and open adhesiolysis have been the treatment for patients who have failed conservative measures or when clinical and physiologic derangements suggest toxemia and/or ischemia. With the...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-7778-0
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:The fields of surgery and trauma care have largely been neglected in the global health discussion. As a result the idea that surgery is not safe or cost effective in resource-limited settings has gone unchallenged. The SIGN Online Surgical Database (SOSD) is now one of the largest databases on trauma surgery...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1817-4
更新日期:2013-02-01 00:00:00
abstract::Most people would agree that successful parathyroidectomy depends on two important variables: the surgeon's recognition and excision of the abnormal parathyroid gland(s) and the pathologist's confirmation that the removed tissue is parathyroid tissue. Frozen section is usually employed to confirm the identity of parat...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002680010218
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:Cardiovascular disease (CVD) and gallstones are reported to be strongly associated because both diseases are frequently part of a metabolic syndrome. Laparoscopic cholecystectomy (LC) has become the standard treatment for gallbladder disease around the world. Cardiovascular disease is considered as an absolu...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0072-9
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Nodal involvement of papillary thyroid carcinoma (PTC) commonly occurs in the paratracheal region and the internal jugular chain. Lymph node metastasis in the parapharyngeal space (PPS) is rare. In this report, we describe our experience and surgical outcomes of patients with PPS metastasis of PTC. METHODS:...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3321-0
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Total mesorectal excision (TME) and preoperative chemoradiation therapy (PCRT) for rectal cancer are used sequentially in our center. The aim of this study was to evaluate survival of patients with stage II/III rectal cancer chronologically and to determine whether therapeutic advances associated with TME an...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2168-5
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Team familiarity has been shown to be important for operative efficiency and number of complications, but it is unclear for which types of operations and for which team members familiarity matters the most. The objective of this study is to further our understanding of familiarity in the OR by quantifying th...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05657-1
更新日期:2020-11-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6360-2
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:New medical therapies available to ulcerative colitis (UC) patients have influenced operative mortality for patients requiring colectomy. We sought to examine trends in treatment and outcome for UC patients treated surgically. METHODS:A review of 36,447 UC patients from the Nationwide Inpatient Sample was p...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0910-9
更新日期:2011-03-01 00:00:00
abstract::Because of the rarity of adrenocortical carcinoma, survival rates and the prognosis for patients who have undergone operation are not well known. The purpose of the French Association of Endocrine Surgery was to evaluate these factors over an 18-year period. A trend study was associated to assess changes in the clinic...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0047-y
更新日期:2001-07-01 00:00:00
abstract::The eponym "Graves' disease" is usually applied to the condition of immunogenic hyperthyroidism, in no small part due to the promotion and influence of the French physician Armand Trousseau who wrote in 1862, "Du Goître Exophthalmique, ou Maladie de Graves." However, the distinguished Bath physician Caleb Hillier Parr...
journal_title:World journal of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1007/s00268-009-0297-7
更新日期:2010-06-01 00:00:00
abstract::Expression of sialyl-Lewisx (sLex) antigen was studied immunohistochemically in 110 resected human gastric carcinomas using an anti-sLex monoclonal antibody. Lymph node, liver, and peritoneal metastases were clearly more prevalent in tumors expressing high levels of sLex than in those with no or low-level sLex express...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/s002689900304
更新日期:1997-09-01 00:00:00
abstract::To evaluate quality of life and functional results following surgery for gastric cancer we studied 104 patients with no evidence of disease at a minimum of 12 months postoperatively. Patients were treated with total gastrectomy and jejunal pouch reconstruction according to Hunt-Lawrence-Rodino (n = 59) or simple esoph...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/BF00294722
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:The lung is the most common site of extrahepatic metastasis from hepatocellular carcinoma (HCC). The aim of this study was to evaluate the significance and long-term outcomes of pulmonary metastasectomy for HCC, especially in patients with multiple nodules or repeated pulmonary recurrence. METHODS:We retros...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3213-3
更新日期:2016-02-01 00:00:00
abstract::Intraperitoneal forgotten foreign bodies are prone to create adhesions and to encapsulate, or to provoke an exudative response, with or without accompanying bacterial infection. Often a process of self-extrusion is initiated. This is also true for gossypibomas, retained surgical sponges. Presentation is possible as a ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689910084
更新日期:2000-05-01 00:00:00
abstract::Endoscopic sphincterotomy (EST) is an established method for treatment of retained or recurrent common bile duct (CBD) calculi after cholecystectomy. Present experience shows that few patients have recurrent biliary tract complications, but follow-up periods are most often short. EST was performed in 147 patients with...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900043
更新日期:1996-03-01 00:00:00