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Related Concept Videos

Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
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Appendicitis-I: Introduction01:22

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The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
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AC Sources01:20

AC Sources

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Direct current is a flow of electric charge in only one direction and has a steady state of constant voltage in the circuit. Rectifiers, batteries, commutator-equipped generators, and fuel cells are some examples of devices that generate direct current. Nowadays, most applications use a time-varying voltage source. Alternating current is a flow of electric charge that periodically reverses direction. An alternating current is produced by an alternating emf that is generated in a power plant. If...
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Reaction Rate02:53

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The rate of reaction is the change in the amount of a reactant or product per unit time. Reaction rates are therefore determined by measuring the time dependence of some property that can be related to reactant or product amounts. Rates of reactions that consume or produce gaseous substances, for example, are conveniently determined by measuring changes in volume or pressure.
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Resistor in an AC Circuit01:31

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An alternating emf or voltage source is needed to supply an alternating current (AC) to a circuit. A coil of wire rotating in a magnetic field at a constant angular speed represents such a source. It also generates a sinusoidal alternating emf and serves as an industrial alternator.
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In a DC circuit, the power consumed is simply the product of the DC voltage times the DC current, given in watts. However, the power consumed for AC circuits with reactive components is calculated differently. Since electrical power is the "rate" at which energy is used in a circuit, all electrical and electronic components and devices have a safe operating range for electrical power.
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Imaging utilization affects negative appendectomy rates in appendicitis: An ACS-NSQIP study.

Joshua Tseng1, Tara Cohen1, Nicolas Melo1

  • 1Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA.

American Journal of Surgery
|January 13, 2019
PubMed
Summary

The negative appendectomy rate (NAR) is 4.5% in the 2016 ACS-NSQIP database. Utilizing computed tomography (CT) scans, especially in conjunction with ultrasound, significantly reduces NAR.

Keywords:
AppendicitisImaging utilizationNSQIPNegative appendectomy

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Area of Science:

  • Surgical outcomes research
  • Diagnostic imaging in surgery

Background:

  • Historically, negative appendectomy rates (NAR) were high, ranging from 15-25%.
  • Recent trends show a decrease in NAR.

Purpose of the Study:

  • To identify predictors of negative appendectomies.
  • To evaluate the impact of imaging modalities on NAR.

Main Methods:

  • Analysis of the 2016 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database.
  • Comparison of patients with and without appendicitis.
  • Multivariate analysis to determine predictors of negative appendectomies.

Main Results:

  • The overall NAR was 4.5% among 11,841 appendectomies.
  • Computed tomography (CT) had the lowest NAR (2.5%) compared to ultrasound (9.7%) and MRI (7.1%).
  • Patients without imaging had the highest NAR (19.2%).
  • Combining ultrasound with CT reduced NAR to 0.6%.

Conclusions:

  • The NAR in the 2016 ACS-NSQIP population is 4.5%.
  • CT is the most effective imaging modality for reducing NAR.
  • Further cost-benefit analysis is recommended for combined imaging strategies.