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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.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
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Barriers to Effective Communication II01:21

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The barriers to effective communication also include cultural barriers, semantic barriers, gender barriers, and time constraints.
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
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Endoscopic Procedures V: ERCP01:26

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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
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Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
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Language Barriers in Appendicitis: What is the Cost?

Brittany E Levy1, Jennifer T Castle1, Lekha P Devara1

  • 1Department of General Surgery, University of Kentucky, Lexington, KY, USA.

The American Surgeon
|February 26, 2025
PubMed
Summary

Limited English proficiency in pediatric appendicitis cases leads to increased imaging, longer hospital stays, and higher costs. Addressing communication barriers is crucial for equitable care and improved outcomes.

Keywords:
health care disparityhealth care utilizationlanguage barrierslevel III treatment study—retrospective comparative studypediatric appendicitis

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Area of Science:

  • Pediatric Surgery
  • Health Services Research
  • Health Equity

Background:

  • Pediatricians often rely on patient history to diagnose appendicitis, minimizing radiation exposure.
  • Language barriers for patients with limited English proficiency (LEP) can negatively impact outcomes, increase imaging use, and raise costs for pediatric appendicitis.
  • Effective communication is vital for accurate diagnosis and efficient care in pediatric surgery.

Purpose of the Study:

  • To compare healthcare utilization and costs for pediatric appendicitis patients with and without limited English proficiency.
  • To identify disparities in diagnostic workup, length of stay, and hospital costs based on primary language.
  • To inform strategies for reducing healthcare inequities in pediatric surgical care.

Main Methods:

  • Analysis of the pediatric-National Surgical Quality Improvement Project database (2011-2021) at a single institution.
  • Propensity matching of patients under 16 undergoing appendectomy based on demographics and insurance.
  • Comparison of outcomes including hospitalization cost, length of stay, and imaging usage between English proficient (EP) and limited English proficiency (LEP) cohorts.

Main Results:

  • Patients with limited English proficiency (LEP) showed higher rates of diagnostic imaging compared to English proficient (EP) patients.
  • The LEP cohort experienced longer median length of stay and higher median hospital costs, including imaging costs.
  • English proficient (EP) patients had higher rates of negative appendectomy compared to the LEP cohort.

Conclusions:

  • Language barriers in pediatric appendicitis care contribute to increased healthcare utilization and costs.
  • Disparities in care related to language diversity necessitate targeted interventions for equitable health outcomes.
  • Improving communication strategies is essential to ensure equitable and efficient delivery of pediatric surgical services.