Most Read Articles
Roshini Claire Anthony, 4 days ago

The presence of pulmonary arterial hypertension (PAH) in individuals with systemic sclerosis is associated with an increased mortality risk, a study from Singapore showed.

23 Dec 2019
At a Menarini-sponsored symposium held during the Asian Pacific Society Congress, renowned cardiologist Prof John Camm provided the latest evidence for chronic stable angina with or without concomitant diseases, with a special focus on the antianginal agent ranolazine and combination therapies. The event was chaired and moderated by Dr Dante Morales from the University of the Philippines College of Medicine.
3 days ago
Serum 25-hydroxyvitamin D (25[OH]D) levels are significantly lower among patients with active uveitis than those with inactive uveitis and local population-based estimates, reports a study. In addition, vitamin D supplementation may help reduce uveitis activity, while sun exposure confers a beneficial effect to those with vitamin D deficiency.
2 days ago
The timing of direct oral anticoagulants (DOACs) administration, either within 3 days or ≥4 days of stroke onset, in patients with nonvalvular atrial fibrillation (AF) does not alter the risk of adverse outcomes such as stroke or systemic embolism, major bleeding, and death, as shown in a recent study.

Anaerobes, S. anginosus among most common bacteria in children with complicated appendicitis

14 Nov 2019
Five-year-old Karis Cochrane suffered from a ruptured appendix which doctors failed to identify in her earlier visits. Photo credit: Daily Record/Mirrorpix

Streptococcus anginosus, aminoglycoside-susceptible Gram-negative bacilli and anaerobes remain the most common bacteria in previously healthy children presenting with complicated appendicitis requiring surgical drainage, reports a study.

A total of 425 children with primary acute appendicitis were included, among whom 158 (37 percent) had complicated appendicitis at presentation. Of the 133 patients who underwent a surgical or interventional radiologic intervention, 53 (40 percent) had bacterial culture.

Those with peritoneal cultures had a higher likelihood of having longer symptom duration prior to admission (3 [interquartile rage, 2–5] vs 2 [interquartile range, 1–2] days; p<0.001) and purulent peritonitis (47 percent [23/53] vs 13 percent [10/80]; p<0.001).

The most common pathogens isolated were anaerobes (81 percent), Escherichia coli (74 percent) and S. anginosus group (62 percent). Of the isolated bacteria, only 4 percent showed resistance to empiric therapy.

Twenty-three (17 percent) patients had postoperative infectious complications. Such complications were associated with more severe disease and higher C-reactive protein values (303 vs 83 mg/L; p=0.03) at presentation but not with the presence of a resistant pathogen or the choice of antimicrobial agents.

“In an attempt to reduce extended-spectrum cephalosporin use, these data were useful in supporting the use of metronidazole with ampicillin and an aminoglycoside, rather than third-generation cephalosporins,” the investigators said.

This retrospective cohort study was conducted from 1 February 2017 to 31 October 2018 in children who underwent appendectomy or interventional radiologic drainage for primary complicated appendicitis.

The proportion of patients who had a pathogen isolated from peritoneal fluid culture that was not susceptible to the recommended empiric therapy was the primary outcome. Total duration of antimicrobial therapy and the proportion of patients with a postoperative infectious complication within 30 days after intervention were the secondary outcomes.

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Most Read Articles
Roshini Claire Anthony, 4 days ago

The presence of pulmonary arterial hypertension (PAH) in individuals with systemic sclerosis is associated with an increased mortality risk, a study from Singapore showed.

23 Dec 2019
At a Menarini-sponsored symposium held during the Asian Pacific Society Congress, renowned cardiologist Prof John Camm provided the latest evidence for chronic stable angina with or without concomitant diseases, with a special focus on the antianginal agent ranolazine and combination therapies. The event was chaired and moderated by Dr Dante Morales from the University of the Philippines College of Medicine.
3 days ago
Serum 25-hydroxyvitamin D (25[OH]D) levels are significantly lower among patients with active uveitis than those with inactive uveitis and local population-based estimates, reports a study. In addition, vitamin D supplementation may help reduce uveitis activity, while sun exposure confers a beneficial effect to those with vitamin D deficiency.
2 days ago
The timing of direct oral anticoagulants (DOACs) administration, either within 3 days or ≥4 days of stroke onset, in patients with nonvalvular atrial fibrillation (AF) does not alter the risk of adverse outcomes such as stroke or systemic embolism, major bleeding, and death, as shown in a recent study.