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Query: UMLS:C0000737 (abdominal pain)
31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical details of 100 patients with proved acute appendicitis were compared with those of 100 patients with perforating or gangrenous appendicitis. Twenty features were found to be significantly different between the two groups. This information was incorporated into a computer data base and used in the differential diagnosis of abdominal pain. A program written to predict the probability that gangrene or perforation was present in patients with appendicitis gave a diagnostic accuracy over 91%. A clinical scoring index, which accurately predicted the state of the appendix in 88% of patients, was constructed from the significant differences between the two groups. When clinical scoring or computer analysis predicts a high probability of perforation or gangrene in patients with appendicitis, surgery should be performed without delay.
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PMID:Computer-aided prediction of gangrenous and perforating appendicitis. 33 8

Since 1974 an epidemic of tertian malaria has been spreading around the Adana and Tarsus townships in southern Turkey, with a peak incidence of 115 500 cases in 1977. A further increase is to be expected because the insect vectors have become resistant to insecticides. Since 1975 eleven children and three adults have been treated for P. vivax malaria. They had all stayed in the epidemic area during the transmission season which lasts from July to October. Because of a long primary latent period seven patients only developed first manifestations of the disease six to nine months after leaving Turkey. The classical malarial paroxysms were missing during the first weeks of the primary attack. Several children had a febrile illness over weeks with headache, vomiting, abdominal pain, hepatosplenomegaly, high blood-sedimentation rate and severe haemolytic anaemia, so that appendicitis or septicaemia had been suspected. Tetracyclines and trimethroprimsulphamethoxazole were able to suppress the disease without preventing relapses.
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PMID:[Tertian malaria in children and adults from an epidemic region in southern Turkey (author's transl)]. 36 41

Children aged at least 4 years admitted to hospital with acute abdominal pain, excluding appendicitis, were investigated for the presence of viruses. Out of 181 children 29 were found with viruses of whom 18 had nonspecific abdominal pain. Eight others were found to have virus-like particles on electron microscopical examination of their faeces. Virus infections contribute to a small extent to nonspecific abdominal pain in childhood, but in many cases the cause remains unknown.
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PMID:Viruses and acute abdominal pain in childhood. 38 71

Acute appendicitis is a well known clinical entity, but many physicians are unwilling to accept appendicitis as a chronic or recurrent illness. Of 225 patients undergoing appendectomy, sixteen (7 per cent) had findings suggestive of chronic, recurrent, or subacute appendicitis. Four patients had chronic abdominal pain and histologic findings of chronic inflammation. Nine patients had previous episodes similar to that which resulted in appendectomy. All had acute suppurative appendicitis pathologically. Three patients had only one episode of abdominal pain, but had pathologic evidence of subacute inflammation. Because this study was retrospective, we suspect that the true incidence of recurrent appendicitis is significantly greater, as reported by others. Indications for operation must be strict, for unless there are specific signs and symptoms of appendiceal disease, appendectomy will often be of no benefit.
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PMID:Chronic and recurrent appendicitis. 43 29

From this study, we note: (1) misdiagnosis of appendicitis in pregnancy is comparable to that of the general female population; (2) with a maternal mortality of zero per cent, the operation is safe even when complicated by perforation; (3) fetal mortality is minimal; (4) clinical judgement rather than laboratory data must be relied on for diagnosis; and (5) the pregnant patient presenting with abdominal pain should be assessed and treated as one would any patient with the same complaint. The general use of this principle may explain the marked improvement in maternal and fetal mortality and morbidity in recent years.
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PMID:Acute appendicitis during pregnancy. 50 47

A family history of appendicectomy was sought in two groups of children admitted to Llandough Hospital over sixteen months. The study group consisted of 29 children with histologically confirmed acute appendicitis, while the control group consisted of 29 children admitted for reasons unrelated to abdominal pain. A history of appendicectomy was elicited in first-degree relatives--that is, siblings and parents of 20 of the children in the study group and of four of the controls--a statistically significant difference. The results obtained from this study suggest that a familial predisposition to appendicitis exists.
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PMID:Is appendicitis familial? 50 69

Laparoscopy has been performed in 60 infants and children over a 32-mo period. Indications included: the problem of possible appendicitis, chronic abdominal pain, possible regional enteritis, possible biliary atresia, and liver biopsy. Fifty-two per cent of patients were spared laparotomy, while in 32% the need for operation was established. There were 2 errors in diagnosis, 3 failures, and 1 complication. Laparoscopy is considered to be a safe, effective, and economical diagnostic procedure that deserves wider application in the pediatric patient.
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PMID:Laparoscopy in infants and children. 59 73

The radiological findings in 93 children operated on for acute appendicitis were reviewed retrospectively; acute appendicitis was confirmed in 76 (81%). These children were compared with 40 children with abdominal pain, but without appendicitis. Pre-operative radiographs in the children with appendicitis showed a significantly higher incidence of scoliosis, properitoneal line displacement, caecal dilatation with air/fluid levels and terminal ileal dilatation with air/fluid levels. The incidence of radiologically demonstrable faecaliths was not statistically higher in the children suffering from acute appendicitis. In children under the age of 4 years, in whom the diagnosis of acute appendicitis is often difficult, the radiological signs are helpful.
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PMID:The radiological signs of acute appendicitis in infancy and childhood. 65 71

In a study designed to investigate the variations in rates of admission to hospital for appendicitis in Wales Hospital Activity Analysis listings were analysed according to the sex and age of the patients and the month and day of the week of admission. The incidence of hospitalisation was greatest among boys aged 10-14 and girls aged 15-19. The number of admissions was higher on weekdays than at weekends, but there were no seasonal variations. Durations of stay differed between the 17 health districts. We conclude that admission rates vary mainly because of differing hospital admission policies. Admission is not wholly governed by the sudden onset of abdominal pain; other factors include the threshold of consultation of each patient, the referral habits of general practitioners, the availability of hospital beds, and the degree to which doctors and patients expect admission.
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PMID:Variation in rates of hospital admission for appendicitis in Wales. 65 66

Sites in the gut that are related to pain are reviewed with respect to the special psychophysiological factors that operate locally. Topics considered are the irritable bowel, appendicitis and appendicectomy, duodenal ulceration and biliary disorders. Psychological states that promote the complaint or experience of abdominal pain are discussed. Possible psychological mechanisms are considered for abdominal pain with the reservation that we still do not know even the main physical mechanisms of pain related to gut disturbance.
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PMID:Abdominal pain and the emotions. 69 72


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