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Antibiotic therapy compared to appendectomy in the treatment of acute appendicitis.

Acute appendicitis is one of the most common surgical causes of acute abdominal pain. Appendectomy is the treatment of choice, however surgical complications are inherent to operative treatment. Recent research on primary antibiotic therapy (without surgery) reported good results.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Laparoscopic ("key‐hole") surgery for appendicitis

In the right lower part of the abdomen there is a small blind ending intestinal tube, called appendix. Inflammation of the appendix is called appendicitis and is usually acute in onset. Appendicitis is most frequent in children and young adults. Most cases require emergency surgery, in order to avoid rupture of the appendix into the abdomen. During the operation, called appendectomy, the inflamed appendix is surgically removed. The traditional surgical approach involves a small incision (about 5 cm or 2 inches) in the right lower abdominal wall. Alternatively, it is possible to perform the operation by laparoscopy. This operation, called laparoscopic appendectomy, requires 3 very small incisions (each about 1 cm or 1/2 inch). The surgeon then introduces a camera and some instruments into the abdomen and removes the appendix as in the conventional operation.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Drain use after an open appendectomy for complicated appendicitis

Appendicitis refers to inflammation of the appendix. Appendectomy, the surgical removal of the appendix, is performed primarily in patients who have acute appendicitis. Patients undergoing an appendectomy for complicated appendicitis, which is defined as gangrenous (soft‐tissue death) or perforated (burst) appendicitis, are more likely to suffer from postoperative complications. The routine placement of a surgical drain to prevent intra‐peritoneal abscess (a localised collection of pus in the abdomen or pelvis) after an appendectomy for complicated appendicitis is controversial.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Early or delayed surgical removal of appendix in people with symptomatic complicated appendicitis

The human appendix is a tube at the connection of the small and the large intestines. Possible functions of the appendix may be to protect the body against infection and to maintain healthy levels bacteria in the gut when recovering from diarrhoea. Appendicitis covers a variety of clinical conditions resulting from inflammation of the appendix.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Antibiotic prophylaxis could be considered for routine in emergency appendectomies.

Appendicitis is the most common cause of acute abdominal pain requiring surgical intervention. This is associated with increased risk of postoperative complications, wound infection being the most commonly reported. Standard prophylaxis is an anti‐bacterial treatment. In order to reduce cost, toxicity and the risk of developing bacterial resistance, it is desirable to establish the shortest and most effective prophylaxis for postoperative complications.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Currently there is no evidence available from randomised control trials to determine whether Single Incision Laparoscopic Surgery provides any better effect than Conventional Multi‐incision Laparoscopic Surgery for appendicectomy.

Laparoscopic appendicectomy is used in treating appendicitis and can be achieved using several skin incisions in the abdominal wall, or more recently with a single skin incision through which instruments are introduced into the peritoneal cavity. Since no randomised control trials of single incision versus conventional multi‐incision laparoscopic surgery for appendicectomy could be found, the efficacy and safety of the two approaches could not be analysed in this review. There is a need for randomised control trials of single incision laparoscopic appendicectomy for appendicitis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Managing acute lower abdominal pain in women of childbearing age

Review question: Cochrane authors reviewed available evidence on the use of laparoscopy to manage acute lower abdominal pain, non‐specific lower abdominal pain or suspected appendicitis in women of childbearing age. We found 12 studies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Green and black tea to prevent cardiovascular disease

Cardiovascular disease (CVD) is a worldwide healthcare burden. However, it is thought that CVD risk can be lowered by changing a number of modifiable risk factors such as diet, and this includes the intake of tea. This review assessed the effectiveness of green tea, black tea or black/green tea extracts in healthy adults and those at high risk of CVD. We found 11 randomised controlled trials, four of which examined black tea interventions and seven examined green tea interventions. There were variations in the dosage and form (drink, tablets or capsules) of the black and green tea interventions, and the duration of the interventions ranged from three months to six months. Adverse events were reported in five of the included trials. These included a diagnosis of prostate cancer, hospitalisation for influenza, appendicitis and retinal detachment; these are unlikely to be associated with the intervention. The results showed black and green tea to have a beneficial effect on lipid levels and blood pressure, but these results were based on only a small number of trials that were at risk of bias. Analysis conducted over both tea types showed beneficial effects of tea on LDL‐cholesterol and blood pressure but again this was based on only a few trials that were at risk of bias. To date the small number of studies included suggest some benefits of green and black tea on blood pressure and lipid levels but more longer‐term trials at low risk of bias are needed to confirm this.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Intranasal fentanyl for the treatment of children in acute pain

Pain is the most common reason why patients are seen in emergency departments (EDs). The challenging nature of treating children in acute severe pain is reflected in the medical literature by poor pain management in this population. We reviewed evidence on the effect of intranasal fentanyl (INF) (a strong pain relief drug, similar to morphine) compared with any other pain‐relieving technique for treatment of children in acute severe pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Fever in children: Overview

Many parents start feeling anxious when their child has a hot, flushed face and is running a high fever. Most of the time a harmless viral infection is the cause. But it is still good for parents to know the signs of more serious medical problems and to realize when a doctor is needed.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 17, 2016

Shingles: Overview

If you've had chickenpox, you may get shingles. Both conditions are caused by the same virus. Having a weakened immune system – due to severe stress or old age, for instance – can increase the risk of developing this often very painful rash. It usually takes about two to four weeks for shingles to clear up.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 6, 2017

Smart Health Choices: Making Sense of Health Advice

This book aims to help consumers and practitioners develop the skills to assess health advice – and hopefully to make decisions that will improve the quality of their care. For some people, making better-informed decisions could be life saving. We hope that it will be useful if you are struggling to come to terms with an illness or injury, and the best ways of managing it. Or you may simply want to lead a healthier life, and may be wondering how to make sense of the often conflicting flood of health information that deluges us every day, through the media, and from our friends and health practitioners.

Hammersmith Press.

Version: 2008

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