Prolonged Antibiotic Treatment does not Prevent Intra-Abdominal Abscesses in Perforated Appendicitis

Contains fulltext : 89619.pdf (publisher's version ) (Open Access)BACKGROUND: Children with perforated appendicitis have a relatively high risk of intra-abdominal abscesses. There is no evidence that prolonged antibiotic treatment after surgery reduces intra-abdominal abscess formation. We compared two patient groups with perforated appendicitis with different postoperative antibiotic treatment protocols. METHODS: We retrospectively reviewed patients younger than age 18 years who underwent appendectomy for perforated appendicitis at two academic hospitals between January 1992 and December 2006. Perforation was diagnosed during surgery and confirmed during histopathological evaluation. Patients in hospital A received 5 days of antibiotics postoperatively, unless decided otherwise on clinical grounds. Patients in hospital B received antibiotics for 5 days, continued until serum C-reactive protein (CRP) was <20 mg/l. Univariate logistic regression analysis was performed on intention-to-treat basis. p < 0.05 was considered significant. RESULTS: A total of 149 children underwent appendectomy for perforated appendicitis: 68 in hospital A, and 81 in hospital B. As expected, the median (range) use of antibiotics was significantly different: 5 (range, 1-16) and 7 (range, 2-32) days, respectively (p < 0.0001). However, the incidence of postoperative intra-abdominal abscesses was similar (p = 0.95). Regression analysis demonstrated that sex (female) was a risk factor for abscess formation, whereas surgical technique and young age were not. CONCLUSIONS: Prolonged use of antibiotics after surgery for perforated appendicitis in children based on serum CRP does not reduce postoperative abscess formation.1 december 201

A comprehensive 1000 Genomes-based genome-wide association meta-analysis of coronary artery disease

Existing knowledge of genetic variants affecting risk of coronary artery disease (CAD) is largely based on genome-wide association studies (GWAS) analysis of common SNPs. Leveraging phased haplotypes from the 1000 Genomes Project, we report a GWAS meta-analysis of 185 thousand CAD cases and controls, interrogating 6.7 million common (MAF>0.05) as well as 2.7 million low frequency (0.005<MAF<0.05) variants. In addition to confirmation of most known CAD loci, we identified 10 novel loci, eight additive and two recessive, that contain candidate genes that newly implicate biological processes in vessel walls. We observed intra-locus allelic heterogeneity but little evidence of low frequency variants with larger effects and no evidence of synthetic association. Our analysis provides a comprehensive survey of the fine genetic architecture of CAD showing that genetic susceptibility to this common disease is largely determined by common SNPs of small effect siz

Beam Energy Dependence of Jet-Quenching Effects in Au plus Au Collisions at root s(NN)=7.7, 11.5, 14.5, 19.6, 27, 39, and 62.4 GeV

We report measurements of the nuclear modification factor, $R_{ \mathrm{CP}}$, for charged hadrons as well as identified $\pi^{+(-)}$, $K^{+(-)}$, and $p(\overline{p})$ for Au+Au collision energies of $\sqrt{s_{_{ \mathrm{NN}}}}$ = 7.7, 11.5, 14.5, 19.6, 27, 39, and 62.4 GeV. We observe a clear high-$p_{\mathrm{T}}$ net suppression in central collisions at 62.4 GeV for charged hadrons which evolves smoothly to a large net enhancement at lower energies. This trend is driven by the evolution of the pion spectra, but is also very similar for the kaon spectra. While the magnitude of the proton $R_{ \mathrm{CP}}$ at high $p_{\mathrm{T}}$ does depend on collision energy, neither the proton nor the anti-proton $R_{ \mathrm{CP}}$ at high $p_{\mathrm{T}}$ exhibit net suppression at any energy. A study of how the binary collision scaled high-$p_{\mathrm{T}}$ yield evolves with centrality reveals a non-monotonic shape that is consistent with the idea that jet-quenching is increasing faster than the combined phenomena that lead to enhancement.We report measurements of the nuclear modification factor RCP for charged hadrons as well as identified π+(-), K+(-), and p(p¯) for Au+Au collision energies of sNN=7.7, 11.5, 14.5, 19.6, 27, 39, and 62.4 GeV. We observe a clear high-pT net suppression in central collisions at 62.4 GeV for charged hadrons which evolves smoothly to a large net enhancement at lower energies. This trend is driven by the evolution of the pion spectra but is also very similar for the kaon spectra. While the magnitude of the proton RCP at high pT does depend on the collision energy, neither the proton nor the antiproton RCP at high pT exhibit net suppression at any energy. A study of how the binary collision-scaled high-pT yield evolves with centrality reveals a nonmonotonic shape that is consistent with the idea that jet quenching is increasing faster than the combined phenomena that lead to enhancement