Young children with perforated appendicitis benefit from prompt appendectomy

Munoz, Amanda; Hazboun, Rajaie; Vannix, Ian; Pepper, Victoria K.; Crane, Tabitha; Tagge, Edward P.; Moores, Donald; Baerg, Joanne

doi:10.1016/j.jpedsurg.2018.10.107

Cited by 4 publications

(4 citation statements)

References 10 publications

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“…Peri-inflammatory conditions in the abdomen induce pathological and molecular changes in the brain [1-4]. Brain uptake of circulating lipopolysaccharide (LPS) is not sufficient to cross the brain-blood barrier (BBB) that most effects of peripherally administered LPS are mediated through LPS receptors located outside the BBB [5].…”

Section: Introductionmentioning

confidence: 99%

HDAC2 hyperexpression alters hippocampal neuronal transcription and microglial activity in neuroinflammation-induced cognitive dysfunction

Sun

Teng

Yang

et al. 2019

J Neuroinflammation

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BackgroundInflammation can induce cognitive dysfunction in patients who undergo surgery. Previous studies have demonstrated that both acute peripheral inflammation and anaesthetic insults, especially isoflurane (ISO), are risk factors for memory impairment. Few studies are currently investigating the role of ISO under acute peri-inflammatory conditions, and it is difficult to predict whether ISO can aggravate inflammation-induced cognitive deficits. HDACs, which are essential for learning, participate in the deacetylation of lysine residues and the regulation of gene transcription. However, the cell-specific mechanism of HDACs in inflammation-induced cognitive impairment remains unknown.MethodsThree-month-old C57BL/6 mice were treated with single versus combined exposure to LPS injected intraperitoneally (i.p.) to simulate acute abdominal inflammation and isoflurane to investigate the role of anaesthesia and acute peripheral inflammation in cognitive impairment. Behavioural tests, Western blotting, ELISA, immunofluorescence, qRT-PCR, and ChIP assays were performed to detect memory, the expressions of inflammatory cytokines, HDAC2, BDNF, c-Fos, acetyl-H3, microglial activity, Bdnf mRNA, c-fos mRNA, and Bdnf and c-fos transcription in the hippocampus.ResultsLPS, but not isoflurane, induced neuroinflammation-induced memory impairment and reduced histone acetylation by upregulating histone deacetylase 2 (HDAC2) in dorsal hippocampal CaMKII+ neurons. The hyperexpression of HDAC2 in neurons was mediated by the activation of microglia. The decreased level of histone acetylation suppressed the transcription of Bdnf and c-fos and the expressions of BDNF and c-Fos, which subsequently impaired memory. The adeno-associated virus ShHdac2, which suppresses Hdac2 after injection into the dorsal hippocampus, reversed microglial activation, hippocampal glutamatergic BDNF and c-Fos expressions, and memory deficits.ConclusionsReversing HDAC2 in hippocampal CaMKII+ neurons exert a neuroprotective effect against neuroinflammation-induced memory deficits.

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Section: Introductionmentioning

confidence: 99%

HDAC2 hyperexpression alters hippocampal neuronal transcription and microglial activity in neuroinflammation-induced cognitive dysfunction

Sun

Teng

Yang

et al. 2019

J Neuroinflammation

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“…It is reported that approximately 30% of children with pediatric appendicitis present with perforation. 7 Their clinical presentations are heterogeneous, and it may be difficult to acquire a reliable history and physical examination findings. To hesitate performing imaging examinations due to concerns about exposure to ionizing radiation may further delay the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…However, the management of complicated appendicitis with or without appendiceal mass remains controversial. It is reported that approximately 30% of children with pediatric appendicitis present with perforation 7 . Their clinical presentations are heterogeneous, and it may be difficult to acquire a reliable history and physical examination findings.…”

Section: Discussionmentioning

confidence: 99%

The experiences of interval appendectomy for inflammatory appendiceal mass

Takahashi

Obata

Matsuura

et al. 2021

Pediatrics International

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Background Interval appendectomy (IA) is a common treatment of acute appendicitis (AA) with inflammatory appendiceal mass (IAM). However, the management of patients with IAM is still controversial. The aim of this study was to assess the outcomes in patients with this condition. Methods We retrospectively evaluated 244 patients with AA for their clinical characteristics and outcomes. Results Forty‐three patients had IAM at the first medical examination. The mean age was significantly younger and the C‐reactive protein level significantly higher (12.6 vs 3.1 mg/dL) in patients with IAM. Thirty‐four patients received IA, and nine received emergency appendectomy (EA). In the IA group, the diameter of the abscess was larger than in the EA group (31.4 vs 16.1 mm). The total length of hospitalization was longer in the IA group than the EA group (20.6 vs 7.0 days), although the operative time was longer in the EA group because of adhesion (101.1 vs 192.1 min). Furthermore, most IA patients received a reduced‐port appendectomy (74% vs 11%). Recurrence occurred in approximately 15% of patients awaiting IA. There were no complications in either group. Conclusions Although each treatment approach has its advantages and disadvantages, both IA and EA can be the first option for the treatment of AA with IAM.

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“…Male children are more prone to it than females. [9][10][11][12][13][14][15] The accurate understanding about pathogenesis of acute appendicitis is not still clearly known as it is accompanied by multi-factors. In school going children the obstruction is caused rather by lymphoidhyperplasia than fecolith.…”

Section: Introductionmentioning

confidence: 99%

Acute Appendicitis in Pre-School Children

Khan¹,

din²,

Khan³

et al. 2021

PJMHS

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Background: Appendicitis is an emergent condition in young children which can cause serious illness. Aim: To identify features related with appendicitis in pre-school children. Study design: Retrospective study Place and duration of study: Department of Paediatric Surgery, Bolan Medical College Hospital Quetta from 1st April 2020 to 31st March 2021. Methodology: Fifty two children between 5-15 years were admitted for appendectomy. All demographic and clinical information including earlier diagnosis, symptoms, biochemical, histopathological as well as radiological imaging were properly documented. The operational technique was open appendecectomy. Results: There were 61.53% boys and 38.46% girls with mean age 8±0.8 years. Abdominal pain was presented in 90.3% while nausea in 82.7% with nausea/vomiting children. There were 51.9% children having perforated appendix with majority between 8-10 years of age. Misdiagnosis was common in 44.2% patients. Conclusion: Appendicitis in pre-school children is difficult and challenging to diagnose which requires careful diagnosis. Key words: Appendectomy, Pre-schoolers, Perforated, Misdiagnosis

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Young children with perforated appendicitis benefit from prompt appendectomy

Cited by 4 publications

References 10 publications

HDAC2 hyperexpression alters hippocampal neuronal transcription and microglial activity in neuroinflammation-induced cognitive dysfunction

HDAC2 hyperexpression alters hippocampal neuronal transcription and microglial activity in neuroinflammation-induced cognitive dysfunction

The experiences of interval appendectomy for inflammatory appendiceal mass

Acute Appendicitis in Pre-School Children

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