Publications by authors named "Michael Gutermacher"
Article Synopsis
- Conservative antibiotic treatment (CAT) for uncomplicated acute appendicitis (AUA) in kids is safe and effective, but there are high rates of recurrent cases and subsequent surgeries.
- A study involving 646 children revealed that 28% experienced recurrent appendicitis, with 21% undergoing appendectomy, highlighting the prognostic importance of factors like age and appendiceal size.
- The researchers developed a decision tree model to help assess the likelihood of needing surgery, aiming to better inform patients and families considering CAT.
Article Synopsis
- The study investigates whether conservative antibiotic treatment (CAT) is a viable alternative to appendectomy for children with uncomplicated acute appendicitis.
- Data was collected from 362 children treated with CAT, showing that most (86.8%) did not require surgery, but some still needed appendectomies later due to recurrences.
- The findings indicate that CAT can be a safe and effective treatment strategy, provided strict diagnostic criteria are followed, though it doesn’t replace surgery for all cases.
Article Synopsis
- - A study evaluated conservative treatment for 197 children with uncomplicated appendicitis, finding an 87% success rate using intravenous antibiotics followed by oral antibiotics, which resulted in shorter hospital stays compared to those needing surgery.
- - Prognostic markers for treatment failure included symptoms of vomiting/nausea and the presence of intraluminal fluid on sonography, with intraluminal fluid being a significant risk factor after multi-regression analysis.
- - The research concludes that conservative treatment can be effective for uncomplicated appendicitis, and those who require surgery typically have a straightforward recovery with no serious complications, emphasizing the need to monitor intraluminal fluid as a contraindication for conservative treatment.
Purpose: To evaluate whether antibiotics without surgery is sufficient treatment for children with clinically and ultrasonographically suspected acute appendicitis (AA).
Method: Children with clinical, laboratory and radiological findings suspicious for AA were evaluated prospectively. Patients with mild clinical signs, without peritonitis were considered for IV followed by oral antibiotics without surgery.
Aim: Based on our experience with acute idiopathic scrotal oedema (AISO) and observations of the incidence of intestinal worm infestation (IWI), we decided to test the hypothesis that IWI occurs more frequently among children with AISO than it does in the general population.
Methods: A retrospective questionnaire-based study was conducted comparing the frequency of IWI between children who had AISO and a matched control group who had inguinal hernia surgery in our Pediatric Surgery Department during 2003-2009. This second group was chosen to represent the incidence of IWI in the paediatric community in our region.
Purpose: Early ultrasound (US) evaluation of children with abdominal pain and suspected acute appendicitis (AA) is an important diagnostic tool. Since 2007, US has become part of routine emergency room (ER) work-up performed for suspected pediatric AA in our hospital.
Methods: We retrospectively compared hospital admissions from 2007 to 2008 with those from 2005 to 2006, when most ultrasounds were done after admission to Pediatric Surgery for observation.
Objectives: : Considering the hazards of pulmonary aspiration of oral contrast material (OCM) during general anesthesia, we investigated the gastric emptying time (GET) of OCM in children and adolescents undergoing abdominal computed tomography (CT).
Patients And Methods: : Included in the study were 101 consecutive patients ages 3.1 to 17.
The pre-operative diagnosis of acute appendicitis (AA) has markedly changed during the last couple of decades due to the advent of modern imaging technology. Nowadays, the use of imaging has dramatically changed the way we approach children admitted to emergency room for abdominal pain with suspected AA. This change is mainly manifested in our diagnostic strategy.
View Article and Find Full Text PDFPurpose: To present our experience with spinal anesthesia in premature and former premature infants, and to focus on technical aspects and pitfalls enlightened with increasing experience.
Methods: The perioperative course of all premature and former premature infants below 60 weeks postconceptual age undergoing spinal anesthesia within an 35-month-period was analyzed. Lumbar puncture was performed while the patient was held seated at L4-5 or L5-S1.
Purpose: To highlight technical aspects and pitfalls of spinal anesthesia (SA) in infants.
Methods: The medical history and perioperative course of all infants who underwent SA over a 28-month period were collected (retrospectively in the first 20).
Results: Sixty-two infants underwent surgery under SA.