A Randomized Trial Comparing #Antibiotics with Appendectomy for #Appendicitis

..In total, 1552 adults (414 with an appendicolith) underwent randomization; 776 were assigned to receive antibiotics (47% of whom were not hospitalized for the index treatment) and 776 to undergo appendectomy (96% of whom underwent a laparoscopic procedure). Antibiotics were noninferior to appendectomy on the basis of 30-day EQ-5D scores (mean difference, 0.01 points; 95% …

Continue reading A Randomized Trial Comparing #Antibiotics with Appendectomy for #Appendicitis

Effect of Multilevel Upper Airway Surgery vs Medical Management on the Apnea-Hypopnea Index and Patient-Reported Daytime Sleepiness Among Patients With Moderate or Severe Obstructive #Sleep #Apnea

Many adults with obstructive sleep apnea (OSA) use device treatments inadequately and remain untreated.. ..Among 102 participants who were randomized (mean [SD] age, 44.6 [12.8] years; 18 [18%] women), 91 (89%) completed the trial. The mean AHI was 47.9 at baseline and 20.8 at 6 months for the surgery group and 45.3 at baseline and …

Continue reading Effect of Multilevel Upper Airway Surgery vs Medical Management on the Apnea-Hypopnea Index and Patient-Reported Daytime Sleepiness Among Patients With Moderate or Severe Obstructive #Sleep #Apnea

Association of New-Onset Atrial #Fibrillation After Noncardiac #Surgery With Subsequent #Stroke and Transient Ischemic Attack

Outcomes of postoperative atrial fibrillation (AF) after noncardiac surgery are not well defined.. ..The median age of the 452 matched patients was 75 years (IQR, 67-82 years) and 51.8% of patients were men. Patients with postoperative AF had significantly higher CHA2DS2-VASc scores than those in the no AF group (median, 4 [IQR, 2-5] vs 3 …

Continue reading Association of New-Onset Atrial #Fibrillation After Noncardiac #Surgery With Subsequent #Stroke and Transient Ischemic Attack

Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic #Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated #Appendicitis

Nonoperative management with antibiotics alone has the potential to treat uncomplicated pediatric appendicitis with fewer disability days than surgery.. ..Patient and family selection of nonoperative management with antibiotics alone (nonoperative group, n = 370) or urgent (≤12 hours of admission) laparoscopic appendectomy (surgery group, n = 698). Main Outcomes and Measures The 2 primary outcomes assessed at 1 year …

Continue reading Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic #Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated #Appendicitis

Surgery versus Conservative Care for Persistent #Sciatica Lasting 4 to 12 Months

..Among the patients assigned to undergo surgery, the median time from randomization to surgery was 3.1 weeks; of the 64 patients in the nonsurgical group, 22 (34%) crossed over to undergo surgery at a median of 11 months after enrollment. At baseline, the mean score for leg-pain intensity was 7.7 in the surgical group and …

Continue reading Surgery versus Conservative Care for Persistent #Sciatica Lasting 4 to 12 Months