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After century of removing appendixes, doctors find antibiotics can be enough

arstechnica.com

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Re: After century of removing appendixes, doctors find antibiotics can be enough

#41

Post by joaomacp »

MaysonL wrote: post #33
bookofjoe wrote: post #32

Somewhat OT but interesting: "When [Kurt] Semm introduced laparoscopic surgery at the University of Kiel, he had to undergo a brain scan at the request of coworkers as 'only a person with brain damage would perform such laparoscopic surgery.' On September 13, 1980, Semm performed the first laparoscopic appendectomy, opening up the path for a much wider application of minimally invasive surgery. At first, his operatio…

The "Semmelweiss reflex" https://en.wikipedia.org/wiki/Semmelweis_reflex

This effect is currently happening on Alzheimer's research: people, including veteran experts, are rejecting the viral theory because it's so crazy.

Maybe in a few years we'll lament that...

Re: After century of removing appendixes, doctors find antibiotics can be enough

#42

Post by arkades »

shoo wrote: post #8

this qualifier is interesting: > researchers led by Paulina Salminen randomly assigned 530 patients that showed up in the hospital with an acute, uncomplicated appendicitis to get either a standard, open surgery to remove their inflamed organ or a course of antibiotics. (By “uncomplicated,” the authors mean there weren’t other issues like perforation, abscess, or suspicion of a tumor.) although if your appendix is al…

You've made the correct conclusion. Management of a perforated appendix is vastly different from management of the (much more common) uncomplicated appy. There isn't much controversy about the management of the perforated appy: it's going to be surgery and antibiotics. Removal at that point isn't in question, because the perforation is due to an increase in intra-appendiceal pressure compressing its vasculature, causing a focal necrosis. The perforation happens when a piece of the appendix dies, and thus loses its integrity. Dead tissue has to go.

And of course surgical clean-up of the abdomen must follow, along with a big pile of abx.

Re: After century of removing appendixes, doctors find antibiotics can be enough

#43

Post by clear_dg »

TheSpiceIsLife wrote: post #14
xbmcuser wrote: post #11

Earlier quoted context omitted.

Wait is that a requirement?

From the Australian Government - Department of the Environment and Energy, Australian Antarctic Division: The answer is no, however doctors who are wintering at Australian Antarctic stations are required to have their appendix removed. This is because there is usually only one doctor on station during winter, and evacuation back to medical care in Australia is impossible for at least part of the year. The requirement…

The self-surgery bit is definitely incredible. The doctor was Leonid Rogozov (https://en.wikipedia.org/wiki/Leonid_Rogozov). More info with photos here: https://rarehistoricalphotos.com/leonid-rogozov-appendix-196...

Re: After century of removing appendixes, doctors find antibiotics can be enough

#44

Post by jazoom »

jaggederest wrote: post #4

It's interesting, an acquaintance of mine had this happen. Hospitalized, with antibiotics, but just fine, no knife. Definitely surprising to hear about, but I'm glad we're still learning about these kinds of things. Imagine all the things we take for granted that are simply superstition when examined closely.

In Australia, where public hospitals provide a free service, antibiotics are first line for uncomplicated appendicitis. Most people recover just fine.

It's amazing how things are different when a surgeon doesn't want to do a procedure since it means more work for them, compared to where a surgeon wants to do a procedure since that's how they get paid.

Obviously, it's much better for the patients if they avoid unnecessary surgery.

Re: After century of removing appendixes, doctors find antibiotics can be enough

#45

Post by ransom1538 »

I found this conversation unnerving at 13 years old:

Doctor: "Does all this make sense? We need to remove your appendix.. now."

Me: "Doctor, ok, so you need to remove my appendix cause if you don't I could get really sick. "

Doctor: "Yes."

Me: "What does the appendix do?"

Doctor: "We don't know."

Re: After century of removing appendixes, doctors find antibiotics can be enough

#46

Post by morgancmartin »

bookofjoe wrote: post #35
MaysonL wrote: post #33

Earlier quoted context omitted.

The "Semmelweiss reflex" https://en.wikipedia.org/wiki/Semmelweis_reflex

That the laparascopic pioneer's name is Semm is unreal. You couldn't make it up.

Wow, given the context, I just immediately assumed it was coined because of the story OP detailed. An incredible coincidence!

Re: After century of removing appendixes, doctors find antibiotics can be enough

#47

Post by krylon »

bookofjoe wrote: post #32

Somewhat OT but interesting: "When [Kurt] Semm introduced laparoscopic surgery at the University of Kiel, he had to undergo a brain scan at the request of coworkers as 'only a person with brain damage would perform such laparoscopic surgery.' On September 13, 1980, Semm performed the first laparoscopic appendectomy, opening up the path for a much wider application of minimally invasive surgery. At first, his operatio…

It's weird in retrospect.

When my grandfather had his gall bladder removed (late 1960s, I think), he spent about 4-6 weeks in hospital and another couple of weeks at home recovering; last year, I had my gall bladder removed, they sent me home after three days. Now that's progress!

Re: After century of removing appendixes, doctors find antibiotics can be enough

#48

Post by ParanoidShroom »

Is this really news ? I've gotten it removed, and before had antibiotics to cure an infection. They misread the echo and though it was too infected to start antibiotics. It hurt like hell. After the operation, he said they removed it but could have been fixed by antibiotics earlier. They decided during the operation is was safer in the future to remove it (as I had more problems with it). They really don't want to remove it here, so I'm surprised this is news ...

Re: After century of removing appendixes, doctors find antibiotics can be enough

#49

Post by chippy »

TheSpiceIsLife wrote: post #14
xbmcuser wrote: post #11

Earlier quoted context omitted.

Wait is that a requirement?

From the Australian Government - Department of the Environment and Energy, Australian Antarctic Division: The answer is no, however doctors who are wintering at Australian Antarctic stations are required to have their appendix removed. This is because there is usually only one doctor on station during winter, and evacuation back to medical care in Australia is impossible for at least part of the year. The requirement…

Evacuation in winter is possible, the Americans do it if there is a real emergency - it's just that it's very very expensive (even for the US). Because it's possible but expensive, all the non-US bases treat it as prohibitive and effectively not to be counted on.

Re: After century of removing appendixes, doctors find antibiotics can be enough

#50

Post by rscho »

arkades wrote: post #40
rscho wrote: post #18

Earlier quoted context omitted.

Yeah, so unfortunately regarding medical science "formalized truth-values finding process" is actually about as far from reality as you could be. "Politicized agenda-propelled random search" would be closer. However, we still slowly are making progress thanks to new technologies, so all is not lost...

I understand that, looking at individual scientific problems, it's easy to get cynical. It's even fashionable to be so. Deaths attributable to heart disease in 1970 were just shy of 800k per annum. As of 2010, it was about 600k. A 25% drop in the leading cause of death, in less than a generation. Life expectancy was 70.8 years in 1970, and 78.7 in 2010 - an increase of more than 10% in a single generation. Science is…

I have both feet in the game, being a clinical researcher. So, cynic but not casual.
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