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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

#71

Post by bookofjoe »

odyssey7 wrote: post #68
tinus_hn wrote: post #57

Earlier quoted context omitted.

You’d be surprised to learn what happened to the person who suggested it is better if the surgeons wash their hands between patients (Ignaz Semmelweis)

I just looked this up and oh wow, and I don't perceive that this situation could have only happened back then. In the modern day, a lot of people with a lot of education will scoff at anything that hasn't been produced by science, or even anything that simply wasn't taught to them in medical school. Meanwhile, the medical system is full of inefficiencies and outdated practices because of politics and resistance to ac…

A recent example: Drs. Barry Marshall and Robin Warren, who discovered that gastritis, gastric ulcers, and stomach cancer are caused by the bacteria H. pylori. "In 1983 they submitted their findings so far to the Gastroenterological Society of Australia, but the reviewers turned their paper down, rating it in the bottom 10% of those they received in 1983."—Wikipedia. Marshall and Warren were awarded the Nobel Prize in Physiology or Medicine in 2005 for their discovery.

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

#72

Post by odyssey7 »

bookofjoe wrote: post #71
odyssey7 wrote: post #68

Earlier quoted context omitted.

I just looked this up and oh wow, and I don't perceive that this situation could have only happened back then. In the modern day, a lot of people with a lot of education will scoff at anything that hasn't been produced by science, or even anything that simply wasn't taught to them in medical school. Meanwhile, the medical system is full of inefficiencies and outdated practices because of politics and resistance to ac…

A recent example: Drs. Barry Marshall and Robin Warren, who discovered that gastritis, gastric ulcers, and stomach cancer are caused by the bacteria H. pylori. "In 1983 they submitted their findings so far to the Gastroenterological Society of Australia, but the reviewers turned their paper down, rating it in the bottom 10% of those they received in 1983."—Wikipedia. Marshall and Warren were awarded the Nobel Prize i…

Hey! We must read similar things.

https://news.ycombinator.com/item?id=17952107

Looking back I could have talked about Zika here. How many childhood viruses are we sure don't cause down-the-road issues like cancer? Most of the time when you get a random virus, the doctor has no clue which one it is and doesn't test to find out. I can remember being told by nurses at the school "there's a virus going around," and that's all we knew: there was some virus, and everyone was getting it. We just assume that these things are harmless and irrelevant once you recover from them.

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

#73

Post by mr_overalls »

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…

Are there examples of other fields being so staunchly/abusively conservative? I'm struggling to imagine a physicist, engineer, or attorney being forced to undergo a mental examination for suggesting a radical new theory or procedure.

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

#74

Post by seszett »

chippy wrote: post #49
TheSpiceIsLife wrote: post #14

Earlier quoted context omitted.

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.

It's only possible in some places, for example Kerguelen island has no airstrip, the closest airstrip being on Réunion island 3000km away (Davis station on the Antarctic continent is closer, 2000km, but does not have a permanent airstrip).

No helicopter in the world has such a range, so the only means of evacuating is by ship, with the fastest ships in the area taking minimum 3 days to make the trip. If a navy ship is around, it could probably treat the emergency on board but most others will have to get back to Réunion first.

In the likely event that no ship from the French navy is around, the fastest means of evacuating will be requisitioning a nearby fishing ship but those will probably not make it to Réunion until at least one week.

Fortunately, the relative emergencies (but not life threatening) I have witnessed have always happened when a ship was already on its way for other reasons, but US or not there are real technical impossibilities in these places.

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

#75

Post by 0xcafecafe »

SECProto wrote: post #70
0xcafecafe wrote: post #67

I wonder if this would eventually be extended to wisdom teeth, something dentists are too trigger happy to remove.

Not quite sure I understand - give antibiotics instead of pulling wisdom teeth? They pull them because wisdom teeth often grow in at an angle to a mouth of fully developed and settled adult teeth. Sort of a "why mess with a good thing" (the teeth there already) approach. I certainly see an issue with the rampant pulling of wisdom teeth for cosmetic reasons, but don't see how it's relevant to a new treatment method fo…

I meant the overall principle of maintain rather than remove.

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

#76

Post by fulafel »

seszett wrote: post #74
chippy wrote: post #49

Earlier quoted context omitted.

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.

It's only possible in some places, for example Kerguelen island has no airstrip, the closest airstrip being on Réunion island 3000km away (Davis station on the Antarctic continent is closer, 2000km, but does not have a permanent airstrip). No helicopter in the world has such a range, so the only means of evacuating is by ship, with the fastest ships in the area taking minimum 3 days to make the trip. If a navy ship i…

Could you parachute fuel down for helicopter refuelings along the way?

Edit: it seems that aetial refueling for helicopters is a thing as well.

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

#77

Post by nielsole »

odyssey7 wrote: post #72
bookofjoe wrote: post #71

Earlier quoted context omitted.

A recent example: Drs. Barry Marshall and Robin Warren, who discovered that gastritis, gastric ulcers, and stomach cancer are caused by the bacteria H. pylori. "In 1983 they submitted their findings so far to the Gastroenterological Society of Australia, but the reviewers turned their paper down, rating it in the bottom 10% of those they received in 1983."—Wikipedia. Marshall and Warren were awarded the Nobel Prize i…

Hey! We must read similar things. https://news.ycombinator.com/item?id=17952107 Looking back I could have talked about Zika here. How many childhood viruses are we sure don't cause down-the-road issues like cancer? Most of the time when you get a random virus, the doctor has no clue which one it is and doesn't test to find out. I can remember being told by nurses at the school "there's a virus going around," and that…

I really look forward when the premise of Theranos becomes technically viable. Cheap continuous medical tests.

So much in medical diagnosis is just a very coarse decision tree and it is uneconomical to investigate every sickness.

Imagine doctors having more time per patient. Imagine many diseases detected before there are symptoms.

I got carried away here, but medicine looks so much more promising then CS sometimes.

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

#78

Post by tawayway »

mr_overalls wrote: post #73
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…

Are there examples of other fields being so staunchly/abusively conservative? I'm struggling to imagine a physicist, engineer, or attorney being forced to undergo a mental examination for suggesting a radical new theory or procedure.

Presumably they had a brain scan machine (scanner?) nearby, ready to go. Everyone likes a joke with a prop.

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

#79

Post by knodi123 »

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.

to paraphrase randall munroe, what are the odds that we would have two unrelated US presidents whose names both started with T-R-U-M ?

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

#80

Post by crazygringo »

I'm so confused. From Wikipedia:

> Appendicitis is caused by a blockage of the hollow portion of the appendix. This is most commonly due to a calcified "stone" made of feces. Inflamed lymphoid tissue from a viral infection, parasites, gallstone, or tumors may also cause the blockage... The combination of inflammation, reduced blood flow to the appendix and distention of the appendix causes tissue injury and tissue death. If this process is left untreated, the appendix may burst, releasing bacteria into the abdominal cavity, leading to increased complications... Acute appendicitis is typically managed by surgery. While antibiotics are safe and effective for treating uncomplicated appendicitis, 26% of people had a recurrence within a year and required an eventual appendectomy.

Given that bacteria are not even listed as a cause of appendicitis above, how do antibiotics help at all? Is there anything they can do to prevent "tissue death" in the appendix itself, and how? What about that "stone"?

Or are the antibiotics for dealing with an actual ruptured appendix (to kill leaking bacteria from the gut into the rest of the body), while the appendix presumably eventually resolves its blockage and heals itself on its own? Which sounds... scary, but of course I'm no MD.

Would love if anyone here knows how to explain what the article doesn't.

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