Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 358 MOC points in the American Board of Internal Medicines (ABIM) Maintenance of Certification (MOC. Suggested readings, and test questions plus its CME/CE/MOC certified.NEJM Knowledge Internal Medicine Board Review: 358 AMA PRA Category 1 Credits ABIM MOC Points. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelinesThis membership has been carefully designed to give you the knowledge you need to. Over 3,800 questions, based on more than 2,500 learning. Robust reporting: NEJM Knowledge+ offers reporting by individual and by program, allowing residency program directors to get the details on each resident’s progress, as well as the big picture view of the residency program’s effectiveness, so you can spot and fix potential problems.MethodsThis executive manuscript summarizes the WSES guidelines for the diagnosis and treatment of AA. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide.In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. See full list on knowledgeplus.nejm.org.World Journal of Emergency Surgery volume 15, Article number: 27 ( 2020)Acute appendicitis (AA) is among the most common causes of acute abdominal pain. 1.2 BA II Plus Professional.
Nejm Knowledge Fm Update Of TheConclusionsThe 2020 WSES guidelines on AA aim to provide updated evidence-based statements and recommendations on each of the following topics: (1) diagnosis, (2) non-operative management for uncomplicated AA, (3) timing of appendectomy and in-hospital delay, (4) surgical treatment, (5) intra-operative grading of AA, (6) ,management of perforated AA with phlegmon or abscess, and (7) peri-operative antibiotic therapy.Acute abdominal pain accounts for 7–10% of all emergency department accesses. Finally, two different practical clinical algorithms are provided in the form of a flow chart for both adults and pediatric (< 16 years old) patients. Several tables highlighting the research topics and questions, search syntaxes, and the statements and the WSES evidence-based recommendations are provided. The statements were voted, eventually modified, and finally approved by the participants to the consensus conference and by the board of co-authors, using a Delphi methodology for voting whenever there was controversy on a statement or a recommendation. Current evidence shows laparoscopic appendectomy (LA) to be the most effective surgical treatment, being associated with a lower incidence of wound infection and post-intervention morbidity, shorter hospital stay, and better quality of life scores when compared to open appendectomy (OA). Since surgeons started performing appendectomies in the nineteenth century, surgery has been the most widely accepted treatment, with more than 300,000 appendectomies performed annually in the USA. The role of diagnostic imaging, such as ultrasound (US), computed tomography (CT), or magnetic resonance imaging (MRI), is another major controversy. The experts reviewed and updated the original list of key questions on the diagnosis and treatment of AA addressed in the previous version of the guidelines. Ceresoli) with high-level experience in the management of AA to serve as experts in this 2020 update of the WSES Jerusalem guidelines. Di Saverio) invited six experienced surgeons (G. Therefore, the board of the WSES decided to convene an update of the 2016 Jerusalem guidelines.These updated consensus guidelines were written under the auspices of the WSES by the acute appendicitis working group.The coordinating researcher (S. Over the last 4 years, major issues still open to debate in the management of AA have been reported concerning the timing of appendectomy, the safety of in-hospital delay, and the indications to interval appendectomy following the resolution of AA with antibiotics. Vidal sassoonSearch syntaxes have been reported in (Supplemetary material file 1). No search restrictions were imposed. A computerized search of different databases (MEDLINE, Scopus, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials), and new citations were included for the period April 2015 to June 2019. Infants were excluded from this review.Based upon the list of topics, research questions (Patients/Population, Intervention/Exposure, Comparison, Outcome (PICO)) were formulated, reviewed, and adopted as guidance to conduct an exploratory literature search (Table 1).The searches were conducted in cooperation with a medical information specialist from the University of Bologna (A. Pediatric patients were defined as including children and adolescents aged between 1 and 16 years old.
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