Treating appendicitis . . . and other stories

Long term outcomes of medically treated acute appendicitisA follow-up study of a Swedish trial that compared surgery with antibiotic treatment for acute appendicitis succeeded in tracing 90% of the participants 20 years later. Although rates of appendectomy were low in the medically treated group after the first year, appendectomies continued to occur throughout the follow-up period. Even so, more than half of the patients treated non-operatively never experienced recurrence and so avoided surgery. Apart from recurrence of appendicitis, no other long term risks of non-operative management emerged (JAMA Surg doi:10.1001/jamasurg.2023.2756).Going with the (pulsatile) flowIn healthy humans, blood flow in the aorta is laminar. This is remarkable, since, if peak rates were replicated in steady state in a pipe, flow would be turbulent. In vitro experiments show that a pulsatile pattern of rapid acceleration, followed by gentle deceleration and a rest phase, is crucial for suppressing turbulence. This sort of pulsatile…
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