Clinical Research Directory

Early Detection of Infection Using the Fitbit in Pediatric Surgical Patients

The purpose of this study is to analyze Fitbit data to predict infection after surgery for complicated appendicitis and the effect this prediction has on clinician decision making.

Clinical Study of PEG Bowel Preparation in Appendectomy Patients

Colonoscopy is a necessary item of physical examination for colorectal cancer. For high-risk groups, annual physical examination is the most effective way of early prevention; At present, a large amount of polyethylene glycol (PEG2000 - 4000) is often used as laxative and lubricant in colonoscopy. However, the widespread use of PEG may cause long-term and irreversible damage to intestinal microorganisms and bring great hidden dangers to health. The appendix has long been regarded as a redundant organ in evolution. The incidence of appendicitis ranks first in surgical acute abdomen. Traditionally, once acute appendicitis is diagnosed, it is usually treated with appendectomy. However, recent studies have revealed that appendectomy may be associated with psychiatric diseases, colorectal cancer, cardiovascular diseases and other diseases. The appendix is not only an important organ of the immune system, but also undertakes the function of storing and protecting intestinal microbes.. . This change may affect the function of the central nervous system through the microbe gut brain axis, and then pose a potential threat to the health and behavior of the host, such as increasing the risk of diseases such as Parkinson's disease. Based on this, this clinical trial aims to investigate (1) the changes of intestinal flora in the appendectomy population before and after colonoscopy in the process of polyethylene glycol intestinal preparation; (2) the differences between the changes of intestinal flora before and after colonoscopy in the appendicectomy population and the normal population in the process of flora recovery.

First Appendectomy Using Revolve Surgical Robotic Arm

This study is testing a new surgical device called the Revolve Surgical System (RSS) during appendix removal surgery. The RSS is designed to help surgeons perform minimally invasive surgery with improved precision and stability while working at the patient's bedside, similar to standard laparoscopic surgery but with robotic assistance. This will be the first time the device is used in patients. It will be evaluated in three adults with uncomplicated appendicitis who are already scheduled to have an appendectomy. The purpose of the study is to assess whether the device can be used safely and effectively and to better understand how it performs during surgery.

The Impact of a Diagnostic Strategy for Acute Appendicitis in Children With Acute Abdominal Pain in Primary Care

BACKGROUND Acute appendicitis (AA) in an early stage is difficult to distinguish from other (self-limiting) causes of acute abdominal pain (e.g. constipation and gastroenteritis), resulting in missing 19% of children with AA at first presentation in primary care and 70% of non-AA cases among referrals. OBJECTIVE To evaluate the impact of the use of a diagnostic strategy for acute appendicitis (AA), which consists of a clinical prediction rule (cPR) including C-reactive protein point-of-care test (CRP POCT), on referral efficiency in children with acute abdominal pain in primary care, as compared to usual care. STUDY DESIGN This is a cluster randomized controlled trial in primary care with a process evaluation. GPs in the intervention group will use an externally validated cPR based on symptoms and signs selectively followed by a CRP POCT in the medium risk group. GPs from general practices allocated to the control group will provide care and diagnosis as usual, i.e. following recommendations of the Dutch College of GPs guideline 'abdominal pain in children'. STUDY POPULATION Children aged 4 to 18 years presenting to their general practitioner (GP) with acute abdominal pain. OUTCOME MEASURES Primary outcome: referral efficiency (proportion non-referrals in non-AA patients during 30 days follow-up). Secondary outcomes: safety (proportion of referrals in AA patients during the first consultation), proportion of children with CRP-POCT, proportion of children with planned reassessment, child anxiety, parent or child satisfaction, quality of life, and costs.

Prevention of Postoperative Hernias in Emergency Surgery

The aim of this observational study is to understand the risk factors and incidence of postoperative hernias among patients undergoing emergency surgery. The main question it aims to answer is: What is the incidence of postoperative hernias in this group of patients? A brief telephone interview will be conducted with participants who will be included in this study one year after the surgery. If the presence of a postoperative hernia is suspected, the patient will be invited to a follow-up visit to the surgical clinic, where the diagnosis will be confirmed by imaging tests.

Low-dose Contrast Media for Low-kVp Abdomen CT

The purpose of this clinical study is to test the performance of low radiation dose abdominal CT combined with low dose contrast media for the diagnosis of acute appendicitis in young patients. The main questions to be answered are: 1, Can low-dose contrast media paired with low-dose radiation CT of the abdomen provide acceptable diagnostic accuracy in acute appendicitis? 2. How much radiation dose can be saved by using low radiation dose abdominal CT in combination with low dose contrast media?

Enhanced Recovery After Surgery (ERAS) for Complicated Appendicitis

The exploratory objective of this pilot study is to evaluate the feasibility and safety of an enhanced recovery protocol that will allow adult patients to be discharged to home on an oral antibiotic regimen for three days following a laparoscopic appendectomy for complicated appendicitis. Feasibility will be determined by high compliance and adherence of patients to the postoperative instructions, while safety will be assessed by the incidence of postoperative infectious complications and requirement for re-admission.