Delayed Surgery for Perforated Appendicitis is Feasible in Children Without Compromising the Outcome in Selected Cases.

BACKGROUND AND AIM: The relationship between time to surgery and risk of postoperative complications and re-intervention has not been conclusively investigated in pediatric perforated appendicitis (PA). The aim of this study was to determine whether time to appendectomy (TTA) is a risk factor for postoperative complications and re-intervention in a cohort of children undergoing appendectomy for PA. METHODS: A total of 254 children (age: 8.7 ± 3.7 years) undergoing appendectomy for PA were retrospectively evaluated and stratified into Group I-III according to the Clavien-Dindo classification for postoperative complications (Group I n = 218, 86%; Group II n = 7, 3%; Group III n = 29, 11%). RESULTS: The TTA was comparable between all groups (group I: 8.8 ± 9.2 h; group II: 7.8 ± 5.3 h; group III: 9.5 ± 9.6 h; overall: 8.8 ± 9.1 h; p = 0.885). A C-reactive protein (CRP) value at admission of ≥128.6 mg/l indicated a higher risk for developing Grade II complications with no need for re-intervention (OR: 3.963; 95% CI: 1.810-8.678; p = 0.001) and Grade III complications with the need for re-intervention (OR: 3.346; 95% CI: 1.456-7.690; p = 0.004). This risk was independent of the TTA (OR: 1.007; 95% CI: 0.980-1.035; p = 0.613). CONCLUSIONS: Appendectomy can be delayed by an average time delay of about 9 h in children with PA without increasing the risk of postoperative complications and re-intervention, also in patients at high risk defined by the initial CRP level ≥ 128.6 mg/l. This data may support the correct risk-adjusted scheduling of surgical interventions in times of limited capacity.

Cholesterol content in market hen eggs.

The yolk cholesterol content in eggs of White Hisex laying hybrid from 3 specialized commercial farms averaged 1230, 1330 and 1230 mg/100 g of yolk over an 11-months laying period, i.e. 303, 304 and 309 mg cholesterol/100 g of consumable egg portions. In testing Babcock B-380, Moravia SSL, Shaver Starcross 288, and Hisex HX-1, the av. cholesterol content varied from 1200 to 1360 mg/100 g of yolk or from 372 to 444 mg/100 g of consumable egg portions. Throughout the egg-laying period, the yolk cholesterol content fluctuated rather irregularly and showed great variability (variation coefficient 9.7-18.2%). The values recorded failed to follow any of the common functions of the trend. Intensive market egg production was found to be associated with decreases in yolk cholesterol content.