A prospective study to evaluate the contribution of the pediatric appendicitis score in the decision process.

BACKGROUND: The objective of this study was to assess the likelihood of acute appendicitis (AA) in children presenting with abdominal symptoms at the emergency department (ED), based on their prior primary care (PC) consultation history. METHODS: Between February and June 2021, we prospectively enrolled all children presenting at the ED with acute abdominal pain indicative of possible acute appendicitis (AA). Subsequently, they were categorized into three groups: those assessed by a PC physician (PG), those brought in by their family without a prior consultation (FG), and those admitted after a PC consultation without being assessed as such. The primary objective was to assess the probability of AA diagnosis using the Pediatric Appendicitis Score (PAS). Secondary objectives included analyzing PAS and C-reactive protein (CRP) levels based on the duration of pain and final diagnoses. RESULTS: 124 children were enrolled in the study (PG, n = 56; FG, n = 55; NG, n = 13). Among them, 29 patients (23.4%) were diagnosed with AA, with 13 cases (23.2%) from the PG and 14 cases (25.4%) from the FG. The mean PAS scores for AA cases from the PG and FG were 6.69 ± 1.75 and 7.57 ± 1.6, respectively, (p = 0.3340). Both PAS scores and CRP levels showed a significant correlation with AA severity. No cases of AA were observed with PAS scores < 4. CONCLUSIONS: There was no significant difference in PAS scores between patients addressed by PG and FG, even though PAS scores tended to be higher for patients with AA. We propose a new decision-making algorithm for PC practice, which incorporates inflammatory markers and pain duration. TRIAL REGISTRATION: Institutional Ethics Committee registration number: 447-2021-103 (10/01/2021). CLINICAL TRIALS REGISTRATION NUMBER: ClinicalTrials.gov Identifier: NCT04885335 (Registered on 13/05/2021).

Corrigendum to Impact of plate shape on the conservation of food praxis in institutionalised elderly adults with severe Alzheimer's disease or mixed dementia: Praxalim an observational before-after non-randomized study.

[This corrects the article DOI: 10.1016/j.ijnsa.2020.100005.].

Impact of plate shape on the conservation of food praxis in institutionalised elderly adults with severe Alzheimer's disease or mixed dementia: Praxalim an observational before-after non-randomized study.

Purpose: To investigate whether the shape of the food plate could affect the conservation of praxis in institutionalised elderly adults with severe Alzheimer's disease or mixed dementia. Patients and methods: We conducted a monocentric, prospective, observational, before-after case-only study in 32 patients with a loss of the ability to self-feed. The primary objective was to assess the change of food praxis using the Blandford scale at 3 weeks after changing the food plate. Secondary variables included the impact of the change of diet on the food praxis at 6 weeks, the patient's autonomy in the food intake evaluated by Tully's Eating Behaviour Scale (EBS), and the enjoyment of eating assessed by Part D of the Alzheimer's Disease-Related Quality of Life (ADRQL) scale at 3 and 6 weeks. Results: At 3 weeks after changing the food plate we observed a significant decrease in the number of aversive feeding behaviours (Δ = -0.90 ± 2.23; p = 0.03) and an improved autonomy in self-feeding (Δ = 1.88 ± 3.36.23; p = 0.001). There was also an increase in the enjoyment of eating at 3 weeks (Δ = 4.07 ± 13.02), but it was not statistically significant. These results were not consolidated at the 6 week timepoint. Conclusion: A simple change in the organisation of care during meals and the use of a familiar object can positively affect the recovery of the self-feeding autonomy of patients with severe dementia.