Correlation between the Alvarado Scale and the macroscopic aspect of the appendix in patients with appendicitis.

OBJECTIVE: To evaluate the possible association between the scale of Alvarado (EA) and macroscopic appearance (MA) of the appendix in patients with acute appendicitis. METHODS: after receiving the diagnosis of acute appendicitis, EA data were collected. During appendectomy, MA data were collected. Data from patients without appendicitis were excluded. The Spearman correlation test was used to compare EA with Appendix MA (p < 0.05). Other variables were represented by simple frequency. The confidence interval (CI) of 95% was calculated for the correlation test. RESULTS: Data were collected from 67 consecutive patients. The mean age was 37.1 ± 12.5 years and 77.6% of patients were male. The Spearman correlation test used for EA and MA was + 0.77 (95% CI 0.65-0.85, p < 0.0001). CONCLUSION: although correlation was not perfect, our data indicate that a high score on the scale of Alvarado in patients with appendicitis is correlated with advanced stages of the inflammatory process of acute appendicitis.

Transoperative refusion: a simple and safe method in emergency surgery.

The objective is to reinforce the importance of blood reinfusion as a cheap, safe and simple method, which can be used in small hospitals, especially those in which there is no blood bank. Moreover, even with the use of devices that perform the collection and filtration of blood, more recent studies show that the cost-benefit ratio is much better when autologous transfusion is compared with blood transfusions, even when there is injury to hollow viscera and blood contamination. It is known that the allogeneic blood transfusion carries a number of risks to patients, among them are the coagulation disorders mediated by excess enzymes in the conserved blood, and deficiency in clotting factors, mainly the Factor V, the proacelerin. Another factor would be the risk of contamination with still unknown pathogens or that are not investigated during screening for selection of donors, such as the West Nile Fever and Creutzfeldt-Jacob, better known as "Mad Cow" disease. Comparing both methods, we conclude that blood autotransfusion has numerous advantages over heterologous transfusion, even in large hospitals. We are not against blood transfusions, just do not agree that the patient's own blood is discarded without making sure there will be enough blood in stock to get him out of the hemorrhagic shock.

Correlation between the Alvarado Scale and the macroscopic aspect of the appendix in patients with appendicitis / Correlação entre a Escala de Alvarado e o aspecto macroscópico do apêndice em pacientes com apendicite

Objective: To evaluate the possible association between the scale of Alvarado (EA) and macroscopic appearance (MA) of the appendix in patients with acute appendicitis. Methods: after receiving the diagnosis of acute appendicitis, EA data were collected. During appendectomy, MA data were collected. Data from patients without appendicitis were excluded. The Spearman correlation test was used to compare EA with Appendix MA (p < 0.05). Other variables were represented by simple frequency. The confidence interval (CI) of 95% was calculated for the correlation test. Results: Data were collected from 67 consecutive patients. The mean age was 37.1 ± 12.5 years and 77.6% of patients were male. The Spearman correlation test used for EA and MA was + 0.77 (95% CI 0.65-0.85, p < 0.0001). Conclusion: although correlation was not perfect, our data indicate that a high score on the scale of Alvarado in patients with appendicitis is correlated with advanced stages of the inflammatory process of acute appendicitis. .

Objetivo: avaliar a possível associação entre a escala de Alvarado (EA) e o aspecto macroscópico (AM) do apêndice em pacientes com apendicite aguda. Métodos: depois de receberem o diagnóstico de apendicite aguda, os dados da EA foram coletados. Durante a apendicectomia, os dados do AM foram coletados. Dados de pacientes sem apendicite foram excluídos. O teste de correlação de Spearman foi utilizado para comparar EA e o AM do apêndice (P<0,05). Outras variáveis foram representadas por frequência simples. O intervalo de confiança (IC) de 95% foi calculado para o teste de correlação. Resultados: os dados foram coletados de 67 pacientes consecutivos. A média da idade foi 37,1 ± 12,5 anos e 77,6% dos pacientes foram masculinos. O teste de correlação de Spearman usado para EA e AM foi + 0,77 (IC 95% 0,65 a 0,85, P<0,0001). Conclusão: apesar de a correlação não ser perfeita, nossos dados indicam que uma pontuação elevada da escala de Alvarado em pacientes com apendicite está correlacionada com estágios avançados do processo inflamatório da apendicite aguda. .

Transoperative refusion: a simple and safe method in emergency surgery / Reinfusão transoperatória: um método simples e seguro na cirurgia de emergência

The objective is to reinforce the importance of blood reinfusion as a cheap, safe and simple method, which can be used in small hospitals, especially those in which there is no blood bank. Moreover, even with the use of devices that perform the collection and filtration of blood, more recent studies show that the cost-benefit ratio is much better when autologous transfusion is compared with blood transfusions, even when there is injury to hollow viscera and blood contamination. It is known that the allogeneic blood transfusion carries a number of risks to patients, among them are the coagulation disorders mediated by excess enzymes in the conserved blood, and deficiency in clotting factors, mainly the Factor V, the proacelerin. Another factor would be the risk of contamination with still unknown pathogens or that are not investigated during screening for selection of donors, such as the West Nile Fever and Creutzfeldt-Jacob, better known as "Mad Cow" disease. Comparing both methods, we conclude that blood autotransfusion has numerous advantages over heterologous transfusion, even in large hospitals. We are not against blood transfusions, just do not agree that the patient's own blood is discarded without making sure there will be enough blood in stock to get him out of the hemorrhagic shock.

O objetivo deste trabalho é reforçar a importância da reinfusão sanguínea como um método barato, seguro e simples, e que pode ser utilizado em hospitais de pequeno porte, destacando aqueles que não dispõem de banco de sangue. Além disso, mesmo com a utilização de aparelhos que realizam a coleta e filtração do sangue, trabalhos mais recentes mostram que a relação custo-benefício é bem melhor, comparando a transfusão autóloga com a transfusão de hemoderivados, mesmo quando há lesão de vísceras ocas e contaminação do sangue. Sabe-se que, atualmente, a transfusão de sangue alogênico acarreta uma série de riscos aos pacientes, dentre eles, estão os distúrbios de coagulação mediados pelo excesso de enzimas no sangue, conservada e deficiência nos fatores de coagulação; destacando o Fator V, a proacelerina. Outro fator seria o risco de contaminação com patógenos ainda desconhecidos ou que não são investigados durante a triagem para seleção de doadores, como por exemplo, a Febre do Nilo Ocidental e a Doença de Creutzfeldt-Jacob, mais conhecida como Doença da "Vaca Louca". Comparando ambos os métodos, concluímos que a autotransfusão sanguínea possui inúmeras vantagens em relação à transfusão heteróloga, mesmo em hospitais de grande porte. Não somos contra a transfusão de hemoderivados, só não concordamos que seja desprezado o sangue do próprio paciente, sem termos certeza de que vai chegar sangue em quantidade suficiente para tirá-lo do choque hemorrágico.