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Appendicitis clinical trials

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NCT ID: NCT06175169 Recruiting - Acute Appendicitis Clinical Trials

IA Model for Acute Appendicitis in CT

Start date: July 4, 2023
Phase: N/A
Study type: Interventional

the investigators's study group has developed a fully automated 3D convolutional neural network (CNN)-based diagnostic framework using information of appendix (IA) model to identify non-appendicitis and simple and complicated appendicitis on CT scan images based on the two-stage binary classification algorithm, as a clinician does for deciding treatment. The dataset was built from a large population of patients visiting emergency departments who underwent intravenous contrast-enhanced abdominopelvic CT examinations to evaluate abdominal pain in the right or lower quadrant area as the chief complaint. Recently, the IA model was externally validated using a dataset of multicenter institutions through data exfiltration. In this study, the investigators hypothesized that the IA model would show a comparable negative appendicitis rate of <10% non-inferior margins compared to non-radiologists with a shorter interpretation time in a prospectively randomized dataset.

NCT ID: NCT06160778 Recruiting - Acute Pain Clinical Trials

Intravenous Ketorolac Vs. Morphine In Children With Acute Abdominal Pain

KETOAPP
Start date: May 14, 2024
Phase: Phase 3
Study type: Interventional

Appendicitis is a common condition in children 6-17 years of age, and the top reason for emergency surgery in Canada. Children with appendicitis can have very bad pain in their belly. Children often need pain medications given to them through a needle in their arm called an intravenous (IV). The most common IV pain medication is a type of opioid called morphine. We know that opioids work well to improve pain, but there are risks and side effects when taking them. There are non-opioid medications that doctors can give to patients, like ketorolac. Ketorolac helps decrease inflammation and pain and has fewer side effects when a patient takes it for a short period of time. Our past and present overuse of opioids, driven by an unproven assumption that opioids work best for pain, resulted in an Opioid Crisis and doctors are now looking for alternatives. To do this, we need to prove that there are other options to treat children's pain that are just as good as opioids, with less side effects. The goal of our study is to discover if school aged children who arrive at the emergency department with belly pain, improve just as much with ketorolac as they do with morphine. To answer this question, we will need a very large number of patients in a study that includes several hospitals across Canada. With a flip of a coin, each participant will either get a single dose of morphine or a single dose of ketorolac. To make sure that our pain assessment is impartial, no one will know which medicine the child received except the pharmacist who prepared the medicine.

NCT ID: NCT06102239 Recruiting - Clinical trials for Complicated Appendicitis

New Diagnostic Markers In Dignosis Of Complicated Appendix

Start date: October 1, 2023
Phase: N/A
Study type: Interventional

Most common cause of acute abdomen is acute appendicitis delay dignosis of acute appendicitis lead to complications as perforation this study examined efficacy of hyperbilirubinemia&hyponatremia as indicator of complicated appendicitis

NCT ID: NCT06091137 Active, not recruiting - Colorectal Cancer Clinical Trials

Appendectomy and Colorectal Cancer

Start date: June 1, 2022
Phase:
Study type: Observational

Colorectal cancer (CRC) is one of the most common cancer worldwide. Initiation and progression of CRC involve complex interactions among genetic, epigenetic and environmental factors. Given that hereditary and familial CRC only accounts for 2% to 5% of cases, environmental factors are the key triggers of CRC. Emerging evidence has indicated that gut microbes are an important environmental factor promoting CRC development. Gut dysbiosis has been shown to promote colorectal carcinogenesis in mice. Several individual bacterial species, such as the enterotoxigenic Bacteroides fragilis (ETBF), Fusobacterium nucleatum and Peptostreptococcus anaerobius, could exert carcinogenic effects by inducing direct DNA damage, oxidative damage and activating oncogenic signaling pathways. Recent studies have shown that the appendix plays an important role in maintaining homeostasis and biodiversity of gut microbiome by providing an ideal ecological niche for commensal bacteria and production of immunoglobulin A. Considering the key role of microorganisms in gastrointestinal pathophysiology, absence of appendix may result in disruption of microbiome homeostasis, which could potentially influence the risk of developing CRC. In terms of epidemiological evidence, the association of appendectomy with the risk of CRC development has been controversial, and to date no consensus has been attained. Although gut microorganisms could be a crucial pivot between appendectomy and risk of subsequent CRC development, the direct contribution of appendectomy and the underlying mechanisms are still largely unexplored. In this study, we aim to study 1. the association between appendectomy and colorectal cancer, and 2. the role of appendectomy in CRC risk through causing gut microbial dysbiosis.

NCT ID: NCT06083064 Recruiting - Appendicitis Clinical Trials

Protocol Based Selective Imaging Versus Routine Computed Tomography or Ultrasound in Suspected Appendicitis

PROSECCO
Start date: November 15, 2023
Phase: N/A
Study type: Interventional

The goal of this clinical trial is to compare protocol based selective imaging to routine imaging in adult patients with suspected appendicitis. The main question[s] it aims to answer are: - Does protocol based selective imaging using clinical scoring affect clinical outcome? - Does protocol based selective observation combined with score based selective imaging affect clinical outcome? Participants will be randomized into three groups: - Selective imaging based on Adult Appendicitis Score - Selective observation based on Appendicitis Severity Score combined with selective imaging based on Adult Appendicitis Score - Routine imaging using ultrasound and/or computed tomography Researchers will compare selective imaging groups separately with routine imaging to see if number of negative appendectomies or number of complicated appendicitis is not significantly increased.

NCT ID: NCT06064331 Completed - Appendicitis Clinical Trials

Effect of Intravenous Lignocaine Infusion on Intraoperative End Tidal Desflurane Concentration Requirements

Start date: January 21, 2021
Phase: N/A
Study type: Interventional

Lignocaine is a local anaesthetic that is widely used in all medical and surgical fields. Many clinical studies have shown that intravenous (IV) lignocaine given in the perioperative period was safe, reduced airway complications, obtunds cough reflex, reduce sore throat, pain, opioid consumption, nausea, length of hospital stay. Multiple animal studies have shown that IV lignocaine was able to lower anaesthetic gas requirements. Desflurane is an anaesthetic gas that has a rapid onset and offset of action. This study aims to evaluate the effect of IV lignocaine infusion on desflurane requirements. Hypothesis of the study is that IV lignocaine infusion reduces desflurane requirements.

NCT ID: NCT06059365 Not yet recruiting - Acute Appendicitis Clinical Trials

Clinical Trial for a Outpatient Clinical Management for Complicated Acute Appendicitis

ASI2
Start date: November 1, 2023
Phase: N/A
Study type: Interventional

The aim of this study is to evaluate the safety and efficacy of outpatient management of complicated acute appendicitis. For this purpose, a randomized clinical trial was designed. Selected patients who have undergone surgery for acute appendicitis are randomized into two groups. One group with hospitalization and another group without admission.

NCT ID: NCT06051825 Not yet recruiting - Acute Appendicitis Clinical Trials

Diagnostic Importance of the C-reactive Protein From Blood and Saliva in Children With Acute Appendicitis

Start date: November 1, 2023
Phase:
Study type: Observational

Diagnosing acute appendicitis in children is still a challenge even for experienced clinicians. Failure to recognize this acute condition can result in perforation, with consequent peritonitis, or misdiagnosis can result in negative appendectomies. C-reactive protein in blood can be elavated in children with acute appendicitis. The aim of this research is to compare the diagnostic value of C-reactive protein from the blood and saliva of children with acute appendicitis and to prove wheter the analysis of biomarker from saliva as a minimally invasive procedure can be sufficient for diagnosis.

NCT ID: NCT06035029 Recruiting - Appendicitis Clinical Trials

Intestinal Flora and Metabonomics of Appendicitis

Start date: April 3, 2023
Phase:
Study type: Observational

The goal of this observational study is to learn about the key bacterial flora and metabolites associated with appendicitis in children. The main questions it aims to answer are: - To screen out the key biomarkers of pediatric appendicitis. - What are the microbial differences in different parts of pediatric appendicitis patients. Participants will detect feces using 16s ribosomal RiboNucleicAcid (16S rRNA) gene sequencing technology and differences of the fecal metabolites between healthy children and appendicitis children were analyzed using untargeted metabolomics based on Liquid chromatography-tandem mass spectrometry(LC-M S/MS) platform.Through the analysis of intestinal bacterial flora and metabolomics association and the differential analysis of intestinal bacterial flora in different parts of the case group, the key bacterial flora and metabolites were excavated.

NCT ID: NCT06000020 Active, not recruiting - Appendicitis Acute Clinical Trials

Leave or Laparoscopic Appendectomy With Normal Findings - a Regional Cohort Study

Start date: March 17, 2017
Phase:
Study type: Observational

Based on a regional cohort, this study we will try to demonstrate the superiority of routine laparoscopic appendectomy vs. leaving an intraoperative assessed normal appendix in situ in cases of normal findings at diagnostic laparoscopy. If routine laparoscopic appendectomy is not superior, we will recommend leaving the "normal" appendix in situ.