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Fever in Sickle Cell -- Is it a One Shot Deal? [Meeting Abstract]

Bruno, Santina; Teng, David; Amlicke, Maire; Appiah-Kubi, Abena; Aygun, Banu; Emeghebo, Kristina; Fishbein, Joanna; Rubin, Lorry; Schleien, Charles
ISSN: 1098-4275
CID: 5018732

A 15-year-old Boy with Right Lower Quadrant Abdominal Pain and Fever

Ahmed, Hira; Kodsi, Alicia; Gagliardo, Christina; Bruno, Santina; Katzow, Michelle
PMID: 33004570
ISSN: 1526-3347
CID: 4617272

Fever In Sickle Cell - Is It A One-shot Deal? [Meeting Abstract]

Emeghebo, Kristina; Amlicke, Maire; Appiah-Kubi, Abena; Aygun, Banu; Bruno, Santina; Fishbein, Joanna; Rubin, Lorry; Schleien, Charles; Teng, David
ISSN: 1545-5009
CID: 4589952

Lack of utility of measuring serum bilirubin concentration in distinguishing perforation status of pediatric appendicitis

Bonadio, William; Bruno, Santina; Attaway, David; Dharmar, Logesh; Tam, Derek; Homel, Peter
BACKGROUND:Pediatric appendicitis is a common, potentially serious condition. Determining perforation status is crucial to planning effective management. PURPOSE/OBJECTIVE:Determine the efficacy of serum total bilirubin concentration [STBC] in distinguishing perforation status in children with appendicitis. METHODS:Retrospective review of 257 cases of appendicitis who received abdominal CT scan and measurement of STBC. RESULTS:There were 109 with perforation vs 148 without perforation. Although elevated STBC was significantly more common in those with [36%] vs without perforation [22%], the mean difference in elevated values between groups [0.1mg/dL] was clinically insignificant. Higher degrees of hyperbilirubinemia [>2mg/dL] were rarely encountered [5%]. Predictive values for elevated STBC in distinguishing perforation outcome were imprecise [sensitivity 38.5%, specificity 78.4%, PPV 56.8%, NPV 63.4%]. ROC curve analysis of multiple clinical and other laboratory factors for predicting perforation status was unenhanced by adding the STBC variable. Specific analysis of those with perforated appendicitis and percutaneously-drained intra-abdominal abscess which was culture-positive for Escherichia coli showed an identical rate of STBC elevation compared to all with perforation. CONCLUSIONS:The routine measurement of STBC does not accurately distinguish perforation status in children with appendicitis, nor discern infecting organism in those with perforation and intra-abdominal abscess.
PMID: 28185747
ISSN: 1532-8171
CID: 4589942