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      Remanentes uracales y abdomen agudo: cuando no es lo que parece Translated title: Urachal remnant and acute abdomen: when it’s not what it seems

      case-report

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          Resumen

          Dentro de las causas de abdomen agudo quirúrgico, la infección de un remanente uracal puede pasar desapercibida en cuadros evolucionados a pesar de las pruebas complemetarias habituales.

          Presentamos tres casos de varones de 11, 6 y 4 años llevados a urgencias por dolor en fosa iliaca derecha, fiebre y síntomas urinarios. La exploración y las pruebas complementarias eran compatibles con patología apendicular aguda evolucionada y fueron intervenidos con dicha sospecha. En el quirófano se descartó apendicitis y se documentaron cambios inflamatorios sugestivos de infección de remanente uracal. Las complicaciones de los remanentes uracales deben ser tenidas en cuenta en el diagnóstico diferencial del abdomen agudo quirúrgico, ya que la infección evolucionada de estos puede confundirnos. Un diagnóstico de presunción más certero puede cambiar nuestra actitud terapéutica, quirúrgica y el seguimiento.

          Abstract

          Among the causes of acute surgical abdomen, infection of a urachal remnant may go unnoticed despite routine complementary studies.

          We present three cases in boys aged 11, 6, and 4 years who were brought to the emergency department for right iliac fossa pain, fever, and urinary symptoms. Examination and complementary tests results were compatible with acute complicated appendicitis and were sent to surgery. While in the operating room, appendicitis was excluded and inflammatory changes suggestive of infection of the urachal remnant were documented. Complications of urachal remnants should be considered in the differential diagnosis of acute surgical abdomen, since advanced infection of the urachus may be a cause of confusion. A more accurate presumptive diagnosis can change the therapeutic/surgical approach and follow-up.

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          Most cited references19

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          A practical score for the early diagnosis of acute appendicitis.

          We conducted a retrospective study of 305 patients hospitalized with abdominal pain suggestive of acute appendicitis. Signs, symptoms, and laboratory findings were analyzed for specificity, sensitivity, predictive value, and joint probability. The total joint probability, the sum of a true-positive and a true-negative result, was chosen as a diagnostic weight indicative of the accuracy of the test. Eight predictive factors were found to be useful in making the diagnosis of acute appendicitis. Their importance, according to their diagnostic weight, was determined as follows: localized tenderness in the right lower quadrant, leukocytosis, migration of pain, shift to the left, temperature elevation, nausea-vomiting, anorexia-acetone, and direct rebound pain. Based on this weight, we devised a practical diagnostic score that may help in interpreting the confusing picture of acute appendicitis.
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            The association between CCND1 G870A polymorphism and colorectal cancer risk

            Abstract Background: CyclinD1 (CCND1) is a key cell cycle regulatory protein. A large number of epidemiological studies have assessed the potential correlation between the CCND1 G870A polymorphism and the risk of colorectal cancer (CRC), but their findings have been inconsistent. To obtain a more precise understanding of the association between the G870A polymorphism in the CCND1 gene and the CRC risk, we conducted a more comprehensive meta-analysis. Methodology: We searched PubMed, Ovid, Springer, Weipu, China National Knowledge Infrastructure (CNKI), and Wanfang databases, covering all publications (the last search was updated on January 10, 2017). The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were derived from a fixed effect or random effect model. Statistical analyses were performed using Review Manager 5.3 and STATA 10.0 software. Results: A total of 7276 CRC patients and 9667 controls from 27 publications were included in this meta-analysis. We found that compared with GG homozygote genetic model, AA, AG, AA + AG genetic models of the CCND1 G870A polymorphism were significantly associated with overall CRC risk (AA homozygote genetic model: OR = 1.28, 95% CI = 1.10–1.49; AG heterozygote genetic model: OR = 1.15, 95% CI = 1.06–1.25; AA homozygote + AG heterozygote genetic model: OR = 1.19, 95% CI = 1.07–1.33). Subgroup analyses by ethnicity and cancer location showed that A carriers were consistently associated with a significantly increased risk of CRC in all subsets of participants (Asian and Caucasian; colon cancer and rectal cancer). When stratified by study design, we found a significant association in hospital-based studies (HB), but no significant associations were found in either population-based studies (PB) or family-based studies (FB). According to subgroup analysis by cancer type, the risk of sporadic colorectal cancer (sCRC) and hereditary nonpolyposis colorectal cancer (HNPCC) were not correlated with the CCND1 G870A polymorphism, except AG (AG vs GG: OR = 1.30, 95% CI = 1.11–1.53). Conclusions: This meta-analysis suggests that the CCND1 G870A polymorphism is associated with an increased risk of CRC, especially that A carriers may be a major risk factor for CRC.
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              Urachal anomalies in children: surgical or conservative treatment?

              To shed light on the current controversy regarding the best treatment option for managing urachal anomalies in children.
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                Author and article information

                Journal
                An Sist Sanit Navar
                An Sist Sanit Navar
                assn
                Anales del Sistema Sanitario de Navarra
                Gobierno de Navarra. Departamento de Salud
                1137-6627
                2340-3527
                28 December 2022
                Sep-Dec 2022
                : 45
                : 3
                : e1026
                Affiliations
                [1] originalCirugía Pediátrica. Hospital Universitario de Navarra. Servicio Navarro de Salud-Osasunbidea. Pamplona. España. normalizedServicio Navarro de Salud-Osasunbidea orgdiv2Cirugía Pediátrica orgdiv1Hospital Universitario de Navarra orgnameServicio Navarro de Salud-Osasunbidea Pamplona, Spain
                Author notes
                [Correspondencia ] Julio César Moreno-Alfonso. E-mail: juliomoreno.md@ 123456gmail.com

                Conflictos de intereses: Los autores declaran no tener conflictos de intereses.

                Financiación: Los autores declaran no haber recibido financiación externa para la realización de este estudio.

                Contribución de autores: JCMA concibió la idea original del estudio. Todos los autores han participado por igual a la investigación, validación, visualización, redacción del borrador original, y revisión del documento final.

                Author information
                http://orcid.org/0000-0002-0414-2888
                http://orcid.org/0000-0002-5038-225X
                http://orcid.org/0000-0002-0943-6367
                http://orcid.org/0000-0002-8273-0220
                Article
                10.23938/ASSN.1026
                10065034
                36576388
                28048941-95c6-4298-9b4e-c96937582e21

                Este es un artículo publicado en acceso abierto bajo una licencia Creative Commons

                History
                : 23 July 2022
                : 18 August 2022
                : 18 November 2022
                Page count
                Figures: 3, Tables: 0, Equations: 0, References: 16, Pages: 0
                Categories
                Notas Clínicas

                uraco,dolor abdominal,apendicitis,pediatría,urachus,abdominal pain,appendicitis,pediatrics

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