ISLAMABAD  – Ultrasound scans relying on sound waves are safer than CT scans or X-rays which use radiation to confirm or rule out surgery to remove the appendix, according to an American study.

The appendix is a finger-shaped pouch that extends from the large intestine. Infection or blockage of the appendix causes appendicitis, which can lead to abdominal pain, vomiting and fever.

Children suspected of appendicitis are more likely to undergo CT scans if they are evaluated at a general hospital, a new study by Washington University School of Medicine, St. Louis has revealed, the journal Paediatrics reports.

Use of either technique can potentially reduce the occurrence of unnecessary surgeries and speed up the diagnosis of appendicitis, according to a Washington statement.

But recent reports have suggested that CT scans can magnify children`s lifetime cancer risk, because of radiation.

Therefore, researchers are reassessing the role of such scans and seeking ways to reduce their use, according to a varity statement.

“Appendicitis is a very tough diagnosis, because its symptoms overlap with viral infections and other problems,” says study co-author Jacqueline Saito, assistant professor of surgery.

“We don`t want to operate when the appendix is fine, but if we wait too long, an inflamed appendix can rupture or perforate, making recovery more complicated and much slower,” added Saito.

Saito and her colleagues analysed case records of 423 children who had appendectomies or surgery to remove the appendix, at St. Louis Children`s Hospital.

In 218 patients initially evaluated at Children`s Hospital and 205 at general hospitals, researchers reviewed how the patients were evaluated for appendicitis and whether the surgery`s results confirmed the diagnosis.

Using ultrasound to detect appendicitis has recently become more frequent, especially at St. Louis Children`s Hospital.

“Ultrasound scans are difficult to perform correctly in this context and what specialists can do at children`s hospital may not be realistic or even available in a general hospital, which doesn`t care for children as often,” Saito says.

Transfusions harmful for anemic heart patients

A meta-analysis of 10 studies involving more than 203,000 heart patients suggests that major blood transfusions for those with anemia may increase their death risk.

Saurav Chatterjee, cardiology fellow at the Alpert Medical School of Brown University and his co-authors combined and analysed data from studies in which anemia patients with heart attacks either received “liberal” blood transfusions or received more restricted versions of the treatment or no transfusions at all.

“What we found is that the possibility of real harm exists with (blood) transfusion,” Chatterjee said.

Anemia is a condition in which the body does not have enough healthy red blood cells which provide oxygen to body tissues.

“It is practiced in emergency departments all across the United States. I think it is high time that we need to answer the question definitively with a randomised trial,” Chatterjee was quoted as saying by the journal Archives of Internal Medicine.

The studies involved 203,000 heart patients. Liberal transfusions were defined as cases in which patients either received two units of blood or more or had a transfusion even with a hematocrit reading (a measure of red blood cell concentration) higher than 30 percent (normal is in the low 40s), according to a Brown statement.

What the researchers found after statistical adjustments to control for important medical factors was that the risk of death was 12 percent higher for people who received the liberal transfusions than those who did not.

Moreover, the group that received liberal transfusions had twice the odds of having another heart attack.

Higher blood protein levels `may be associated with depression

Elevated levels of C-reactive protein, a marker of inflammatory disease, appear to be associated with increased risk of psychological distress and depression in the general population of adults in Denmark, researchers say.

Depression is one of the leading causes of disability and previous studies suggest that low-grade systemic inflammation may contribute to the development of depression.

C-reactive protein (CRP) is a commonly used marker of inflammation, and inflammatory disease is suspected when CRP levels exceed 10 mg/L.

Researchers are unclear whether and to what extent elevated CRP levels are associated with psychological distress and depression in the general population, according to the study background.

Marie Kim Wium-Andersen, M.D., of Herlev Hospital and Copenhagen University Hospital, Denmark, and colleagues examined whether elevated plasma levels of CRP were associated with distress and depression. Researchers analyzed CRP levels using data from two general population studies in Copenhagen, which included 73,131 men and women ages 20 to 100 years.

“The main finding of this study consisted of an association of elevated CRP levels with an increased risk for psychological distress and depression in the general population,” the authors of the study said.

Increasing CRP levels were associated with increasing risk for psychological distress and depression in analyses. For self-reported antidepressant use, the odds ratio was 1.38 for CRP levels of 1.01 to 3 mg/L, 2.02 for 3.01 to 10 mg/L, and 2.7 for greater than 10 mg/L compared with 0.01 to 1 mg/L.

For prescription of antidepressants, the corresponding odds ratios were 1.08, 1.47 and 1.77, respectively; for hospitalization with depression they were 1.30, 1.84 and 2.27 respectively.

Other analyses suggest that increasing CRP levels also were associated with increasing risk for hospitalization with depression, according to the study results.