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Enterobacteriaceae in Europe. Euro Surveill 2008.,13(47): 26. Vatopoulos A: High rates of metallo-beta-lactamase-producing Klebsiella pneumoniae in Greece – a review of the current evidence. Euro Surveill 2008.,13(4): Competing interests The authors declare that they have no competing interests. Authors’ contributions MS wrote the manuscript. All authors read and approved the final manuscript.”
“Introduction Certainty of clinical diagnosis is the most challenging task in clinical practice. It is relatively straight forward to look up the treatment once a

correct diagnosis has been made. A single perfect diagnostic test for acute appendicitis www.selleckchem.com/products/oicr-9429.html does not buy Atezolizumab exist [1–3]. selleck chemicals Despite the number of algorithms and diagnostic tests available, about 20%

of patients with appendicitis are misdiagnosed [3–9]. Presence of normal appendix ranges from 5-25% out of suspected cases of acute appendicitis [5, 10–13]. Negative appendectomies were thought to be relatively harmless; nevertheless, they result in considerable unnecessary clinical and economic costs [14]. Even despite the uncertainty of diagnosis, appendicitis demands prompt treatment in order not to be neglected and misdiagnosed leading to progression of the disease with its associated morbidity and mortality that may include the risk of perforation which happens in approximately one third of the cases [5, 15, 16]. In an attempt to improve diagnosis, attention has turned to radiological imaging. The use of ultrasound scan (US) has been advocated as the readily available simple and fast imaging modality particularly in thin patients and children. A normal appendix is not frequently observed using gray-scale US [17, 18]. On the other hand Harmonic imaging (HI) increases the contrast and spatial resolution resulting in artifact-free images, and has been shown to significantly improve abdominal ultrasonography. Only a handful of reports exist regarding its application in pediatric patients. Most of them do not encompass its use in acute appendicitis [19].