Conclusions
This statewide epidemiological study for the years 1995–2009 finds that incidence of appendicitis has increased over time, incidence rates are higher in the summer months, and whites and Hispanics are at a greater risk of appendicitis compared to African Americans or Asians. Hispanics and Asians have higher odds of perfo- ration compared to whites, and patients with Medicare,
This study provides important updates on the epidemi- ology of appendicitis, including information on risk factors of appendicitis, risk factors of perforated appendicitis, and an examination of trends in surgical management. How- ever, it is unknown why the incidence of this disease is increasing over time, is higher during the summer months, or varies by race. More research must be done to under- stand the etiology of this common disease in order to identify possible preventative measures.
Examining a Common Disease with Unknown Etiology: Trends in Epidemiology and Surgical Management of Appendicitis in California, 1995–2009
Jamie E. Anderson • Stephen W. Bickler • David C. Chang • Mark A. Talamini

Conflict of interest The authors declare no conflict of interest or financial ties to disclose.

I. Epidemiology Discussion: Provide a brief description of the epidemiology of the disease process, focusing on national, state and local epidemiologic information. Reflection should also address observed trends in morbidity/mortality, population or ethnic dimensions and/or other contributing data to help define the significance of the problem (one or two paragraphs at most).

Disease Etiology: Discuss the etiology of the chosen disease process. How does it come about? What are the causal elements of this disease process? You should discuss using anatomy and physiologic terms at the cellular and tissue level. If it is considered idiopathic, then theoretical causes should be discussed and supported with research and literature, again at the cellular and tissue level.

Disease Pathogenesis: Discuss the pathogenesis of the disease process. Include cellular, tissue, and organ levels. If applicable, disease stages and progression should be discussed as well, at the cellular and tissue levels.

Clinical Manifestations of Disease:

When one is assessing a patient it is important to important to assess all clinical manifestation objective as well as subjective manifestations.
The primary care provider should assess the onset of pain, which is crucial in the case of appendicitis since when a patient begins to feel pain there is not much time for the patient to be at risk of a rapture appendix. Another important factor to ask and observe what provokes the pain, sometimes a patient with appendicitis would not be able to jump up and down since the increase and decrease of pressure in the area causes greater pain. A patient who present with appendicitis will e complaining of right lower quadrant pain since anatomically this is the location of the appendix. There is a medical term called the McBurneys point, this is the location of the iliac crest to the belly button. A patient will have pain in between these two points. With appendicitis A patient will have rebound pain, when a patient have appendicitis there is an inflammation in the appendix which means the appendix is protruding when you place pressure in the location there is a relief of pain in the site since the appendix is actually been placed back in place, however when one removes the had the patient may feel the pain again, which is called a rebound pain. The health care provider would also observe if abdomen is distended which could be if patient had not had a bowel movement in a few days. The health care provider would order CBC as well as a Ct of the abdomen to diagnose appendicitis. The CBC would demonstrate an elevated WBC and the CT would show……. In case the the appendix has raptured the WBC would be …….. Pathological changes…..

Treatment Implications: Discuss the treatment (pharmacological and/or non-pharmacological) implications and how it will affect the overall disease process (pathogenesis and/or clinical manifestations). Do not discuss specific drug names, but rather drug classes, and how drugs are used to manage the particular disease process. What cellular or tissue changes occur as a result of the treatments that help manage or treat the disease?

During the treatment of the appendicitis there are things that must be done and there others must be avoided. When a health care provider begging to take care of the patient. Some basic care is necessary such as keeping the patient withi nothing to eat or drink in case the patient may need to have a surgery, so consequentlythe patient shoud have Intravenous fluids infusing to prevent dehydration. Patient should also avoid all laxatives, since laxative increase peristalsis movement of the smooth muscles and in case of appendicitis we need to decrease pressure in the area of inflammation and possible rapture, which makes the pat at risk or peritonitis. Patient should definetly avoid enemas, bc the fluid up into the large intestine inflaming the appendix even more, also should avoid heat packs. Heat draw circulation to the area, because it adds pressure to the site itself. Patient may have an appendectomy, most commonly laparascopic minimaly invasive. After surgery it is important to educate patient on avoiding weight bearig activity. Appendicitis after an appendectomy

A risk factor of a rapture appendicitis is peritonitis, the peritoneal cavity becomes inflamed.