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https://www.readbyqxmd.com/read/27826086/the-rate-of-complications-after-ventriculoperitoneal-shunt-surgery
#1
Alexander E Merkler, Judy Ch'ang, Whitney E Parker, Santosh B Murthy, Hooman Kamel
BACKGROUND: Although ventriculoperitoneal shunt (VPS) surgery is the most frequent surgical treatment for patients with hydrocephalus, modern rates of complications in adults are uncertain. METHODS: We performed a retrospective cohort study of adult patients hospitalized at the time of their first recorded procedure code for VPS surgery between 2005 and 2012 at nonfederal acute care hospitals in California, Florida, and New York. We excluded patients who during the index hospitalization for VPS surgery had concomitant codes for VPS revision, CNS infection, or died during the index hospitalization...
November 5, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27737696/il-10-plays-an-important-role-in-the-control-of-inflammation-but-not-in-the-bacterial-burden-in-s-epidermidis-cns-catheter-infection
#2
Yenis M Gutierrez-Murgas, Gwenn Skar, Danielle Ramirez, Matthew Beaver, Jessica N Snowden
BACKGROUND: Shunt infection is a frequent and serious complication in the surgical treatment in hydrocephalus. Previous studies have shown an attenuated immune response to these biofilm-mediated infections. We proposed that IL-10 reduces the inflammatory response to Staphylococcus epidermidis (S. epidermidis) CNS catheter infection. METHODS: In this study, a murine model of catheter-associated S. epidermidis biofilm infection in the CNS was generated based on a well-established similar model for S...
October 13, 2016: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/27686676/central-nervous-system-device-infections
#3
REVIEW
Rodrigo Hasbun
Nosocomial meningitis can occur in association with central nervous system (CNS) devices such as cerebrospinal shunts or drains, intrathecal pumps, and deep brain stimulators and carry substantial morbidity and mortality. Diagnosing and treating these infections may be challenging to physicians as cerebrospinal fluid cultures may be negative due to previous antibiotic therapy and cerebrospinal abnormalities may be secondary to the primary neurosurgical issue that prompted the placement of the CNS device (e...
November 2016: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/27043949/systematic-review-of-efficacy-pharmacokinetics-and-administration-of-intraventricular-aminoglycosides-in-adults
#4
Marlys LeBras, Ivy Chow, Vincent H Mabasa, Mary H H Ensom
Due to increasing prevalence of intracranial device use and multidrug-resistant and nosocomial organisms, central nervous system (CNS) infections requiring treatment with intraventricular (IVT) aminoglycosides are becoming increasingly common. This article systematically reviews IVT aminoglycoside literature in adults and integrates available evidence to serve as a practical reference for clinicians. Medline (1946 to December 2015), Embase (1974 to December 2015), PubMed (1966 to December 2015), Google, and Google Scholar were searched using the term aminoglycoside combined individually with the terms IVT, meningitis, shunt infection, ventriculitis, and cerebral spinal fluid...
April 4, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/26753898/short-term-prognostic-factors-in-myelomeningocele-patients
#5
Andre Broggin Dutra Rodrigues, Vera Lucia Jornada Krebs, Hamilton Matushita, Werther Brunow de Carvalho
PURPOSE: Patients with myelomeningocele have a high mortality and neurological disabilities that are correlated with the anatomical characteristics of the defect and with the development of acquired complications. The challenge in the postnatal management of myelomeningocele (MMC) is the early recognition of cases at risk for complications in order to establish individualized treatment strategies. This study aims to identify short-term prognostic markers for newborns with MMC. Anatomical characteristics of the spinal defect and technical aspects of the neurosurgical correction were analyzed for this purpose...
April 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/26618013/first-report-of-ventriculoperitoneal-shunt-infection-due-to-cyberlindnera-fabianii
#6
Jonathan Baghdadi, Peera Hemarajata, Romney Humphries, Theodoros Kelesidis
Fungal infections in the central nervous system (CNS) are associated with significant morbidity and death. Transient fungemia in immunocompetent patients without any other risk factors for fungemia has been suggested as a possible mechanism that may lead to serious fungal ventriculoperitoneal (VP) shunt infections, but evidence is lacking. The clinical spectrum, diagnosis, and optimal therapy of Cyberlindnera fabianii infections remain to be determined. We describe the first case of CNS infection due to C. fabianii that occurred in an immunocompetent adult with a VP shunt...
2015: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/26394787/vp-shunt-dysfunction-caused-by-malaria-cns-infection
#7
Michael Karl Fehrenbach, Matthias Bernhard, Manuela Siekmeyer, Norman Lippmann, Wieland Kiess, Ulf Nestler, Jürgen Meixensberger, Matthias Preuss
INTRODUCTION: Malaria is a widespread mosquito-borne infectious disease with over 300 million cases and roughly 900 thousand deaths in 2013. Cerebral involvement of malaria causes 50 % of all infection-associated deaths, especially in children below the age of 5 years. Hydrocephalus is a medical condition with abnormal accumulation of cerebrospinal fluid in physiological cavities and ventricles. Standard treatment is the implantation of a cerebrospinal fluid shunt device. A common problem associated with shunt treatment especially in pediatric patients is infection and consecutive shunt dysfunction caused by bacteriae or high protein levels clogging the valve...
April 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/26148928/mycobacterium-abscessus-ventriculoperitoneal-shunt-infection-and-review-of-the-literature
#8
Jose A Montero, Sally F Alrabaa, Todd S Wills
A 30-year-old man with history of neonatal hydrocephalus requiring ventriculoperitoneal shunt placement presented with Mycobacterium abscessus shunt infection despite no shunt manipulation over 10 years prior to presentation. Cure was not achieved until complete removal of all CNS shunt foreign body was performed despite initial adequate antimicrobial therapy.
April 2016: Infection
https://www.readbyqxmd.com/read/25276446/a-case-of-recurrent-cryptococcal-meningoencephalitis-in-an-immunocompetent-female
#9
Negin Niknam, Negar Niknam, Kola Dushaj, Erfidia Restrepo
Cryptococcus neoformans is commonly associated with meningoencephalitis in immunocompromised patients and occasionally in apparently healthy individuals. Duration and regimen of antifungal treatment vary depending on the nature of the host and extent of disease and CNS shunts are placed in persistently elevated intracranial pressures. Recurrence of infection after initial treatment is not uncommon in HIV positive patients, Kaya et al. (2012) and Illnait-zaragozí et al. (2010). We describe a 39-year-old immunocompetent female that presented with neurologic deficits and increased intracranial pressure (ICP) due to cryptococcal meningoencephalitis that had a complicated course with drug induced hepatitis and persistently increased ICP that ultimately required shunt placement and presented again with relapse of cryptococcal meningoencephalitis after completion of antifungal treatment...
2014: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/25225619/use-of-a-stop-flow-programmable-shunt-valve-to-maximize-cns-chemotherapy-delivery-in-a-pediatric-patient-with-acute-lymphoblastic-leukemia
#10
Sheri K Palejwala, David A Stidd, Jesse M Skoch, Puja Gupta, G Michael Lemole, Martin E Weinand
BACKGROUND: The requirement for frequent intraventricular drug delivery in the setting of shunt dependence is particularly challenging in the treatment of central nervous system infection, neoplastic disease, and hemorrhage. This is especially relevant in the pediatric population where both hematogenous malignancy requiring intrathecal drug delivery and shunt-dependent hydrocephalus are more prevalent. Intrathecal and intraventricular chemotherapy agents can be prematurely diverted in these shunt-dependent patients...
2014: Surgical Neurology International
https://www.readbyqxmd.com/read/25217065/central-nervous-system-involvement-in-adult-patients-with-invasive-infection-caused-by-streptococcus-agalactiae
#11
B Oyanguren, L Esteban, M Guillán, A de Felipe, A Alonso Cánovas, E Navas, C Quereda, I Corral
INTRODUCTION: Streptococcus agalactiae is frequently an asymptomatic coloniser and a cause of neonatal and puerperal sepsis. Infections in nonpregnant adults are uncommon. The frequency of neurological complications caused by invasive infection with this microorganism in adults remains unknown. Here, we study the frequency and characteristics of central nervous system (CNS) involvement in adults with invasive S. agalactiae infection. PATIENTS AND METHODS: Review of all adults with invasive S...
April 2015: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/25156073/ventricular-shunt-infections-immunopathogenesis-and-clinical-management
#12
REVIEW
Yenis Gutierrez-Murgas, Jessica N Snowden
Ventricular shunts are the most common neurosurgical procedure performed in the United States. This hydrocephalus treatment is often complicated by infection of the device with biofilm-forming bacteria. In this review, we discuss the pathogenesis of shunt infection, as well as the implications of the biofilm formation on treatment and prevention of these infections. Many questions remain, including the contribution of glia and the impact of inflammation on developmental outcomes following infection. Immune responses within the CNS must be carefully regulated to contain infection while minimizing bystander damage; further study is needed to design optimal treatment strategies for these patients...
November 15, 2014: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/24876738/donor-transmitted-and-de-novo-cancer-after-liver-transplantation
#13
REVIEW
Rajeev Desai, James Neuberger
Cancers in solid organ recipients may be classified as donor transmitted, donor derived, de novo or recurrent. The risk of donor-transmitted cancer is very low and can be reduced by careful screening of the donor but cannot be abolished and, in the United Kingdom series is less than 0.03%. For donors with a known history of cancer, the risks will depend on the nature of the cancer, the interventions given and the interval between diagnosis and organ donation. The risks of cancer transmission must be balanced against the risks of death awaiting a new graft and strict adherence to current guidelines may result increased patient death...
May 28, 2014: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/24777835/safety-profile-of-long-term-intraventricular-access-devices-in-pediatric-patients-receiving-radioimmunotherapy-for-central-nervous-system-malignancies
#14
Kim Kramer, Mariel Smith, Mark M Souweidane
BACKGROUND: The use of Ommaya catheters or ventriculoperitoneal shunts with programmable valves (pVP-shunts) for intraventricular drug administration is increasingly more common. PROCEDURE: We reviewed the safety and complication rate associated with ventricular access devices in patients receiving compartmental intraventricular radioimmunotherapy (cRIT). RESULTS: One hundred fifty one patients with recurrent primary or metastatic central nervous system (CNS) tumors (1-34 years) had a ventricular access device (143 Ommaya reservoirs, 8 VP shunts with programmable valves) placed for drug administration and cerebrospinal fluid acquisition...
September 2014: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/24457777/central-nervous-system-infections-due-to-cryptococcus-gattii-epidemiology-and-implications-for-management
#15
Sharon Chen
The emergence of Cryptococcus gattii in temperate climates has challenged the assumption that this fungus is 'tropical'. In Australia, C. gattii still largely causes infection in healthy hosts although a recent study identified 28% of patients with immunocompromised/co-morbid conditions. In contrast, 40-76% of cases in the outbreaks in North America had predisposing conditions/were immunosuppressed. Meningitis ± cerebral infection (≈85% cases) is common in Australia, whilst in the outbreaks lung infection predominated...
February 2014: Pathology
https://www.readbyqxmd.com/read/24386336/staphylococcus-aureus-sara-regulates-inflammation-and-colonization-during-central-nervous-system-biofilm-formation
#16
Jessica N Snowden, Matt Beaver, Karen Beenken, Mark Smeltzer, Alexander R Horswill, Tammy Kielian
Infection is a frequent and serious complication following the treatment of hydrocephalus with CSF shunts, with limited therapeutic options because of biofilm formation along the catheter surface. Here we evaluated the possibility that the sarA regulatory locus engenders S. aureus more resistant to immune recognition in the central nervous system (CNS) based on its reported ability to regulate biofilm formation. We utilized our established model of CNS catheter-associated infection, similar to CSF shunt infections seen in humans, to compare the kinetics of bacterial titers, cytokine production and inflammatory cell influx elicited by wild type S...
2013: PloS One
https://www.readbyqxmd.com/read/24259634/dual-intraventricular-plus-systemic-antibiotic-therapy-for-the-treatment-of-klebsiella-pneumoniae-carbapenemase-producing-klebsiella-pneumoniae-ventriculitis
#17
Sonia Nevrekar, Kathleen C Cunningham, Kasey M Greathouse, Nicholas G Panos
OBJECTIVE: To report a case of Klebsiella pneumoniae carbapenemase (KPC)-producing K pneumoniae ventriculitis successfully treated with dual intraventricular plus systemic antibiotic therapy. CASE SUMMARY: A 43-year-old woman with a ventriculoperitoneal shunt was transferred from a nursing home with fever, altered mental status, and leukocytosis. She was found to have KPC-producing K pneumoniae ventriculitis. Combination intraventricular antibiotic therapy with colistin and gentamicin plus systemic colistin and amikacin led to the resolution of infection...
February 2014: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/24066685/foramen-magnum-decompression-for-chiari-i-malformation-a-procedure-not-to-be-underestimated
#18
John Charles Duddy, David Allcutt, Darach Crimmins, David O'Brien, Donncha Finbarr O'Brien, Daniel Rawluk, Mohammed Taufiq Sattar, Steven Young, John Caird
OBJECTIVE: Chiari I malformation may be treated with foramen magnum decompression (FMD). We aim to describe the symptoms with which patients initially present, and to determine the number and type of complications occurring after FMD for Chiari I malformation. METHODS: Retrospective review of medical records for patients who had FMD performed for Chiari I malformation between January 2009 and December 2011. Post-operative outcomes were recorded and analysed. Patient demographic details and other relevant medical conditions were also noted...
June 2014: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/24011367/etiology-associated-with-developing-posthemispherectomy-hydrocephalus-after-resection-disconnection-procedures
#19
Jennifer Phung, Paul Krogstad, Gary W Mathern
OBJECT: The authors sought to determine if clinical epilepsy variables, maximum daily temperature (Tmax), and blood and CSF findings were associated with the risk of developing hydrocephalus after first-time resection-disconnection hemispherectomy. METHODS: Patients who underwent cerebral hemispherectomy in whom a standardized perioperative protocol was used, including the use of ventriculostomies (n = 79), were classified into those who developed and those who did not develop hydrocephalus requiring CSF shunts...
November 2013: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/23999355/brucella-melitensis-infection-of-ventriculo-peritoneal-shunt-a-form-of-neurobrucellosis-manifested-as-gastrointestinal-symptoms
#20
Abdulnasir Al-Otaibi, Maha Almuneef, Mohammad Al Shaalan
A report of a 9 year-old child with Myelomeningocele who has a ventriculo-peritoneal (VP) shunt presented with gastrointestinal symptoms and peritonitis. The patient had no CNS symptoms but the cerebrospinal fluid was positive for Brucella melitensis. We discuss neurobrucellosis in children, its various presentations, complications and challenges in treatment, choice of antibiotics and duration.
February 2014: Journal of Infection and Public Health
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