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Shunt infection

Muhammad A Baig, Muhammad B Majeed, Bashar M Attar, Zubair Khan, Melchor Demetria, Seema R Gandhi
Hepatic hydrothorax (HH) is an infrequent but debilitating and therapeutically challenging complication of advanced liver cirrhosis. As evidence suggests against chest tube placement in HH, many clinicians are reluctant to place indwelling pleural catheters (IPCs) for non-malignant effusions like HH. We aim to study the efficacy and safety of IPCs as an alternative treatment option in our systematic review. A literature search was conducted using the electronic database engines MEDLINE, PubMed, EMBASE, Ovid, Scopus and Cochrane Library (Cochrane Central Register of Controlled trials and Cochrane Database of Systematic Reviews) from inception to April 2018 to identify published articles and reports addressing outcomes in patients treated for HH with IPCs...
August 6, 2018: Curēus
Lin Jiang, Guangzhong Gao, Yanfeng Zhou
BACKGROUND: The surgical methods of endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VS) for patients with noncommunicating hydrocephalus have rapidly increased in the past 2 decades. However, there is controversy regarding the efficacy and safety of these 2 surgical methods for noncommunicating hydrocephalus. The purpose of this study was to identify whether ETV is safer and more efficacious than VS for patients with noncommunicating hydrocephalus. METHODS: We performed electronic searches in PubMed, Embase, China National Knowledge Internet, and the Cochrane Library to identify studies published up to February 03, 2018...
October 2018: Medicine (Baltimore)
Farah Tanveer, Mariam Younas, Joel Fishbain
Solid organ transplant recipients (SOTR) are at increased risk for a wide variety of typical and atypical infections as a consequence of impaired cell mediated and humoral immunity. We report a case of meningoencephalitis in a renal transplant recipient caused by lymphocytic choriomeningitis virus (LCMV) acquired by exposure to mice excreta. The clinical course was complicated by the development of hydrocephalus, requiring a ventriculoperitoneal shunt. To our knowledge, this is the first reported case of LCMV infection in a SOTR that was not organ donor derived...
October 16, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Michael Kim, Ilya Rybkin, Harrison Smith, Jared Cooper, Michael Tobias
BACKGROUND: Hydrocephalus is an international disease process that is commonly treated surgically with a ventriculoperitoneal shunt. This device may be prone to malfunction, most commonly from obstruction, disconnection, or infection. CASE DESCRIPTION: A 35-year-old female with hydrocephalus and a ventriculoperitoneal shunt presented with altered mental status and imaging concerning for a shunt malfunction. Intraoperatively, she was found to have bone growing over and compressing the proximal occluder of the shunt valve, causing a mechanical obstruction...
October 12, 2018: World Neurosurgery
V V Shlomin, I G Drozhzhin, Iu P Didenko, N Iu Grebenkina, P D Puzdriak, P B Bondarenko, D G Pavlov, G A Vereshchako
Described herein is a clinical case report concerning treatment of a 32-year-old female patient with rupture of an aneurysm of the arch and descending portion of the thoracic aorta, with the bleeding having penetrated the upper lobe of the left lung. The woman was admitted to the Department of Vascular Surgery of Municipal Multimodality Hospital No 2 of Saint Petersburg, presenting with a clinical pattern of aneurysmal rupture previously diagnosed by computed tomography performed at one of the local hospitals...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Aodhnait S Fahy, Stephanie Tung, Maria Lamberti-Pasculli, James Drake, Abhaya Kulkarni, Justin T Gerstle
INTRODUCTION: Ventriculoperitoneal shunts (VPSs) are the mainstay of treatment of hydrocephalus but frequently need revision. We sought to directly compare the impact of laparoscopic versus open peritoneal shunt revision on the need for subsequent VPS revisions in pediatric patients. MATERIALS AND METHODS: A prospectively maintained, externally validated database of pediatric patients who underwent a first peritoneal VPS revision at a single center between 2008 and 2016 was reviewed...
October 12, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Xiaosong Hu, Bangtian Peng, Yanwei Zhang, Feng Ai, Jiayong Zheng
This retrospective, single-center study evaluated short-term and mid-term results of minimally invasive surgery to occlude ventricular septal defects (VSDs) using a subaxillary approach. The procedure was performed on 429 children (224 boys, 205 girls; age 2.4 ± 2.5 years; mean weight 12.7 ± 10.1 kg) between January 2014 and December 2016 at the Children's Heart Center of Henan Province People's Hospital. An approximately 2-cm subaxillary incision was made between the third and fifth ribs, and the appropriate right atrium or ventricle was punctured under the guidance of transencephalographic echocardiography (TEE)...
October 8, 2018: Pediatric Cardiology
X Wei, M Meng, G Zou, F H Zhou, Y J Yang, Y Zhang, M Z Yuan, F Y Wu, L M Sun
Objective: To evaluate the safety and perinatal outcomes of thoracoamniotic shunting in the treatment of fetuses with severe primary hydrothorax. Methods: 22 cases of suspected severe primary fetal hydrothorax which underwent thoraco-amniotic shunting in Shanghai First Maternity and Infant Hospital, Fetal Medicine Unit and Prenatal Diagnosis Center from January 2012 to December 2017 were analyzed retrospectively. Hydrothorax associated with structural or chromosomal abnormalities, infections and immune fetal hydrops were excluded...
September 25, 2018: Zhonghua Fu Chan Ke za Zhi
Suzaan Marais, Izanne Roos, Ayesha Mitha, Vinod Patel, Ahmed I Bhigjee
OBJECTIVES: To describe the clinical presentation, spinal magnetic resonance imaging (MRI) findings and outcome of HIV-infected patients with tuberculosis (TB)-associated syringomyelia and to compare these findings between all HIV-infected and -uninfected cases published in the literature. METHODS: A retrospective observational study conducted over a 12.5-year period at a public-sector referral hospital in South Africa. HIV-infected adults with neurological TB in whom MRI confirmed a syrinx were included...
September 28, 2018: Journal of the Neurological Sciences
Noritaka Wakui, Hidenari Nagai, Yu Ogino, Kojiro Kobayashi, Daigo Matsui, Takanori Mukozu, Yasushi Matsukiyo, Teppei Matsui, Yasuko Daido, Koichi Momiyama, Mie Shinohara, Takahide Kudo, Kenichi Maruyama, Yasukiyo Sumino, Yoshinori Igarashi
PURPOSE: Arrival time parametric imaging (At-PI) using contrast-enhanced ultrasonography (CEUS) is a procedure for evaluating liver disease progression in chronic hepatitis C infection (CHC). We investigated At-PI diagnostic efficacy in predicting development of collateral veins. METHODS: In total, 171 CHC patients underwent CEUS and upper gastrointestinal (UGI) endoscopy before liver biopsy. Conventional US was performed before CEUS to identify paraumbilical veins (PV) or splenorenal shunts (SRS)...
October 5, 2018: Journal of Ultrasound
Amir Erps, Jonathan Roth, Shlomi Constantini, Liat Lerner-Geva, Galia Grisaru-Soen
AIM: To identify independent risk factors for cerebrospinal fluid (CSF) shunt infection. METHODS: The medial records of all patients aged 0-18 years that underwent shunt-related surgeries for the treatment of hydrocephalus at our institution between January 1996 and December 2015 were reviewed. For each case, 2 randomly selected controls with no shunt infection were chosen. Demographic clinical and microbiological data were abstracted. RESULTS: A total of 1570 shunt-related procedures met the inclusion criteria, yielding 68 infections (in 63 patients)...
October 5, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
Mohannad Essam Elgamal, Essam A Elgamal, Anwar Ahmad, Adham Aly Elsayed, Basel Younes, Mohammad Khalid Aljaraki, Tamer Ibrahim Elholiby
Although ventriculoperitoneal shunt (VPS) is the most common procedure performed by pediatric neurosurgeons, it is still associated with frustrating complications, most common of which are obstruction and infection. Traumatic occipital artery pseudoaneurysm is a very rare complication of VPS procedure. To the best of our knowledge, there is no similar case reported in the English language literature. A 12-month-old patient suffered posthemorrhagic hydrocephalus of prematurity, and multiple other complications due to extreme prematurity, including immature lung disease, retinopathy of prematurity, necrotizing enterocolitis, bowel perforation, short bowel syndrome resulting in total parenteral nutrition-dependence, and hydrocephalus which was treated by insertion of VPS...
July 2018: Asian Journal of Neurosurgery
Barun Kumar, Anupam Singh, Mohamad Akram, Manish Singh
It is unusual for a moderate-size ventricular septal defect (VSD) to remain asymptomatic and complication-free until the age of 45 years. Similarly, infective endocarditis of anatomically normal pulmonary valve is also rare. Here we report a case in which nature created a protection for VSD, i.e. right ventricular outflow tract (RVOT) obstruction, which led to a complication, i.e. pulmonary valve endocarditis. A 45-year-old sick-looking man presented in medical emergency with fever and progressively increasing breathlessness for the previous 2 weeks...
March 2018: Journal of Cardiology Cases
Ashish Chugh, Sarang Gotecha, Gaurav Amle, Anil Patil, Prashant Punia, Megha Kotecha
Background: Ventriculoperitoneal (VP) shunt is commonly used in the treatment of hydrocephalus. Migration and extrusion of the distal end of the VP shunt are relatively rarely occurring complications. Aim: To retrospectively analyze patients with extrusion of the abdominal end of ventriculoperitoneal shunts and evaluate the possible etiology and outcome. Settings and Design: All patients presenting with extrusion of lower end of the shunt were included...
July 2018: Journal of Pediatric Neurosciences
Jessica Seidelman, Sarah S Lewis
In this review article, we discuss the epidemiology, microbiology, diagnosis, treatment and prevention of infections associated with cerebrospinal fluid shunts, cerebrospinal fluid drains, and deep brain stimulators. We also briefly discuss prevention strategies with appropriate antibiotics, devices, and operating room practices to decrease the risk of these infections.
September 18, 2018: Infectious Disease Clinics of North America
Anna E Sharrock, Kyle N Remick, Mark J Midwinter, Rory F Rickard
BACKGROUND: Haemorrhage is the leading cause of death on the battlefield. Seventy percent of injuries are due to explosive mechanisms. Anecdotally, these patients have had poorer outcomes when compared to those with penetrating mechanisms of injury (MOI). We wished to test the hypothesis that outcomes following vascular reconstruction were worse in blast-injured than non blast-injured patients. METHODS: Retrospective cohort study. British and American combat casualties with arterial injuries sustained in Iraq or Afghanistan (2003-2014) were identified from the UK Joint Theatre Trauma Registry (JTTR)...
September 1, 2018: Injury
Tae Seok Jeong, Gi Taek Yee
OBJECTIVE: This study aimed to investigate the rates, types, and risk factors of surgical site infection (SSI) following intracranial neurosurgical procedures evaluated by a Korean SSI surveillance system. METHODS: This was a prospective observational study of patients who underwent neurosurgical procedures at 29 hospitals in South Korea from January 2017 to June 2017. The procedures included craniectomy, craniotomy, cranioplasty, burr hole, and ventriculoperitoneal shunt...
September 2018: Journal of Korean Neurosurgical Society
Wen-Jian Zheng, Liang-Ming Li, Zi-Hui Hu, Wei Liao, Qi-Chang Lin, Yong-Hua Zhu, Shao-Hua Lin
BACKGROUND: Cranioplasty is a routine procedure, but it carries a significantly higher complication rate over standard clean cranial surgery. Surgical site infection is the most common but severe complication. Risk factors for surgical site infection are still debated. METHODS: A retrospective survey of 155 patients (≥16 years old) who exclusively underwent customized titanium cranioplasty from April 2014 to January 2017 was performed. Preoperative clinical parameters, surgeon's hemostasis technique, temporalis dissection, operative time, intraoperative blood loss, postoperative catheter duration and drainage, postoperative hemorrhage and extradural fluid collection (EDFC), and prophylactic antibiotics were recorded and compared between patients with superficial surgical site infection (sSSI) and patients with non-sSSI...
August 30, 2018: World Neurosurgery
Alberto Feletti, Domenico d'Avella, Carsten Wikkelsø, Petra Klinge, Per Hellström
BACKGROUND: Ventriculoperitoneal shunt (VP-shunt) is the standard of treatment for idiopathic normal pressure hydrocephalus (iNPH). However, a thorough investigation of VP-shunt complications in this population is lacking. OBJECTIVE: To present the analysis and the rates of complications progressively occurring during the first year after shunt surgery in the patients with iNPH included in the European multicenter (EU-iNPH) study. METHODS: Patients (n = 142) were prospectively included in the EU-iNPH study by 13 institutions...
August 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
Gregory Czajka, Halley Kreminski
Hydrocephalus can be the result of an infection, obstruction, impaired reabsorption of cerebrospinal fluid (CSF), or an abnormal increase in CSF. Ventriculoperitoneal (VP) shunting is the gold standard treatment for hydrocephalus despite its high rate of complications, including catheter obstruction and infection. Spontaneous cecal perforation by a VP shunt is extremely rare. Headache or subtle change in personality may indicate a VP shunt infection. Early recognition of the infection is critical for optimal patient outcomes...
September 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
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