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Shunt infection

Chandrashekhar E Deopujari, Llewelyn Padayachy, Alias Azmi, Anthony Figaji, Saurav K Samantray
The treatment of hydrocephalus has changed in recent years with better imaging and introduction of endoscopic procedures as well as enhanced shunts. Indications of endoscopic third ventriculostomy (ETV) are now more refined with better quantification of outcome. This article reviews the current state of neuroendoscopy for infective hydrocephalus in children. The roles of third ventriculostomy as a primary procedure or after shunt malfunction, endoscopic interventions in multiloculated hydrocephalus and introduction of intraventricular lavage to salvage severely infected children are evaluated...
August 11, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Pradyumna Pan
Aim: To study the clinical outcome of shunt surgeries in children with hydrocephalus and evaluate the risk factors for ventriculoperitoneal (VP) shunt failure. Materials and Methods: Patients who underwent VP shunt surgery for hydrocephalus were included. Medical charts, operative reports, imaging studies, and clinical follow-up evaluations were reviewed and analyzed retrospectively. Results: A total of 137 patients with the average age of 20...
April 2018: Journal of Pediatric Neurosciences
Jakob Bönnighausen, Nicolas Schauer, Wilhelm Schäfer, Jörg Bormann
Fusarium graminearum is a filamentous ascomycete and the causal agent of Fusarium head blight on wheat that threatens food and feed production worldwide as infection reduces crop yield both quantitatively by interfering with kernel development and qualitatively by poisoning any remaining kernels with mycotoxins. In wheat, F. graminearum infects spikelets and colonizes the entire head by growing through the rachis node at the bottom of each spikelet. Without the mycotoxin deoxynivalenol (DON), the pathogen cannot penetrate the rachis node and wheat is able to resist colonization...
August 7, 2018: New Phytologist
Wang Man, Ma Xinxin, Zhang Yueli, Li Feng
RATIONALE: Fenestrated atrial septal defect (ASD) occlusion has been performed in patients complicated with severe pulmonary hypertension (PH). Nevertheless, the persistent interatrial residual shunting in the fenestration might increase the risk of paradoxical embolism. Percutaneous closure of fenestrated ASD occluder (ASO) has not yet been reported. PATIENT CONCERNS: A 26-year-old patient with a 25-mm ASD and severe PH underwent ASD closure using a Memory ASO with a waist of 32 and 6-mm custom-made fenestration...
August 2018: Medicine (Baltimore)
Simone Peraio, Mohamed Mohsen Amen, Nabil Mansour Ali, Ahmed Zaher, Ahmed Nageeb Mohamed Taha, Gianpiero Tamburrini
OBJECTIVE: To define the role of neuroendoscopy as an adjuvant technique for the management of pediatric complex hydrocephalus METHODS: The authors performed a retrospective analysis of a series of pediatric patients operated on for complex hydrocephalus between January 2002 and March 2017 in two pediatric neurosurgery units, Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy, and Mansoura University Hospitals, Mansoura, Egypt. The endoscopic procedures performed included cyst or membrane fenestration, septum pellucidotomy, foraminoplasty, aqueductoplasty with or without stent; in selected cases, an ETV was performed as a combined procedure...
July 31, 2018: World Neurosurgery
Rajiv R Iyer, Noah Gorelick, Karen Carroll, Ari M Blitz, Sarah Beck, Caroline M Garrett, Audrey Monroe, Betty Tyler, Sean T Zuckerman, Jeffrey R Capadona, Horst A von Recum, Mark G Luciano
OBJECTIVE Ventricular shunt infection remains an issue leading to high patient morbidity and cost, warranting further investigation. The authors sought to create an animal model of shunt infection that could be used to evaluate possible catheter modifications and innovations. METHODS Three dogs underwent bilateral ventricular catheter implantation and inoculation with methicillin-sensitive Staphylococcus aureus ( S. aureus). In 2 experimental animals, the catheters were modified with a polymer containing chemical "pockets" loaded with vancomycin...
August 3, 2018: Journal of Neurosurgery
Claudia L Craven, Simon D Thompson, Ahmed K Toma, Laurence D Watkins
Objective: Ventriculoperitoneal (VP) shunt surgery is a common and effective treatment for hydrocephalus and cerebrospinal fluid disorders. Infection remains a major cause of morbidity and mortality after a VP shunt. There is evidence that a deep skin flora microbiome may have a role to play in post-operative infections. In this technical note, we present a skin preparation technique that addresses the issue of the skin flora beyond the initial incision. Methods: The patient is initially prepped, as standard, with...
August 1, 2018: Journal of Korean Neurosurgical Society
Khadija Khan, Wajihullah Khan
Toxoplasma gondii is an obligate intracellular parasite which is known to infect one-third of the total world population chronically though it is asymptomatic in immunocompetent patients. However, in an immunocompromised patient or an infected fetus, it may cause devastating effects. The parasite may cross the placenta of an infected pregnant woman and probably infect the fetus congenitally. The severity of the infection depends on the gestational age at which the infection has occurred i.e., if it has occurred in the early phase, the rate of transmission is low but the severity is high if the fetus is infected and if it has occurred in the later phase then transmission rate is higher while the severity would be low...
July 21, 2018: Parasitology International
Tae Kyoung Jo, Hyo Rim Suh, Bo Geum Choi, Jung Eun Kwon, Hanna Jung, Young Ok Lee, Joon Yong Cho, Yeo Hyang Kim
PURPOSE: The present study aimed to evaluate progression and prognosis according to the palliation method used in neonates and early infants aged 3 months or younger who were diagnosed with pulmonary atresia with ventricular septal defect (PA VSD) or tetralogy of Fallot (TOF) with severe pulmonary stenosis (PS) in a single tertiary hospital over a period of 12 years. METHODS: Twenty with PA VSD and 9 with TOF and severe PS needed initial palliation. Reintervention after initial palliation, complete repair, and progress were reviewed retrospectively...
July 2018: Korean Journal of Pediatrics
Bartosz Polis, Lech Polis, Krzysztof Zeman, Jarosław Paśnik, Emilia Nowosławska
PURPOSE: The aim of the article is to describe an immunological reaction to shunt infection in children with hydrocephalus. The main cause of shunt infection involves methicillin resistant Staphylococcus epidermidis (Bhatia et al. Indian J Med Microbiol 35:120-123, 2017; Hayhurst et al. Childs Nerv Syst 24:557-562, 2008; Martínez-Lage et al. Childs Nerv Syst 26: 1795-1798, 2010; Simon et al. PLoS One, 2014; Snowden et al. PLoS One 8:e84089, 2013; Turgut et al. Pediatr Neurosurg 41:131-136, 2005), a bacterial strain which is responsible for the formation of biofilm on contaminated catheters (Snowden et al...
July 21, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Aodhnait S Fahy, Stephanie Tung, Maria Lamberti-Pasculli, James Drake, Abhaya V Kulkarni, Justin T Gerstle
INTRODUCTION: Ventriculoperitoneal shunts (VPSs) are the mainstay of treatment of hydrocephalus but have frequent complications including shunt failure and infection. There has been no comparison of laparoscopic versus open primary VPS insertion in children. We hypothesized that laparoscopic VP shunt insertion may improve patient outcomes. METHODS: A prospectively-maintained, externally-validated database of pediatric patients who underwent VPS insertion at a single center between 2012 and 2016 was reviewed...
July 6, 2018: Journal of Pediatric Surgery
Audrey Crousilles, Stephen K Dolan, Paul Brear, Dimitri Y Chirgadze, Martin Welch
The glyoxylate shunt bypasses the oxidative decarboxylation steps of the tricarboxylic acid (TCA) cycle, thereby conserving carbon skeletons for gluconeogenesis and biomass production. In Escherichia coli , carbon flux is redirected through the first enzyme of the glyoxylate shunt, iso citrate lyase (ICL), following phosphorylation and inactivation of the TCA cycle enzyme, iso citrate dehydrogenase (ICD), by the kinase/phosphatase, AceK. In contrast, mycobacterial species lack AceK and employ a phosphorylation-insensitive iso citrate dehydrogenase (IDH), which is allosterically activated by the product of ICL activity, glyoxylate...
July 20, 2018: Journal of Biological Chemistry
Bandar Al-Ghamdi
Sudden cardiac death (SCD) is a significant health problem worldwide. Multiple randomized controlled trials have shown that implantable cardioverter defibrillators (ICDs) are effective life-saving management option for individuals at risk of SCD in both primary and secondary prevention. Although the conventional transvenous ICDs (TV-ICDs) are safe and effective, there are potential complications associated with its use, including localized pocket or wound infection or systematic infection, a vascular access related complication such as pneumothorax, and venous thrombosis, and lead related complications such as dislodgement, malfunction, and perforation...
July 16, 2018: Current Cardiology Reviews
Hiroshi Fukui, Hideto Kawaratani, Kosuke Kaji, Hiroaki Takaya, Hitoshi Yoshiji
Among the various risky complications of liver cirrhosis, refractory ascites is associated with poor survival of cirrhotics and persistently worsens their quality of life (QOL). Major clinical guidelines worldwide define refractory ascites as ascites that cannot be managed by medical therapy either because of a lack of response to maximum doses of diuretics or because patients develop complications related to diuretic therapy that preclude the use of an effective dose of diuretics. Due to the difficulty in receiving a liver transplantation (LT), the ultimate solution for refractory ascites, most cirrhotic patients have selected the palliative therapy such as repeated serial paracentesis, transjugular intrahepatic portosystemic shunt, or peritoneovenous shunt to improve their QOL...
2018: Hepatic Medicine: Evidence and Research
Adam Tucker, Yoshinaga Kajimoto, Tomohisa Ohmura, Naokado Ikeda, Motomasa Furuse, Naosuke Nonoguchi, Shinji Kawabata, Toshihiko Kuroiwa
BACKGROUND: Spinal catheter insertion in lumboperitoneal (LP) shunt surgery for idiopathic normal pressure hydrocephalus (iNPH) is frequently associated with technical difficulties especially in patients with obesity and elderly patients with vertebral deformities. OBJECTIVE: To elucidate the accuracy and safety of image-guided spinal catheter placement using a paramedian approach (PMA). METHODS: We retrospectively analyzed 39 consecutive iNPH patients treated by LP shunting with spinal catheter insertion via the PMA...
July 13, 2018: Operative Neurosurgery (Hagerstown, Md.)
Robert Kellogg, Philip Lee, Christopher P Deibert, Zachary Tempel, Nathan T Zwagerman, Christopher M Bonfield, Stephen Johnson, Stephanie Greene
OBJECTIVE The authors reviewed 20 years' experience with the surgical management of open myelomeningocele in a well-defined retrospective cohort from a single large academic medical center. Their goal was to define the characteristics of a modern cohort of children with myelomeningocele to allow for evidence-based decision-making for the treatment of these patients. METHODS After IRB approval was obtained, the authors queried an operative database maintained by the Department of Neurological Surgery at Children's Hospital of Pittsburgh for patients who underwent closure of a myelomeningocele between 1995 and 2015...
July 13, 2018: Journal of Neurosurgery. Pediatrics
Seif Eid, Joe Iwanaga, Rod J Oskouian, Marios Loukas, W Jerry Oakes, R Shane Tubbs
INTRODUCTION: The subgaleal space is the fibroareolar layer found between the galea aponeurotica and the periosteum of the scalp. Due to its elastic and absorptive capabilities, the subgaleal space can be used as a shunt to drain excess cerebrospinal fluid from the ventricles. A subgaleal shunt consists of a shunt tube with one end in the lateral ventricles while the other end is inserted into the subgaleal space of the scalp. This will allow for the collection and absorption of excess cerebrospinal fluid...
July 12, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Gabriella S Lamb, Coralee Del Valle Mojica, Nivedita Srinivas, Jeffrey Starke
A 4-year-old former 24-week gestation male and an 18-month-old former 26-week gestation female, both with history of intraventricular hemorrhage resulting in hydrocephalus, presented with Mycobacterium abscessus ventricular shunt infections affecting both the shunt track and the ventricular fluid. Both children required prolonged combination antimycobacterial therapy; the 4 year old required more than two months of triple intravenous antibiotics and intraventricular amikacin to sterilize the cerebrospinal fluid...
July 11, 2018: Pediatric Infectious Disease Journal
C Gaderer, A Schaumann, M Schulz, U W Thomale
OBJECTIVE: The treatment of infectious CSF condition with ventriculitis and hydrocephalus in children is an interdisciplinary challenge. Conventional surgical treatment includes external ventricular drain (EVD) and systemic antibiotic therapy. However, infectious contamination of large ventricles combined with CSF protein overload often requires long treatment regimens. We retrospectively investigated neuroendoscopic lavage as a new option for clearance of CSF in children with hydrocephalus and active CSF infection...
July 11, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Rowland H Han, Andrew McKinnon, Travis S CreveCoeur, Brandon S Baksh, Amit M Mathur, Christopher D Smyser, Jennifer M Strahle, Margaret A Olsen, David D Limbrick
PURPOSE: The goal of this longitudinal, population-level study was to examine factors affecting mortality in preterm infants with intraventricular hemorrhage (IVH). METHODS: The study examined patients who were born at 36 weeks estimated gestational age (EGA) or less with a diagnosis of IVH between the years 2005 and 2014 using data from the New York and Nebraska State Inpatient Databases. Potential predictors for mortality were investigated with multivariable survival analysis...
July 9, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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