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Single ventricule

Nicholas B Figura, Wendy Long, Michael Yu, Timothy J Robinson, Sepideh Mokhtari, Arnold B Etame, Nam D Tran, Roberto Diaz, Hatem Soliman, Heather S Han, Solmaz Sahebjam, Peter A Forsyth, Kamran A Ahmed
PURPOSE: Leptomeningeal disease is a rare and devastating presentation of advanced stage metastatic breast cancer with historically poor overall survival. We assessed the safety and feasibility of intrathecal (IT) trastuzumab in HER2+ leptomeningeal disease. METHODS: A total of 13 patients were treated at our institution with IT trastuzumab beginning November 2012 and followed until November 2017. Outcomes including craniospinal progression as well as overall survival (OS) following initiation of IT trastuzumab were assessed from review of the clinical chart and radiologic examinations...
February 1, 2018: Breast Cancer Research and Treatment
Jaya Madhura Parasuraman, Mahableshwar Albur, Greg Fellows, Axel Heep
PURPOSE: Ventriculitis is a known complication during external CSF drainage in preterm infants with posthaemorrhagic ventricular dilatation. Staphylococci are most frequently isolated in device-associated ventriculitis, and hence, intraventricular vancomycin is a commonly used therapy. Our aim was to study the CSF vancomycin level pattern and drug safety in ventriculostomy access device infection in preterm infants less than 28 weeks gestation. METHODS: This single-centre, retrospective case series included seven infants with a median gestational age of 25 + 4 weeks (range 23 + 6 to 27 + 5 weeks)...
October 24, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Saad Akhtar Khan, Muhammad Waqas, Usman T Siddiqui, Muhammad Shahzad Shamim, Karim Rizwan Nathani, Rashid Jooma, Faisal Mehmood
BACKGROUND: Postoperative meningitis is a growing cause of concern, especially with the evolution of multidrug-resistant organism. The authors evaluate the use of intraventricular/intrathecal (IVT/IT) antibiotics for postoperative gram-negative meningitis in patients whom intravenous antibiotics were ineffective. METHODS: Medical records were retrospectively reviewed and neurosurgery patients with gram-negative postoperative infection meningitis/ventriculitis were enrolled in the study...
2017: Surgical Neurology International
Emily Hill, Thomas P Bleck, Kamaljit Singh, Bichun Ouyang, Katharina M Busl
INTRODUCTION: In a febrile patient with a ventriculostomy, diagnosing or excluding bacterial or microbial ventriculitis is difficult, as conventional markers in analysis of cerebrospinal fluid (CSF) are not applicable due to presence of blood and inflammation. CSF lactate has been shown to be a useful indicator of bacterial meningitis in CSF obtained via lumbar puncture, but little and heterogenous data exist on patients with ventriculostomies. METHODS: We reviewed all CSF analyses obtained via ventriculostomy in patients admitted to our tertiary medical center between 2008 and 2013, and constructed receiver operating characteristic (ROC) curves to evaluate the accuracy of CSF lactate concentration in discriminating a positive CSF culture from a negative one in setting of ventriculostomy and prophylactic antibiosis...
June 2017: Clinical Neurology and Neurosurgery
Nikolaj Dinevski, Johannes Sarnthein, Flavio Vasella, Jorn Fierstra, Athina Pangalu, David Holzmann, Luca Regli, Oliver Bozinov
OBJECTIVES: To determine the rate of surgical-site infections (SSI) in neurosurgical procedures involving a shared-resource intraoperative magnetic resonance imaging (ioMRI) scanner at a single institution derived from a prospective clinical quality management database. METHODS: All consecutive neurosurgical procedures that were performed with a high-field, 2-room ioMRI between April 2013 and June 2016 were included (N = 195; 109 craniotomies and 86 endoscopic transsphenoidal procedures)...
July 2017: World Neurosurgery
Brandon A Sherrod, Anastasia A Arynchyna, James M Johnston, Curtis J Rozzelle, Jeffrey P Blount, W Jerry Oakes, Brandon G Rocque
OBJECTIVE Surgical site infection (SSI) following CSF shunt operations has been well studied, yet risk factors for nonshunt pediatric neurosurgery are less well understood. The purpose of this study was to determine SSI rates and risk factors following nonshunt pediatric neurosurgery using a nationwide patient cohort and an institutional data set specifically for better understanding SSI. METHODS The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-P) database for the years 2012-2014, including all neurosurgical procedures performed on pediatric patients except CSF shunts and hematoma evacuations...
April 2017: Journal of Neurosurgery. Pediatrics
John Joseph Steele
BACKGROUND: The Afghanistan Surge saw NATO troops working with their Afghan partners to remove Taliban governance and replace it with a more democratic model. As part of this endeavor, medical support for both trauma and humanitarian cases was needed. OBJECTIVE: Identify and discuss disease trends to better prepare for future combat medical treatments. METHODS: Retrospective review of operative experience from a neurosurgeon from November 2010 to April 2011...
January 2017: Military Medicine
David O Udoh, Emmanuel Ibadin, Mojisola O Udoh
BACKGROUND: Intracranial abscess collections, though uncommon, are dreaded complications of head trauma, neurosurgical operations, meningitis, and otogenic, mastoid, and paranasal air sinus infections. Combining surgical evacuation with the appropriate antibiotic therapy is the effective treatment for intracranial abscesses. However, literature on surgical treatment is replete with several procedures which, on their own, may not. OBJECTIVES: To determine the epidemiology and outcomes (of various treatment modalities) of intracranial abscesses in our institution, a major referral center for neurosurgical conditions in the midwestern region of Nigeria...
October 2016: Asian Journal of Neurosurgery
Tulin Demir, Selcuk Kilic
Zika virus (ZIKV) is a single-stranded RNA virus in the Flaviviridae family and transmitted to human through infected mosquitos (Aedes aegypti and Aedes albopictus). Virus is closely related with other flaviviruses; dengue virus, yellow fever virus, West Nile virus, and Japanese encephalitis virus phylogenetically. Due to the possible relationship between virus and clinical features including microcephaly, ventricule, and eye deformities, Guillain-Barre syndrome increases the interest on this virus gradually...
November 2016: Folia Microbiologica
Thanh N Nguyen, Hesham Masoud, Nicholas Tarlov, James Holsapple, Lawrence S Chin, Alexander M Norbash
BACKGROUND: Very small ruptured aneurysms (≤3 mm) demonstrate a significant risk for procedural rupture with endovascular therapy. Since 2007, 1.5-mm-diameter coils have been available (Micrus, Microvention, and ev3), allowing neurointerventionalists the opportunity to offer patients with very small aneurysms endovascular treatment. In this study, we review the clinical and angiographic outcome of patients with very small ruptured aneurysms treated with the 1.5-mm coil. METHODS: This is a retrospective cohort study in which we examined consecutive ruptured very small aneurysms treated with coil embolization at a single institution...
October 2015: Interventional Neurology
Gillian C Braden, Rodolfo Ricart Arbona, Michelle Lepherd, Sébastien Monette, Aziz Toma, James G Fox, Floyd E Dewhirst, Neil S Lipman
During 1 year, experimentally naïve C57BL/6NCrl weanlings born to timed-pregnant dams from a single vendor demonstrated markedly increased mortality associated with runting, abnormal gait, and decreased activity. Gram-positive, aerobic, α-hemolytic, coccoid bacteria were isolated from the meninges (n = 16), blood (n = 1), and kidneys (n = 1) of clinically affected weanlings (n = 15); from the uterus (n = 1), meninges (n = 1), and oral cavity (n = 2) of 3 dams; and from the meninges and oral cavity of a clinically affected 86-d-old mouse in the same colony...
June 2015: Comparative Medicine
Sadaharu Tabuchi, Mitsutoshi Kadowaki
If not controlled in the early stage, ventriculitis is difficult to treat neurosurgically and can lead to serious sequelae, a long course of treatment, and hospitalization. We report two cases of ventriculitis and progressive hydrocephalus after shunt infection. Both were successfully treated by neuroendoscopic septostomy in combination with thorough intraventricular irrigation through a single burr hole followed by single shunt revision. Although surgical intervention has not been established as a first-choice treatment for ventriculitis, including early-stage ventriculitis, prompt neuroendoscopic surgery appears effective for the management of ventriculitis and hydrocephalus after shunt infection...
May 2015: Asian Journal of Endoscopic Surgery
Sunit Singhi, Ramesh Kumar, Pratibha Singhi, Muralidharan Jayashree, Arun Bansal
OBJECTIVE: Intracranial pressure monitoring can help in early identification of raised intracranial pressure and in setting more informed goals for treatment. We describe our 10-year experience of bedside burr holes performed by pediatric intensivists to establish intracranial pressure monitoring in children with CNS infections in a resource-limited setting and the technical difficulties and complications encountered. DESIGN: Descriptive study of prospectively recorded data...
June 2015: Pediatric Critical Care Medicine
Yasemin Benderli Cihan, Vedat Arsav
OBJECTIVE: This experimental study aims to investigate whether radiotherapy (RT) plus trastuzumab (T) followed by subsequent hormonotherapy increase the cumulative toxic effect on cardiac functions in rats. METHODS: A total of 70 Wistar-Albino female rats with a mean weight 213 ± 27 g were randomly divided into equal seven groups. The first group (C) underwent no procedure. The second group (RT) underwent the whole thoracic radiation including heart. The third group (T) was administered T through tail vein alone...
June 2014: Anadolu Kardiyoloji Dergisi: AKD, the Anatolian Journal of Cardiology
Arlete R Penitente, Rômulo D Novaes, Deoclécio A Chianca, Márcia F da Silva, Marcelo E Silva, Aline M A Souza, Silvia Guatimosim, Pedro W M Almeida, Márcia N M Alves, Leonardo B Felix, Clóvis A Neves, Antônio J Natali
Protein restriction (PR) is associated with cardiovascular diseases. The purpose of this study was to investigate the effects on single ventricular cardiomyocyte contractile function of a short-term PR after weaning. Male Fischer rats that were 28 days old were randomly divided into a control group (CG, n = 16) and a protein-restricted group (PRG, n = 16). After weaning, CG and PRG animals received isocaloric diets containing 15 and 6% protein, respectively, for 35 days. Biometric parameters were then measured, and the hearts were removed for the analysis of contractile function and calcium transient in isolated cardiomyocytes of the left ventricule (LV), and the quantification of calcium and collagen fibers in LV myocardium...
2013: Cells, Tissues, Organs
Cem Dinc, Ahmet Celal Iplikcioglu, Erdinc Ozek
AIM: The aim of this study was to retrospectively analyse the clinical, radiological features and surgical outcome of pineal epidermoid tumors treated at a single neurosurgical department. MATERIAL AND METHODS: We performed surgery on five patients with pineal region epidermoid tumors at a single neurosurgical department between the years 1998 and 2006. Headache, diplopia and ataxia were the most common presenting findings. Parinaud's syndrome was found in three patients...
2013: Turkish Neurosurgery
Andrew J Fabiano, Thomas J Gruber, Melissa S Baxter
OBJECTIVE: Intraventricular tissue plasminogen activator (alteplase) has been advocated for prevention of vasospasm in aneurysmal subarachnoid hemorrhage and treatment of traumatic or spontaneous intraventricular hemorrhage. External ventricular drain (EVD) insertion is often performed to manage increased intracranial pressure and hydrocephalus associated with these disease states. EVD-related ventriculitis is a serious infection with an up to 50% mortality rate. METHODS: We assessed the EVD infection rate in patients receiving intraventricular alteplase over a 12-month period...
November 2013: Clinical Neurology and Neurosurgery
M Ozbaran, T Yagdi, C Engin, S Erkul, O Balcioglu, B Baysal, S Nalbantgil, S Ertugay
BACKGROUND: The Berlin Heart EXCOR is a first-generation paracorporeal, pneumatic ventricular assist device that creates pulsatile flow. It can be used for long-term support of the left and/or right ventricule during end-stage heart failure. The aim of this study was to share our clinical experience in 54 patients. METHODS: Between April 2007 and August 2012, 54 patients with end-stage heart failure underwent Berlin Heart EXCOR ventricular assist device implantation, including 5 females and 9 children...
April 2013: Transplantation Proceedings
Rosemary J Rippon, Maurice R Alley, Isabel Castro
Nestling mortality in the endangered and endemic Hihi, also called Stitchbird (Notiomystis cincta), was studied over the 2008-09 breeding season at Zealandia-Karori Sanctuary, Wellington, New Zealand. Histopathology showed traumatic ventriculitis in seven of 25 (28%) dead nestlings. Single or multiple granulomas centered on chitinous insect remnants were found lodged within the gizzard mucosa, muscle layers, and ventricular or intestinal serosa. The insect remnants were confirmed as bee or wasp stings (Hymenoptera) using light and electron microscopy...
January 2013: Journal of Wildlife Diseases
Zeynep Kubilay, Shahram Amini, Loretta Litz Fauerbach, Lennox Archibald, William A Friedman, A Joseph Layon
OBJECT: Ventricular infection after ventriculostomy placement carries a high mortality rate. Responding to ventriculostomy infection rates, a multidisciplinary performance improvement team was formed, a comprehensive protocol for ventriculostomy placement was developed, and the efficacy was evaluated. METHODS: A best-practice protocol was developed, including hand hygiene before the procedure; prophylactic antibiotics; sterile gloves changed between preparation, draping, and procedure; hair removal by clipping for dressing adherence; skin preparation using iodine povacrylex (0...
March 2013: Journal of Neurosurgery
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