Mandana Behbahani, Clayton L Rosinski, Nauman S Chaudhry, Anisse N Chaker, Ryan G Chiu, Xinjian Du, Ankit I Mehta, Gregory D Arnone, Sepideh Amin-Hanjani
Background: The optimal timing of ventriculoperitoneal shunt (VPS) and gastrostomy placement, relative to the safety of simultaneous versus staged surgery, has not been clearly delineated in the literature. Objective: To study the optimal inter-procedural timing relative to distal VPS infection and pertinent reoperation. Methods: A fifteen-year, retrospective, single-center study was conducted on adults undergoing VPS and gastrostomy within 30-days. Patients were grouped according to inter-procedural interval: 0-24 hr (immediate), 24 hr-7 days (early), and 7-30 days (delayed)...
May 4, 2021: Neurological Research
Khushboo Borah, Tom A Mendum, Nathaniel D Hawkins, Jane L Ward, Michael H Beale, Gerald Larrouy-Maumus, Apoorva Bhatt, Martine Moulin, Michael Haertlein, Gernot Strohmeier, Harald Pichler, V Trevor Forsyth, Stephan Noack, Celia W Goulding, Johnjoe McFadden, Dany J V Beste
The co-catabolism of multiple host-derived carbon substrates is required by Mycobacterium tuberculosis (Mtb) to successfully sustain a tuberculosis infection. However, the metabolic plasticity of this pathogen and the complexity of the metabolic networks present a major obstacle in identifying those nodes most amenable to therapeutic interventions. It is therefore critical that we define the metabolic phenotypes of Mtb in different conditions. We applied metabolic flux analysis using stable isotopes and lipid fingerprinting to investigate the metabolic network of Mtb growing slowly in our steady-state chemostat system...
May 2021: Molecular Systems Biology
Ersin Erek, Yusuf Kenan Yalçınbaş, Nejat Sarıosmanoğlu, Murat Özkan, Okan Yıldız, Işık Şenkaya, Fatih Özdemir, Mehmet Biçer, A Bülent Sarıtaş, Yüksel Atay, Serkan Seçici, Ali Kutsal, Sertac Haydin, Cagatay Bilen, Ismihan Selen Onan, Osman Nuri Tuncer, Gorkem Citoglu, Abdullah Doğan, Riza Turkoz, Bahar Temur, Murat Koc, C Tayyar Sarıoğlu
OBJECTIVES: A new congenital heart surgery database (CKCV) with real-time online reporting function was recently developed in Turkey. All standard international parameters were used, but Aristotle Comprehensive Complexity score was modified. In this study, the first analysis of the CKCV Database is reported. METHODS: The CKCV Database included 2307 procedures from 12 centers between January 2018 and March 2020. All parameters, including 10 real-time online reports, which represent the number of centers, number and mortality rates of all procedures, number of extracorporeal membrane oxygenation (ECMO) and results, details of postoperative complications, age-group statistics, analysis for priority status, mean intensive care and hospital stay durations of the procedures, results of Aristotle Basic, Modified Aristotle Comprehensive (MACC) and Society of Thoracic Surgeons-European Association (STAT) Score Categories, comparison of centers were analyzed...
May 2021: World Journal for Pediatric & Congenital Heart Surgery
Mithun G Sattur, Elizabeth A Genovese, Aimee Weber, Jaime Martinez Santos, Orgest M Lajthia, Joseph M Anderson, Mathew D Wooster, Ravikumar Veeraswamy, Alejandro M Spiotta
BACKGROUND: Acute occlusion of the posterior sagittal sinus may lead to dramatic increase in intracranial pressure (ICP), refractory to standard treatment. Hybrid vascular bypass of cranial venous outflow into the internal jugular vein (IJV) has seldom been described for this in recent neurosurgical literature. OBJECTIVE: To describe creation of a novel vascular bypass shunt from the superior sagittal sinus (SSS) to internal jugular vein (IJV) utilizing a covered stent-Dacron graft construct for control of refractory ICP...
May 4, 2021: Acta Neurochirurgica
Rui Dai, Alan A Sag, Jonathan G Martin, Nicholas T Befera, Waleska M Pabon-Ramos, Paul V Suhocki, Tony P Smith, Charles Y Kim, Andrew J Muir, James Ronald
PURPOSE: Proton pump inhibitor (PPI) use is a potential risk factor for hepatic encephalopathy (HE), but few studies have examined the effect on post-TIPS HE. The purpose of this study was to determine whether PPIs are associated with increased rates of post-TIPS HE in an independent patient cohort. MATERIALS AND METHODS: This single-institution retrospective study analyzed 86 patients (54 male, mean age 58.2) following TIPS from 1/1/2017 to 12/31/2019. Dates of PPI usage and episodes of new or worsening HE were recorded...
April 29, 2021: Clinical Imaging
Dárius David Andrade Lima, Rodrigo Becco de Souza, Paulo Ribeiro Nóbrega
Tension pneumocephalus is an uncommon complication of neurosurgical procedures. We report a patient who presented with headache, vomiting, left hemiparesis and rhinorrhea 30 days after correction of a recurrent nasal cerebrospinal fluid (CSF) fistula and shunt placement. A computed tomography (CT) scan revealed a massive collection of air with air-fluid level in the right sylvian fissure and midline shift. A right pterional craniotomy was performed and a small corticectomy resulted in evacuation of air from the sylvian fissure...
April 30, 2021: World Neurosurgery
Richard D White, Katherine S Moore, M Ghali Salahia, W Rhodri Thomas, Andrew C Gordon, Ian M Williams, Andrew M Wood, Ian A Zealley
The renal arteries (RAs) are important vessels that usually arise from the abdominal aorta and supply the kidneys; thus, these arteries play a vital role in physiologic functions such as hemofiltration and blood pressure regulation. An understanding of the basis for embryologic development and the frequently variable anatomy of the RAs is necessary to fully appreciate the range of diseases and the implications for procedural planning. Hemorrhage from an RA is relatively common and is typically traumatic or spontaneous, with the latter form often seen in association with underlying tumors or arteriopathy...
May 2021: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Stefanie Kaestner, Rebekka Sani, Katharina Graf, Eberhard Uhl, Jana Godau, Wolfgang Deinsberger
BACKGROUND: Shunt obstruction is a common cause of shunt failure in the treatment of hydrocephalus. Valve occlusion is traditionally believed to originate from elevated CSF protein or cellular components, although detailed evidence is scarce and contradictory. Therefore, this study aimed to examine CSF protein and cell count as risk factors for valve obstruction. METHODS: We retrospectively examined 274 patients who underwent shunt placement for hydrocephalus between 2009 and 2018 and had at least 1 year follow-up...
May 3, 2021: Acta Neurochirurgica
Muhammad Tariq, Ibrahim Zahid, Shiraz Hashmi, Muneer Amanullah, Syed Shahabuddin
Objectives: Congenital heart defects (CHDs) affect more than 40,000 children annually in Pakistan. Approximately 80' of patients require at least one surgical intervention to achieve a complete or palliative cardiac repair. The Glenn shunt, a palliative procedure is established between superior vena cava (SVC) and the right pulmonary artery to provide an anastomosis offering minimal risk to patients with univentricular heart disease. The aim of this study was to assess the clinical outcomes of the Glenn shunt procedure in patients with complex congenital heart diseases in a developing country like Pakistan...
January 2021: Annals of Cardiac Anaesthesia
Francesca Chemello, Anna Rodella, Guido Barosco, Piero Ceruti, Roberto Tosi, Giorgio Marchini
PURPOSE: To evaluate the safety and efficacy of double compared to single intraluminal suture stenting in reducing early postoperative hypertensive spikes (HS) and hypotony after Baerveldt glaucoma implant surgery. METHODS: For this retrospective study, we reviewed the medical charts of 60 patients (60 eyes) who underwent Baerveldt drainage device surgery between 2017 and 2019. Two groups were formed according to whether a single suture stent was placed within the tube (5-0 polypropylene, 30 eyes, group 1) or a double suture (5-0 and 6-0 polypropylene, 30 eyes, group 2)...
May 2, 2021: European Journal of Ophthalmology
Ming-Hui Zou, Li Ma, Yan-Qing Cui, Huai-Zhen Wang, Wen-Lei Li, Jia Li, Xin-Xin Chen
Objectives: Pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries (PA/VSD/MAPCAs) is complex and diverse that has led to a variety of treatment strategies. Experience has been largely obtained in the advanced countries. The clinical diversity is greater in China. We evaluated our surgical approaches and outcomes of these patients. Methods: We reviewed 127 patients undergoing varied surgeries in our center in 2010-2019. Results: Thirty patients underwent single-stage complete repair by unifocalizing MAPCAs and VSD closure (aged 3...
2021: Frontiers in Cardiovascular Medicine
Marietta Jank, Raimund Stein, Nina Younsi
Purpose: Congenital lower urinary tract obstruction (cLUTO) includes a heterogeneous group of conditions caused by a functional or mechanical outlet obstruction. Early vesicoamniotic shunting (VAS) possibly reduces the burden of renal impairment. Postpartum, pediatric urologists are confronted with neonates who have a shunt in place and a potentially impassable urethra with a narrow caliber. Early management of these patients can be challenging. Here, we would like to share the approach we have developed over time...
2021: Frontiers in Pediatrics
Nidal B Omar, Kristen O Riley
Rarer etiologies of shunt malfunction may be difficult to detect, can present insidiously, and often require a multidisciplinary approach to safely and effectively address.
April 2021: Clinical Case Reports
Yuka Yuhara, Takahiro Kido, Kazuo Imagawa, Yusuke Yano, Yoshihiro Nozaki, Takumi Ishiodori, Nobuyuki Ishikawa, Hideyuki Kato, Yoshiaki Kato, Miho Takahashi-Igari, Takashi Murakami, Hitoshi Horigome, Hidetoshi Takada
We note the risk of paradoxical embolism in patients with congenital heart defects with a right-to-left shunt. These patients should be managed to ensure that abdominal aortic thrombi are not overlooked when their clinical conditions change.
April 2021: Clinical Case Reports
Nadia Chaudhry-Waterman, Stephen Shapiro, James Thompson
The unique design of the NobleStitch™ EL allows it to be used to close residual defects following failed device PFO closure without impacting the integrity of previously placed double-disk Gore occluders.
April 2021: Clinical Case Reports
Binoy D Thavara, Bijukrishnan Rajagopalawarrier, Geo S Kidangan
Multiloculated hydrocephalus (MLH) is a disease in which no single treatment has shown to be superior to others. The authors report a pediatric case of postmeningitic MLH diagnosed at the age of 3 months. It was treated with antibiotics and right ventriculoperitoneal (VP) shunt. At 10 months of age, the patient again presented with gross MLH and non-functioning shunt tube. Patient underwent endoscopic fenestration of the multiple cysts along with endoscopic-guided left VP shunt. At 1 year of age, the patient again presented with MLH with large right-sided cyst...
October 2020: Journal of Pediatric Neurosciences
Mohammad Elbaroody, Hossam Eldin Mostafa, Mohamed F M Alsawy, Mohamed E Elhawary, Ahmed Atallah, Mohamed Gabr
Purpose: Chiari malformation type III (CM III) is the rarest type compared to other types of CMs. CM III usually reported as sporadic case reports which reflect the rarity of this anomaly. We report two cases of operated CM III at our institute with a reasonable outcome and reviewed the literature to illustrate the variability of prognosis and related hydrocephalus. Materials and Methods: We operated two cases of CM III in our hospital followed by ventriculoperitoneal shunt (VPS) placement with an accepted neurological outcome at 10 and 6 months follow-up...
October 2020: Journal of Pediatric Neurosciences
Andrea Malits, Julia A Boras, Vanessa Balagué, Eva Calvo, Josep M Gasol, Cèlia Marrasé, Carles Pelejero, Jarone Pinhassi, Maria Montserrat Sala, Dolors Vaqué
Anthropogenic carbon emissions are causing changes in seawater carbonate chemistry including a decline in the pH of the oceans. While its aftermath for calcifying microbes has been widely studied, the effect of ocean acidification (OA) on marine viruses and their microbial hosts is controversial, and even more in combination with another anthropogenic stressor, i.e., human-induced nutrient loads. In this study, two mesocosm acidification experiments with Mediterranean waters from different seasons revealed distinct effects of OA on viruses and viral-mediated prokaryotic mortality depending on the trophic state and the successional stage of the plankton community...
2021: Frontiers in Microbiology
Shoshana Steinhart, Emmanuel Kornitzer, Patrice L Weiss, Michal Katz-Leurer
PURPOSE: To assess hand dexterity in children with myelomeningocele (MMC) and to explore factors related to hand dexterity in these children. METHODS: Ninety-four children with myelomeningocele, aged 4 to 18 years, were assessed. Demographic characteristics, disease factors, visual perception (Beery test of Visual Motor Integration), cognition (WeeFunctional Independence Measure), and self-care (Pediatric Evaluation of Disability Inventory) were assessed in relation to the Nine-Hole Peg Test (9HPT) for hand dexterity using Spearmen correlations and linear regressions...
April 29, 2021: Journal of Pediatric Rehabilitation Medicine
Benjamin Gravesteijn, Eline Krijkamp, Jan Busschbach, Geert Geleijnse, Isabel Retel Helmrich, Sophie Bruinsma, Céline van Lint, Ernest van Veen, Ewout Steyerberg, Kees Verhoef, Jan van Saase, Hester Lingsma, Rob Baatenburg de Jong
OBJECTIVES: Coronavirus disease 2019 has put unprecedented pressure on healthcare systems worldwide, leading to a reduction of the available healthcare capacity. Our objective was to develop a decision model to estimate the impact of postponing semielective surgical procedures on health, to support prioritization of care from a utilitarian perspective. METHODS: A cohort state-transition model was developed and applied to 43 semielective nonpediatric surgical procedures commonly performed in academic hospitals...
May 2021: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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