Background: The management of post-infectious hydrocephalus (PIH) remains challenging for neurosurgeons. It requires a temporary diversion procedure till the normalization of CSF parameters prior to the permanent one. Ventriculosubgaleal shunt (VSGS) was widely used in pediatric cases with post-hemorrhagic hydrocephalus (PHH). However, its role in PIH is still lacking. This study was done to elucidate the safety and efficacy of VSGS as a temporary CSF diversion procedure before the permanent one in patients with PIH.
Patients And Methods: This retrospective investigation analyzed the data of 50 consecutive cases who underwent VSGS for PIH.
Results: The age of the included patients ranged between 1 and 10 months. Twenty-six cases had meningitis and or ventriculitis (52%), while the remaining had shunt infection. At follow-up, arresting of hydrocephalus was noted in ten patients (20%), while another 36 cases required the permanent diversion procedure within 35 days. Regarding the shunt complications, scalp infection, tissue breakdown, and shunt exposure were encountered in ten cases (20%), while CSF leakage was noted in 12 cases (24%). Shunt migration was noted in only two patients (4%). Shunt revision was needed in 16 cases (32%). Mortality was encountered in four cases (8%) because of sepsis. Risk factors for morbimortality included younger age, lower weight, male gender, and meningitis and or ventriculitis.
Conclusion: VSGS is a safe and effective procedure in infants awaiting definitive VPS for postinfectious hydrocephalus. It was proven that VSGS has shortened the hospital stay and the economic burden on the country.
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http://dx.doi.org/10.1007/s00381-022-05661-x | DOI Listing |
Cureus
December 2024
Bariatric Surgery, Phoenix Health, Chester, GBR.
Introduction Bariatric surgery is increasingly employed to address the global burden of morbid obesity, with Roux-en-Y gastric bypass (RYGB) representing the predominant procedure. However, some patients, particularly those with extreme obesity (BMI >50 kg/m²), may experience unsatisfactory weight-related outcomes following RYGB. While biliopancreatic diversion with duodenal switch (BPD-DS) offers superior weight reduction for this population, its complexity and associated risks limit its widespread use.
View Article and Find Full Text PDFOpen Forum Infect Dis
January 2025
Department of Medicine, UMass Chan Medical School, Worcester, Massachusetts, USA.
Background: Blood culture contaminants can lead to inappropriate antibiotic use, prolonged length of stay, and additional hospital costs. Several devices have been developed to reduce the risk of blood culture contamination by diverting a portion of the initial blood sample from the blood culture bottle. We assessed the effectiveness of 1 blood diversion device (BDD) in a prospective trial performed at the 2 separate emergency departments (EDs) of an academic medical center.
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Department of Center for Pulmonary Vascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Rationale: The transcatheter closure and atrioseptopexy are the main treatment methods for atrial septal defect (ASD). However, persistent hypoxemia due to iatrogenic diversion of inferior vena cava (IVC) to the left atrium (LA) is reported as a rare complication after ASD closure. Contrast echocardiology is a reliable and powerful tool to detect iatrogenic diversion and identify the etiology accurately.
View Article and Find Full Text PDFFront Pharmacol
January 2025
Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Background: Radical cystectomy constitutes the standard therapeutic approach for high-risk urothelial carcinomas of the bladder. Contemporary guidelines advise urologists to discontinue anticoagulation therapy during the perioperative period to mitigate the risk of significant intraoperative or postoperative hemorrhage. Nevertheless, in elderly patients with a history of coronary artery disease, the cessation of anticoagulant medication elevates the risk of acute myocardial infarction, thereby posing a substantial threat to their survival.
View Article and Find Full Text PDFDrug Alcohol Depend Rep
September 2024
Maryland Treatment Centers, 3800 Frederick Ave, Baltimore, MD 21229, United States.
Background: Buprenorphine maintenance treatment remains unavailable in most jails in the US. We provide data on a four-day rapid sublingual buprenorphine (SL-B) induction strategy followed by a weekly dose of extended-release injectable buprenorphine (XR-B) with incarcerated individuals with opioid use disorder (OUD) who were not opioid tolerant.
Methods: Between October 2020 to April 2024, = 65 individuals with an opioid use disorder in jails participating in a larger randomized, controlled trial received SL-B and XR-B prior to release.
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