The Ventriculo-Gallbladder Shunt in the Treatment of Refractory Hydrocephalus: A Review of the Current Literature

2009 ◽  
Vol 75 (8) ◽  
pp. 734-737 ◽  
Author(s):  
Micah E. Girotti ◽  
R. Ramesh Singh ◽  
Bradley M. Rodgers

The ventriculo-gallbladder (VGB) shunt has been reported on several occasions for the alleviation of ventriculo-peritoneal (VP) –shunt-refractory hydrocephalus. There is little data regarding VGB shunts and a need for delineating appropriate surgical therapy when cerebrospinal fluid drainage to the peritoneum becomes infeasible. We report our experience with VGB shunt placement in three patients with chronic hydrocephalus. All three had a history of prior VP-shunt placements and revisions due to distal obstruction or infection, or contraindications to alternative forms of ventricular drainage. In one patient, the VGB shunt functioned well for 9 years but was revised due to contamination during an unrelated operation. Neither of the other two patients have experienced VGB shunt-related complications. VP shunts are presently regarded as the standard of care for uncomplicated hydrocephalus. When VP shunts fail, the most common alternatives have been ventriculo-atrial and ventriculo-pleural shunts. In five case series involving 59 patients with VGB shunts, the long-term success rate was 62.7 per cent. Infection (10.2%) and obstruction (10.2%) were the most common complications. Based on durability and a low incidence of complications, it is the current consensus that VGB shunts are a viable alternative with good outcomes in the case of failed VP shunts.

Author(s):  
Tetsuya Akaishi ◽  
Tomomi Suzuki ◽  
Harumi Nemoto ◽  
Yusuke Utsumi ◽  
Moe Seto ◽  
...  

Abstract Objective: This study aims to evaluate the long-term impact of living in post-disaster prefabricated temporary housing on social interaction activities and mental health status. Methods: A total of 917 adult residents in a coastal town, whose residences were destroyed by the tsunami caused by the Great East Japan Earthquake (GEJE), were enrolled for the assessment held five years after the disaster. They answered questions about their experience and consequence of living in prefabricated temporary housing after the disaster. Their present scores on five types of self-reported measures regarding the psychosocial or psychiatric status and their present and recalled social interaction activities were cross-sectionally collected. Results: A total of 587 (64.0%) participants had a history of living in prefabricated temporary housing, while the other 330 (36.0%) had not. The prevalence of social interaction activities significantly decreased after the GEJE. However, the experience of living in prefabricated temporary housing did not adversely affect the subsequent social interaction activities or mental conditions of the participants five years after the disaster. Conclusions: Living in post-disaster prefabricated temporary housing may not negatively impact subsequent psychosocial conditions or social interaction activities five years later.


2018 ◽  
Vol 40 (1) ◽  
pp. 98-104 ◽  
Author(s):  
Johanna Marie Richey ◽  
Miranda Lucia Ritterman Weintraub ◽  
John M. Schuberth

Background: The incidence rate of venous thrombotic events (VTEs) following foot and ankle surgery is low. Currently, there is no consensus regarding postoperative prophylaxis or evidence to support risk stratification. Methods: A 2-part study assessing the incidence and factors for the development of VTE was conducted: (1) a retrospective observational cohort study of 22 486 adults to calculate the overall incidence following foot and/or ankle surgery from January 2008 to May 2011 and (2) a retrospective matched case-control study to identify risk factors for development of VTE postsurgery. One control per VTE case matched on age and sex was randomly selected from the remaining patients. Results: The overall incidence of VTE was 0.9%. Predictive risk factors in bivariate analyses included obesity, history of VTE, history of trauma, use of hormonal replacement or oral contraception therapy, anatomic location of surgery, procedure duration 60 minutes or more, general anesthesia, postoperative nonweightbearing immobilization greater than 2 weeks, and use of anticoagulation. When significant variables from bivariate analyses were placed into the multivariable regression model, 4 remained statistically significant: adjusted odds ratio (aOR) for obesity, 6.1; history of VTE, 15.7; use of hormone replacement therapy, 8.9; and postoperative nonweightbearing immobilization greater than 2 weeks, 9.0. The risk of VTE increased significantly with 3 or more risk factors ( P = .001). Conclusion: The overall low incidence of VTE following foot and ankle surgery does not support routine prophylaxis for all patients. Among patients with 3 or more risk factors, the use of chemoprophylaxis may be warranted. Level of Evidence: Level III, retrospective case series.


Author(s):  
Zarema H. Ibragimova

On the history of the Memorial Book of the Chechen Republic as compared with preparation and publication of similar books in the other country’s regions. Working out of historical and documentary sources and present them a wide public in the long term reconstruction of historical events of the Great Patriotic War is actual.


2021 ◽  
pp. 1098612X2110548
Author(s):  
Catherine Tindale ◽  
Filippo Cinti ◽  
Matteo Cantatore ◽  
Alistair Freeman ◽  
Leonardo Cavaliere ◽  
...  

Case series summary Lung lobe torsion is rare in cats. The aim of this multi-institution retrospective study was to describe clinical and diagnostic findings, treatments and outcomes of lung lobe torsion (LLT) in 10 cats. Dyspnoea and tachypnoea were the most common clinical signs. Pleural effusion was present in nine cats at presentation. Fluid analysis confirmed chylothorax in three cats. Nine cats underwent CT and five cats had thoracic radiographs taken. A diagnosis was made preoperatively in six cats, while in the other four cats it was made at exploratory thoracotomy. Affected lung lobes were the right cranial (n = 4/11), left cranial (n = 4/11) and right middle (n = 3/11). One cat had a concurrent torsion of two lung lobes. Lung lobectomy was successfully performed in all cases. Based on clinical, diagnostic and lung histopathology findings, three cats had idiopathic and seven cats secondary LLT. Intraoperative complications included hypotension and hypothermia in four and five cats, respectively. Postoperative complications occurred in six cats and lead to euthanasia or death in four cats, whereas complications resolved in the other two cats. Three cats were euthanased within 5 weeks of discharge. For the three cats surviving long term, including one euthanased at 252 days postoperatively, owner-described outcomes and quality of life were considered good to excellent. Relevance and novel information Secondary LLT associated with underlying thoracic pathology was associated with high complication rates and poor outcomes. Long-term outcomes of cats undergoing surgery for LLT and surviving the perioperative period were deemed good to excellent.


2021 ◽  
pp. 1-21
Author(s):  
Anna von der Goltz

This chapter introduces the book’s protagonists and main subject: the other ‘68ers, a group of centre-right activists who had participated in the West German student movement of the late 1960s and 1970s and later commemorated their efforts as a form of democratic resistance against left-wing radicals. It argues that a close examination of the other ‘68ers’ ideas, experiences, repertoires, and remarkable career trajectories enables us to rethink the history of 1968 and its afterlives in important ways. Studying the hitherto neglected role these individuals played at the time, as well as their life paths and long-term impact on West German political culture, opens up new vistas for understanding the history of protest in 1968, the late Federal Republic, and the role that generation played in postwar Germany. The Introduction also discusses the different sources used for this study, including the oral history methodology on which parts of the book are based.


2017 ◽  
Vol 7 (4) ◽  
pp. 141-157 ◽  
Author(s):  
Rafael G. dos Santos ◽  
José Carlos Bouso ◽  
Jaime E. C. Hallak

Ayahuasca is a hallucinogen brew traditionally used for ritual and therapeutic purposes in Northwestern Amazon. It is rich in the tryptamine hallucinogens dimethyltryptamine (DMT), which acts as a serotonin 5-HT2A agonist. This mechanism of action is similar to other compounds such as lysergic acid diethylamide (LSD) and psilocybin. The controlled use of LSD and psilocybin in experimental settings is associated with a low incidence of psychotic episodes, and population studies corroborate these findings. Both the controlled use of DMT in experimental settings and the use of ayahuasca in experimental and ritual settings are not usually associated with psychotic episodes, but little is known regarding ayahuasca or DMT use outside these controlled contexts. Thus, we performed a systematic review of the published case reports describing psychotic episodes associated with ayahuasca and DMT intake. We found three case series and two case reports describing psychotic episodes associated with ayahuasca intake, and three case reports describing psychotic episodes associated with DMT. Several reports describe subjects with a personal and possibly a family history of psychosis (including schizophrenia, schizophreniform disorders, psychotic mania, psychotic depression), nonpsychotic mania, or concomitant use of other drugs. However, some cases also described psychotic episodes in subjects without these previous characteristics. Overall, the incidence of such episodes appears to be rare in both the ritual and the recreational/noncontrolled settings. Performance of a psychiatric screening before administration of these drugs, and other hallucinogens, in controlled settings seems to significantly reduce the possibility of adverse reactions with psychotic symptomatology. Individuals with a personal or family history of any psychotic illness or nonpsychotic mania should avoid hallucinogen intake.


2017 ◽  
Vol 4 (4) ◽  
pp. 255-262
Author(s):  
Ryan Rhome ◽  
Isabelle M Germano ◽  
Ren-Dih Sheu ◽  
Sheryl Green

Abstract Background Growth hormone (GH)-secreting pituitary adenomas represent an uncommon subset of pituitary neoplasms. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) have been used as primary or adjuvant treatment. The purpose of this study is to report the long-term tumor control and toxicity from our institution and to perform a systematic literature review of acromegaly patients treated with FSRT. Methods We retrospectively reviewed all patients treated with FSRT (median dose 50.4 Gray [Gy], range 50.4–54 Gy) between 2005 and 2012 who had: 1) GH-secreting adenoma with persistently elevated insulin growth factor-1 (IGF-1) despite medical therapy and 2) clinical follow up >3 years after FSRT. Patients were treated with modern FSRT planning techniques. Biochemical control was defined as IGF-1 normalization. Systematic review of the literature was performed for FSRT in acromegaly. Results With a median follow-up of 80 months, radiographic control was achieved in all 11 patients and overall survival was 100%. Long-term biochemical control was achieved in 10 patients (90.9%) with either FSRT alone (36.4%) or FSRT with continued medical management (45.5%). No patient experienced new hypopituitarism, cranial nerve dysfunctions, or visual deficits. Our systematic review found published rates of biochemical control and hypopituitarism vary, with uniformly good radiographic control and low incidence of visual changes. Conclusions Adjuvant FSRT offered effective long-term biochemical control and radiographic control, and there was a lower rate of complications in this current series. Review of the literature shows variations in published rates of biochemical control after FSRT for acromegaly, but low incidence of serious toxicities.


2019 ◽  
Vol 8 ◽  
Author(s):  
Susan M Kenyon

Drawing on long-term ethnographic research in the Blue Nile town of Sennar, supported by archival and historical documentation, this article explores the history of Zar spirit possession in Sudan, and the light this throws on the interplay of religions over the past 150 years. Life history data supports the argument that contemporary Zar is grounded in forms and rituals derived from the ranks of the ninteenth-century Ottoman army, and these remain the basis of ritual events, even as they accommodate ongoing changes in this part of Africa. Many of these changes are linked to the dynamic interplay of Zar with forms of Islam, on the one hand, and Christianity, on the other. In the former colonial periods, political power resided with the British, and Khawaja (European) Christian Zar spirits are remembered as far more important. Today that authority in Zar has shifted to spirits of foreign Muslims and local holy men, on the one hand, and to subaltern Blacks, on the other. These speak to concerns of new generations of adepts even as changes in the larger political and religious landscapes continue to transform the context of Zar.


2019 ◽  
Vol 2 (1) ◽  
pp. 6-29
Author(s):  
Andrew Stuart Turnbull

Computer software media has long had intrinsic similarities to books...so why may one be borrowed in a library and not the other? The answer lies in the context and history of how computer media came to be. In this essay I explore the early history of software distribution, where many different proposals fought to succeed. I provide an overview of the software industry’s early embrace of copy-protected floppy disks as a distribution medium, and how they harmed the notion of software as a borrowable medium. Lastly, I cover how CD-ROM materials were treated as books by publishers and libraries, yet failed to realize this premise with long-term success. I argue that a combination of industry actions and technological constraints over four decades caused computer software to fail to succeed as a tangible medium that can be borrowed like a book, lent, or resold at will.


2021 ◽  
Vol 5 (3) ◽  
pp. 301-306
Author(s):  
Landon Kaleb Hobbs ◽  
Darren Guffy ◽  
R. Hal Flowers

Background: Diffuse dermal angiomatosis (DDA) is a rare, reactive vascular disorder of the skin. Association with vascular disease, smoking, and large pendulous breasts has been reported. No standard of care exists but benefit with medication and reduction mammaplasty has been reported. Methods: We report a case of a 49-year-old obese female with a history of smoking who presented with DDA that improved with smoking cessation and pentoxifylline prior to reduction mammaplasty. We also performed a retrospective chart review of all patients with DDA seen at our institution between 2010 and 2020. Results: Eight female patients with DDA affecting the breasts were evaluated at our institution. The mean age was 49.5 years. Five of the patients noted symptoms at presentation. Obesity was seen in 7 (87.5%) patients and 5 (63%) had a smoking history. There was no significant difference between symptomatic and asymptomatic groups in regard to age, t4=-0.63, p=0.56, but BMI trended higher in the symptomatic group, t6=2.27, p=0.06. Three patients (38%) were noted to have fibromyalgia. All symptomatic patients saw improvement in their symptoms with treatments including reduction mammaplasty (1 patient), aspirin (1 patient), pentoxifylline (3 patients), smoking cessation (2 patients), and/or weight loss (1 patient). Conclusions: Our series is the second largest series of DDA of the breasts and confirms many reported associations including obesity, smoking, and large pendulous breasts. We report the first known case of improvement with weight loss as a sole intervention, as well as identify a novel potential association between DDA and fibromyalgia.


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