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51.
Purpose
In a previous well-controlled study, routine endoscopic-guided placement of ventricular catheters did not seem to decrease the rate of shunt failure or proximal shunt malfunction. Since this study was published, this technique does not seem to gain much acceptance. However, in selected cases, it may assist in accuracy and safety. We therefore have analyzed our experience with selective intra-catheter endoscopic use for ventricular hardware placement.Methods
We retrospectively collected clinical and radiological data on all children undergoing intra-catheter endoscopic-assisted ventricular catheter placement.Results
During 25?months, 16 children (ages 3?months–18?years) underwent 18 procedures using the above technique. Indications for surgery were: proximal shunt malfunction with relatively small ventricles (ten children), proximal shunt malfunction with intraventricular membranes (one child), proximal shunt malfunction with distorted ventricles (one child), new shunt with small to medium sized ventricles (two children), or large ventricles and a loculated fourth ventricle secondary to an aqueductal web (two children). Fourteen procedures were technically successful. The catheter was properly located on postoperative imaging in 13 procedures. Frameless navigation was used in three cases.Conclusions
Selective use of intra-catheter endoscopic-assisted proximal shunt placement is useful and may be indicated in small or distorted ventricles and in cases when fenestration of an intraventricular membrane or aqueductal web is indicated. The main value of such a technique is the ability to accurately place the catheter tip within distorted or small ventricles. Larger series are needed to refine these indications. 相似文献52.
Polachek Ari Polachek Shlomi Inbal Spitzer Karen Pereira Daniel Ye Justine Yang Chandran Vinod Laskin Carl A. Gladman Dafna D. 《Clinical rheumatology》2019,38(3):895-902
Clinical Rheumatology - The mean age at onset of psoriatic arthritis (PsA) ranges between the 4th–6th decades of life. However, little is known about fertility and pregnancy outcome in PsA... 相似文献
53.
Veronica Giorgione Karina Krajden Haratz Shlomi Constantini Roee Birnbaum Gustavo Malinger 《Prenatal diagnosis》2022,42(13):1674-1681
Fetal cerebral ventriculomegaly is a relatively common finding, observed during approximately 1% of obstetric ultrasounds. In the second and third trimester, mild (≥10 mm) and severe ventriculomegaly (≥15 mm) are defined according to the measurement of distal lateral ventricles that is included in the routine sonographic examination of central nervous system. A detailed neurosonography and anatomy ultrasound should be performed to detect other associated anomalies in the central nervous system and in other systems, respectively. Fetal MRI might be useful when neurosonography is unavailable or suboptimal. The risk of chromosomal and non-chromosomal genetic disorders associated with ventriculomegaly is high, therefore invasive genetic testing, including microarray, is recommended. Screening for prenatal infections, in particular cytomegalovirus and toxoplasmosis, should also be carried out at diagnosis. The prognosis is determined by the severity of ventriculomegaly and/or by the presence of co-existing abnormalities. Fetal ventriculoamniotic shunting in progressive isolated severe ventriculomegaly is an experimental procedure. After delivery, ventricular-peritoneal shunting or ventriculostomy are the two available options to treat hydrocephalus in specific conditions with similar long-term outcomes. A multidisciplinary fetal neurology team, including perinatologists, geneticists, pediatric neurologists, neuroradiologists and neurosurgeons, can provide parents with the most thorough prenatal counseling. This review outlines the latest evidence on diagnosis and management of pregnancies complicated by fetal cerebral ventriculomegaly. 相似文献
54.
Cardiac Disease‐Induced Post‐traumatic Stress Symptoms (CDI‐PTSS) Among Patients' Partners
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Keren Fait Noa Vilchinsky Rachel Dekel Nitza Levi Hanoch Hod Shlomi Matetzky 《Stress and health》2017,33(2):169-176
It is well established that a patient's partner can be deeply affected by the traumatizing nature of the patient's illness. Yet, no study to date has focused on post‐traumatic stress symptoms (PTSS) among partners of patients coping with an acute coronary syndrome (ACS). The current study's main aims were to address this gap and to evaluate cardiac disease‐induced (CDI) PTSS prevalence in partners of patients who experienced ACS. Patients who experienced ACS and their partners were interviewed by telephone 2 to 6 months after patients' hospitalization. All patients and partners were screened for CDI‐PTSS. Demographic and medical variables as well as partners' level of exposure to the cardiac event were assessed. Prevalence of CDI‐PTSS was higher among partners than among patients. Partners' number of CDI‐PTSS was not significantly associated with patients' number of CDI‐PTSS or with any of the other explanatory factors measured, except for education level. The preliminary results that arose from the current study point to the vast number of individuals who must act as caregivers for their ill partners while having to cope with their own PTSS. Much effort should be channelled into integrating partners into cardiac recovery programmes. Copyright © 2016 John Wiley & Sons, Ltd. 相似文献
55.
L. Beni-Adani Vitaly Siomin Yoram Segev Sara Beni Shlomi Constantini 《Child's nervous system》2000,16(7):402-405
Object: Endoscopic III ventriculostomy (ETV) is an effective and a rather safe treatment for noncommunicating hydrocephalus secondary
to aqueductal stenosis and other obstructive pathologies. Though not devoid of risk, ETV is increasingly replacing shunt operations,
and it prevents related complications, including overdrainage. Methods: We report a rare case of a large chronic subdural hematoma (ChSDH) after ETV in a patient with aqueductal stenosis. Three
weeks after he was shunted elsewhere, he presented to us with clinical symptoms of intracranial hypotension and overdrainage.
ETV was performed and the shunt removed uneventfully. On routine postoperative MRI a few weeks later, a large ChSDH was noted,
the patient being totally asymptomatic. Since the ChSDH grew significantly, causing a mass effect on the follow-up MRI, it
was finally drained. Large and increasing ChSDHs have previously been reported secondary to overdrainage after shunt placement,
but not after ETV. Conclusions: We conclude that though rare, a ChSDH may evolve even after ETV, if there is a substantial decrease in previously elevated
intracranial pressure.
Received: 28 December 1999 相似文献
56.
Avi Sabbag Shlomi Matetzky Avital Porter Zaza Iakobishvili Mady Moriel Donna Zwas Paul Fefer Elad Asher Roy Beigel Shmuel Gottlieb Ilan Goldenberg Amit Segev 《The American journal of medicine》2017,130(11):1324.e15-1324.e22
Background
Young women are usually protected against coronary artery disease due to hormonal and risk-factor profile. Previous studies have suggested poorer outcome in women hospitalized with acute coronary syndrome as compared with men. However, when adjusted for age and other risk factors, this difference does not remain significant. We compared the risk profile and outcome between young (≤55 years) women and men admitted with acute coronary syndrome.Methods
We analyzed clinical characteristics, management strategies, and outcomes of men and women ≤55 years of age enrolled in the biennial Acute Coronary Syndrome Israeli Surveys between 2000 and 2013.Results
Among 11,536 patients enrolled, 3949 (34%) were ≤55 years old (407 women, 3542 men). Women were slightly older (48.9 ± 5.7 vs 48.3 ± 5.5, P = .007) and suffered more from diabetes (34% vs 24%) and hypertension (47% vs 37%, P <.001 for both). Rates of prior myocardial infarction were high in both sexes (18% vs 21%). Women presented less often with ST-elevation myocardial infarction (50% vs 57%, P = .007) and with typical chest pain (73% vs 80%, P = .004), and had higher rates of Global Registry of Acute Coronary Events (GRACE) score ≥140 (19% vs 12%, P = .007). After adjustment for GRACE score, diabetes, and enrollment year, women had a lower likelihood to undergo coronary angiography during hospitalization (odds ratio 0.6, P = .007). Female sex was independently associated with higher risk of in-hospital mortality (hazard ratio [HR] 4.1; 95% confidence interval [CI], 1.15-14.0), 30-day major adverse cardiac and cerebral events (HR 2.1; 95% CI, 1.31-3.36), and 5-year mortality (HR 1.96; 95% CI, 1.3-2.8).Conclusions
Young women admitted with acute coronary syndrome are a unique high-risk group that presents a diagnostic challenge for clinicians. Women receive less invasive therapy during hospitalization and have worse in-hospital and long-term outcomes. 相似文献57.
Biopsies are currently the 'gold standard' method for identifying cancer of the prostate. While biopsies yield very accurate information regarding the area they sample, they are performed at discrete points and provide no information on the adjacent tissue. To enhance procedural accuracy, biopsies of a large number of sites are routinely carried out. Although more accurate, this method is both more complex and nevertheless remains discrete. In this paper, we evaluate the advantages of using bio-impedance information as the input for a support vector machines (SVMs) classifier to overcome these limitations. In this method, the biopsy probes are used as electrodes to obtain electrical impedance data during each biopsy sample. Using a computer model of the prostate, a SVM was trained and tested. Different tumor shapes and conductivity values, and the classifier's ability to generalize to these different properties, were examined. We demonstrate that by using this classifier the number of biopsies can be reduced and valuable information concerning the adjacent tissue which was not biopsied can be generated. 相似文献
58.
Shimrit Uliel-Sibony Uri Kramer Itzhak Fried Aviva Fattal-Valevski Shlomi Constantini 《Child's nervous system》2011,27(9):1413-1418
Purpose
This paper summarizes our experience with surgical treatment of pediatric low-grade glial temporal lobe tumors focusing on the long-term outcome of seizures and identifying factors associated with seizure control and failure.Methods
We reviewed all medical records of pediatric patients that underwent temporal lobe surgery due to seizures at our institution between 1997 and 2009. Only patients with temporal lobe tumors were included in this series. The files were retrospectively reviewed for seizure history. All children had undergone pre- and postoperative evaluation, neurological examination, EEG, and MRI.Results
The cohort includes 48 children with mean follow-up time of 5.15?years (1?C12?years). The mean age at surgery was 8.2?years (1?C18.1) and the mean seizure duration until surgery was 2.6?years. All lesions in the cohort were low-grade tumors; pilocytic astrocytoma was the most common (41%). Eighty-three percent of the patients were classified as Engel class I following surgery. There was no correlation between Engel score and the preoperative epilepsy duration, age of seizure onset or type of seizures, and pathology. The surgical complication rate was 4.1% (2/48).Conclusions
Surgical treatment for seizure control in children and adolescents with low-grade temporal tumors provides excellent long-term results. 相似文献59.
Jonathan Roth Naresh Biyani Suhas Udayakumaran Xiao Xiao Orna Friedman Liana Beni-Adani Shlomi Constantini 《Child's nervous system》2011,27(1):101-110
Purpose
Slit ventricle syndrome (SVS) remains a major problem for early shunted children. Several conservative and surgical treatment paradigms have been suggested; however, there is no consensus on the optimal surgical treatment. We present our experience using bilateral subtemporal decompressions with dura and arachnoid opening for the treatment of a subgroup of children with severe and resistant SVS. 相似文献60.
Bo Xiao Jonathan Roth Suhas Udayakumaran Liana Beni-Adani Shlomi Constantini 《Child's nervous system》2011,27(5):749-755