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Literatura académica sobre el tema "Central nervous system Meningitis in children"

Autor: Grafiati

Publicado: 4 de junio de 2021

Última modificación: 1 de febrero de 2022

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Artículos de revistas sobre el tema "Central nervous system Meningitis in children"

Janowski, Andrew B. y Jason G. Newland. "From the microbiome to the central nervous system, an update on the epidemiology and pathogenesis of bacterial meningitis in childhood". F1000Research 6 (27 de enero de 2017): 86. http://dx.doi.org/10.12688/f1000research.8533.1.

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In the past century, advances in antibiotics and vaccination have dramatically altered the incidence and clinical outcomes of bacterial meningitis. We review the shifting epidemiology of meningitis in children, including after the implementation of vaccines that target common meningitic pathogens and the introduction of intrapartum antibiotic prophylaxis offered to mothers colonized withStreptococcus agalactiae. We also discuss what is currently known about the pathogenesis of meningitis. Recent studies of the human microbiome have illustrated dynamic relationships of bacterial and viral populations with the host, which may potentiate the risk of bacterial meningitis.

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Ahmed, Amina. "Treatment of Central Nervous System Tuberculosis". Journal of Pediatric Infectious Diseases 13, n.º 02 (15 de enero de 2018): 141–52. http://dx.doi.org/10.1055/s-0037-1607235.

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AbstractCentral nervous system tuberculosis (CNS-TB) manifests as tuberculous meningitis, intracranial tuberculoma, or spinal tuberculous arachnoiditis. Children are disproportionately affected, with high rates of mortality and morbidity reported even in the era of treatment. Most guidelines for the treatment of drug-susceptible CNS-TB recommend 9 to 12 months of a standard regimen of isoniazid, rifampin, pyrazinamide, and ethambutol, with the adjunctive use of corticosteroids early in therapy. Recent trials have demonstrated improved outcomes with intensified regimens using nonstandard regimens or higher dosages of standard drugs. Accumulating evidence also supports shorter duration of treatment. Further investigation is warranted to identify the optimal regimen and duration of treatment for CNS-TB. Complications such as hydrocephalus may be managed medically or surgically. Although outcomes have improved with effective chemotherapy and immunomodulation of disease, prompt diagnosis and treatment in the early stages of disease remain paramount to improve prognosis.

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Andreeva, I. G., R. N. Mamleev, A. D. Evdokimova y A. F. Galiullina. "Neurological complications of acute otitis media in children". Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 64, n.º 5 (16 de noviembre de 2019): 250–55. http://dx.doi.org/10.21508/1027-4065-2019-64-5-250-255.

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The complications of acute otitis media remain an unsolved problem in pediatrics, as they often lead to disability of children. The damage to the nervous system is the most dramatic complications of acute purulent otitis media. Neurological complications include both intracranial lesions of the central nervous system (meningitis, encephalitis, brain abscesses) and neuropathy of the cranial nerves. We presented clinical cases of various neurological complications of otitis media, analyzed diagnostic and therapeutic errors and showed the ways to solve this difficult problem.

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Rahaman, Sk Rafikul, Anshuman Panda, Pradyut K. Mandal, Kripasindhu Chatterjee y R. V. Borgaonkar. "Adenosine deaminase activity in cerebrospinal fluid: diagnostic investigation in central nervous system disorders in children". International Journal of Contemporary Pediatrics 4, n.º 2 (22 de febrero de 2017): 596. http://dx.doi.org/10.18203/2349-3291.ijcp20170716.

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Background: Tubercular meningitis (TBM) is an endemic disease in developing countries. Adenosine deaminase activity (ADA) has been of great importance for many years in TBM diagnosis. The objective of this study was to determine the CSF-ADA levels in different CNS disorders, to compare the CSF-ADA activity in different types of meningitis, to find out the sensitivity and specificity of CSF-ADA in the diagnosis of TBM and to establish the prognostic value of CSF-ADA in TBM in comparison to Control group.Methods: For control group CSF was collected from the patients of simple febrile convulsions and idiopathic epilepsy.Results: The present study was carried out in the 112 cases of different CNS disorders, age ranging from 4 months to 12 years with a mean age of 4.12 years and 38 cases (27+11) of control group (simple febrile convulsion and idiopathic epilepsy). In the present study CSF-ADA level was statistically significantly increased in all types of meningitis (p<0.05). In case of TBM, the mean CSF-ADA level increased statistically significantly with increase in CSF protein level (p<0.05). In case of TBM, there was no significant difference in the mean ADA value according to CSF sugar level (p<0.10). In case of TBM, the mean CSF-ADA level increased significantly with increase in CSF cell count (p< 0.01) mainly lymphocytes.Conclusions: Thus it can be concluded from our study that CSF-ADA estimation is relatively simple and inexpensive procedure in the early diagnosis of tuberculous meningitis with high sensitivity (100%) and specificity (97.5%) at a cut-off level of 5IU/L and can be used in differentiating TBM from other types of meningitis. Along with diagnostic utility of CSF-ADA, it has also prognostic value in the follow-up case of tuberculous meningitis.

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Volotko L. O. "NEUROSONOGRAPHIC STUDY OF CHILDREN WITH HYPOXIC-ISCHEMIC BRAIN IJURY". Science Review, n.º 4(31) (30 de abril de 2020): 7–11. http://dx.doi.org/10.31435/rsglobal_sr/30042020/7050.

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The study is aimed at neurosonographic characteristics of brain injury in newborn patients with perinatal hypoxic-ischemic injury of central nervous system, complicated with inflectional process (meningitis, ventriculitis). It is settled that brain immaturity, hydrocephalic syndrome, ischemia of the brain tissue and intraventricular hemorrhages are found 2 times more often in infants with perinatal hypoxic-ischemic injury of central nervous system, complicated with inflectional process. This fact generally characterizes disorders of the hemato-encephalic barrier and the development of destructive processes in the tissue of the brain.

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Jawad, Aiyar Shakir. "Spectrum of central nervous system infections in neurosciences hospital in two years : a retrospective study". AL-Kindy College Medical Journal 16, n.º 1 (12 de septiembre de 2020): 67–73. http://dx.doi.org/10.47723/kcmj.v16i1.197.

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Background :Infectious disorders in general have high morbidity and mortality.. CNS infections include many disorders like bacterial meningitis, tuberculous and other subacute and chronic meningitis, viral meningitis, cerebral abscess, spinal cord infections, and others.Objective: To assess our locality about prevalence of CNS infections , to have more awareness regarding CNS infections, and to try to find the proper way to reduce their prevalence and to treat them in appropriate way.Method :We revised the records of all the cases of CNS infections excluding cases of spinal cord infections who were admitted in the wards of neuroscience hospital over the previous two years ( from July/2010 to June 2012 ),those were 132 cases.Seasonal incidenceand other clinical aspects and other parameters like age , sex, , fever are extracted and recordedResults: The most common CNS infections in sequence from the most to the least were bacterial meningitis, viral encephalitis, tuberculous meningitis, viral meningitis, and cerebral abscess.The most common age group which is affected by CNS infections was below 10 years.Males are affected more than females taking in consideration all types of infection.P values were statistically significant for age, fever, signs of meningeal irritation, focal neurological deficit, and seizures.Conclusion : The total rate of admission of CNS infections in our series was lower than other study.The most frequent type of CNS infections was bacterial meningitis which is the same as most of the studies.Males are affected more than females in our study in all types of CNS infections, this was approximate to other studies except for tuberculous meningitis.Bacterial meningitis and viral encephalitis were more common in preschool children in our study.Fever rate in bacterial and tuberculous meningitis was different from other studies.Seizure rate in bacterial meningitis and viral encephalitis was approximate to other results.Rate of focal deficit in viral encephalitis and tuberculous meningitis was different from other studies.Rate of CSF protein elevation in all CNS infections was approximate to other studies.Rate of hypoglycorrhachia was different from other studies only in tuberculous meningitis.CSF pleocytosis was approximate to other studies in all types of CNS infections.The two most common types of CNS infections , bacterial meningitis and viral encephalitis, are more common in preschool age groups.

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Bahtera, Tjipta, Bagus Putu Ngurah Arsana y Maria Lidwina. "Early Ditection of Central Nervous System Infection by C-reactive Protein Examination of Cerebrospinal Fluid". Paediatrica Indonesiana 32, n.º 5-6 (29 de enero de 2019): 144–52. http://dx.doi.org/10.14238/pi32.5-6.1992.144-52.

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There are still many cases of bacterial meningitis in Indonesia. The highest morbidity rate are between 2 months until 2 years of age. The important factors that influence the success of treatment are early diagnosis and detection of the cause. C-reactive protein (=CRP) could be found in the spinal fluid of meningitis patients. The aim of this study is to judge the ability of CRP as a tool in making diagnosis as soon as possible whether there is a bacterial infection of the central nervous system and to compare it with the result of the spinal fluid culture. Also to compare the ability of it a conventional or routine examination of the spinal fluid was done. This was a prospective study on 30 children that were admitted in the child ward of Kariadi Hospital, Semarang during the first of April until the and of july 1990. The ages of the children were between one month until 14 years, with clinical symptoms such as fever, seizure and neurological disorders. CRP examination was done with Latex Agglutination method. The result of CRP examination on spinal fluid showed that the sensitivity was 91.6% , the specificity 94.4% , the positive prediction value 91.6% and the negative prediction value 94.4%. As a conclusion, CRP examination of spinal fluid gives better results than the conventional or routine examination in distinguishing bacterial meningitis from non bacterial meningitis.

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Gupta, Sanjay, Shobhan Vachhrajani, Abhaya V. Kulkarni, Michael D. Taylor, Peter Dirks, James M. Drake y James T. Rutka. "Neurosurgical management of extraaxial central nervous system infections in children". Journal of Neurosurgery: Pediatrics 7, n.º 5 (mayo de 2011): 441–51. http://dx.doi.org/10.3171/2011.2.peds09500.

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Object Extraaxial infections of the CNS, including subdural empyema and epidural abscess, are rare but potentially life-threatening conditions. Symptoms are usually progressive, and early diagnosis is therefore important. Early intervention with appropriate treatment offers the best opportunity for eradicating the infection and promoting maximal neurological recovery. Methods The medical records of children with extraaxial CNS infection over the last 24 years at the Hospital for Sick Children were analyzed. Only those patients with radiological and/or operative confirmation of the diagnosis of subdural empyema or epidural abscess were included in the study. Demographic and clinical data were collected to determine the outcomes after such infections and factors that predict for such outcomes. Results The authors identified 70 children who fulfilled the inclusion criteria. Sinusitis was the most common etiology and was seen in 38 patients. All of these patients were older than 7 years of age at diagnosis. Subdural empyemas were diagnosed in 13 patients following bacterial meningitis, and they were found primarily in infants within the 1st year of life. Other etiological factors included otogenic infection (4 cases), postneurosurgical infection (7 cases), and hematogenous spread of infection (7 cases including 6 cases of spinal epidural abscess). Streptococcus anginosus and Staphylococcus aureus were the most common pathogens identified. Sixty-four patients (91.4%) underwent at least 1 neurosurgical procedure. Seizures and cerebral edema from cortical vein thrombosis were the most common complications. Conclusions Due to variable etiology, identification of the responsible microorganism through neurosurgical drainage followed by long-term intravenous antibiotics remains the mainstay in treating extraaxial CNS infections. Optimal outcome is achieved with early diagnosis and therapy.

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Liberalesso, Paulo Breno Noronha, Izabella Celidônio Bertoldo da Silva, Karlin Fabianne Klagenberg, Ari Leon Jurkiewicz, Bianca Simone Zeigelboim y Victor Horácio Costa Júnior. "Incidence and risk factors for seizures in central nervous system infections in childhood". Journal of Epilepsy and Clinical Neurophysiology 15, n.º 2 (junio de 2009): 83–88. http://dx.doi.org/10.1590/s1676-26492009000200007.

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INTRODUCTION: The infections of the central nervous system remain as a public health problem in several countries and there is a direct relation between poverty and underdevelopment with high mortality and morbidity rates. Seizures represents a complication related to infections of the central nervous system, are considered a clinical emergency and requiring neurological investigation. OBJECTIVE: In this article, we propose to describe the incidence and risk factors for seizures in central nervous system infections in childhood. METHODS: a retrospective study was performed between October 2007 and October 2008 and all patients who were hospitalized with the diagnosis of infections of the central nervous system were analyzed. Newborns were excluded. The patients were divided into GROUP 1 (without seizures) and GROUP 2 (with seizures). RESULTS: 731 patients were included, 47.75% males, with average age of 15.7 years. GROUP 1 - with fever (652/92.35%), headache (580/82.15%), vomits (550/77.9%), and viral meningitis predominance (652/93.06%). GROUP 2 - with fever (25/100%), vomits (12/48), headache (6/24%), and viral encephalitis predominance (14/56%). Ten (40%) patients from the GROUP 2 presented EEG alterations. The incidence of seizures was 3.42% and a significant statistical difference was noticed related to mean age (p<0.000069), presence of headache (p<0.0000), vomits (p<0.0005), stiff neck (p<0.0105) and drowsiness (p<0.0265). CONCLUSIONS: the occurrence of seizures during the hospitalization is significantly more frequent in cases of viral encephalitis and bacterial meningitis compared to viral meningitis. The risk of seizures increases in early ages. Headache, vomits, stiff neck and drowsiness are more frequent symptoms in children with infection of the central nervous system who presented seizures during the hospitalization.

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Калоева, Zinaida Kaloeva, Гуссоева, I. Gussoeva, Албегова, B. Albegova, Будаева y Z. Budaeva. "Clinical and epidemiological features and residual manifestations of serous enteroviralmeningitis in children in North Ossetia-Alania". Vladikavkaz Medico-Biological Bulletin 21, n.º 32 (24 de marzo de 2016): 46–51. http://dx.doi.org/10.12737/18547.

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The article presents the analysis of the epidemiological, clinical and laboratory features of serous meningitis enteroviral etiology in children hospitalized at the RCCH of Vladikavkaz in 2008–2012. We have also studied the residual manifestations of enteroviral meningitis in 44 patients in the early period of convalescence. The study showed that of RNO-Alania typical summer – autumn seasonality of serous meningitis enteroviral etiology in children. The central nervous system caused by enteroviruses more often develops in children of preschool and school age. The clinical picture of enteroviral meningitis remains a leading hypertension – hydrocephalic syndrome. In the early period of convalescence enteroviral meningitis in children often formed cerebro-asthenic, hypertension, neurosis-like syndromes and syndrome immune dysfunction.

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Más fuentes

Tesis sobre el tema "Central nervous system Meningitis in children"

Carlini, Sophia Magdalena. "Adenylate kinase values in cerebrospinal fluid as a marker to predict neurological outcome in children with meningitis". Thesis, Cape Technikon, 1997. http://hdl.handle.net/20.500.11838/1456.

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Thesis (Master's Diploma(Technology (Medical Technology))-- Cape Technikon, 1997
Meningitis in children is a common and serious disease. Bacterial and tuberculous meningitis often lead to neurological complications. A sensitive marker to predict brain damage in children with meningitis could be of great importance. Frithz F et aI, 1982 suggested that increased adenylate kinase values could indeed be used as a marker for brain damage. Adenylate kinase (AK) is an enzyme present in brain tissue. Low concentrations are present in normal cerebrospinal fluid (CSF) « 1 uti). Increased concentrations were found in cases of ischemic brain damage (Frithz et aI, 1982), malignant brain tumours (Ronquist G et aI, 1977) and bacterial meningitis. As AK has a low molecular weight (22,00 Daltons), in comparison to other kinases (40,000 Daltons) it is one of the first enzymes that can be detected in the CSF after brain damage and it can thus be used as a reliable marker for brain cell damage. The aim of this study was to quantify the AK values in CSF of children with bacterial and tuberculous meningitis and to evaluate their use to predict the neurological outcome in children with bacterial and tuberculous meningitis. Eighty eight children with tuberculous meningitis (TBM) and thirty three children with bacterial meningitis were included in the study. Sixty children with suspected meningitis but who were later diagnosed with urinary tract infections, gasto-enteritis, bronchitis, febrile convulsions or other non-neurological infections were used as controls. The results showed raised AK values in the CSF of children with bacterial- and TB meningitis. There was a statistically significant difference of AK values between stage III and II TBM AK values in patients at week 1 after diagnosis (p=0,03). There was also a statistically significant correlation between CSF AK values and lactate concentrations (P=0,001) which reflected hypoxic brain metabolism. Although AK values did not always correlate directly with the patients’ clinical outcome, there is proof that increased AK values in CSF can be used to predict neurological outcome.

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Ryder, Stephen J. "Studies on the recruitment of macrophages into the central nervous system". Thesis, University of Cambridge, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309144.

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Tager, Dany, Anne Hatch, Jennifer Segar, Brentin Roller, Mohajer Mayar Al y Tirdad T. Zangeneh. "Coccidioidal meningitis complicated by central nervous system vasculitis in a patient with leukemia". ELSEVIER SCIENCE BV, 2017. http://hdl.handle.net/10150/625216.

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Central Nervous System (CNS) vasculitis is the most common life-threatening complication of coccidioidal meningitis. It is manifested by cerebral ischemia, hemorrhage, and infarction. We report a case of CNS vasculitis in a patient receiving chemotherapy and review of the literature on coccidioidal meningitis. The patient was treated with combination antifungal therapy and a short course of high dose corticosteroids with a modest improvement in her neurological examination after initiation of steroids.

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Stanley, Alan Michael. "The utility of CSF PCR in central nervous system Varicella zoster infection in HIV". Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16778.

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Includes bibliographical references
Aims: To assess the clinical and cerebrospinal fluid characteristics, and the role of tuberculous meningitis (TBM) as a confounder, in a cohort of HIV positive individuals with positive varicella zoster virus (VZV) positive cerebrospinal fluid PCR. Methods: Patients in the NHLS database at Groote Schuur Hospital with positive CSF VZV PCR who were also HIV co-infected and whose folders were available for clinical review were reviewed. Clinical and biochemical data were collected. Patients were divided into two groups based an accepted case definition for TBM. Differences between groups were assessed using Mann-Whitney U or Chi squared tests as appropriate. Results: There were 437 for VZV PCR over three years. Of these 98 were positive and, after exclusions, 31 HIV positive patients were included for further analysis. Median age was 31 and median CD4 count was 146 cells/mm³. 11 (35%) had meningitis and 8 (25%) had encephalitis. 13 (42%) met the case definition for TBM. Patients with CNS varicella were frequently confused whereas those with TBM presented sub-acutely. There were no differences in CSF characteristics. Additional organisms were detected 6 (19%) patients. 4 (13%) patients died in hospital. CSF TB culture was requested in 24 (77%) patients and extra CNS samples were sent in only 4 patients. Conclusion: The clinical and CSF presentation of CNS Varicella and TBM overlap and in this cohort patients were under investigated for TB. In settings of high TB prevalence the possibility of false positive PCR or incidental varicella reactivation should be considered.

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Abdalla, Hana Khidir. "Modulation of inflammatory mediators during experimental bacterial meningitis /". Linköping : Department of Molecular and Clinical Medicine, Linköping university, 2005. http://www.bibl.liu.se/liupubl/disp/disp2005/med907s.pdf.

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Pelegrín, Senent Iván. "Clinical approach and management of bacterial infections of the central nervous system related to hydrocephalus". Doctoral thesis, Universitat de Barcelona, 2017. http://hdl.handle.net/10803/585886.

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INTRODUCTION: Community-acquired bacterial meningitis is a relevant entity related to a high morbidity and mortality, despite of the adjuvant and antibiotic treatments available. Morbidity and mortality are caused by neurological complications, being hydrocephalus one of the less investigated one and related to Listeria monocytogenes meningoencephalitis episodes, which increase have been reported in the last decade. Moreover, the devices used for treatment of hydrocephalus have a high risk of infection. These infections have a high personal and economic costs, and their prevention and treatment management can be optimised. HYPOTHESIS: Studying certain aspects of community-acquired bacterial and device-related infections of the central nervous system might improve management and outcome of these patients. OBJECTIVES: 1. To describe the impact on outcome with hydrocephalus complicating community acquired bacterial meningitis patients. 2. To evaluate prognostic factors related to sequelae and mortality in L. monocytogenes meningoencephalitis. 3. To assess efficacy of different treatment strategies on a cohort of patients with ventriculoperitoneal shunt infections. 4. To evaluate, in vitro, a new antibiotic-impregnated external ventricular drainage catheter to prevent Acinetobacter baumannii infections. METHODS: Observational clinical study of a cohort of community-acquired bacterial meningitis and ventriculoperitoneal shunt infection patients during more than 35 years in a university reference hospital. Experimental study of efficacy of an antibiotic-impregnated external ventricular catheter tested by a dynamic in vitro model. RESULTS: Among 790 community-acquired bacterial meningitis patients, 22 (3%) presented complicating hydrocephalus. 7/22 (32%) episodes were caused by L. monocytogenes and Streptococcus pneumoniae. Mortality of patients with complicating hydrocephalus was 50%. Age, time to illness and L. monocytogenes aetiology were risk factors related to development of hydrocephalus. L. monocytogenes episodes increased in the last decade (from 0.73 episodes/1000 admissions to 1.02/1000 admissions per year). Mortality was 24% and neurological sequelae 18%. Seizures were present in 14% and hydrocephalus in 16% of patients. The addition of gentamicin to ampicillin, use of adjuvant dexamethasone and antiepileptic prophylaxis with phenytoin did not influence outcome. Risk factors related to a worse outcome were the presence of hydrocephalus and the inappropriate empirical antibiotic treatment. Among 86 episodes of ventriculoperitoneal shunt infections: 6 received only antibiotic therapy; 24 were managed with a shunt removal without replacement; 37 were managed with a shunt replacement in 2 steps; and 19 with a shunt replacement in one step. The most effective strategy was shunt replacement in 2 steps (89% cure). 6/9 (67%) external ventricular drainage catheters impregnated with trimethoprim, rifampin and triclosan were free of colonisation at least for 3 weeks after several inoculations with 104 A. baumannii in an in vitro model. CONCLUSIONS: The development of hydrocephalus complicating an episode of community acquired bacterial meningitis causes a worse rate of mortality and sequelae. The outcome of L. monocytogenes patients could be improved if the empirical antibiotic treatment is accurate and if a precise suspicion and management of potential hydrocephalus occurs. Shunt removal, particularly in 2 steps when the patient is not shunt-dependant, is the best strategy in the treatment of a ventriculoperitoneal shunt infection, without increasing morbidity. A new external ventricular drainage catheter impregnated with triclosan, rifampin and trimethoprim might prevent multirresistant A. baumannii ventriculitis.
INTRODUCCIÓN: La meningitis bacteriana adquirida en la comunidad es una enfermedad asociada a una elevada morbimortalidad a pesar de los tratamiento adyuvantes y antibióticos disponibles. Su principal causa son las complicaciones neurológicas. La hidrocefalia secundaria es de las menos estudiadas y además está asociada a la etiología Listeria monocytogenes, de reciente incremento en países desarrollados. Por otra parte, los dispositivos utilizados para el tratamiento de la hidrocefalia, drenajes ventriculares temporales y permanentes, tienen alto riesgo de infección. Cuando esto sucede, las consecuencias de la infección, tanto en el paciente como en el sistema sanitario, son importantes, siendo las estrategias de prevención y tratamiento de estas infecciones mejorables. Hipótesis: Estudiar aspectos concretos de las infecciones bacterianas del sistema nervioso central, tanto comunitarias como asociadas a dispositivos, puede ayudar a mejorar el manejo y pronóstico de los pacientes. OBJETIVOS: 1. Determinar el impacto de la hidrocefalia secundaria en el pronóstico de los pacientes con meningitis bacteriana adquirida en la comunidad. 2. Analizar los factores pronósticos de mortalidad y secuelas en la meningoencefalitis por L. monocytogenes. 3. Evaluar la eficacia de diferentes estrategias de tratamiento en una cohorte de pacientes con infecciones de shunt ventriculoperitoneal. 4. Evaluación in vitro de un nuevo drenaje ventricular externo impregnado con antibióticos para prevenir las infecciones por Acinetobacter baumannii multiresistente. MÉTODOS: Estudio clínico observacional de una cohorte de pacientes con meningitis bacteriana adquirida en la comunidad e infecciones de shunt ventriculoperitoneal durante más de 35 años en un Hospital universitario de referencia para infecciones del sistema nervioso central. Estudio experimental de la evaluación de la eficacia de un drenaje ventricular externo impregnado en antibióticos en un modelo dinámico in vitro. Resultados: De 790 pacientes con meningitis bacteriana adquirida en la comunidad, 22(3%) presentaron hidrocefalia como complicación. 7/22(32%) episodios fueron causados por L. monocytogenes y Streptococcus pneumoniae. La mortalidad de los pacientes que presentaron hidrocefalia fue del 50%. La edad, un tiempo de enfermedad avanzado y la etiología L. monocytogenes fueron factores de riesgo asociados a desarrollar hidrocefalia. Los episodios de meningoencefalitis por L. monocytogenes se incrementaron en los últimos 10 años (de 0.73 episodios/1000 admisiones a 1.02/1000 admisiones). La mortalidad fue 24% y las secuelas neurológicas 18%. La frecuencia de crisis comicial fue del 16% y de hidrocefalia del 14%. La adicción de gentamicina al tratamiento con ampicilina no modificó el pronóstico, al igual que el uso de dexametasona ni de profilaxis con fenitoína. Los factores asociados a mal pronóstico fueron la presencia de hidrocefalia y el tratamiento antibiótico empírico inadecuado. De 86 episodios de infección de shunt ventriculoperitoneal: 6 episodios se manejaron sólo con antibióticos; en 24 se retiró el shunt sin recambio; en 37 se realizó un recambio en 2 tiempos del shunt; y en 19 un recambio en un tiempo. La estrategia más efectiva fue el recambio en 2 tiempos (89% de curación). 6/9(67%) drenajes ventriculares externos impregnados en trimetroprim, rifampicina y triclosan permanecieron libre de colonización al menos 3 semanas tras varias inoculaciones con 104 A. Baumannii en un modelo in vitro. CONCLUSIONES: La hidrocefalia secundaria a un episodio de meningitis bacteriana adquirida en la comunidad conlleva una mayor gravedad neurológica y un peor pronóstico en cuanto a mortalidad y secuelas. El pronóstico de la meningoencefalitis por L. Monocytogenes podría mejorar si se administra un tratamiento antibiótico empírico adecuado y si se sospecha y se maneja correctamente la potencial hidrocefalia secundaria. La retirada del shunt , concretamente en dos tiempos cuando el paciente es shunt dependiente, es la estrategia de elección en el tratamiento en una infección de shunt ventriculoperitoneal, sin aumentar la morbilidad. Un nuevo drenaje ventriuclar externo impregnado con triclosan, rifampicina y trimetroprim podría prevenir las ventriculitis por A. baumannii multiresistente.

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Saba, Villarroel Paola Mariela. "Epidemiology of central nervous system infections and of Zika virus in Bolivia". Thesis, Aix-Marseille, 2020. http://theses.univ-amu.fr.lama.univ-amu.fr/200424_SABAVILLARROEL_796lerwvy638nrfmjn965osdp469z_TH.pdf.

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Nous avons réalisé une étude prospective (nov-2017 à oct-2018) chez des patients boliviens hospitalisés suspectés d'infection du SNC pour identifier les plus courants étiologies et orienter les stratégies de diagnostic, de traitement, de prévention et de santé publique. Nous avons recruté 257 patients hospitalisés (20,2% VIH positifs), une étiologie infectieuse a été confirmée chez 49,8% des patients. Les principales étiologies chez les patients VIH positifs étaient Cryptococcus spp. (41,7%) et M. tuberculosis (27,8%) et chez les patients VIH négatifs, M. tuberculosis (26,1%) et S. pneumoniae (18,5%). La mortalité était de 42,1%. Notre étude appelle à renforcer la politique de santé publique, en particulier en ce qui concerne la tuberculose, la rage et la prévention et les soins du VIH.Le virus Zika (ZIKV) a récemment émergé dans les Amériques, et des complications neurologiques chez le fœtus de femmes infectées pendant la grossesse ont été rapportés. Tout d'abord, nous avons développé un test de neutralisation rentable, automatisé, sensible et spécifique basé sur l'effet cytopathique (CPE) pour effectuer de grandes études de séroprévalence. Deuxièmement, nous avons effectué une étude de séroprévalence en 5 villes de la Bolivie (Décembre 2016 à avril-2017) pour estimer l'immunité collective du ZIKV, confirmant la circulation dans les régions tropicales (Santa Cruz (21,5%) et Beni (39%)) avec Santa Cruz toujours vulnérable aux futures épidémies. Troisièmement, 74 femmes enceintes de Santa Cruz (Bolivie) ont été recrutées (2018), 15 (20,3%) étaient positives pour ZIKV en analysant différent méthodes moléculaires et sérologiques
We performed a prospective study from Nov-2017 to Oct-2018 in Bolivian inpatients with suspected CNS infections to identify the most common aetiologies and to guide diagnosis, treatment, prevention, and public health strategies. We recruited 257 inpatients (20.2% HIV-positive), an infectious aetiology was confirmed in 49.8% of patients. The main aetiologies in HIV-positive patients were Cryptococcus spp. (41.7%) and M. tuberculosis (27.8%), in HIV-negative patients M. tuberculosis (26.1%) and S. pneumoniae (18.5%). The mortality rate was 42.1. Our study calls to reinforced public health policy, in particular regarding tuberculosis, rabies and HIV prevention and care. Zika virus (ZIKV) has recently emerged in the Americas and congenital abnormalities in fetus from women infected during pregnancy have been reported. First, we developed a cost-effective, automatized, sensitive and specific neutralization test based on cytopathic effect (CPE) to perform large seroprevalence studies. Second, we performed a seroprevalence study in 5 cities of Bolivia (Dec-2016 to April-2017) to estimate the ZIKV protective herd immunity, confirming the circulation in the tropical regions (Santa Cruz (21.5%) and Beni (39%)), with Santa Cruz still vulnerable to future outbreaks. Third, 74 pregnant women from Santa Cruz (Bolivia) were recruited (2018), 15 (20.3%) were positive by analyzing different molecular and serological methods

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Kihara, Michael. "Neurocognitive impairment following central nervous system infections in Kenyan children as detected by event related potentials". Thesis, Open University, 2008. http://oro.open.ac.uk/54642/.

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As mortality in childhood decreases due to advances in modern medicine, presence of better nutrition and fresh water supply, the impact of disability has become increasingly important especially in resource poor countries. Children living in sub- Saharan Africa are also exposed to a number of potentially debilitating infections which have been shown to have long-term cognitive effects even in absence of clinical neurological sequelae. The objective of the study is to demonstrate that event related potentials (ERPs) can be used to detect neurocognitive impairment following the most common central nervous (CNS) system infections affecting children in sub-Saharan Africa, namely falciparum malaria, acute bacterial meningitis (ABM) and human immune-deficiency virus (HIV). Four groups of children were recruited: children previously admitted with severe falciparum malaria (n= 50), or acute bacterial meningitis (n = 65), or mY-infected (n= 39) or were unexposed to any of these conditions (n= 177). Passive auditory and visual oddball ERP protocols were used. The results of the group of 50 children aged 6-7 years old with a history of severe falciparum malaria (cerebral malaria, CM= 27, malaria plus seizures, M/S= 14 and prostrated malaria, PM= 9) show that children exposed to CM, MIS and PM had significantly longer auditory N200 and P3a latencies and smaller N200 amplitudes than study controls. The results of 65 children aged between 4-15 years old with a history of pneumococcal meningitis shmved that children with a history of bacterial meningitis had significantly smaller auditory P100 amplitudes, longer N200 latencies and longer visual P200 latencies than community controls. Finally, the results of 40 children aged between 18-40 months infected with IllV showed that they had longer auditory P100 latencies, larger auditory P200 amplitudes and smaller Negative component, Nc, amplitudes than community controls. It is concluded that the CNS infections may result in neuro-developmental delays in childhood. Further, CNS infections may interfere with normal education outcomes by precipitating attention deficit amongst children post infection.

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Nunes, Rafaella Almeida Lima. "Aplicação de técnicas moleculares no diagnóstico laboratorial complementar das infecções virais do sistema nervoso central no Hospital Universitário da USP". Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/42/42132/tde-19032014-160513/.

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Enterovírus (HEV), herpesvírus 1 e 2 (HHV-1 e HHV-2) e adenovírus (HAdV) são importantes agentes de infecções do SNC. Neste trabalho, técnicas moleculares foram aplicadas para a detecção destes vírus em quadros de infecção do SNC. Amostras de líquor foram colhidas de pacientes atendidos no HU-USP entre agosto e novembro/2010 e fevereiro/2012 a janeiro/2013. Através da Nested-PCR HEV foram detectados em 9,8% das amostras, HAdV em 2,5% e HHV-1 e 2 em 1,1%, além de 3 casos de coinfecção, 2 entre HEV e HHV, e 1 entre HEV e HAdV. O material genético viral foi extraído através dos métodos Qiaamp DNA Blood (Qiagen®) e MagMAXTM Viral RNA Isolation (Ambiom), e este último pareceu mais adequado à aplicação na rotina clínica. A análise quimiocitológica do líquor mostrou-se importante no direcionamento da conduta clínica, mas a detecção do vírus é fundamental para a conclusão do diagnóstico. A PCR em tempo real, cuja padronização foi iniciada neste trabalho, consiste em importante ferramenta para a utilização futura no diagnóstico complementar das infecções virais do SNC.
Enteroviruses (HEV), herpesviruses 1 and 2 (HHV-1 and HHV-2) and adenoviruses (HAdV) are important causative agents of infections of the CNS. In this study, molecular techniques were applied to the detection of these viruses. CSF samples were collected from patients treated at the University Hospital of USP, between August and November, 2010, and February 2012 and January 2013. By the Nested-PCR reaction, HEV were detected in 9.8% of the samples, HAdV in 2.5% and HHV-1 and 2 in 1.1%. There were 3 cases of coinfection: 2 with HEV and HHV and other with HEV and HAdV. The viral genetic materials were extracted by QIAamp DNA Blood kit (Qiagen®) and MagMAXTM Viral RNA Isolation (Ambiom), and the second one showed to be more suitable for the application in clinical diagnosis. The CSF chemocytologic analysis proved to be important in directing the clinical conduct, but the detection of viruses is essential for the diagnosis. The real time PCR, which standardization was initiated in this work, will be an important tool for complementary diagnosis of viral infections of the CNS.

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Nunes, Cristina Freitas. "Etiologia das encefalites e meningites de líquor claro". Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/99/99131/tde-27112018-144215/.

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Infecções no sistema nervoso central (SNC) causadas por microrganismos desencadeiam sintomas de moderados a severos, dependendo da região atingida, podendo ser designadas como encefalites ou meningites. Os vírus são os agentes mais comuns nestas infecções. Os agentes virais responsáveis por essas enfermidades que apresentam maior incidência na população mundial são certos herpesvírus, flavivírus, influenza A, enterovírus e vírus da caxumba. Entretanto, essa prevalência varia de acordo com a população, estado imunológico do indivíduo, idade e região estudada. Embora existam dados bem estabelecidos da etiologia dessas doenças em alguns países, ainda há uma carência de informação no que diz respeito à etiologia dessas moléstias no Brasil. Assim, informações mais precisas em relação à prevalência desses agentes em nosso meio são necessárias para o desenvolvimento e aplicação de métodos de diagnósticos mais rápidos e eficientes. Neste trabalho, foram analisadas 120 amostras de liquido cefalorraquidiano (LCR), procedentes de dois centros da cidade de São Paulo (Irmandade Santa Casa de Misericórdia e Hospital das Clínicas da Faculdade de medicina da Universidade de São Paulo), as quais foram submetidas à reação em cadeia de polimerase para o herpesvirus simples 1 e 2 (HSV 1 e 2), vírus da varicela zoster (VZV), herpesvirus humano 6 (HHV-6), influenza A (FLUA), enterovírus, vírus da caxumba, poliomavírus vírus BK (BKV) e vírus JC (JCV) para flavivírus. Do total, 44 amostras (36,7%) apresentaram resultado positivo para algum dos vírus analisados no âmbito desta pesquisa, sendo 15 (12,5%) para poliomavírus BKV, 2 (1,7%) para poliomavírus JCV, 21 (17,5%) para HSV1 e 2, 5 (4,2%) foram positivos para BKV e HSV1 e 2 (coinfecção) e 1 (0,8%) para vírus Epstein-Barr (EBV). Uma parte das amostras negativas foi submetida a sequenciamento direto de nova geração (n=8 amostras), resultando em amostras positivas para vírus (vírus simio 40), protozoários e bactérias. Este estudo mostrou que infelizmente, menos de 50% das encefalites e meningites assépticas puderam ser relacionadas a algum agente viral. Houve uma alta prevalência de HSV no material estudado, de acordo com o esperado, mas a presença de poliomavírus no LCR destes indivíduos foi acima da observada na literatura. Esses, bem como os resultados de sequenciamento direto e sua associação a etiologia das encefalites e meningites, devem ser interpretados com cautela.
Central nervous system (CNS) infections caused by microorganism trigger moderate to severe symptoms, depending on the region affected and may be referred as encephalitis or meningitis. Viruses are the most common agents in these infections. The viral agents responsible for these diseases with highest incidence worldwide are certain herpesviruses, flaviviruses, influenza A, enteroviruses, and mumps virus. However, their prevalence vary according to the population, immunological state of the individual, age and region studied. Although there are well-established data on the etiology of these diseases in some countries, there is little information regarding the etiology of these diseases in Brazil. Thus, data regarding the prevalence of these agents in our environment is necessary for the development and application of faster and more efficient diagnostic methods. In this study, 120 cerebrospinal fluid (CSF) samples from two centers of the city of São Paulo (Hospital Santa Casa de Misericordia and Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo) were investigated by PCRs for herpes simplex virus (HSV 1 and 2), varicela zoster virus (VZV), human herpesvirus 6 (HHV6), influenza A, enterovirus, mumps virus, polyomavirus BK virus and JC virus and flaviviruses. From these, 44 samples (36.7%) presented positive result for one of the viruses analyzed, being 15 (12.5%) for polyomavirus BKV, 2 (1.7%) for polyomavirus JCV, 21 (17.5%) for HSV 1 and 2, 5 (4.2%) samples were positive for BKV and HSV1 and 2 (coinfection) and 1 (0.8%) for Epstein-Barr virus (EBV). A part of the negative samples (n=8) were submitted to next generation direct sequencing and revealed the presence of agents as viruses (simian virus 40), protozoa and bacteria. This study showed that unfortunately, less than 50% of the aseptic encephalitis and meningitis could be related to some viral agent. It was found high prevalence of HSV, as expected, but the presence of polyomavirus in the CSF of these individuals was higher than that observed in the literature. These results, as well as direct sequencing results and its relationship to the etiology of encephalitis and meningitis should be interpreted with caution.

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Libros sobre el tema "Central nervous system Meningitis in children"

Britain), SCOPE (Great, ed. CNS magnetic resonance imaging in infants and children. [London]: MacKeith Press, 1995.

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Faerber, Eric N. CNS magnetic resonance imaging in infants and children. [London]: MacKeith Press, 1995.

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Neurobehavioral and perceptual dysfunction in learning disabled children. Lewiston, NY: C.J. Hogrefe, 1985.

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Virgilio, Gallai, ed. Maturation of the CNS and evoked potentials: Proceedings of the International Congress on Maturation of the Central Nervous System and Clinical Applications of Cerebral Evoked Potentials in Children, Perugia, 21-24 May 1986. Amsterdam: Excerpta Medica, 1986.

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Catherine, Bagwell y Erkulwater Jennifer L, eds. Medicating children: ADHD and pediatric mental health. Cambridge, Mass: Harvard University Press, 2008.

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Conference on Brain and Behavior in Pediatric HIV Infection (1989 New York, N.Y.). Brain in pediatric AIDS: Proceedings of the Conference on Brain and Behavior in Pediatric HIV Infection, New York, N.Y., July 24-25, 1989. Editado por Kozlowski Piotr B. 1950-. Basel, Switzerland: Karger, 1990.

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Current issues in clinical neurovirology: Pathogenesis, diagnosis and treatment. Philadelphia, Pa: Saunders, 2008.

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Catherine, Mollica y Maruff Paul, eds. Cognitive impairment in children with ADHD. Hauppauge, N.Y: Nova Science, 2010.

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Handbook of learning disabilities: A multisystem approach. Boston: Allyn and Bacon, 1990.

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Cruz, Andrea T. y Jeffrey R. Starke. Central Nervous System Tuberculosis. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0154.

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Mycobacterium tuberculosis is a common cause of bacterial meningitis in areas with high HIV prevalence and its diagnosis often is delayed in industrialized nations. Children (particularly infants) and immunocompromised persons are at higher risk of developing TB meningitis. Lymphocytic meningitis, high CSF protein, and (in children) frequently an abnormal chest radiograph should raise clinician index of suspicion for TB meningitis. Neuroimaging may show hydrocephalus, basilar leptomeningeal enhancement, ischemia, and/or tuberculomas. Prompt recognition and initiation of antituberculous antibiotics and corticosteroids can decrease morbidity and mortality.

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Bodman, Alexa y Walter A. Hall. "Meningitis and Meningoencephalitis". En Fungal Infections of the Central Nervous System, 245–51. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-06088-6_17.

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Malhotra, Hardeep Singh y Ravindra K. Garg. "Vascular Complications of Tuberculous Meningitis". En Tuberculosis of the Central Nervous System, 139–55. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-50712-5_12.

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Schmutzhard, Erich, Ulrich Roelcke y Thomas P. Bleck. "Tuberculous Meningitis and Central Nervous System Tuberculosis". En Neurocritical Care, 398–406. Berlin, Heidelberg: Springer Berlin Heidelberg, 1994. http://dx.doi.org/10.1007/978-3-642-87602-8_37.

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Jain, Amita. "Methods of Microbiological Confirmation in Tuberculous Meningitis". En Tuberculosis of the Central Nervous System, 375–88. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-50712-5_26.

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Figaji, Anthony, Graham Fieggen y Ursula Rohlwink. "Hydrocephalus Surgery in Childhood Tuberculous Meningitis with Hydrocephalus". En Tuberculosis of the Central Nervous System, 419–28. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-50712-5_29.

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Bloom, H. J. G. "Tumours of the Central Nervous System". En Cancer in Children, 197–222. Berlin, Heidelberg: Springer Berlin Heidelberg, 1986. http://dx.doi.org/10.1007/978-3-642-96889-1_20.

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Tait, D. M., C. C. Bailey y M. M. Cameron. "Tumours of the Central Nervous System". En Cancer in Children, 184–206. Berlin, Heidelberg: Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-84722-6_17.

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Parker, Whitney E., Shahiba Q. Ogilvie, Lily McLaughlin y Mark M. Souweidane. "Management of Solid Tumor CNS Metastases in Children". En Central Nervous System Metastases, 259–68. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-42958-4_18.

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Yadav, Y. R., Nishtha Yadav, Vijay Parihar, Shailendra Ratre y Jitin Bajaj. "Role of Endoscopic Third Ventriculostomy in Tuberculous Meningitis with Hydrocephalus". En Tuberculosis of the Central Nervous System, 429–46. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-50712-5_30.

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Tlili-Graiess, Kalthoum, Nadia Mama-Larbi, Nadine Girard y Charles Raybaud. "Central Nervous System Vasculitis in Children". En Systemic Vasculitis, 383–412. Berlin, Heidelberg: Springer Berlin Heidelberg, 2011. http://dx.doi.org/10.1007/174_2011_354.

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Actas de conferencias sobre el tema "Central nervous system Meningitis in children"

Saliou, G., M. Eyries, M. Iacobucci, J. Knebel, M. Wail, F. Coulet, A. Ozanne y F. Soubrier. "Clinical and Molecular Findings in a Cohort of Children with Central Nervous System Arteriovenous Fistulas". En Joint Annual Meeting 2017: Swiss Society of Neurosurgery, Swiss Society of Neuroradiology. Georg Thieme Verlag KG, 2017. http://dx.doi.org/10.1055/s-0037-1603839.

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Elmoneim, Abeer Abd, Ahlam Eladawy, Mona Abu Elkasem y Soumaya Hadhood. "Abstract 4910: Neurocognitive effects of central nervous system directed chemotherapy in Non Hodgkin Lymphoma diseased children". En Proceedings: AACR Annual Meeting 2019; March 29-April 3, 2019; Atlanta, GA. American Association for Cancer Research, 2019. http://dx.doi.org/10.1158/1538-7445.sabcs18-4910.

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Rayamajhi, A. y S. Sharma. "G440(P) Validation of world health organization definition of acute encephalitis syndrome with central nervous system infection in nepali children". En Royal College of Paediatrics and Child Health, Abstracts of the RCPCH Conference–Online, 25 September 2020–13 November 2020. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2020. http://dx.doi.org/10.1136/archdischild-2020-rcpch.381.

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Shvaikova, Irina N. "Of the application a vector-modeling and visual diagnostic images in the system of monitoring and diagnostics of pathology of the central nervous system at children". En EUROCON 2007 - The International Conference on "Computer as a Tool". IEEE, 2007. http://dx.doi.org/10.1109/eurcon.2007.4400525.

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Lefrere, J. J., D. Vittecoq, D. Gozin y J. Modai. "CIRCULATING ANTICOAGULANT IN AIDS". En XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644859.

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The frequency of a circulating anticoagulant has been reported to be high in AIDS, in particular in case of Pneumocystic carinii pneumonia (Pep). Twenty-five non-hemophiliac patients (23 homosexual males,1 drug addict, 1 tranfused) with AIDS were followed over a six month period. Mean age was 32 (21-42). All patients had a markedly decreased T4/T8 ratio (mean 0.12), a low absolute T4 level (mean : 155/mm3), an elevated total serum immunoglobulins level.Activated partial thromboplastin time (APTT), prothrombintime and thrombin time were measured once a week during hospitalisation. A prolonged APTT (more than 10 seconds as compared to controls) with normal prothrombin time and thrombin time was found only once in 11patients and in two or more occasions in two others.No specific factor level of intrinsic pathway wasfound low enough to explain a prolonged APTT.Evidenceofcirculating anticoagulant (failure to correct aprolonged APTT by equal mixure of normal plasma and patient plasma) was found in all these 13 patients.Nothrombotic or haemorraghic manifestations occured.AIDS manifestations were 2 Pep.1 cytomegalovirus retinitis. 2 Kaposi's sarcomas, 1 Hodgkin's disease, 2 mycobacterium avium intracellulare pulmonary infection, 4 central nervous system toxoplasmosis, 1 Cryptococcus meningitis. Amongst the 12 patients with normal APTT,3_Pcp, 2 cytomegalovirus retinitis. 2 Kaposi's sarcomas, 2 central nervous system toxoplasmosis, 1 unexplained fever, and 2 oesophagus candidiasis were diagnosed. A transiently prolonged APTT associated to a circulating inhibitor seems to be common in AIDS. Weobserved this anomaly in 52 % (13/25). In our five cases of Pcp, 3 had normal APTT. During other opportunistic infections, the circulating inhibitor was found.The similar complications seen in two groups suggest that a circulating anticoagulant is not specifically associated to any opportunistic infection and any malignancybut appearr independently from these circumstances.

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Khatua, Soumen, Vidya Gopalakrishnan, Laurence Cooper, Dean Lee, David I. Sandberg, Michael Rytting, Jason J. Johnson et al. "Abstract CT033: Phase I study of intraventricular infusions of autologous exvivo expanded NK cells in children with recurrent/refractory malignant posterior fossa tumors of the central nervous system". En Proceedings: AACR Annual Meeting 2017; April 1-5, 2017; Washington, DC. American Association for Cancer Research, 2017. http://dx.doi.org/10.1158/1538-7445.am2017-ct033.

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Khatua, Soumen, Dean Lee, Laurence Cooper, Judy Moyes, David Sandberg, Zsila Sadighi, Heather Meador et al. "Abstract CT216: Phase I study of intraventricular infusions of autologous ex vivo expanded NK cells in children with recurrent/refractory malignant posterior fossa tumors of the central nervous system". En Proceedings: AACR Annual Meeting 2019; March 29-April 3, 2019; Atlanta, GA. American Association for Cancer Research, 2019. http://dx.doi.org/10.1158/1538-7445.sabcs18-ct216.

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Hood, R. Lyle, Tobias Ecker, John Rossmeisl, John Robertson y Christopher G. Rylander. "Improving Convection-Enhanced Delivery Through Photothermal Augmentation of Fluid Dispersal". En ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80720.

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Malignant tumors of the central nervous system are the third leading cause of cancer-related deaths in adolescents and adults between the ages of 15 and 34; in children, brain tumors are the leading cause of cancer death. Convection-enhanced delivery (CED) has emerged as a promising method for the transport of high concentrations of chemotherapeutic macromolecules to brain tumors. CED is a minimally-invasive surgical procedure wherein a stereotactically-guided small-caliber catheter is inserted into the brain parenchyma, to a tumor site, for low flowrate infusion of chemotherapy [1]. This direct-delivery method bypasses obstacles to systemic chemotherapy caused by the selective impermeability of the blood-brain barrier. Although preliminary studies were favorable, CED recently failed Phase III FDA trials because clinical goals for tumor regression were not met [2]. This was primarily attributed to insufficient diffuse delivery of the drug throughout tumor masses and their surrounding margins.

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