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Flag Raising Pediatric Hydrocephalus Awareness September 2, 2020

I am visiting Gandhamardan Hills since year 1990 for Ethnobotanical surveys and collected information worth several TBs in these years. The present series is an effort to bring all aspects of Biodiversity rich Gandhamardan Hills among world community. For details please visit pankajoudhia.com Related References Oudhia, P. (2014). Medicinal Rice Laicha with Red, Brown and Black Rice based Traditional Herbal Formulations (Gandhamardan Hills Series) for Adrenocortical carcinoma . Medicinal Rice Formulations (1990-2014) in Encyclopedia of Tribal Medicines by Pankaj Oudhia at pankajoudhia.com Oudhia, P. (2014). Medicinal Rice Laicha with Red, Brown and Black Rice based Traditional Herbal Formulations (Gandhamardan Hills Series) for Adrenoleukodystrophy. Medicinal Rice Formulations (1990-2014) in Encyclopedia of Tribal Medicines by Pankaj Oudhia at pankajoudhia.com Oudhia, P. (2014). Medicinal Rice Laicha with Red, Brown and Black Rice based Traditional Herbal Formulations (Gandhamardan Hills Series) for Adult onset agammaglobulinemia . Medicinal Rice Formulations (1990-2014) in Encyclopedia of Tribal Medicines by Pankaj Oudhia at pankajoudhia.com Oudhia, P. (2014). Medicinal Rice Laicha with Red, Brown and Black Rice based Traditional Herbal Formulations (Gandhamardan Hills Series) for Age-associated memory impairment (AAMI) . Medicinal Rice Formulations (1990-2014) in Encyclopedia of Tribal Medicines by Pankaj Oudhia at pankajoudhia.com Oudhia, P. (2014). Medicinal Rice Laicha with Red, Brown and Black Rice based Traditional Herbal Formulations (Gandhamardan Hills Series) for Age-related macular degeneration . Medicinal Rice Formulations (1990-2014) in Encyclopedia of Tribal Medicines by Pankaj Oudhia at pankajoudhia.com Oudhia, P. (2014). Medicinal Rice Laicha with Red, Brown and Black Rice based Traditional Herbal Formulations (Gandhamardan Hills Series) for Aggressive fibromatosis . Medicinal Rice Formulations (1990-2014) in Encyclopedia of Tribal Medicines by Pankaj Oudhia at pankajoudhia.com

218 pages, 1 unnumbered leaf ; (8vo)

The Greater Chattanooga Area Hydrocephalus Association Walk will take place October 27th in Coolidge Park. The 5K walk will begin at 11:00 AM. Proceeds will benefit the Hydrocephalus Association to promote support, education and advocacy for people touched with hydrocephalus. Around and About is a production of WUTC in Chattanooga.

"Hydrocephalus Bizarre Pathology" - альбом Xatar, записанный в 2012 году. Список композиций: 1. Пролежни шунтирования в охвате окружном блещут менингоэнцефалитом - 08:32 2. Вентрикулярная пункция желудочков ануса - 13:32 3. Эндоскопическая вентрикулоцистерностомия дна головного мозга - 8:05 4. Детский невропатолог пророчит нейросонографией и вещает - 10:02 5. Обтурация субарахноидального пространства. Мой ветвистый куст потух - 5:56 6. Черепномозговые нервы попахивают вытянутыми очеллами - 13:40 http://xatarov.livejournal.com/

Kislak Center for Special Collections, Rare Books and Manuscripts, 378.748 POM 4.20. Dissertation submitted to the School of Medicine at the University of Pennsylvania. For item on the University of Pennsylvania website see: go to Colenda

Kislak Center for Special Collections, Rare Books and Manuscripts, 378.748 POM 4.20. Dissertation submitted to the School of Medicine at the University of Pennsylvania. For item on the University of Pennsylvania website see: go to Colenda

Kislak Center for Special Collections, Rare Books and Manuscripts, 378.748 POM 4.20. Dissertation submitted to the School of Medicine at the University of Pennsylvania. For item on the University of Pennsylvania website see: go to Colenda

Kislak Center for Special Collections, Rare Books and Manuscripts, 378.748 POM 4.20. Dissertation submitted to the School of Medicine at the University of Pennsylvania. For item on the University of Pennsylvania website see: go to Colenda

This article is from BMC Infectious Diseases , volume 13 . Abstract Background: Community-acquired bacterial meningitis (CABM) continues to have a high mortality rate and often results in severe sequelae among survivors. Lately, an increased effort has been focused on describing the neurological complications of meningitis including hydrocephalus. To aid in this field of research we set out to ascertain the risk and outcome of hydrocephalus in patients with community-acquired bacterial meningitis (CABM) in North Denmark Region. Methods: We conducted a retrospective population-based cohort study of CABM cases above 14 years of age. Cases diagnosed during a 13-year period, 1998 through 2010, were identified in a laboratory register and data were acquired through patient records. Cases not confirmed by culture met other strict inclusion criteria. The diagnosis of hydrocephalus relied upon the radiologists’ reports on cranial imaging. Outcome was graded according to the Glasgow Outcome Scale at discharge from the primary admission. Long-term sequelae were based upon any subsequent hospital contacts until the end of 2011. Results: Hydrocephalus was diagnosed in five of 165 episodes (3%) and all were classified as communicating. Only 120 patients had cranial imaging done and in this group the rate was 4.2%. In three cases hydrocephalus was present at admission, while two cases were diagnosed on days 44 and 99, respectively, due to altered mental status. The aetiology was either Eschericia coli (n = 2) or Streptococcus pneumoniae (n = 3). Case fatality was 60% among cases with hydrocephalus and 17% among other cases. Case fatality was similar irrespective of whether patients had a cranial CT or not. Conclusions: Hydrocephalus was diagnosed in 3% of adolescent and adult cases with CABM and had a high case fatality rate in spite of specialised medical care and neurosurgical interventions. Our findings are comparable with a recent Dutch national prospective study.

Protocol for a scoping review

Protocol for a scoping review

The incidence of sepsis causing meningitis is a common finding seen in neonates. Meningitis, if not diagnosed early and intervened on time with adequate amount and duration of antibiotics can lead to catastrophic complications in the neonate, mainly leading to a communication hydrocephalus

The centricular catheter comprises a multiplicity of inlet microtubules. Each microtubule has both a large opening at its inlet end and a multiplicity of microscopic openings along its lateral surfaces. The microtubules are perforated by an ion beam sputter etch technique. The holes are etched in each microtubule by directing an ion beam through an electro formed mesh mask producing perforations having diameters ranging from about 14 microns to about 150 microns. This structure assures a reliable means for shunting cerebrospinal fluid from the cerebral ventricles to selected areas of the body.

The centricular catheter comprises a multiplicity of inlet microtubules. Each microtubule has both a large opening at its inlet end and a multiplicity of microscopic openings along its lateral surfaces. The microtubules are perforated by an ion beam sputter etch technique. The holes are etched in each microtubule by directing an ion beam through an electro formed mesh mask producing perforations having diameters ranging from about 14 microns to about 150 microns. This structure assures a reliable means for shunting cerebrospinal fluid from the cerebral ventricles to selected areas of the body.

label :  Regurgitated Stoma Stew Productions CATALOG NUMBER : NONE FORMAT : CDR L

label :  Regurgitated Stoma Stew Productions CATALOG NUMBER : NONE FORMAT : CDR L

Kislak Center for Special Collections, Rare Books and Manuscripts, 378.748 POM 47.20. Dissertation submitted to the School of Medicine at the University of Pennsylvania. For item on the University of Pennsylvania website see: go to Colenda

This article is from Journal of Medical Case Reports , volume 7 . Abstract Introduction: Hydrocephalus is very uncommon in neurosarcoidosis. To date, there have been only five reported cases of hydrocephalus occurring as the first manifestation of neurosarcoidosis. Such a presentation in a previously healthy patient is challenging to diagnose. Case presentation: A 31-year-old Japanese man who had no relevant past history other than sinusitis was admitted to our institution complaining of low-grade fever and mild headache. He was alert and neurologically intact. No respiratory symptoms were observed. Laboratory examination revealed mild elevation of erythrocyte sedimentation rate and serum CD4/CD8 ratio. Serum angiotensin-converting enzyme level was in the normal range. His cerebrospinal fluid showed mild pleocytosis and increased protein level. A chest X-ray revealed bihilar lymphadenopathy with normal lung parenchyma. Computed tomography of his head showed remarkable hydrocephalus with dilatation of all ventricles, particularly the fourth. Gadolinium-enhanced magnetic resonance imaging demonstrated leptomeningeal millet seed-like enhancement and multiple small enhancing lesions along the Virchow–Robin spaces. These findings strongly suggested a chronic inflammatory disease such as neurosarcoidosis. To treat the hydrocephalus, a ventriculoperitoneal shunt was inserted. The postoperative course was satisfactory. After surgery, nasal and skin biopsies were performed and pathological analysis revealed non-caseating granulomas consistent with sarcoidosis. The findings of gallium scintigraphy also supported the diagnosis of sarcoidosis. We obtained the definitive diagnosis of sarcoidosis 3 weeks after admission from the pathological findings by the nasal and skin biopsies, and corticosteroid therapy was started after that. Conclusion: We present a rare case of neurosarcoidosis manifesting as acute hydrocephalus with dilatation of all ventricles, particularly the fourth. As hydrocephalus due to neurosarcoidosis has high morbidity and mortality, early diagnosis and proper treatment are particularly important.

This article is from Fluids and Barriers of the CNS , volume 9 . Abstract Background: A new adjustable valve, the Codman CertasTM valve for treatment of hydrocephalus was introduced into clinical practice in January 2011. It has 8 different settings with an opening pressure varying from 36 to over 400 mm H2O at a flow rate of 20 mL/h. The 8th setting is designed to provide a "virtual off" function. The objective of this report is to describe the initial clinical experience with the CertasTM valve and evaluate clinical usage with the main focus on the portable adjustment device - Therapeutic Management System (TMS), the “virtual off” setting and compatibility with magnetic resonance imaging (MRI). Findings: Forty-two patients with hydrocephalus from different etiologies were treated with the CertasTM adjustable shunt system. Data regarding implantation procedures, the use of the TMS system, x-ray imaging, and MRI procedures were recorded prospectively. All patients had clinical follow-up at four weeks after implantation and every three months until a stable clinical condition was obtained.The mean time for follow-up was 8.6 months (1–16.6). Seventy-one adjustments were performed with the TMS, 12 were problematic. Twenty-nine MRI procedures were performed and did not cause accidental resetting. Five patients were treated with the "virtual off" function for a period. Conclusions: We found the CertasTM valve valuable in the treatment of hydrocephalus, usability of the TMS was high because it is small and portable, but in some cases we experienced adjustment problems with the first procedures performed by a surgeon, indicating that there is a learning curve. The "virtual off" function provided a possibility of treating over-drainage without the need for shunt ligation or other invasive procedures.

Kislak Center for Special Collections, Rare Books and Manuscripts, 378.748 POM 4.12. Dissertation submitted to the School of Medicine at the University of Pennsylvania. For item on the University of Pennsylvania website see: go to Colenda

https://anonim-noise.bandcamp.com/album/demo-2020-congenital-centrofacial-dysgenesia

https://anonim-noise.bandcamp.com/album/demo-2020-congenital-centrofacial-dysgenesia

We will conduct a systematic review of the literature, starting from a literature search in the following electronic databases. We will include original peer-reviewed articles measuring patient-reported HRQoL in iNPH patients. We will evaluate domains of QoL that improved (e.g. physical activities, urinary symptoms), positive predictors of improved quality of life, clinical aspects, severity of symptoms.

Idiopathic normal pressure hydrocephalus (iNPH) is a clinical syndrome prevalent in up to 2.9% of the elderly, characterized by gait disturbance, cognitive impairment, and urinary disorders. The diagnosis of iNPH is challenging due to its overlap with other neurological conditions such as Parkinson's and Alzheimer's diseases. While neuroradiological characteristics of iNPH are well-documented, there is a lack of standardized diagnostic criteria, making it difficult to identify patients who would benefit from VP shunt surgery. Previous studies have suggested that the duration of symptoms before surgery might influence the surgical outcome, but conclusions remain inconsistent. Given the diagnostic challenges and the variability in symptom progression, this review aims to clarify whether the duration of preoperative symptoms can serve as a prognostic marker for surgical improvement. This systematic review highlights the effectiveness of VP shunting in improving clinical outcomes for iNPH patients, regardless of symptom duration. However, the variability in study designs and findings underscores the need for more standardized and long-term studies to better understand the prognostic value of symptom duration in iNPH treatment.

This article is from PLoS ONE , volume 9 . Abstract Background: The significance of amyloid precursor protein (APP) and neuroinflammation in idiopathic normal pressure hydrocephalus (iNPH) and Alzheimer's disease (AD) is unknown. Objective: To investigate the role of soluble APP (sAPP) and amyloid beta (Aβ) isoforms, proinflammatory cytokines, and biomarkers of neuronal damage in the cerebrospinal fluid (CSF) in relation to brain biopsy Aβ and hyperphosphorylated tau (HPτ) findings. Methods: The study population comprised 102 patients with possible NPH with cortical brain biopsies, ventricular and lumbar CSF samples, and DNA available. The final clinical diagnoses were: 53 iNPH (91% shunt-responders), 26 AD (10 mixed iNPH+AD), and 23 others. Biopsy samples were immunostained against Aβ and HPτ. CSF levels of AD-related biomarkers (Aβ42, p-tau, total tau), non-AD-related Aβ isoforms (Aβ38, Aβ40), sAPP isoforms (sAPPα, sAPPβ), proinflammatory cytokines (several interleukins (IL), interferon-gamma, monocyte chemoattractant protein-1, tumor necrosis factor-alpha) and biomarkers of neuronal damage (neurofilament light and myelin basic protein) were measured. All patients were genotyped for APOE. Results: Lumbar CSF levels of sAPPα were lower (p

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This paper is in the public domain in USA. Metadata comes from the CrossRef API, see full record in the source URL below.

This article is from Fluids and Barriers of the CNS , volume 9 . Abstract Background: The cerebrospinal fluid (CSF) tap test (TT) has been regarded as an important test for the prediction of shunt effectiveness in patients with suspected idiopathic normal pressure hydrocephalus (iNPH). Although its specificity and sensitivity are reportedly high, there remains some disagreement over this point. Herein, the TT as a test for predicting shunt effectiveness was investigated in our multicenter prospective study named SINPHONI and strategies to increase its predictability were examined. Methods: One hundred suspected iNPH patients with the following entry criteria were enrolled in the study: (1) 60 to 85 years old, (2) one or more of the NPH triad signs, (3) ventriculomegaly (Evans index > 0.3), (4) high convexity tightness in coronal-section MRI, and (5) no antecedent disorders. Changes in NPH triad symptoms were assessed using the iNPH grading scale and other measures before and after removal of 30 ml lumbar CSF. A positive response to TT was pre-defined by specific improvements on the grading and other scales. A ventriculoperitoneal shunt was performed with a programmable valve. The sensitivity and specificity of the TT was calculated with a contingency table. A decision tree analysis was performed to increase the predictability of the TT. Results: Among 100 patients, 80 were shunt responders. A statistically-significant variable between shunt responders and non-responders was CSF pressure. The changes in single variables in the iNPH grading scale after TT showed high specificity with low sensitivity. In contrast, change of the total score in the iNPH grading scale showed a relatively high sensitivity of 71.3% with specificity of 65%. A decision tree analysis revealed that using the iNPH grading scale total score and pre-shunt CSF pressure ≥ 15 cmH20, sensitivity increased to 82.5%, without a decrease in specificity. Conclusions: The sensitivity and specificity of the TT for predicting shunt responsiveness were optimum when improvement on any iNPH grading scale was combined with CSF pressure ≥ 15 cmH20. To increase the sensitivity of the TT, further effort is necessary. Trial Registration: This study is registered with ClinicalTrials.gov, with the number NCT00221091.

This article is from Fluids and Barriers of the CNS , volume 11 . Abstract I was honored to be awarded the Casey Holter Essay Prize in 2013 by the Society for Research into Hydrocephalus and Spina Bifida. The purpose of the prize is to encourage original thinking in a way to improve the care of individuals with spina bifida and hydrocephalus. Having kept this purpose in mind, I have chosen the title: Neural stem cells, are they the hope of a better life for patients with fetal-onset hydrocephalus? The aim is to review and discuss some of the most recent and relevant findings regarding mechanisms leading to both hydrocephalus and abnormal neuro/gliogenesis. By looking at these outcome studies, it is hoped that we will recognize the potential use of neural stem cells in the treatment of hydrocephalus, and so prevent the disease or diminish/repair the associated brain damage.

A New Trocart for the Puncture in the Hydrocephalus, and for Other Evacuations, Which are Necessary to Be Made at Different Times; By M. le Cat, F. R. S. Translated from the French by Tho. Stack, M. D. F. R. S Stack, T.; Cat, M Philosophical Transactions (1683-1775). 1753-01-01. 47:267–272

This article is from Surgical Neurology International , volume 3 . Abstract Background:: Between 2005 and 2010, we treated patients with hydrocephalus related to cerebral metastases, who were not good candidates for surgical resection by either endoscopic third ventriculostomy (ETV) or ventriculoperitoneal shunting (VPS). Patients were excluded from ETV if they had a clinical history suggestive of non-obstructive hydrocephalus, including: (1) history of infection or ventricular hemorrhage and (2) leptomeningeal carcinomatosis. The rest of the patients were treated with VPS. Methods:: We analyzed the clinical outcome of these patient cohorts, to determine whether the efficacy of VPS was compromised due to a history of infection, ventricular hemorrhage, or leptomeningeal carcinomatosis, and compared these results to those patients who underwent ETV. Results:: Sixteen patients were treated with ETV and 36 patients were treated with VPS. The overall efficacy of symptomatic palliation was comparable in the ETV and VPS patients (ETV = 69%, VPS = 75%). In both groups, patients with more severe hydrocephalic symptoms such as nausea, vomiting, and lethargy were more likely to benefit from the procedure. The overall complication rate for the two groups was comparable (ETV = 12.6%, VPS = 19.4%), although the spectrum of complications differed. The overall survival, initial Karnofsky performance status (KPS), and three-month KPS, were similarly comparable (median survival: ETV 3 months, VPS 5.5 months; initial KPS: ETV = 66 ± 7, VPS = 69 ± 12; 3 months KPS: ETV = 86 ± 7, KPS = 84 ± 12). Conclusion:: VPS remains a reasonable option for poor RPA grade metastasis patients with hydrocephalus, even in the setting of a previous infection, hemorrhage, or in those with leptomeningeal disease. Optimal treatment of this population will involve the judicious consideration of the relative merits of VPS and ETV.

Book Source: Digital Library of India Item 2015.145810 dc.contributor.author: Russell Dorothy S. dc.date.accessioned: 2015-07-04T05:56:43Z dc.date.available: 2015-07-04T05:56:43Z dc.date.digitalpublicationdate: 2012-10-00 dc.date.citation: 1949 dc.identifier.barcode: 99999990299416 dc.identifier.origpath: /data9/upload/0297/348 dc.identifier.copyno: 1 dc.identifier.uri: http://www.new.dli.ernet.in/handle/2015/145810 dc.description.scanningcentre: Banasthali University dc.description.main: 1 dc.description.tagged: 0 dc.description.totalpages: 157 dc.format.mimetype: application/pdf dc.language.iso: English dc.publisher.digitalrepublisher: Digital Library Of India dc.publisher: Great Britain In Prented dc.rights: Out_of_copyright dc.source.library: Rabindra Nath Tagore Medical College, Udaipur dc.subject.classification: Medical dc.title: Odservations On The Pathology Of Hydrocephalus

Kislak Center for Special Collections, Rare Books and Manuscripts, 378.748 POM 4.10. Dissertation submitted to the School of Medicine at the University of Pennsylvania. For item on the University of Pennsylvania website see: go to Colenda

This article is from Surgical Neurology International , volume 4 . Abstract Background:: Modern ventriculoperitoneal shunts (VPS) are programmable, which enables clinicians to adjust valve-pressure according to their patients’ individual needs. The aim of this retrospective analysis is to evaluate indications for valve-pressure adjustments in idiopathic normal pressure hydrocephalus (iNPH). Methods:: Patients operated between 2004 and 2011 diagnosed with iNPH were included. Kiefer-Scale was used to classify each patient. Follow-up exams were conducted 3, 6, and 12 months after shunt implantation and yearly thereafter. Initial valve-pressure was 100 or 70 mmH2O. Planned reductions of the valve-pressure to 70 and 50 mmH2O, respectively, were carried out and reactive adjustment of the valve-pressure to avoid over- and under-drainage were indicated. Results:: A total of 52 patients were provided with a Medos-Hakim valveCodman® with a Miethke shunt-assistantAesculap® and 111 patients with a Miethke-proGAVAesculap®. 180 reductions of the valve-pressure took place (65% reactive, 35% planned). Most patients (89%) needed one or two adjustments of their valve-pressures for optimal results. In 41%, an improvement of the symptoms was observed. Gait disorder was improved most often after valve-pressure adjustments (32%). 18 times an elevation of valve-pressure was necessary because of headaches, vertigo, or the development of subdural hygroma. Optimal valve-pressure for most patients was around 50 mmH2O (36%). Conclusion:: The goal of shunt therapy in iNPH should usually be valve-pressure settings between 30 and 70 mmH2O. Reactive adjustments of the valve-pressure are useful for therapy of over- and underdrainage symptoms. Planned reductions of the valve opening pressure are effective even if postoperative results are already satisfactory.

This article is from Annals of Indian Academy of Neurology , volume 17 . Abstract None

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This paper is in the public domain in USA. Metadata comes from the CrossRef API, see full record in the source URL below.

Introduction: Hydrocephalus is defined by the increase in cerebrospinal fluid (CSF), the result of dilation of the cerebral ventricles resulting from this accumulation. Spasticity in the upper and lower limbs, postural deviations, irritability, changes in fine and thick motor coordination, personality changes and developmental retardation are some of the signs and symptoms. Physiotherapy plays an essential role in the neuropsychomotor development of these patients. Objective: Understand the performance and benefits of physiotherapy in the early treatment of patients diagnosed with hydrocephalus. Material and Method: The methodology used was an integrative bibliographic review of qualitative character, which aims to demonstrate the contribution of physiotherapy in early performance in patients with hydrocephalus. Conclusion: Physiotherapy plays an important role in the development of patients with hydrocephalus, softening motor sequelae and improving the quality of life of patients.

Kislak Center for Special Collections, Rare Books and Manuscripts, 378.748 POM 4.14. Dissertation submitted to the School of Medicine at the University of Pennsylvania. For item on the University of Pennsylvania website see: go to Colenda

Septenary/Octonary/Tertiary/Quinary/Dena­ry Ingredients of Important Traditional Herbal Formulations from Pankaj Oudhia's Medicinal Plant Database Medicinal Rice of India with reference to Healing Flora of Chhattisgarh, Andhra Pradesh, Assam, Karnataka, Kerala, Gujarat, Jharkhand, Madhya Pradesh, Maharashtra, Meghalaya, Sikkim, Arunachal Pradesh, Orissa, Rajasthan, Tamilnadu, Punjab, Haryana, West Bengal, Uttarakhand and Uttar Pradesh. - This video is a part of Compilation of Pankaj Oudhia's Research Works at Indira Gandhi Agricultural University, Raipur, India (1990-2001), For details please visit http://www.pankajoudhia.com Related Research Documents Oudhia, P. (2013). Red Rice based Traditional Herbal Formulations for Cancer of the skin . Medicinal Rice Formulations (1990-2013) in Pankaj Oudhia's Medicinal Plant Database at pankajoudhia.com Oudhia, P. (2013). Red Rice based Traditional Herbal Formulations for Cancer of the small intestine . Medicinal Rice Formulations (1990-2013) in Pankaj Oudhia's Medicinal Plant Database at pankajoudhia.com Oudhia, P. (2013). Red Rice based Traditional Herbal Formulations for Cancer of the stomach . Medicinal Rice Formulations (1990-2013) in Pankaj Oudhia's Medicinal Plant Database at pankajoudhia.com Oudhia, P. (2013). Red Rice based Traditional Herbal Formulations for Cancer of the testes . Medicinal Rice Formulations (1990-2013) in Pankaj Oudhia's Medicinal Plant Database at pankajoudhia.com Oudhia, P. (2013). Red Rice based Traditional Herbal Formulations for Cancer of the throat . Medicinal Rice Formulations (1990-2013) in Pankaj Oudhia's Medicinal Plant Database at pankajoudhia.com Oudhia, P. (2013). Red Rice based Traditional Herbal Formulations for Cancer of the thyroid . Medicinal Rice Formulations (1990-2013) in Pankaj Oudhia's Medicinal Plant Database at pankajoudhia.com

This paper is in the public domain in USA. Metadata comes from the CrossRef API, see full record in the source URL below.

This paper is in the public domain in USA. Metadata comes from the CrossRef API, see full record in the source URL below.

This article is from Journal of Neurology, Neurosurgery, and Psychiatry , volume 84 . Abstract Objectives: To investigate whether gravitational valves reduce the risk of overdrainage complications compared with programmable valves in ventriculoperitoneal (VP) shunt surgery for idiopathic normal pressure hydrocephalus (iNPH). Background: Patients with iNPH may benefit from VP shunting but are prone to overdrainage complications during posture changes. Gravitational valves with tantalum balls are considered to reduce the risk of overdrainage but their clinical effectiveness is unclear. Methods: We conducted a pragmatic, randomised, multicentre trial comparing gravitational with non-gravitational programmable valves in patients with iNPH eligible for VP shunting. The primary endpoint was any clinical or radiological sign (headache, nausea, vomiting, subdural effusion or slit ventricle) of overdrainage 6 months after randomisation. We also assessed disease specific instruments (Black and Kiefer Scale) and Physical and Mental Component Scores of the Short Form 12 (SF-12) generic health questionnaire. Results: We enrolled 145 patients (mean (SD) age 71.9 (6.9) years), 137 of whom were available for endpoint analysis. After 6 months, 29 patients in the standard and five patients in the gravitational shunt group developed overdrainage (risk difference −36%, 95% CI −49% to −23%; p

This article is from Journal of Neurosciences in Rural Practice , volume 4 . Abstract A rare case of a 42-years old man presented with repeated hydrocephalus due to the neurocysticercosis cyst (NCC) in the lateral ventricle. Patient was operated previously 2½ years back for a similar lesion at same site. Both times he was treated endoscopically with removal of the cyst. Interestingly there was no parenchymatous lesion at any stage of follow up. Isolated recurrent intraventricular NCC is a rare condition that has never been reported in the literature.

This article is from Journal of Neurosciences in Rural Practice , volume 4 . Abstract A rare case of a 42-years old man presented with repeated hydrocephalus due to the neurocysticercosis cyst (NCC) in the lateral ventricle. Patient was operated previously 2½ years back for a similar lesion at same site. Both times he was treated endoscopically with removal of the cyst. Interestingly there was no parenchymatous lesion at any stage of follow up. Isolated recurrent intraventricular NCC is a rare condition that has never been reported in the literature.

This article is from Journal of Neurosciences in Rural Practice , volume 4 . Abstract A rare case of a 42-years old man presented with repeated hydrocephalus due to the neurocysticercosis cyst (NCC) in the lateral ventricle. Patient was operated previously 2½ years back for a similar lesion at same site. Both times he was treated endoscopically with removal of the cyst. Interestingly there was no parenchymatous lesion at any stage of follow up. Isolated recurrent intraventricular NCC is a rare condition that has never been reported in the literature.

This article is from Journal of Neurosciences in Rural Practice , volume 4 . Abstract A rare case of a 42-years old man presented with repeated hydrocephalus due to the neurocysticercosis cyst (NCC) in the lateral ventricle. Patient was operated previously 2½ years back for a similar lesion at same site. Both times he was treated endoscopically with removal of the cyst. Interestingly there was no parenchymatous lesion at any stage of follow up. Isolated recurrent intraventricular NCC is a rare condition that has never been reported in the literature.

In this episode, Dr Jeff Pugh and Mitch Wilson, discuss hydrocephalus. After listening to this episode, learners will be able to: - Define the term 'hydrocephalus' and list three mechanisms by which hydrocephalus can develop. - Describe the signs and symptoms of hydrocephalus and describe common diagnostic tests. - Outline the surgical options for the management of hydrocephalus. Running time 16:40

This article is from Journal of Medical Case Reports , volume 7 . Abstract Introduction: Although the brain is a common site of metastasis from lung cancer, pineal region metastasis from lung adenocarcinoma is rare. Most cases of pineal metastases are asymptomatic, and are diagnosed by autopsy. Therefore, the management of pineal region tumors remains controversial. Here, we present a rare case of lung carcinoma presenting with pineal region metastasis and obstructive hydrocephalus as the first manifestation of the lung adenocarcinoma. Case presentation: A 63-year-old Japanese woman was referred to our hospital for treatment of a tumor of the pineal region associated with hydrocephalus. On admission, she was found to have a mass in her right lung on a chest radiograph. During the preoperative investigation, the patient began to show a progressively worsening level of altered consciousness. Therefore, neuroendoscopic surgery was performed as an emergency procedure, which resulted in improvement of the hydrocephalus and diagnosis of adenocarcinoma. A systematic investigation revealed adenocarcinoma of her right lung as the primary lesion. She was treated by a platinum-based chemotherapy regime. Stereotactic radiation to the pineal region was undertaken concurrently. After completion of the chemotherapy, the primary lesion and pineal region metastasis showed good partial response. Conclusion: The prognosis of pineal region metastasis is extremely poor, and only three patients with metastatic pineal region metastasis from lung cancer who were treated by chemotherapy have been reported. We performed neuroendoscopic surgery to obtain resolution of the obstructive hydrocephalus and the definite histological diagnosis. This resulted in improvement of the general condition of the patient, and the patient could be treated by chemotherapy and radiotherapy. We strongly believe that neuroendoscopic surgery was a good option in this case. This case report suggests that in the presence of an isolated pineal region tumor, metastasis should be considered a possible diagnosis, and careful examination for systemic malignant disease will be needed.

1Ivanhoe

By Sir Walter Scott

Follows the fortunes of the son of a noble Saxon family in Norman England as he woos his lady, disobeys his father, and is loved by another. Set in late 12C England and in Palestine with Richard Cœur-de-Lion at the Crusades, it's another ripping historical yarn by Scott. (summary by annise)

2Talisman

By Sir Walter Scott

The Talisman is a gripping tale set near the end of the Third Crusade. King Richard the Lionheart is grievously ill, and all around him the leaders from allied countries plot and scheme to gain personal power, putting the future of the crusade in jeopardy. Sir Kenneth of Scotland finds himself caught up in events, and finds both his honour and his life are now on the line. Can a cure be found for the King? Can Kenneth redeem his honour? – Written by Rowen

3Rob Roy

By Sir Walter Scott

Rob Roy is a historical novel by Walter Scott. It is narrated by Frank Osbaldistone, the son of an English merchant who travels first to the North of England, and subsequently to the Scottish Highlands to collect a debt stolen from his father. On the way he encounters the larger-than-life title character of Rob Roy MacGregor. Though Rob Roy is not the lead character (in fact the narrative does not move to Scotland until half way through the book) his personality and actions are key to the development of the novel. (Summary from Wikipedia)

4Journals of Robert Falcon Scott; Vol 1 of 'Scott's Last Expedition'

By Leonard Huxley and Robert Falcon Scott

Capt. Robert F. Scott's bid to be the leader of the first expedition to reach the South Pole is one of the most famous journeys of all time. What started as a scientific expedition turned out to be an unwilling race against a team lead by R. Admunsen to reach the Pole. The Norwegian flag already stood at the end of the trail when Scott's party reached their target. All the five men of the Scott expedition who took part in the last march to the Pole perished on their way back to safety.<br><br> Robert F. Scott kept a journal throughout the journey, all the way to the tragic end, documenting all aspects of the expedition. The famous last words of the journal were: 'It seems a pity, but I do not think I can write more. For God's sake look after our people.'<br> (Summary by Illiterati)

5Kenilworth

By Sir Walter Scott

An Elizabethan era historical novel by Scotland's master of fiction, Sir Walter Scott. With a cast of historical and created characters, including the Queen herself, Scott presents the sad history and tragic consequences of the secretive marriage of young Amy Robsart and the Earl of Leicester. (Summary by SK)

6Antiquary

By Andrew Lang and Sir Walter Scott

Illegitimacy, false identity, and bankruptcy are the major elements of Sir Walter Scott's 1816 novel, The Antiquary. Set in the period of the French Revolution, the novel's hero, Lovel, struggles to gain repute and the hand of his beloved despite his uncertain parentage. During these pursuits, he befriends the title's antiquary, Johnathan Oldbuck, who finds Lovel a captive audience to his scholarly studies and a tragic likeness to his own disappointments in love. Readers will discover whether Lovel's acts of bravery and courage ultimately earn him the birth and fortunes of a nobleman. (Summary by S. Kovalchik)

7Waverley, Volume 1

By Sir Walter Scott

<i>Waverley</i> is set during the Jacobite Rebellion of 1745, which sought to restore the Stuart dynasty in the person of Charles Edward Stuart (or 'Bonnie Prince Charlie'). It relates the story of a young dreamer and English soldier, Edward Waverley, who was sent to Scotland in 1745. He journeys North from his aristocratic family home, Waverley-Honour, in the south of England first to the Scottish Lowlands and the home of family friend Baron Bradwardine, then into the Highlands and the heart of the 1745 Jacobite uprising and aftermath. (Summary by Wikipedia)

The narrative poems in this collection are written by Sir Walter Scott - the well-known Scottish poet and novelist. Each of these five poems are based loosely upon German ballads: rewritten in flowing English meter. <br></br> * The Chase - a.k.a. The Wild Huntsman - A profligate, noble-born keeper of the royal forest - avidly addicted to the pleasures of the hunt - cruelly uses and mistreats his fellow-men. One day God's messengers come to test him: executing sentence immediately in just proportion to the huntsman's responses.<br></br> * William & Helen - William - long thought dead - unexpectedly returns at midnight from the crusades to marry his betrothed. Helen - relieved at his return - joyfully agree,s after initial misgivings: follows him on horseback into the night. Approaching the church in which they will celebrate their wedding: it is clear to Helen that all is not what it seems. But, with their mutual love strong enough to transcend death itself - what can possibly go wrong?<br></br> * The Fire King - Count Albert never returns from crusade: having being imprisoned by Saracens. Rosalie, his betrothed, swears to leave at once for Lebanon to find him. Rosalie succeeds - but alas, all is changed between them forever: and their parting is death itself.<br></br> * Frederick & Alice - Frederick breaks troth and abandons the beautiful Alice: sending her mad with grief. But Alice contrives to meet her faithless lover once more: beyond the grave.<br></br> * The Erl-King - The Erl-King (or Oak-King) sings for the soul of a human boy: who cringes for dear life within the arms of his father riding home through the dreary wood. But do spirits really have power to charm away the lives of the living?<br></br> (Introduction by Godsend)

Scott's The Bridal of Triermain is a rhymed, romantic, narrative poem which weaves together elements of popular English legend using dramatic themes. <br></br>This beautiful poem celebrates the exploits of a knight errant - Sir Roland De Vaux - as he seeks to rescue (and hopefully espouse) a beautiful maiden, Gyneth. Gyneth is the illegitimate daughter of King Arthur: doomed by Merlin 500 years previously to an enchanted sleep inside a magic castle. The enchantment can only be broken by a rescuer both brave and noble enough to overcome the temptations used successively to distract and overcome him, namely: fear, wealth, pleasure and pride.<br></br>(Introduction by Godsend)

Harold the Dauntless is a rhymed, romantic, narrative-poem by Sir Walter Scott. Written in 1817, it weaves together elements of popular English legends and folklore using dramatic themes.<br><br>The poem recounts the exploits and the personal spiritual journey of a doubtful knight errant - Harold the son of Danish Count Witikind: who seeks to recover his lands and wed a suitable spouse.<br><br>Fire-breathing Harold is as much a stranger to love as he is addicted to dangerous adventure: yet his own confrontations with the spirit-world shake his faith in supposed omnipotence of the traditional Norse pantheon.<br><br>Can a blood-thirsty warrior like Harold ever feel the raptures of love? <br><br>Can a man born to cherish gods of war really wish to exchange them for a God of peace?<br>(Introduction by Godsend)

11Waverley, Volume 2

By Sir Walter Scott

<i>Waverley</i> is set during the Jacobite Rebellion of 1745, which sought to restore the Stuart dynasty in the person of Charles Edward Stuart (or 'Bonnie Prince Charlie'). It relates the story of a young dreamer and English soldier, Edward Waverley, who was sent to Scotland in 1745. He journeys North from his aristocratic family home, Waverley-Honour, in the south of England first to the Scottish Lowlands and the home of family friend Baron Bradwardine, then into the Highlands and the heart of the 1745 Jacobite uprising and aftermath. (Summary by Wikipedia)

In stunning narrative poetry, the story begins during the time when Robert Bruce, Earl of Carrick has been hunted out of Scotland into exile by the English and their allies. Bruce returns over sea from the Island of Rachrin: but is forced to land close to hostile forces at Artonish Castle on the seacoast of Argylshire. Seeking refuge from tempestuous seas, Bruce begs shelter from Ronald, Lord of the Isles: inadvertently on the day of his marriage feast to the beautiful Edith of Lorn.<br><br /> Bruce's very presence is enough to interrupt the nuptials and to break up the festivities: the guests quickly polarise into two armed and equally matched factions: one ready to raise Bruce to the Scottish crown, the other ready to slay him for desecration and murder. The combatants are dispersed with no bloodshed only by the combined offices of Lord Ronald himself, aided by a visiting Abbot: whereupon Bruce quickly removes himself to first the Island of Sky, and then Ayrshire: raising the an army willing to rout the English and re-establish Scottish independence. <br><br /> Bruce begins to win a steady stream of victories as his armies march inevitably towards Bannockburn. There, Bruce confronts Scotland's formidable enemy - led by the son of the Hammer of the Scots: the English outnumbering the Scots by more than two to one. <br><br /> - Can Bruce - the so-called fugitive, traitor, and turn-coat - succeed against the massed might of England?<br> - Will the beautiful Edith choose to side with her blood-relations - who fight for England; or with Lord Ronald, her betrothed - who marches to battle behind Scotland's Bruce? <br /> (Introduction by Godsend)

13Ivanhoe NL

By Sir Walter Scott

Ivanhoe is een historische roman uit 1819 van Sir Walter Scott. Het verhaal speelt ten tijde van het bewind van koning Richard Leeuwenhart en handelt over de smeulende tegenstellingen tussen de Normandiërs en de Saksen in de eeuwen na de Normandische verovering. De historische juistheid van het verhaal werd al meteen na verschijning van het boek in twijfel getrokken en Scott gaf ook toe dat het zeer waarschijnlijk was "dat ik de gebruiken van twee of drie eeuwen heb verward", maar hij troostte zich ermee dat "de fouten van deze aard aan de meeste lezers voorbij zou gaan".

14Lady of the Lake

By Sir Walter Scott

The scene of the following Poem is laid chiefly in the vicinity of Loch Katrine, in the Western Highlands of Perthshire. The time of Action includes Six Days, and the transactions of each Day occupy a Canto. (Summary by William J. Rolfe, ed.)

15Rival Pitchers of Oakdale

By Morgan Scott

Play Ball!!! It's the start of another baseball season at Oakdale Academy. But there is a rivalry brewing between the pitchers. One wants to be a starting pitcher, but he is inconsistent. Another, a new kid from Texas, has been mentored by last year's starter, and is proving to have talent. And don't forget that starting pitcher from last season, he wants to continue to take the rubber for the team. This should prove to be an exciting season for the boys! (Summary by Ann Boulais)

LibriVox volunteers bring you eight readings of End of Harvest, by William Bell Scott. This is the fortnightly poetry project for November 9, 2014.

17Monastery

By Sir Walter Scott

Dame Elspeth is kept in a tower after the death of her husband. The widow of the Baron of Avenel and her daughter seek safety with Elspeth in her tower. Hearing the baroness's deathbed confession, Father Philip notices her Bible. As he carries it to the Lord Abbot, it is taken from him by a White Lady. A sub-prior investigates this story and finds that the Bible is now back in the owner's hands. Later, Elspeth's son sees the White Lady when he snatches the Bible from a flaming altar. Intrigue follows intrigue. Halbert and Sir Piercie Shafton fight, and Halbert flees, leaving Sir Piercie mortally wounded. Shafton, however, recovers only to be accused of murdering Edward's missing brother. Mysie helps Shafton escape from jail. Edward has vowed to become a monk at the urging of the White Lady. After a battle between English and Scottish soldiers against Sir John's troops, Mysie is declared a suitable wife for Sir Piercie. The monks are allowed to keep their monastery. Summary by Bill Boerst, based on Wikipedia

18In the Village of Viger

By Duncan Campbell Scott

These ten superb short stories of Duncan Campbell Scott, published in 1896, portray humorous, farcical, and tragic aspects of life in the fictional Quebec village of Viger. Scott’s tales of the lives and vicissitudes of Viger’s inhabitants include an established milliner who is upset by the appearance of a younger, more popular rival; an innkeeper whose obsession with the Franco-Prussian War drives him mad; and a strange peddler with a carefully guarded secret that is accidentally revealed. <br><br> Duncan Campbell Scott was born in Ottawa, Ontario, in 1862. He entered the civil service in 1879 and remained until his retirement in 1932. Scott was an honored, skilled and popular poet, short-story writer, and essayist. He died in Ottawa in 1947. <br><br> For more information see https://en.wikipedia.org/wiki/Duncan_Campbell_Scott. (Lee Smalley)

An aging minstrel seeks who hospitality at Newark Castle and in recompense tells a tale of a sixteenth-century Border feud. In the poem, Lady Margaret Scott of Buccleuch, the "Flower of Teviot" is beloved by Baron Henry of Cranstown an ally of the Ker Clan, but a deadly feud exists between the two border clans of Scott and Carr/Ker, which has resulted in the recent murder of Lady Margaret's father, Sir Walter Scott of Buccleuch by the Kers on the High Street in Edinburgh. Maragaret's widowed mother – Lady Janet – hates the Ker clan as a result, and is adamant in refusing her consent to any suggestion of marriage between the lovers. Summary by Wikipedia

20Woodstock, or, The Cavalier

By Sir Walter Scott

This novel is set during the English Civil War and the Commonwealth. It is comprised of real events, along with fictional ones. If you are looking for an adventure novel with romance and mystery, please look no further. This is Scott at his finest. - Summary by Stav Nisser.

A fun poem with a great rhythm . - Summary by Stav Nisser

22Black Dwarf

By Sir Walter Scott

The Black Dwarf is the first of the “Tales of My Landlord” series, which also includes The Bride of Lammermoor and The Heart of Midlothian. The third preliminary chapter depicts two horsemen arriving at the Wallace Inn in Gandercleugh, where one of the horsemen relates the tale. The story proper is set on the Scottish borders during the reign of Queen Anne. The Jacobite movement is in its infancy, but the inhabitants of this part of the country have enough to quarrel about without politics inciting them to it. Several families of high and low birth bear no good intentions to each other, and a weird, brooding dwarf, who wishes ill on all of humanity, seems to direct and perpetuate the mayhem from his lonely cottage on Mucklestane Moor. (tbragg)

23Marmion: A Tale of Flodden Field

By Sir Walter Scott

Marmion is an epic poem in six cantos, written in emulation of the ancient Scottish minstrel style which was of such great interest to Scott. Unlike its predecessor, The Lay of the Last Minstrel, this one contains "introductions" to each canto, in the guise of poetic letters which serve the purpose of linking the ancient historical setting with Scott's contemporaneous society - a device which attracted some criticism.<br></br>The story of Lord Marmion and his arch-enemy Harold de Wilton is told with Scott's familiar swirling dark flair, combining a complex tale of intrigue, inconstancy and deception with the historical details of the Battle of Flodden Field, in which the English forces routed those of Scotland, killing the Scottish king. - Summary by Peter Tucker

24Romance of Polar Exploration

By G. Firth Scott

While stories of the Polar explorers and their efforts to reach the Poles have been told again and again, the constant renewal of expeditions adds, every year, fresh incidents to the record, until it may almost be said that the fascination of the frozen regions is as inexhaustible as the list of Polar heroes is illimitable. Nor is the interest confined solely to the achievement of modern explorers. However great the results of their exertions may be, the fact that, in spite of all the advantages conferred by recent scientific discovery and modern appliances, the explorers of to-day have failed to penetrate the uttermost secrets of the worlds of ice, renders more impressively heroic the struggles of the earlier travellers, whose equipment, viewed in comparison with that of modern man, was apparently so inadequate and often inappropriate. <br></br> No series of Polar adventure stories would be complete without a prominent place being given to the earlier explorers, and especially to that British hero, Franklin, whose name is so inseparably associated with the history of Arctic exploration. The account of his daring voyages and of his tragic end, at the moment of victory, has already been given in many a form; but the tale is one which will stand re-telling for generations yet to come. In the present instance it has been of necessity briefly written, but in such a manner as will, it is hoped, without loss of interest, render clear a comparison of the conditions under which he and his brave companions worked and fought to their death, with those that existed for later expeditions and especially the expeditions of Nansen, Peary, and Abruzzi. <br></br> The Antarctic, equally with the Arctic, now commands the attention of man. In the South, as in the North, the British race has again produced explorers who have fought their way into the icy fastnesses. From the time that Captain Cook sailed round the unknown southern ocean, more than a century ago, the British flag has waved in the forefront of the advance. The work which Sir James Ross began, over half a century since, has now been carried farther than ever it was anticipated it could be. By the voyage of the Discovery, the Antarctic continent has been revealed to within five hundred miles of the Pole, and in the gallant exploits of the commander, Captain Robert Scott, there are many who see a repetition of all that made the name of Franklin so immortal. <br></br> The source of the information on which these stories are based (as is frequently mentioned in the text) is the personal narrative of the explorer concerned, where available; and if the interest aroused in any of them requires more to satisfy it than the exigencies of space renders possible in this volume, the attention which will thereby be drawn to the more comprehensive records will stand as a slight acknowledgment of the indebtedness of the writer of these re-told stories to the authors of the original narratives. - Summary by the Preface

25Bride of Lammermoor

By Sir Walter Scott

An historical novel by Sir Walter Scott, part of the Tales of My Landlord series, published anonymously in 1819. Based on a true story, it is set in south-east Scotland and (in this edition) in the reign of Queen Anne, after the 1707 Acts of Union which joined Scotland and England. It tells of a tragic love affair between young Lucy Ashton and Edgar Ravenswood, her family's enemy. Lady Ashton sets out to end their engagement and make Lucy marry a man better placed politically. - Summary by Gillian Hendrie

Ivanhoe ist ein 1820 publizierter Roman von Sir Walter Scott und zugleich der Name der Hauptperson des Romans, des Kreuzritters Sir Wilfred of Ivanhoe.<br><br> Die Geschichte thematisiert die Rivalitäten in England zwischen Angelsachsen und Normannen nach dem Sieg Wilhelms des Eroberers sowie die Spätfolgen der Kreuzzüge mit der Geiselnahme des englischen Königs Richard Löwenherz in Österreich. Ebenso sind die zur Zeit der Handlung existierenden Vorurteile gegenüber Juden dargestellt. Robin Hood tritt unter dem Namen „Locksley“ in Erscheinung. Die normannischen Gegenspieler Ivanhoes tragen französische Namen, weil der Adel Englands damals noch Französisch sprach (Brian de Bois-Guilbert, Maurice de Bracy, Philippe de Malvoisin, Ralph de Vipont, Reginald Front-de-Boeuf Herr von Torquilstone). In Abwesenheit König Richards stützt sich dessen jüngerer Bruder Johann Ohneland auf die Macht dieser normannischen Ritter und Barone. Gegensätze zur düsteren Gestalt des normannischen Tempelritters Bois-Guilbert bilden der Held Ivanhoe und die tragische Rolle der Rebekka. - Summary by Wikipedia

27Legend of Montrose

By Sir Walter Scott

A Legend of Montrose is one of Sir Walter Scott's <i>Tales of my Landlord</i>. It is set in the tumultuous 17th century during the Earl of Montrose's military campaign in Scotland. Allan M'Aulay and his friend Lord Menteith both serve in Montrose's army, together with the loose cannon Dugald Dalgetty. The friends are also both in love with Annot Lyle, a beautiful young lady of mysterious heritage. Will they all make it through the war, and which of the friends will Annot finally choose? - Summary by Carolin

28Guy Mannering, or, The Astrologer

By Sir Walter Scott

Guy Mannering is a young astrologer, just down from Oxford. While travelling in Scotland, he loses his way and unexpectedly comes to stay at Ellangowan, just as the son of Godfrey Bertram is born. Guy Mannering consults the stars to tell the fortune of the new-born, but as the boy is destined to face much danger in his life, Mannering decides not to alarm the new parents just yet. He seals his predictions in a letter and instructs Betram to open it when the boy is five years old. But even a learned astrologer could not have foreseen how the fates of Guy Mannering and the Bertram family are intertwined.. - Summary by Carolin

29Fair Maid of Perth, Or, St. Valentine's Day

By Sir Walter Scott

Henry Gow has fallen in love with the Fair Maid of Perth, Catherine, the glovemaker's daughter. To make sure that he would be the first person she sees on Valentine's day, he walks to her house at the break of dawn, and arrives - just in time to save her from am attempted kidnapping. Henry acts immediately to save her, but the attackers are not just some ruffians but well-born and well-connected. Henry and Catherine are drawn into the games and intrigues of the nobility, with little choice but to play along.. - Summary by Carolin