Molly, great job. You obviously have an interesting topic about which you are very passionate and you found some great websites and do a great job telling us about them. You got some good peer reviews as well... I think you can see how you have two minor websites--the individual stories or postings--and two bigger institutional ones...choose one from each category for your larger reviews.

And thanks for your very well done and detailed peer reviews--they are a model for everyone else!

LF
Choose topic: 10 points
Find four websites: 20 points
Peer reviews: 10 points

Website 1 Yahoo News
I thought this article was very interesting. I liked how it actually talked about somebody’s life that is dealing with the condition. I liked how they had a link to where you could learn more about the disease if you wanted to.

Website 2 Simon’s site
Simon’s website was awesome. It was very easy to get around the website and it was highly organized. It was easy to read and understand the information.

Website 3 Hydrocephalus Association
This website gives hope to the patients with hydrocephalus with their events and donations my people wanting to help. It also helps patients find a doctor and great information about the disease they have to live with.

Website 4 National Institute of Neurological Disorders and Strokes
This website had great information. It really helped me really understand what hydrocephalus is and how much it really affects people. The words were kept simple so the normal public could understand what was being said.

Want to know about Hydrocephalus? Visit the Hydrocephalus Association today
URL: http://www.hydroassoc.org/

The Hydrocephalus Association is a proud member of the National Health Council. Their intentions are to provide support, educational resources, and advocacy to individuals directly affected, to their families, as well as, to the professional community. Their goal is to provide families and individuals alike with personal support to move on with life, offer comprehensive educational materials to further understand this neurological condition, and to ensure that ongoing quality health care is provided to each person affected. The Hydrocephalus is a great website; they provides useful information about the condition; in addition, they provide information pertaining to prenatal hydrocephalus, hydrocephalus in infants and children, hydrocephalus diagnosed in young and middle-aged adults, and the adult-onset normal pressure hydrocephalus. The Hydrocephalus Association also provides helpful, informative packets and comprehensive booklets to better educate those affected. Unlike many organizations that offer information to the public, the people at the Hydrocephalus provide their members with opportunities to socialize at designated gatherings throughout the country; to recognize the young adults (ages 17-30) with hydrocephalus, the Association awards three scholarships to assist them in their educational journeys (i.e. a four-year or junior college, a high school post-graduate year, technical or trade school, an accredited employment training program or a post-graduate program). Annually, the organization holds a three-day conference in a chosen city to give individuals, families and professionals the tools that they may need to overcome the medical, educational, and social challenges presented from this neurological condition. On a quarterly basis, a newsletter is issued and will often have upcoming events, articles about new members, or an uplifting story! Also, this website provides those hydrocephalic patients with additional links to become more informed on their neurological condition; they also provide a list of neurologists and neurologists who are familiar with normal pressure hydrocephalus and adult-onset hydrocephalus, for both, pediatrics and adults.

Hydrocephalus comes from the Greek language: “hydro” means water and “cephalus” means head. This is a neurological condition where there is an abnormal accumulation of cerebrospinal fluid (CSF) within the cavities called ventricles. Therefore, my topic relates back to our studies in Anatomy and Physiology because it is a neurological condition of the brain, which we have yet to cover! Cerebrospinal fluid has several important functions – it surrounds the brain and spinal cord and acts as a protective barrier against injury, it contains nutrients and proteins that are necessary for the nourishment and normal function of the brain, and carries waste products away from the surrounding tissues. Cerebrospinal fluid is produced in the ventricles, circulates through the ventricular system, and is absorbed into the bloodstream. Hydrocephalus occurs when this balance is disrupted; it causes the ventricles in the brain to enlarge and the pressure in the head (intracranial pressure) to rise. There are two types of hydrocephalus – congenital and acquired. Hydrocephalus that is congenital (present at birth) is thought to be caused by a combination of environmental and genetic factors. Acquired hydrocephalus may result from intraventricular hemorrhage (uncontrolled bleeding inside the ventricles), meningitis (inflammation of the meninges), head trauma, tumors or cysts. According to the Association, hydrocephalus is believed to occur in about 2 out of 1,000 births; amazing! There is no known way to prevent or cure hydrocephalus, but there are treatment options. The most effective treatment is through the surgical insertion of a shunt, a flexible tube that is about 1/8 inch in diameter and is made of a soft, pliable plastic that is well tolerated by the body’s tissues. The shunt is placed into the ventricular system to divert the flow of CSF into another region of the body where it can be reabsorbed, such as the peritoneal (abdominal) cavity or the right atrium of the heart; the most common insertion site is the peritoneal cavity. An alternative treatment option is called a third ventriculostomy, which involves making a hole in the floor of the third ventricle to allow the cerebrospinal fluid to free flow into the basal cisterns: a basal cistern is a dilation of the subarachnoid space in the front pons, where the arachnoid membrane stretches across between the two temporal lobes over the base of the diencephalon, the midbrain.

The Hydrocephalus Association is a wonderful tool for people who do not know anything about hydrocephalus, as well as, for those who are very familiar with the neurological condition! At this website, you will find that information is provided to help you understand the basics of hydrocephalus but it also provides detailed explanations about prenatal hydrocephalus, hydrocephalus in infants and children, hydrocephalus diagnosed in young and middle-aged adults, in addition to, an understanding of adult-onset normal pressure hydrocephalus. I really like their section “Hydrocephalus in Infants and Children,” because the information is precise, accurate, and detailed; it is also nice to learn about the various causes of hydrocephalus – aqueductal stenosis, neural tube defects or myelomeningocele, intraventricular hemorrhage, meningitis, a head injury, tumor, arachnoid cysts, or Dandy-Walker Syndrome. For those afflicted by hydrocephalus, it is a good “tool of reference” because they provide detailed booklets about a variety of aspects of hydrocephalus that are suited for families, parents, teachers and patients, at different stages in one’s life.

Another feature of this website that I believe is very informative and interesting is the precise explanations about the Codman shunt systems. The Codman, a Johnson & Johnson Company can be found at the following the link: http://www.codman.com/CSFshunting.asp. Codman provides easy-to-understand information about the products – Codman Hikam Programmable Valve, Codman Hikam Precision Valve, Bactiseal Antimicrobial Catheter System, and the SIPHONGUARD Anti-Siphon Device - they provide to aid in the management of hydrocephalus. The Codman Hikam Programmable Valve allows flexibility in changing the opening pressure of a shunt system before and after implantation. Before this shunt was invented, a surgery was required to change the pressure; a complete bummer! Another advantage is that this shunt system offers different pressure settings, depending upon tolerance and comfort levels. Afterall, we are different from one another. The SIPHONGUARD Anti-Siphon Device is a newer device that I am quite familiar with. This device prevents excessive CSF flow during positional changes using resistance to impede the flow.

Website 1 http://www.ninds.nih.gov/disorders/hydroce...l_hydrocephalus.htm

This site seems to be a really good source of information and from a reliable sources as well. I found this site to be very easy to understand and move around in. It also provided a lot of different information on Hydrocephalus. Good find.

Website 2 http://www.hydroassoc.org/information/adults.html
I really liked that this site had the basic information like the last but it also had the separate links on the right hand side that liked you to info about prenatal hydrocephalus and hydrocephalus in young children and in adults and so on. This is a well organized site and seems like a reliable source.

Website 3 http://simon.allanach.dk/index2.htm
This site it also a very good site. I really enjoyed that it explained the different types of procedures available. I also like the picture available to get a general idea of what the brain consists of. It was also nice that they provide a link to a glossary for clarification on key terms.

Website 4 http://news.yahoo.com/s/wesh/20071016/lo_wesh/14350050
This last site does not seem like a very reliable source compared to the first 3 but it is very interesting to read about a individual that has hydrocephalus.

Edited by author 11-12-2007 09:02 PM
Taking His Passion of Golf to Help Find a Cure for Hydrocephalus
http://news.yahoo.com/s/wesh/20071016/lo_wesh/14350050

This posting came from the Channel 2 News in Orlando, Florida. I believe that this story was posted on the worldwide web to make those affected by hydrocephalus aware that life outside of hospitals, needle pokes, tests, and surgeries does exist! Hogan-Ira’s story is inspirational; I love his determination to not let the number of surgeries that he’s endured or the never-ending hospital trips get in the way of living his life. Furthermore, he has taken something that he loves (golf) and is putting it to use to help find a cure. Playing golf has become a hobby and part of this Seminole County teenager’s life. After all, he wasn’t able to convince his parents to let him play basketball, so he found another sport to fill his time. Even though, hydrocephalus affects one in every 500 babies born, Chais Hogan-Ira and I are living testimonies that life can go on!
 
I realize that this story is not a medical reference about hydrocephalus, but it is a great article of inspiration and lends to people who are afflicted by hydrocephalus that a future does exist. “By watching Hogan-Ira hit a golf ball, one wouldn’t know he had any medical issues.” People are often not able to differentiate a hydrocephalic sufferer from a perfectly healthy person, because the symptoms and effects of the condition are internal. Even though it is an extra link that is posted within the story about Chais Hogan-Ira, the Childhood Neurosurgery and Center for Hydrocephalus in Pennsylvania is very precise in detailing hydrocephalus. Within the website, there is a very nice image of what the ventricles in the brain appear like when hydrocephalus is present; as you can see, the ventricles (which are in blue) are enlarged taking up much of the space within the brain. Here is the web address to access the addition explanations - http://www.pedneurosurgery.net/hydrocephalus.php3
 
When reading my peers comments, I noted that they wished there was more information about his personal life (day to day experience) and the frequency of surgeries. Yes, you my peers) are right that the reporters did not focus on his personal life as much, but I think that was not the point of the article; my assumptions by the title and the information provided, Channel 2 News wanted to get awareness out to the public about Chais Hogan-Ira’s efforts to raise money for hydrocephalus research by holding a golf tournament in Seminole County. I know that current research is being done at several Universities and medical organizations across the country, and anticipate that a cure will be found. In regards to the frequency of brain surgeries, it all depends on the function of the implanted shunt; some individuals with hydrocephalus only require one or two surgeries throughout their life, while others require many more. And certainly, there is no warranty on shunts; in one respect, it’s the luck of the draw! As noted at the Hydrocephalus Association, complications with shunts can vary.
 
This article about Chais Hogan-Ira sounds so familiar that in ways it brings back chills. Statements like “When he goes to the hospital, everyone knows his name” and “I go in there, and they know my name, and I know them. It’s pretty cool” were once true for myself. For several years, I encountered the same situations after having multiple surgeries and long hospitalizations - Admitting knew who I was, the nurses knew my name, and my neurosurgeon always cracked jokes with me about how often he saw me - but the bond with my neurosurgeon will remain forever! At just 16-years-old, Chais has endured so much, but it’s his sense of humor that allows him to “roll it off his back” and take it all in stride. Knowing his perspective, I am glad to read that he has found people in the hospital that he can trust; there is some security in knowing that people know you, especially when you’re putting your life in their hands.
 
I disagree with one of the statements on part of research coordinator Kimberlee Antonetti in that she says “Once the shunt is inserted, the patient is shunt-dependent for the rest of their life.” In fact, a patient can be “weaned” from their shunt through a series of shunt tests. With the Codman Hikam Programmable Valve, a neurosurgeon can adjust the opening pressure before and after surgery; this enables surgeons to monitor overdrainage and underdrainage (http://www.medscape.com/viewarticle/413363_3) and it also allows the space for drainage to enlarge and remain open. After tests are ran to ensure that the cerebrospinal fluid is draining in a normal fashion and scans are taken to see that the brain is adhering to changes, some shunts can be taken out; I like this optimistic outcome…and I’m proof!
 
In closing, a sense of humor (laughter) is another form of medicine and helps to overcome trials in life. Try to make someone laugh today!

Edited by author 11-15-2007 03:13 PM
Please note that I stand corrected about my assumption that shunt "weaning" can be successful with a ventriculoperitoneal (VP) shunt. My neurosurgeon whom I sent the URL to my QuickTopic wrote an e-mail to me, commenting and saying this:

It is my strong impression that shunt weaning with a programmable shunt cannot be achieved with a VP [ventriculoperitoneal] shunt. This is an asset of a lumbar shunt and why you were converted to this. Ventricle cysts typically reheal after endoscopic opening (fenestration) if a VP shunt is employed. You were proof of this problem! On the other hand, once CSF [cerebrospinal fluid] pressure control is achieved from the outside of the brain through an LP [lumboperitoneal] shunt and all cysts are communicated, an extended range configuration of programmable shunts has a good chance of working. There are many brands of programmable shunts now available, but I only have data personally and the use of two Codman valves in series to give a sufficient range to wean a person. I really doubt it would work with a single valve. Another thing: I have found it essential to have a tapping reservoir in the lateral ventricle to monitor and prove maintained communication through the weaning process. It is not at all widely held or believed yet among neurosurgeons that shunts can be weaned. This is very new information. Most still believe, "Once a shunt, always a shunt." Thanks to patients like you who have the courage to try new approaches, we're getting somewhere. I sincerely doubt you will ever need another neurosurgeon for hydrocephalus! At least you better not!! (laugh)

See a sense of humor can bring a smile to another person's face...try it today with someone!

Edited by author 11-19-2007 12:56 PM
Great job on your review of this site "Taking His Passion of Golf to Help Find a Cure for Hydrocephalus" you really seemed touched by the story at hand. The only real thing I noticed is that you didn't really explain how this site/story relates back to the basic anatomy and physiology of the body. You briefly mention that ventricals are enlarge and taking up much of the space in the brain but I think a few more sentences just explaining how this site relates. I noticed that you mentioned something you didn't like that the research cordinator said but what was the best and worst features of this website? Also I tried the links http://news.yahoo.com/s/wesh/20071016/lo_wesh/14350050 and (http://www.medscape.com/viewarticle/413363_3)
and I could not get the first to open and the second needed a login in order to view this site. I really did like how detailed you went in explaining this mans experiance with hydrocephalus. I dont see your second website so I will check back for it.

WEBSITE REVIEW #1
Want to know about Hydrocephalus? Visit the Hydrocephalus Association today
URL: http://www.hydroassoc.org/

The Hydrocephalus Association is a proud member of the National Health Council. Their intentions are to provide support, educational resources, and advocacy to individuals directly affected, to their families, as well as, to the professional community. Their goal is to provide families and individuals alike with personal support to move on with life, offer comprehensive educational materials to further understand this neurological condition, and to ensure that ongoing quality health care is provided to each person affected. The Hydrocephalus is a great website; they provides useful information about the condition; in addition, they provide information pertaining to prenatal hydrocephalus, hydrocephalus in infants and children, hydrocephalus diagnosed in young and middle-aged adults, and the adult-onset normal pressure hydrocephalus. The Hydrocephalus Association also provides helpful, informative packets and comprehensive booklets to better educate those affected. Unlike many organizations that offer information to the public, the people at the Hydrocephalus provide their members with opportunities to socialize at designated gatherings throughout the country; to recognize the young adults (ages 17-30) with hydrocephalus, the Association awards three scholarships to assist them in their educational journeys (i.e. a four-year or junior college, a high school post-graduate year, technical or trade school, an accredited employment training program or a post-graduate program). Annually, the organization holds a three-day conference in a chosen city to give individuals, families and professionals the tools that they may need to overcome the medical, educational, and social challenges presented from this neurological condition. On a quarterly basis, a newsletter is issued and will often have upcoming events, articles about new members, or an uplifting story! Also, this website provides those hydrocephalic patients with additional links to become more informed on their neurological condition; they also provide a list of neurologists and neurologists who are familiar with normal pressure hydrocephalus and adult-onset hydrocephalus, for both, pediatrics and adults.

Hydrocephalus comes from the Greek language: “hydro” means water and “cephalus” means head. This is a neurological condition where there is an abnormal accumulation of cerebrospinal fluid (CSF) within the cavities called ventricles. Therefore, my topic relates back to our studies in Anatomy and Physiology because it is a neurological condition of the brain, which we have yet to cover! Cerebrospinal fluid has several important functions – it surrounds the brain and spinal cord and acts as a protective barrier against injury, it contains nutrients and proteins that are necessary for the nourishment and normal function of the brain, and carries waste products away from the surrounding tissues. Cerebrospinal fluid is produced in the ventricles, circulates through the ventricular system, and is absorbed into the bloodstream. Hydrocephalus occurs when this balance is disrupted; it causes the ventricles in the brain to enlarge and the pressure in the head (intracranial pressure) to rise. There are two types of hydrocephalus – congenital and acquired. Hydrocephalus that is congenital (present at birth) is thought to be caused by a combination of environmental and genetic factors. Acquired hydrocephalus may result from intraventricular hemorrhage (uncontrolled bleeding inside the ventricles), meningitis (inflammation of the meninges), head trauma, tumors or cysts. According to the Association, hydrocephalus is believed to occur in about 2 out of 1,000 births; amazing! There is no known way to prevent or cure hydrocephalus, but there are treatment options. The most effective treatment is through the surgical insertion of a shunt, a flexible tube that is about 1/8 inch in diameter and is made of a soft, pliable plastic that is well tolerated by the body’s tissues. The shunt is placed into the ventricular system to divert the flow of CSF into another region of the body where it can be reabsorbed, such as the peritoneal (abdominal) cavity or the right atrium of the heart; the most common insertion site is the peritoneal cavity. An alternative treatment option is called a third ventriculostomy, which involves making a hole in the floor of the third ventricle to allow the cerebrospinal fluid to free flow into the basal cisterns: a basal cistern is a dilation of the subarachnoid space in the front pons, where the arachnoid membrane stretches across between the two temporal lobes over the base of the diencephalon, the midbrain.

The Hydrocephalus Association is a wonderful tool for people who do not know anything about hydrocephalus, as well as, for those who are very familiar with the neurological condition! At this website, you will find that information is provided to help you understand the basics of hydrocephalus but it also provides detailed explanations about prenatal hydrocephalus, hydrocephalus in infants and children, hydrocephalus diagnosed in young and middle-aged adults, in addition to, an understanding of adult-onset normal pressure hydrocephalus. I really like their section “Hydrocephalus in Infants and Children,” because the information is precise, accurate, and detailed; it is also nice to learn about the various causes of hydrocephalus – aqueductal stenosis, neural tube defects or myelomeningocele, intraventricular hemorrhage, meningitis, a head injury, tumor, arachnoid cysts, or Dandy-Walker Syndrome. For those afflicted by hydrocephalus, it is a good “tool of reference” because they provide detailed booklets about a variety of aspects of hydrocephalus that are suited for families, parents, teachers and patients, at different stages in one’s life.

Another feature of this website that I believe is very informative and interesting is the precise explanations about the Codman shunt systems. The Codman, a Johnson & Johnson Company can be found at the following the link: http://www.codman.com/CSFshunting.asp. Codman provides easy-to-understand information about the products – Codman Hikam Programmable Valve, Codman Hikam Precision Valve, Bactiseal Antimicrobial Catheter System, and the SIPHONGUARD Anti-Siphon Device - they provide to aid in the management of hydrocephalus. The Codman Hikam Programmable Valve allows flexibility in changing the opening pressure of a shunt system before and after implantation. Before this shunt was invented, a surgery was required to change the pressure; a complete bummer! Another advantage is that this shunt system offers different pressure settings, depending upon tolerance and comfort levels. Afterall, we are different from one another. The SIPHONGUARD Anti-Siphon Device is a newer device that I am quite familiar with. This device prevents excessive CSF flow during positional changes using resistance to impede the flow.


WEBSITE REVIEW #2
Personal Perspective on Hydrocephalus
URL: http://simon.allanach.dk/index2.htm

This website has been posted by Simon; he is in no way a doctor, but he does have hydrocephalus. I believe that Simon made this website for others to learn from, but as a tool for himself. Throughout the process of compiling this information, I am sure that he became more educated about the various types of hydrocephalus that are often unmentioned, learning about the multitude of possible causes, becoming familiar with the history, and the different effects that can cause difficulties during life. Similarly to what was stated above, several topics were covered. Nine main topics are discussed and they include, an explanation of hydrocephalus; the causes of hydrocephalus; the signs and symptoms (objective and subjective data), as well as, the two types of diagnostic tests; the choices of shunt systems, as well as, a newer procedure that is becoming more prevalent in treating hydrocephalus (third ventriculostomy). He also goes into a lot of detail about the complications and effects that are possible. However, I thought that anatomical diagrams were fascinating as we’ve been learning about the vertebral column and will soon be learning about the head and neck!

This condition is related to our studies in Anatomy and Physiology, because hydrocephalus is a neurological condition which disrupts the constant circulation of cerebrospinal fluid that cushions and protects our brains!

Simon’s website was put together nicely. One area of his website that I thought was interesting was the “History.” Not many people are familiar with how a disease or condition was once discovered, and Simon explains this very nicely in his website. Like anything, someone must “mess around” enough with one thing or another to make something wonderful: some people become so desperate to help their loved ones that they’ll do anything to help find treatment. Another feature in the Raving Lunatics website that I really enjoyed looking at, were the anatomical diagrams of the brain. From my own understanding and knowledge, the diagrams of the brain are accurate. The middle diagram gives us a visual of how the ventricles are “laid out” in the brain, and how when they become enlarged, it must be quite uncomfortable. We can relate to the placement of the “Temporal horn” and the “Occipital horn” now that we have learned about the lobes of the brain. The diagram of the vertebral column is also very well-done. We can see the seven cervical vertebrae, the twelve thoracic vertebrae, and the five lumbar vertebrae. Well done!

Trying to find the two worst features of this website were hard to distinguish, because I believe that it was quite bold of Simon to put himself out there. One feature that was hard to ignore and was sometimes bothersome is his lack of spelling correctly. Another feature that I (and, probably others) would have liked to be more informed about is Epilepsy. In the tab “Complications of Shunting,” Simon goes into a lot of detail about the different complications, but only mentions ‘Epilepsy’ briefly. I don’t know why Simon even mentions it, if he’s only going to say one broad statement. I am left to wonder, “How does epilepsy cause hydrocephalus?” or “What does excess fluid in the brain due to signal a mis-fire?”

** I apologize about review of the personal story from Yahoo; it turned out that it was a temporary posting.

You did a great job on both of your reviews. I didn't notice anything missing. The only suggestion I have is to read over them really quick I noticed a few words that needed to be fixed but nothing serious. Great job on both!

Molly Kate, you over achiever (J/K)-
I think you did a fantastic job. I really couldn’t find anything that was missing on either one of your website reviews. It flowed nicely but I think I found a couple of typos. I felt that your website reviews were very informative. I think you really found some great information on your websties. Awesome job Molly-Kate!!

Your review of the Hogan website is touching and full of information. You have really done the research and backed up the sites lack of specific physiological information. Thanks you for your willingness to share your personal experience. Jen Perkins

The hydrocephalus organization review was asol packed full of information. I really enjoyed reading about these anatomical structures that we just talked about in class. Your topic really brings my studying into 3D. I can find no flaws. Thanks for your topic. Jen

The Simon site is another great review. Sorry, I can’t find anything lacking from your concise summary. You really display a familiarity and careful reading of the site. I agree about the diagrams and I really liked how real his language is. Thanks again. Jen

The Hydrocephalus Association

Really great job on this review, Molly! The best aspect of it is the amount of detail on the physiology of Hydrocephalous. It was also a very well organized paper that was very easy to understand. I can’t think of anything to change, although, you forgot a ‘signature.’ Great job!

Personal Perspective on Hydrocephalus

Again, a nice review, Molly. However, I am still a little skeptical on Simon’s credibility, (spelling is a red flag for me.) I can’t think of anything to change – you have written two very good, detailed reviews!

cash from no where i show you how to get it free money to find out
how to get free money send a $10.00 bill or moneyorder for listing in
New York city of where to get Cash need money i take money to get money
send a copy of this ads and a large addressed stamped envelope to:
Richard Lee Lanier 306 East 171 Street Apt 2-F Bronx New York 10457

the hand of god book show you how to go to god to get whatever you need
publish in England for where to write for this booklet send $5.00 cash
or moneyorder and a large addressed stamped envelope if you wish to talk
to god this is the book send to: Richard Lee Lanier 306 East 171 Street
Apt 2-F Bronx New York 10457

i pay you for your junk mail everyone get junk mail get cash for your
junk mail i sell my to find out how to sell your junk mail send $5.00
moneyorder or cash this is no joke this is real we want your junk mail
the 5,000 person who send me a letter will get a free computer
send phone nubber to call and address on a 3x 5 index cards to be give
away on nov 15-2008 send to: Richard Lee Lanier 306 East 171 Street
Apt 2-F Bronx New York 10457

i need some one to show me how to download movies and music to a dvd
or cd i will pay someone to do this write me and show me how to do this
to: Richard Lee Lanier 306 East 171 Street Apt 2-F Bronx New York 10457
i will pay $100.00 cash or moneyorder to lean