J Neurosurg Anesthesiol
Volume 27, Number 2, April 2015
shunt. Case report. J Neurosurg. 1973;39: 775–776. 3. Menguy E, Mangez JF, Roux P, et al. Pneumothorax after ventriculoperitoneal shunt procedure. Ann Fr Anesth Reanim. 1986;5:615–616. 4. Schul DB, Wolf S, Lumenta CB. Iatrogenic tension pneumothorax resulting in pneumocephalus after insertion of a ventriculoperitoneal shunt: an unusual complication. Acta Neurochir (Wien). 2010;152:143–144. 5. Solmaz I, Tehli O, Kaya S, et al. Bilateral pneumothorax during subdural-peritoneal shunting. Turk Neurosurg. 2011;21:421–422.
Dexamethasone and Hypothalamic-PituitaryAdrenal Axis Suppression After Transsphenoidal Pituitary Surgery To the Editor: We read with interest the article by Burkhardt et al1 and commend the authors on their interesting study on the effect of dexamethasone prophylaxis on the alteration of hypothalamic-pituitary-adrenal (HPA) after transsphenoidal pituitary surgery. Despite major limitations of retrospective data, authors have attempted a good and informative study. However, we would like to add few comments in this context. Firstly, the units of blood hormone levels mentioned in this article are confusing because they are neither in SI units (nmol/L for cortisol and pmol/L for ACTH) nor the conventional units (mcg/dL and picogram/ mL). Hence, it is very difficult to interpret the results accurately without the normal reference range. For example, if the cortisol levels are 5000 pituitary surgeries over the last 40 years, we apologize for not mentioning these blood draws and the corresponding levels of cortisol in the manuscript. However, we want to point out again that our results clearly present the suppressive effect of dexamethasone as PONV-prophylaxis on postoperative cortisol levels and should therefore be taken into consideration by pituitary surgeons. Till Burkhardt, MD Nils O. Schmidt, MD Department of Neurosurgery, Hamburg University Medical Centre, Hamburg Germany
2014 Wolters Kluwer Health, Inc. All rights reserved.
Volume 27, Number 2, April 2015
shunt. Case report. J Neurosurg. 1973;39: 775–776. 3. Menguy E, Mangez JF, Roux P, et al. Pneumothorax after ventriculoperitoneal shunt procedure. Ann Fr Anesth Reanim. 1986;5:615–616. 4. Schul DB, Wolf S, Lumenta CB. Iatrogenic tension pneumothorax resulting in pneumocephalus after insertion of a ventriculoperitoneal shunt: an unusual complication. Acta Neurochir (Wien). 2010;152:143–144. 5. Solmaz I, Tehli O, Kaya S, et al. Bilateral pneumothorax during subdural-peritoneal shunting. Turk Neurosurg. 2011;21:421–422.
Dexamethasone and Hypothalamic-PituitaryAdrenal Axis Suppression After Transsphenoidal Pituitary Surgery To the Editor: We read with interest the article by Burkhardt et al1 and commend the authors on their interesting study on the effect of dexamethasone prophylaxis on the alteration of hypothalamic-pituitary-adrenal (HPA) after transsphenoidal pituitary surgery. Despite major limitations of retrospective data, authors have attempted a good and informative study. However, we would like to add few comments in this context. Firstly, the units of blood hormone levels mentioned in this article are confusing because they are neither in SI units (nmol/L for cortisol and pmol/L for ACTH) nor the conventional units (mcg/dL and picogram/ mL). Hence, it is very difficult to interpret the results accurately without the normal reference range. For example, if the cortisol levels are 5000 pituitary surgeries over the last 40 years, we apologize for not mentioning these blood draws and the corresponding levels of cortisol in the manuscript. However, we want to point out again that our results clearly present the suppressive effect of dexamethasone as PONV-prophylaxis on postoperative cortisol levels and should therefore be taken into consideration by pituitary surgeons. Till Burkhardt, MD Nils O. Schmidt, MD Department of Neurosurgery, Hamburg University Medical Centre, Hamburg Germany
2014 Wolters Kluwer Health, Inc. All rights reserved.
