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Sweid A, Daou BJ, Weinberg JH, Starke RM, Sergott RC, Schaefer J, Hauge J, Elizabeth C, Chalouhi N, Gooch MR, Herial N, Zarzour H, Jabbour P, Rosenwasser RH, Tjoumakaris S. In Reply: Experience With Ventriculoperitoneal and Lumboperitoneal Shunting for the Treatment of Idiopathic Intracranial Hypertension: A Single Institution Series. Oper Neurosurg (Hagerstown) 2021; 21:E579-E580. [PMID: 34791406 DOI: 10.1093/ons/opab359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 07/31/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ahmad Sweid
- Department of Neurosurgery Thomas Jefferson University and Jefferson Hospital for Neuroscience Philadelphia, Pennsylvania, USA
| | - Badih J Daou
- Department of Neurosurgery University of Michigan Ann Arbor, Michigan, USA
| | - Joshua H Weinberg
- Department of Neurosurgery Thomas Jefferson University and Jefferson Hospital for Neuroscience Philadelphia, Pennsylvania, USA
| | - Robert M Starke
- Department of Neurosurgery University of Miami Hospital Miami, Florida, USA
| | - Robert C Sergott
- Neuro-Ophthalmology Service Wills Eye Hospital and Thomas Jefferson University Philadelphia, Pennsylvania, USA
| | - Joseph Schaefer
- Department of Neurosurgery Thomas Jefferson University and Jefferson Hospital for Neuroscience Philadelphia, Pennsylvania, USA
| | - Julie Hauge
- University of Pennsylvania Philadelphia, Pennsylvania, USA
| | | | - Nohra Chalouhi
- Department of Neurosurgery Thomas Jefferson University and Jefferson Hospital for Neuroscience Philadelphia, Pennsylvania, USA
| | - M Reid Gooch
- Department of Neurosurgery Thomas Jefferson University and Jefferson Hospital for Neuroscience Philadelphia, Pennsylvania, USA
| | - Nabeel Herial
- Department of Neurosurgery Thomas Jefferson University and Jefferson Hospital for Neuroscience Philadelphia, Pennsylvania, USA
| | - Hekmat Zarzour
- Department of Neurosurgery Thomas Jefferson University and Jefferson Hospital for Neuroscience Philadelphia, Pennsylvania, USA
| | - Pascal Jabbour
- Department of Neurosurgery Thomas Jefferson University and Jefferson Hospital for Neuroscience Philadelphia, Pennsylvania, USA
| | - Robert H Rosenwasser
- Department of Neurosurgery Thomas Jefferson University and Jefferson Hospital for Neuroscience Philadelphia, Pennsylvania, USA
| | - Stavropoula Tjoumakaris
- Department of Neurosurgery Thomas Jefferson University and Jefferson Hospital for Neuroscience Philadelphia, Pennsylvania, USA
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Sweid A, Daou BJ, Weinberg JH, Starke RM, Sergott RC, Schaefer J, Hauge J, Elizabeth C, Chalouhi N, Gooch R, Herial N, Zarzour H, Jabbour P, Rosenwasser RH, Tjoumakaris S. Experience With Ventriculoperitoneal and Lumboperitoneal Shunting for the Treatment of Idiopathic Intracranial Hypertension: A Single Institution Series. Oper Neurosurg (Hagerstown) 2021; 21:57-62. [PMID: 33885792 DOI: 10.1093/ons/opab106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 02/08/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND CSF shunting is among the most widely utilized interventions in patients with idiopathic intracranial hypertension (IIH). Ventriculoperitoneal shunting (VPS) and lumboperitoneal shunting (LPS) are 2 possible treatment modalities. OBJECTIVE To evaluate and compare complications, malfunction, infection, and revision rates associated with VPS compared to LPS. METHODS Electronic medical records were reviewed to identify baseline and treatment characteristics for patients diagnosed with IIH treated with VPS or LPS. RESULTS A total of 163 patients treated with either VPS (74.2%) or LPS (25.8%) were identified. The mean follow-up was 35 mo. Shunt revision was required in 40.9% of patients. There was a nonsignificant higher rate of revision with LPS (52.4%) than VPS (36.4%, P = .07). In multivariate analysis, increasing patient age was associated with higher odds of shunt revision (P = .04). LPS had higher odds of shunt revision, yet this association was not significant (P = .06). Shunt malfunction was the main indication for revision occurring in 32.7%, with a significantly higher rate with LPS than VPS (P = .03). In total, 15 patients had shunt infection (9.4% VPS vs 12.2% LPS P = .50). The only significant predictor of procedural infection was the increasing number of revisions (P = .02). CONCLUSION The incidence of shunt revision was 40.9%, with increasing patient age as the sole predictor of shunt revision. The incidence of shunt malfunction was significantly higher in patients undergoing LPS, while there was no significant difference in the incidence of shunt infection between the 2 modalities.
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Affiliation(s)
- Ahmad Sweid
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Badih J Daou
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Joshua H Weinberg
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Robert M Starke
- Department of Neurosurgery, University of Miami Hospital, Miami, Florida, USA
| | - Robert C Sergott
- Neuro-Ophthalmology Service, Wills Eye Hospital and Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Joseph Schaefer
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Julie Hauge
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Nohra Chalouhi
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Reid Gooch
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Nabeel Herial
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Hekmat Zarzour
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Pascal Jabbour
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Robert H Rosenwasser
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Stavropoula Tjoumakaris
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
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Elizabeth C, Suzanna S, Tim CF, Shek LP, Chi SL, Mital R, Bee Wah L, Bee-Wah L. Pediatric asthma quality of life questionnaire: validation in children from Singapore. Asian Pac J Allergy Immunol 1999; 17:155-61. [PMID: 10697253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
"Quality of Life" is a multidimensional measure encompassing the physical, emotional and social functioning of the child. The asthma specific questionnaire contains 23 questions (items) in three areas (domains) of activity, symptoms and emotions. The objective of the present study was to validate the Paediatric Asthma Quality of Life Questionnaire "PAQLQ"(copyright 1991 McMaster University). If the questionnaire is valid, a change in the child's asthma will be accompanied by a change in the "Quality of Life" questionnaire score. The questionnaire was administered twice over four weeks and the child's asthma status was assessed concurrently. Two groups were thus identified; Group A = unchanged asthma, Group B = changed asthma. Forty-seven children, aged 7 to 14 years, completed the study. Reliability of the questionnaire shows an intraclass-correlation coefficient of only 0.71. Cross-sectional construct validity was demonstrated by a significant correlation between the whole questionnaire and the clinical asthma score (p<0.001) but not in the separate domains. Longitudinal construct validity was also demonstrated by the significant correlation between change in the total questionnaire score, but not separate domains, with change in the child's asthma score (p<0.05). Responsiveness was shown by a significant difference in the magnitude of the change in the questionnaire score between the two groups (p<0.001), but again not in the separate domains. It was concluded that the questionnaire was validated as a whole but not in as convincing a manner, as has been done by others, and we are therefore in a position to advise caution in its application in our population.
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Affiliation(s)
- C Elizabeth
- Children's Medical Centre, National University Hospital, Singapore
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Abstract
Sixteen cases of external hydrocephalus (EH) were seen from January 1993 to June 1995. There were 13 (81.3 per cent) male and three female children. Fourteen (87.5 per cent) were under 12 months of age. Three siblings with EH were seen in one family. All but three of the 16 recovered over time without medical or surgical intervention. These three needed cerebral decongestants in the acute phase.
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Affiliation(s)
- K Roshan
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman
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