eLetters

143 e-Letters

published between 2006 and 2009

  • Re: The exact negative predictive value of procalcitonin remains to be determined
    Aurélien Jacquot

    We would like to thank Mr Degraeuwe for his interest about our study [1]. He is correct in stating that the confidence intervals are useful in interpreting the diagnostic value of procalcitonin. The sensitivity, specificity, positive and negative predictive values expressed as percentages (95% CI) were respectively 100 (88-100), 65 (54-76), 67 (56- 78) and 100 (88-100) for PCT at the 0.6 ng/mL cut-off value.

    Mr...

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  • Diagnostic value of subependymal pseudocysts and choroid plexus cysts on neonatal ultrasound
    Breda C Hayes

    Sir, Alvarez and colleagues1 report a clinically useful metanalysis on the diagnostic value of subependymal pseudocysts and choroid plexus cysts seen on neonatal cerebral ultrasound. It appears that complex subependymal cysts at the caudothalamic groove may be more important clinically than simple cysts here or in the choroid plexus. Their analysis did not expose two other important conditions causing multiple and/or bila...

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  • Neuromuscular blockers in compasionate care
    Ian A Laing

    Verhagen et al describe the use of analgesics, sedatives and neuromuscular blockers during reorientation of care to compassionate measures in Groningen, the Netherlands (1). The authors draw attention to the fact that in 16% of such events, neuromuscular blockers (NMBs) were used. In cases, NMBs were used to eliminate gasping after the endotracheal tube had been removed. Diagnoses and reasons for administering NMBs afte...

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  • The exact negative predictive value of procalcitonin remains to be determined
    Pieter L.J. Degraeuwe

    Dear Sir

    I am writing this letter in reference to the article "Rapid quantitative procalcitonin measurement to diagnose nosocomial infections in newborn infants" by Jacquot et al. [1] The aim of this study was to investigate the diagnostic accuracy of procalcitonin in neonatal nosocomial infections. However, the flawed methodology and the incomplete reporting preclude a reliable conclusion with respect to the d...

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  • Further evidence in support of the eyelid speculum as the cause of distress during screening for ret
    karel allegaert

    dear editor,

    Many procedural interventions remain a burden as they result in pain or discomfort in neonates. Adequate management of pain necessitates an integrated approach. Such an approach should also include the use of the most effective methods to perform a given procedure. [1] We therefore appreciate the paper on the randomized comparison between binocular indirect ophthalmoscopy (BIO) and wide-field digit...

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  • Treatment of asphyxiated newborns with moderate hypothermia in routine clinical practice: how coolin
    Michael W Quinn

    Azzopardi et al (1) report the experience of introducing total body cooling as a standard form of therapy for infants with moderate or severe perinatal asphyxia. It is notable that this publication includes only one level 2 neonatal intensive care unit of the 25 units providing data for the TOBY register (Royal Cornwall Hospital, Truro). The Royal Devon and Exeter Hospital (also a level 2 unit) has since joined the TOBY...

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  • Visual assessment or serum bilirubin: Both are suboptimal for intervention
    Kanchan Sharma

    Dear editor, the article by Keren et al 'Visual assessment of jaundice in term and late preterm infants' justifies the limitations of visual assessment of jaundice in newborns. The authors have advised to do serum bilirubin levels in case of visible jaundice. The problem with total serum bilirubin level is that it is dependent on the serum albumin level. Therefore a healthy newborn with a good serum albumin will bind bili...

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  • Potential hazards of the Neopuff
    Colin J Morley

    Dear Sir, Dr Hawkes is right, if a gas flow meter that will deliver very high flows when turned up to its maximum flow, which may be over 80 L/min, is used with the Neopuff then if the flow is increased about the set level dangerously high levels of PIP and PEEP will be delivered. What is not commonly known is that some flow meters that are marked to deliver a flow from 0 to 15 L/min can deliver these very high flows whi...

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  • Reply to "Controlling an outbreak of MRSA in the neonatal unit"
    Geraldine Y Ng

    We read with interest Laing’s article on controlling an outbreak of MRSA in a neonatal unit. We have also learnt from outbreaks on our neonatal unit. Laing et al talk about cohort nursing for those babies found to be colonised. In our experience it is important to isolate/cohort not just those babies that are MRSA colonised, but also to cohort those babies whom are known contacts, with MRSA swabs repeated weekly. It is i...

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  • Microenvironment and Colonisation in the neonatal unit
    Narayana M Indana

    We read with interest the article by K Ganesan et al 1 about using prophylactic oral Nystatin to prevent fungal colonisation and invasive fungaemia. We strongly support this practice especially in preterm babies who are on broad spectrum antibiotics.

    It is interesting to know if the authors discovered any other bacterial organisms apart from candida in there routine surveillance swabs. We in our unit in Royal O...

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