eLetters

635 e-Letters

  • Beauty is in the eye of the beholder
    William E. King

    Regarding Coggins' Heart rate characteristic index monitoring for bloodstream infection in an NICU: a 3-year experience:

    Wirschafter[1] has labeled the CDC definition a minimum estimate of infection burden, while labeling antibiotic administration a maximum estimate. The authors refuse to provide metrics such as Specificity and NPV on the grounds that establishing health of the patients was not possible. By...

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  • Proper Use of the Heart Rate Characteristics Monitor in the NICU
    Karen Fairchild

    In the report "Heart rate characteristics index monitoring for bloodstream infection in an NICU: a 3-year experience", Coggins and colleagues make several observations that are important for properly using the HRC (HeRO) monitor in the NICU: 1) Continuous monitoring is more effective than intermittent. Coggins analyzed scores recorded in the medical record every 12 hours, or 8% of the hourly scores; high scores may have...

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  • The MBRRACE-UK perinatal surveillance report - clarification
    Elizabeth S Draper

    We very much welcome Martin Ward Platt's review of the MBRRACE-UK perinatal surveillance report and would like to respond to a number of points that he has highlighted. The article focussed on the first perinatal surveillance report (1) from the MBRRACE-UK team and noted that it was produced from a new system of data collection after a three year gap in national perinatal surveillance. As well as changing the approach to...

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  • Personality of young adults born preterm
    Gorm Greisen

    We read with interest the article by Eryigit-Madzwamuse et al (1) on the personality of young adults who were born preterm. We would like to draw the attention of the journal's readers to our recent work in the same field (2) with some important similarities and some interesting differences.

    We also studied approximately 200 cases and 200 controls and also assessed the 'big five' personality traits (neuroticism...

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  • Stopping rules for resuscitation at birth
    Pamela A Cairns

    I read with interest the editorial by D Wilkinson and B Stenson commenting on a series of papers which suggest that current outcomes of neonates with APGAR scores of zero at 10 minutes are not universally poor. Given that stopping at 10 minutes in all cases will then lead to a number of unnecessary death they rightly ask what stopping time is appropriate.

    I wonder if this is the right question. A baby who has fa...

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  • Re: Herpes virus must be considered as one of the causes for late onset sepsis
    Christian P. Speer

    A culture-negative neonatal sepsis is more than herpes virus infection

    Ying Dong a, Christian P. Speer b

    a Department of Paediatrics, Children's Hospital of Fudan University, Shanghai, China

    b University Children's Hospital, University of Wurzburg, Wurzburg, Germany

    We highly appreciate the authors' contribution to the full picture of pathogens causing systemic late-onset neonatal inf...

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  • Genomic Intensive Care: not a panacea
    Katherine B Burke

    Prognostication using whole genome and whole exome (WG/WE) sequencing depends on the use of a tool which - currently - has the potential to add to rather than decrease uncertainty. A problem in using information from genomic testing as a prognostic tool is the self-fulfilling nature of these 'diagnoses'. Many of these will initially be hypotheses, which become untestable unless the same genotypes are seen in family member...

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  • CRP in the wrong context
    Nitin Rajput

    Unfortunately the authors have failed to understand the utility of CRP at 18-24 hours. This has a high negative predictie value but low positive predictive value. This means that while a low CRP is reassuring but a high value has to be evaluated in the clinical context. A high CRP should not be equal to a lumbar puncture. I should point that NICE guidelines do not recommend using CRP in isolation and clinical acumen sho...

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  • Re: Congenital Chylothorax in the UK: Findings from a BPSU epidemiological study
    Anja Bialkowski

    We are grateful to our colleagues Haines and Davis from the UK for their comments confirming many of our findings in their British population -based cohort. We agree that differences in findings (e.g., different rates of syndromal anomalies associated with congenital chylothorax) may simply be due to small numbers. It is nice to see that this rare but serious condition is receiving more scientific attention

    Confl...

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  • Missed opportunties for qualitative insight
    Morris Gordon

    I read this Randomised controlled trial with great interest. I applaud the authors for including focus group discussions in the study.

    A study that simply tells us 'whether' parental presence on a bedside round is appropriate is of limited value and so deeper qualitative discourse is needed. This can consider more meaningful questions such as 'how', 'why' and 'when' such parental presence impacts the neonatal j...

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