eLetters

619 e-Letters

  • Need for prospective studies
    Elpis Mantadakis

    This review on alloimmune thrombocytopenic purpura (ATP) by OUWEHAND et al is excellent and describes the current knowledge on ATP. Regarding the management of this condition, since no randomised trials have been performed using IVIg or intravenous corticosteroids during pregnancy, no evidence-based guidelines for the use of either treatment exist. I believe it is necessary for a multi-institutuional trial on the preventio...

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  • Premedication before procedures in neonates
    Shabih Manzar

    Editor,

    Neonates are exposed to many procedures, including intubation, IV access, central line placement, chest tube insertion, lumber puncture, catheterisation, suprapubic aspiration etc. These procedures are associated with pain and stress. No clear guidelines are available for alleviating the distress by premedication before such procedures. Researchers are looking for methods to minimise the pain and distre...

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  • Cut-off for normal serum creatinine levels in preterm infant.
    Shabih Manzar

    Editor,

    I read with interest the article by Marlow et al(1) on sensorineural hearing loss and prematurity. In their study of preterm infant of less that 33 weeks gestation, they put the cut-off value of serum creatinine (as one of the variables) as 60 mmol/l. My comment is regarding the cut- off of 60. In a recent study from Leeds, UK, Miall et al(2) have shown that preterm babies have higher serum creatinine an...

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  • Premedication for neonatal intubation - current practice in Australia and the UK
    Stephen Hancock

    The paper by Bhutada et al (1) adds to the growing body of evidence that premedication for tracheal intubation in neonates both improves physiological stability and makes the procedure easier to perform. The results of the telephone survey of premedication use in UK neonatal units by Whyte et al (2) helps to define current practice. In a similar study, we recently tried to define the routine use of premedication for trac...

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  • Unit Specific Antibiotic Policies
    Laura Stewart

    Sir, We read with interest the article by Isaacs on the rationing of antibiotic use in neonatal units.(1) This encourages the use, where possible, of flucloxacillin and an aminoglycoside as empiric therapy of late onset sepsis.

    While this represents a valid approach to the empiric therapy of late onset infection, the epidemiology of bacterial sepsis will vary from unit to unit. In our unit we use a combination...

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  • Perinatal cortical infarction with no obvious cause
    Péter Temesvari

    Sir,

    In a recent, elegant study Govaert et al published their ultrasonographical observations in newborn infants with perinatal cortical infarctions (1). Like many others before them, they could not find a cause for stroke in a high proportion in (25%) of cases. They also confirmed an association between stroke and pulmonary hypertension requiring assisted ventilation (2).

    We have previously published...

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  • Calcium stimulation test for hyperinsulinism in infancy
    L J Abernethy

    We read with great interest the consensus article on the investigation and management of hyperinsulinism in infancy (1). The authors discuss the value of the intra-arterial calcium stimulation test, but speculate that there is a significant risk of bowel infarction.

    Intra-arterial calcium stimulation for localisation of insulinomas in adult patients has been described by several authors (2,3,4). To our knowledge...

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  • Severe retinopathy of prematurity survival rates
    Arun K Manglik

    Wonderful work by Vyas et al on ROP and its incidence in different cities of Britain. The statistically significant difference in the incidence of ROP in different centres may be related to the differences in the level of care provided. The advancements in neonatal care, particularly the use of surfactant and the resultant reduction in the requirements of O2 has greatly influenced outcome and possible development of ROP (...

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  • A simple practice to increase red cell transport in newborns
    Cory Mermer

    The finding of Pladys et al (1), that preterm infants are able to compensate for deficiencies in hematocrit by increasing cardiac output is reassuring. However, it would seem to be a good idea to attempt to minimize the need for such efforts, which are another added stress to an already overburdened newborn’s system.

    There is a simple procedure with little, if any risk that can increase red cell transport or...

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