76 e-Letters

published between 2010 and 2013

  • The Trouble with Informed Consent
    Matthew B. Wallenstein

    I read with great interest the commentary by John D. Lantos on the SUPPORT study controversy. Dr. Lantos makes a compelling argument that the OHRP was misguided in its criticism of SUPPORT, primarily because both arms of the trial were within standard of care.1-2

    Eligible infants whose parents refused to participate in SUPPORT received the same medical care, but instead of randomization via protocol, they were su...

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  • Statistical Queries
    Simon J Clark

    Dear Editor,

    I enjoyed reading this paper, but I have some comments about the statistics, which I think should have been picked up in the peer review process.

    In the paper it is stated that the Bland Altman plot showed good correlation. Correlation should produce a coefficient and a p-value.

    The paper does not report the value for the mean difference between the two methods. From the graph it...

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  • Preterm twins and singletons differ in their neurodevelopment at 5 years of age.
    Vincenzo Zanardo

    We read with interest the thought provoking paper written by Dr. Bodeau-Livinecr and colleagues on behalf of the EPIPAGE. They concluded that compared with very preterm singletons, twins had higher mortality, no difference in severe deficiencies, but slightly lower Mental Processing Composite scores at 5 years. 1

    The Authors suggest that although all the infants studied who were born preterm had been exposed...

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  • Another reason to deliver babies with CCHD at local NICU's
    Kenneth L. Harkavy

    The authors are to be thanked for looking into outcomes of fetuses identified with Critical Congenital Heart Disease (CCHD) based on the location of birth. Bennett et al (1) came to the same conclusion: that birth hospital had little impact on survival. As the authors point out, 75% of CCHD may be missed during prenatal evaluations. This means that the physicians at the non-specialty hospitals have to be able to recognize...

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  • Re: In vitro comparison of neonatal suction catheters using simulated 'pea soup' meconium
    Adriana M. Aguilar

    Dear Editor, The paper by Zareen et al. recently published in Archives, evaluates the effectiveness for suctioning meconium of various catheters and bulb syringes. The data provide useful information for caregivers of infants in the delivery room. [1] The authors describe meconium suctioning as a routine procedure. They quote: "However, recent guidelines recommend that, if the baby born with meconium stained fluid has a n...

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  • Re:Procalcitonin for early diagnosis of neonatal nosocomial sepsis
    Cinzia Auriti

    Dear Editor, Thank you for the opportunity of answering to the comments of Chiesa (1) about our paper (2). First, the assay: Procalcitonin (PCT) was measured with an immunoluminometric, quantitative method, as in studies cited by us and by Chiesa. We used reagents Brahms and Berthold LB9507 luminometer (Dasit). The analytical signal, proportional to the concentration of the PCT in the sample, was converted into continuou...

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  • Survey of management of patent ductus arteriosus in neonatal units across England
    Anay M. Kulkarni

    We read with great interest the review "Patent ductus arteriosus-time to grasp the nettle" (Smith, Kissack, ADC F&N 2013; 98) which highlighted the controversies in PDA management and variation in management. Evidence to support the routine closure of the ductus arteriosus to improve neonatal morbidity remains inconclusive1. We recently conducted a survey on PDA management in neonatal units across England to understan...

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  • This may due to Low Maternal DHEA
    James M. Howard

    It is my hypothesis that evolution selected dehydroepiandrosterone(DHEA) because it optimizes replication and transcription of DNA. Therefore DHEA levels affect all tissues and life span. (I think selection for DHEA produced mammalia. "Hormones in Mammalian Evolution," Rivista di Biologia / Biology Forum 2001; 94: 177- 184).

    A case may be made that sufficient maternal DHEA is necessary both for conception an...

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  • End of life decision making
    Anushma Sharma

    End of Life Decision Making (EoL DM) in NICU is an extremely sensitive issue. In our unit we have practiced shared DM for a long time however as the authors write we did not come across any large studies looking into parents perceptions of EoL DM in the long term.

    1. We appreciate that telephonic interviews were discarded in this paper to ensure accurate assessment of parent's self-perceived role. Also interv...

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  • Positioning of neonates for lumbar puncture
    Anushma Sharma

    Lumbar puncture is a blind procedure (no guidance about the path of the lumbar puncture needle except for the sensory information that the performer obtains about interspinous distance before inserting the needle and upon puncturing the duramater). 1. We feel that the for a successful procedure, besides ensuring adequate interspinous space to insert the needle by ensuring optimum position of the patient it is very import...

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