eLetters

228 e-Letters

published between 2002 and 2005

  • Pooling of trials is not appropriate in case of heterogeneity
    Casper W Bollen

    Dear Editor

    We read the systematic review by Thome et al. with great interest on the elective use of high frequency ventilation compared with conventional mechanical ventilation in preterm infants.[1] Thome et al. included 17 randomized trials and stated that unlike previous meta-analyses they did not find significant benefits in pulmonary outcome. They also referred to our published cumulative meta-...

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  • Identifying death due to neonatal sepsis by verbal autopsy
    Radhanath Satpathy

    Dear Editor

    I read the review article by Vergnano S et al. with interest.

    It is correct that many deaths in developing countries do occur without health facility notification. Up to 70% of deliveries occur at home and nearly 50% of those may occur in unhygienic conditions. Both mother and baby remain at risk.

    We also agree that neonatal deaths are frequently under-reported. This could be for m...

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  • Re: Avoiding ROP blindness
    Kanchan Majumdar

    Your articles are very valid. But, these will be more meaningful if you give the practices followed in the Neonatal Units in hospitals to prevent blindness due to ROP. e.g.:

    Frequency of eye examinations after birth of a premature child?
    Level of oxygen and how it is administered in the incubator?
    Frequency and method of monitoring?
    What specific action is taken...

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  • Not all osmolality is created equal
    Tanis R Fenton

    Dear Editor,

    The article “Increased osmolality of breast milk with therapeutic additives” by L Srinivasan et al. reports the osmolality of supplements, drugs and fortifiers to breastmilk for preterm infants based on the assumption that laboratory measured osmolality presents an increased risk of necrotizing enterocolitis (NEC) for the preterm infant.[1] In the consideration of the association between hyperosmolar...

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  • Postnatal weight loss in term infants: what is "normal" and do growth charts allow for it?
    Peter D Macdonald

    Dear Editor,

    In their study Drs Wright and Parkinson report that breast fed infants showed less postnatal weight gain compared to formula-fed infants and were significantly more likely to lose more than 10% of their birth weight.[1] They comment that this trend was no longer significant after adjustment for birth weight, which was significantly higher in breast fed infants. I wonder if adjusting for birthweight is act...

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  • Avoiding ROP blindness
    Padmaja Kumari Rani

    Dear Editor,

    We read with interest the article by Haines et al.[1] We would like to add few points which can improve ROP screening programs world wide. Even though low birth weight is an important risk factor, ROP increasingly reported in higher birth weight babies also.[2]

    Varying morphology of ROP also noted in especially in very low birth weight infants (...

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  • Re: Inadvertent overdosing of neonates
    Anjali S. Bangalore

    Dear Editor,

    I agree with you that there can be overdosage while administrating IV medications in neonates. These are few of the precautions we take in our neonatal unit to avoid medication errors.

    1. The required quantity of diluent is first drawn in the syringe and then the required amount of the drug is drawn in the syringe and quantity measured in the middle part of the syringe.

    2. Required qua...

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  • Avoiding another source of dilutional errors
    Kathleen S Bohanon

    Dear Editor,

    Both Drs. Bhambhani and Richmond miss an important point in discussing methods to avoid syringe dead space errors in diluting medications for neonatal dosing. The assumption that volumes as small as 0.02 cc can be accurately measured with a 1 cc syringe is erroneous. A number of years ago I was investigating the etiology of wildly erratic gentamicin levels and learned that the syringe manufacturer on...

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  • Postnatal weight loss in term infants: to correct for birthweight or not.
    Peter D Macdonald

    Dear Editor,

    In their study Drs Wright and Parkinson report that breast fed infants showed less postnatal weight gain compared to formula-fed infants and were significantly more likely to lose more than 10% of their birth weight. [1] They comment that this trend was no longer significant after adjustment for birth weight, which was significantly higher in breast fed infants. I wonder if adjusting for birthweigh...

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  • Avoiding the syringe dead space
    Sam Richmond

    Dear Editor,

    There is a simpler solution to the problem of the syringe dead space when diluting drugs which was raised by Dr Bhambani et al. and that is to draw some of the diluent into the syringe first. Perhaps I may be allowed to quote from the section on neonatal drug administration on page 5 of the Neonatal Formulary (4th edition, 2003 - www.neonatalformulary.com).

    "Many drugs have to be diluted be...

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