110 e-Letters

published between 2008 and 2011

  • Question about the article
    Leonie C Rubbens

    Dear Mario de Curtis,

    With attention I read your article 'Comparison between rectal and infrared skin temperature in the newborn' in Arch Dis Child Fetal Neonatal Ed (2008) 93. As I see, you found hopeful results of the skin device. At this moment I investigate an infrared skin device as well. Therefore, I read some literature including your article. However, there is one thing I do not understand. In the results p...

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  • Delayed cord clamping in clinical practice needs more evidence
    Dr Egware B Odeka FRCP FRCPCH

    We read with interest the article on delayed cord clamping in preterm infants (1)

    The authors looked at the outcomes of early versus delayed cord clamping in babies born between 34 and 36 weeks of gestation on haemoglobin and blood glucose levels during early neonatal period and haemoglobin and ferritin levels at 10 weeks of age. They found that the haemoglobin levels were consistently higher at both early neona...

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  • Management of neonatal diabetes mellitus
    Cheri Mathews John


    I read with interest the authors’ description of transient neonatal diabetes mellitus in a pre-term infant. Genetic studies have an important role in the management of these patients. This is an example of pharmacogenetics where the genetic cause of the insulin deficiency determines the response to treatment. It is important that mutations in the ABCC8 are looked for. In a recent case series (1), fou...

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  • Noise levels during neonatal helmet CPAP
    Daniele Trevisanuto

    High noise levels during nCPAP reported by Karam et al. demonstrate the presence of a continuous exposition to audio trauma by the developing ears of preterm infants.1 These levels were directly related to the flow through the circuits, but not to the pressure generated, neither to the type of nCPAP device used. To improve the patient-ventilator interface we developed a new device (neonatal helmet CPAP) to administer C...

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  • Gap in continuos monitoring with fetal distress
    David J R Hutchon

    O'Donnell et al (1) explain the need for documenting neonatal resuscitation for audit and teaching purposes. Obstetricians make great efforts to monitor the fetus during labour in the hope of being able to intervene when signs of significant fetal hypoxia develop. Intermittent monitoring may be sufficient in low risk women but continuous monitoring is common in hospital units. If fetal distress is detected and the decisi...

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  • Pulse Oximetry as a Screening Test for Detecting Congenital Heart Diseases
    Abhay Bhoyar

    Dear Editor

    We agree with Dr Gandhi¡¯s view that a large, well designed study is required to answer the important question about accuracy and feasibility of pulse oximetry in the early neonatal period. However, we would like to clarify the design of such a study particularly focussing on outcome measures that should be investigated. It should be a test accuracy study for prediction of congenital heart disease (...

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  • Improving diagnosis of neonatal CVS malformations – a genuine prospect or wishful thinking?
    Anjum Gandhi


    We read with interest the original article by Wren et al about the trends in diagnosis of major congenital cardiovascular malformations published in the fetal and neonatal issue of the journal1. The paper discusses the difficulties which we are still experiencing in diagnosing the cardiovascular (CVS) abnormalities. It is evident that we continue to miss life threatening abnormalities despite efforts to imp...

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  • Spontaneous gastric perforation in newborn
    Abraham Neduvamkunnil
    Your point of transillumination test to detect pneumoperitoneum in gastric perforation in a newborn is quite valid and shows the importance of simple bedside test to detect an early abdominal catastrophe. Recently, we encountered a 35 weeker, No risk factors for sepsis,commenced on nasogastric feeds on day1,and on D2 had marked abdominal distension.X-ray abdomen showed dilated loops with no air under diaphragm, a repeat X-ray on...
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  • Resuscitate with the placental circulation intact
    David JR Hutchon

    Reynolds, like the majority of us neonatologists and obstetricians, would be unable to keep his nerve and delay three minutes before clamping and cutting the cord to be able to proceed with resuscitation. However maintaining a placental circulation may sometimes be all that is required as Aristotle (1) observed “Frequently the child appears to be born dead, when it is feeble and when, before the tying of the cord,...

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  • Practical approach to improve prophylaxis against fungal infections
    Yoram A Bental

    áñ"ã To the Editor, We read with interest the article by McCrossan et al on selective fluconazole prophylaxis. Reviewing the data presented in Table 2, in 3 out of 4 infants with positive blood culture, cephalosporin was involved. A practical conclusion would be to eliminate the use of cephalosporin in VLBW infants. Another measure would be to shorten empiric antibiotic use to 3-4 days (if cultures prove to be negative)...

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