151 e-Letters

published between 2005 and 2008

  • 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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  • Conservative treatment of symptomatic patent ductus arteriosus beyond the first week of life
    Jasper V Been

    Bose and Laughon have clearly reviewed the lack of evidence for current treatments of patent ductus arteriosus (PDA) in preterm infants.[1] As highlighted, the general tendency to treat a clinically relevant PDA for fear of adverse clinical outcome with either indomethacin or surgery when indomethacin fails has caused a lack of information on the natural history of symptomatic PDA. Spontaneous PDA closure has been report...

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  • Prevalence and pathogenesis of congenital anomalies in cerebral palsy - letter to editor
    Maria A Loane
    Peter Pharoah conducted a study comparing the livebirth prevalence of congenital anomalies in children with CP living in Merseyside UK to the prevalence of congenital anomalies in 8 UK EUROCAT population-based congenital anomaly registers 1. EUROCAT is a European network of population-based registries for the epidemiologic surveillance of congenital anomalies. Currently, the network consists of 39 active registries in 20 count...
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  • Prophylaxis to reduce fungal infection in neonates
    Renato S Procianoy

    The study by McCrossan et al showed that fluconazole prophylaxis in a selected group of preterm infants with birth weight less than 1,500 grams decreases invasive fungal infection [1]. We agree that a carefully delineated risk-factor approach to the prevention of Candida infection in neonates may be a useful alternative to continuous fluconazole prophylaxis and may decrease the risk of the emergence of fluconazole-resistan...

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