110 e-Letters

published between 2008 and 2011

  • Lactobezoar or Gavisconoma
    Nicholas D Embleton
    Vallabhaneni et al. describe a preterm infant developing obstruction secondary to bezoar formation. This is a rare but important occurence. The relationship with gaviscon (an un-licensed and un-proven treatment for gastro-oesophageal reflux) has been previously reported in this journal and is an alternative explanation. Should this be reported using the yellow card system to the BNF?


    (1) Sorbie AL, Symon DN,...

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  • Response to 'Thresholds for antibiotic resistance at which we change empirical treatment choices' (Postscript ADC November 2010, Volume 95, Issue 6)
    Berit Muller-Pebody

    Dr. Millar raises the point that an alternative broader-spectrum (and more expensive) antibiotic combination could be considered for empirical therapy of neonates with suspected early-onset sepsis in preference to penicillin and gentamicin which (based on our data) he estimated to be ineffective for 6% of cases.

    We support Dr Millar's view on the importance of appropriate empirical antibiotic treatment for septi...

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  • Maternal Testosterone Levels May Determine Birth Weight
    James M. Howard

    Black women produce more testosterone than white women and, I suggest, this is directly involved in problematic birth weights of offspring which occur more often in black women. Additionally, I think testosterone is increasing in women of different races and may account for ongoing changes in birth weight of offspring as well as a group of other negative pregnancy outcomes and problems in these offspring in later life....

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  • The bronze-baby syndrome: overlooked literature and pictures
    Antony F. McDonagh

    It is not true that the bronze baby syndrome "has never been pictorially described" (1). The first description of the syndrome in 1972 (2), to which De Luca et al did not refer (1), was illustrated with striking color photographs. Other color photographs of bronze babies have been published since then (3-5).

    The notion that the syndrome is caused by bilirubin-sensitized phototransformation of Cu(II)-protoporphy...

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  • Need for more evidence to support feeding protocols for the preterm babies.
    Dr Falak. N Gureebun Spr

    We are very grateful to Caroline for the very thoughtful and well- timed review of evidence for the feeding practices in neonates. We agree with the summary of this review. It is true that feeding of the preterm neonate has undergone major change since the beginning of the 20th century [1]. However, we remain far off from having evidence-based protocols for feeding the preterm or very low birth weight infant. The main que...

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  • Therapeutic hypothermia: Accessibility not availability
    Julie-Clare Becher

    Ponnusamy et al report on the availability of cooling equipment within UK neonatal units in 2009 (1). They conclude that only 28% of all units and 78% of level 3 units possess such equipment despite evidence supporting therapeutic hypothermia. Whilst we agree with the authors in supporting universal access to cooling for asphyxiated infants, the lack of local availability of equipment need not equate to a lack of access...

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  • 'Not enough breast milk' jaundice.
    Carol A Walshaw

    Preer and Philipp have drawn attention to inadequate breastfeeding and neonatal jaundice but omitted to mention the most important factor in breastfeeding success: the let-down reflex.1 In addition to prolactin, oxytocin (the hormone associated with the reflex) stimulates milk production: numerous oxytocin receptors on the milk secreting cells of the breast alveoli mediate a massive release of casein (milk protein) into...

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  • Cerebral tissue oxygen extraction in preterm infants before and after blood transfusion
    Stephen P Wardle

    Dear Sir,

    I read this paper with interest and would like to comment on some of the results and conclusions reached.

    The authors have studied changes in regional cerebral saturation (RSO2) using near infrared spectroscopy and used these to calculate fractional tissue oxygen extraction (FTOE) in babies felt to require blood transfusion and have made measurements before and after transfusion. They describ...

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  • Downward tonic gaze may not always be benign
    Sheila S Mathai

    Sir, The authors have rightly made a retrospective diagnosis of benign tonic gaze in the three infants described. However, no mention is made of whether or not tests for hypoglycemia and hypocalcemia were done at the time of occurance as subtle seizures not picked up on later EEG may present in this way and should be ruled out immedietely.

    Conflict of Interest:

    None declared...

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  • Need to focus on the next generation to solve this public health problem.
    Pradip K Thakur

    Dr. Mactier has done an excellent service by writing this article and bringing this issue to the fore front. It is indeed a huge public health problem and we do need many more studies to understand better treatment for long term outcomes for children of opiate dependent mothers. However, until such treatments and alternatives to methadone/buprenorphine are available, we need to keep treating these women with methadone/bu...

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