eLetters

228 e-Letters

published between 2002 and 2005

  • Re: Cardiac skills in neonatology/ A response from Jasper Katumba-Lunyenya
    Jasper Katumba-Lunyenya

    Dear Editor

    I would like to thank Dr Thomson and colleagues for their comments. I need to clarify on an issue they picked upon which when quoted in isolation gives the reader the wrong impression. They seem to suggest that I am advising the reader that inappropriate referrals are “firmly refused” out of hand. What I actually meant, if you read on, was that one should refuse to see referrals from other colleagues w...

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  • Positivity of neonatal blood cultures - what is the relevance of timing? Points to ponder!
    Girish Gupta

    Dear Editor

    We read the article by Kumar et al[1] with interest especially in light of the changing profiles of NICU practices as applicable to a developing nation with limited resources and lack of uniform parameters for antibiotic usage, resulting in the emergence of drug resistant strains. However, the utility of a rapid diagnostic system has to be viewed in the light of its universal applicability. The cost of s...

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  • Cardiac skills in neonatology
    John D Thomson

    Dear Editor

    Dr Katumba-Lunyenya rightly recognises that management of common cardiological problems in neonates is beyond the resource provision for congenital heart disease specialists in the UK. The author also realises that along with the echocardiographic skills come the “innappropriate referrals”. Sadly there is no doubt that the increased reliance on investigations of all types (particularly the echocardi...

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  • Re: The forgotten organ in the NICU/ Katumba-Lunyenya responds
    Jasper Katumba-Lunyenya

    Dear Editor,

    I would like to thank Dr McNamara for his useful comments about my paper. It is quite clear from his letter, however, that his degree of development of the skill of echocardiography is way beyond that required by a neonatologist. This needs to be emphasised lest neonatologists are put off for fear of having to go for formal retraining to achieve the obviously very advanced level of scanning like D...

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  • The forgotten organ in the NICU
    Patrick J McNamara

    Dear Editor

    The personal experience by Katumba-Lunyenya echoes the views and experiences of many contemporary neonatologists who recognize the importance of routine echocardiography as an integral part of neonatal intensive care [1]. Oftentimes the importance of routine echocardiography in the management of the sick preterm or term infant is underestimated. The echocardiographic needs of a large neonatal intensive c...

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  • Dehydration and hypoglycaemia in term breast fed infants
    Roslyn M Thomas

    Dear Editor

    We have read with interest the article by Oddie et al [1] and subsequent correspondence from Williams [2], Harding et al [3] about weighing breast fed babies. With the ongoing shortage of midwives throughout the UK, staffing levels on postnatal wards are low. We are increasingly worried about the decline in support available to mothers trying to establish lactation in the days immediately after delivery...

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  • Cardiac murmurs in healthy newborn infants - have we updated our practice?
    Nicola J Robertson

    Dear Editor

    We would like to highlight the varying practices in the management of cardiac murmurs in well newborn infants. Two years after the publication of Wren's important paper on this subject[1] urging an early definitive structural diagnosis to be made on such infants we conducted a telephone survey of local hospitals to assess whether practices had changed.

    Until recently it was common practice to...

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  • Ketamine for procedural pain in neonates - Risk vs. benefit
    Ramachandran Satya-Krishna

    Dear Editor

    Whilst we would applaud the search for an alternative to opioid analgesia for procedural pain relief in neonates (Saarenmaa et al. Arch Dis Child Fetal Neonatal Ed 2001;85:F53-6), we are rather puzzled by the choice of ketamine. The authors chose ketamine as it has "few cardiovascular effects and minor respiratory depression" and have quoted references to support ketamine's safety. We believe there is...

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