71 e-Letters

published between 2011 and 2014

  • This may due to Low Maternal DHEA
    James M. Howard

    It is my hypothesis that evolution selected dehydroepiandrosterone(DHEA) because it optimizes replication and transcription of DNA. Therefore DHEA levels affect all tissues and life span. (I think selection for DHEA produced mammalia. "Hormones in Mammalian Evolution," Rivista di Biologia / Biology Forum 2001; 94: 177- 184).

    A case may be made that sufficient maternal DHEA is necessary both for conception an...

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  • End of life decision making
    Anushma Sharma

    End of Life Decision Making (EoL DM) in NICU is an extremely sensitive issue. In our unit we have practiced shared DM for a long time however as the authors write we did not come across any large studies looking into parents perceptions of EoL DM in the long term.

    1. We appreciate that telephonic interviews were discarded in this paper to ensure accurate assessment of parent's self-perceived role. Also interv...

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  • Positioning of neonates for lumbar puncture
    Anushma Sharma

    Lumbar puncture is a blind procedure (no guidance about the path of the lumbar puncture needle except for the sensory information that the performer obtains about interspinous distance before inserting the needle and upon puncturing the duramater). 1. We feel that the for a successful procedure, besides ensuring adequate interspinous space to insert the needle by ensuring optimum position of the patient it is very import...

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  • Re:Minimally-invasive (and painful?) surfactant therapy.
    Rosilu F. Barbosa

    Sir, we read with interest the article by Dargaville et al., entitled "Minimally-invasive surfactant therapy in preterm infants on continuous positive airway pressure", in which the authors describe significant results using a semirigid vascular catheter inserted into the trachea by direct laringoscopy for surfactant administration, without analgesia and sedation(1). However, direct laringoscopy and tracheal manipulation...

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  • Born just a few weeks early: does it matter?
    Sailesh Kotecha

    Sarah J Kotecha1, John Henderson2, Sailesh Kotecha1.

    1Department of Child Health, Cardiff University, Cardiff. 2School of Social and Community Medicine, University of Bristol, Bristol.

    Re: Born just a few weeks early: does it matter? Boyle et al. 98:F85- 88. Doi:10.1136/archdischild-2011-300535.

    We read with interest the review by Boyle and Boyle on early and late morbidity in late preterm bo...

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  • Should air insufflation to aid location of gastric feeding tube tip location in neonates become standard practice?
    Rachel Beckett

    Quandt et al (1) have emphasised stomach insufflation as a means to improve neonatal feeding tube location rates. Experience in our neonatal unit indicates that other measures may be more important.

    It is a practice standard in our neonatal unit for a gastric tube to be placed prior to performing the first chest radiograph. We retrospectively audited all first chest radiographs taken during the six month perio...

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  • Delay in identification of oesophageal atresia in a preterm neonate with radial club hand due to coiling of 5F nasogastric tube
    Gengaimuthu Karthikeyan

    We had a 29 weeks/1.29kg/male neonate born with left radial club hand deformity. The resident attending the resuscitation had 'passed' a 5F nasogastric tube and certified the orifices patent. Baby was admitted in NICU, had no respiratory distress and was started on trophic feeds of 2ml 2 hourly by 5F nasogastric tube passed via the nostril which the baby 'accepted'. After 12 hours baby developed worsening respiratory dist...

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  • Etiology of perinatal stroke; a role for prothrombotic coagulation factors?
    Spalice Alberto

    We read with grat interest the article on perinatal stroke of J Harteman and co-workers. In our experience in perinatal stroke, multiple, often coexisting, risk factors are involved, varying from maternal and fetal risk factors during pregnancy and delivery, to infectious causes and cardiac diseases as well as medical interventions and congenital prothrombotic coagulation factors. We have performed a retrospective study t...

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  • ROP in larger babies gives insight into basic mechanisms but poses a clinical challenge
    Alistair R Fielder

    Aggressive posterior retinopathy of prematurity (APROP), the most aggressive form of ROP which carries a poor prognosis despite treatment, is seen only rarely in the UK. It was formally described in 2005 1 and is thought to be confined to the most immature preterm baby when the developing retinal vessels have reached only zone I or posterior zone II. This belief was challenged most effectively by Shah et al who recently...

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  • Measuring the wrong force leads to unjustified conclusions
    Andrew J McArdle
    Dear Editor,

    While commending van Vonderen et al. for an interesting and well-executed study on forces applied during mask ventilation of neonates1, I have two criticisms.

    Firstly, the study was inappropriate to discover whether in compensating for mask leak, clinicians "[press] down on the mask too hard, leading to obstruction of the nose and mouth.1" In measuring the force transmitted...
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