110 e-Letters

published between 2008 and 2011

  • This is evidence of the ongoing "Secular Trend."
    James M. Howard

    It is my hypothesis that the "secular trend," the increase in size and earlier puberty occurring in children, is caused by an increase in the percentage of individuals of higher testosterone. More specifically, I suggest this is due to an increase in the percentage of mothers of higher testosterone with time within the population. This exposes more fetuses to increased maternal testosterone with time within the population....

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  • Risk factors for early neonatal sepsis
    Deepak Chawla

    Very well conceived, conducted and analysed study. Two comments: 1. In table 1 "received intrapartum antibiotics" should be "not received intrapartum antibiotics" as later appears to be risk factor (OR>1) as per text. 2. In table 2: scores allocated to risk factors are respective adjusted odds ratios rounded to nearest integers. However, for per vaginal examination 3 or more and for clinical chorioamnionitis, the score...

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  • The Rationale for managing gastrooesophageal reflux in neonates needs more research and sensible use of available evidence.
    Egware B Odeka DCH FRCP FRCPCH

    The team from Leeds have highlighted a very important area of neonatal practice that is still seeking clarification and enlightenment.Neonates do have a high incidence of reflux due to physiologic and iatrogenic causes.These have been clearly highlighted in this review.The choice and rationale for treating these babies clearly shows that more work still needs to done before we can be sure that the doctors and nurses are...

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  • Ethical Issues, Critical care decisions in Neonates - Do the Swiss have the answer?
    Egware B Dr Odeka

    The challenge of making ethical decisions on 'end of life issues' in neonates remains a hot and emotive topic for debate and individual detailed analysis everytime it comes to light.This paper which discusses the Swiss experience,highlights the variability in the application of ethical judgement in this area of medicine.While this paper examined the practical impact of implimenting the Swiss society of neonatology guide...

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  • Delayed cord clamping should be more widely practised
    Andrew C Gallagher

    Dear Sir Professor Weindling questions why therapeutic hypothermia, an intervention that may be incompletely proven, has been widely adopted into clinical practice whereas other interventions such as delayed cord clamping (DCC) have not.[1] DCC has been subjected to RCTs and meta-analyses all of which demonstrate benefits for both term and premature infants with no evidence of any harmful effects.[2] We consider that DCC s...

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  • Is permissive hypotension safe?
    Hilary Klonin

    We read with interest the paper by Dempsey and colleagues regarding permissive hypotension in low birth weight infants. We are unsure that the data as presented fully supports some of the conclusions drawn.

    Those infants in whom hypotension was treated were deemed to be unwell by the clinicians looking after them. This appears to have been a sicker group at outset in terms of clinical and crib assessment. These...

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  • Re: The exact negative predictive value of procalcitonin remains to be determined
    Aurélien Jacquot

    We would like to thank Mr Degraeuwe for his interest about our study [1]. He is correct in stating that the confidence intervals are useful in interpreting the diagnostic value of procalcitonin. The sensitivity, specificity, positive and negative predictive values expressed as percentages (95% CI) were respectively 100 (88-100), 65 (54-76), 67 (56- 78) and 100 (88-100) for PCT at the 0.6 ng/mL cut-off value.


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  • Diagnostic value of subependymal pseudocysts and choroid plexus cysts on neonatal ultrasound
    Breda C Hayes

    Sir, Alvarez and colleagues1 report a clinically useful metanalysis on the diagnostic value of subependymal pseudocysts and choroid plexus cysts seen on neonatal cerebral ultrasound. It appears that complex subependymal cysts at the caudothalamic groove may be more important clinically than simple cysts here or in the choroid plexus. Their analysis did not expose two other important conditions causing multiple and/or bila...

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  • Neuromuscular blockers in compasionate care
    Ian A Laing

    Verhagen et al describe the use of analgesics, sedatives and neuromuscular blockers during reorientation of care to compassionate measures in Groningen, the Netherlands (1). The authors draw attention to the fact that in 16% of such events, neuromuscular blockers (NMBs) were used. In cases, NMBs were used to eliminate gasping after the endotracheal tube had been removed. Diagnoses and reasons for administering NMBs afte...

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  • The exact negative predictive value of procalcitonin remains to be determined
    Pieter L.J. Degraeuwe

    Dear Sir

    I am writing this letter in reference to the article "Rapid quantitative procalcitonin measurement to diagnose nosocomial infections in newborn infants" by Jacquot et al. [1] The aim of this study was to investigate the diagnostic accuracy of procalcitonin in neonatal nosocomial infections. However, the flawed methodology and the incomplete reporting preclude a reliable conclusion with respect to the d...

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