eLetters

679 e-Letters

  • Erythromycin for feeding intolerance
    HD Dellagrammaticas

    Dear Editor

    We read with interest the study by Ng et al [1], showing that 12.5mg/kg 6 hourly of oral erythromycin is effective in facilitating enteral feeding in VLBW neonates with GI dysmotility. As noted by the authors, a recent randomised controlled trial, using the same dose of intravenous however eryhtromycin [2], failed to show such benefits and possible reasons for this are stated by the authors in their...

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  • Hydrocortisone:Early treatment of hypotension in preterm infants
    A Soe

    Dear Editor

    We note with interest the paper by Ng et al[1]. Their study concluded that corticosteriod treatment could be lifesaving in severely hypotensive preterm infants who do not respond to conventional treatment with volume expanders and inotropes. The use of steroids in the management of hypotension in very low birthweight has already been shown to be effective [2].

    We wrote to this Journal in 199...

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  • A closer look at neonatal bacterial meningitis
    Gil Klinger

    Editor,

    Bacterial meningitis has its peak incidence in the neonatal period, but there are few data regarding factors affecting outcome. Like Holt and colleagues [1], we studied infants with meningitis, but focused on bacterial culture-proven cases [2]. Prognostic factors were identified by multivariate analysis in 101 infants with bacterial meningitis admitted between 1979 and 1998 to the Hospital for Sick Chi...

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  • Neonatal paroxetine withdrawal syndrome or actually serotonin syndrome? - Authors' response
    Joseph Stiskal

    Dear Editor,

    Isbister and colleagues point out important issues in defining the syndrome we and others described.[1][2] Their argument is that the described syndrome is due to a hyper-serotonergic state, rather than a lack of serotonin effect, as the term "withdrawal" suggests. We agree that this issue must be clearly solved because of the significant implications in the clinical management of some of the patient...

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  • Selection bias in preterm survival studies
    Peter Macfarlane
    Dear Editor,

    The systematic review by Evans and Levine[1] identifies sources of selection bias in reporting preterm survival and recommends cohort characteristics, which should be defined to avoid bias in future studies. To these should be added the more fundamental source of confounding; that of lack of uniformity in defining a ‘live birth’, particularly around the margins of viability. Statute law does not consiste...

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  • Knowledge of neonatal ultrasound for a neonatologist
    Mohan Swaminathan
    Dear Editor,

    I congratulate the authors of this article for highlighting the importance of Neonatal Ultrasound scan interpretation skills needed for a neonatologist.

    I feel that knowledge and skills needed to perform and interpret cranial ultrasound scans in newborns is as important to a Neonatologist as the need for good Echocardiography skills for a Cardiologist.

    Ultrasound scan interpretation should...

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  • Two sacred cows of neonatal intensive care - Authors' response
    Edmund Hey

    Dear Editor,

    I am glad to have a chance to respond to Dr Roberton's assertion that the care of the babies nursed using oximeter settings of 70-90% was "negligent", since I was responsible for these children, but time and space does not allow a full response. Neither does space allow me to respond to the criticism implicit in your own introductory statement that such care "breaches BAPM guidelines".

    Dr R...

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  • Oxygen saturation and retinopathy of prematurity - Authors' response
    Win Tin

    Dear Editor,

    We are happy to make it clear that we have never suggested that hypoxia is "beneficial" to babies with chronic lung disease. Indeed in describing our own practice we said, quite specifically, that "babies who were at least 8 weeks old [and it should be remembered that all our babies were born more than 12 weeks early], and whose retinal vasculature was mature, received liberal oxygen supplementatio...

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  • Dexamethasone, survival and neurological impairment
    William Tarnow-Mordi
    Dear Editor,

    Professor Pharoah questions whether the increased rate of cerebral palsy among newborn infants who were randomly allocated early postnatal dexamethasone therapy in the trial by Shinwell et al[1] might be because dexamethasone increased survival of infants who were impaired before birth, and not because dexamethasone caused cerebral impairment.

    However, two recent systematic reviews of randomise...

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  • Neonatal paroxetine withdrawal syndrome or actually serotonin syndrome?
    Geoffrey K Isbister
    Dear Editor

    We would like to comment on the article “Neonatal paroxetine withdrawal syndrome” in the March 2001 issue of the journal.[1] The authors describe what they have called “neonatal paroxetine withdrawal syndrome”. However the syndrome reported in the 4 neonates appears to be more consistent with serotonin toxicity, rather than withdrawal of paroxetine.

    The literature to date contains one large serie...

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