Clinical Problem-Solving: Decision Making by Analogy

Abstract

1 demonstrated the effectiveness of povidone-iodine prophylaxis against ophthalmia neonatorum but limited their observation of side effects to local toxic reactions. Were the systemic effects of povidone-iodine, such as alterations in thyroid metabolism, evaluated in a pilot study?Topical application of povidone-iodine has been known to cause transient hypothyroidism in newborns as a result of iodine excess. 2 Iodine-induced hyperthyroidism has also been described in a newborn exposed to large doses of iodine. 3 Although probably unimportant in most cases, the systemic effects of the conjunctival application of povidone-iodine should be thoroughly evaluated before the use of this form of prophylaxis becomes widespread, with special attention given to its impact on thyroid function in newborns.Letters to the Editor are considered for publication (subject to editing and abridgment) provided they do not contain material that has been submitted or published elsewhere. Please note the following:• Your letter must be typewritten and triple-spaced. • Its text, not including references, must not exceed 400 words (please include a word count). • It must have no more than five references and one figure or table.• It should not be signed by more than three authors. • Letters referring to a recent Journal article must be received within four weeks of its publication. • Please include your full address, telephone number, and fax number (if you have one). Our fax numbers: 617-739-9864 and 617-734-4457Our Internet address: letters@edit.nejm.orgWe cannot acknowledge receipt of your letter, but we will notify you when we have made a decision about publication. We are unable to provide prepublication proofs. Please enclose a stamped, self-addressed envelope if you want unpublished material returned to you.Financial associations or other possible conflicts of interest must be disclosed. Submission of a letter constitutes permission for the Massachusetts Medical Society, its licensees, and its assignees to use it in the Journal 's various editions (print, data base, and optical disk) and in anthologies, revisions, and any other form or medium. The New England Journal of Medicine Downloaded from nejm.org at DEAKIN UNIVERSITY on August 10, 2015. For personal use only. No other uses without permission.