eLetters

331 e-Letters

published between 1999 and 2002

  • PCD or not PCD
    Maggie G Meeks

    Dear Editor

    In response to the leading article on Primary Ciliary Dyskinesia (PCD) [1] and the commentary by Dr Andrew Boon, we write as clinicians with an interest in PCD who work in general paediatrics and neonatology.

    We agree with Dr Boon that the identification of an uncommon medical disorder from the large number of children presenting with common symptoms and signs is a major challenge for the gene...

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  • Refugee children: don't replace one form of severe adversity with another
    Elspeth Webb

    Dear Editor

    We strongly agree with Fazel and Steinn’s view that refugee families require help that is culturally sensitive.[1] Failure to provide appropriate interventions in a culturally sensitive way to these children and their families means we potentially replace one form of severe adversity with another. Contrary to Fazel and Stein’s positive view of school such adversity may include, for some children, integra...

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  • Authors Reply to the comments of Nicola Wilson and
    Tabish Hazir

    Dear Editor

    Obviously the message which has gone across to Nicola Wilson and Michael Silverman is not what the authors had intended. What authors attempted to emphasize was the impact that carers perception may have on the general well being of an asthmatic patient. In no way the authors were being dismissive of these perceptions. Certain perceptions if allowed to prevail can have serious implications and the attempt wa...

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  • When do we apply the decision support system?
    C Vidyashankar

    Dear Editor

    Decision supports systems like Isabel are an useful aid to clinical diagnosis, more so in a primary care setting. The question is, at what stage do we apply the decision support system?

    1. It need not be applied to all patients presenting to our Out patient department or admitted to our hospitals as the diagnosis can be reached in a majority of the cases without the use of such tools...
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  • Carers’ perception of childhood asthma and its management in a selected Pakistan community.
    Nicola M Wilson

    Dear Editor

    As the authors demonstrated,[1] asthma awareness in their population could be improved. However, the failure of the majority of carers to recognise the hereditary basis of a condition that is increasing in prevalence is understandable, as is the perception that acute asthma is contagious, when an infection was correctly identified as the most frequent precipitating factor. What is more disturbing is the f...

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  • Questions on questionnaire development
    Johannes C van der Wouden

    Dear Editor

    With interest I read the paper by Powell et al.[1] on the development of a questionnaire to describe respiratory symptoms in infants and preschool children. Because of the age of the children this is a difficult topic, and the authors are to be congratulated for their attempt. However, a number of questions arose when reading their paper.

    First of all, the method for assessing test-retest re...

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  • Time for a randomised controlled trial of empyema treatment?
    Sam J Moss

    Dear Editor

    We were interested to read Pierrepoint MJ et al.’s short report in October’s edition of Archives,[1] which concluded that first line treatment of empyema thoracis should be with a pigtail catheter drain and urokinase. However, there is still on going debate as whether empyema thoracis is best treated like this[2] or by open thoracotomy and decortication.[3] It is interesting that the inpatient da...

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  • The BPSU, Reye's syndrome, and aspirin
    Susan M Hall

    Dear Editor

    In their excellent leading article on the British Paediatric Surveillance Unit, Verity and Preece refer to the value of the data from the Reye's syndrome (RS) surveillance study in demonstrating the decline in RS in the British Isles following the 1986 Committee on Safety of Medicines (CSM) warning about the use of aspirin in children under 12 years.[1]

    We wish to bring this observation up to da...

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  • Interesting pilot but more information required.
    Liza J Boyle

    Dear Editor

    I found the article regarding immunoglobulin levels in paediatric rheumatology patients receiving methotrexate interesting and relevant.[1] It is certainly important to recognise potential hazards with methotrexate in view of the fact that it is been used earlier and in higher doses in this group of patients.

    However, I feel that it would have been more beneficial to have a prospective study inc...

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  • LP controversies
    Denis G Gill

    Dear Editor

    Your commentaries (Sept 2002 ADC) on the role of lumbar puncture are welcome. I share your contributors' concern at the drop in numbers of lumbar punctures being performed often driven by certain protocols. One frequently hears paediatric trainees say that lumbar punctures make no difference to management. Children admitted with suspected meningitis are then "covered" with potent antibiotics and/or Acycl...

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