eLetters

132 e-Letters

published between 2014 and 2017

  • Sleep duration for children with autism spectrum disorders: longitudinal study
    Tomoyuki Kawada

    Humphreys et al. investigated a prospective longitudinal study of sleep duration in 73 children with autistic spectrum disorder (ASD) by setting controls (1). Sleep data were collected by questionnaire survey from parents. Although there was no significant difference in total sleep duration in infancy, shortening of night sleep duration became predominant in children with ASD from 30 months of age, which was caused by lat...

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  • Re: The value of Child Death Overview Panels (CDOP) remains unproven
    Dr Luke Allen

    Value for money

    We endorse the sentiments expressed by Mecrow and O'Connor, and acknowledge the concerns they raise. As emphasised in our paper, there is currently a lack of evidence for the efficacy, efficiency and effectiveness of the child death review process. However, we would argue that the value of the CDOP process is not predicated on a demonstrable reduction in mortality alone.

    While demons...

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  • Cultural awareness; small volumes of blood for culture cause under-detection of invasive infections
    Alasdair P.S Munro

    We read with interest your article demonstrating surprisingly low levels of culture-confirmed invasive bacterial infections in children.[1] Whilst we agree better strategies are needed for separating low risk, febrile children from those with invasive-infections, we believe there is another significant factor contributing to their apparent low rates.

    Large studies demonstrate that blood-culture volumes are frequ...

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  • The value of Child Death Overview Panels (CDOP) remains unproven
    ian k Mecrow

    Allen et al (1) are to be congratulated in reporting the first attempt to quantify the efficacy and impact of Child Death Overview Panels (CDOP) in the UK. They note that Paediatricians contributing to the workings of the panel are of the view that the panels function well with 71% of responders agreeing or agreeing strongly that they offer good value. However, the nature of the study may have involved significant bias as...

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  • Re: NGS : ethical and social considerations
    Andrea Nemeth

    To the Editor,

    We are very pleased to see the comment from Dr Burke regarding the ethical and social considerations of Next Generation Sequencing, in response to our review.

    As we noted in our original article, the field is very complex, with a major issue being the interpretation of sequencing data, such that without follow up investigations many variants cannot be confidently assigned as either beni...

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  • Rapid tube weaning - benefits and challenges
    Peter J Scheer

    Dear Editor-in-chief, in reaction to Charlotte M Wrights editorial "Failure to wean" (2013, 98: 838-840) we would like to add some data on the option of rapid tube weaning to enhance the discussion between rapid versus slow weaning programs and to advocate a flexible and individually tailored approach. As Mrs Wright comments saying that no program suits every child we would like to stress that especially medically fragil...

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  • Audit confirming appropriate requesting of CT head scans in children with minor head injury
    Dr Ravindran Visagan

    Dear Sirs,

    We read with great interest your work on the cost effectiveness of clinical decision rules for minor head injury. As you point out, increased CT scanning reduces the risk of missing patients that require neurosurgery at the expense of increased radiation risk. This latter point has been recently raised in the literature [1,2] and prompted us to audit our practice of the appropriateness of CT scanning c...

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  • NGS : ethical and social considerations
    Katherine B Burke

    The new paradigm in which children undergo genetic investigations acknowledges that genetic information belongs to families, as well as individuals. Recent ACMG guidance [1] requires clinical laboratories in the USA to 'screen' genomes for 56 highly penetrant mutations with 24 disease associations when undertaking next generation sequencing (NGS), regardless of the indication, the age of the patient, and their preferenc...

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  • A patient-centred-care message
    Pierre R. Smeesters

    I read with great interest the important and elegant article written by Sullivan et al. Dealing with the death of children is always distressing, emotional and complex. It naturally leads to many difficult questions about what and when to say and do. There are no simple answers.

    However, one of the few certainties is that whatever decisions are taken, the parents will have to live, and hopefully cope, with what...

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  • Incorrectly quoted JCVI Guidance
    Sanjeev Deshpande

    I read with interest the article by Murray et al on prevention of respiratory syncytial virus disease in infants and children. However, the indications for use of passive immunoprophylaxis with Palivizumab as shown in Box 1 and referenced to in the statement 'Current JCVI guidance states that palivizumab is only cost-effective..... at most risk of severe disease (see box 1)17' are incorrect and represent a mixture of the...

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