eLetters

331 e-Letters

published between 1999 and 2002

  • Conflicting advice
    Adam Finn

    Dear Editor

    As a follow up to this article, the most recent CMO letter [1] sent out in August 2002, updates the recommendations issued by the Dept. of Health (DoH) in January 2002[2] by making the recommendations for "at risk" under 2 year old children coincide with the manufacturer's recommendations for immunisation of normal healthy children in their Summary of Product Characteristics for their European product licence...

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  • Re: Acute ataxia complicating Langherans cell histiocytosis
    Jon Pritchard

    Dear Editor

    Some of the statements in this interesting "Short Report" by A Polizzi et al.[1] can be challenged. It is incorrect to suggest that cerebellar ataxia has been reported "only occasionally" in children and that it is commoner in adults with Langerhans Cell Histiocytosis (LCH). Diabetes insipidus is the only CNS complication that is more common than cerebellar disease and though the precise relative...

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  • Short duration antibiotic therapy for lower tract UTI
    Elisabeth M Hodson

    Dear Editor

    In response to Keren and Chan’s thoughtful letter [1] regarding our recent systematic review,[2] we need to emphasise that the study question we addressed was different from that addressed by Keren and Chan in their own systematic review[3] of randomised controlled trials comparing short with standard duration therapy in the treatment of children with urinary tract infection (UTI). The aim of our study was to...

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  • Defer and practise
    Stuart Crisp

    Dear Editor

    1. Defer
    I am a Registrar who used to lumbar puncture (LP) almost anyone febrile under a year, but then swung to the opposite extreme. Nowadays I decide on the balance of risk based on my clinical experience.The decision on whether to perform a LP should be taken by an experienced paediatrician, but this does not need to be the moment the child arrrives in A&E. Is there anything...

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  • Hypocalcaemia and calcitonin precursors in critically ill patients
    Basil J Ammori

    Dear Editor

    We read with interest the paper by Baines and Colleagues [1] in which the authors reported a strong inverse relationship between total serum calcium concentrations and disease severity in 70 critically ill children with meningococcal disease. Calcitonin concentrations were measured in a subgroup of 23 children on admission, and significantly correlated with disease severity. In particular, however, the...

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  • Author's reply
    Rachel Kneen

    Dear Editor

    We thank Dr Isaacs for his helpful letter. He rightly points out that the published recommendations as to which Glasgow Coma Scale score serves as a contraindication to a lumbar puncture vary between < 8 and < 13, though we are not aware of any definitive evidence supporting either value. For the purposes of our overview commentary we chose the most conservative value (<13), which is also...

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  • Developing a managed clinical network in Paediatric Gastroenterology
    Shomik Ghosal

    Dear Editor

    We would like to respond to the comments made by Dodd K, in respect to the article by Cropper S et al.[1]

    Paediatric Gastroenterology was chosen by Partners in Paediatrics (PiP) as the first subspecialty for developing a managed clinical network. Two accredited Paediatric Gastroenterologists were appointed in 2001 making a total of two full time and one part time specialists in the PiP ar...

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  • Why blame worms only?
    Vinayak A. Pai

    Dear Editor

    We read with an interest the case of cerebellar ataxia reported by Drs Shroff and Houston.

    Having worked in India for some time ,we have come across few cases of cerebellar ataxia of unusual etiology. Anti-helminthic are known to cause few side effects including cerebellar ataxia. Authors are correct in presuming temporal relation between piperazine citrate ingestion and ataxia. But delayed neu...

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  • A self-fulfilling prophesy?
    Theo H Fenton

    Dear Editor

    Carroll and Brookfield[1] quote a widely used definition of febrile convulsion in their second paragraph: "an epileptic seizure occurring in a child aged from 6 months to 5 years, precipitated by fever arising from infection outside the nervous system in a child who is otherwise neurologically normal". The authors then go on to say that only a tiny percentage of children with febrile convulsions have meni...

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  • LP: contraindications
    Vijayashankara C Nanjegowda

    Dear Editor

    I read the article and the two responses regarding the declining practice of lumbar puncture in children with CNS infections.[1-3] Yes, it is true that the number of LPs (lumbar punctures) have become less and less over the years in the developed countries. However, LB is still practiced as a common investigative procedure in suspected CNS infections in these countries, even in the presence of definitiv...

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