eLetters

1458 e-Letters

  • Re:Bruising in children with bleeding disorders - Limitations
    Peter Collins

    Dear Editors

    We thank Drs Chakraborty and Morris for their interest in our study. We acknowledge that the children without bleeding disorders were only recruited in south Wales whilst those with bleeding disorders were recruited in centres around the UK. Given the data available we are not able to comment on whether children are likely to bruise differently dependent on where they live.

    We agree that...

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  • What we may have missed
    Michael A. Colvin

    Two alternative explanations are given by Professor Taylor for the global problem with ADHD diagnosis, but he overlooks one interesting possibility- perhaps the reported prevalences are about right. That is, perhaps the rates really do vary considerably between populations and are rising in the USA and in other countries.

    Professor Taylor recognises some obvious facts. Firstly, there is a large unmet need. Seco...

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  • Acute, unplanned paediatric admissions and earlier consultant review
    Julian M Sandell

    The team from Evelina are to be commended for questioning the current direction of travel of acute hospital practice, seeking to find "policy- based evidence" supporting the drive for increasingly consultant-delivered healthcare and their detailed report should help inform wider discussions, not just in paediatrics but across the entire spectrum of acute hospital medicine.

    Apart from two specific instances (very sh...

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  • Re: Apple juice for rehydration.
    Robert Scott-Jupp

    I am grateful to Prof Weizman for his response to my Archivist article. Like him, I was concerned that the saccharide content and high osmolality of apple juice might make diarrhoea worse, not better. However, the authors of this article did not find this. It is possible that their surveillance for this adverse effect was inadequate but this cannot be deduced from the article. Archivist can only convey what authors report...

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  • The challenges of communication to address Moral Distress
    Trisha Prentice

    We thank Dr Kraemer for his constructive response and commend his initiative to facilitate weekly staff meetings within neonatal intensive care units. We concur that communication is an essential component of addressing not only moral distress but improving workplace culture.

    As Dr Kraemer notes, finding the best forum for such discussions continues to be challenging. In our various institutions we continue to...

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  • Re:Hypercalcaemia and neonatal sepsis
    Jane D McNeilly

    The purpose of our study was to document the prevalence of hypercalcaemia in children and its possible associations and we agree with the correspondent that it would be helpful to confirm these associations, such as the one highlighted for sepsis, thorough more detailed and rigorous studies.

    Conflict of Interest:

    None declared

  • Apple juice for rehydration.
    Zvi Weizman

    I read with great interest the Archivist regarding Apple juice for rehydration. It summarizes a recent study from Toronto, Canada set out to see whether dilute apple juice was as good as standard electrolyte maintenance solution for rehydration (Freedman S, et al. JAMA 2016;doi:10.1001/jama.2016.5352). They conclude that the use of half- strength apple juice may be an appropriate alternative to electrolyte maintenance fl...

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  • Bruising in children with bleeding disorders - Limitations
    Mallinath Chakraborty

    Dear Sir,

    We would like to congratulate the authors of this excellent observational study. For paediatricians, and for medico-legal professionals, data from this study would be invaluable in their practice.

    While the authors have discussed most of the limitations of their study, we would like to point out a few more which have come to our notice.

    1) Controls were recruited only from South Wal...

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  • reflective staff meetings include attention to moral distress
    Sebastian KRAEMER

    The findings of this important paper should be used to promote regular staff development meetings in neonatal intensive care units. In my experience the reason these are not more widespread is lack of availability of suitably qualified staff to facilitate such groups. Clinicians may ask for support then find the meetings disappointing.

    Over many years in a district general hospital neonatal unit a colleague and...

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  • Re:Fowl Language - a role in paediatric advocacy
    Delan Devakumar

    We thank Dr Williams and Mrs Scudamore for their letter. We entirely agree with the comments made and congratulate them on giving a voice to Rosie and other children and their families. We endorse the approach taken that makes children and young people central to any advocacy efforts. As we describe, and is mentioned in article 12 of the UNCRC, the first step is to listen to and engage with the children and young people th...

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