264 e-Letters

published between 2008 and 2011

  • Congenital and neonatal varicella in the United Kingdom
    Janet E Berrington

    We note with interest the paper from Khandaker (1) and colleagues on the reduction of congenital and neonatal varicella infections following the introduction of immunisation of 18 month old children in Australia from 2005. Using surveillance methodology similar to that of the British Paediatric Surveillance Unit (BPSU) rates of congenital varicella (per 100,000 live births with 95% CI) have fallen from 0.8 (0.3 to 1.8) t...

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  • ERS guidelines for bronchoalveolar lavage in children with cystic fibrosis should not be abandoned
    Andrew T Hughes

    We read with interest the recent paper by Gilchrist et al(1) that looked at the issue of how many lobes should be sampled by bronchoalveolar lavage (BAL) in children with cystic fibrosis (CF). There is little evidence to guide our practice in this area.

    We note that the majority of the BAL results analysed in their study were taken from symptomatic patients, but it is unclear whether the BALs were performed du...

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  • Medical treatment in India - a major risk factor ?
    Samridh Nagar

    I read with great interest the leading article regarding the threat from ESBL organisms in children and was surprised and amused to note how the author reached the conclusion that medical treatment in India is a major risk factor for infection with carbapenemase - producing organisms in the UK. The author has herself noted that as per the Health protection Scotland wkly report 2009 which has documented the spread of thes...

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  • Mediation in medical-parental conflict
    Anne Ward Platt

    Dear Sir

    I am delighted that Meller and Barclay have echoed my call for mediation to be considered when the beliefs or views of parents are so at variance with those of the paediatricians that conventional clinical relationships break down, and matters are taken to Court. In 'Conflicts of Care - Could mediation help?' [1] I and my co-author highlighted the cases of Charlotte Wyatt who was severely disabled fol...

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  • Prevention not cure - focus Vitamin D treatment on the mother
    Nicholas D Embleton

    Gupta et al. yet again highlight a worrying trend in poor management of Vitamin D - both prevention and treatment. The majority of affected children come from high risk populations where rates of social disadvantage are high. The mothers of these children could all have been identified and given cheap, effective preventative treatment. Whilst we should be concerned that 30% of the children received inappropriate treatme...

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  • Response to "Food as a source of outbreaks of group A streptococcal disease"
    Kenneth H Lamden


    Eisenhut raises the possibility that food was the source of the outbreak of group A streptococcal disease at the primary school. This hypothesis was considered, but was rejected as implausible for several reasons; firstly the outbreak was not a true point source as it was preceded by five sentinel cases over a 12 day period, in addition the peak on the 16th May was inflated as it included cases with on...

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  • Respiratory and peripheral muscle function in asthmatic children and inhaled corticosteroids

    Dear Editor,

    We read with interest the paper by Villa F et al (1) and we would like to add some conclusions reached by our group after a clinical research evaluating peripheral muscle function in children with asthma treated with inhaled corticosteroids. (2) Asthma is one of the most prevalent chronic diseases in children, and its secondary exercise limitation, among other several effects, usually cause a decre...

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  • Time for Change to make sure there is Time to Train
    Damian T Roland

    Giles at al. highlights a significant issue which has previously been recognised but not always as well framed. It is vital for patient safety that specialists in all fields have had the opportunity to develop their skills once their core competencies have been achieved. The continuing need for trainees in the UK to provide an active service while at the same time undertake and be involved in post-graduate education is not...

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  • a graded attachment programme
    Sebastian Kraemer

    I am pleased to see a recommendation for shared paediatric/mental health clinics in treating CFS/ME. My clinical impression in a non- specialist hospital department is that most of these patients do not experience or exhibit anxiety or depression as much as profound frustration. This is similar to the presentation of children who cannot attend school ('school refusal') which of course is often a feature of CFS too.

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  • Models of paediatric care for cystic fibrosis: local clinics can deliver equitable care and offer many benefits
    Carol Dryden

    We read with interest the recent paper by Doull et al [1] which explores the optimal model for delivery of paediatric cystic fibrosis (CF) care. The authors compared three models of paediatric CF care within their established CF network: full centre care; local clinic based care with annual review by the CF centre; and hybrid care, where a child is usually reviewed at least three times a year by the specialist centre....

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