423 e-Letters

published between 2006 and 2009

  • Editors should not be propagandists
    David Elliman

    We feel Dr Markovitch (1) was over critical of Hilton et al (2). Although we agree that there was a paucity of evidence to allow them to rebut Dr Wakefield’s suggestion that MMR could in some children cause autism, we believe that they still could have been clearer in reporting the full situation. The suggestion that the MMR vaccine should be given as its separate components came, not from a scientific paper, but as an a...

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  • aneroid devices should be the preferred "new" sphygmanometers
    oscar,m jolobe

    It would be useful to ascertain whether or not the "new" sphygmanometer being compared with the Omron HEM 711(1) was an aneroid device, given the fact that those of us who lamented what we perceived to be an ill advised rejection of the mercury device welcomed the prospect that aneriod sphygmanometers "may replace the traditional mercury column in the healthcare workplace"(2). In the latter study, there were no signific...

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  • Decline in hospital MMR vaccinations: Are children being left unimmunised?
    Andrew Riordan

    I was interested to read Govindaraj et al’s audit showing a fall in the number of MMR vaccines given in their hospital over the last 2 years. Unfortunately there was no data to show what happened to those children initially referred to hospital for MMR, but referred back by the outpatient sister.

    A study from New Zealand suggests that children inappropriately referred for MMR in hospital can be referred back a...

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  • A/H1N1: Effectiveness of prevention in childhood
    Valerio Paolini

    The question on how to manage the presence of the pandemic virus A/H1N1 in schools when the specific vaccine is not yet available is still open. Some countries have decided to postpone the opening of schools to avoid the epidemic peak, others have preferred to wait for the mass vaccination to contain the epidemic. WHO has recently issued a briefing note in which measures to be taken in school activities to limit the spr...

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  • Managing frequent medical absences from school.
    Jill Davies

    We were interested to read the paper by Jones at al1 on ‘Frequent medical absences in secondary school students’. They conclude that ‘this study should prompt education departments and their NHS partners to look more critically at the problem … and to establish a system that provides more comprehensive assessment and treatment.’

    Within Bolton PCT such a system has been designed in order to identify causes of...

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  • The TSH Threshold in Neonatal Screening for Congenital Hipothyroidism: a Variable Solution
    Jose Ramon Alonso-Fernandez


    Dear Editor:

    In their paper on the TSH threshold in neonatal screening for congenital hypothyroidism (CH), Korada et al. (1) conclude that a threshold of 6 mIU/L for DELFIA-measured TSH in samples collected between days 5 and 8 may be preferable to the 10 mIU/L recommended by the UK Newborn Screening Programme C...

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  • Children's growth: measured but rarely plotted
    Louisa Pollock

    Lek and Hughes(1) recently highlighted concerns that opportunities for growth measurement in children attending hospital are frequently missed. This has important implications for the current UK policy for growth monitoring, which encourages opportunistic measurement. It also has important implications for clinical practice –growth faltering may result from any chronic illness or may be the only marker of abuse or neglect...

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  • "Siginificant value" of CT scan in diagnosis of Hirschsprung's associated enterocolitis?
    Ronny Cheung

    In the “Images in Paediatrics” section of ADC, Sept 2009 (1), I read with interest, and some alarm, Sheth et al.’s assertion that CT scan findings were of “significant value” in establishing the diagnosis of Hirschsprung’s associated enterocolitis.

    As the authors themselves point out, diagnosis of enterocolitis in a child with a history of endorectal pull-through operation for Hirschsprung’s disease should be m...

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  • Paediatric training for GP's
    Rajashree Ravindran

    I read with interest the article ‘making choices: why parents present to the emergency department for non-urgent care’ published in ADC journal in the October 2009 edition. Amongst the reasons mentioned for coming to PED, a total of 26 parents (18%) responded that they were either unhappy or wanted a second opinion for their child’s condition. It is this group of patients who increase the workload of staff and waiting time...

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  • Re: Bulging fontanelle in febrile infants: lumbar puncture is mandatory
    Shira Shacham

    Dear Editor, We thank doctors Beri and Hussain for their comments. They disagree with the suggestion of withholding a lumbar puncture in a specific subset of infants with fever and bulging fontanelle. One of the points they raised is that cases with aseptic meningitis will be missed. However, the purpose of performing a lumbar puncture in infants with fever and bulging fontanelle is not to diagnose aseptic meningitis but...

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