264 e-Letters

published between 2008 and 2011

  • An unusual case of tetraparesis, anterior spinal artery syndrome
    Christian G.E.L. De Goede

    Dear Sir,

    It was with great interest that I read the case report of an unusual case of tetraparesis.[1] The authors present a case of transverse myelopathy, and I agree that it is most likely that this was caused by a vascular insult rather than inflammatory transverse myelitis, and the presentation would be in keeping with 'Anterior spinal artery syndrome'. This typically presents with a combination of flaccid...

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  • Neonatal scalp lesion is not necessarily due to trauma
    Celia Moss

    I was surprised that the report of "keloid scarring secondary to foetal blood sampling"[1] omitted any differential diagnosis. This 2 cm hairless tumour "present and unchanged since birth" cannot easily be attributed to trauma. The location at the crown is in fact highly characteristic of aplasia cutis congenita (type 1, Frieden classification[2]), the morphology with complete alopecia and "lumpiness" is typical, and th...

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  • Management of fever in febrile seizures among health care workers: the more skilled, the more reassuring
    Gianluca Tornese

    Dear Editor,

    the proper management of fever in children (1) is jeopardized by the exaggerated fear of fever (the so called "fever phobia") not only among parents but also among health professionals, leading to misalignment between evidence and practice (2). While it could be comprehensible a limited understanding of fever by parents, it is not acceptable that professionals could still believe that fever is dan...

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  • Epidemiological surveillance of rare diseases.
    Alan M Emond

    Sir, We welcome the recent elucidation of the significance of rare diseases in children provided by the Archives of Disease in Childhood (Arch Dis Child 2011;96:791-792), and the increased recognition they are receiving by the European Union, and in England by the Chief Medical Officer (CMO report 2009). A key component of increasing recognition will be the provision of epidemiological surveillance of rare diseases....

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  • Caution in extrapolating the FEAST Trial findings to surgical hypovolaemic shock.
    Kokila Lakhoo

    Dear Editor,

    We read the findings of the Feast Trial Group with interest and agree with many comments that the results appear counter-intuitive. Given our experience of managing children with hypovolaemic shock secondary to a surgical cause, in Africa and beyond, we feel that it is necessary to state that the findings of The FEAST trial should not be extrapolated to hypovolaemic shock secondary to a surgical cau...

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    Dimitrios Doganis

    We read with interest the publication by Ladomenou et al entitled "Protective effect of exclusive breastfeeding against infections during infancy" (1). The authors conclude that exclusive breastfeeding protects infants against common infections and lessens the frequency and severity of infectious episodes. This study, however, failed to reach a conclusion about the potential protective role of breastfeeding on the sever...

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  • Enabling Paediatricians to contribute to improved outcomes in maltreated children?
    Dr Michelle D Zalkin

    We welcome Dr Rees' October review as it highlights the need for a radical re-think in safeguarding training if the paediatrician is to start to contribute to the protection of children in the way she suggests. Most maltreated children are seen by paediatric trainees and traditional training has not equipped them or their seniors to view their role in the way suggested. As well as recognition and response, training should...

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  • Malnutrition in hospitalized children
    Peter Cartledge

    Dear Sir:

    We read with interest Marko Kerac's excellent article on wasting amongst under 6-month old infants in developing countries (1). There is a considerable amount of excellent research on how to identify malnutrition. We also have comprehensive, effective, evidence on how to manage malnutrition and reduce mortality (2). However, we and others have audited the identification of malnutrition in children...

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  • Nomenclature of inflammatory arthritis in children and adults
    Judith S Clark

    Re: Association of paediatric inflammatory bowel disease with other immune-mediated diseases. Kappelman at al. 96: 1042-6

    We read with interest the article by Michael Kappelman et al (1) exploring the association of paediatric inflammatory bowel disease with other immune-mediated diseases. There is however the potential for confusion over the nomenclature used within the article. The article uses the term rheum...

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  • Mortality in bilateral cerebral palsy
    Brian G Neville


    The Editor Archives of Disease in Childhood

    Dear Sir,

    The study of the mortality of 'bilateral cerebral palsy' by Gillian Baird and colleagues from the South East Thames cohort indicates factors that are associated with high and lower risk of death. Although they have used the category of bilateral cerebral palsy , these fall into three clearly recognisable clinico-pathological diagno...

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