153 e-Letters

published between 2012 and 2015

  • Re: Faecal calprotectin as an effective diagnostic aid for necrotising enterocolitis
    James Frederick Bremner Houston

    Many thanks for the recent letter regarding a rapid assay technique for testing fecal calprotectin1. This would indeed be useful in the clinical setting if it allows the transmission of accurate and rapid fecal calprotectin levels to treating clinicians. As discussed in the original archimedes report, the difficulties surrounding the need for an adequate cut-off remain the main barrier to the use of fecal calprotectin a...

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  • Re: Where do the differences in childhood mortality rates between England & Wales and Sweden originate?
    Ingrid Wolfe

    We thank Zylbersztejn, et al for their constructive letter and for their support for the Countdown initiative. Their data suggests that high rates of preterm birth and thresholds for reporting preterm birth [1] in the UK were one of the most likely explanations for the disparities seen between the UK and European countries such as Sweden, and we agree this is likely (as outlined in our recent Lancet paper [2]. We agree en...

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  • Re: Pickled Red Herrings
    Ingrid Wolfe

    Colvin correctly notes that we are interested in solution-focused research, and expresses some anxiety about our recommendations for improving child survival. There are two issues to consider in addressing his concerns: determining causality, and the burden of proof required to take action.

    First, Bradford Hill's criteria for considering causality are helpful in demonstrating why the association between poverty...

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  • Re: Tachypnoea in a well baby: don't forget the head
    Ian M Balfour-Lynn

    Dear Editor

    We are so sorry not to have included cerebral arterio-venous fistula in the aetiology of unexplained tachypnoea because it is of course a rare but classic cause. Typically the symptoms begin almost immediately after birth if there is a large fistula and the pulmonary artery pressure remains elevated. The fistula allows a large systemic artery to systemic venous shunt with right atrial and right vent...

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  • Re: A useful tool for parents
    Lane E Volpe

    We would like to thank Dr Levene for her letter, and the Editors for the opportunity to respond. The authors are familiar with the Infant Sleeplab App; we are both associated with the Durham University Parent- Infant Sleep Lab (Dr Volpe as an Honorary Fellow, and Professor Ball as the Founder and Director). The Infant Sleep Info Source Website (ISIS, www.isisonlineorg.uk) was conceived of in 2010 by Professor Ball and her...

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  • Re:The Skeletal Survey in suspected abuse- how necessary is it?
    Amaka C Offiah

    We thank Dr Cohn and his colleagues for their interest in our article and agree - as stated within our paper - that there is considerable variability in the reported fracture yield of skeletal surveys. This variability is not only dependent on methods of data display (as Dr Cohn et al illustrate), but also on epidemiological and demographic differences between reported study populations and on the process by which clinicia...

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  • Re: Cross-sectional presentation of longitudinal data
    Alison M Kemp

    We would like to thank Dr Clifford for his interest in our research. We do not agree with him that the title and abstract are misleading. The study was a longitudinal one and the results reflect that; for example we looked at the children over time and assessed the importance of within- child variation over time compared to between-child variation. It is very important to distinguish between a collection, that is a point...

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  • Re: Neonatal vitamin A supplementation is not all about deficiency
    Robert Scott-Jupp

    Dear Professor Aaby

    Thank you for your helpful response to the Archivist feature on neonatal Vitamin A supplementation, pointing out the difficulty in attributing any benefit to pre-existing deficiency. Obviously it is not possible to include a full discussion of the conflicting literature on this subject in a short article. I did not intend to endorse any conclusions from the editorial, but merely to stimulate...

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  • The Skeletal Survey in suspected abuse- how necessary is it?
    anthony cohn

    Drs Bajaj and Offiah present compelling reasons for performing skeletal surveys in all children under 2 years of age with unexplained injury, as recommended by the RCPCH guidelines. We have followed this practice for a number of years but an audit of our skeletal surveys came to a very different conclusion.

    We reviewed the results of the skeletal surveys requested in our hospital over a period of 7 years and 4...

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  • Tachypnoea in a well baby: don't forget the head
    Paul A.J. Heaton

    We highlight the recent case of a term female neonate aged 9 days who was referred by her community midwife on account of features of mild respiratory distress symptoms. Initially sepsis was suspected and treatment with antibiotics was initiated. Tachypnoea persisted though there were no other abnormal physical signs; laboratory studies were normal. An echocardiogram, performed to exclude a primary cardiac cause showed...

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