eLetters

498 e-Letters

published between 2001 and 2004

  • ALTE and gastro-oesophageal reflux
    John WL Puntis

    Dear Editor,

    McGovern and Smith [1] have embarked upon the welcome development of an evidence based algorithm for the investigation of infants presenting with an apparent life threatening event (ALTE). Unfortunately, they do not distinguish between coincidence and causality. Recurrent vomiting occurs in over 60% of 4 month old babies [2], and it is therefore unsurprising that gastro-oesophageal reflux is commonly...

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  • Taking a history
    Adam Finn

    Dear Editor,

    In reading this piece and the published response concerning the merits of personal interviews in child protection cases, I was struck by the sentence introducing the topic which reads: "Most paediatricians would not dream of giving a clinical opinion without taking a history".

    Accordingly this week I kept a diary of clinical opinions given. It was a quiet week "off service", there were only...

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  • Should expert witnesses interview parents?
    John C Furness

    Dear Editor,

    Professor David's article [1] was, in the majority a helpful guide to those involved in this specialised work. I wonder how many of the readers are involved in this sort of work?

    As a recently qualified general paediatrician I was surprised to read his recommendation that expert witnesses should interview the family. In the few child protection cases that I have been involved in as a witnes...

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  • Analysing Adverse Events.
    Deborah Shanks

    Dear Editor,

    I enjoyed Ricci et al's article on the ' Pitfalls of adverse event reporting..'.This is a difficult issue for medical departments.As well as a robust reporting system it is important to have a forum to deal with the incidents and educate staff.

    Our paediatric unit has had a Clinical Practice Meeting for the past 2 years. This happens every 6-8 weeks, it is multidisciplinary (nursing,doc...

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  • Comparison to placebo vs. comparison to nocebo: a chiropractic result in perspective.
    Travis L. Gee

    Dear Editor,

    There is a bias in research on treatments that sometimes manifests itself in odd ways. The preference for a one-tailed test, for instance, may lead us to focus on whether a treatment makes things better, but leads us to miss important details when a treatment makes things worse. This is an important point when testing treatments against such alternatives.

    Before turning to the central point,...

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  • Informed choice: why measuring behaviour is important
    Theresa M Marteau

    Dear Editor,

    Olusanya et al debate the principles of informed choice within the context of infant hearing screening [1]. In doing so they draw upon our conceptualisation and measure of informed choice. Unfortunately they draw an erroneous conclusion, namely that it is inappropriate to measure uptake as part of assessing informed choice. This is based upon a misinterpretation of both our definition of info...

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  • Beware of Soya containing Medication
    Dylan J Broomfield

    Dear Editor,

    We read with interest the recent letter of Laguda et al[1], advising vigilance in reading food labels in those with food allergies. We would suggest that this vigilance should include drug information sheets, particularly in those who are allergic to Soya. Soya is used in the pharmaceutical industry as an excipient, most notably in Ipratropium Bromide metered dose inhalers (Atrovent) although...

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  • Bloodless treatment of infants with rhesus-haemolytic disease
    Mark P Tighe

    Dear Editor,

    We read with interest the letter discussing bloodless treatment of infants with haemolytic disease [1], which highlighted the successful use of erythropoietin and D-penicillamine. We wish to contribute to the discussion of the use of erythropoietin with a case report:

    Mrs M (G2 P1), a Jehovah’s Witness, presented at 12 weeks with high avidity anti-D antibodies (9.5 I.U.), and anti-JKa antib...

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  • Expert Witnesses: Opinion and dogma are pitfalls in medical journalism as well as in reports.
    Paul M Davis

    Dear Editor,

    Professor David’s review provides a welcome summary of the Code of Guidance for Expert Witnesses in Family Proceedings. All Paediatricians who undertake this type of work should be familiar with the Code of Guidance and have due regard to it. However, Professor David also goes on to express some highly personal opinions which, whilst forcefully argued, are unreferenced and not evidence based. The most...

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  • Paediatrics is community paediatrics
    Tony Waterston

    Dear Editor,

    Drs. Bannon and Mather give a gloomy prognosis for the future of community paediatrics which is not new: many of the same views were expressed in the RCPCH review of the field by Craft et al. However there are a number of reasons for being more positive and presenting a clear vision.

    First, we should stop saying that community paediatrics is difficult to explain. I say that 'I practic...

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