eLetters

534 e-Letters

published between 2003 and 2006

  • Author's response: NICE guidelines and the epilepsies: how should practice change?
    Colin Dunkley

    Dear Editor,

    Smith’s letter responding to our paper (1) examining the issues around service improvement for children with epilepsies is very welcome. His letter and paper (2) provide useful data and insight which is helpful when considering how national recommendations could or should translate into the ‘real world’.

    Many long-term paediatric conditions benefit from designated services with defined p...

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  • Preventing hypernatraemic dehydration in babies- Time for action.
    rafeeq muhammed

    Dear Editor,

    It was interesting to read the case report by Shroff et al (1) on hypernatraemic dehydration in breast fed babies. Recently published retrospective study from the USA (2) also showed that breast feeding associated hypernatraemia is under diagnosed and its incidence is rising. It is not clear why the incidence of breast feeding associated hypernatraemia is rising, but early discharge from hospital(3) or...

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  • Is it in the milk or in the genes: why focus on milk?
    Scott M Montgomery

    Dear Editor,

    I would like to thank Dr Reimer for his interest in our work and reciprocate by correcting his flawed understanding of the paper. Perhaps it would be helpful to start by summarising the hypothesis, results and interpretation of the study. Our a priori hypothesis was that positive physical contact between mother and child in early life may result in enhanced control of the stress response as indicate...

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  • The change in haematological presentation of iron deficiency is also an issue
    oscar,m jolobe

    Dear Editor,

    Notwithstanding the fact that iron deficiency anaemia is the commonest extraintestinal manifestation of subclinical coeliac disease(CD)(1)(2), in ordinary clinical practice diagnostic strategies for early detection of iron deficient erythropoiesis have not been optimised to the same extent as diagnostic strategies for early recognition of CD. For example, when serological testing is the chosen paramete...

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  • A missing confounder
    John Stone

    Dear Editor,

    Figure 1 in this study shows a rise in autism incidence (recorded) from 22 cases in the birth cohort of 1989 to 46 in 1991. R Lingam, A Simmons, N Andrews, E Miller, J Stowe and B Taylor fail to take into consideration the introduction of the accelerated Diptheria, Pertussis, Tetanus (DPT) as a potential confounder, advancing the doses from 3, 5 and 10 months to 2, 3 and 4 months [1]: each dose also c...

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  • High-Dose Inhaled Fluticasone, Adrenal Crisis and a Fatal Accident Inquiry
    geoffrey todd

    Dear Editor,

    Russell in his editorial “Very high-dose corticosteroids: panacea or poison?” (1) speculates about the reasons why “the practice of using increasingly high doses of inhaled corticosteroid therapy (ICT), particularly of fluticasone, became commonplace in the UK”. He blames doctors – “it appears that better disciplined clinicians elsewhere in the world were less willing to stray beyond licensed dosages”...

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  • Free vitamin D supplementation for every infant in Turkey
    sukru hatun

    Dear Editor,

    We read with interest the article by C S Zipitis, G A Markides and I L Swann concerning primary Care Trusts provide funds for vitamin D supplementation of Asian children for at least the first 2 years of life (1).

    Nutritional rickets remains prevalent in developing regions of the world such as Africa, the Indian subcontinent, Asia and the Middle East, and ranks among the five most common dise...

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  • Is it in the milk or in the genes?
    Mats Reimer

    Dear Editor,

    This paper has in my view several serious flaws, and the conclusions does not seem well supported. The effect of reduced anxiety is so small that it seems clinically irrelevant, and is seen only in the subgroup of children having experienced divorce. Anxiety is a hereditary trait, but adjustment has only been made for very serious mental illness (not just anxiety) in the mother, and no adjustment wa...

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  • ...no need for further confusions!
    Hüseyin Özbey

    Dear Editor,

    It is interesting to read the comments, proposals, agreements and disagreements on terminology related to “developmental” variations, with “functional” disorders of sexual properties. In medical use, the term “disorder” is explained as “an abnormal physical or mental condition”, like the “refraction disorder” what I have since 7 years of age. If you look at the contents of “The Merck Manual of Dia...

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  • High-Dose Inhaled Fluticasone, Asthma, and Adrenal Insufficiency
    geoffrey todd

    Dear Editor,

    Paton et al (1) described varying degrees of adrenal insufficiency in children treated with high-dose inhaled Fluticasone Propionate (FP) for asthma. They state “The attempts to reduce FP in the other children with flat responses resulted in unacceptable worsening of asthma symptoms, reflecting the value of high-dose FP in children with more severe asthma”. However, is it not the case that high-dose FP...

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