517 e-Letters

published between 2004 and 2007

  • Yes, there is a place for bariatric surgery (and paediatric surgeons) in childhood obesity
    Niall M Jones

    Dear Editor,

    I commend Dr Shield and colleagues for their 9 year-old multidisciplinary obesity service for children and adolescents and I am delighted that a bariatric surgeon is now part of the team. Longterm results are still awaited to prove the benefits of this approach to weight loss in teenagers, but short-term evidence is very promising as the authors have pointed out.

    I would like to describe...

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  • A or E?
    Tricia A McGill

    Dear Experts, What behaviour,symptoms, tests etc absolutely concluded that the children were suffering from Asperger's and not the effects of emotional abuse? If the children had Asperger's, would you expect their blood to have less stress hormones than a similar child that was emotionally abused? If the children were treated for Asperger's but actually were emotionally abused, would you expect their behaviour/symptoms to...

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  • Ceftriaxone drug alert - no longer for first line use in meningococcal sepsis
    Saul N. Faust

    Dear sir,

    Although UK and international high income country practice has been to recommend ceftriaxone or cefotaxime as first line therapy for the initial treatment of paediatric sepsis, the US FDA has issued an alert (1) that has led to changes in the US label for ceftriaxone (2). Due to concerns regarding the potential for calcium chelation in vivo, ceftriaxone must no longer be administered within 48 hours o...

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  • Gelofusine and NEC - a misleading conclusion
    Sam Richmond


    The Archimedes offering by Khashu and Balusubramaniam contains a serious error as well as a somewhat eccentric spelling of gelofusine. They suggest in their 'Clinical Bottom Line' (bullet point 3) that "Weak evidence suggests and increased risk of necrotising enterocolitis with use of Gelofuscine (sic) in neonates (Grade B)". In fact there is no such evidence, weak or otherwise.

    Analysis 05.11 in...

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  • Looking beyond the perspective of a limited metaphor
    A.N. Willaims

    Welcome as an article on this topic is in a high profile paediatric journal I was disappointed by its contents, especially as a leading article is often taken to be ‘flying the flag’ of what current opinion is within the profession.

    I agree fully that historical metaphors are useful and have a role in the public understanding of children,whether sick or well, and also of childhood.

    However I am concern...

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  • Infants, children and young people are part of the human family.
    Dr Timothy Chambers

    Gillis and Loughlan make important points but, with respect, their metaphor could be extended - with profit. The limitations of clinical assessment, especially history taking and symptom analysis, experienced by physicians attending infants and children may also beguile those attending the elderly and younger adults with learning difficulties. Furthermore even so-called competent adults may behave in child like ways when...

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  • Re: Blood pressure charts in UK children
    Dr. Narayan Bahadur Basnet

    Respected Sir,

    It was my pleasure to read important notes on blood pressure in UK children. I tried to see the chart but couldn't locate it. May I request you to provide the chart for our reference?

    Thank you very much.

    With best regards,

    Sincerely, Dr. Narayan Bahadur Basnet

  • Cyclosporin seems to be a confounding factor.

    We commend the authors for evaluating HPA axis in patients with nephrotic syndrome. They have concluded that patients with good Synacthen response have less relapse. However, most of the patients with good Synacthen response were receiving Cyclosporin. Therefore, use of Cyclosporin can be a confounding factor and the good nephrotic control may be related in large part to the use of this drug. Low adrenocortical suppressi...

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  • Would be even more useful if broken down by organism
    Peter M B English

    The article by de Louvois et al is very useful in quantifying the long-term effects on achievement of meningitis.1 It adds to their previous work,2, 3 and will be much appreciated by those advising parents of infants who have, or have had, bacterial meningitis; and it should also be useful to those planning for their education and longer-term health care.

    I suspect that the reason why little evidence...

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  • Pharmacokinetics and –dynamics of paracetamol (acetaminophen) during childhood
    karel allegaert

    Dear editor,

    We read with great interest the paper of Anderson and Gibb on the pharmacodynamics (analgesia, antipyretic response) of paracetamol in children [1]. It is hereby striking that even more than 100 years after its discovery, clinical aspects on the use of this drug in children remain to be unveiled.

    We fully agree that the cerebospinal fluid time-concentration (CSF) profile of paracetamol lik...

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