136 e-Letters

published between 2013 and 2016

  • Do exicpients have an impact on paracetamol clearance: the jury is still out
    karel allegaert

    We support any idea or initiative to try to better understand the covariates of paracetamol PK in neonates, including the potential impact of excipients (propylene glycol, mannitol or none) on paracetamol clearance.

    We have carefully read the e-letter of Pisapia et al., and support the potential impact of mannitol co-administration on paracetamol clearance, however, we do have some relevant additional comments...

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  • Non-specific abdominal pain and appendicitis, an unespected correlation
    Alberto Di Mascio

    Dear editor, In their study G C D Thornton and al (1) found a diagnosis of appendicitis in 6065 children out of 268623, previously diagnosed as non specific abdominal pain (NSAP) at the first access, who returned within one year. According to their data, the RR to develop appendicitis in the first year after discharge with a diagnosis of NSAP is 15.04 times higher than the risk in the control cohort. Appendicitis is an a...

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  • Title : Congenital hypothyroidism screening- incidence in semi-urban hospital.

    Thyroid hormone is critical for normal growth and brain development, and hypothyroidism in infancy is the leading cause of intellectual impairment worldwide. Congenital hypothyroidism (CH), defined as deficiency of thyroid hormones at birth. Congenital hypothyroidism is very important clinically since severe cases will lead to irreversible mental handicap without prompt treatment.

    The essential role of thyroid...

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    Jorge Pisapia

    To the editor:

    We have found very interesting the paper by Dr Allegaert et al. about iv paracetamol pharmacokinetics (1) in which they referred that between- subject variability (BSV) is explained by covariates such as size, weight, disease characteristics or co-administration of drugs. They mentioned that they found an unexplained variance in paracetamol clearance, and that it remained high (39,1 per cent) even a...

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  • Exploring the impact of early life factors
    Michael A. Colvin

    The MCS research by Massion and colleagues on childhood obesity should be read in the light of other recent cohort studies exploring the impact of early life factors in the UK and the USA (1). Kimbro and Augustine found that US children living in married two biological parent households had a lower risk of obesity than those living in other family types. In the presence of other controls, poverty was not a significant r...

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  • Re:Holes in the net: safety netting in Emergency Departments needs to improve
    Evelien de Vos-Kerkhof

    Dear editor,

    In their letter, colleagues Jacob et al. raised further evidence of the lack of standardised safety netting. We thank them for their comments emphasizing the disparity between paediatric trainees' perception of their safety netting practice and their documentation in the medical notes.

    To overcome the lack of information on the difference of given safety netting advice and its documentation...

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  • Treatment of Bronchiolitis in a Poor- Resourced Settings
    Suhair A osman

    Bronchiolitis is on rise, both in prevalence and severity in our country due to many social and life style factors. in our hospital we adopted a protocol named: SuProNO INCLUDE:- - PROVIDE VITAL SIGN ASSESSMENT and close monitoring - PROVIDE O2 AS NEEDED - Provide IV fluid/ NGT Feeds as appropriate -provide Hypertonic (3%) saline nebulization -provide nasal decongestant drops/ spray and suctioning as needed - provide anti...

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  • Holes in the net: safety netting in Emergency Departments needs to improve
    Hannah C Jacob

    Safety netting in the Emergency Department (ED) is key to the practice of safe medicine. Following the article by de Vos-Kerkhof (1), we present further evidence to suggest that there is a lack of standardised safety netting. In addition, we found a disparity between paediatric trainees' perception of their safety netting practice and what they actually documented in the medical notes.

    In a retrospective case...

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  • Point of care lactate testing in resource-poor settings
    Aubrey J Cunnington

    Khan et al. make a strong case for investment in point-of-care lactate testing in low and middle income countries (LMICs) (1). They believe that this would identify children at high risk of death, and would save lives because these children could receive earlier resuscitation. Unfortunately the optimal management of children with hyperlactataemia in LMICs is far from clear. Although Khan et al. extrapolate from findings i...

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  • Re: Treatment of the hyperinsulinaemic hypoglycaemia unresponsive to diazoxide and octreotide: sirolimus should be considered
    Arunabha Ghosh

    We agree that sirolimus may help children with Congenital Hyperinsulinism who do not respond to diazoxide or octreotide. Sirolimus is, however, unlicensed, with little long term experience, and the mechanism by which it reduces hypoglycaemia remains speculative. As sirolimus is an immunosuppressant, its use in young infants has to be carefully monitored in specialist centres under strict protocols. We are, therefore, re...

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