140 e-Letters

published between 2015 and 2018

    Davendralingam Sinniah

    I read with great interest the arguments whether 0.9% saline with 5% dextrose would be a more appropriate choice than 0.45% saline with 5% dextrose for maintenance fluids in hospitalized children. In 1975, WHO and the United Nations Children's Fund (UNICEF) decided to promote a single ORS (WHO-ORS) containing (in mmol/L) sodium 90, potassium 20, chloride 80, base 30, and glucose 111 (2%) for use among diverse populations....

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  • Should 0.9% saline be used for maintenance fluids in hospitalised children?
    Graham C. Smith

    I just have a simple question for Dr Morgan in relation to her Archimedes article entitled "Should 0.9% saline be used for maintenance fluids in hospitalised children?"[1]. Is she telling me that the recommended maintenance sodium intake for a 10kg child who would normally be prescribed 1000 mls/day of fluid based on 100 mls/kg/day, is 150 mmol or 15 mmol/kg/day. This is far in excess of the recommended NaCl intake of 2g...

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  • Oral salbutamol is of use in other settings too
    Anthony Cohn

    I have always been confused at the bad reputation acquired by oral salbutamol which, in the UK, has been confined to pharmacological oblivion on the contradictory premises that it is both ineffective and responsible for unacceptable side effects. Paradoxically, intravenous salbutamol is becoming evermore popular in the treatment of severe asthma. Given the acceptance that intravenous salbutamol is effective, oral salbutam...

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  • Invertase is an alternative to Sucraid in the treatment of CSID
    Iain S. Chalmers

    We read with interest the article by Puntis and Zamvar(1), reporting their experience of children with congenital sucrase-isomaltase deficiency (CSID) including response to enzyme replacement therapy with Sucraid (sucrasidase). We report our own experience of a child with CSID which offers an additional perspective and therapeutic option. Our patient is a girl who was diagnosed with CSID at 8 months of age. She was refer...

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  • Patient with Non Ketotic Hyperglycinemia
    Rachael Fawcett

    I came upon this article by chance and realised it is infact my daughter Emilys case.She was born on 10/11/11 and passed away from nkh on 16/11/11.Knowing her case has been used to highlight non ketotic hyperglycinemia is very heartwarming.I am in daily contact with families with children living with this terrible condition and they all remain positive a cure will eventually be found,i am aware researchers in the uk hav...

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  • Mothers' perception of their child's weight status
    Filippo Festini

    Dear Editor, We read with interest the article by Dowd and coll. (1) and we would like to share the results of a similar study we carried out in a cluster of Primary Schools in Florence, Italy, that show similarities with those reported by Dowd. Our aim was to assess possible correlations between mothers' BMI and their child's BMI; children's BMI and correctness of mothers' perception of their child nutritional status pe...

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  • Comfort in numbers
    Ian D Wacogne

    Dear Editor,

    Andrew Riordan writes, as ever, with excellent good sense about the duration of courses of antibiotics. (1)

    Doctors who have trained with me will have heard me talk about this. We are falsely comforted by some numbers, which are highly likely to themselves to be false. The "true" duration of antibiotic therapy ought to be an awkward number - 3.4 days, or 8.7 days. It shouldn't be a neat...

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  • Neonatal vitamin A supplementation is not all about deficiency
    Christine S. Benn

    According to the current paradigm vitamin A supplementation works by preventing vitamin A deficiency, and it was predictable that the lack of effect of neonatal vitamin A supplementation in the recent African trials was interpreted as being due to absence of vitamin A deficiency. It follows that there may still be a role for NVAS in deficient subgroups(1). The Archivist approves this conclusion.

    However, there...

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  • Cardiac MRI screening in Turner syndrome: less may be more
    Paul E. Kahlke

    We read with interest Turtle and colleagues recommendations on screening for and management of aortic dissection (AD) in Turner syndrome (TS)[1]. The authors recommend multiple pediatric cardiac MRIs for girls with TS, but do not discuss the costs, harms, or effectiveness of such a program. The cost of at least two to three cardiac MRIs for low risk girls alone would be high, but could be much higher if extra clinical fol...

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  • Use of digital multimedia may bolster both patient and investigator recruitment into randomised controlled trials
    Rajiv K Sethi

    Dear Sir/Madam,

    We read the paper by Tait and colleagues with interest [1]. The authors advocate digital media for delivering participant education in randomised controlled trials (RCTs) involving children. We agree and propose that this strategy may offer broader benefits beyond those discussed by the authors.

    Patient recruitment to clinical trials is difficult, with many failing to achieve their ex...

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