eLetters

1175 e-Letters

published between 2015 and 2018

  • Re: Where do the differences in childhood mortality rates between England & Wales and Sweden originate?
    Ingrid Wolfe

    We thank Zylbersztejn, et al for their constructive letter and for their support for the Countdown initiative. Their data suggests that high rates of preterm birth and thresholds for reporting preterm birth [1] in the UK were one of the most likely explanations for the disparities seen between the UK and European countries such as Sweden, and we agree this is likely (as outlined in our recent Lancet paper [2]. We agree en...

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  • Re: Faecal calprotectin as an effective diagnostic aid for necrotising enterocolitis
    James Frederick Bremner Houston

    Many thanks for the recent letter regarding a rapid assay technique for testing fecal calprotectin1. This would indeed be useful in the clinical setting if it allows the transmission of accurate and rapid fecal calprotectin levels to treating clinicians. As discussed in the original archimedes report, the difficulties surrounding the need for an adequate cut-off remain the main barrier to the use of fecal calprotectin a...

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  • A beautiful example of reflux -but is there really a posterior urethral valve?
    Andrew Lunn

    Dear Editor,

    We read with interest the article by Patti et al(1) and agree with their conclusion that a history of normal voiding does not exclude a diagnosis of posterior urethral valve (PUV). This has also been demonstrated in other case series and reports.(2,3) The article by Patti et al demonstrates a beautiful example of bilateral vesico-ureteric reflux (VUR) on micturating cystourogram. We however raise...

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  • Imaging in suspected child abuse
    Peter D Sidebotham

    Monika Bajaj and Amaka Offiah are to be commended for their thoughtful and helpful review of the benefits and risks of skeletal imaging in cases of suspected child abuse.(1) The diagnosis of child abuse is a complex process which requires an evidence-informed approach combining clinical acumen with collaborative multi-agency working. Skeletal imaging, including CT scans, provide a valuable tool for the clinician, but,...

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  • The sensitivity of non-invasive clinical examination to detect dehydration has been questioned without any evidence
    Malcolm G Coulthard

    The ADC Archivist recently reported that Freedman et al had revealed that "old-fashioned clinical examination" missed about 20% of cases of significant dehydration in children.[1] Their assessment of this work was not surprising because the meta-analysis in the Journal of Pediatrics carries the headline message that even the "most accurate, noninvasive" methods could only "identify dehydration suboptimally", and it was a...

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