142 e-Letters

published between 2014 and 2017

  • Vitamin D supplementation - The North Tyneside Experience
    Stephen Owens

    The Department of Health (DoH) recommends universal vitamin D supplementation for non-formula-dependent children aged 6 months to 5 years [1]. Following the report by Jamieson et al. [2], we share similar data from North Tyneside, showing that few children are being supplemented with vitamin D and that parental awareness of current recommendations is poor.

    We distributed questionnaires to consecutive parents an...

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  • Is litigation an indispensable form of protection against error
    Sze M Ng

    I read with great interest, Dr Rosenbloom's recent article. He discusses how difficult issues are raised involving blame when a medical error is discovered but the process may offer families restitution and compensation. 'Parental responsibility' is a term used to describe the legal duty that a parent has to their child (1). Parents act, therefore, as surrogate decision makers on the basis of what they believe to be in...

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  • Anxiety disorders in children with tics
    Sally J Robinson

    We read with great interest the recent review article by Creswell, Waite and Cooper on 'Assessment and management of anxiety disorders in children and adolescents'. The article brought to the forefront the importance of accurately identifying and treating anxiety disorders during development, with an encouraging discussion of new treatment strategies and delivery approaches to increase access to psychological therapies fo...

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  • Re: Epidemiology of Paediatric Firearm Injuries
    Saranya Srinivasan

    We appreciate the response from Murch(1) and colleagues as it highlights the dramatic difference in firearm injury rates between the United Kingdom and the United States. Great Britain's firearm regulation is among the strictest in the world while there is significant state to state variability in the United States (2, 3). A study by Fleegler (3), et al. demonstrated that greater statewide firearm regulations are asso...

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  • At the threshold
    Ross J. Langley

    The question asks would a rapid PCR test on blood alter management in a febrile infant by way of discontinuing antibiotic therapy if found to be negative.

    The multiplex PCR offered would not alter management in a "hot, grumpy, 2 month old" even if it offered 100% certainty that the infant did not have bacteraemia. Bacteraemia implies bacterial infection directly in the blood and is only one of a number of potentia...

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  • Malawi trial is included
    Indi Trehan

    The second paragraph of this brief note is entirely incorrect, as the trial from Malawi is indeed included in the BMJ meta-analysis. It is included as reference #34 and mentioned explicitly by name in Tables 1 and 2 and Figures 2 and 3. That trial in fact provided approximately 2/3 of the participants included in the meta-analysis.

    Conflict of Interest:

    None declared

  • Re: Cultural awareness; small volumes of blood for culture cause under-detection of invasive infections
    Shamez Ladhani

    We support Drs. Munro and Flanagan's recommendations to increase awareness of the need for larger volumes of bloods for culturing in children,1 and additionally recommend larger volumes of cerebrospinal fluid during lumbar puncture, given the increasing availability of molecular diagnostic tests for viruses causing meningitis. However, we believe that the findings of their recent audit identifying similar blood volumes...

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  • Epidemiology of Paediatric Firearm Injuries
    Hannah K Murch

    We were interested in the paper by Srinivasan and colleagues1 as it brings into focus the differences in the epidemiology of firearm injuries in children and young people between the USA and the United Kingdom and the importance that gun control has had in child and adolescent safety here. Through the Child Death Review in Wales we have previously reviewed deaths from firearm injuries in the UK. This followed the death i...

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  • Interveening in childrens' health
    Richard G. Wilson

    Mitch Blair's article is an important commentary on the relationship between academic enquiry and changes which affect child health, and justifies some amplification. The two examples he relies on are very different and obscure a third. The benefit of antenatal steroids in reducing R.D.S. was based on research but occurred as a result of a steady increase in collaboration of paediatricians (responsible for treatment of R....

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  • Evidence based medicine and research activities in the developing world
    Sascha Meyer

    Dear Sir, We read with interest the work by Duke et Fuller (1) demonstrating an increase in the publication of randomized controlled trial (RCT); total: 1553) in 76 low- and middle income countries (LMIC) over a 11-year period. Of note, studies of nutrition (366 publications, 23.6%) and malaria (336 publications, 21%) predominated. Trials of infectious diseases - most importantly malaria involved a comprehensive range of...

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