eLetters

1476 e-Letters

  • Re: Oral steroids and inflammatory markers in asthma
    Claire Hogg

    Dear Editor,

    We thank Dr Grigg for his interest in our work.[1] We agree that the asthma attacks may have resolved spontaneously in some cases, which was precisely why we stated that the markers fell in association with steroid therapy, and nowhere implied causality. Nevertheless, the statistical analysis suggests that the chances this occurred at random are extremely low.

    We agree that corticosteroid...

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  • Decline in male gonadal health: nappies not to blame
    Louise Parker

    Dear Editor:

    Partsch and colleagues speculate that a rise in testicular temperature in infants and young children consequent to the wearing of modern plastic lined disposable nappies [diapers] may have contributed to both the fall in sperm counts and the increase in testicular cancer which have been reported in some countries.[1] In support of this hypothesis Partsche et al refer to reports of rising incidence ra...

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  • Re: Visceral leishmaniasis: Beware of these deceptive microbes also in non-endemic countries!
    Victor Grech
    Dear Editor:

    The development of visceral leishmaniasis after travel to endemic countries is not a new facet to this problem. At the time of writing, a Medline search using the key words visceral leishmaniasis and Malta yielded 16 papers. Of these, almost a third (n=5) deal with patients who visited Malta and contracted visceral leishmaniasis.[1-5]

    References

    (1) Wheatley T, Sacks S, Flemans RJ, Rubenste...

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  • Visceral leishmaniasis: Beware of these deceptive microbes also in non-endemic countries!
    Tom Revesz

    Dear Editor

    We read with interest this report by Grech et al.[1] It appears from their population-based study that as a result of the eradication of stray dogs, the annual incidence of visceral leishmaniasis (VL) declined considerably in Malta. VL is still endemic around the Mediterranean sea and sporadic cases are reported in children living in Northern Europe. It seems likely that with increasing tourism the...

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  • Lumbar puncture and meningococcal disease
    R Chodhari

    Dear Editor

    We read with interest Professor Gill’s[1] concerns about complete avoidance of lumbar puncture (LP) in the emergency management of meningococcal disease according to the algorithm suggested by Pollard and colleagues.[2] However, from public health perspective, we agree with Professor Gill's remarks that the correct diagnosis and identification of strains would help in prophylaxis of contacts and prev...

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  • Reflex sympathetic dystrophy in children - our experience
    Karen Davies

    Dear Editor:

    We noted with interest the recent study reported by Murray et al[1] in which the characteristics of a cohort of 46 children with reflex sympathetic dystrophy (RSD) were reported. In a similar fashion in our paediatric rheumatology unit, chronic idiopathic musculoskeletal pain syndromes including RSD form a significant proportion of referrals. A retrospective review of 23 children referred to us in...

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  • Re: Intestinal inflammation in cystic fibrosis
    Rosalind L Smyth
    Dear Editor:

    We thank Dr Briars for his comments and are aware of his opinions regarding the potential source of the intestinal cytokines which we have discussed in the paper including reference to his previous paper.[1] We do not agree that our data is dependant upon IL-8 alone. We have shown statistically significant differences for a whole range of proteins and types of assays.

    Due to the large number of pr...

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  • Intestinal inflammation in CF - An alternative hypothesis
    Larry Eisenberg

    Dear Editor:

    I was interested by the report of Smyth et al regarding the finding of markers of intestinal inflammation in whole gut lavage in patients with cystic fibrosis.[1] As the alpha 1 antitrypsin levels were not increased compared to controls, perhaps another hypothesis needs to be considered.

    Conceivably the inflammatory markers are not actually increased within the bowel, but rather, they are...

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  • Re: Dipsick examination of urine
    Sudhin Thayyil Sudhan

    Dear Editor,

    Our study[1] was done on a selected group of children who were at an increased risk of having urinary tract infection (UTI). The inclusion criteria were the presence of any of the following

    1. Clinical suspicion of UTI
    2. History of previous UTI or renal anomalies
    3. Children requiring antibiotics (urine culture was send prior to starting antibiotics)...

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  • Oral steroids and inflammatory markers in asthma
    Jonathan Grigg
    Dear Editor:

    Although the paper of El-Radhi et al[1] presents interesting data about decreases in inflammatory markers during the resolution of acute asthma, some of their conclusions are not valid. First, acute asthma has a tendency to resolve without corticosteroid therapy.[2] Since all of the children with acute asthma (quite rightly) received steroids, the observed effect may equally reflect processes associated wit...

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