eLetters

1513 e-Letters

  • Community paediatrics - a misnomer
    Ashok Nathwani

    Dear Editor:

    Stewart-Brown's paper on the compatibility of medical practice in community paediatrics with that in public health[1] is a superlative effort. This is more so as it has come at a time when community paediatrics is being actively discussed by the RCPCH (UK Royal College of Paediatrics and Child Health) for a variety of reasons but, perhaps, most importantly because it does not seem to attract enough...

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  • Re: Spacers and holding chambers: Not the last word, we hope
    Heather Zar

    Dear Editor

    Dr Mitchell is concerned that the methodology used in our study does not simulate the release of aerosol from a metered dose inhaler (MDI). As discussed in the article, the method of aerosol delivery in our study differs from that of a MDI but as the delivery system was kept constant and the particular spacer varied, a valid comparison of the efficacy of different spacers could be made.[1] This deli...

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  • Computer program to calculate percentage weight for height
    Bryan Lask
    Dear Editor

    Poustie et al state that there is no computer package available in the United Kingdom for calculating percentage weight for height (%WFH). This is incorrect and for many years there has been available just such a package entitled W4H under the copyright of Great Ormond Street Hospital for Children NHS Trust. The program can be used on any version of Windows from 3.1 onwards, Excel, and on Psion's. This p...

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  • Sweat chloride and conductivity
    H Lewis Webster

    Dear Editor

    As I understand the Scientific Method, a statement purporting to be factual, either in a scientific article or in a discussion with peers, must be supported by cited evidence that may be publicly examined for its scientific veracity.

    The paper by Heeley et al provides data to illustrate the equivalence of conductivity and chloride in cystic fibrosis (CF) diagnosis,[1] and therefore corrob...

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  • Impact of diagnostic delay on acute appendicitis
    Peter F Jones

    Dear Editor

    Cappendijk and Hazebroek (Arch Dis Child 2000;83:64-6) conclude from their data that "the major factor in delay is suspected gastroenteritis". Other studies have not given this factor such prominence and the study population suggests that the Sophia Hospital was acting as a referral centre: 32 of 78 children whose admission was delayed for 48 hours had been seen first by a paediatrician, which may i...

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  • Re: Growth monitoring
    Paul Garner
    Dear Editor

    Michael Perkin[1] is absolutely right. The initial protocol defined routine growth monitoring in the setting familiar to us in poorer countries as three monthly measurements. As we found so few studies in our first search, we extended the inclusion criteria to any trial where growth is routinely monitored twice or more in any two year period in children aged 0-5 years, but neglected to change the wording in t...

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  • Spacers and holding chambers: Not the last word, we hope
    Jolyon P Mitchell

    Dear Editor:

    Zar and colleagues[1] compared home-made spacers and two commercially available valved holding chambers (VHCs) for the treatment of children with acute asthma. We acknowledge that the practice of using empty drink bottles is common in some countries (by either necessity or choice). We, as a manufacturer of one of the VHCs that was evaluated, are highly concerned about the support to the hypothesi...

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  • Re: Sweat chloride and conductivity
    Mary Heeley
    Dear Editor

    As the principal author of the NCCLS guideline on sweat testing methodology, Dr Le Grys should be better informed of its content. It includes the clear statement that when sweat test results are obtained by conductivity measurement "the patient should be referred for quantitative sweat electrolyte testing". In our paper we refer to this statement as implying that sweat conductivity measurement should be re...

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  • Re: Tertiary paediatrics needs a disability model
    Brian Neville

    Dear Editor:

    I am grateful to Dr Waterston for his commentary. In order to clarify the issues that he raised, I will confirm the following:

    (1) I was suggesting that the practice in all branches of tertiary paediatrics should be considered as a disability service from the perspective of the family and child’s predicament. I was not confining the proposal to traditional neurodisability.

    (2)...

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  • Re: The impact of diagnostic delay on the course of acute appendicitis
    Stephen K Dotse

    Dear Editor

    The article from the Netherlands by Cappendijk and Hazebroek[1] has again confirmed what is already known in clinical practice. A recent paper from the Leicester Royal infirmary[2] is almost identical.

    As the authors pointed out, the factors determining the diagnostic delay are numerous and often cannot be influenced. However, I agree with their statement that “in a child with abdominal pai...

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