1577 e-Letters

  • Dietary products used in infants for treatment and prevention of food allergy
    Arnaldo Cantani
    Dear Editor

    In a not cited paper published by Pediatric Allergy Immunology I have detailed everything about soy formulas (SFs). Children with atopic dermatitis fare well on SFs, those with colitis/enterocolitis have reactions to soy, but Burks demonstrated that these are not IgE-mediated, therefore it is improper to classify such reactions as allergenic.

    In Table 4, 19.8% of children (mean) reacted to SFs, but...

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  • Are we requesting too many DMSA scans?
    A H Sackey
    Dear Editor

    The recent article by Christian et al (1) highlights the value of clinical features in assessing the risk of renal scarring and therefore the need for DMSA scan after urinary tract infection (UTI). We recently performed a case note study to assess the recording of fever, malaise, recurrent UTI and urine culture results in children investigated with DMSA scan after UTI. Between April 1996 and October 199...

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  • Guidelines for the ethical conduct of medical research involving children
    William Tarnow-Mordi

    Dear Editor:

    While strongly supporting this document, I think that its recommendation that research in children should not simply duplicate earlier work is open to misinterpretation.

    Many randomised studies in paediatrics are too small and under powered to provide conclusive results. (1, 2) Meta analysis of multiple similar studies provides a useful tool for overcoming the limitations of inadequate...

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  • Sputum induction not more sensitive than gastric lavage
    H E Wiersma

    Dear editor:

    With interest we read the study of Zar et al¹ on the usefullness of sputum induction in infants and young children for the diagnosis of pulmonary tuberculosis. Bacteriological confirmation of pulmonary tuberculosis in infants and young children remains a problem because it is difficult to obtain sputum. Therefore, in young children, gastric lavage is the recommended method for the collection of res...

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  • Systematic review had no relevance to routine monitoring as it is undertaken in the UK
    Michael Perkin

    Dear Editor

    As someone who is in the throes of writing a chapter on growth monitoring in primary care for the Royal College of General Practitioners I read Garner et al's article(1) as well as their original Cochrane review (2) with interest. Both Professor Davies commentary and Professor Marcovitch’s precis in "Archives this month" discuss the findings in relation to growth monitoring in the United Kingdom. Un...

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  • Simply poison
    Camille de San Lazaro

    A six month old child is admitted with seizures as a result of the deliberate administration of sulphonylurea.

    Things have come to a pretty pass when the term "poisoning" does not feature in the keywords of this paper.

    The authors' use of the term "Munchausen syndrome by proxy" implies that they have knowledge of the perpetrator's motivation. In our view, they have not justified this conclusion. The on...

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  • Reliability of adolescents
    Bryan Lask

    Dear Editor

    I write with reference to the article by "Archivist" on Sex Preference in the April issue.

    "Archivist" asks if the view that adolescent iconoclasm and tongue in cheek humour could have an effect upon how they answer questionnaires, or whether that is just too cynical. I am the father of two sons, both of whom were often approached during their adolescent years to participate in psychologic...

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  • Adolescents have it too easy
    P S Prabhu

    I fully agree with the authors of this letter and suggest that the paediatricians in the whole country should pressurise the health secretary to bring out a bill to highlight this problem. Many of my nights on call are now spent taking care of 15 and 16 year old kids who have taken overdoses of paracetamol or aspirin. There seems to be an especially large number of such cases in the Lincolnshire area as compared to Yorksh...

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  • The debate between sedation and anaesthesia for children undergoing MRI
    Michael Sury

    Drs Lawson and Bray (1) have presented arguments for and against deep sedation of children by non-anaesthetists. We would like to contribute to the debate by expanding on issues which have influenced and encouraged the development of a nurse led sedation service for MRI at our hospital.(2)

    There continues to be a huge demand for MR imaging and as a result we have had to meet the challenge of providing a sedation a...

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  • Re: Dipstick examination for urinary tract infections: misleading analysis?
    Sudhin Thayyil Sudhan

    We agree with Dr Deshpande that the sensitivity quoted for dipstick testing might not be the "true value" as a screening test for urinary tract infection as urine culture was not done on all the children in the study.

    Our study was based on the current practice at our hospital of sending urine for culture if any dipstick (nitrites, protein, leucocyte esterase or blood) was abnormal or if there was a clinical su...

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