1586 e-Letters

  • Re: Cross-sectional presentation of longitudinal data
    Alison M Kemp

    We would like to thank Dr Clifford for his interest in our research. We do not agree with him that the title and abstract are misleading. The study was a longitudinal one and the results reflect that; for example we looked at the children over time and assessed the importance of within- child variation over time compared to between-child variation. It is very important to distinguish between a collection, that is a point...

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  • Breast Feeding Increases Infant DHEA
    James M. Howard

    I suggest breast feeding increases infant DHEA which positively affects growth and development. Please read "DHEA is the Reason Breast Milk is Beneficial," at: http://anthropogeny.com/DHEA%20Breast%20Milk.htm

    Conflict of Interest:

    None declared

  • Response to "Food as a source of outbreaks of group A streptococcal disease"
    Kenneth H Lamden


    Eisenhut raises the possibility that food was the source of the outbreak of group A streptococcal disease at the primary school. This hypothesis was considered, but was rejected as implausible for several reasons; firstly the outbreak was not a true point source as it was preceded by five sentinel cases over a 12 day period, in addition the peak on the 16th May was inflated as it included cases with on...

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  • Re:The Skeletal Survey in suspected abuse- how necessary is it?
    Amaka C Offiah

    We thank Dr Cohn and his colleagues for their interest in our article and agree - as stated within our paper - that there is considerable variability in the reported fracture yield of skeletal surveys. This variability is not only dependent on methods of data display (as Dr Cohn et al illustrate), but also on epidemiological and demographic differences between reported study populations and on the process by which clinicia...

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  • The wider implications of non-anaemic iron deficiency
    oscar,m jolobe

    The highly commendable and detailed characterisation of non-anaemic iron deficiency(1) is timely and, perhaps, even overdue, given the fact that animal studies show that, even in the absence of anaemia, iron deficiency can ,in its own right, adversely affect both cerebral function(2), and thyroid function(3). In the animal model of non-anaemic iron deficiency it has been shown that iron uptake by a divalent metal ion tr...

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  • Re: A useful tool for parents
    Lane E Volpe

    We would like to thank Dr Levene for her letter, and the Editors for the opportunity to respond. The authors are familiar with the Infant Sleeplab App; we are both associated with the Durham University Parent- Infant Sleep Lab (Dr Volpe as an Honorary Fellow, and Professor Ball as the Founder and Director). The Infant Sleep Info Source Website (ISIS, www.isisonlineorg.uk) was conceived of in 2010 by Professor Ball and her...

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  • CT scans in children with concussion
    Sascha Meyer

    We read with interest the paper by Drs Colvin and colleagues on the diagnosis and acute management of children with concussion at children?s hospitals in the United States (1). The authors reported an astonishing 59.9% of children with concussion receiving CT scans of the head (1).

    We would like to make two comments with regard to this study: First, the terminology surrounding trauma to the head remains confus...

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  • Re: Tachypnoea in a well baby: don't forget the head
    Ian M Balfour-Lynn

    Dear Editor

    We are so sorry not to have included cerebral arterio-venous fistula in the aetiology of unexplained tachypnoea because it is of course a rare but classic cause. Typically the symptoms begin almost immediately after birth if there is a large fistula and the pulmonary artery pressure remains elevated. The fistula allows a large systemic artery to systemic venous shunt with right atrial and right vent...

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  • Re: Diagnosis and acute management of patients with concussion at children's hospitals
    William P. Meehan III

    Dear Drs. Meyer and Oster,

    Thank you for your interest in our paper(1) and for your concern for the proper management of children suffering from acute brain injury.

    As you know, a concussion is a complex pathophysiologic process resulting from a rapid rotational acceleration of the brain caused by trauma.(2-4) It is a form of traumatic brain injury. The Glasgow Coma Scale, on the other hand, was develo...

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  • Re: Pickled Red Herrings
    Ingrid Wolfe

    Colvin correctly notes that we are interested in solution-focused research, and expresses some anxiety about our recommendations for improving child survival. There are two issues to consider in addressing his concerns: determining causality, and the burden of proof required to take action.

    First, Bradford Hill's criteria for considering causality are helpful in demonstrating why the association between poverty...

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