197 e-Letters

published between 2009 and 2012

  • Children's Doses Should be Measurable
    Neil A Caldwell

    Dear Sir

    We read with interest the suggestion that dosing charts may reduce gentamicin prescribing errors.(1)

    We fully support the concept but raise question with some of the detail.

    BNFc advises against use of unecessary decimal points.(2) They may be misinterpreted or misread and result in 10-fold overdose.(3) Doses in the neonatal table include trailing zero’s. We would suggest that the in...

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  • Vital Signs Monitoring For Severity-Of-Illness Assessment:
    Shomi Raman

    Thompson and colleagues have shown that commonly recorded vital signs can be used to identify children with serious infections in the pediatric- assessment-unit and that its sensitivity is comparable to more complicated triage systems (1). However they did not take their study to the next logical step of developing a scoring system for triage, using these vital signs.

    We have developed such a scoring system and t...

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  • “Best interests” verses “Rights”
    Delan Devakumar

    Thank you for highlighting this important topic that has wider implications than medicine alone. As you rightly say overt conflict is rare and there are several steps before the courts can or should become involved, but the possibilities should be considered.

    I feel the key difference is whether the law is designed "in the best interests" or in terms of the "rights of the child". The arguments that follow dif...

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  • Variation vs. Disorder, Development vs. Differentiation
    Merius Atangcho

    Dear Editor,

    There is no doubt that language is contextual. Disorder as a term, while innocuously descriptive to one, may hold a negative connotation for another, especially those afflicted with whatever said disorder.

    Regarding brain sex, I agree with the Consensus Statement on Management of Intersex Disorders (CoSMID) that “Structure of the brain is not currently useful for gender assignment.” Quan...

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  • Observations and concerns
    John Stone

    Emond [1] sits on the United Kingdom Joint Committee on Vaccination and Immunisation [2] which is not disclosed here, and therefore shares collective responsibility for United Kingdom vaccination policy, particularly since the government handed the committee autocratic powers earlier this year [3,4]. Given the controversy which surrounds the alleged non-disclosure of competing interests by Andrew Wakefield in the paper c...

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  • Determining wisdom
    Ian D Wacogne

    Johnston makes an important point regarding the judging someone’s competence from the apparent wisdom of their decision. I’m struck by an interesting parallel. As an editor at ADC I see papers which discuss complex predictive tests. Examples of this might be a test to determine the likelihood of a patient surviving a disease process. These papers are submitted at various stages in their genesis.

    Stage one is...

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  • Childhood constipation
    Narayana Murthy Indana

    We read with great interest the systematic review written by pijpers and the response to the article by candy. Functional childhood constipation continues to top the charts in the paediatric out patient clinics and laxatives seem to be a sensible option along with dietary intervention, but the authors say these are not evidence based.

    The authors, after a mammoth systematic literature review, concluded statin...

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  • Marilyn Elizabeth Rogers

    The systematic review of mothers' experiences of bottle feeding conducted by Lakshman et al (2009) is a valuable contribution to the evidence base underpinning care for new mothers by maternity services. As the authors indicate, the Unicef Baby Friendly Initiative (BFI) and recent guidance on post natal care from the National Institute for Health and Clinical Excellence (NICE), whilst promoting breastfeeding, also recogni...

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  • Response from UNICEF UK
    Sue C Ashmore

    UNICEF UK strongly endorses Larkshman, Ogilvie and Ong's conclusion that parents who bottle feed require adequate education in order to minimise the risks. However, the implication within the article that support for breastfeeding through implementation of the WHO/UNICEF Baby Friendly Initiative may cause inadequate care for bottle feeding mothers is to be questioned. The Baby Friendly Initiative standards recommend that...

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  • This could be due to increasing testosterone: the secular trend.
    James M. Howard

    It is my hypothesis that the "secular trend," the increase in size and earlier puberty in children is caused by an increase in the percentage of individuals of higher testosterone within the population over time. The driving force is an increase in women of higher testosterone within the population over time. This exposes their fetuses to higher levels of testosterone in utero. In groups which began the trend with already h...

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