197 e-Letters

published between 2009 and 2012

  • Another question for NICE on UTI Guide?
    Dr Egware Odeka frcp,frcpch

    I read with interest this latest paper questioning the recommendation from NICE about the management of UTI in children. While the need for evidence is crucial to informed practice it is not always the case that in all medical conditions that this level is reached. Consensus therefore can be arrived at after a thorough review of good practice by eminent practitioners in the field. I have no doubt that the respected membe...

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  • Pijpers et al.
    David CA Candy

    Pijpers et al rightly highlight the lack of high quality evidence for the treatment of constipation. In their conclusion they state ‘Insufficient evidence exists supporting that laxative treatment is better than placebo in children with constipation’. This paper derives from the Academic Medical Centre, Amsterdam, where Benninga’s group have successfully demolished all other treatments for constipation other than laxative...

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  • Never?
    Richard G Fiddian-Green

    Subhi et al have asked when oxygen should be given to children at high altitude observing that hypoxaemia is the most common fatal complication in deaths occurring from pneumonia in children in developing countries (1). Might the answer be never?

    Supplementary oxygen appears to be harmful in climbers on Everest possibly because it eliminates the up-regulation of oxidative phosphorylation by mass action by hypoc...

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  • Procalcitonin is not necessarily better than C-reactive protein in febrile infants under 3 months of
    Ming-Chih Lin

    To the editor:

    Olaciregui et al. reported an interesting article and concluded that the diagnostic value of procalcitonin (PCT) is greater than C reactive protein (CRP) in predicting infants with more invasive bacterial diseases (sepsis, bacteraemia). However, due to the following reasons, the conclusion should be more conservative.

    First, the authors claimed that the area under curve (AUC) is greater...

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  • In Child we trust
    Lucio Piermarini

    Dear Sir I absolutely agree with your conclusions about demand feeding being something “we might all be able to live with”, but we should really respect the children’s “demand”. I also agree that there is no strong evidence to support exclusive breast feeding for six months, but there is neither strong evidence about the optimal complementary diet and there is not any certainty that the child introduced to solid foods wi...

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  • Being open: Good, Bad, or Ugly?
    Amitabh Shankar

    I read this article with great interest. It has been a long time since a PICU data from England and Wales has been published in the Archives of Diseases in Childhood.

    Interestingly, I noted that although the admission in 1-4 yr age group was lesser (7.54 & 7.22%) than other age groups (more than 10%) amongst male and female South Asians respectively, the 0–4 yr standardised admission (incident) rate amongst...

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  • Medical Education and Specialist Trainees – need for awareness of Best Evidence Medical Education
    Shalini Ojha

    I read this article with interest and was pleased by the emphasis given to Medical Education in this journal(1, 2). There is necessity for more literature on Medical Education in frontline journals like this.

    Reading the RCPCH document for Level 2 competency for Core Highest Specialist Training in Paediatrics(3), I was disappointed that Best Evidence Medical Education (BEME)was not included.

    It is nece...

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  • Liver Transplantation and Genetic Testing for mtDNA depletion
    David P Dimmock

    Dear Sir, I appreciate the review of mtDNA depletion provided by Drs Rahman & Poulton, and whole-heartedly agree with there opinion that oligo-arrayCGH is not a first line test for single gene disorders but rather is a follow on test when sequencing fails to detect 2 causal alleles.

    However, in their perspective, they state: “a molecular diagnosis of dGK deficiency may be regarded as a useful prognostic ind...

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  • Stuttering and bilingualism: A reply to Packman, Onslow, Reilly, Attansio & Shenker
    Peter Howell

    Dear Editor.

    Packman et al. responded to Howell et al.’s article (doi 10.1136/adc.2007.134114) on bilingualism and stuttering. We showed that speaking two languages in the preschool years increased the chances of children starting to stutter and decreased the likelihood of recovery from stuttering relative to speakers who learned English when they started school.

    We do not consider, as Packman et al. s...

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  • Transient synovitis vs. Kingella kingae infection of the hip in children
    Pablo Yagupsky

    In a recent article published in the journal, Taekema et al. discussed the use of clinical criteria and laboratory tests to differentiate between septic arthritis and transient synovitis in children.2 Distinguishing between these two conditions is crucial to avoid local and systemic complications (if a joint infection is missed) or unnecessary hospitalization, surgical interventions, and antibiotic treatment (if transien...

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