eLetters

498 e-Letters

published between 2001 and 2004

  • Does readability matter in clinic letters sent to families?
    Alex Henderson

    Dear Editor,

    We read with interest the article by Bartle et al suggesting that most families want correspondence following outpatient appointments.[1] This question has been discussed in other specialties with studies from anaesthetics,[2] ophthalmology,[3] psychiatry,[4] and respiratory medicine [5] all suggesting that patients do want to receive letters.

    However, we believe this discussion fa...

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  • The NICE guidelines on the management of head injury - implications for a district general hospital
    Sandeep Kapoor

    Dear Editor,

    We read with interest the study of Dunning et al [1]. We have done a similar audit in our department and would like to share our results.

    As in the study, our own local guidelines on the management of children presenting with head injury, are based on the guidelines of the Royal College of Surgeons (RCS) of England published in June 1999 [2]. The aim of our audit was to ensure that chi...

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  • Hypothyroidism revealed following metrorrhagia in a child with Down's Syndrome
    Richard A Banks

    Dear Editor,

    The case report for Chemaitilly et al is quite interesting due to a recent patient of ours who presented with metrorrhagia at an outside hospital. She was a 5.75 year old girl with Down's syndrome. Physical examination revealed Tanner I breast and Tanner I pubic hair. CT of the abdomen was abnormal, and a subsequent MRI revealed that the uterus was large for age and in an adult configuration...

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  • Influenza vaccine effectiveness for preventing asthma exacerbations
    Robert L. Davis

    Dear Editor,

    We are concerned that the conclusions of the recent article by Christy et al [1] are not supported by their data, and that their article might be misinterpreted by some as casting doubt on the usefulness of influenza vaccine among asthmatics.

    In observational studies such as the one by Christy, a crucial issue in interpreting the results is understanding how the authors went about...

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  • Obesity in Plymouth Toddlers
    David M Hall

    Dear Editor,

    The report by Stenhouse and colleagues on obesity trends in Plymouth toddlers [1]. is important since there are still few data on when and how obesity begins in the pre-school years.

    Unfortunately, the data they present, though suggestive, do not make the case as strongly as they might. The paper implies that during the years in question there was a policy of universal review at 6-9 mon...

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  • Further experience of early weaning
    Sarah K. Doyle

    Dear Editor,

    We read with interest the recent article by Wright et al[1], which pointed out that most infants are weaned before 4 months of age, and not at 6 months as recommended by the Department of Health.

    We addressed similar issues in a questionnaire survey of weaning practice in Wirral, Merseyside. This was conducted in May and June 2004, at the time of the 8-month health visitor appointment....

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  • Related Systematic Review
    Bob Phillips

    Dear Editor,

    I would like to bring your attention to the following [1] formal systematic review of the safety and efficacy of inbrprofen vs. paracetamol (acetaminophen) vs. placebo, published after this Archimedes topic had gone to press.

    The report is a systematic review with meta-analysis of the broad question of safety and effectiveness of these commonly used antipyretics. It does not specifically a...

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  • Ablatio Penis: More on the John v Joan Case
    Kenneth J. Zucker

    Dear Editor,

    In their timely review regarding gender assignment in newborns with physical intersex conditions, Ahmed et al [1] made a cursory reference to the ‘John v Joan case,’ noting that it ‘famously challenged’ John Money’s hypothesis about the importance of the rearing environment vis-á-vis gender identity differentiation and formation. Ahmed et al comment that ‘this single, rather atypical ca...

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  • Indications for surgery in hereditary spherocytosis
    Mark D Stringer

    Dear Editor,

    In the excellent review of hereditary spherocytosis (HS) by Bolton- Maggs [1], I was particularly interested to read the advice regarding surgery. There is general agreement on the following points:

    i) cholecystectomy is indicated for patients with symptomatic gallstones and for those with asymptomatic stones who are undergoing splenectomy for haematological reasons (since the gallstones will...

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  • Re: Is it fallacious to predict future outcomes using developmental tests alone?
    Frances M Cowan

    Dear Editor,

    We thank Drs Gada and Kanumakala for their letter [1]. We agree that prediction of future outcome using developmental tests alone is difficult. However, despite these difficulties we have shown good sensitivity and positive predictive value of an abnormal score on the Griffiths scales for an abnormal outcome at 5-6 years [2]. Whilst we recognise the influence of genetic, socio-economic factors and env...

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