eLetters

534 e-Letters

published between 2003 and 2006

  • Practical issues
    Marion Schmidt

    Dear Editor,

    Thanks you for a very thourough study addressing the important issue of head injury in children.

    However in practical terms doing a CT scan on 14 % of all children presenting to A+E with head injury can be difficult.

    Many children particularly toddlers will not allow a scan without sedation or a general anaesthetic which again increase the risk associated with CT. In a DGH setting the...

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  • Compliance with inhaled corticosteroids is important when considering adrenal suppression
    Malcolm Brodlie

    Dear Editor,

    We read with interest the article by Paton and colleagues[1] reporting the results of low dose Synacthen tests in children prescribed fluticasone proprionate (FP). The finding of flat adrenal responses in 2.8% of children tested (all prescribed greater than or equal to 1,000 micrograms of FP per day) provides further evidence of the potential dangers of high doses.

    We recently published the...

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  • Lowering the burden of atopic dermatitis
    Matthias Wjst

    Dear Editor,

    The study of Moro et al. (Ref.1) deals with the interesting question if there is any treatment that may prevent the development of allergy. Their main outcome is atopic dermatitis where a group comparison between maltodextrin (placebo) and galacto-/fructo- oligosaccharides (verum) showed an exact p of 0.014 as reported in Figure 2. I assume that they used a two sided test for the cumulative incidence o...

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  • Convulsive status epilepticus with fever - Could it be Viral meningitis or Encephlitis ?
    Mohit Singla

    Dear Editor,

    Convulsive status epilepticus (CSE) with fever is one of the very common presentations to the emergency room (ER) in infants and children. The management of this clinical entity involves a major medical issue. At present many questions have to be answered: when to treat, which antimicrobial to use, and how to investigate CSE with fever?

    Different ERs have different protocols to handle this cli...

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  • Children's services: Author's response to Zuckerman
    Mitch E Blair

    Dear Editor,

    Barry Zuckerman's letter describes the Reach out and Read programme (TM) as an essential part of child health promotion. Since literacy is probably one of the most health protective skills we can equip children and young people with, we would agree with him. In the UK, Bookstart was initiated in 1992 and by 2001 had a reach of over 1 million children. Through the Sure Start centres in England, a scheme...

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  • Re: spenectomy in cystic fibrosis
    Richard G Fiddian-Green

    Dear Editor,

    Not only might the risk of overwhelming sepsis after splenectomy have been exaggerated (1) even in children but any impairment in immune function might have an enteral rather than an asplenic origin. A fall in gut intramucosal pH, which may induced not only by endotoxaemia and sepsis but also by haemorrhage, may be accompanied by significant reductions in the number of T lymphocytes in the villi and inc...

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  • Non-Adherence to TB treatment
    Murtuza A Khan

    Dear Editor,

    Marais et al (1) reported on a prospective community based study into adherence of mono-chemotherapy with isoniazid in preventing tuberculosis in suburbs of Cape Town, South Africa. They studied children who were less than five years age and who had household contact with an adult pulmonary tuberculosis index case. The main evaluation was the children’s prescription collection at various intervals fr...

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  • Enteric origins to hepatic and pulmonary dysfunction in cystic fibrosis?
    Richard G Fiddian-Green

    Dear Editor,

    I have considered the possiblity that asthma might have an enteric origin in the past (1) but did not include some of the more compelling data (2,3). Nielsen et al's data are particularly compelling demonstrating in addition the possible relevance of gut dysfunction in the evolution of hepatic diseases.

    The demonstration that the pH of breath condensate is significantly lower in patients with...

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  • Diagnostically, the low dose short synacthen test and the high dose test can complement each other
    oscar,m jolobe

    Dear Editor,

    The concept utilised in this study,namely, that the low-dose short synacthen test(LDT)is more sensitive than the conventional high dose test(HDT)(1), should not rule out the use of the HDT, given the fact that the two tests can complement each other in the context of suspected secondary hypoadrenalism, depending on the pre-test probability of this disorder(2). The rationale is that the superior sensiti...

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  • Praise is due too, but.............!
    SUE P ELFORD

    Dear Editor,

    I have read the comments on the Consensus Statement with great interest. On the whole, I felt the document recommendations were to be commended and provide us with an excellent guide for optimal care, in particular with regard to surgical and psychological advice and support. However, I admit to being very uneasy about the way nomenclature was included in this meeting. Various CAH support grou...

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