eLetters

517 e-Letters

published between 2004 and 2007

  • Tracheal intubation in meningococcal disease and septic shock
    Robert Ross-Russell

    In a letter to your journal recently published, Dr Gray and his colleagues criticised the newly published algorithm for the treatment of meningococcal disease and septic shock in children.1,2 In particular, they were concerned that the ‘sole trigger’ for intubation was 60ml/kg of fluid resuscitation. This is not the case. The algorithm indicates that after each bolus of fluid, the child should be assessed for ‘signs of sho...

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  • Paediatric prescribing of asthma drugsin
    Donald N Payne

    Editor

    So, doctors in the UK are not prescribing asthma drugs according to published guidelines [1]. Sadly, UK medical journals are also failing to hit the spot, by printing images of children using inappropriate inhalers, with suboptimal technique. Although paediatricians and current asthma guidelines recognise the difficulty that children have in using a metered- dose inhaler (MDI) without a spacer, the photo o...

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  • A very useful new statistical method
    Antonio J Cunha

    Dear Editor,

    The article by Akobeng and Heller (1) is very interesting indeed and seems to be very useful. They suggest that using the PIN-ER-t (population impact number of eliminating a risk factor over a period of time), which is defined as the potential number of disease events prevented in a population over the next t years by eliminating a risk factor (2), allows numbers to be communicated in a more friend...

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  • Is the current threshold level for screening for congenital hypothyroidism too high?
    David Elliman

    Dear Editor,

    We were interested to read the letter from Pryce and colleagues (1), describing how, over a two year period, they detected one extra case of congenital hypothyroidism (CHT) by reducing the threshold level of TSH for referral from the newborn screening programme. The UK Newborn Screening Programme Centre is currently reviewing a number of aspects of the CHT programme, including the cut off for ref...

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  • 4G/4G genotype associated with both obesity and increased severity of meningococcal septicaemia
    Vinod Sharma

    Dear Editor,

    We read with great interest the article of Perez et al (1) on the relationship of severity of meningococcal infection with anthropometrical parameters in children. Patients with severe disease and non-survivors had higher weight for age z scores than patients with non-severe disease. Body mass index was significantly higher in those with severe disease. Binder A et al (2)reported an association of the 4G...

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  • Monitoring of Newborn Weight, breast Feeding and Severe Neurological Sequelae secondary to dehydrati
    Dr. Joe A Fawke

    Dear Editor,

    With respect to van Dommelen et al’s(1) interesting paper we would like to make the following contribution.

    Neonatal hypernatraemic dehydration screening is complicated by an unclear but possibly rising incidence(2) and the need to avoid undermining the ‘breast is best’ message whilst recognizing the severity of the condition. The notoriously variable clinical presentation adds to this dif...

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  • A Simple Policy for Prevention of Vitamin D Deficiency & Rickets in Childhood
    Justin Davies

    Dear Editor,

    The recently published study (1) and accompanying perspectives (2, 3) follow the recent report of the RCPCH Standing Committee on Nutrition (4). With the recent introduction of the Healthy Start scheme in the UK, it is important for health care staff throughout the NHS to have a simple, yet effective, policy for prevention of Vitamin D deficiency that can be implemented in the community. Whilst we ag...

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  • Misleading illustrations used for dermatology articles
    Celia Moss

    Dear Editor,

    I am delighted to see dermatology featured on the covers of both blue and green sections of the August Archives, but concerned that both pictures are misleading. The image chosen to illustrate an article on eczema in fact shows typical impetigo, which would worsen if treated as eczema with topical steroid. The illustration on the cover of the Education supplement shows caustic being applied to a few ti...

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  • Dilemma indeed
    Sharryn E Gardner

    Dear Editor,

    I read with interest Robin Powell’s analysis of the ramifications for Paediatricians of the recent judgement in MB [2006] EWHC 507 (Fam) (1). Although Mr Justice Holman made it very clear in his final words of judgement that ‘every case and every child is unique, and this case concerns M alone’(2) , the case will undoubtedly be used as precedent. M is indeed unusual in that he was diagnosed with SMA1 s...

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  • Management of menstruation in severe learning disability
    Mel M McMahon

    Dear Editor,

    The recent review of suppression of menstruation by Albanese and Hopper1 in adolescents with severe learning difficulties is the first review of its type published in the UK. We have recently looked at the issues surrounding puberty and management of menstruation in a group of young women with severe learning difficulties and epilepsy who are living at a residential school in Cheshire.

    In our...

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