197 e-Letters

published between 2009 and 2012

  • Reply to "This question deserves a more indepth review"
    Iain Martin

    Dear Archimedes,

    We thank Dr Gallagher for his interesting contribution, and welcome further debate on this topic.

    While we agree that in the study from Schanler et al. fortifier is used in all infants when on >100ml/kg/day of milk, one can draw the conclusion that early fortification does not change the risk of NEC. The use of fortifier above 100 ml/kg/day, however, may attenuate the overall effe...

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  • This question deserves a more indepth review
    Andrew Gallagher

    Dear Archimedes, This is a very important question and one that deserves more consideration. Many health care staff looking after these vulnerable infants do recognise that some of them seem to develop poor feed tolerance after addition of fortifier. The papers used to support the conclusion that fortification does not appear to increase the risk of NEC deserve a rereading by the authors. The paper by Schanler et al is p...

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  • Magic has no role in medicine, especially when children are concerned
    Eerik T. Skytta

    The principles of homeopathy run contrary to modern science and have never been empirically established. The so-called law of similars, for example, is little more than an ancient and common superstition known as sympathetic magic - that things have an essence or essential quality that can be transferred. There is no scientific knowledge about biology or chemistry to support the notion that a small dose of a drug or subs...

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  • Clear duct tape based wart studies are flawed
    Curt Samlaska

    I read with much interest the article by Stubblings and Wacogne 1 on the efficacy of topical treatment for cutaneous warts with duct tape. Duct tape is a polyethylene reinforced multipurpose pressure sensitive tape with a soft and flexible shell and pressure sensitive adhesive.2 There are three layers consisting of a polyisoprene-based adhesive, a fabric reinforcement (scrim) and a polyethylene backing. Clear duct tap...

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  • Don't Excise -- Exorcise
    Jerome Z Litt

    Dermatologists around the world are commenting on the article published in the Archives of Diseases in Children, 2011;96(9):897-899 They are commenting specifically to me, who had written an article, published 34 years ago, in the journal Cutis, 1978;Dec; 22(6);673-6 titled "Don't Excise--Exorcise," the PubMed number for which is 720133. Look it up . . . (The Abstract is below.")

    In their Search Strategy and Outc...

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  • Stand alone vs integrated PIC retrieval. Is is true that a large integrated service can't deliver 24/7?
    Sara Hanna

    Ramnarayan and Polke describe how far paediatric intensive care (PIC) retrieval has come over the last few decades but also raise concerns, quite rightly, over sustainability and cost(1). The authors go on to suggest that a stand alone service is best placed to provide a regional service, available 24/7, something that an integrated service with high demand could only provide 'ad hoc'. The South Thames Retrieval Service...

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  • Practicalities of Implementing Pulse Oximetry Screening
    Jason A Horsley

    We welcome the recent article examining the cost-effectiveness of pulse oximetry screening for newborns[1]. Implementing a new screening programme creates ongoing operating costs and start up costs. The model for their cost effectiveness analysis was based on a previous model described by Knowles et al[2], which based the cost of echocardiography on provision by a senior radiographer.

    Ewer et all calculated a s...

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  • Is selective immunisation policy for Hepatitis B in high risk children in UK really effective?

    Hepatitis B is a public health problem. Ten per cent of infants born to HBsAg positive and 70-90% born to HBsAg and HBeAg positive mothers become infected with 90% of these babies becoming chronic carriers. Universal Hepatitis B vaccination is practised as a norm in many countries including USA and Europe. The United Kingdom follows a "Targeted immunisation policy ".Current rates of vaccine uptake in the UK are poor....

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  • Judgement should only be based on a small number of treatment failures
    Theo Verheij

    Every GP acknowledges the difficulties of differentiating between severe and non-severe respiratory tract infections in children. Diagnostic value of signs and symptoms are known to be low and additional investigations in all symptomatic children is neither efficient nor feasible. Nevertheless GPs manage to diagnose and treat over 95% of children with a respiratory infections without referral to secondary care. Doing...

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  • Re:Statistical vs. Clinical Significance
    Marieke R. Potijk

    We fully agree with Dr Miller, who draw attention to the fact that statistical significance is not always equal to clinical significance. We also agree that the effect size is the appropriate measure for clinical relevance. For the difference in mean total problems scores on the Child Behavior Checklist (CBCL) between moderately preterm and term-born children the effect size is 0.22 in our study, being a small (but not...

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