163 e-Letters

published between 2011 and 2014

  • Re: NGS : ethical and social considerations
    Andrea Nemeth

    To the Editor,

    We are very pleased to see the comment from Dr Burke regarding the ethical and social considerations of Next Generation Sequencing, in response to our review.

    As we noted in our original article, the field is very complex, with a major issue being the interpretation of sequencing data, such that without follow up investigations many variants cannot be confidently assigned as either beni...

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  • Rapid tube weaning - benefits and challenges
    Peter J Scheer

    Dear Editor-in-chief, in reaction to Charlotte M Wrights editorial "Failure to wean" (2013, 98: 838-840) we would like to add some data on the option of rapid tube weaning to enhance the discussion between rapid versus slow weaning programs and to advocate a flexible and individually tailored approach. As Mrs Wright comments saying that no program suits every child we would like to stress that especially medically fragil...

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  • Audit confirming appropriate requesting of CT head scans in children with minor head injury
    Dr Ravindran Visagan

    Dear Sirs,

    We read with great interest your work on the cost effectiveness of clinical decision rules for minor head injury. As you point out, increased CT scanning reduces the risk of missing patients that require neurosurgery at the expense of increased radiation risk. This latter point has been recently raised in the literature [1,2] and prompted us to audit our practice of the appropriateness of CT scanning c...

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  • NGS : ethical and social considerations
    Katherine B Burke

    The new paradigm in which children undergo genetic investigations acknowledges that genetic information belongs to families, as well as individuals. Recent ACMG guidance [1] requires clinical laboratories in the USA to 'screen' genomes for 56 highly penetrant mutations with 24 disease associations when undertaking next generation sequencing (NGS), regardless of the indication, the age of the patient, and their preferenc...

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  • A patient-centred-care message
    Pierre R. Smeesters

    I read with great interest the important and elegant article written by Sullivan et al. Dealing with the death of children is always distressing, emotional and complex. It naturally leads to many difficult questions about what and when to say and do. There are no simple answers.

    However, one of the few certainties is that whatever decisions are taken, the parents will have to live, and hopefully cope, with what...

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  • Incorrectly quoted JCVI Guidance
    Sanjeev Deshpande

    I read with interest the article by Murray et al on prevention of respiratory syncytial virus disease in infants and children. However, the indications for use of passive immunoprophylaxis with Palivizumab as shown in Box 1 and referenced to in the statement 'Current JCVI guidance states that palivizumab is only cost-effective..... at most risk of severe disease (see box 1)17' are incorrect and represent a mixture of the...

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  • Do we have the right focuses?
    Lutz Nietsch

    Dr. Bauchner and many other professionals inside and around pediatric emergency medicine are asking: Why doesn?t staff members like parents present in resuscitation?

    Let us ask two other questions - one to the man on the street: What would be worst: to meet your child dead after resuscitation or the alternative: to meet your dead child dead AND to experience your dying child under ongoing resuscitation? The othe...

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  • Why such articles are of limited value
    Tony Lopez

    Dr Kemp and her colleagues have done us a great service over the years in collating and analysing the evidence base related to safeguarding.

    I wonder however how they themselves translate their work into practice. Consistently they report the likelihood that an abused child will have such and such an injury. But in practice we must travel the other direction. We must ask: in a child with such and such an inju...

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  • Re:Management of Kawasaki disease Eleftheriou et al
    Despina Eleftheriou

    We thank Professor Hall for drawing our attention to this issue. At present there are no relevant published recommendations in the UK but we would agree that both vaccination against VZV and influenza should be offered and recommended to children receiving long term aspirin.

    Conflict of Interest:

    None declared

  • Re:Is the effect of parental separation underestimated?
    Maria Quigley

    Maria A Quigley1, Claire Carson1, Julia Morinis1,2,3.

    1 National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK

    2 Department of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada

    3 Centre for Research on Inner City Health, The Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada

    We would like to...

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