eLetters

517 e-Letters

published between 2004 and 2007

  • Reverse remodeling should be the new frontier for heart failure management
    oscar,m jolobe

    Dear Editor,

    The potential for furosemide to exacerbate the maladaptive processes involved in the worsening of heart failure(1) can, at least in theory, be mitigated by the use of torasemide in preference to furosemide, given the fact that the former agent is characterised by antialdosterone as well as by antifibrotic properties(2)(3), which, in combination, have the potential to enhance the process of reverse remo...

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  • No arachis oil in octenidine preparations
    Joerg Siebert

    Dear Editor,

    While acknowledging the potential of alcohol-based disinfectants to cause extensive skin burns in extremely preterm infants, Upadhyayula et al (1) conclude that there is no safe alternative. However, skin burns can be minimized by using an aqueous solution of 0.1% octenidine with 2% phenoxyethanol (Octenisept), which was found to be safe in a prospective trial in preterm infants of 23-26 weeks gestatio...

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  • EWTD: Different solutions for different hospitals
    John Gilbert

    Dear Editor,

    Campbell and Spencer have enumerated the challenges that the European Working Time Directive (EWTD) presents(1). The basis of the problem appears to be that doctors in training will have to be grouped together in larger cells with a minimum of 10 on each rota. The rationale behind this assertion is that exposure to useful training time in clinics and non- acute work will be eroded with smaller numbers...

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  • misdiagnosis of obstructive sleep apnea
    Daniel K Ng

    Dear Editor,

    We read with interest the paper by Verhulst et al 1 and there are a few areas that warrant further discussion.

    On the accuracy of sleep polysomonography study, the accuracy of the thoracoabdominal strain gauge used in their study requires elaboration. Although strain gauge is one of the qualitative methods to measure thoracoabdominal circumference, it is not very sensitive to detect shallow...

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  • Is Lumbar Puncture necessary in the Evaluation of Early Neonatal Sepsis?
    Rebecca A Samuel

    Dear Editor,

    We read with interest the Archimedes review by Ray and Mangalore regarding the need for lumbar puncture in evaluating early neonatal sepsis. The conclusions of the review were that lumbar puncture was not necessary when there were only perinatal risk factors or a baby had “mild” symptoms of sepsis.

    Our attention was brought to this review when we tried to reach an evidence based decision on...

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  • GLUT 1 deficiency syndome is seldom a neonatal problem
    Paul A.J. Heaton

    Dear Editor,

    In their leading article on Treatable Neonatal Epilepsy, Surtees and Wolf list the syndrome of glucose transporter deficiency Type 1 (GLUT 1) as the second entry on their list of metabolic causes of early onset epilepsy(1). I think that this could mislead many practitioners into thinking that seizures affecting infants in the first few weeks of life could be due to this disorder.

    I am no...

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  • Evidence calls for paradigm shift towards non aggressive approach in immune thrombocytopenic purpura
    P Anoop

    Dear Editor,

    The Nordic Study on Childhood ITP does provide valuable data on the initial management of children with acute idiopathic/immune thrombocytopenic purpura (ITP). Treutiger et al have rightly concluded that aggressive treatment of such children neither reduces the morbidity nor decreases the risk for developing chronic ITP.[1] However, the two most striking observations from this study are the obvious inc...

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  • Sitting devices could protect against sudden infant deaths
    Paul Vaucher

    Dear Editor,

    Cote et al [1] concluded that sitting devices increased risk of infant sudden death. The only results supporting this conclusion was done by comparing the relative risk of dying in a sitting device between infants under 1 month and infants over one month adjusted for prematurely born infants (RR=3.8). However this could be explained by the fact that small children sleep more often in the car than o...

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  • Evidence calls for paradigm shift towards non aggressive approach in immune thrombocytopenic purpura
    P Anoop

    Dear Editor,

    The Nordic Study on Childhood ITP does provide valuable data on the initial management of children with acute idiopathic/immune thrombocytopenic purpura (ITP). Treutiger et al have rightly concluded that aggressive treatment of such children neither reduces the morbidity nor decreases the risk for developing chronic ITP.[1] However, the two most striking observations from this study are the obvious inc...

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  • The demographics and change in BMI-SDS of Asian children attending a weight management clinic
    Simon Fountain-Polley

    Dear Editor,

    Sabin et al in their study on patients in a hospital based weight management clinic inform our understanding regarding the demographics and morbidity of children with obesity(1). However, they only saw a small proportion of children from ethnic minorities. Asian children are more liable to obesity than their white peers(2) so investigating this in different geographical areas is important. Since Octobe...

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