423 e-Letters

published between 2006 and 2009

  • follow up of children with community acquired pneumonia
    Egware B Odeka DCH FRCPCH FRCP

    We read with interest your article on follow up of children with community acquired pneumonia and also your eletter response on the subject. I t is interesting to note that children with pre-existing asthma are at significant risk of persistent cough after admission to hospital for community acquired pneumonia. However the risk of subsequent asthma is increased only in children of non-atopic parents. In routine clinical pr...

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  • Paraldehyde for CSE; its role in a national guideline
    Rod C Scott


    Dr Rowland and colleagues have recently reported a prospective audit on the use of rectal paraldehyde in children with prolonged seizures (1). On the basis of their data they conclude that “This would appear to confirm that paraldehyde should remain a treatment for the management of prolonged tonic-clonic convulsions, including convulsive status epilepticus”. Unfortunately there are several issues that req...

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  • Mandatory Reporting of Child Abuse: all that glitters is not gold
    Minoo Irani

    The leading article on child protection by Ben Matthews et al (1) starts with a promising review of the difficulties experienced by UK Paediatricians with child protection work. However, their argument that low substantiated cases of abuse and neglect in UK represent the reluctance of paediatricians in England to engage in the business of child protection is not supported by their statistics. Also, their approach of comp...

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  • Review of Epigenetic Imprinting Disorders Also Required
    Marjorie A Garvey

    Dear Editor,

    Samuel and colleagues(1) aim to review the clinical and epidemiological evidence relevant to the use of pre-implantation diagnosis (PGD) to create a “saviour sibling.” A thorough literature review regarding the use of this method should include consideration of the medical problems that may occur in the child born following assisted reproduction technology (ART), but this was not addressed in this...

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  • Possible explanations for unchanged incidence of microalbuminuria with time
    Myra Poon

    We read with interest the finding of an unchanged incidence of microalbuminuria with time in children with type 1 diabetes in the Oxford Regional Prospective Study cohort. Figure 1 demonstrates no difference in the cumulative prevalence of developing microalbuminuria in relation to year of diabetes onset. However we note the small numbers of patients remaining at 10 years, particularly in group C, and wonder whether a d...

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  • Another question for NICE on UTI Guide?
    Dr Egware Odeka frcp,frcpch

    I read with interest this latest paper questioning the recommendation from NICE about the management of UTI in children. While the need for evidence is crucial to informed practice it is not always the case that in all medical conditions that this level is reached. Consensus therefore can be arrived at after a thorough review of good practice by eminent practitioners in the field. I have no doubt that the respected membe...

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  • Pijpers et al.
    David CA Candy

    Pijpers et al rightly highlight the lack of high quality evidence for the treatment of constipation. In their conclusion they state ‘Insufficient evidence exists supporting that laxative treatment is better than placebo in children with constipation’. This paper derives from the Academic Medical Centre, Amsterdam, where Benninga’s group have successfully demolished all other treatments for constipation other than laxative...

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  • Never?
    Richard G Fiddian-Green

    Subhi et al have asked when oxygen should be given to children at high altitude observing that hypoxaemia is the most common fatal complication in deaths occurring from pneumonia in children in developing countries (1). Might the answer be never?

    Supplementary oxygen appears to be harmful in climbers on Everest possibly because it eliminates the up-regulation of oxidative phosphorylation by mass action by hypoc...

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  • Procalcitonin is not necessarily better than C-reactive protein in febrile infants under 3 months of
    Ming-Chih Lin

    To the editor:

    Olaciregui et al. reported an interesting article and concluded that the diagnostic value of procalcitonin (PCT) is greater than C reactive protein (CRP) in predicting infants with more invasive bacterial diseases (sepsis, bacteraemia). However, due to the following reasons, the conclusion should be more conservative.

    First, the authors claimed that the area under curve (AUC) is greater...

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  • In Child we trust
    Lucio Piermarini

    Dear Sir I absolutely agree with your conclusions about demand feeding being something “we might all be able to live with”, but we should really respect the children’s “demand”. I also agree that there is no strong evidence to support exclusive breast feeding for six months, but there is neither strong evidence about the optimal complementary diet and there is not any certainty that the child introduced to solid foods wi...

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