eLetters

465 e-Letters

published between 2000 and 2003

  • Meningitis without rash – a suitable group for Dexamethasone?
    Niten Makwana

    Dear Editor

    We read with interest the article by Bashir and colleagues [1] on the diagnosis and treatment of bacterial meningitis. Within this article they commented that they favour the empiric use of dexamethasone in developed countries for children with suspected meningitis.

    The metanalysis by McIntyre et al [2] showed that the benefits for dexamethasone were greatest for H. influenzae me...

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  • Only wholeness leads to clarity
    Malcolm J. Wardlaw

    Dear Editor

    Authors Lee and Mann argue for law compelling use of cycle helmets by children to prevent road deaths and serious injuries.[1] This observer is surprised that the peer reviewers allowed publication of material lacking evidence either that the actual risks faced by child cyclists justify compulsion, or that the real world results of helmet compulsion in other countries justify compulsion in this count...

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  • Meningococcal Sepsis: an alternative hypothesis
    Philip C Holland

    Dear Editor

    In their article on the pathophysiology of meningococcal sepsis Pathan et al. highlight their view that thrombosis is the principal etiology of the purpuric rash that is so characteristic of meningococcal sepsis.[1] As the explanation for this they cite the well-described procoagulant state found in the severe form of the disease and the impairment in the thrombolytic pathway.

    Evans [2]...

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  • Therapeutic implications of sex differences in asthma and atopy.
    Peter JFM Merkus

    Dear Editor

    With great interest I read the review by M Osman [1] on the sex- related differences of prevalence and severity of asthma and atopy before and after puberty.

    Dr Osman postulates that testosterone and female sex steroids directly affect the immunological respons to e.g. allergens. If these hormones do play a role at physiological levels in vivo there is, indeed, most certainly a reason to c...

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  • Pathological demand avoidance syndrome or psychiatric disorder?
    M Elena Garralda

    Dear Editor

    In the recent issue of the Archives, Newson et al.[1] make the case for a distinctive "pathological demand avoidance syndrome". This arose out of the work by the authors in a clinic for children with problems in communication.

    These children are described as having a tendency to avoid or resist ordinary demands, to have surface sociability but a lack of sense of identity, pride and sham...

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  • Height screening at school
    David M Hall

    Dear Editor

    We applaud the honesty of Banerjee et al. in reporting on their review of community height screening. They found that the quality of measurement was poor but perhaps this is not surprising, since there seems to have been little investment in training or quality monitoring. We wish to make two points in reply to the commentary by Betts.

    Firstly, we emphasise that the reason we hav...

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  • Weaning of infants; timing should be individualized
    Dr Egware Odeka FRCP

    Dear Editor

    I read with interest the review by Foote and Marriott about weaning practices.[1] I agree with some of the general sentiments and do suggest that more research is needed to fully understand the reasons for advocating a stance.

    Weaning as a process, enables the nutritional needs of a rapidly growing child to be met. The growth in infants double by 5 months and expected on average to treble by 1...

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  • Re: Response to Jan et al
    Bob Phillips

    Dear Editor

    We would like to take this opportunity to thank Jan and colleagues for responding to our article. It is acknowledged that the team at the Melatonin Research Group has the longest experience worldwide in the use of melatonin in children with neurodevelopmental disability.

    The paper they refer to [1] includes a randomised controlled trial (RCT) of fast-acting vs. controlled release melatonin. Only the...

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  • Response to is melatonin likely to help children with neurodevelopmental
    J E Jan

    Dear Editor

    Last year, Archimedes, a new format, was launched by Archives of Disease in Childhood for offering "practical, best evidence based answers to practical, clinical questions". One of the first questions was : "Does melatonin help developmentally delayed children with sleep problems?".[1] Since the conclusions of this brief article are now on the Internet and physicians have access to them, our Melatonin Res...

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  • Authors reply
    Richard Reading

    Dear Editor

    We congratulate Keith Ross and his colleagues who have achieved what many other districts have failed to.[1] Their use of an asthma card as a prescription and health care plan is, we agree, an example of good practice that works well. However, their experience illustrates exactly the point we were trying to make. In order to circumvent the legal problems they have persuaded themselves and colleagues...

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