eLetters

517 e-Letters

published between 2004 and 2007

  • The Working Time Direct – the next step?
    Roger M Buchdahl

    Dear Editor,

    Colin Campbell and Stephen Spencer (1) have presented elegantly the dilemmas facing most UK paediatric units in their attempt to reduce the average hours to 48 by 2009. Their solutions include employing senior doctors as resident on call, the “hospital at night” solution , the expansion of the advanced nurse practioner grade and rationalisation of the number of units. They left out however the one so...

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  • Differentiating osteopenia of prematurity from child abuse
    Chandan Gupta

    Dear Editor,

    The review on fractures in infancy is brilliant and very informative. I would like to take this opportunity to stress the sensitive issue of fractures due to osteopenia of prematurity that many a times needs differentiating from child abuse.

    Reports of osteopenia/rickets of prematurity are on the increase because of improved survival rates of low birthweight infants.2 The incidence of oste...

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  • partners for paediatricians
    Sebastian Kraemer

    Dear Editor,

    As a close psychiatric colleague of paediatricians for over 25 years I welcome this paper, but regret that the authors did not mention the multidisciplinary team that makes general paediatrics so effective in a disintegrating public service.

    Close links with education, social work and mental health in particular are essential and can only be achieved if these staff are on site: hospital schoo...

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  • A rational policy
    Alpana K Somale

    Dear Editor,

    May be if the general practitioners follow a rational policy in starting an antibiotic, unnecessary use may be reduced significantly. General practitioners need to be stressed on the point that there are simple clinical markers that may help them differentiate a viral and bacterial infection.

    Viral infections are abundant, bacterial infections are occasional. bacterial infections tend to local...

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  • Ignorance is bliss ?
    SIMON BIRCH

    Dear Editor,

    Neena Modi writes a generally very good perspective on this important issue. In particular, there is sensible comment in a call for reason now that a sense of McCarthyism seems to surround any suggestion that breast feeding can be difficult. However, I think it often unwise to be reassured by mother and baby being 'well'. In my experience, the very fact that nothing seems to be wrong is often a major co...

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  • Crossover design is not appropriate for CPAP RCT
    Daniel K Ng

    Dear Editor,

    We read with great interest on the article “Randomised controlled trial of nasal Continuous Positive Airways Pressure (CPAP) in bronchiolitis” by Thia et al. 1 because the evidence of CPAP use in patients with acute bronchiolitis has not been very well established. 2 Nevertheless, we have adopted CPAP as standard management in bronchiolitis in our department for severe bronchiolitis for...

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  • Down syndrome with OSA may not snore
    Daniel K Ng

    Dear Editor,

    We read with interest the article “Severity of obstructive apnoea in children with Down syndrome who snore” by Fitzgerald et al. 1 Fitzgerald et al reported that 97% of Down syndrome (DS) children who snored had obstructive sleep apnea. In light of the limited access to sleep polysomnography (PSG) in children, 2 it would seem appropriate for DS children who snore together with tonsil hy...

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  • Estimating children's weights: a developing country perspective
    Louisa Pollock

    Dear Editor,

    We read with interest the study by Luscombe and Owens(1)in which a new age-based formula is proposed for estimating weight in paediatric resuscitation. However, as the authors admit, the study findings are limited to a specific UK population and may not apply elsewhere.

    In contrast to the UK, where children's weights are increasing, in Malawi undernutrition is a significant problem with 48% of...

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  • Children with pneumonia: short stay assessment facilities lower admission rate
    Carol R Dryden

    Dear Editor,

    I read with great interest the article by Clark et al1 which described the spectrum of clinical features and management of community acquired paediatric pneumonia in the UK. The patients were children (0-15 years) with radiologically-proven pneumonia who presented to hospitals in the North East of England between August 2001 and July 2002. Children were excluded if there was a clinical diagnosis of br...

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  • Febrile neutropenia in the United Kingdom- time to standardize care?
    Sarah L Humphrey

    Dear Editor,

    Philips et al (1) confirm findings which we presented at the York Spring meeting in 2005 (2). What perhaps needs highlighting is the increasing burden of work taken on by shared care centres in managing patients with febrile neutropenia. It is this group who may benefit more greatly from the development of a standardized febrile neutropenia protocol. Working in a shared care oncology centre the need fo...

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