326 e-Letters

published between 2007 and 2010

  • Spontaneous TSH normalisation in children with subclinical hypothyroidism is very likely
    Tommaso Aversa

    In the review by O'Grady and Cody (1), the Authors concluded that "in the pediatric population with subclinical hypothyroidism (SH), the majority of children with slightly elevated TSH levels are likely to normalise without treatment or have persistent mild TSH elevation". Our goal is to reinforce that conclusion on the basis of the results of an our study aiming to prospectively evaluate for the first time the natural co...

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  • Nuances of category definitions
    Ingrid J Wolfe

    Van Esso et al highlight interesting differences in primary care provision between European countries, pointing out a possible change in the relative balance between paediatric and general practitioner/family doctor systems since Katz's paper in 2002(1). Our findings, from an ongoing study for the European Observatory on Health Systems and Policies, suggest caution in the interpretation of GP/FD models in some countries....

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    Jose Ramon Alonso-Fernandez

    Dear Editor: In their paper on the TSH threshold in neonatal screening for congenital hypothyroidism (CH), Korada et al. (1) conclude that a threshold of 6 mIU/L for DELFIA-measured TSH in samples collected between days 5 and 8 may be preferable to the 10 mIU/L recommended by the UK Newborn Screening Programme Centre. Our laboratory instituted DELFIA measurements of TSH in 5-8-day paper-borne heelprick samples in 1985. S...

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  • a staring point for guidelines for the management of suspected viral encephalitis
    oscar,m jolobe

    One of the issues arising from the review of management of suspected viral encephalitis(1) is the interpretation of cerebrospinal fluid(CSF) glucose content, and CSF glucose/blood glucose ratio(GR), given the overlap in clinical features between suspected viral encephalitis(1), meningitis of bacterial origin(including m tuberculosis aetiology)(2), and viral meningoencephalitis(3). What needs to be recognised is that the...

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  • Care planning in children with life-limiting conditions
    Toni Wolff

    Sir, in Nottingham, we have been operating a similar system to Fraser et al (1), for person specific planning for children with life limiting conditions since 2004. We have presented it at several national and international meetings (2-7).

    Our system has 2 parts. The first part is the personal resuscitation plan (PRP) which describes in detail the interventions which are appropriate in the event of deterioratio...

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  • Should we now stop cohort nursing babies with RSV?
    Benjamin Jacobs

    A major finding of this study was: "Infants with dual infections (RSV and hBoV) had a higher clinical severity score and more days of hospitalisation"

    In our hospital, and many others round the world, babies with RSV infection are nursed in a room together and are not tested for Bocavirus. Should this practice now stop to prevent Bocavirus crossinfection increasing morbidity?

    Conflict of Interest:

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  • Managing frequent medical absences from school.
    Jill Davies

    We were interested to read the paper by Jones at al1 on ‘Frequent medical absences in secondary school students’. They conclude that ‘this study should prompt education departments and their NHS partners to look more critically at the problem … and to establish a system that provides more comprehensive assessment and treatment.’

    Within Bolton PCT such a sy...

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  • Editors should not be propagandists
    David Elliman

    We feel Dr Markovitch (1) was over critical of Hilton et al (2). Although we agree that there was a paucity of evidence to allow them to rebut Dr Wakefield’s suggestion that MMR could in some children cause autism, we believe that they still could have been clearer in reporting the full situation. The suggestion that the MMR vaccine should be given as its separate components came, not from a scientific paper, but as an a...

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  • aneroid devices should be the preferred "new" sphygmanometers
    oscar,m jolobe

    It would be useful to ascertain whether or not the "new" sphygmanometer being compared with the Omron HEM 711(1) was an aneroid device, given the fact that those of us who lamented what we perceived to be an ill advised rejection of the mercury device welcomed the prospect that aneriod sphygmanometers "may replace the traditional mercury column in the healthcare workplace"(2). In the latter study, there were no signific...

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  • Decline in hospital MMR vaccinations: Are children being left unimmunised?
    Andrew Riordan

    I was interested to read Govindaraj et al’s audit showing a fall in the number of MMR vaccines given in their hospital over the last 2 years. Unfortunately there was no data to show what happened to those children initially referred to hospital for MMR, but referred back by the outpatient sister.

    A study from New Zealand suggests that children inappropriately referred for MMR in hospital can be referred back a...

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