182 e-Letters

published between 2010 and 2013

  • Identifying Hypertension using Centile Charts: Overcoming the Problem of Blood Pressure Variability
    Jacob Puliyel

    We commend Wu et al for their work on blood-pressure-ratios. Up until now hypertension was defined using statistically derived limits based on gender, age and height specific norms. The formulation of Wu et al permits assessments of adverse effects at different blood-pressure- ratios across age, gender and height percentile groups. (1) However given that multiple readings in an individual fluctuate quite wildly, identif...

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  • SIDS and Sudden Unexpected Death in Children (SUDC) are the same phenomenon
    David T. Mage

    McGarvey et al. have done a thorough job of exploring the differences between the sudden unexplained deaths in infants (SIDS < 1 year) and children (SUDC 1 - 4 years) in Ireland. However, they should have noted the following history of SIDS and that the one-year limit for SIDS is an administrative definition that is not based on any physiological phenomenon. Indeed, we have shown that these two phenomena (SIDS and SUDC...

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  • Moderately preterm and late preterm infants:brief history
    Shilpi Chabra

    I read with interest the recent article (1) wherein the authors use variable definitions for moderately preterm (MP) infants as 32-35 weeks of gestational age (GA) and 32-36 weeks GA. In the methods however , the authors categorize infants born at 32-35weeks gestation as MP infants and do not include 36 0/7-36 6/7 weeks of gestation due to study design. Upon review of the brief history of this terminology, it was found...

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  • Findings do not inform maternal request caesarean risk
    Pauline M Hull

    As far as I can ascertain (having not yet accessed the full text), this study did not specifically examine maternal request caesareans, and in fact found that "after all factors were taken into account there was a stronger link with emergency caesarean than with pre-planned ones, although the numbers were small for this calculation."(1)

    It is very concerning therefore that the authors appear to be presenting th...

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  • C-Section Births may Represent Low DHEA and the Consequences of Low DHEA
    James M. Howard

    I suggest the explanation of the findings of Huh, et al., involves dehydroepiandrosterone (DHEA). The fetus does not produce significant DHEA until just before birth. Prior to birth, the fetus is dependent upon maternal DHEA. I suggest a combination of maternal and fetal DHEA combine to initiate birth. If insufficient DHEA exists, then caesarean section would be necessary.

    Low DHEA is connected with obesity....

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  • Re:Specific antibody deficiency in children with chronic wet cough
    Adam Finn

    Lim et al(1) understandably interpret the results of their retrospective study with caution. However they only consider one possible chain of causation in seeking to explain their findings, namely that children with worse chest radiographs who made poorer antibody responses did so as a consequence of an underlying primary immunodeficiency. An alternative explanation would be that previous, chronic lower and/or upper resp...

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  • Clinical management of children receiving homeopathic treatment
    Gianpaolo Guzzi

    Dear Editor,

    We appreciate the interesting article by Erlewyn-Lajeunesse1 on homeopathy in children. We would like to make the following points about the safety and efficacy associated with the use of homeopathic medicines among children with a wide spectrum of clinical diseases.1 Surprisingly, the author did not mention the potential severe adverse outcomes of homeopathy in children. Sometimes the reaction ca...

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  • The link between increased lactate production and mortality in pneumonia
    Michael Eisenhut

    A recent study established increased lactate levels as a predictor for mortality from pneumonia. X-ray abnormalities were increased in patients with elevated lactate levels (1). Recent work established that prophylactic specific inhibition of nitric oxide production by N- acetylcysteine leads to a reduced lactate production as well as a reduced severity of lung injury in an animal model of sepsis induced lung injury (2)....

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  • Vaccines and disparities in male and female infant mortality in Guinea-Bissau: the problem of small numbers, high attrition rates and incomplete reporting
    Carsten Kruger

    Peter Aaby and colleagues present again highly controversial data in the Archives, namely that vaccines have non-specific effects on infant survival depending on the timing and sequence of vaccines and on sex.[1] The same research group has already published many articles on this topic which have generated much debate [2-4] without reaching a final conclusion whether their claims are correct or not (for a full publication...

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  • The possible cause for the rapid rise in incidence of Irish paediatric inflammatory bowel disease
    Xiaofa Qin

    I read with interest the article by Hope B et al recently published online in Arch Dis Child regarding the rapid rise in incidence of Irish paediatric inflammatory bowel disease (IBD)[1]. I just published a paper on World Journal of Gastroenterology with a unified hypothesis regarding the etiology of IBD, including the possible cause and mechanism of IBD as well as the relationship between ulcerative colitis and Crohn's...

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