eLetters

534 e-Letters

published between 2003 and 2006

  • Clinically relevant data needed to inform prescribing decisions
    Andrew Riordan

    Dear Editor

    Ladhani and Gransden are right to encourage other units to review local data on antibiotic resistance among urinary tract isolates. There is not adequate evidence to suggest one antibiotic is superior to others in presumptive therapy of urinary tract infection (UTI).[1] Local antibiotic susceptibility patterns should thus help make the antibiotic choice. However I have two major concerns about their con...

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  • Hypothalamic hamartomas: syndromes and surgery
    Leslie G Biesecker

    Dear Editor

    The recent article by Ng et al. and the accompanying commentary [1] address the notion that girls with precocious puberty should undergo cranial imaging to exclude a CNS malformation.

    One consideration not discussed in that article or the commentary is that hypothalamic hamartomas can be part of a malformation syndrome, most commonly Pallister -Hall syndrome.[2] Because this disorder can b...

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  • Vitamin K deficient bleeding in cystic fibrosis
    Paul Clarke

    Dear Editor

    The report by Drs Verghese and Beverley of the 9 week old infant with cystic fibrosis (CF) who presented with late vitamin K deficiency bleeding (VKDB) was very interesting.[1] However the quoted prothrombin time (PT) and normal range was confusing.

    A PT of > 10 seconds could be normal, since the normal reference range for PT in healthy 1 month old term infants is 10.6 – 13.1.[2] Yet the P...

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  • Malaria chemoprophylaxis in children: practical problems
    Beena Padmakumar

    Dear Editor

    I am writing in response to the article on fever in returned travellers [1] that highlights the disappointing uptake of malaria chemoprophylaxis in travellers.

    I wish to point out the practical problems associated with malaria chemoprophylaxis in children. The medications used for chemoprophylaxis varies depending on the area travelled to. A combination of weekly chloroquine and daily proguanil...

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  • Authors' Reply: Education and training in the paediatric senior house officer grade
    Claire P Smith

    Dear Editor

    We were pleased to receive the comments from Martin Richardson [1] about our article [2] because it allows us to clarify the College's position on education in the modern NHS. Our survey of College Visit reports covered the period 1997 to mid 2001 which was before most departments introduced shift patterns of working. The article was written many months ago and this inevitably resulted in some of ou...

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  • The one child family policy in China and the gender ratio
    Filippo Festini

    Dear Editor

    Zhu points out the favorable effects of the One Child Family Policy (OCFP) on China’s demographic problems and on the population.[1] In our opinion, the considerable, unfavorable consequences of the OCFP are not sufficiently taken into consideration in the article. One of the major problems is the gender imbalance of Chinese population. The gender ratio mentioned by Zhu refers to the entire population,...

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  • Guidelines already there
    Oliver J Rackham

    Dear Editor

    This was a very useful example of evidence based medicine. However, we already have advice as to the answer to this question from the British Thoracic Society. The child concerned need not have had a chest Xray at presentation. The guidelines state that "Chest radiography should not be performed routinely in children with mild uncomplicated acute lower respiratory tract infection". (Strength of recommen...

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  • Describing impairment and disability for children with cerebral palsy
    Christopher Morris

    Dear Editor

    We concur with Drs Colver and Sethumadhavan that the term diplegia has limited clinical value as a way to communicate about children with cerebral palsy and that use of the term should generally be discouraged.[1]

    The definition of diplegia is imprecise and requires judgment; the dividing lines between diplegia and quadriplegia, or between diplegia and hemiplegia with ‘some’ involvement of t...

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  • Health records of looked after children
    Chris Tomlinson

    Dear Editor

    With interest we read the study by Ashton-Key and Jorge looking at immunisation status in looked after children.[1]

    We find the results similar to a study performed locally in a residential school for boys aged 11- 16 looked after by local authorities. On admission to the unit all boys have a medical, which includes an immunisation history. For the purposes of the study 85 boys over a six month...

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  • Hazards in the epidemiological study of SIDS
    Theo H Fenton

    Dear Editor

    Sir Roy states that:
    ‘As the number of infants categorised each year as SIDS in England and Wales comes nearer to 200, so it becomes more important for those involved in epidemiological studies to be sure that the categorisation (i.e. the diagnosis) is correct’.
    He mentions that some such deaths later prove to have been murders, yet nobody corrects the stat...

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