eLetters

465 e-Letters

published between 2000 and 2003

  • Fosfomycin for osteomyelitis?
    Scott J Hackett

    Dear Editor

    We were interested to read the recent article by Corti et al. examining the use of fosfomycin for infective osteomyelitis.[1]

    Whilst fosfomycin has good gram-positive including anti- staphylococcal and gram-negative coverage it is only available in the intravenous preparation. Concern regarding the emergence of resistance means that in our hospital it is reserved for resistant / relapsi...

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  • Authors Reply
    Richard J Tomlinson

    Dear Editor

    Sudhir Kumar writes an excellent review of the likely pathology of cerebral malaria.[1] They state that Mannitol should not be used routinely, an opinion with which I agree. They say however, it should be used judiciously, but on what evidence do they make this summation, and on what clinical indication? I assume this opinion is based on clinical experience. It was anecdotal evidence that led me to searc...

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  • Risk assessment from single procedures
    Robert A Johnson

    Dear Editor

    I read with interest the article by the team from Southampton. They described an elegant strategy for the retrieval of impacted central venous lines. However they describe the technique as safe based on a single reported procedure. As a rough guide in order to achieve a 10% level of risk of an adverse event with 95% confidence then around 28 uncomplicated procedures are required. How would one quote t...

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  • Re: This palm tree does not usually cause thorn injury
    Assaf Kratz

    Dear Editor

    I thank Dr D'Souza for his comment.[1]

    The date palm may, indeed, look like the coconut palm in it's form. But the shape of the date palm thorns are different, as can be seen in figure 3. Those thorns are vicious and can cause severe penetrating injuries (As worse as getting hit by a falling dried coconut...).

    Reference...

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  • Emergency asthma inhalers in schools
    Keith R Ross

    Dear Editor

    We were interested in the review by Reading et al.[1] In Wolverhampton we are fortunate in having had a schools asthma policy in place since 1994 which includes supplying emergency inhalers to schools for use when the pupil’s own inhaler is not available.

    The policy was initiated by two hospital paediatricians with an interest in asthma and was quickly incorporated into the local Respirat...

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  • High dose fluticasone and adrenal suppression
    Joanne M. Balfe

    Dear Editor

    Following the editorial by Russell [1] recommending a short synacthen test for asthmatics receiving fluticasone in a daily dose of 1000 mcg or above, we undertook a computer search of our records of asthmatic patients.

    Asthmatics have approximately 4000 consultations per year with our team. We identified 190 children taking inhaled fluticasone either alone or in combination with salmeterol. Of...

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  • Iatrogenic hyponatraemia
    Michael Cosgrove

    Dear Editor

    We were interested to read the letter from Playfor in which he detailed the fatal consequences of iatrogenic hyponatraemia following administration of intravenous 4% dextrose/0.18% saline to a young child with moderate dehydration.[1]

    We were reminded of a similar though less severe case which led us to change our unit policy in a manner exceeding that recommended by Playfor.

    A 3 year old...

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  • Re: Tell me a story
    Andrew N Williams

    Dear Editor

    I applaud Rudolf and Storr for writing their paper[1] and the Archives for having the courage to publish it. The Medical literature after all represents only a fraction of literature as a whole.

    After a busy day trawling through evidence based websites it would be wonderful to have access to a different source of intellectual refreshment. May I suggest that the RCPCH website develops a “reading...

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  • Intravenous mannitol should not be routinely recommended for cerebral malaria
    Sudhir Kumar

    Dear Editor

    I read with great interest the recent article by Tomlinson et al.[1] Authors feel that intravenous mannitol may improve the outcome in patients with cerebral malaria, though there are no randomized controlled trials on the subject. However, I would like to make certain observations.

    Cerebral oedema in cases of cerebral malaria is often multifactorial.[2] Main pathogenic mechanisms includ...

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  • Antibiotic resistance in urinary tract isolates and risk of renal scarring.
    Michael Eisenhut

    Dear Editor

    Lakhani and Gransden [1] stated in their article that in urinary tract infection the initial use of an antibiotic the urinary tract isolate is resistant to will through a delay in effective treatment lead to an increased risk of renal scarring. The authors concluded that nitrofurantoin should replace trimethoprim as the first line antibiotic for treatment of urinary tract infection (UTI) in childhood beca...

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