163 e-Letters

published between 2011 and 2014

  • ADHD -Safeguarding responsibilities
    anthony cohn

    Dr Webb's article highlights the fact that ADHD can be considered as a behavioural problem caused by many different aetiologies, including significan physical and emotional abuse. She identifies that the sort of abuse that triggers this behaviour is often longstanding and at a level that becomes tolerated by statutory services who are usually quick to intervene when there is physical harm, but allow emotional and social...

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  • Yes, We Need to Change the Way We Deliver Unscheduled Care: and More.
    John C Furness

    Dear Ed Gill [1] and Powell [2] state there is little data on delivery of unscheduled care. We would like to share our learning.

    To improve paediatric training in primary care one of us (SC) has worked with Advanced Life Support Group (ALSG) led by SW and piloted a, "Poorly Child Pathway Course." This one day course deals with the most common acute childhood presentations and uses a traffic light system (gree...

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  • Light drinking in pregnancy and mid-childhood mental health and learning outcomes
    Oscar Garcia-Algar

    Dear Editor,

    We have read with interest the paper by Sayal et al. concerning a cohort of 11-year-old children prenatally exposed to alcohol and the major conclusion that light drinking in pregnancy does not appear to be associated with clinically important adverse effects for mental health and academic outcomes at the age of 11 years.

    This broad epidemiological study has several problems related to the...

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  • Re: The importance of a preschool booster for children born to hepatitis B-positive mothers
    Dayan Vijeratnam

    We read Ladhani and Ramsay's editorial with great interest. Whilst we agree on the need for the delivery of a completed course of Hepatitis B vaccinations in infants of high-risk mothers where the fourth vaccination is administration by their first birthday, in order to improve uptake of vaccines it is essential to recognise factors preventing this occurring.

    Firstly, Hepatitis B positive mothers diagnosed in an...

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  • Response to: "Capillary refill time: Time to fill the gaps!"
    Jodie Crook

    Thank you for your response to our research 'The agreement of fingertip and sternum capillary refill time (CRT) in children'

    We agree that there is a lack of gold standard for assessing tissue perfusion in a simple and timely manner and continue to extrapolate that in shock, blood is usually diverted from the skin in an attempt to perfuse vital organs. Current practice and guidance assumes that CRT is a reflecti...

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  • Re: The importance of a preschool booster for children born to hepatitis B-positive mothers
    Tom A. Yates 1

    We are grateful to Dr Ladhani and Dr Ramsay [1] for their thoughtful editorial that accompanied the publication of our paper [2]. We would agree that, despite discrepant observational data in the UK regarding the waning of antibody titres [2, 3], there is now a large body of evidence [4] demonstrating that, even where antibody titres have waned, booster doses are not required if an adequate primary schedule has been comp...

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  • Capillary refill time:Time to fill the gaps!
    Biju M John

    Dear Editor,

    We read with great interest the article on capillary refill time (CRT) in children. Crook J and Taylor RM have carried out a simple and yet very relevant study on CRT in children.CRT is almost universally checked by child care providers particularly in emergency room or intensive care setting and is taken as a surrogate of the perfusion status. However, two issues have plagued this simple bedside te...

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  • Should we use linear splines to model complex growth processes?
    William Johnson

    Fairley et al(1) describe differences in growth between White and Pakistani infants in the BiB study using mixed effects linear splines, an approach becoming popular in the analysis of serial anthropometry. Linear splines were used because they summarize noisy data in meaningful parameters: an intercept and linear slope terms (connected by knots) governing different age sections. Adding an exposure obtained estimates of...

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  • Issues relating to basilar artery strokes in children
    oscar,m jolobe

    The timely commentary on basilar artery stroke(1) serves as an opportunity to highlight the importance of a high index of suspicion for posterior circulation transient neurological episodes(TNAs)(2), especially in the presence of risk factors for vertebral artery dissection(3). It is also a reminder of the underuse of magnetic resonance imaging(utilised in only 44.3% of 97 children in one review)(4), notwithstanding the f...

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  • Rickets
    Henrique C. Mota

    To the editor of Archives of Disease in Childhood.

    I read the article by Nick J Shaw, M Zulf Mughal. Arch Dis Child 2013; 98: 368-372 with great interest and I would like to comment on some items of the summary which I quote: "Factors responsible for worldwide resurgence of rickets among infants and adolescents are complex and include: residence in northern or southern latitudes, voluntary avoidance of exposure...

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