112 e-Letters

  • autism assessment tools- a (partial) misinterpretation
    Alan S Stanton

    Carter and colleagues have done a superb job in summarising the theory and practice of tools used in assessing children for autism. Unfortunately their paper is marred by a mathematical error which, if left unchallenged, could undermine trust in the use of one such tool, the ADOS.

    According to the paper, the positive predictive value (ppv, i.e. the proportion of those who test positive who actually have the cond...

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  • Attention must also be drawn to alternative pathogens for tonsillitis
    oscar,m jolobe

    Although it may be difficult to make a distinction between retropharyngeal abscess, and retropharyngeal cellulitis attributable to organisms such as Group A bete-haemolytic Streptococcus, Staphylococcus Aureus, and Group B Streptococcus(1), retropharyngeal abscess should remain high in the differential diagnosis because Fusobacterium necrophorum(F necrophorum), the gram negative culprit pathogen,although initially givin...

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  • How to use lupus anticoagulants in neonates born to mothers with antiphospholipid syndrome
    Maria Pia De Carolis

    .Dear Sir, We read with great interest the accurate paper by Sen et al. regarding the indications for testing lupus anticoagulants (LA) in pediatric patients1. We believe that two further considerations might provide a complete overview on this issue. First, it has to be underlined the important contribution given by Boffa MC concerning either the laboratory methods for the detection of LA2 or the association between an...

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  • Suboptimal INH dosage in prophylaxis
    Luis I. Gonzalez-Granado

    The authors state that INH does not prevent the development of active tuberculosis. However, it is well known that with lower dosage than 15mg/kg daily of INH, we cannot assure therapeutical INH levels, precluding its efficacy, as it correlates with lower levels than 3g/l in the pharmacokinetic parameter of response Cmax

    Conflict of Interest:

    None declared

  • Sexual health and contraception
    Alyson J Elliman

    Straw and Porter write an important article on Sexual health and Contraception (Arch Dis Chld Educ Pract Ed 2012; 97:177-184), but there are some points which I think need clarification or correction. There may also be missed opportunities for highlighting the most effective methods of contraception in real life situations for young people. The statement that 'Levonelle 1500 is an an oral progestogen which can be obtaine...

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  • Unde venis? loosely paraphrased to "where did you spend your last holiday?"
    oscar,m jolobe

    Surprisingly, especially in view of a recent article highlighting the importance of including a history of recent travel when evaluating neurological symptoms and signs(1), such an inquiry was not mentioned as a fundamental requirement in the 15 minute consultation on facial paralysis(2). In the anecdotal report of a patient with multiple cranial nerve involvement(inclusing facial nerve paralysis) in whom the diagnosis of...

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  • The abbreviated patient-held health record should be part of the process of transition
    oscar,m jolobe

    At the heart of good management of the health transition process(figure 1)(1) should be a recognition of the "power of information- putting all of us in control of the healthcare information we need"(2). This can be achieved, in part, through the medium of the so-called "abbreviated patient-held record"(3), so as to bridge the communication gap between a variety of healthcare services when the young person makes the tra...

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  • Options for procedural pain, current practice in England
    Hemantha R Balehithlu

    In her review of options for procedural pain in newborn infants Judith Meek is herself premature in her assertion that "the statement that we are no longer in equipoise over the use of sucrose may be premature..."[1].

    We surveyed current practice and attitudes to procedural pain in English Neonatal Units in 2011 using paper questionnaires sent to the lead clinician in each unit. Replies were received from 102 of...

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  • Differential molecular diagnosis is a need to support the history
    Atif Baig

    Respected Sir. We have read the entire article. We agree with the history and the condition of the Alice as mentioned by the respected authors. But, we strongly believe the molecular diagnosis testing must be performed to confirm Benign hereditary chorea which is map to chromosome 14q (Vries et al., 1999). Beside mapping a mutation in TITF-1 gene has been reported to be associated with hereditary benign chorea (Breedveld...

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  • right-to-left shunts as a risk factor for pneumococcal meningitis
    oscar,m jolobe

    For the sake of completeness, one should add right-to left shunts to the list of underlying causes under the heading of "certain populations of children [who] are at increased risk of IPD(invasive pneumococcal disease)"(1). Although the most striking example was that of a 77 year old man(2), the prinicple is also applicable to children with atrial septal defect(ASD) that this congenital anomaly could predispose to recurren...

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