30 e-Letters

published between 2008 and 2011

  • 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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  • The long-term psychosocial impact of living-related donation in paediatric transplant recipients
    Raymond Reding

    Dear Sir,

    We read with great interest the concise and accurate summary of P J McKiernan regarding best-practice milestones for long-term care following paediatric liver transplantation (1).

    Although we fully agree with all medical considerations raised by the author, we reckon that the complexity of the psychosocial challenges met by the patients and their families as they adjust to the process of organ...

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  • there may also be a role for long-term leukotriene antagonist therapy
    oscar,m jolobe

    Support for a "united airways approach" to best practice(1) comes from a study which evaluated factors influencing asthma remission in a cohort enrolled at the age of 7, and followed-up for 39 years(from 1968 to 2007), remission being defined either as "no asthma attacks for 2 years and no current asthma medication use" or "no self-reported asthma in adult life but with parent-reported childhood asthma"(2). In that communi...

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  • Management of Lichen Sclerosus in Children
    Monika Bajaj

    I would like to respond to Prof. AS Garden's excellent article on Vulvovaginitis and other common gynaecological conditions (1). The author states that treatment of Lichen Sclerosus is with potent topical steroids such as Clobetasol propionate 0.05% , applied twice daily for periods of up to 2 weeks. This may be a minor issue but topical steroids are classified into 4 grades of potency (mild, moderate, potent and very po...

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  • Safer options (other than fluoride) for prevention of tooth decay
    Neeru Gupta

    Safer options (other than fluoride) for prevention of tooth decay

    Despite reports of decreased dental carries after water and toothpaste fluoridation, Studies indicate, however, that the prevalence and, to a lesser extent, the intensity of dental fluorosis have increased in schoolchildren in both fluoridated and fluoride-deficient areas. Several studies show that young children inadvertently ingest sizable pro...

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  • Non infectious CRP elevation and correlation with gestational age
    Nora Hofer

    Non infectious CRP elevation and correlation with gestational age

    Dear editor, We read with interest the discussion on the reliability of CRP as a sepsis marker in the newborn in the context of non infectious conditions following the interesting article on the use of CRP by McWilliam and Riordan (1). We have recently conducted an analysis on this topic including 690 newborns having CRP values done within the firs...

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  • Complicated pneumococcal pneumonia: do not think to penicillin-resistance
    Gianluca Tornese

    Dear Editor,

    the "Best Practice" article by Randle et al. (1) on invasive pneumococcal disease gives a complete and up-to-date review on this topic. Notwithstanding the Authors did not mention the fact that at least complicated pneumonia (necrotizing pneumonia, pleural effusion, pleural empyema, lung abscess) are not related to penicillin-resistance of Streptococcus pneumoniae (2-4). Since an increasing number o...

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  • The use of inhaled corticosteroids in the wheezy under 5-year-old child.
    giovanna ventura

    We read with interest the paper by BR Davies and WD Carroll about the role of inhaled corticosteroids (ICS) in management of wheeze in children <5 years. As the authors underline, asthma in children is defined by the clinical progression from episodic to multi-triggered, unremitting wheeze. The first and more common condition is atopic persistent asthma, characterized by atopic features such as aeroallergen sensitizati...

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  • Inadequate history taking regarding in utero exposure to teratogens leads to missed diagnoses of Fetal Alcohol Spectrum Disorders
    Elizabeth M. Peadon

    Dr Horridge provides a practical overview of the approach to assessment and investigation of the child with disordered development and emphasises the importance of a thorough history. We were surprised that Dr Horridge did not discuss the importance of obtaining the history of in utero exposure to teratogens, particularly alcohol.

    Fetal alcohol exposure is the most common preventable cause of intellectual disabi...

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  • Plasmodium malariae and relapse
    Bernhard R. Beck

    Dear Editor

    In the article of Delane Shingadia and Shamez Ladhani about the treatment of malaria in table 3 it is mentioned that primaquine is used in higher doses for preventing relapses in P.malariae infections. This must be a typing error since the same authors stated in an earlier article about the malaria treatment (1) that this dosage is used for preventing relapses in P.vivax infections. Plasmodium malari...

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