eLetters

118 e-Letters

  • Codeine in paediatrics: CYP2D6 maturation matters, also for other drugs.
    Karel Allegaert

    K Allegaert

    Intensive Care and Department of Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands and Department of Development and Regeneration, KU Leuven, Leuven, Belgium Karel.allegaert@uzleuven.be

    We have read with great interest the review article on the pharmacology, prescribing and controversies of codeine in paediatrics and we agree to a very large extent to the position t...

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  • The YOURR Project: Young People's Opinions Underpinning Rheumatology Research.
    Janet E McDonagh

    Dear Editor, we would like to congratulate Dr Bate et al for so eloquently highlighting the importance of public and patient involvement specifically in paediatric research [1]. We would like to further the discussion by highlighting the involvement of adolescents and young adults who by virtue of age may be in either paediatric and/or adult-focussed research. Mattila et al reported that young people in this age group who...

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  • How to interpret malaria tests
    Aubrey J Cunnington

    Dyer et al. wrote an instructive review on how to interpret malaria tests (1). However there are two important caveats in the interpretation of these tests which they did not mention. First, a positive test does not necessarily confirm a diagnosis of malaria. Second, a positive test does not necessarily mean that malaria is the only diagnosis.

    Strictly speaking, the tests described by Dyer et al. are parasite de...

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  • Re:A different view of studies with deferred consent
    Kerry Woolfall

    The author makes an interesting point about the current legislation and automatic inclusion of data in trials where prior informed consent is not possible.

    EU legislation focuses on when research without prior consent (RWPC) can occur and the need to obtain consent for continued participation, but does not cover the options for use of data collected prior to consent. The exception to this is where consent is not pr...

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  • A different view of studies with deferred consent
    Anthony M Kaiser

    Thank you for outlining so clearly the current basis for "deferred consent" studies and suggesting good practice in dealing with the issues it raises. Unfortunately I believe that the current practice is the worst of possible worlds: not only do we submit vulnerable subjects to interventions without the expression of their/their parents' autonomy (ie consent), but also we risk losing any data obtained because we retrospect...

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  • Re: Toe walking in infancy
    Arnab Seal

    We agree that baby walkers and door suspenders can be associated with transient toe walking and delayed walking, which usually would correct spontaneously relatively quickly once the children stop using the device. The use of such devices should be strongly discouraged as part of normal parenting practice. Enquiry regarding inappropriate use of either of these devices in a toddler who has tip toe gait on independent or sup...

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  • Not all petechial rashes require admission.
    Robin D Marlow

    This was succinct and helpful article. However as a paediatric emergency doctor I would query the phrase "There is still a risk of meningococcal disease even when blood tests are normal; therefore, admit all children for 4-6 hours with hourly observations". It may seem pedantic, but this is not what NICE says. The pathway states "Assess clinical progress (vital signs) and carry out observations at least hourly over t...

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  • Toe walking in infancy
    Siddika S. Yalcin
    I read with interest Sivaramakrishnan et al's structured approach to a child with toe walking [1]. Various levels of contexts such as parenting, maternal education, poverty and social networks interact with each other and with genetic expression to create long-lasting consequences for development [2,3]. Sometimes, single or isolated negative environmental factors may make a major contribution to developmental problems with most n...
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  • The Wiggle Sign
    Stephen M Mullen

    Dear Editor, We were interested to read the article by Parige and Power entitled, 'A chest x-ray that doesn't look right'. (Archives of Disease in Childhood - Education and Practice Edition 2014; 99: 72). This article described extravasation of TPN from a PICC line resulting in a pleural effusion. Our attention was drawn to the initial 'check x-ray' which identified what we refer to locally as the "wiggle sign". The "wigg...

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  • There is an association between herpes simplex encephalitis and anti-NMDAR antibodies
    Rebecca A. Brooks

    We read with interest the review by Le Doare et al. discussing the presentation and management of neonatal and childhood herpes simplex encephalitis (HSE). The article nicely outlines the importance of timely treatment of this potentially catastrophic infection. The authors have provided practical advice that is applicable for many of the challenges that clinicians might be faced with.

    Although they mentioned...

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