eLetters

38 e-Letters

published between 2007 and 2010

  • the riddle of the association of alpha 1-antitrypsin deficiency, henoch-schonlein purpura, and ANCA
    oscar,m jolobe

    Although examples of interstitial lung disease such as diffuse alveolar haemorrhage and interstitial fibrosis were the only ones acknowledged to be associated with Henoch-Schonlein purpura(HSP) in a recent review(1), the association of HSP and pan-acinar emphysema attributable to alpha-1 antitrypsin(AAT) deficiency also deserves mention(2), especially in view of the speculative relationship between anti neutrophil cytosp...

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  • Alopecia? Think to celiac disease
    Valentina Kiren

    We found Lio’s paper on alopecia in children (Arch. Dis. Child. Ed. Pract., December issue) very interesting, but noticed that the author does not mention celiac disease among the autoimmune diseases associated with alopecia areata.

    Both thyroid dysfunction and alopecia may point to celiac disease even in the absence of gastrointestinal complaints.[1, 2] Alopecia areata is in fact significantly associated to cel...

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  • Osteoporosis in pediatrics: don't forget celiac disease
    Valentina Kiren

    We read with great interest the paper by Shaw “Osteoporosis in pediatrics” (Arch. Dis. Child. Ed. Pract., December issue). The author doesn’t cite celiac disease as a specific cause of osteoporosis in children, although he correctly recommends celiac screening in case of suspected secondary osteoporosis.

    A diminished bone mineral density with z score lower than -1.0 standard deviation (SD) can be found in up to...

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  • alopecia can also be caused by chemical hair relaxants
    oscar,m jolobe

    Alopecia may also be attributable to the use of hair relaxants such as sodium hydroxide and guanidine hydroxide, respectively(1) or other products containing sodium, potassium, or guanine sulfites or thioglycolates(2) to straighten or "relax" tightly curly(spiral) black hair of the type found among South African blacks(1) or African- Americans(2). These products work by rearranging the cysteine disulfide bonds of the hai...

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  • Author's Reply
    Peter A Lio

    Dear Editor,

    Dr Roberts questions the point of treating warts and molluscum which are benign and will often spontaneously resolve, and expresses concern about discussing these methods of treatment at all. In terms of the former, I regret that I did not more explicitly state that the so-called "tincture of time" is, by far, the preferred method of treating these lesions. The focus of the review is on those cas...

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  • Warts and Molluscum: An impractical guide
    Stephen Roberts

    Dear Editor

    The August edition of ADC Education and Practice supplement prominently displays on the front cover an infant receiving treatment for molluscum lesions on the thigh. The associated article on the management of warts and molluscum contagiosum explores available treatment options and the differential diagnosis of these benign skin infections.

    What messages are conveyed in this review of Nort...

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  • Management points for Toxic Shock Syndrome
    Julia E Clark

    Dear Editor,

    We welcome the Education and Debate article on Toxic Shock Syndrome(1), which helps improve the profile of this potentially devastating disease and enhances diagnostic recognition.

    It is however important to highlight some specific areas in prevention, diagnosis and therapy which are not fully discussed within this review.

    As the authors state, early diagnosis can be difficult but...

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  • Warts, molluscum and things that go bump on the skin: A practical guide
    Helen M Goodyear

    Dear Editor,

    We read this article with concern. Incorrect and potentially harmful messages may be relayed to paediatricians, especially to those in training and other healthcare professionals.

    Dr Lio asserts that Evidence-based Medicine (EBM) leads to stagnation in medicine and therapeutic nihilism, and expresses his concerns of EBM as a “philosophy in treating actual human beings”. Unfortunately this is rath...

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  • Drugs for the treatment of gastro-oesophageal reflux: in search for clear evidence-based indications
    Federico Marchetti

    Dear Editor,

    Keady S (1) provides some updated guidelines on the drug treatment of gastro-oesophageal reflux (GOR) and gastro-oesophageal reflux disease (GORD). However, in order to give clear management guidelines, we believe that the review should have first addressed the definition of GOR (ie, physiological) versus GORD (ie, pathological). In fact, the results of a recent survey on the knowledge, attitudes a...

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  • How green was my vomit?
    John WL Puntis

    Dear Editor,

    I enjoyed this excellent review on malrotation. The title, however, implies that the key alerting sign for clinicians is that the vomit is green, and the paper fails to address the issue of the lack of consensus regarding the colour of ‘bile’. This topic has been the subject of a recent study involving hospital and community nurses, parents and GPs (1). Participants were sent a questionnaire with colour...

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