29 e-Letters

published between 2014 and 2017

  • 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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  • Properly randomised trial of tongue tie division is needed!
    Nigel Mercer

    The paper cites various studies but in only one is the placebo effect studied it seems and it found that almost half the mothers said that feeding was improved. The inference is that almost 50% of the treated children did not require the procedure and so have been subjected to a surgical procedure on one of the most sensitive organs in the body un- necessarily.

    Until the placebo effect is fully investigated in t...

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  • Prenatal and neonatal paracetamol (acetaminophen) may increase the risk for ADHD and asthma.
    Inge Axelsson

    Dr. Catherine Williams argues against and Dr. Damian Roland for using antipyretics in feverish children (Arch Dis Child Educ Pract Ed 2014;99:158-159) but they do not mention that paracetamol may be a risk factor for ADHD and asthma.

    In the last two years, an animal study1, two cohort studies2 3, and an ecologic study4 have presented evidence for an increased risk of disturbed neuropsychiatric development after...

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  • Re: Viable alternatives to Toddler Taming
    Deborah Shanks

    Dear Ellen,

    Thank you for your letter and the many alternative recommended books, it is a fascinating topic. My opinions were mainly personal and parenting styles are a personal choice and differ greatly. I would however wish to reply firstly to your comments on the 'controlled crying' technique. This is not 'prolonged, unrelieved stress', it is a well researched technique of managing sleep behaviours where the...

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  • Viable alternatives to Toddler Taming
    Ellen M. Storm

    I read with interest Deborah Shanks' article on the book Toddler Taming by Christopher Green (Vermilion, 2006). Senior colleagues recommended that I read this book during my community paediatric placement, and several of my peers also told me they found it useful both personally and professionally.

    I would like to offer an alternative for those who, like me, seek gentler, more compassionate parenting methods, a...

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  • Duration of Prolonged Rupture of Membranes for Early-Onset Neonatal Sepsis
    Mallinath Chakraborty

    Dear Sir, We would like to draw your attention to an apparent inconsistency in two related guidelines published by the National Institute of Health and Clinical Excellence (NICE), in response to your recent review article of the NICE guideline on antibiotics for early onset neonatal sepsis (EONS) [1]. Maternal prolonged rupture of membranes (PROM) before delivery is a commonly used risk-factor to suspect EONS. The durat...

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  • Pulse oximetry in Children - consider variant haemoglobin.
    Melanie M Cotter

    We read with interest the recent review by Sinha et al[1] regarding physiological background, technological basis and limitations of pulse oximetry. The factors listed by the authors that may affect the accuracy of pulse oximetry include motion artifact, inadequate perfusion, nail polish, and high-ambient infrared light.

    We would like to add to that list structural variants of haemoglobin. Over 1,000 variant haemo...

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  • Let`s not forget CSF lactate
    Mohamed OE Babiker

    The authors have done an impressive task by taking us through the physiological and biochemical basis and the clinical value of serum/blood lactate. However, I was hopeful that they would touch on CSF lactate as an important investigation tool, not only useful for paediatric neurologists but for general paediatricians alike.

    Lumbar puncture (LP) is commonly performed as part of the evaluation process of a chi...

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