eLetters

125 e-Letters

  • 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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  • Gastro-oesophageal reflux and Cow's milk protein allergy in young infants
    Nisar A Mir

    Du Toit, Meyer and Shah have offered an excellent approach to cow's milk protein allergy (CMPA) and related disorders.(1)

    There is evidence to suggest that an increasing number of infants are seeking medical attention with symptom-complex suggestive of gastro- oesophageal disease (GORD).(2) Infants with cow's milk protein allergy (CMPA), especially those with non-IgE mediated cow's milk-induced reactions, prese...

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  • One more "S"
    Giordano Perez Gaxiola

    In an Editorial from last year (Evid Based Nurs 2009;12:99-101), DiCenso et al, added one more layer to the preappraised evidence pyramid. Basically, we have now 2 synopses: synopses of studies and synopses of syntheses.

    Synopses of single studies appear above studies and below syntheses. They provide a brief summary of an important single study. This type of synopsis can be found in evidence-based abstraction...

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  • How to use CRP - authors reply
    Andrew Riordan

    We were grateful to a number of people who contacted us about our article on How to use C - reactive protein [1].

    Dr Abelian of Wrexham Maelor Hospital drew out attention to data on plasma half-life suggesting this was 19 hours in an adult [2] rather than the previously quoted 4-7 hours [3,4].

    Dr Emmerson asked if there was robust data in support of the range of non infectious conditions quoted to cause...

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  • CRP is a useful marker in preterm infants
    David Burgner

    Dear Editors

    Re: How to use: C-reactive protein. McWilliam, et al. 95:55-58

    McWilliam and Riordan recently reviewed the use and limitations of C- reactive protein (CRP) in clinical practice, particularly in the diagnosis of infection.(1) The authors imply the authors suggest preterm infants cannot mount a CRP response (CRP levels remain low) when compared to term infants and older children. In the cont...

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  • automated reporting of QT interval and other issues in the channelopathies
    oscar,m jolobe

    The recommendation that a 12-lead electrocardiogram(ECG) should be performed on every patient presenting with transient loss of consciousness(TLOC)(1)) is a sound one, regardless of whether the provisional diagnosis is syncope or epilepsy, given the fact that convulsive syncope can simulate epilepsy(1). An important caveat regarding investigation of underlying causes of TLOC using the 12 lead ECG in settings such as the...

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  • Erratum: Commentator Omitted
    Bob Phillips
    Please note the commentary on this article was written by:

    Prof. Bill McGuire
    Professor of Paediatrics and Child Health Hull York Medical School / Centre for Reviews and Dissemination
    University of York
    York
    YO10 5DD

    We unreservedly apologise for the omission of his name and designation on this Picket.

    Conflict of Interest:

    None declared

  • CRP - a marker of systemic inflammation
    Jonathan L Marks

    Dear Editor we read with interest the recent article regarding how to use C- reactive protein (CRP). While the authors discuss the role of CRP as a non-specific indicator of serious bacterial infection (SBI) they do not acknowledge that CRP is a non-specific indicator of systemic inflammation, the causes of which are many and varied with acute infective processes being only one.

    It is important to consider alter...

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  • CRP and the Newborn Infant
    Anthony J Emmerson

    I was interested in the excellent article on How to use C-Reactive Protein in Education and Practice by McWilliam and Riordan. I was particularly interested in your comments in the article on Ruling in Sepsis and the comment that CRP is not diagnostic for sepsis in the neonate because it may be raised for other reasons. The article quotes - prolonged rupture of membranes - (most frequently caused by local sepsis and is...

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