eLetters

121 e-Letters

  • Green for Danger
    Robert B Fitzsimons

    Sir, Your two recent articles dealing with malrotation of the intestine (1,2), whilst being very specific with regard to the colour of the vomitus (green), were perhaps not specific enough. Yellow vomiting as a sign of malrotation has been noted by Millar et al (3), Walker et al (4) and personal experience some years earlier. Awareness of this may aid early diagnosis.

    Reflux of yellow bile into the stomach,...

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  • Endotracheal tube length for neonatal oral and nasal intubation
    Yoginder Singh

    Dear editor,

    Kempley et al (1) have recommended the length based on the gestation of the neonates rather than the rule of ‘7-8-9’, which has been being used traditionally over the years. I have read both articles with great interest – excellent review by Wylie’s (2) on neonatal resuscitation published in education and practice of Archives diseases in childhood and Endotracheal tube length for neonatal intubation...

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  • pH-impedance studies have greater clinical utility than pH-monitoring alone.
    Michiel P. van Wijk

    Dear Sir,

    With interest we read the paper by Tighe et al about the use of pH- monitoring in childhood.(1) However, we believe that the authors overestimate the role of this technique and their omission of a detailed discussion of the utility of pH-impedance monitoring renders this review incomplete.

    The term ‘gold standard’ can no longer be applied to 24-hour pH- monitoring because pH-probes only d...

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  • How to use: a rating score to diagnose attention deficit hyperactivity disorder
    Dr Somnath Banerjee

    Carter and Syed-Sabir1 gave a good account on the utility of rating scales in ADHD. The time was appropriate when the new NICE guidance was published. 2. However, I wish to emphasise to the readers that in UK, many centres use the short version of Conners' Rating Scales- Revised (CRS-R).3 There are significant differences between the short and long versions of the CRS.4 The Cognitive Problems / Inattention subscale on the...

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  • Bile stained vomiting in the infant
    David W Pilling

    I have just read this very good article in “Problem solving in clinical practice” (Arch Dis Child Educ Pract Ed 2008:93;84-86)

    Unfortunately Figure 1 is very unlikely to relate to the patient in the case study as there are umbilical arterial and venous lines in situ which would not be the case in a 3 week old. It is disappointing that the authors could not find a suitable example from their extensive experience...

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  • Need for investigations in young infants
    C Vidyashankar

    Sir, Should all infants less than three months of age with fever be investigated, including those in the "low risk" category?

  • Management of children with Guillain-Barré Syndrome
    Richard Appleton

    The review of Guillain-Barre Syndrome (GBS) (Arch Dis Child Educ Pract Ed 2007; 92: ep161-ep168) was clear and comprehensive and will be of practical value to all who manage these children, whether or not they are admitted to an intensive care unit. The authors appropriately address the important issue of communication and emphasise that this may be very difficult if not impossible for the child and young person who is c...

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  • 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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