eLetters

56 e-Letters

  • Maternal pertussis vaccination
    Elyse O Kharbanda

    Dear Editor,

    We were pleased to read the commentary by Millar and Sanz(1) regarding our publication on Tdap safety in pregnancy from the Vaccine Safety Datalink.(2) We agree that policies regarding routine vaccination should be made after careful review of the risks and benefits of vaccination. For maternal vaccination, evaluations of risk-benefit profiles are complex, as both maternal and infant outcomes must be...

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  • Re:Further research in low dose CT scan for suspected appendicitis.
    William D Rogers

    We share your enthusiasm for the current efforts to reduce radiation exposure associated with the use of CT scanning and agree with your assertion that performance of appendectomy without scanning will inevitably lead to more negative appendectomies. We are confident though based on the NHS laparoscopic appendectomy statistics reviewed by Omar and Clark in the Annals of Surgery that those negative appendectomies are asso...

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  • Further research in low dose CT scan for suspected appendicitis.
    Dr. Paul V Puthussery

    Dear Editor,

    We read with great interest the recent article written by William Rogers et al on the Harms of CT scanning prior to surgery for suspected appendicitis(1). It highlights the radiation risk of cancer while routinely performing an abdominal CT scan on an otherwise healthy patient with symptoms suggestive of appendicitis. This radiation risk of cancer becomes all the more important in patients with 'ne...

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  • In Response to Windish D. "EBM apps that help you search for answers to your clinical questions."
    Gavriel D. Kohlberg

    Dear Editor,

    We read with great interest the recent article by Dr. Windish [1] reviewing a number of Evidence-Based Medicine (EBM) smartphone apps. Immediate access to brief summaries of the literature is essential in bringing EBM knowledge to the bedside, as physicians are often busy and are presented with frequent interruptions which hinder their ability to perform detailed searches or read complete articles dur...

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  • Opinion editorials: necessity of present times
    Pankaj Jorwal

    Dear Editor,

    This article brings into light the upcoming ways in which medical health care knowledge is disseminated between general population and the various pitfalls such an approach can have. Although such issues are in nascent stage in a developing country like India but its climbing up the ladder at a brisk rate. The new generation of physicians is media savvy but can get easily influenced by media based...

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  • Author's response
    Kit Byatt

    Dear Editor,

    I am very grateful to Ken Uchino for amplifying and clarifying the detail of some of the points I was trying to make within the word limits of a 'Perspectives' paper. I suggest there are four key elements:

    1. The epidemiology is indeed complex and I am neither an academic nor an epidemiologist. However, it would appear that we can agree that there is indeed a difference between 'younger old'...

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  • Overreacting to possible over-treatment? Hypertension treatment in the very elderly.
    Ken Uchino

    Dear Editor,

    While I agree with Dr Byatt that it is important to discuss with patients the choices of treating risk factors to prevent disease, the basis for the discussion needs to be clarified and fine-tuned.

    Epidemiology: The attributable risk of hypertension in stroke decreases in the elderly. This phenomenon may be partly because other factors such as atrial fibrillation become more dominant factor....

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  • Comment on "Need for standardising adverse event reporting in testosterone trials" by Basaria
    C. Mary Schooling

    Dear Editor,

    We are very grateful for the positive comments from Dr Basaria about our meta-analysis of randomized controlled trials (RCTs) showing that testosterone therapy among men increases the risk of a cardiovascular -related event (1;2). As per the Preferred Reporting Items for Systematic Reviews and meta-Analysis (PRISMA) guidelines (item 25) (3), we also highlighted the limitations of our review. We are surpr...

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  • Potential aetiological significance of statin's raising glucose
    C Mary Schooling

    Dear Editor,

    Montori and Brito draw attention to the limited clinical significance of statins' raising glucose (1), consistent with the non-linear association of fasting glucose with cardiovascular disease (2). It is quite possible that the limited clinical significance of statins' minor effects on glucose also translates into limited aetiological significance. On the other hand, statins are not alone in having diver...

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  • Reply to DeFrank and Brewer
    John Brodersen

    Dear Editor,

    We would like to thank DeFrank and Brewer for their interest in our recently published paper: Long-Term Psychosocial Consequences of False- Positive Screening Mammography.(1)

    In the Methods section DeFrank and Brewer write: "Brodersen and colleagues conducted a study of 454 adult women in Denmark screened in the same time period who had normal mammography screening results, false- positives or...

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