eLetters

113 e-Letters

published between 2004 and 2007

  • Classic diseases revisited: Lyme neuroborrelioses Overdiagnosis
    Deborah Frye-McKeen

    Dear Editor,

    With the advent of designer pathologic therapies based on an individual's genetic code on the horizon, those who dismiss LB patients' complaints would do well to consider the fact that all patients' immune systems are not created equal. The answer is not in the Western Blot. It is in the patient's already-existing autoimmune phenotype, which is based on genotype + environment. For example, Patient A...

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  • Diagnosis of NSAID enteropathy using Capsule Endoscopy - United Kingdom pilot data
    Reena Sidhu

    Dear Editor,

    We read with interest the review by Adebayo and Bjarnason on non- steroidal anti-inflammatory drug enteropathy. The article cites capsule endoscopy (CE) as an important tool to diagnose intestinal damage caused by NSAID (1). The diagnosis of NSAID induced enteropathy prior to CE was limited, as visualization of the small bowel using other modalities was often suboptimal (2). In addition, patient’s s...

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  • Keeping ‘diabesity’ in check – the onus is on clinicians
    Arun Natarajan

    Dear Editor,

    The finding that most patients with type 2 diabetes are either obese or overweight (1) is not surprising, but is nevertheless worrisome. Recently published data (2) show that there has been a steady increase in the prevalence of type 2 diabetes in England and Wales between 1994 and 2001. This study which evaluated a large number of individuals in several primary care centres also found that prevale...

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  • Misguided Treatment
    Eric K. Pritchard

    Dear Editor,

    The recommended T4 only treatment may be preferred, but if the peripheral metabolism of T4 to T3 is deficient, the addition to or the replacement of T4 therapy with a T3 therapy is indicated. One might liken T4 to the crude oil that we extract from nature. In order to use it in our vehicles we must refine it to make an active hydrocarbon fuel - like T3. If we run out of fuel but not out of crude, w...

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  • Autonomic dysreflexia caused by blocked catheters
    David Ash

    Dear Editor,

    Bycroft et al provide a useful overview of autonomic dysreflexia. However as a nurse with many years experience of managing episodes of AD in Spinal Cord Injured patients, I would disagree with a couple of the practical interventions suggested.The authors twice mention 'flushing' blocked catheters, which is generally not recommended for two reasons: it may be possible to force liquid through the cath...

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  • The true interpretation of the AFFIRM study
    Oscar, M Jolobe

    Dear Editor,

    The reason why studies of rhythm vs rate control in atrial fibrillation (AF) have failed to show an advantage to a rhythm control policy is that, without stringent monitoring of rhythm control along the lines of the Catheter Ablation for the Cure of Atrial Fibrillation Study(1), investigators such as those in the AFFIRM Study were not in a position to acertain which of their rhythm control patients h...

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  • Neuromytonia and heart block
    Jia Haur Tho

    Dear Editor,

    I read with interest the case reported by Dr De associating acquired neuromyotonia (NMT) and sinoatrial block.1 He correctly pointed out there was no previous literature describing the association between it and any kind of heart block. However, there was one case subsequently by Dr Liguori et al. suggesting between Morvan's syndrome and cardiac arrhythmia with antibodies to voltage-gated potassium ch...

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  • Cannabinoids as appetite stimulants
    Oscar, M Jolobe

    Ranged against the impressive array of endogenous appetite suppresants described by the author there is, not only ghrelin(1), but also the endogenous cannabinoid system, the orexigenic effects of the latter being purportedly mediated by cannabinoid receptors located in the hypothalamus(2). Just as ghrelin has been utilised for the purpose of stimulating appetite in anorexic cancer patients(3), and also in cachectic patie...

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  • The usefulness of serum IgA/C3 ratio in IgA nephropathy and Henoch-Schonlein glomerulonephritis
    Jae Seung Lee

    Dear Editor,

    We read with interest the concise review on Acute glomerulonephritis by Vinen et al.[1] The mechanisms involved in the pathogenesis of IgA nephropathy or Henoch-Schonlein glomerulonephritis (HSP-GN) are still poorly understood, but mesangial IgA and C3 deposition play an important role in the renal damage. Although the Japanese Society Nephrology reported that serum IgA of more than 350 mg/dl in adult...

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  • What is the proper route for administering adrenaline in anaphylaxis?
    Michal R. Pijak

    Dear Editor,

    I read with great interest the article by Gompels, et al. (1) which highlights the confusion regarding the correct dose, concentration, and route of administration for adrenaline recommended in the treatment of anaphylaxis. Although the authors rightly point out that improved training in this area is required, further clarification of some points is warranted, especially with regard to the proper...

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