85 e-Letters

published between 2006 and 2009

  • Use of empirical hydrocortisone in suspected adrenal crisis
    Mark A R Jadav


    In their helpful review article, Kearney and Dang advocate giving hydrocortisone to suspected adrenal crisis pending ACTH stimulation testing. Many authorities suggest the use of dexamethasone prior to testing as it does not interfere with cortisol assay (eg. Webb et al 1999, Shenker et al 2001). Can the authors justify their postponement of confirmatory tests?

    Yours sincerely


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  • Systematic review of individualised herbal medicine misunderstood
    Peter H Canter

    Dear Editors

    We thank E. J. Koprowski for her/his comments on our recent systematic review of individualised herbal medicine which reveal that s/he has totally misunderstood the nature of our review in several respects.

    Firstly, we were not at all interested in homeopathy as s/he seems to believe. We can only surmise that s/he is confusing homeopathy with Western medical herbalism which was included....

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  • Fatally Flawed Study Design in Herbal Medicine Review Article
    E. J. Koprowski, M.A.

    Dear Editors,

    A recent article, A systematic review of randomized clinical trials of individualized herbal medicine in any indication, published in October, 2007 in the Postgraduate Medical Journal, by R. Guo , P. H. Canter , E. Ernst, of the Peninsula Medical School, Universities of Exeter & Plymouth, Exeter, U.K., warns public health authorities that the effectiveness of individualized, herbal medicine...

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  • CPR Guidelines: Differences and changes
    Ricardo J Jose

    Dear Editor,

    It is with interest that I have read the article by Dr Wanis Ibrahim titled Recent advances and controversies in adult cardiopulmonary resuscitation (1) in which the changes to the guidelines and the evidence for these is summarised.

    I note that the differences in the cardiopulmonary resuscitation (CPR) guidelines between the American Heart Association (AHA) and the European resuscitati...

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  • Delirum in older terminal illness
    Angel J. Romero-Cabrera

    Editor: We agree with Harris (1) that delirium is a common condition shows a high prevalence in advanced diseases, especially in palliative care practice. Elderly patients have particular characteristics (comorbidities, polipharmacy, and cognitive, social and functional impairment)leading them to terminal illness and this topic is an important aspect in the daily geriatric assistance management (2). Thus, medical doctors m...

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  • channelopathies cell volume and bipolar disorder
    Joe R Nweton

    Dear sir,

    In 1999 I postulated abnormal cell size, action potential speed and thus dyscoordination for bipolar disorder. (Med Hypotheses Jan 1999 77-83)

    Anormal cell volumes were then confirmed in several studies.

    Several other linked and associated genes (possibly involving cell size) are also suggested in genetic studies.(Psychiatric Genetics Feb 2007 Newton JR)

    The recent genome-...

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  • Levodopa-induced dyskinesia in Parkinson’s disease: role of serotonergic neurons
    Sandip Kumar Dash

    Dear Editor,

    I have read the review article by Bhomraj et al (1) with interest and found it to be very useful in our day to day practice and also have updated information. However I would like to add few things to the patho physiology of levodopa induced dyskinesia.

    In Parkinson’s disease formation of dopamine from exogenous administration of levodopa, storage and release takes place in the remaining d...

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  • Current antiviral strategies in HCV related cryoglobulinaemic vasculitis
    Francesco Iannuzzella

    Dear Editor,

    As GS Braun and colleagues have rightly pointed out in their well written review, for hepatitis C virus (HCV) associated cryoglobulinaemic vasculitis, antiviral strategies aiming at cure of HCV infection is clearly superior to conventional immunosuppression.[1] Unfortunately, the authors did not discuss the optimal antiviral strategy to use in the case of HCV related mixed cryoglobulinaemia (MC) synd...

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  • Iatrogenic Hyponatraemia due to 5% Dextrose Infusion.
    Kamran Khan

    Dear Editor,

    The authors of this article deserve appreciation for such a detailed description of pathophysiology and treatment of hyponatraemia. It is a very pertinent discussion of a not so uncommon problem in hospitalised patients. The authors have briefly mentioned use of 5% Dextrose infusion as a cause for hyponatraemia in postoperative patients. This is a very valid point and needs further discussion.

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  • Clinical findings are not enough.
    Weekitt Kittisupamongkol

    Dear Editor

    In excellent review of Hyponatremia by Biswas and Davies (1) they do not emphasize that clinical assessment correctly identified only 47 percent of hypovolemic patients and 48 percent of normovolemic patients (2). Moreover, McGee et al. reported that a large postural pulse change (> or =30 beats/min) or severe postural dizziness is required to clinically diagnose hypovolemia due to blood loss, alth...

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