87 e-Letters

published between 2017 and 2020

  • Q: Retrospectively identified in the CT images?
    Peter M. Koehler


    I wonder whether that plastic toy could be spotted in the CT images by a reader who has been informed about it. Did the radiology department comment about this?

    I am pretty shure the cone cannot be detected on a plain x-ray. The ABS polymer used by toy manufacturers like Playmobile or Lego seems to have x-ray attenuation properties very near to human tissue (Saps et al., World J Clin Pediatr 201...

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  • PFO and Stroke in Sickle Cell Re Dattani and Jackson
    Michael M Dowling

    Dear Sir, We read with great interest the case report by Dattani and Jackson detailing a case of potential cardioembolic stroke in a young man with sickle cell anemia (SCA), without significant cerebral vasculopathy but with PFO. We have conducted a controlled clinical study to determine the prevalence of potential left-to-right shunting (intracardiac or intrapulmonary) in children with SCA and overt clinical stroke...

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  • Mg dose with 3 TBSP Epsom Salts is over 4000 mg -- Way too HIGH
    Andrea Rosanoff

    It is important to consider the very high dose of elemental magnesium (Mg) in this case of severe livery injury due to Epsom salt intake (1).

    Using information from the Epsom Salt Council that Epsom Salts is 10% elemental Mg by weight, and that one pound of Epsom Salts = 32 Tbsp, I calculate that 3 Tbsp. Epsom Salts would deliver 4,250 mg elemental Mg.

    This amount of supplemental Mg is definitely exces...

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  • A plastic traffic cone masquerading as bronchial carcinoma
    Sarjeet Gill

    I felt that the article was highly informative. We as nurses and doctors see many patients each day and on some occasions we do not have answers for peculiar symptoms or pains a patient may complain of. In my opinion, the pains and symptoms, are there because there is a cause but the cause is not known to the examiner or the patient. It is my view that we do our best but we seldom go far enough before we label a pain or...

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  • Thoracic heat exchange
    Erik B. Kulstad

    I enjoyed the important and educational case report submitted by Dr. Little, and congratulate him on a successful outcome using aggressive resuscitation techniques. One additional option to transfer heat efficiently to the patient's core is via a device recently introduced that allows warming through the esophagus using a closed-system silicone tube connected to standard water blanket heat exchanger.[1] This approach ha...

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  • Rest tremor due to hypoglycaemic injury?
    Halil Onder

    Title Page: Rest tremor due to hypoglycaemic injury? 1Halil Onder, 2 Javid Jahanroshan

    1Department of Neurology, Yozgat State Hospital, Yozgat, Turkey 2Department of Neurology, Hacettepe University Hospital, Turkey

    Corresponding author: Halil Onder Department of Neurology, Yozgat State Hospital, Yozgat, Turkey Post Code: 66000 Telephone number: 4442066 email: halilnder@yahoo.com

    Key words: Hypo...

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  • Re:Antenatal management of Cystic Pulmonary adenomatoid malformation
    Terry Cullen

    Dear Dr Kumar,

    Thank you for your letter.

    In relation to the points raised:

    1. Much of the evidence for successful use of steroids in CPAMs relates to microcystic lesions. In this case, the lesion was a large macrocystic CPAM. The case was discussed at an antenatal MDT, and the decision not to treat with steroids was reached.

    2. We thank you for your comment on measuring baseline and...

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  • Antenatal management of Cystic Pulmonary adenomatoid malformation
    Jogender Kumar

    We read case report by Cullen et al and found it very interesting. It was a successfully managed case however, I have certain queries regarding management in the index case.

    1. In a prenatally detected CPAM (previously known as CCAM) with hydrops detected prior to 32 weeks, there is a well-defined role of maternal steroids.(1) Even multiple courses of betamethasone can be tried. Whether it was thought off in inde...

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  • Rheumatic fever with chronic carditis: still prevalent in Germany
    Friedrich Flachsbart

    Dear Sir,

    1953 born I was never treated with antibiotics as child.

    1985 a post-streptococcal-myocarditis was diagnosed in the University -hospital Goettingen. Treatment with penicillin and oral penicillin- prophylaxis. Many episodes of respiratory infections, complicated by arrhythmias.

    2004 atrial fibrillation.

    2017, July 4., anticoagulation with heparin/coumarin changed the intra-a...

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  • A field level reality
    Sandeep Bhattacharya

    I am impressed by the straight forward write up with giving emphasis on practical aspects in field.

    Conflict of Interest:

    None declared