eLetters

193 e-Letters

published between 2001 and 2004

  • Authors' response to Heywood and Fatovich
    Simon G. A. Brown

    Dear Editor

    Dr Fatovich asks about initial reaction severity in three participants who were prescribed steroids and antihistamines for large local reactions or persistent urticaria.[1]

    Two initially had severe (hypotensive) reactions whereas the other had no systemic reaction. Although frequently used, it is difficult to determine the benefit of steroids and antihistamines to manage large local reactions an...

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  • Minutes matter - Hours matter more!
    David K Pedley

    Dear Editor

    Leah et al’s interesting paper describes a 10.5-minute time saving based on preparation of thrombolytic therapy for acute myocardial infarction (AMI). They go on to demonstrate an improvement in performance against the door to needle standard.[1]

    While no cost – benefit examination is made, the authors make reference to Boersma’s work to illustrate the benefits of early thrombolysis.[2...

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  • Accurate assessment of skin viability in pretibial haematomas
    Beryl De Souza

    Dear Editor

    I agree with Karthikeyan et al.[1] regarding simple and safe evacuation of pretibial haematomas using a Yankauer sucker as a means to evacuate a haematoma and thereby reducing skin loss. However, the procedure described needs to be carried out under aseptic conditions which was not emphasized with care to avoid damage to underlying structures and to prevent further haematoma formation.

    ...

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  • Airway care in Ludwigs angina
    Malcolm Cameron

    Dear Editor

    There are two points we would like to raise in the management of the case described. We feel they are important "lessons learned" and have not been given emphasis by the authors.

    1. The patient’s symptoms were recorded in detail (noisy, gurgling breathing with drooling of saliva; dyspnoea; dysphagia; trismus; bilateral submandibular tense swellings; elevated, immobile tongue; tachycardia;...

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  • Domestic violence against women
    Rudy Crawford

    Dear Editor

    Sethi et al.[1] state that a lack of data on the prevalence of domestic violence is particularly true of A&E departments and that only two studies of prevalence were identified in the past ten years.

    In 1995 we published a combined prospective and retrospective study [2] of violence against women presenting to Glasgow Royal Infirmary over a six month period. The prevalence was 0.75%....

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  • Questions raised by this study
    Matt Heywood

    Dear Editor

    Brown et al's [1] study provoked lively debate amongst the staff at Ipswich Hospital.

    I would like to pose two questions:

    1) What was the interval between sting challenge and onset of symptoms? Was this related to severity of reaction?

    2) What were the details of ethical approval, and what was the consent process and documentation?

    I wonder if such a stu...

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  • Limited use of corticosteroids for insect sting anaphylaxis
    Daniel M Fatovich

    Dear Editor

    I congratulate Dr Brown and his colleagues on conducting the first prospective trial of a management protocol for anaphylaxis.[1]

    Perhaps one of the most telling results was that corticosteroids and antihistamines were prescribed for only three of the 21 patients. In my experience, corticosteroids and antihistamines are frequently overprescribed and overemphasised for the management of allergic...

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  • Prevalence of domestic violence
    Adrian A Boyle

    Dear Editor

    I read with great interest the cross-sectional study about the prevalence of domestic violence conducted by Sethi et al.[1]

    I experienced a moment of deja vu having published a study with almost identical methods and conclusions in the EMJ in 2003.[2] It is reassuring to see that they came to similar conclusions in a different department! This perhaps shows the problems of a long submissio...

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  • Consensus on the prehospital approach to burns patient management. February 2004
    Keith P Allison

    Dear Editor

    We thank Allison Walker for her letter and helpful comments.[1] With respect to mention of the fire service with this patient group; care was taken to generically include all pre-hospital carers and there were two representatives from the fire service present at the consensus meeting. The fire services nationally are looking to use these guidelines as a standard of care and interface with their ambulanc...

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  • Acute General Medicine
    Mark L Mallet

    Dear Editor

    Whilst I share Terry Brown's concern that some trainee physicians may not receive adequate exposure to acutely ill adults, the role of the acute general physician can not therefore be said to be in demise. The recent emergence of acute medicine as a subspecialty in its own right, and the recognition of this by the Royal Colleges of Physicians, has paralleled a large expansion in the number of acute physi...

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