eLetters

218 e-Letters

published between 2003 and 2006

  • Don't blame it "all" on Reperfusion
    Hari Dandapantula

    Dear Editor,

    At the out-set, I want to congratulate the authors of the article "The patho-physiology of myocardial reperfusion: a pathologist's perspective" (1)for an outstanding job in summarizing a complex topic in a simplified way.

    However, it was presented as if “reperfusion” is the culprit ("Reperfusion Injury”), even though, an attempt is made to clarify that the injury after reperfusion is happenin...

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  • Noncompaction patients may profit from neurological investigations
    Claudia Stollberger

    Dear Editor,

    With interest we read the article by McMahon et al. about the application of tissue Doppler imaging (TDI) in assessing the prognosis of children with left ventricular hypertrabeculation/noncompaction (LVHT).[1]

    We have, however, several questions and concerns:

    There are only limited experiences in the follow-up of patients with LVHT and the prognosis is largely unknown.[2] The “undul...

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  • Should we keep looking for “new” and slightly different versions of depression screening tools?
    Brett D. Thombs

    Dear Editor,

    Dr. Huffman and colleagues [1] studied 131 post-myocardial infarction (MI) patients (17 with major depressive disorder [MDD]) and reported that two items from the Beck Depression Inventory (BDI) related to sadness and loss of interest formed an effective screening tool for post-MI depression. The sensitivity and specificity results reported by Huffman et al. are, in fact, highly similar to those repo...

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  • Are the risks of amiodarone exagerated?
    Will B Nicolson

    Dear Editor,

    The Committee for the Safety of Medicines has only two entries for amiodarone extravasation injury, yet almost every consultant seems to remember a patient who has had their arm amputated following extravasation of amiodarone. Surely this is a case of the dangers of peripheral amiodarone being exagerated? In periarrest / cardiac arrest situations amiodarone has been given as a peripheral bolus countl...

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  • Weighing up the risks
    Alasdair I Moonie

    Dear Editor,

    Skin necrosis is a recognised complication of amiodarone infusion, but how does it compare with the risks of central venous cannnulation? The risks are considerable (and potentially fatal), especially if performed by inexperienced junior staff, or in units with no Sonosite or other ultrasound device.
    I think, for many patients, it is reasonable to deliver amiodarone via a large perip...

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  • Percutaneous Coronary Intervention without on-site Cardiac Surgery
    Antoon E Weyne

    Dear Editor,

    From April 2002 until now, our hospital performed 1006 percutaneous coronary interventions (PCIs) without surgical backup on-site. Our total case load is now about 1500 coronary angiograms and 375 PCIs per year, and the number of PCIs performed has increased steadily during the period 2002-2006. In order to improve the access to PCI, a firm debate is ongoing in Belgium whether to choose for stand alone...

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  • 'Safe than sorry'
    Pradeep Orakkan

    Dear Editor,

    Amiodarone is frequently used in the intensive care units. Very often it is used to treat atrial fibrillation in septic patients. As Russel and Saltissi mentioned in the case report we also give first a bolus of amiodarone followed by an maintainance infusion over 23 hours. It is advised in the BNF that amiodaorne has to be given through the central line. In the intensive Care Unit we follow this stri...

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  • Effect of remote ischaemic preconditioning on troponin release after PCI is yet to be established
    Stephen P Hoole

    Dear Editor,

    We read with interest the recent article published by Iliodromitis et. al.(1), but do not agree with the conclusions drawn by the authors. The study appears to be under-powered to draw meaningful conclusions as to the therapeutic value of remote ischaemic preconditioning, and certainly the size of the study precludes a subgroup analysis of the role of statins. The authors do not state the actual number...

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  • Risk scoring for percutaneous coronary intervention: we've done it!
    Antony D Grayson

    Dear Editor,

    We read with interest the recent editorial by Siotia and Gunn [1] which emphasised the need and growing enthusiasm for risk scoring for percutaneous coronary intervention (PCI). This editorial focuses on the recent publication by Wu and colleagues from New York of a risk model to predict in-hospital mortality following PCI [2]. This particular risk model was based on 46,090 patients undergoing PCI between 2...

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  • study does not dispute the need for clinical judgement
    A Conway Morris

    Dear Editor,

    We note Dorman et al's comments regarding our paper (1). We agree that risk scores should not be used in isolation to determine either the management or triage of patients. Although, in our study, no patient with a score of 0 experienced a major cardiac event within thirty days, the confidence interval includes a rate of up to 1.5%. A recent prospective evaluation of the TIMI score used in a simila...

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