eLetters

77 e-Letters

published between 2000 and 2003

  • Do inhaled corticosteroids slow FEV1 decline in COPD after all?
    Martin G Duerden

    Dear Editor

    I question the findings of this meta-analysis[1] and the content of the associated editorial.[2] The meta-analysis has drawn from available long-term data from randomised-controlled studies (RCTs) into inhaled corticosteroids (ICS) in chronic obstructive airways disease (COPD). The whole purpose of meta-analysis is to systematically analyse such data to answer a question. This study seems to selectively...

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  • NOx exposure probably diesel exposure
    Michael J Collins

    Dear Editor

    Just a casual letter from a layman here, but it would seem clear that the NOx higher levels correlating with higher lung cancer would be as a result simply of higher exposure to diesel exhaust. Looking on the Web I see worker exposure studies to older diesels show higher lung cancer rates as well. When I was in Norway visiting my wife's relatives in 1992 I was stunned by the unhealthy stench of diesel even...

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  • Variations in mortality in acute COPD may reflect nihilism as well as resources
    Martin J Wildman

    Dear Editor

    I read with great interest the Roberts et al. Thorax article [1] and the accompanying editorial by Rudolf.[2]

    The study highlights important variation in the outcomes of patients with a common chronic disease and once more illustrates that doctor: patient ratios may be an important contributor to variation. It is also likely that some of the observed variation may arise because of varia...

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  • Spirometry in Primary Medical Care: FEV1 and FVC
    Ben P Ponsioen

    Dear Editor

    The reproducibility of FEV1 and FVC and their respective agreement with a gold standard is an issue for early diagnosis and follow-up of COPD patients in general practice.[1] Schermer et al. performed a within subject comparison of FEV1 and FVC measured in 388 COPD-patients with a turbine flow spirometer.[2] The values of FEV1 and FVC measured by general practice personnel were compared with the val...

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  • Author's reply
    Michael Rudolf

    Dear Editor

    I thank Dr Wolstenholme for his comments.[1] Although the 90 day mortality was very similar for both teaching hospitals and large DGHs, the in-hospital death rate for large DGHs was 9% compared with 4.8% for the teaching hospitals.

    Whether or not hospital size and resource is indeed significant in deciding mortality from acute COPD clearly needs to be established, and hopefully the large nation...

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  • Evidence-Based Thrombolysis with Alteplase in Massive Pulmonary Embolism
    Michael T Henry

    Dear Editor

    We read with interest the guidelines for the management of suspected acute pulmonary embolism by the British Thoracic Society.[1] However, we were somewhat concerned about the recommendation of administering a 50mg intravenous bolus of alteplase for the treatment of patients with massive PE [grade C recommendation]. We believe that this recommendation is misleading as this advice is based on a case ser...

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  • Whooping cough. Author's reply
    Johan C. De Jongste

    Dear Editor

    We thank Dr Gueiros for his interest in our paper and appreciate his comment.[1] Indeed, whooping cough should not be forgotten as an important cause of chronic cough. Especially the emergence of B. pertussis strains that are less sensitive to the protective effects of vaccination has caused increased morbidity.

    We mentioned pertussis in our paper several times: in the paragraph on infections...

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  • Authors' Reply
    C Mike Roberts

    Dear Editor

    We thank Dodd et al. for their letter that reflects the concerns of many clinicians that short burst oxygen must be beneficial to patients if only we could prove it. Unfortunately the evidence collected to date for short bust therapy does not support this hope and since our own publication [1] a further very similar study has reached the same conclusion.[2]

    In answer to the specific points ra...

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  • Lung resection and noninvasive ventilation
    Igor Auriant

    Dear Editor

    The paper of Beddow et l. deal with important topics such as acute respiratory failure following lung resection.

    Postoperative mortality and morbidity after lung resection are decreasing but remain significant. When treated with invasive endotracheal mechanical ventilation (ETMV), acute respiratory insufficiency after lung resection is fatal in up to 80% of cases. In a prospective observat...

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  • Response to Dr Chan
    Michael T Henry

    Dear Editor

    We thank Dr Chan for his further reponse 'error in citation' to the recently published BTS guidelines for the management of spontaneous pneumothorax.[1] Dr Chan has pointed out that our statement in a previous correspondence to him, that a 2cms rim of pneumothorax was a clear indication for use of an intercostal chest drain, was supported by the recent ACCP Delphi consensus document [2] is a error in...

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