eLetters

229 e-Letters

  • Re: Sampling in tuberculosis RFLP clustering analyses
    Helen Maguire

    Dear Editor

    Paynter and Coker have made an important point about the extent to which clustering depends upon sample coverage. We believe that this is valid, but strictly correct only in the situation where a representative (e.g. random) sample of the population have been studied. In our study we included 2490 isolates with linked demographic information. This is 77 % of the total of 3260 culture-confirmed cases...

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  • Neutrophil involvement in mild asthma.
    David W Reid

    Dear Editor

    We wholeheartedly welcome the article by Douwes et al. and it’s accompanying editorial by O’Donnell and Frew.[1,2] The review highlights the heterogeneity of airway inflammation in 'asthma' and especially the potential role of the neutrophil in a substantial proportion of patients. The authors use the term 'non-eosinophilic asthma' to categorise this disease entity and they state that other manif...

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  • Sampling in tuberculosis RFLP clustering analyses
    Stuart J Paynter

    Dear Editor

    Maguire et al.[1] estimated recently in the journal that the rate of recent transmission of M tuberculosis in London was 14.4 % between 1995 and 1997. Estimation of this parameter is an important contribution to the understanding of transmission dynamics of tuberculosis in the capital and should assist policy-makers in developing responses to enhance control. We suggest, however, that if this estim...

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  • Mechanism of airflow obstruction in PPH
    Tarek Saba

    Dear Editor

    I read with interest the paper by Meyer et al about the increased incidence of peripheral airflow obstruction in 171 patients with PPH when compared to 64 age and sex matched controls. [1]

    The authors speculate on possible explanations for this finding. They provide three main theories, all of which are plausible. First, that increased production of cytokines and growth mediators in...

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  • AMP challenge in asthma
    Stephen J Fowler

    Dear Editor

    Dr Polosa and colleagues provided an informative review of the mechanisms and clinical application of bronchial challenge with adenosine monophosphate (AMP) in asthma and COPD.[1] I would however contest their proposal that AMP may be the preferred challenge stimulus for monitoring treatment efficacy, as well as disease progression and severity when compared with direct agents such as methacholine, and a...

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  • Socioeconomic gradient related to respiratory complaints in pupils
    Coppieters Yves

    Dear Editor

    Such as the paper from Dales et al. concerning the influence of family income on asthma morbidity,[1] understanding socioeconomic effects on adolescent health is a critical and important area of research if we are to eliminate health disparities.[2] Moreover, traditionally used tools to evaluate socio-economic gradient are difficult to construct within this population and new indicators must...

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  • HIV and TB
    Bello S Oricha

    Dear Editor

    The relationship between HIV and tuberculosis are probably predictable. Both are lentiform diseases and immuno suppressive. Primary tuberculous lesions may be re-activated in an immuno suppressive state and new infections are more easily established. The real danger is that one partner (tuberculosis) of this vicious circle is transferable by droplet infection and in its presence the precaution required o...

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  • Are type 1 and type 2 reponses really reciprocal?
    Wendy JA Anderson

    Dear Editor

    I read with interest the paper by Papadopoulos et al. describing the balance between type 1 and type 2 responses by CD4 and CD8 T lymphocytes in atopic asthmatics and normal subjects stimulated by rhinovirus. They state that their data is consistent with ‘reciprocal regulation of type 1 and type 2 responses’. Their figure demonstrates that in both normals and atopic asthmatics interferon gamma and in...

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  • High-dose of Fluticasone propionate in mild asthmatics
    S K Agarwal

    Dear Editor

    In a study [1] by Ward et al the dose of fluticasone propionate used for mild asthmatics was several folds higher (1500 mcg) whereas the recommended dose in different International guidelines is only 200 mcg.The other flaws which need clarification are:
    a) Inhaled corticosteroid was withdrawn 3 months before putting the patients on this study; there is no mention of the number of puffs o...

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  • COPD outcomes in ICU
    Luke S Howard

    Dear Editor

    The data presented by Breen et al[1] regarding the outcomes of patients with COPD are encouraging and lend support to the respiratory physician often faced with nihilistic attitudes towards ventilating these patients in acute respiratory failure. However, despite the proposition by the authors that certain patients with likely poor outcomes might have been excluded, the ICU stays for both gr...

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