711 e-Letters

  • More Data is Needed to Prove the Safety of Metformin
    Fang LIU

    Dear Editor, Metformin is the most widely used hypoglycemic agent in the world. But the application among the diabetic patients who have the chronic kidney disease(CKD) is still controversial. What gave us a pleasant surprise was the observational study written by Ekstrom et al found that there were no increased risks of acidosis/serious infection in patients with renal impairment according to the large numbers of patient...

    Show More
  • Mantoux testing may cause positive interferon gamma release assay results
    Michael Eisenhut

    The authors of a publication of a contact investigation described two children they labelled as having latent Mycobacterium (M.) tuberculosis infection: One 9-year old child had initially a negative interferon gamma release assay (IGRA) result when the initial Mantoux test was found to be positive with 8 mm. Three months later another IGRA was performed and found to be positive. The second patient was found to have a posi...

    Show More
  • Waste incineration, human health and the zero hypothesis
    Agostino Di Ciaula

    I read with great interest the article titled "Spatial analysis of health effects of large industrial incinerators in England, 1998-2008: a study using matched case-control areas" by Nicola F Reeve et al, published in BMJ Open 2013;3:e001847. The issue is of great relevance. The paper, however, contains some critical points that need to be underlined.

    1. The definition of "control" circles does not exclude the pr...

    Show More
  • RE:"National survey of US primary care physicians' perspectives about causes of obesity and solutions to improve care"
    Yvette L. Rooks

    RE:"National survey of US primary care physicians' perspectives about causes of obesity and solutions to improve care" Bleich SN, Bennett WL, Gudzune KA, et al. BMJ Open 2012;2:e001871. doi:10.1136/bmjopen-2012- 001871 http://bmjopen.bmj.com/content/2/6/e001871.abstract?sid=05bcca2b-326b-408b -9825-6569fe7970fd

    It was with great interest that I read Dr. Sara Bleich's study on primary care physicians' perspectives...

    Show More
  • Re:Second Reply: A Highly Biased and Flawed Study
    Megan A. Arroll

    Dear Dr Geraghty,

    This paper was based on a preliminary study and so was not 'perfect' by any means. BMJ Open states that in addition to more traditional studies "we also welcome more preliminary or only locally relevant research if it raises good questions and is cautiously interpreted". There are a number of limitations with this study and these have been discussed both in the paper and in our previous respons...

    Show More
  • Re:Didn't help me
    Megan A. Arroll

    Dear Dr Goudsmit,

    Thank you for your eletter.

    Are you referring to the following study?

    Paul, L., Wood, L., Behan, W.M.H., & Maclaren, W.M. (1999). Demonstration of delayed recovery from fatiguing exercise in chronic fatigue syndrome. European Journal of Neurology, 6, 63-69.

    I find no mention of ME in this paper, which uses the Fukuda et al. (1994) criteria for diagnosis of CFS....

    Show More
  • Piperacillin-tazobactam is not nephrotoxic
    Jan F Bugge

    Dear editor

    It was with great interest we read the paper "Kidney failure related to broad-spectrum antibiotics in critically ill patients: secondary end point results from a 1200 patient randomised trial" by Jensen and co- workers1. Unfortunately they seem to have ended up with a wrong conclusion. When using surrogate measures as in this investigation, it is extremely important to be aware of its limitations. eG...

    Show More
  • Depression Resulting from Iron Deficiency Anaemia Caused by Blood Donating
    Alistair P Bolt

    An interesting and well-conducted piece of work that may shed light on causes of depressive disorders. I have personal experience of bipolar depression caused by blood donating. Over 10 years the depression was manifested as bouts every 4-5 months occuring approximately 2 weeks after each blood donation. The depression was only partially controlled with lamotridine and SSRI antidepressants. Prior to each donation, the Hb...

    Show More
  • Didn't help me
    Ellen M Goudsmit

    I have been diagnosed with ME since 1984 and was a patient at the Optimum Health clinic. I found the staff sympathetic but the advice just didn't help.

    Three MRIs have shown increasing demyelination. Brain scans on fellow patients have also identified other abnormalities, e.g. enlarged ventricles. We're not talking about a disorder without evidence of pathology.

    When the NHS shows little interest,...

    Show More
  • Second Reply: A Highly Biased and Flawed Study
    Keith J Geraghty

    Dear Authors,

    Thank you for your response. I have looked even more closely at your paper, it's methodology, and your results, and I stand over my original contention that this is a biased study.

    The primary bias is that Dr. Arroll and Mr. Howard have a vested financial interest in the products being sold, notably psychological support and life coaching and so on. This fact would not preclude an in- hou...

    Show More