eLetters

798 e-Letters

  • Editor's Note

    Since publication, BMJ Open has received queries relating to the ethical approval statement in the article along with the reference number provided. We have asked the University of Bristol to investigate the accuracy of the statement and to confirm that the correct approval processes were followed. We are also in contact with the Health Research Authority, who are investigating the project.

    Once we have clarification of the ethical approval process, we will post an update.

  • There is a fundamental but overlooked limitation of this study

    The data of such a study are fundamentally biased. As a matter of facts, the Authors do not refer to an essential data: the presence of the CVD Inherited Real Risk of enlisted subjects. To declare the real microvascular outomes in patients with Type 2 Diabetes Mellitus under treatment with SGLT-2, only individuals are to be enrolled, involved by ATS Constitution-Dependent, Inherited Real Risk f CVD. (1-5)

    References.
    1) Stagnaro-Neri M., Stagnaro S., Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of ischaemic Heart Disease even silent. Acta Med. Medit. 13, 109, 1997
    2) Stagnaro Sergio. CAD Inherited Real Risk, Based on Newborn-Pathological, Type I, Subtype B, Aspecific, Coronary Endoarteriolar Blocking Devices. Diagnostic Role of Myocardial Oxygenation and Biophysical-Semeiotic Preconditioning. International Atherosclerosis Society. www.athero.org, 29 April, 2009 http://www.athero.org/commentaries/comm907.asp
    3) Stagnaro Sergio. Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning - c007i. Lecture, V Virtual International Congress of Argentine Cardiology. http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php
    4) Sergio Stagnaro and Simone Caramel. The Inherited R...

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  • Baby-led weaning and iron - looking good but not clear-cut

    It is reassuring to learn that a modified version of the approach to the introduction of solid foods for infants known as ‘baby-led weaning’ does not lead to an increased risk of iron deficiency (Daniels, L., Taylor, R.W., Williams, S.M., Gibson, R.S., Fleming, E.A., Wheeler, B.J., Taylor, B.J., Haszard, J.J. and Heath, A-L.M. (2018) Impact of a modified version of baby-led weaning on iron intake and status: a randomised controlled trial, BMJ Open, 8: e019036). However, before drawing firm conclusions it is important to note that two variables were at play in this trial: One group – the BLISS (‘modified BLW’) group – followed a self-feeding approach and received specific information concerning the method, which included an emphasis on the importance of offering iron-rich foods; the other (control) group spoon-fed their infants and received only standard care, with no extra information regarding iron.

    While it is indeed possible that iron levels in the BLW/BLISS group would have been lower, had the parents not been given additional dietary information – as implied by the authors’ cautious conclusion – it is equally possible that drawing their attention to the need for iron either had no effect, or had a negative impact that was offset by the infant being allowed to feed himself. Without a comparison between a self-feeding group and a spoon-feeding group, where both groups have the same information regarding iron, or between two BLW groups, only one of which is advise...

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  • Response to Peter Kemp

    Thank you for your letter and sharing the results of your work. We agree on the importance of accurate testing for Lyme disease. In our study, we required that participants have a positive IgG Western blot, a lab result only present at least six to eight weeks after infection, as we were interested in studying patients diagnosed in the later stages of disease. However, as we note in our paper, we recognize that this requirement excluded patients with false-negative laboratory results. Thank you for your comment.

  • Study population

    Could you clarify the study population? It is unclear to me whether people who completely stopped smoking during the study period were included in the study population. If, as appears the case, such potential subjects were excluded, this would result in a significant underestimate of the association between e-cigarette and NRT use and average cigarette consumption.

  • Advice that has stood the Test of Time

    In their manuscript, Petrilli et al. reference an abundance of literature showing that bacteria and other pathogens can be isolated from physician attire, including items that are typically not laundered after a single use, such as white coats and neckties. Despite this, they claim an absence of literature linking said contamination to source or transmission of disease. I caution the authors not to dismiss lower levels of evidence for clinical studies, such as case series. In his essay, which was later published in The New England Quarterly Journal of Medicine and Surgery, Oliver Wendell Holmes Sr. describes what can be interpreted as a clinical demonstration of early germ theory related to the contagiousness of postpartum infections and subsequent maternal death.(1) Holmes references multiple cases where physicians performing obstetrical duties in clothes worn in the care of (or performance of autopsy on) patients who succumbed to puerperal fever, would have similar outcomes on future patients with whom they came in contact. He references a similar case report published by Brodie in the Lancet where a provider, after destroying his entire wardrobe, had no recurrent cases of puerperal peritonitis.(2) He finishes with a list of recommendations, which instructs physicians to change “every article of dress” after post-mortem contact with patients who died of puerperal fever. In the absence of convincing evidence refuting the now common sense nature of Holmes’ recommendat...

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  • Research priorities and hearing loss

    Thank you for highlighting the health communication challenges that can be experienced by people with hearing loss, and the importance of training for health professionals to improve this. One of the things participants consistently told us during this project is that anyone can be vulnerable to experiencing poor health communication and participation, but individuals and groups with certain health or social characteristics may be more likely to experience this. The list of characteristics participants described was extensive, but not exhaustive, given it did not include people with hearing loss. We agree (and so did the participants in our study) that research into interventions aimed at improving health professionals’ (and health services’) health communication practices is the way forward so that everyone can participate in their care.

  • Full-text publication rate of abstracts presented at the Japan Primary Care Association Annual Meetings (2010– 2012): a retrospective observational study

    Dear Authors,
    Recently, the work “Full-text publication rate of abstracts presented at the Japan Primary Care Association Annual Meetings (2010–2012): a retrospective observational study” [1] was published in BMJ Open, it explored the factors associated with publication rate of abstracts presented at the Japan Primary Care Association Annual Meetings. And we enjoyed it with great interest. But, in our opinion, the sentence “a past systematic review reported that the most frequently cited barriers to abstract publication were a lack of time, although all studies included in that systematic review were conducted outside Japan” in Discussion section, its citation format maybe with problem. The subject of this sentence “a past systematic review”, but in the first sub-clause there were other 4 references [2-5]. To regulate citation and writing format, we thought it is our duty to point the situation.

    Conflicts of interest
    We declare that we have no conflicts of interest.

    [1] Komagamine J, Yabuki T. Full-text publication rate of abstracts presented at the Japan Primary Care Association Annual Meetings (2010-2012): a retrospective observational study. BMJ open. 2018;8(6): e021585.
    [2] Montané E, Vidal X. Fate of the abstracts presented at three Spanish clinical pharmacology congresses and reasons for unpublished research. Eur J Clin Pharmacol 2007; 63:103–11.
    [3] Sprague S, Bhandari M, Devereaux PJ, et al. Barriers to full-text publication fo...

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  • A systematic assessment of Cochrane reviews and systematic reviews published in high-impact medical journals related to canc

    Dear Dr. Lu,
    Dear Professor Yang,

    many thanks for this very important remark. Indeed, element #6 in the Appendix table 1: " Search strategy for high-impact journals SRs"" should correctly read: "#6 Search (#4 or #5) Filters: Publication date from 2011/01/01 to 2016/05/31”.

    Best regards,

    Marius Goldkuhle

  • A systematic assessment of Cochrane reviews and systematic reviews published in high-impact medical journals related to cancer

    Dear Authors,
    Recently, the work “A systematic assessment of Cochrane reviews and systematic reviews published in high-impact medical journals related to cancer” [1] was published in BMJ Open, it compared cancer-related systematic reviews published in the Cochrane Database of SRs (CDSR) and high-impact journals, we enjoyed it with interest. But we found there was a mistake about #6 in the Appendix table 1: Search strategy for high-impact journals SRs. we cannot find the #7, but it emerged. In our opinion, it should be “#6 Search (#4 or #5) Filters: Publication date from 2011/01/01 to 2016/05/31”. Although this mistake is minor, but it may affect the paper quality and other researchers in the same research field.
    [1] Goldkuhle M, Narayan V M, Weigl A, et al. A systematic assessment of Cochrane reviews and systematic reviews published in high-impact medical journals related to cancer[J]. Bmj Open, 2018, 8(3):e020869.

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