504 e-Letters

published between 2013 and 2016

  • Differential contribution of each corticofugal tract to disability and motor deficit in subcortical stroke: hierarchical partition analysis
    Thanh G Phan

    To the Editor We had previously published an article in this journal on effect of damage to descending motor corticofugal fibers on motor deficit and disability post stroke1. These corticofugal fibers (primary motor cortex (CSTM1), premotor area (CSTPMd) and supplementary motor area (CSTSMA)) are close to each in the corona radiata, posterior limb of the internal capsule and lateral brainstem. Due to the close spatial rela...

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  • Empiricism, Rationalism & Cognition
    Joseph W Arabasz MD

    Dear Drs Bernardino Oliva, Sebastia March, Cristina Gadea, Erik Stolper, Magdalena Esteva et al,

    I hope this note finds You well and Congratulations on Publishing such an Intuitive Article "Gut feelings in the diagnostic process of Spanish GPs: a focus group study"

    Having had a most interesting Senior Patient with some sort of non- repetitive, unpredictable arrhythmia placed on the OR schedule was worr...

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  • Publication bias "baked into" conventional systematic review methods

    The method proposed here follows the conventional systematic review approach, which is to begin with a search of the published literature. Unfortunately, it is becoming increasingly apparent that clinical trials are published selectively. Thus the notion that the published literature will provide an accurate and unbiased view of a drug's risk-benefit ratio is no longer tenable. In order to circumnavigate this problem, one must look "upstream" by seeking and working with an inception cohort of clinical trials. (As one example, one sees a quite different estimate of the efficacy of antidepressants medications, depending on whether the cohort is from the published literature or from a regulatory agency (e.g. FDA).*) The term "systematic review" could, and in my opinion should, apply to the "systematic" use of an inception cohort, not an approach based on a selective subset of that cohort.

    * Turner EH, Matthews AM, Linardatos E, et al. Selective publication of antidepressant trials and its influence on apparent efficacy. N Engl J Med 2008;358:252–60. doi:10.1056/NEJMsa065779

  • Correction
    M. Constantine Samaan

    On Page 4, paragraph 2, line 5: the word 'concave' should be changed to 'convex'. We apologize for any inconvenience caused by this omission.

    Conflict of Interest:


  • Response to: Evaluation of a minor eye condition service delivered by community optometrists
    Imran Jawaid

    Dear Sir It is with great interest that we read your article evaluating a Minor Eye Condition Scheme (MECS) in the Lambeth and Lewisham area1. We note that 2123 patients were seen in this scheme, of which 1747 were seen and maintained within the community setting (82.3%). This was despite the fact that predominantly lubricants and chloramphenicol/fuscidic acid was prescribed. No steroids or antivirals were prescribed. It is...

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  • Patient and healthcare perspectives on the importance and efficacy of addressing spiritual issues within an interdisciplinary bone marrow transplant clinic: a qualitative study
    Ann Frederique Laforest

    This study addresses an important gap in the literature regarding the assessment of spiritual issues for patients undergoing a bone marrow transplant. Despite knowing that spiritual well-being is an important component of quality of life, it remains under addressed by healthcare professionals. In this study, both sides of participants, patients and clinicians, agreed that addressing spiritual issues was an important aspe...

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  • Amazing low use of P2 Y12 inhibitors following ACS
    Rajeev Gupta

    Following ACS (with or without PCI) the use of P2Y12 receptors receptors inhibitors are almost invariable, unless contraindicated absolutely. Use of such drugs only in 49% is exceptionally low, particularly in a regulated health system like that of Finland. There is need to understand why it is so low? Were patients with non- life threatening conditions not put on P2Y12 inhibitors? The study casts more doubts than it solv...

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  • NICE guidelines fail to provide evidence on first line fertility treatment
    Gulam Bahadur

    We note the recommendation that NICE together with HFEA should provide fertility guidance on what is offered (1). Although HFEA have no legal jurisdiction in providing guidance, NICE have failed to address several important points in the evidence review for first line treatment options (2). The original NICE document proposing that IVF should be offered over intrauterine insemination (IUI) was controversial to such an ex...

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  • Re:reference neglected
    Sarah E Seaton

    Dear Babak Khoshnood,

    Thank you for taking the time to read our article and respond to it. We did identify your paper in our literature search but it did not meet the inclusion criteria for our systematic review. This was because although the paper was published in 1996 the data contained in it was from 1990. We only included papers reporting data for births from 1994 onwards. If papers contained data from both b...

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  • Commentary: Symptoms in patients with takotsubo syndrome: a qualitative interview study
    Laura Craigie

    Wallstrom, S., Ulin, K., Omerovic, E., & Ekman, I. (2016). Symptoms in patients with takotsubo syndrome: a qualitative interview study. BMJ open, 6(10), e011820.

    The study "Symptoms in patients with takotsubo syndrome: a qualitative interview study" was a very interesting read. As a critical care cardiology nurse in Canada I found the results very informative for practice. I really appreciated that this phe...

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