805 e-Letters

  • 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...

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  • 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...

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  • 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,...

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  • 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...

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  • Re:A Highly Biased and Flawed Study
    Megan A. Arroll

    Dear Dr Geraghty,

    Many thanks for your eletter. We will respond to each of your concerns in turn.

    1. The clinic offers psychological and nutritional approaches for the management of ME/CFS. Individuals do indeed pay for the support offered by the clinic, often because they have felt that the care they have received previously was lacking. Numerous countries offer private care and conduct research on the...

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  • A Highly Biased and Flawed Study
    Keith Geraghty

    I find this study highly biased and flawed for the following reasons.

    1. Alex Howard is founder of this clinic, which he started some years ago offering counselling and life coaching to people looking for support. Alex Howard runs the OHC as a private enterprise. The term clinic evokes a clinical setting, yet this is a non-clinical business. The term patients is often used by Mr Howard, yet this is a non-clinical...

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  • Expressed genes in alveolar type II cells.
    Hiroshi Kubo

    Data is available from the Dryad data repository at http://datadryad.org/ with doi:10.5061/dryad.mc4s1.

    Conflict of Interest:

    None declared

  • Hazards of hypnotics probably underestimated
    Daniel F. Kripke

    Daniel F. Kripke, M.D. and Robert D. Langer, M.D., M.P.H.

    This study provides additional evidence that use of hypnotics is significantly associated with future poor health and mortality. The analysis has the strength of evaluating the potentially-confounding roles of sleep duration and subjective insomnia and offers new information about several morbidities predicted by hypnotic use. The presentation gives con...

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  • Metformin is a safe medication in mild-to-moderate chronic kidney disease.
    David Arroyo

    Dear Editor,

    Ekstrom and colleagues publish a very interesting observational study comparing the rates of various outcomes depending on the type of antidiabetic drug prescribed.(1) This large population-based study presents some limitations, such as baseline difference between groups, attributing outcomes to initial treatment regardless of changes over time, or grouping diverse outcomes such as acidosis and infec...

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  • Data mapping for GPs
    Ditch Townsend

    We are not aware of any primary care trusts (PCTs) or emerging clinical commissioning groups (CCGs) who regularly provide a range of detailed data on health by lower level super-output area (LSOA). We became aware of this paper on 15th June 2012 having already begun to consider ways to map general practice (GP) Quality Outcomes Framework (QOF) data by LSOA. The paper's conclusions presented us with useful indicators of ef...

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