eLetters

158 e-Letters

  • From scientific approach to technical details
    Tarik Belhocine

    Dear Editor

    I read with great interest the paper of Mijnhout et al.[1] I also appreciated the scientific approach of the study. The main conclusion of this article showing the inability of 18FDG PET to detect sentinel node micrometastases are in line with recent studies by Wagner JD et al.[2,3], Acland KM et al.[4], Kokoska MS et al.[5], Crippa F et al.[6], and more recently Longo MI...

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  • Authors' response
    Gail L. Stark

    Dear Editor

    We appreciate the interest of RP Britt in our recent case report.[1]

    As suggested in our report, we agree that the laboratory findings in this case do not rule out nutritional vitamin B12 deficiency. We did, however, feel that the precipitate nature of this lactating patient's presentation with a documented MCV of 87.8fl four months prior to her admission, made acute folate deficiency more lik...

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  • Demand management of microbiology
    Malila Noone

    Dear Editor

    I fully support the view that the time is ripe for demand management of pathology tests.[1] The NHS cannot continue to provide an open access pathology service which is used indiscriminately. The service should be evidence-based. If we received specimens for culture which we believe are irrelevant we withhold culture and return a report with the comment:
    "Culture of this specime...

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  • Demand control in pathology
    William SA Smellie

    Dear Editor

    Rao et al. describe a wide range of testing in pathology where targeted effort could improve appropriateness.[1]

    One of the blocks to improving use of pathology testing is the limited evidence base. This should not stop us however trying to improve practice.[2] The medical literature contains a large resource of reviews and consensus guidance, some of which has an evidence base, and the...

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  • Re: Investigation of infertility
    S Vivekanandan

    Dear Editor

    The article by Williams et al. [1] published in April issue highlights the analytical issues related to LH measurement, as reported.[2] The article fails to mention problems with measurement of steroid hormones due to the presence of closely related cross-reacting substances.[3] Traditionally, most steroid hormones were determined after removing those cross reactants by various methods, most co...

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  • Nutritional vitamin B12 deficiency
    Reg P Britt

    Dear Editor

    I read with interest the case report by GL Stark and PJ Hamilton [1]. In 1970 we drew attention to the occurrence of megaloblastic anaemia in asian migrants coming to the UK [2]. Further investigation [3,4] revealed many of these to be nutritional vitamin B12 deficiency.

    The features in the case reported certainly do not rule out this possibility in their patient. They administered three injec...

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  • Authors' reply
    Christian Gulmann

    Dear Editor

    We are grateful to Dr Campodonico’s for the interest shown in our recent report of a case of chronic osteomyelitis mimicking a sarcoma.[1,2] The main point made in the letter is the need for a high level of suspicion of malignancy in unusual cases of chronic osteomyelitis (COM).

    We entirely agree with this point of view. In fact, the reason for reporting the present case was that to highlight the...

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  • BAS post vasectomy guidelines
    Paul Hancock

    Dear Editor

    In reply to the points raised by Cunningham et al.[1] to the British Andrology Society post vasectomy guidelines, we feel that the authors answer their own criticism - especially the need to assess fresh samples if sperm are found in the initial sample. Our guidelines are to allow the identification of men with few motile cells following heavy c...

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  • It's time for truth!
    Marcello Eusepi

    Dear Editor

    I think the time has come for the medical profession to admit a major mistake in its history and for a moment leave pride and arrogance on one side. I have a university degree, am father of two and have spent several days reading books about childhood vaccination and information downloaded from the Internet. As vaccination was a “joke” of industrial development, owing to the coincidence of improving general...

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  • Chronic osteomyelitis mimicking sarcoma
    Fabio Campodonico

    Dear Editor

    Gulmann et al. reported on a case of chronic osteomyelitis presenting as a mass of the chest mimicking a soft tissue sarcoma.[1] The authors suggested that, although chronic osteomyelitis is a known cause of confusion with bone tumors, a definitive diagnosis is feasible by specific immunohistochemical staining. However, the potential risk of transformation of a chronic osteomyelitis in a malignant l...

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