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Erratum: Oral rehydration
1 60
E d i t o r i a l correspondence
Pedialyte RS, a rehydration solution, has the same carbohydrate concentration and a higher sodium concentration, 75 mEq/L. William C. MacLean, Jr., M.D. Medical Director Pediatric Nutrition Ross Laboratories Columbus, OH 43216 REFERENCE
1. Tamer AM, Friedman LB, Maxwell SRW, Cynamon HA, Perez HN, Cleveland WW. Oral rehydration of infants in a large urban U.S. medical center. J PEO1AT• 1985;107:14.
Erratum: Oral rehydration To the Editor: The article by Tamer et al. 1 contains two typographic errors in the abstract. The glucose concentration in solution A as reported in the body of the article is 2 gm/dL, or 2%, not 2 mg/dL, as noted in the abstract. In addition, the glucose concentration of solution B is 3 gm/dL, or 3%, not 3 mg/dL. Mary B. Ross, B.S., M.B.A. Clinical Pharmacist Drug Information Service Department o f Pharmacy Services University o f Michigan Hospitals Ann Arbor, M1 48109 REFERENCE
1. Tamer AM, Friedman LB, Maxwell SRW, Cynamon HA, Perez HN, Cleveland WW. Oral rehydration of infants in a large urban U.S. medical Center. J PEtnATR 1985;107:14.
Reply To the Editor: We thank Mary B. Ross for her letter pointing out the typographic errors regarding the glucose concentration in solutions A and B. We identified other typographic errors: the word chlorine was printed instead of chloride; and in Table Ill, COz value was given as torr instead of mEq/L. Akram Tamer, M.D. Lawrence B. Friedman, M.D. Stefan R. IV. Maxwell, M.D. Harry A. Cynamon, M.D. Hugo N. Perez. M.D. William W. Cleveland, M.D. Department of Pediatrics University of Miami School o f Medicine Miami, FL 33101
The Journal ofPediatrics January1986
Holding room treatment of status asthmaticus To the Editor: The article by Willert et al, z demonstrating that emergency holding room therapy for childhood status asthmaticus is medically and economically effective offers an attractive alternative for the child with mild asthma. However, the following questions arise. 1. Was optimal asthma therapy used in the study patients? Currently, an inhaled sympathomimetic agent is the most effective initial treatment for acute pediatric asthma? -4 How many of the attacks could have been "broken" early, and could asthma severity and duration of treatment have been different of a nebulized beta2 agonist had been used at the start of treatment and every 20 minutes thereafter before randomization to treatment location? 2. The physical examination of children with asthma, with the exception of pulse rate, respiratory rate, blood pressure, pulsus paradoxus, and Downes asthma score, is subjective. 4 Determination of the site and degree of airway abstruction by measurement of pulmonary function (peak expiratory flow rate, spirometry), pulsus paradoxus, and arterial blood gases would have helped the reader better compare the two treatment groups and the population studied. 3. Can community hospital emergency rooms and "walk-in emergicenters" (often staffed by physicians who are not pediatricians) deliver the same level of medical care provided in this study with pedicatric attending physicians, pediatric residents, and pediatric emergency room nurses? 4. If hospitals charged hourly for inpatient care and physicians made more frequent rounds to allow for discharge at any time, how would duration of stay and costs be affected? Are these reasonable alternatives to consider? The choice of setting (holding ward, inpatient ward, or pediatric intensive care unit) may vary depending on personnel and facilities. I f optimal care cannot be provided, another setting should be sought, or we may see an increase in pediatric asthma morbidity and mortality, which may already be happening? Jacob Hen, Jr., M.D. Assistant Clinical Professor o f Pediatrics Yale University School o f Medicine Director Pediatric Intensive Care Unit Bridgeport Hospital Bridgeport, CT 06610
REFERENCES
1.
2. Comment: This exchange again points up the responsibility of
authors to review manuscripts and especially galley proofs with great care.--J.M.G.
Willert C, Davis AT, Herman J J, Holson BB, Zieserl E. Short-term holding room treatment of asthmatic children. J PED1ATR 1985;106:707-711. Rossing TH, Fanta CH, Goldstein DH, Snapper JR, McFadden ER. Emergency therapy of asthma: comparison of the acute effects of parenteral and inhaled sympathomimetics and infused aminophylline. Am Rev Respir Dis 1980;122:365-371.
E d i t o r i a l correspondence
Pedialyte RS, a rehydration solution, has the same carbohydrate concentration and a higher sodium concentration, 75 mEq/L. William C. MacLean, Jr., M.D. Medical Director Pediatric Nutrition Ross Laboratories Columbus, OH 43216 REFERENCE
1. Tamer AM, Friedman LB, Maxwell SRW, Cynamon HA, Perez HN, Cleveland WW. Oral rehydration of infants in a large urban U.S. medical center. J PEO1AT• 1985;107:14.
Erratum: Oral rehydration To the Editor: The article by Tamer et al. 1 contains two typographic errors in the abstract. The glucose concentration in solution A as reported in the body of the article is 2 gm/dL, or 2%, not 2 mg/dL, as noted in the abstract. In addition, the glucose concentration of solution B is 3 gm/dL, or 3%, not 3 mg/dL. Mary B. Ross, B.S., M.B.A. Clinical Pharmacist Drug Information Service Department o f Pharmacy Services University o f Michigan Hospitals Ann Arbor, M1 48109 REFERENCE
1. Tamer AM, Friedman LB, Maxwell SRW, Cynamon HA, Perez HN, Cleveland WW. Oral rehydration of infants in a large urban U.S. medical Center. J PEtnATR 1985;107:14.
Reply To the Editor: We thank Mary B. Ross for her letter pointing out the typographic errors regarding the glucose concentration in solutions A and B. We identified other typographic errors: the word chlorine was printed instead of chloride; and in Table Ill, COz value was given as torr instead of mEq/L. Akram Tamer, M.D. Lawrence B. Friedman, M.D. Stefan R. IV. Maxwell, M.D. Harry A. Cynamon, M.D. Hugo N. Perez. M.D. William W. Cleveland, M.D. Department of Pediatrics University of Miami School o f Medicine Miami, FL 33101
The Journal ofPediatrics January1986
Holding room treatment of status asthmaticus To the Editor: The article by Willert et al, z demonstrating that emergency holding room therapy for childhood status asthmaticus is medically and economically effective offers an attractive alternative for the child with mild asthma. However, the following questions arise. 1. Was optimal asthma therapy used in the study patients? Currently, an inhaled sympathomimetic agent is the most effective initial treatment for acute pediatric asthma? -4 How many of the attacks could have been "broken" early, and could asthma severity and duration of treatment have been different of a nebulized beta2 agonist had been used at the start of treatment and every 20 minutes thereafter before randomization to treatment location? 2. The physical examination of children with asthma, with the exception of pulse rate, respiratory rate, blood pressure, pulsus paradoxus, and Downes asthma score, is subjective. 4 Determination of the site and degree of airway abstruction by measurement of pulmonary function (peak expiratory flow rate, spirometry), pulsus paradoxus, and arterial blood gases would have helped the reader better compare the two treatment groups and the population studied. 3. Can community hospital emergency rooms and "walk-in emergicenters" (often staffed by physicians who are not pediatricians) deliver the same level of medical care provided in this study with pedicatric attending physicians, pediatric residents, and pediatric emergency room nurses? 4. If hospitals charged hourly for inpatient care and physicians made more frequent rounds to allow for discharge at any time, how would duration of stay and costs be affected? Are these reasonable alternatives to consider? The choice of setting (holding ward, inpatient ward, or pediatric intensive care unit) may vary depending on personnel and facilities. I f optimal care cannot be provided, another setting should be sought, or we may see an increase in pediatric asthma morbidity and mortality, which may already be happening? Jacob Hen, Jr., M.D. Assistant Clinical Professor o f Pediatrics Yale University School o f Medicine Director Pediatric Intensive Care Unit Bridgeport Hospital Bridgeport, CT 06610
REFERENCES
1.
2. Comment: This exchange again points up the responsibility of
authors to review manuscripts and especially galley proofs with great care.--J.M.G.
Willert C, Davis AT, Herman J J, Holson BB, Zieserl E. Short-term holding room treatment of asthmatic children. J PED1ATR 1985;106:707-711. Rossing TH, Fanta CH, Goldstein DH, Snapper JR, McFadden ER. Emergency therapy of asthma: comparison of the acute effects of parenteral and inhaled sympathomimetics and infused aminophylline. Am Rev Respir Dis 1980;122:365-371.