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Apparent Life-Threatening Events as an Indicator of Occult Abuse—Reply
Arch Pediatr Adolesc Med. 2004;158:402-403.
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In reply
We agree with the commentary of Dr Maffei and associates and support their suggestion to reconsider the definition of ALTE. Such a change in terminology would, in turn, be expected to increase awareness of the need to rule out inflicted injury in this group of patients.
While we agree with the concept of updating the definition of ALTE, it is not clear how best to redefine the term. The suggestion of Dr Maffei and associates is one possibility, but their definition leaves open to interpretation what would constitute "obvious examination findings." For example, would the term ALTE apply to a 5-week-old infant after a sudden episode of apnea if the physical examination revealed upper airway congestion? Although congestion could cause apnea, we would suggest that abusive head injury still be considered.
In addition, the existence of a sizable gray area could complicate ALTE research. It could make it . . . [Full Text of this Article]
Robin L. Altman, MD
Valhalla, NY
Donald A. Brand, PhD
Valhalla, NY
Corresponding author: Robin L. Altman, MD, Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY 10595 (e-mail: robin_altman@nymc.edu).
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RELATED ARTICLE
Apparent Life-Threatening Events as an Indicator of Occult Abuse
Frank A. Maffei, Karen S. Powers, and Elise W. van der Jagt
Arch Pediatr Adolesc Med. 2004;158(4):402.
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