The Problem of Mental Deficiency in Children

For general practitioners, who handle more than 85 per cent of all pediatric care, Postgraduate Medicine here presents authoritative, up-to-date summaries by specialists in pediatric problems.     

The Role of Potassium in Fluid Therapy

For general practitioners, who handle more than 85 per cent of all pediatric care, POSTGRADUATE MEDICINE here presents authoritative, up-to-date summaries by specialists in pediatric problems.     

The Myofascial Genesis of Pain

For general practitioners, who handle more than 85 per cent of all pediatric care, POSTGRADUATE MEDICINE here presents authoritative, up-to-date summaries by specialists in pediatric problems.     

Foot Problems in Children

For general practitioners, who handle more than 85 per cent of all pediatric care, POSTGRADUATE MEDICINE here presents authoritative, up-to-date summaries, prepared by specialists in pediatric problems.     

Recurrent Convulsions in Children

For general practitioners, who handle more than 85 per cent of all pediatric care, Postgraduate Medicine here presents authoritative, up-to-date summaries by specialists in pediatric problems.     

This Month in Medicine

For general practitioners, who handle more than 85 per cent of all pediatric care, POSTGRADUATE MEDICINE here presents authoritative, up-to-date summaries, prepared by specialists in pediatric problems.     

Abnormal Bleeding in Childhood

For general practitioners, who handle more than 85 per cent of all pediatric care, Postgraduate Medicine here presents authoritative, up-to-date summaries, prepared by specialists in pediatric problems.     

Drugs Used in Pediatric Allergy

For general practitioners, who handle more than 85 per cent of all pediatric care, Postgraduate Medicine here presents authoritative, up-to-date summaries by specialists in pediatric problems.     

Primary Atypical Pneumonia in Children

For general practitioners, who handle more than 85 per cent of all pediatric care, POSTGRADUATE MEDICINE here presents authoritative, up-to-date summaries, prepared by specialists in pediatric problems.     

Hypocretin measurement: shelf age of radioimmunoassay kit,but not freezer time,influences assay variability

The hypothalamic peptide hypocretin 1 (orexin A) may be assayed in cerebrospinal fluid to diagnose narcolepsy type 1. This testing is not commercially available, and factors contributing to assay variability have not previously been comprehensively explored. In the present study, cerebrospinal fluid hypocretin concentrations were determined in duplicate in 155 patient samples, across a range of sleep disorders. Intra-assay variability of these measures was analyzed. Inter-assay correlation between samples tested at Emory and at Stanford was high (r?=?0.79, p?<?0.0001). Intra-assay correlation between samples tested in duplicate in our center was also high (r?=?0.88, p?<?0.0001); intra-assay variability, expressed as the difference between values as a percentage of the higher value, was low at 9.4% (SD?=?7.9%). Although both time the sample spent in the freezer (r?=?0.16, p?=?0.04) and age of the kit used for assay (t?=?3.64, p?=?0.0004) were significant predictors of intra-kit variability in univariate analyses, only age of kit was significant in multivariate linear regression (F?=?4.93, p?=?0.03). Age of radioimmunoassay kit affects intra-kit variability of measured hypocretin values, such that kits closer to expiration exhibit significantly more variability.     

L-Arginine in the treatment of valproate overdose – five clinical cases

Background: Valproic acid and its metabolites – particularly valproyl-CoA – are inhibitors of the enzyme N-acetylglutamate synthetase. The amino acid l-arginine can stimulate N-acetylglutamate synthetase activity and could be potentially used therapeutically to correct hyperammonemia caused by valproate therapy or overdose. Severely valproic-acid-poisoned patients are usually treated with l-carnitine or hemodialysis in order to decrease hyperammonemia. We herein report of five cases, in which l-arginine was administered.

Methods: Observational study on five cases. Patients with hyperammonemia (i.e., ammonia 80?>?μg/dL) and symptoms consistent with valproate overdose (i.e., drowsiness, coma) were selected for treatment with l-arginine. Data was collected retrospectively.

Results: l-Arginine decreased ammonia levels in a close temporal relation (case I ammonia in EDTA-plasma [μg/dL] decreased from 381 to 39; case II from 281 to 50; case III from 669 to 74; case IV from 447 to 56; case V from 202 to 60). In cases I and II, hemodialysis was performed and l-carnitine was given before the administration of l-arginine. In case III, hemodialysis was performed after the administration of l-arginine was already started. In cases IV and V, treatment with l-arginine was the sole measure to decrease ammonia levels in plasma.

Conclusion: The results suggest that l-arginine may be beneficial in selected cases of valproate overdose complicated by hyperammonemia. l-Arginine could extend our conventional treatment options for valproic acid overdose.     

The Treatment of Flatfeet in Small Children

For general practitioners, who handle more than 85 per cent of all pediatric care, POSTGRADUATE MEDICINE here presents authoritative, up-to-date summaries by specialists in pediatric problems.     

Physiologic Considerations in Parenteral Fluid Therapy

For general practitioners, who handle more than 85 per cent of all pediatric care, Postgraduate Medicine here presents authoritative, up-to-date summaries by specialists in pediatric problems.     

Association Notes

This department offers the latest, proved methods for the treatment and management of commonly encountered conditions based on the extensive experience of the physicians who prepare these summaries for POSTGRADUATE MEDICINE.     

Acute and Chronic Pancreatitis

This department offers the latest, proved methods for the treatment and management of commonly encountered conditions based on the extensive experience of the physicians who prepare these summaries for Postgraduate Medicine.     

Psychotherapy in General Practice

This department offers the latest, proved methods for the treatment and management of commonly encountered conditions based on the extensive experience of the physicians who prepare these summaries for POSTGRADUATE MEDICINE.     

Infections of the Respiratory Tract in Patients with Cardiac Disease

This department offers the latest, proved methods for the treatment and management of commonly encountered conditions based on the extensive experience of the physicians who prepare these summaries especially for POSTGRADUATE MEDICINE.     

The University of California School of Medicine

This department offers the latest, proved methods for the treatment and management of commonly encountered conditions based on the extensive experience of the physicians who prepare these summaries especially for Postgraduate Medicine.     

Pediatrics in General Practice

For general practitioners, in u/hose practice is included a major proportion of the medical management of infants and children, and for the specializing pediatrician as well, Postgraduate Medicine presents this special regular department devoted to brief discussions by recognized authorities on their preferred methods of the treatment and management of diseases and problems of infancy and childhood.     

Pediatrics in General Practice

For general practitioners, in whose practice is included a major proportion of the medical management of infants and children, and for the specializing pediatrician as well, Postgraduate Medicine presents this special regular department devoted to brief discussions by recognized authorities on their preferred methods of the treatment and management of diseases and problems of infancy and childhood.