Pelizaeus-Merzbacher disease (PMD) is a rare, slowly progressive, sex-linked demyelinating disorder generally classified with the sudanophilic leukodystrophies. The onset is most often in the pediatric age group and may be diagnosed as cerebral palsy because of the subtle onset. Cranial magnetic resonance (MR) imaging of two patients with PMD showed reversal of the normal gray/white matter signal relationships, consistent with dysmyelination, as well as low intensity lentiform nuclei and thalami possibly suggesting pathologic iron deposition. Magnetic resonance also better demonstrated low volume brain without the beam hardening limitations of X-ray CT. Although our MR findings correlate well with the pathophysiology of PMD, the MR characteristics are not specific. The diagnosis of PMD remains one of clinical and laboratory exclusion.

Adolescent↗

PubMedDate not supplied

Consignment purchasing saves money, improves cash flow, streamlines material management function.

The responsibility of materials managers has grown tremendously in the past few years as cost containment has become a top priority. Today materials managers are responsible not only for seeing that supplies are on hand, but also for contributing to the hospital's cost savings efforts. For Southeastern General, those goals were met through consignment purchasing. In fact, the ACCESS consignment program enabled the hospital to increase its linen inventory by three times the amount it had previously carried. Whereas Southeastern General's materials management department used to be caught with stockouts at the unpredictability of an antiquated laundry system, it is now the most reliable hospital in the area. It maintains a fully stocked inventory and is prepared for the unexpected. For example, many of the small hospitals in the region will borrow from Southeastern General when they are confronted with an immediate inventory crisis rather than wait the standard 15 to 30 days for shipment from suppliers. In this circumstance, Southeastern General provides the other hospitals with materials from its inventory and Medline bills the other hospitals directly for supplies used. Overall, Southeastern General has benefited from consignment through elimination of stockouts, price stability, improved cash flow, and time and labor savings. Above all, savings through the use of consignment directly impacts the hospital's bottom line.

Bedding and Linens↗

PubMedDate not supplied

1991 Magadan, USSR/Alaska, USA Dental Exchange Program Report.

In August 1991, three rural Alaska Public Health dentists made a professionally significant return visit to the Soviet Far East. The city of Magadan was the site for the first actual demonstration of portable American dental equipment and treatment techniques in this remote region of Russia. This exchange was held at several clinical locations and took place during the time of the attempted USSR government coup.

Alaska↗

PubMedDate not supplied

Ketamine: its place for neurosurgical diagnostic procedures.

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Journal Article↗

PubMedDate not supplied

Determination of pantothenic acid, biotin, and vitamin B12 in nutritional products.

Until recently, liquid chromatographic (LC) methodology for pantothenic acid, biotin, and B12 (cyanocobalamin) has been only marginally successful. These vitamins are difficult to determine by conventional LC techniques and UV detection at 254 or 280 nm, because either the chromophore is inadequate for detection or interference from co-eluting vitamins is overwhelming. Biotin and B12 are usually present in pharmaceutical products at concentrations 100-1000 times lower than other commonly occurring water-soluble vitamins. Co-extraction of all water-soluble vitamins results in gross interferences, especially in LC when the interfering vitamins co-elute with biotin or B12. In addition, pantothenic acid and biotin are colorless in solution and do not exhibit strong UV absorption above 240 nm. As a result, they must be quantitated either by using a low UV wavelength for detection or by derivatizing the vitamin to obtain an adequate chromophore. A description of procedures for LC determination of pantothenic acid, panthenol, cyanocobalamin, and biotin in pharmaceutical products is presented. Pantothenic acid has been measured by using both a derivatization technique and low UV wavelength detection. Biotin has been quantitated by using low UV wavelength detection. The limitations of these techniques are also discussed. Chromatographic separation of cyanocobalamin is complicated by co-eluting vitamins such as riboflavin. It is detected by using the 546 nm wavelength where riboflavin does not interfere.

Biotin↗

PubMedDate not supplied

Valproic acid therapy in childhood epilepsy.

Valproic acid, used alone or in combination with other anticonvulsants in 100 children with epilepsy, improved seizure control in all age groups. Mean improvement in seizure control was 82%. Petit mal seizures responded best, but other types of seizures, even with associated mental and physical handicaps, also responded well. A substantial improvement in alertness and behavior often occurred. Leukopenia (27%) and an elevated SGOT value (44%) were frequent but transient. Other side effects included alopecia (1), gastrointestinal distress with vomiting (7), pancreatitis (1), thrombocytopenia (1), edema (2), and coma (2). Three severely retarded children with frequent seizures died while receiving valproic acid, but it is not clear that death was caused by valproic acid. Children must be monitored carefully for potential toxic effects, and drug interactions with other anticonvulsants may cause problems in treatment.

Anticonvulsants↗

PubMedDate not supplied

The domain of health.

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Attitude to Health↗