Management of postoperative nesidioblastosis with zinc protamine glucagon and oral starch.
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Administration, Oral↗
Biomedical subjects
S R Rose
Publications and source records attributed to S R Rose.
Deficient nocturnal surge of thyrotropin in central hypothyroidism.
In normal individuals, serum TSH concentrations have a circadian pattern characterized by a nocturnal surge which begins in the late afternoon and reaches its peak after midnight. We assessed the nocturnal surge of TSH in 16 patients with pituitary and/or hypothalamic diseases, 6 of whom were judged to be hypothyroid. To assess the magnitude of the nocturnal surge in individual patients, TSH was measured in 5 serum samples obtained during the normal time of the TSH nadir in the late afternoon and in 5 samples obtained during the normal time of the peak of serum TSH after midnight. A significant nocturnal surge of TSH was defined as a significantly greater mean nighttime TSH level than the mean daytime TSH concentration. The nocturnal TSH surge was absent in the 6 patients with central hypothyroidism, while it was present in the 10 euthyroid patients with central lesions. In 6 hypothyroid patients who did not have pituitary or hypothalamic lesions, the nocturnal TSH surge was intact, indicating that hypothyroidism per se does not account for the deficient nocturnal TSH surge in central hypothyroidism. We conclude that central hypothyroidism is characterized by a deficient nocturnal surge of TSH, and accordingly, we suggest that evaluation of the circadian pattern of TSH may be a useful adjunct in making the diagnosis of hypothyroidism in patients with diseases involving the pituitary or hypothalamus.
Adolescent↗
Review of research on endorphins and learning.
Advances in the neurochemistry of learning suggest that many endogenous substances modulate learning processes. Endorphins promote or interfere with learning depending on dose (physiologic versus pharmacologic), task (negative versus positive consequences), and learning stage during which the substance is administered. Endorphins cause amnesia for extraneous details of a task (allowing focusing on main events) and prevent extinction of a learned task (even when forgetting might be adaptive). We have summarized endorphin physiology and review studies of endorphins in animal learning. Implications for the study of human attention and learning disorders are presented.
Animals↗
Minoxidil overdose with ECG changes: case report and review.
A 20-year-old female ingested an unknown quantity of minoxidil tablets as a suicide gesture. She presented to the emergency department about 90 minutes later with tachycardia, diffuse T wave inversion, and S-T segment depression on the ECG, labile hypotension, and a substantially elevated total serum minoxidil concentration of 3140 ng/mL. She responded to supportive therapy with intravenous fluids, and was discharged 32 hours later with stable blood pressure and mild residual tachycardia. The clinical toxicology, treatment, and previous case reports of minoxidil overdose are reviewed.
Adult↗
Six-hour and four-hour nocturnal sampling for growth hormone.
UNLABELLED: Overnight sampling for growth hormone (GH) is a research tool for quantifying characteristics of spontaneous GH secretion. However, the study is costly in assays and blood volume, particularly that required from a small child. DESIGN AND PATIENTS: Existing overnight GH data from 126 normal children and from 227 children with GH deficiency or short stature were reanalyzed, examining 6-h and 4-h segments of this data for accuracy in representing each child's 12-h GH secretion. The goal was to see whether the test could be made shorter and more practical without losing accuracy. RESULTS: The 6-h segment 2200-0400 h consistently contained the majority of GH peaks. Correlation was high between GH values from 2200-0400 h and from the 12-h period. Normal 95% confidence limits (CL) for GH during 2200-0400 h were derived from data in normal children for gender and each pubertal stage. Data from short children were compared with the normal 6-h 95% CL. In short children, GH values low for 12-h were also low for 6-h. Only a few children with normal 12-h values (1.5% of normals, 0.5% with short stature) had GH values outside 95% CL for 6-h. CONCLUSIONS: Six-hour GH sampling (2200-0400 h) is accurate and cost-efficient compared to the 12-h overnight GH study. These studies are primarily useful in research settings.
Adolescent↗
Caloric restriction for 24 hours increases mean night growth hormone.
UNLABELLED: In obesity, serum growth hormone (GH) is usually low, confounding GH assessment of short obese children. We evaluated whether 24-h caloric restriction would permit better discrimination between normal GH secretion and GH deficiency (GHD) by elevating night GH levels. DESIGN AND PATIENTS: Serum was obtained every 20 minutes 2000-0800 h before and 2200-0400 h after 24 hours of caloric restriction (8% of usual calories) in 24 normal height children [14 normal (weight for height 10-90th percentile); 10 obese (weight for height > 95th percentile)] and in 31 short children (height shorter than -2.0 SD below mean for age). All samples from both nights per child were assayed for GH simultaneously to eliminate interassay variability. RESULTS: Mean GH increased significantly in all groups after caloric restriction (P < 0.01). Obese children had lower baseline mean GH and GH amplitude compared to normal (P < 0.01); GH increased into normal range after restriction. Basal GH studies in short children were not significantly below normal. Surprisingly, some with low stimulated GH increased their night GH into the normal range after caloric restriction. CONCLUSIONS: Caloric restriction for 24 h enhances night GH similarly in short and in normal children, and thus does not increase the diagnostic utility of night GH studies in non-obese short children. Caloric restriction reverses suppressed GH secretory state of obese children, perhaps by decreasing diet-dependent somatostatin inhibition of GH secretion.
Adolescent↗
Incidence of short stature in children with hydrocephalus.
OBJECTIVE: To characterize heights and growth velocities of non-referred children with shunted hydrocephalus. METHODS: Accurate home height measurements of 94 subjects (age 1-18 yr); repeated in 54 after one year. Heights were compared with those of general population, and with sibling and target height. RESULTS: 31% were below population 5th percentile, 34% were short for target height, and 25% were short for siblings. Slow growth velocity was present in 41%. Short stature (SS) was present in 40% with concurrent medical problems, and in 24% with no such problems. Medical problems with increased risk of SS included spina bifida or meningomyelocele, Dandy Walker syndrome, brain tumor, cerebral palsy, epilepsy, impaired vision, mental retardation, and pulmonary disorders. Finally, history of premature birth, seen in 31%, led to higher incidence of SS for target height (54%) than did term birth (28%). Accelerated growth was present in 37%. CONCLUSIONS: Children with hydrocephalus are at increased risk for short stature, slow growth velocity, or accelerated growth. Observation of premature entry to puberty, or accelerated or slow growth velocity should prompt an endocrine evaluation.
Adolescent↗
Poison control in North Carolina.
Poison centers contribute importantly to public health. They provide expert emergency advice without charge, offer early telephone triage of poisoning cases, assist parents and caretakers in managing simple exposures at home, and recommended hospital evaluation for patients suspected of serious exposure. Their efforts lead to significant cost savings by averting unnecessary medical evaluations. Poison centers offer physicians and other clinicians consultation with board-certified medical toxicologists to arrange for definitive care or, more often, to help provide good, cost-effective care in local communities. The Poison Center's efforts to prevent accidental poisoning and to increase awareness and utilization of its services benefit both patients and health care providers by reducing morbidity and costs associated with poisonings.
Cost-Benefit Analysis↗