American journal of diseases of children (1911)
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Kleine-Levin syndrome is characterized by periodic hypersomnia associated with megaphagia and striking behavioral and psychiatric symptoms; it occurs primarily in adolescent boys. We treated a 17-year-old boy who had typical recurring somnolent episodes. His bizarre behavior included fire setting and stealing, both of which may have represented compulsions. ⋯ Between episodes, his EEG was normal. The relationship between Kleine-Levin syndrome and other sleep disorders is discussed. The neurochemistry and neurocircuitry that may provide the requisite substrate for this complex and fascinating neuropsychiatric disorder are briefly reviewed.
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Case Reports
Nocturnal intragastric infusion of glucose in management of defective gluconeogenesis with hypoglycemia.
Three children with defective gluconeogenesis and hypoglycemia were treated with frequent daytime feeding and continuous intragastric infusion of glucose at night. By this technique, the blood glucose level was maintained at or slightly above the physiological range. ⋯ Strength and sense of well-being improved. Nocturnal intragastric infusion of glucose is now the management of choice for children with defective gluconeogenesis and hypoglycemia.
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Percutaneous transthoracic needle aspiration was performed on 228 occasions to obtain lung specimens from 202 patients with suspected Pneumocystis carinii pneumonitis. In 121 patients the diagnosis was established by identifying P carinii organisms in lung aspirates. Six patients whose aspirates did not contain P carinii were found to have the organism at autopsy. ⋯ Pneumothorax that required a thoracotomy tube occurred in 39 patients. Other infectious agents, either bacteria or fungi, were found in only four patients. Percutaneous pulmonary needle aspiration--when performed under fluoroscopic guidance--is a rapid and effective method for the diagnosis of P carinii pneumonitis.
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Child health associates are individuals who have completed the three-year Child Health Associate Program at the University of Colorado School of Medicine and are certified by the Colorado State Board of Medical Examiners to practice pediatrics under physician supervision. To our knowledge, this study is the first to describe the practice profile of child health associates. ⋯ Each supervising physician spent an average time of 5.9 minutes with the child health associate in evaluating the 8.6% of patients who required consultation. The child health associate is fully able to serve as a primary health care practitioner for children.