Appendix S Formulary

Short Synacthen test 0-6 months - 36 g kg intravenous (IV) or intramuscular (IM). Maximum dose 125 g. Depot preparations contraindicated in neonates (see protocol in Appendix 2). 20-100 ng kg dose every 24 h (up to 2 g kg dose 24 h may be required). Calcium gluconate Calcium gluconate 10 solution contains 0.22 mmol of calcium per millilitres For maintenance treatment of hypocalcaemia 2.5 mL kg (0.55 mmol kg calcium) of 10 solution given continuously or in divided doses over 24 h. Maximum rate...

What to tell parents

If uncomplicated (i.e. if not part of an intersex problem) Cryptorchidism is a common problem which can be corrected with surgery or hormone therapy. Cryptorchidism refers to a developmental condition in which one or both testicles fail to descend into the scrotum. Many will descend normally in the first few months of life. Testes begin to descend into the scrotum at about 34 weeks gestation and 95 of newborn males have fully descended testicles at birth. If the testes have not descended by 6...

Maternal thyrotoxicosis

This inCludes a current or past history of maternal thyrotoxiCosis, espeCially those treated with surgery or radioiodine (who may now be CliniCally hypothyroid). ThyrotoxiCosis is nearly always due to Graves' disease and persisting thyroid stimulating antibodies renders the baby at risk of neonatal thyrotoxi-Cosis. Co-existing inhibiting antibodies may Cause neonatal hypothyroidism. Maternal TSH reCeptor antibody levels should be assessed during pregnanCy. Maternal TSH reCeptor antibody level...

Kallman syndrome

Characteristic features are hypogonadotrophic hypogonadism and anosmia. It can be associated with small penis, cryptorchidism (and absent postnatal rise in LH and testosterone, with blunted response to gonadotrophin-releasing hormone (GnRH) and human chorionic gonadotrophin (hCG)). Anosmia may be elicited in family history. Choanal atresia and cleft lip or palate have also been reported. Kallmann syndrome may represent the least severe form of the holoprosencephaly-hypopituitarism complex....

For severe hyperinsulinism

Site a central line (e.g. long silastic) for glucose infusion. This should be done at an early stage. Glucagon 100-200 g kg dose intramuscularly (IM) or sub-cutaneously (SC) can be used for emergencies (i.e. if the drip has tissued) but will cause rebound increase in insulin secretion thereafter. Buccal hypostop (1 mL kg dose) will also allow time for venous access to be obtained. If the blood glucose requirement is > 12 mg kg min, drugs may be needed to suppress insulin secretion. If the...

Antenatal treatment of 21OHD

Indifferent Gonads

Following the birth of an affected infant, it is usual to undertake genetic studies of that infant and both parents. This information allows for antenatal diagnosis in a future pregnancy. It is possible to suppress excessive androgen production in an affected fetus by the administration of dexa-methasone to the mother, and this has been shown to reduce virilization of affected girls. To be effective, dexamethasone has to be started by 7 weeks of gestation, and preferably before. Dexamethasone...

Diy Increase Cock

Charmandari E, Dattani MT, Perry LA, et al. Kinetics and effect of percutaneous administration of dihydrotestosterone in children. Horm Res 2001 56 177-181. Cheng PK, Chanoine JP Should the definition of micropenis vary according to ethnicity Horm Res 2001 55 278-281. Ludwig G. Micropenis and apparent micropenis - a diagnostic and therapeutic challenge. Andrologia 1999 31 (Suppl 1) 27-30 (review). Tuladhar R, Davis PG, Batch J, Doyle LW. Establishment of a normal range of penile length in...

Useful Links

Management of hyperinsulinism Chapter S. g Beckwith-Wiedemann Support Network www.beckwith-wiedemann.org m Beckwith-Wiedemann Support Group www.bws-support.org.uk Lee PJ, Leonard JV. Hypoglycaemia. In Clinical Paediatric Endocrinology, third edition, Ed. Brook CGD. pp. 677-693. Hawdon JM, Aynsley-Green A. Disorders of blood glucose homeostasis in the neonate. In Textbook of Neonatology, third edition, Eds. Rennie JM, Roberton NRC. Churchill Livingstone, pp. 939-956. Hawdon JM, Weddell A,...

Further Reading

Disorders of the thyroid in the newborn and infant. In Pediatric Endocrinology, second edition, Ed. Sperling MA. Saunders. pp. 97-110, 161-185. Rapaport R, Rose SR, Freemark M. Hypothroxinaemia in the preterm infant the benefits and risks of thyroxine treatment. J Pediatr 2001 139 182-188. g Van Wassenaer AG, Kok JH, de Vijlder JJ, et al. Effects of thyroxine supplementation on neurologic development in infants born at less than 30 weeks' gestation. New o ONTOGENY OF FETAL AND...