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Information on both is accumulating so rapidly that a lengthy review would be inappropriate and quickly out of date. however, to provide readers with a short summary of im- portant initial observations and a tentative assessment of the potential role of these hormones in clinical diagnosis and therapy. In addition to providing respiratory support, the "big gun" used in the treatment of propoxyphene overdose is nalox- one (Narcan), a very effective, safe, narcotic antagonist. This article reviews the actions of the different vitamins, the disease states associated with their deficiencies, the recommended doily intake of these nutrients, and identifies those indi- viduals more prone to require vita- min supplementation. The results suggest important factors and programs that should be considered when providing migrant health care.

Both have been isolated and characterized only within the past two years. University of Nortti Carolina School of Medicine, Chapel Hill 27514. There are some good animal studies that suggest that repeated doses of activated charcoal could be quite beneficial in the treatment of this problem, i.e., repeated doses of 1 00-200 grams of activated charcoal , administered via N-G tube, in the first few hours post ingestion. NC SCRAP METAL "Southern National's quick-decision policy gi\es us terrific purchasing leverage. And their courtesy means a lot to me." Jack Miklas Oinie [^ Miklas Tile &Aulo Senice. NC TRANSMISSIONS "Working with Southern Nationa gives me a ver\' comfortable feeling. so instead of wasting m\ time shopping |^ the market for rates and sen'ices. Mis- conceptions surrounding vitamin use are both plentiful and varied. These include the two federally funded migrant health care clinics discussed above and nine health departments or clinics which offer migrant health programs (table 1).

Furthermore, the patient's acromegaly persisted after operation, and a search was made for an ectopic source of GRF. It is not easy to cause a "therapeutic misadventure" with acetaminophen as it is in infants who are often given aspirin in too large a dose, in doses too close together, for too long a period of time. If sun exposure is insuffi- cient, though, vitamin D must be obtoined from the diet. Given in large doses (1-10 gm), ascorbic acid is generally safe; however, significant interactions may occur with drugs or lab tests. On the other hand, the four state clinic evening clinics served more than 1,621 migrants, greater than 57% of total state outpatients.

A CT scan of the abdomen showed a 5 cm tumor in the tail of the pancreas. Acetaminophen can probably be given to children in much higher dosage than prescribed on the bottle. Deficiency of vitamin D in children con lead to rickets, a disease char- acterized by soft bones and deformed joints due to o lock of adequate cal- cium in the bone. Most people obtain the rec- ommended daily ollowonce of vita- min D in their diet and from exposure to sunlight. Urine glucose tests may give false readings if given while the pa- tient is taking megadose vitamin C. The seven state clinics conducting outreach screened over two times as many migrants than all nine served as outpatients.

Within hours following its removal there was a dramatic fall in serum GH concentrations. We give, when indicated, an initial dose of 20-25 mg/kg with subsequent doses of 15-20 mg/kg at 3-4 hour intervals. The adult disease equivalent to rickets is osteomalacia, on equally debilitating disease seen in patients with kidney disease, molabsorption syndromes or other endocrine problems. In addition, the actions and/or toxici- ties of several antibiotics, including the sulfa drugs, may be affected by ascorbic acid. More than 10,453 migrants were seen by nine outreach programs.

Cell culture medium in which pieces of the tumor were incubated caused the release of GH from cul- tured rat pituitary cells. The toxic dose of acetaminophen in people over 9 or 10 years of age is about 140 mg/kg; the toxic dose in younger patients is not actually known at this time. Milk and milk products ore the ma- jor sources of vitamin D in the U. You should consult your pharmacist or physician to determine whether ingestion of large amounts of vitamin C will hove an effect on medications or tests you may be us- ing. The TCCHC performed outreach to 4,328 migrants, 83.8% of its outpatient encounters.

r¥-i HE long-suspected connection between the brain and X the endocrine system and the search for hypothalamic hormones was begun nearly forty years ago, when Geof- frey Harris of Cambridge University reviewed the available evidence and came to a compelling conclusion: There is much experimental and clinical evidence that the hypothalamus is functionally linked with anterior pituitary activity. So far the drug is only available in oral form and is extremely damaging to veins if injected IV by the "serious" addict. Bolles 304 Features for Patients The Patient Has a Sore Throat. Terms such as "cost-effectiveness analysis" and "cost-benefit analysis" ore being used to describe efforts to develop the best treatment at the least possible cost. 310 Glenwood Ave., Kinston 28501 (1985) Third District R. In addition to county health departments, two locally administered migrant health centers receive funding from the federal government's Public Health Service, Depart- ment of Health and Human Services, the Office of Migrant Health of the Bureau of Health Care Delivery and Assist- ance. In this article we will review the current knowledge relating to the two most recently discovered factors, corti- cotropin-releasing factor, or CRF, and growth hormone- releasing factor, or GRF. Activated charcoal works quite nicely here to bind the ingested propoxyphene remaining after gastric emptying. The time and mone\' I sav by working with Southern National i a big help. References 1- Gognon R, De Lozier J, Mc Lemore T: The National Ambulatory Medical Care Survey, Urited States, 1979 Summory, U. Deponmen T of Heol Th and Human Services, Public Heolth Service, Publ. Holmberg SD, Faich GA: Streptococcol phoryngitis and ocute rheumottc fever in Rhode Island. Again, very few of these people will derive much benefit from such therapy. Raleigh 27611 Councilors and Vice-Councilors — 1984-1985 First District Robert E. The TCCHC utilizes two nurse practitioners and one full-time physician while * Personal aommunication with Ms. This paper presents the results of a survey of eleven migrant health care programs in the state. The names of the known factors and some of their major effects are summarized in table 1 . The use of gastric emptying in propoxyphene overdose can be very tricky; because of the propensity for coma, seizures and respiratory depression soon after an overdose, very "cautious" gastric lavage would seem to be the wiser course. NC Itsit TIRES "It's not easy these days for the small businessman to keep his inde pendence. NC SOUTHERN NATIONAL BANM \m can tc U \ c \ ant \ otir busixics: aans BB (te i NJorth Carolina 4EDICAL JOURNAL )r doctors and their patients lover illustration by Ernest Craige, M. In this climate the patient must remain in close communication with primary care physicians, so that mutually satisfactory management of sore throats in 1984 can be attained. Pediatrics 1953,11:7-13, 5 Report of the Eighty-Sixth Ross Conference on Pediatric Research, Monogement of Phoryngitis in on Era of Declining Rheumotrc Fever, 1984 6. Another segment of the American public seeks vitamin therapy for re- lief or cure of such i I Inesses as cancer, heart disease, and arthritis. The MFHS serves mainly Henderson, Polk, Burke, Haywood, and Rutherford counties, and migrants from northern South Carolina. As in many migrant clinics, nurse practi- tioners provide a majority of the care. (Greene County) Hyde County Health Department Nash County Health Department Prospect Hill Clinic (Caswell, Alamance Counties) Surry County Health Department Wilson County Health Department Yadkin County Health Department the MFHS employs three nurse practitioners and one part- time physician. Wiles — page 43 Contents on page 3 mi K\ tb tk » Carolina History Babies Hospital, 1920-1978 -page 53 by Lockert B. The data from this analysis point to the wide range of disorders that may affect adolescent females. None of these substances has met the criteria necessary to be considered a primary humoral regulator of ACTH secretion. For those narcotics with longer half-lives CWi), such as Darvon, one could consider using continuous IV infusion of naloxone, e.g.. Questions relating to sub- scription rales, advertising, etc.. Postmaster: Send address changes to North Carolina Medical Society. and v\-e'll be happy to give you all the references vou need. Most people eating a balanced diet do not need to take vitamin pills. All eleven clinics were able to provide some of the data requested. Socioeconomics Corporate Restructuring in Response to TEFRA by Paul M. f YWd H l Wy V'IWWlfff percent of the patients came for their visit because they had a complication related to sexual activity (pregnancy, postpregnancy. These potential consequences of sexual activity should be explained to those young women who are considering be- come sexually active. Capraro VJ: The Gynecologv of Childhood and Adolescence Philadelphia: W. Among these are vasopressin, norepinephrine, angiotensin II, and fragments of large proteins such as hemoglobin or myelin. Therefore, for adults or children, administer initially 0.8 mg IV followed by 2.0 mg as needed. Address manuscripts and communications regarding editorial matters to the Durham address. North Carolina 2 761 1 and additional mailing offices. If you don't find your npe of business represented here, just c;iil our marketing depart- ment toll-free at 1-800-672-9863. By def- inition, vitamins must be chemicals supplied from external sources. In addition, the number of refertals that were inpatient hospitalizations, outpatient clinic or specialist refertals, and dental refertals was obtained.Attempts over the past 20 years to purify GRF from animal hypothalami, however, have been unsuccessful, primarily because of the minute quantities present. This substance remains an ever increasingly popular OTC analgesic-antipyretic; new brands are still appearing of the drug alone, e.g.. and in a host of "cold remedies," "pain killers" (often associated with aspirin), "sinus medicines." etc. World- wide, vitamin A deficiency is a lead- ing cause of blindness in childhood. High doses of retinol should only be token under close medical supervision. Occasionally, a vitamin K deficiency is seen in o per- son who takes antibiotics that may inhibit the organisms responsible for vitamin K synthesis. Hodgson 375 Physicians' Forum Is There a Doctor Glut? Linfors 379 Features for Patients Stepped Care for Diabetes Mellitus George J. Blythe 403 Ethics Human Experimentation: The Ethical Dilemma John B. 510 7th Ave., W,, Hendersonville 28739 First Vice-President F. Results Data on outpatient encounters, referrals, outreach, and evening clinics are summarized in table 2.