Drug DosageThe authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text arc in accord with current recommendations and practice at the time of publication.However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug forany change in indications and dos age and for added warnings and precautions.This is par ticularly important when the recommended agent is a new and/or infrequently employed drug.

A computerized screening system for growth disorders is presented. Its aim is to save time and to facilitate the decision of whether a patient with a suspected growth problem should be referred for specialized evaluation. It uses accepted methods and common sense, and has been shown to be effective. A radiography of the hand and wrist, and a completed data sheet (birth date, date of x-ray, height and weight, parental height, and in girls, whether menarche has occurred) are mailed for analysis. Bone age is rated according to Greulich and Pyle, and Tanner et al. by trained technicians, and the results are supervised by a consultant pediatric endocrinologist. The supplied data and bone age values are then processed by a computer, which compares them with normal values, calculates three different height predictions (Bayley and Pinneau, Roche et al., Tanner et al.), as well as "target height" (estimation of genetic potential), and prints an easy-to-read growth curve. Depending on the constellations of height (normal, below 3rd, above 97th percentile), bone age (normal, retarded, advanced in comparison with chronologic age), and height predictions vs. target height (predictions within, below, above target height range), different messages suggesting the most likely diagnostic possibilities are listed on a computer printout.

Bone age ratings according to Greulich and Pyle and to Tanner and co-workers (RUS) of 88 children from two pediatric endocrine centers were compared with ratings from 2 trained technicians and independent ratings from a consulting pediatric endocrinologist. Considering the mean of all ratings as 'true bone age', the mean errors of the individual estimations were small (0.15-0.38 years for the Greulich and Pyle method, 0.12-0.27 years for the method according to Tanner and co-workers). Only in 2 of 338 ratings were differences larger than 1 year observed. In these 2 cases, there was marked dissociation between the maturation of carpal and phalangeal bones. It is concluded that estimations of bone maturation can be carried out reliably by properly trained technicians.

Drug DosageThe authors and the publisher have exerted every effort to ensure that drug selection and dosage