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Summary. Using single subject research design, we performed pilot research to evaluate the safety and efficacy of famotidine for the treatment of children with autistic spectrum disorders. We studied 9 Caucasian boys, 3.8–8.1 years old, with a DSM-IV diagnosis of a pervasive developmental disorder, living with their families, receiving no chronic medications, and without significant gastrointestinal symptoms. The dose of oral famotidine was 2 mg/kg/day (given in two divided doses); the maximum total daily dose was 100 mg. Using single-subject research analysis and medication given in a randomized, double-blind, placebo-controlled, cross-over design, 4 of 9 children randomized (44%) had evidence of behavioral improvement. Primary efficacy was based on data kept by primary caregivers, including a daily diary; daily visual analogue scales of affection, reciting, or aspects of social interaction; Aberrant Behavior Checklists (ABC, Aman); and Clinical Global Improvement scales. Children with marked stereotypy (meaningless, repetitive behaviors) did not respond. Our subjects did not have prominent gastrointestinal symptoms and endoscopy was not part of our protocol; thus, we cannot exclude the possibility that our subjects improved due to the effective treatment of asymptomatic esophagitis. The use of famotidine for the treatment of children with autistic spectrum disorders warrants further investigation. [ABSTRACT FROM AUTHOR]

Background: Intraoperative measurement of intact parathyroid hormone (iPTH) has been used increasingly as a means of confirming complete removal of hyperfunctioning parathyroid tissue. It remains uncertain, however, whether normalization of iPTH levels at operation accurately predicts postoperative values of iPTH. Methods: Forty-five consecutive patients with primary hyperparathyroidism underwent parathyroidectomy between March and November 1999. Baseline intraoperative iPTH levels were measured before and at manipulation, then subsequently at 5 and 10 min after tissue was removed. Follow-up values were measured at 1- and 3-month intervals. Results: Before operation the mean(s.d.) iPTH concentration was 211(182) pg ml[sup -1] with a mean serum calcium level of 11·4(1·0) mg dl[sup -1]. In all but four patients, the final intraoperative iPTH normalized to absolute values below 60 pg ml[sup -1] (mean 38(36) pg ml[sup -1]). One week after operation, serum calcium levels had returned to normal (mean 9·2(0·9) mg dl[sup -1]) and this correlated directly with final intraoperative iPTH values when assessed by linear regression analysis (r = 0·373, P < 0·03). By 1 month, all but two patients were normocalcaemic (mean 9·6(0·6) mg dl[sup -1]) with a mean iPTH of 81(99) pg ml[sup -1]. There was no correlation between the final intraoperative iPTH and postoperative iPTH values as determined by linear regression analysis (r = 0·035, P < 0·881). Both patients with persistent hypercalcaemia at 1 month had appropriate intraoperative decreases in iPTH level. Conclusion: Although there is significant correlation between intraoperative iPTH levels and postoperative serum calcium levels, this does not hold true for postoperative iPTH levels. There was a 4 per cent failure rate in correcting postoperative calcium levels and a 20 per cent failure rate in normalizing postoperative iPTH levels despite appropriate intraoperative decr... [ABSTRACT FROM AUTHOR]