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The ketogenic diet (KD) is an established, effective nonpharmacologic treatment for intractable childhood epilepsy. The KD is provided differently throughout the world, with occasionally significant variations in its administration. There exists a need for more standardized protocols and management recommendations for clinical and research use. In December 2006, The Charlie Foundation commissioned a panel comprised of 26 pediatric epileptologists and dietitians from nine countries with particular expertise using the KD. This group was created in order to create a consensus statement regarding the clinical management of the KD. Subsequently endorsed by the Practice Committee of the Child Neurology Society, this resultant manuscript addresses issues such as patient selection, pre-KD counseling and evaluation, specific dietary therapy selection, implementation, supplementation, follow-up management, adverse event monitoring, and eventual KD discontinuation. This paper highlights recommendations based on best evidence, including areas of agreement and controversy, unanswered questions, and future research.

Objective To assess the opinions of pediatricians regarding the supply and utilization of child neurologists in the United States. Study design A 32-item questionnaire was circulated by e-mail to a random sample of 5000 pediatricians with the assistance of the American Academy of Pediatrics. Results After 2 mailings, 422 responses were received. Respondents ranged in age from 30 to 75 years (median 50 years), 60.4% were male, 96% were board certified in pediatrics, and 76% had a 2 or more–week rotation in child neurology during pediatric training. Approximately 79% indicated that there were few or too few child neurologists in their area, and 90% indicated that there were few or too few child neurologists in the United States. Sixty-one percent indicated that they always or almost always seek consultation from a child neurologist for a child with new onset seizures; 7% and 21% seek consultations for children with migraine or tics. The delay for child neurology consultation was 5 or more weeks in 63% and >12 weeks in 15%. Satisfaction with child neurologists was linked to the level of inter-physician communication. Neither satisfaction nor wait time influenced the frequency of consultations. Increasing level of patient complexity and parental expectations were cited as reasons for increasing numbers of consultations with child neurologists. Conclusions Pediatricians perceive that a work force shortage exists in child neurology. Satisfaction with child neurology consultations is linked to communication with pediatricians.

A set of programs is presented for the reconstruction of a DNA sequence from data generated by the M13 shotgun sequencing technique. Once the sequence has been established and stored other programs are used for its analysis. The programs have been written for the Apple II microcomputer. A minimum investment is required for the hardware and the software is easily interchangeable between the growing number of interested researchers. Copies are available in ready to use form.