Patient managed analgesia with use of intravenous opioids morphine, meperidine, hydrocodone, or fentanyl has been used successfully in most centers (Ryan et al. The legislation also instructed the Secretary to ask the National Academies to conduct updates each 2 years for 10 years from the date of the frst report so as to review newly available literature and draw conclusions from the overall evidence. This metabolic dysfunction just isn't all the time treatable with vitamin B12: one study reported a new child with the vitamin B12-unresponsive type of methylmalonic acidemia (41)
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