Management of prolactinomas in children and adolescents; which factors define the response to treatment?

Pituitary ◽  
2021 ◽  
Author(s):  
Ayfer Alikasifoglu ◽  
Nur Berna Celik ◽  
Zeynep Alev Ozon ◽  
Elmas Nazli Gonc ◽  
Nurgun Kandemir
Keyword(s):  
Children And Adolescents ◽  
Response To Treatment

scholarly journals Treatment of children and adolescents with hemangioma using propranolol: preliminary results from a retrospective study

2014 ◽  
Vol 132 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Juliana Costa Albuquerque ◽  
Rosane Aline Magalhaes ◽  
Jamille Araujo Felix ◽  
Maria Vilani Rodrigues Bastos ◽  
Juvenia Bezerra Fontenele ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Children And Adolescents ◽  
Previous Treatment ◽  
Capillary Hemangioma ◽  
Response To Treatment ◽  
Vascular Tumors ◽  
Lesion Volume ◽  
Chi Square ◽  
One Year ◽  
Almost All

CONTEXT AND OBJECTIVE: Hemangiomas are the commonest vascular tumors during childhood. In 2008, the effect of propranolol for treating capillary hemangiomas was demonstrated. Other similar results followed, showing that it rapidly reduces lesion volume. The objective here was to evaluate children and adolescents with hemangiomas that were treated with propranolol. DESIGN AND SETTING: Retrospective study, conducted in a children's hospital. METHODS : Patients aged 0-19 years with or without previous treatment, who were treated between January 2009 and December 2010, were included. The response was assessed by comparing the lesion appearance between the start of treatment and the last consultation. We considered partial or complete responses as the response to treatment. RESULTS : Sixty-nine patients with a median follow-up of 11 months (mean age: 31 months) were included. Of these, 58 patients were recently diagnosed and 11 had had previous treatment. A response (partial or complete) was seen in 60 patients (87%). Among the capillary hemangioma cases, responses were seen in 50 out of 53 (94%), while in other lesion types, it was 10 out of 16 (63%) (P = 0.3; chi-square). Responses in patients less than one year of age were seen in 37 out of 38 (97%), whereas in those over one year of age, in 23 out of 31 (74%) (P = 0.4; chi-square). Side effects were uncommon and mild. CONCLUSIONS: Propranolol seemed to be effective for treatment of hemangiomas in children and adolescents, and not just in the proliferative stage, with responses in almost all the patients.

SCHOOL PHOBIA IN OLDER CHILDREN AND ADOLESCENTS: DIAGNOSTIC IMPLICATIONS AND PROGNOSIS

PEDIATRICS ◽  
1961 ◽  
Vol 28 (3) ◽  
pp. 462-471
Author(s):  
Doris H. Milman
Keyword(s):  
Children And Adolescents ◽  
Social Adjustment ◽  
Psychiatric Symptoms ◽  
School Achievement ◽  
Somatic Complaints ◽  
Response To Treatment ◽  
Prior History ◽  
Childhood And Adolescence ◽  
Older Children ◽  
School Phobia

A series of 20 cases of school phobia in older children and adolescents was analyzed and categorized into three diagnostic groups: neurotic, organic and schizophrenic. Important differences were noted between neurotic and schizophrenic patients, particularly with respect to the malignant psychiatric symptoms, high intelligence and relapsing tendency of the schizophrenic group. The features common to all groups were pathological maternal attitudes, somatic complaints, anxiety and depression, rarity of prior history of significant anxiety about school, and favorable response to treatment. The symptoms most amenable to treatment were anxiety (both sexual and separation), depression, somatic complaints, and school phobia. With alleviation of these symptoms, there followed an improvement in physical health, school achievement, and social adjustment. Regular school attendance was achieved without coercion in 18 patients. A long-term follow-up averaging 5 years showed sustained improvement in 18 patients. School phobia in late childhood and adolescence is a different syndrome from that in early childhood, and it has graver diagnostic implications.

Updated entrectinib data in children and adolescents with recurrent or refractory solid tumors, including primary CNS tumors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 107-107 ◽  
Author(s):  
Ami Vijay Desai ◽  
Giles W. Robinson ◽  
Ellen M. Basu ◽  
Jennifer Foster ◽  
Karen Gauvain ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Solid Tumors ◽  
Tyrosine Kinases ◽  
Bone Fractures ◽  
Phase 1 ◽  
Objective Response ◽  
Cns Tumors ◽  
Response To Treatment ◽  
Grade 3 ◽  
Best Responses

107 Background: The phase 1/2 STARTRK-NG trial (NCT02650401) is evaluating entrectinib, a CNS-penetrant oral inhibitor of TRK, ROS1 and ALK tyrosine kinases, in children and adolescents < 21 years old with recurrent/refractory solid tumors, including primary CNS tumors. Methods: After determining the recommended dose as 550mg/m2/day in all-comers, expansion cohorts with gene-fusion-positive CNS/solid tumors ( NTRK1/2/3 and ROS1) are being enrolled. Results: As of 1 July 2019 (data cut-off), 34 patients (4.9 months to 20 years old; median age 7 years) have been evaluated for response to treatment with entrectinib. Responses were classified as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD) using RANO for CNS tumors, RECISTv1.1 for solid tumors, or Curie score for neuroblastomas. Responses in fusion-positive patients were assessed by blinded independent central review (BICR), and occurred at doses ≥400mg/m2. Best responses in patients with fusion-positive CNS tumors (n = 8) were four CR ( ETV6-NTRK3, EML1-NTRK2, GOPC-ROS1, and TPR-NTRK1), two PR ( KANK1-NTRK2 and EEF1G-ROS1), and two PD ( EML4-ALK and PARP6-NTRK3). In patients with fusion-positive solid tumors (n = 6) best responses were three CR ( DCTN1-ALK, ETV6-NTRK3, and ETV6-NTRK3), and three PR ( TFG-ROS1, EML4-NTRK3, and KIF5B-ALK). Responses (Investigator-assessed) in patients with non-fusion tumors (n = 20) were one CR ( ALK F1174L mutation), four SD, ten PD, and five patients were unevaluable or had no data. The objective response rate (defined as the total number of CR and PR) in fusion-positive patients was 86% (12/14) versus 5% (1/20) in non-fusion patients. Similarly, PFS was 17.5 months (95% CI 7.4–NE) in fusion-positive patients versus 1.9 months (1.8–5.7; p = 0.0002) in non-fusion patients. Most commonly reported treatment-related adverse events included weight gain (n = 14 [5 Grade 3/4]), elevated creatinine (n = 13), anemia (n = 13), nausea (n = 11), increased ALT (n = 10 [1 Grade 3/4]), increased AST (n = 10 [1 Grade 3/4]), decreased neutrophils (n = 9 [6 Grade 3/4]), and bone fractures (n = 7, of which 4 were treatment related). Conclusions: In children and adolescents < 21 years old, entrectinib has produced striking, rapid, and durable responses in solid tumors with target gene fusions, especially in high-grade CNS neoplasms. Clinical trial information: NCT02650401.

scholarly journals Association of lamotrigine and valproate in refractory epilepsies of children and adolescents

2008 ◽  
Vol 66 (3a) ◽  
pp. 477-481 ◽  
Author(s):  
Karen P. Grisotto ◽  
Isac Bruck ◽  
Sérgio A. Antoniuk ◽  
Lúcia H.C. Santos
Keyword(s):  
Side Effects ◽  
Children And Adolescents ◽  
Retrospective Analysis ◽  
Sodium Valproate ◽  
Seizure Control ◽  
Common Type ◽  
Response To Treatment ◽  
Seizure Type ◽  
Treatment Side Effects ◽  
Clonic Seizures

OBJECTIVE: To evaluate the efficacy or eventual side-effects of the association of lamotrigine and sodium valproate in the control of refractory epilepsies. METHOD: A retrospective analysis of 37 children with a mean age of 12 years taking exclusivelly lamotrigine and sodium valproate. Efficacy of seizure control was considered satisfactory if there was a reduction in seizures >50% or total control. RESULTS: The association of lamotrigine and sodium valproate was considered satisfactory in 65% of the studied children, independent of seizure type. Total seizure control was obtained in 33% and 35% had an unsatisfactory response or remained unchanged. Primary generalized tonic clonic seizures were the most common type with 84% of day-time seizures having a good response to treatment. Side-effects were seen in 11% of patients and the most common was tremor. CONCLUSION: Total or satisfactory control of seizures was seen in the majority of patients and side-effects were uncommon.

scholarly journals Squamous cell carcinoma antigens (SCCAs) are sensitive biomarkers for atopic dermatitis in children and adolescents: a cross-sectional study

2020 ◽  
Author(s):  
Junya Hirayama ◽  
Takao Fujisawa ◽  
Mizuho Nagao ◽  
Yu Kuwabara ◽  
Keigo Kainuma ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Atopic Dermatitis ◽  
Children And Adolescents ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Linear Regression Analysis ◽  
International Study ◽  
Serum Levels ◽  
Response To Treatment ◽  
Cross Sectional

Abstract Background We recently reported that squamous cell carcinoma antigen 2 (SCCA2) is a reliable biomarker for atopic dermatitis (AD) in children. To further clarify its utility, we investigated for possible effects of comorbid allergies and AD treatment on serum SCCA levels in children and adolescents.Methods Volunteers aged less than 18 years were recruited through our website. Their allergic status was elucidated using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. We also recruited pediatric patients who needed to be hospitalized because of severe AD. The serum levels of SCCA1 and SCCA2 were measured by ELISAs. In the severe AD patients, the levels of thymus and activation-regulated chemokine (TARC), SCCA1 and SCCA2 were measured before and after hospitalization. The severity of AD was assessed using the severity scoring of atopic dermatitis (SCORAD) index.Results A total of 576 participants (547 volunteers and 29 patients) were enrolled in the study. The levels of SCCA1 and SCCA2 were significantly higher in volunteers with mild AD and patients with severe AD than in healthy volunteers without allergic diseases. In contrast, the levels were not elevated in those who had mild bronchial asthma or mild allergic rhinitis without AD. TARC, SCCA1 and SCCA2 were decreased in patients with severe AD, reflecting clinical improvement in response to treatment. Linear regression analysis for predicting a decrease in the SCORAD index showed R2 values of 0.16, 0.38 and 0.48 for TARC, SCCA1 and SCCA2, respectively..Conclusions SCCAs, especially SCCA2, are sensitive biomarkers for detecting AD in children and adolescents, even in the mild stage, and for assessing the severity and response to treatment of severe AD.

scholarly journals Characteristics, correlates, and outcomes of childhood and adolescent depressive disorders

2009 ◽  
Vol 11 (1) ◽  
pp. 45-62 ◽  
Keyword(s):  
Children And Adolescents ◽  
Depressive Disorders ◽  
Current Knowledge ◽  
Unipolar Depression ◽  
Depressive Illness ◽  
Developmental Differences ◽  
Natural Course ◽  
Response To Treatment ◽  
Childhood And Adolescence ◽  
Full Potential

Depressive illness beginning early in life can have serious developmental and functional consequences. Therefore, understanding the disorder during this developmental stage is critical for determining its etiology and course, as well as for developing effective intervention strategies. This paper summarizes current knowledge regarding the etiology, phenomenology, correlates, natural course, and consequences of unipolar depression in children and adolescents. Using adult depression as a framework, the unique aspects of childhood and adolescence are considered in order to better understand depression within a developmental context. The data suggest that the clinical presentation, correlates, and natural course of depression are remarkably similar across the lifespan. There are, however, important developmental differences. Specifically, the familial and psychological context in which depression develops in youngsters is associated with variability in the frequency and nature of depressive symptoms and comorbid conditions among children and adolescents. Maturational differences have also been identified in the neurobiological correlates of depression. These developmental differences may be associated with the observed variability in clinical response to treatment and longitudinal course. Characterization of the developmental differences will be helpful in developing more specific and effective interventions for youngsters, thereby allowing them to reach their full potential as adults.

scholarly journals Baseline Factors Predicting Placebo Response to Treatment in Children and Adolescents With Autism Spectrum Disorders

2013 ◽  
Vol 167 (11) ◽  
pp. 1045 ◽  
Author(s):  
Bryan H. King ◽  
Kimberly Dukes ◽  
Craig L. Donnelly ◽  
Linmarie Sikich ◽  
James T. McCracken ◽  
...  
Keyword(s):  
Autism Spectrum Disorders ◽  
Children And Adolescents ◽  
Placebo Response ◽  
Autism Spectrum ◽  
Response To Treatment ◽  
Adolescents With Autism ◽  
Baseline Factors ◽  
Spectrum Disorders

Aripiprazole in Juvenile Bipolar Disorder Comorbid with Attention-Deficit/Hyperactivity Disorder: An Open Clinical Trial

CNS Spectrums ◽  
2007 ◽  
Vol 12 (10) ◽  
pp. 758-762 ◽  
Author(s):  
Silzá Tramontina ◽  
Cristian Patrick Zeni ◽  
Gabriel Ferreira Pheula ◽  
Carla Ketzer de Souza ◽  
Luis Augusto Rohde
Keyword(s):  
Bipolar Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Rating Scale ◽  
Response To Treatment ◽  
Adhd Symptoms ◽  
Young Mania ◽  
Global Functioning ◽  
Hyperactivity Disorder

ABSTRACTIntroductionJuvenile bipolar disorder (JBD) is a highly impairing chronic mental health condition that affects children and adolescents' overall functioning. Comorbidity with attention-deficit/hyperactivity disorder (ADHD) is extremely prevalent and may determine worse response to treatment. Few investigations have addressed the use of recent atypical antipsychotics in JBD, although several guidelines suggest their use.MethodsWe conducted a 6-week open trial with aripiprazole in 10 children and adolescents with JBD comorbid with ADHD to assess impact on mania and ADHD symptoms, respectively, by means of the Young Mania Rating Scale and the Swanson, Nolan and Pelham Scale, as well as on global functioning (Clinical Global Impressions–Severity), and adverse events.ResultsSignificant improvement in global functioning scores (F=3.17, P=.01, effect size=0.55), manic symptoms (F=5.63, P<.01; ES=0.93), and ADHD symptoms (t=3.42, P<.01; ES=1.05) were detected. Although an overall positive tolerability was reported, significant weight gain (F=3.07, P=.05) was observed.ConclusionAripiprazole was effective in improving mania and ADHD symptoms, but neither JBD nor ADHD symptom remission was observed in most of the cases. Randomized placebo-controlled trials for JBD and ADHD are needed.

scholarly journals Variability in phenotype and response to treatment in chronic nonbacterial osteomyelitis; the Irish experience of a national cohort

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Daire O’Leary ◽  
Anthony G. Wilson ◽  
Emma-Jane MacDermott ◽  
Clodagh Lowry ◽  
Orla G. Killeen
Keyword(s):  
Children And Adolescents ◽  
Treatment Guidelines ◽  
Age Of Onset ◽  
Paediatric Rheumatology ◽  
Response To Treatment ◽  
Second Line ◽  
Treatment Protocols ◽  
Childhood Arthritis ◽  
National Cohort ◽  
Chronic Nonbacterial Osteomyelitis

Abstract Background Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory disease affecting bone with considerable phenotypic heterogeneity and variable association with other autoinflammatory conditions. Disease pathogenesis is incompletely understood, and treatment protocols vary between physicians with no clinical treatment guidelines available prior to 2017. Although CNO was previously considered benign, it is now clear that long-term sequelae do occur. The aim of this study is to provide a detailed phenotypic description of children and adolescents with CNO who attended tertiary paediatric rheumatology services in Ireland between September 2017 and September 2019, their disease course, treatment and outcomes. Methods This study involved retrospective review of clinical notes, laboratory, radiology and histology results of Irish children and adolescents with CNO who are currently attending tertiary paediatric rheumatology services. The Bristol diagnostic criteria were applied retrospectively; only patients who met these criteria were included. Criteria for remission and partial response were based on the Childhood Arthritis and Rheumatology Research Alliance (CARRA) criteria for treatment failure. Results Forty-four children and adolescents were recruited. Demographics in terms of age of onset, gender and number of sites were similar to those previously reported. Overall, 18/44 (40.9%) had extraosseous manifestations associated with CNO; 12/44 (27.2%) had cutaneous involvement. All patients received a regular nonsteroidal anti-inflammatory drug (NSAID) after diagnosis with 27/44 (61.4%) requiring at least 1 second-line medication. Second-line agents used in this cohort were bisphosphonates, methotrexate and TNF-blockers. No patients received systemic corticosteroids. Conclusion This national cohort showed a high prevalence of extraosseous involvement and a low response rate to NSAID treatment. This may reflect a more inflammatory phenotype and highlights the need to define different subtypes of CNO.

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