scholarly journals Lack of Effect of GnRH Agonists on Final Height in Girls with Advanced Puberty: A Randomized Long-Term Pilot Study

1999 ◽  
Vol 84 (10) ◽  
pp. 3575-3578 ◽  
Author(s):  
C. Bouvattier ◽  
J. Coste ◽  
D. Rodrigue ◽  
C. Teinturier ◽  
J. C. Carel ◽  
...  

Abstract GnRH agonists improve final height in girls with “true” precocious puberty. To test if a comparable effect can be obtained in older girls, we performed a long-term controlled study in 30 caucasian girls whose puberty started between 8.4 and 10 yr (9.4 ± 0.1 yr), a variant of normal called “advanced” puberty. At entry into trial, these girls had clinical, biological, and sonographic manifestations of puberty and a bone age greater than 10.9 yr. They were randomized 2:1 to receive 3.75 mg triptorelin im every 4 weeks for 2 yr (n = 20, group I) or no treatment (n = 10, group II). Mean height at inclusion was 135.2 ± 4.3 cm (+0.6 sds) in group I, 136.1 ± 4.2 cm (+0.8 sds ) in group II, with target height 157.6 ± 4.3 cm (group I) and 157.8 ± 4.7 cm (group II), and predicted height (Bayley-Pinneau) 154.1 ± 3.9 cm and 155.2 ± 3.7 cm. Although GnRH agonists transiently delayed sexual maturation as well as bone age and growth rate, they had no clear-cut long-standing effect, and final height was comparable in treated (157.6 ± 4.0 cm) and untreated girls (156.1 ± 5.3 cm) (NS).

1986 ◽  
Vol 113 (4_Suppl) ◽  
pp. S157-S163 ◽  
Author(s):  
K.W. KASTRUP ◽  
_ _

Abstract Early therapy with a low dose of estrogen (estradiol-17β) was given to 33 girls with Turner's syndrome (T.s.) for a period of 4 years. The dose (0.25-2 mg/day) was adjusted every 3 months to maintain plasma estradiol in the normal concentration range for bone age. Growth velocity was compared with that of untreated girls with T.s. All girls were above age 10 years. Bone age was below 10 years in 11 girls (group I) and above 10 years in 22 girls (group II). Growth velocity in the first year of treatment in group I 7.5 ± 1.3 cm (SD) with mean SD score (SDS) of +4.3 and in group II 4.9 ± 1.3 with mean SDS of +3.5. Growth velocity decreased in the following years to 1.6 ± 1.0 cm, SDS -1.44 in group I and 0.9 ± 0.6cm, SDS -2.34 in group II during the fourth year. Withdrawal bleeding occurred in 16 girls of group II after the mean of 23 (range 15-33) months and in 3 girls of group I after 15 to 51 months of treatment. The treatment did not cause an inappropriate acceleration of pubertal development. Breast development appeared in most girls by 3 months of treatment. Pubic hair appeared by 12 months of treatment in group I; it was present in most girls in group II at start of treatment. Final height is known for 12 girls of group II; it was 144.2 ± 4.5 cm. The final height as predicted at the start of therapy was 142.2 ± 5.3 cm. Bone age advanced in the first year of treatment by 2 years. Early treatment with small doses of estrogens induces a growth spurt and normalizes the events of puberty. This will presumably decrease the psychological risks associated with abnormally delayed development.


2001 ◽  
Vol 86 (10) ◽  
pp. 4711-4716 ◽  
Author(s):  
Karen Oerter Klein ◽  
Kevin M. Barnes ◽  
Janet V. Jones ◽  
Penelope P. Feuillan ◽  
Gordon B. Cutler Jr.

We report 98 children who have reached final adult height in a long-term trial of LHRH agonist treatment. These children were 5.3± 2.1 yr old at the start of treatment and were treated with either deslorelin (4 μg/kg·d sc) or histrelin (4–10 μg/kg·d) for an average of 6.1 ± 2.5 yr. Final height averaged 159.8 ± 7.6 cm in the 80 girls, which was significantly greater than pretreatment predicted height (149.3 ± 9.6 cm) but still significantly less than midparental height (MPH) (163.7 ± 5.6). Final height averaged 171.1 ± 8.7 cm in the 18 boys, which was significantly greater than pretreatment predicted height (156.1 ± 14.2 cm) but still significantly less than MPH (178.3 ± 5.2 cm). However, the average adult height of the 54 children who had less than a 2-yr delay in the onset of treatment was not significantly different from their MPH, and 21 children exceeded MPH. Final height sd score correlated positively with duration of treatment (P < 0.01), midparental height (P < 0.001), predicted height at the start of treatment (P < 0.001), and growth velocity during the last year of treatment (P < 0.001) and correlated inversely with delay in the onset of treatment (P < 0.001), age at the start of treatment (P < 0.001), bone age at the start of treatment (P < 0.001), bone age at the end of treatment (P < 0.001), breast stage at the start of treatment (P = 0.02), and bone age minus chronological age at the start of treatment (P = 0.001). We conclude that LHRH agonist treatment improves the final height for children with rapidly progressing precocious puberty treated before the age of 8 yr for girls or 9 yr for boys. Less delay in the onset of treatment, longer duration of treatment, and lower chronological and bone age at the onset of treatment all lead to greater final height. All children with onset of pubertal symptoms before age 8 in girls and age 9 in boys should be evaluated for possible treatment. Treatment is appropriate in children with rapidly progressing puberty, accelerated bone maturation, and compromise of adult height prediction, regardless of bone age or chronological age at time of evaluation. However, once treatment is considered appropriate, it should be initiated quickly, because longer delays lead to shorter final height. In addition, the longer the treatment is continued, the greater is the final height outcome.


Author(s):  
Lucia Schena ◽  
Cristina Meazza ◽  
Sara Pagani ◽  
Valeria Paganelli ◽  
Elena Bozzola ◽  
...  

AbstractBackground:In recent years, several studies have been published showing different responses to growth hormone (GH) treatment in idiopathic short stature children. The aim of the present study was to investigate whether non-growth-hormone-deficient (non-GHD) short children could benefit from long-term GH treatment as GHD patients.Methods:We enrolled 22 prepubertal children and 22 age- and sex-matched GHD patients, with comparable height, body mass index (BMI), bone age, and insulin-like growth factor 1 (IGF-I) circulating levels. The patients were treated with recombinant human GH (rhGH) and followed until they reach adult height.Results:During GH treatment, the two groups grew in parallel, reaching the same final height-standard deviation score (SDS) and the same height gain. On the contrary, we found significantly lower IGF-I serum concentrations in non-GHD patients than in GHD ones, at the end of therapy (p=0.0055).Conclusions:In our study, the response to GH treatment in short non-GHD patients proved to be similar to that in GHD ones. However, a careful selection of short non-GHD children to be treated with GH would better justify the cost of long-term GH therapy.


2021 ◽  
Vol 15 (6) ◽  
pp. 1227-1229
Author(s):  
R. Farooqi ◽  
T. Iqbal ◽  
M. S. Mehmood ◽  
Z. Y. Bhatti ◽  
F. Liaquat

Aim: To Compare frequency of sore throat in early post operative period among patients undergoing general anaesthesia and endotracheal intubation for abdominal surgeries who are given dexamethasone and normal saline. Study Design: Randomized controlled study Setting: Department of Anesthesia/ ICU, Sheikh Zayed Hospital, Lahore Duration of study: Six months i.e. 25-09-2009 to 25-03-2010. Methodology: 120 patients undergoing elective general surgery on abdomen were selected. They were divided into two groups. Group I received dexamethasone 8mg (2ml) I/V pre-operatively and group II received 2ml normal saline I/V pre-operatively. Chi square test was used. Visual analogue (VAS) scale was used for recording sore throat. The VAS score ≤4 was considered as no sore throat and VAS scores>4 were considered as the sore throat. Results: Frequency of post-operative sore throat after the first 24 hours following GA and endotracheal intubation was lower in group (I) as compared to the control group (II). Eleven (20%) patients with dexamethasone had post-operative sore throat compared to thirty one (56.3%) patients in control group. (p<0.01). Conclusion: Pre-operative use of dexamethasone was associated with decreased incidence of post-operative sore throat. Keywords: Visual analogue scale (VAS), Post-operative sore throat, general anesthesia


2003 ◽  
Vol 1 (3) ◽  
pp. 119-123 ◽  
Author(s):  
G. Ilonidis ◽  
G. Anogianakis ◽  
CH. Trakatelli ◽  
A. Anogeianaki ◽  
M. Chomatidis ◽  
...  

The effect of long-term treatment with sodium nedocromil on airway hypereactivity was investigated in two groups of 20 patients each. Group I patients presented with allergic asthma while Group II patients presented with intrinsic asthma. For each subject of the two groups, the base FEV1 was measured and nebulized methacholine was administrated in consecutively higher concentrations until a decrease in FEV1 of >20 % was observed. Following measurement, all patients included in the study were treated with 12 mg of sodium nedocromil per day for 12 months. At the end of the treatment, bronchial hyperreactivity was evaluated for a second time by administering the same dosage of methacholine that originally produced a decline in FEV1 of >20 %. In Group I patients (allergic asthma) mean FEV1 was 3126 ml, before challenge, while after methacholine challenge FEV1 was 2400ml. Following 1-year of sodium nedocromil administration the FEV1 was 2601ml (P<0.05). Before treatment, the mean fall in FEV1, following methacholine challenge, was 23.67% while following a 1-year-long sodium nedocromil administration this value reduced to 15.70% (P<0.05). Correspondingly, PC20 was 5.59 while after sodium nedocromil administration it increased to 11.66 (P<0.05). In Group II patients (intrinsic asthma) mean FEV1 was 2750 ml, before challenge, while after methacholine challenge FEV1 was 2066ml. Following 1-year of sodium nedocromil administration the FEV1 was 2223ml (P<0.05). Before treatment, the mean fall in FEV1, following methacholine challenge, was 27.65 % while following a 1-year-long sodium nedocromil administration this value reduced to 21.92 % (P<0.05). Correspondingly, PC20 was 5.91 while after sodium nedocromil administration it increased to 6.19 (P<0.05). The results suggest a positive effect of long-term sodium nedocromil administration in bronchial hyperreactivity for both groups of patients.


2003 ◽  
Vol 1 (1) ◽  
pp. 13-16
Author(s):  
G. Ilonidis ◽  
G. Anogianakis ◽  
Chr. Trakatelli ◽  
A. Anogeianaki ◽  
J. Giavazis ◽  
...  

Thirty subjects (20 female and 10 male), all allergic to the mites D. Pteronyssinus and D. Farinae, participated in the present study which covered a period of four years. The subjects were randomly divided in two groups. Group I included 10 female and 5 male subjects, with an average age of 25.8 (+/− 3.5) years who received immunotherapy only. Group II had an average age of 31.5 (+/− 4) years and they received immunotherapy along with fluticazone propionate (1000mcg/day). The protocol for immunotherapy was the same for both groups. The basis FEV1 was determined for each subject of both Groups I and II and afterwards they were subjected to provocation tests of nebulized methacholine solution administered in consecutively larger concentrations until a drop in FEV1 >20 % (PC20), was observed. Three years later, when their therapy was completed, all subjects were subjected to the same provocation test and a significant reduction in bronchial hyperactivity was documented for both groups. In particular, for Group I, the percentage of change in FEV1 values was 27.25 +/- 5.23 % and PC20 5.11 +/− 2.64 mg/ml before immunotherapy, while after immunotherapy the same indicators were 22.22 +/- 7.08 % (P<0.05) and 6.85 +/− 4.03 mg/ml, (P<0.05) respectively. For Group II, the percentage of change in FEV1 values was 26.28 +/− 2.5 % and PC20 5.42 +/− 2.5 mg/ml before immunotherapy, while after immunotherapy the same indicators were 12.27 +/- 2.49 % (P<0.01)and 11.64 +/− 5.14 mg/ml, P<0.01 respectively. It is concluded that although significant reduction in hyperreactivity can be achieved through immunotherapy, the combination of immunotherapy with daily fluticazone propionate administration shows the most promising results.


2021 ◽  
Vol 6 (4) ◽  
pp. 105-110
Author(s):  
Nadia Irshad Wani ◽  
Navneet Kour ◽  
Manju Verma

Background: the main idea behind the pulpotomy of a primary tooth is to remove the infected or inflamed coronal pulp tissues and cover the pulp with a suitable medicament or dressing which promotes healing and preserve the vitality of the teeth especially in young permanent teeth. A medicament should be biologically compatible, have healing capabilities, should be non cytotoxic, or mutagenic and with no carcinogenic potential. Aim: the main aim of the study was to compare and evaluate the efficacy of commonly used two medicaments i.e. formocresol and sodium hypochlorite in pulpotomy of mandibular primary teeth. Material and methodology: a randomized controlled single blinded clinical trial was done on 50 subjects of age ranging from 3 to 6 years with bilateral mandibular first or second molar requiring pulpotomy. The subjects were randomly divided into two groups with 25 subjects in each. Group I, consisted of subjects on which formocresol medicament was used after extirpation of coronal pulp while in Group II, 3% sodium hypochlorite was used. Clinical along with the radiographic signs and symptoms were blindly recorded at an interval of 1, 3, 6 and 12 months respectively. Results: Statistically significant results were obtained in group II, when patients treated with 3% sodium hypochlorite. There was no major difference between the two medicaments used, but to the various adverse effects of formocresol, its usage has been limited. Conclusion: within the limitation of the study, it was concluded that sodium hypochlorite medicament proved to have better prognosis and can be suggested as a pulpotomy agent for primary teeth. Although formocresol was found to have similar significant results can also be used as a medicament. Keywords: Formocresol, Pulpotomy, Primary Teeth, Sodium Hypochlorite


Author(s):  
Maksim V Sinitsyn ◽  
Nadezhda A Pozdeyeva ◽  
Nikolai P Pashtayev

ABSTRACT Purpose To comparatively analyze the intrastromal MyoRing implantation with femtosecond laser (FL) using the standard and optimized technologies in the experiment and based on the long-term clinical-functional results of the patients with keratoconus (KC) at stages II and III. Materials and methods The experimental work was performed on 24 eyes of rabbits. All eyes were divided into six groups according to the method of operation. In the clinical part of the research, the surgical treatment of 70 patients (76 eyes) with KC at stages II and III was done. Depending on the technology of the operation, all patients were divided into two groups. Group I consisted of 29 patients (32 eyes) with KC, in which MyoRing implantation was performed according to the standard, group II consisted of 31 patients (32 eyes) with KC, in which MyoRing implantation was performed according to the optimized technology. Results Higher voltage was required for stretching samples of the second group in comparison with the third and the sixth group in comparison with the fifth group. In group I, during the period of 6 to 36 months the surgery reverses keratometry, corneal thickness above the MyoRing, and posterior corneal elevation. In group II, 12 months after surgery the clinical and functional parameters remained stable throughout the period of observation. Conclusion Greater reduction in corneal biomechanical stability was observed after formation of the intrastromal pocket in comparison with an intrastromal tunnel; a more pronounced increase in the strength characteristics of the cornea was observed after implantation of the ring in intrastromal pocket, compared with implantation intracorneal segments in intrastromal tunnel, and with increasing depth of intrastromal ring implantation. Application of optimized MyoRing implantation technology compared with standard allows more biomechanical parameters of the cornea to improve and reduce the risk of the ring protrusion. How to cite this article Sinitsyn MV, Pozdeyeva NA, Pashtayev NP. Comparative Analysis of the Intrastromal MyoRing Implantation performed with the Femtosecond Laser. Int J Kerat Ect Cor Dis 2017;6(2):49-57.


2020 ◽  
Vol 25 (1) ◽  
pp. 33-38
Author(s):  
A. M. Soldatova ◽  
V. A. Kuznetsov ◽  
T. P. Gizatulina ◽  
L. M. Malishevsky ◽  
S. M. Dyachkov

Aim. To assess the relationship between the prolonged PR interval (≥200 ms) and the long-term survival of patients undergoing cardiac resynchronization therapy (CRT).Material and methods. A total of 85 patients (mean age — 55,1Ѓ}9,9 years; men — 81,2%) with NYHA class II-IV heart failure (HF) were examined. The mean follow-up was 34,0Ѓ}21,2 months. Patients with PR<200 ms (n=52) made up group I, with PR≥200 ms (n=33) — group II. Then the patients were divided into subgroups depending on the QRS duration: ≥150 ms (n=33 in group I and n=14 in group II, respectively) <150 ms (n=19 in group I and n=19 in group II, respectively).Results. In patients of group II, a history of myocardial infarction (MI) was more often registered (p=0,005), left ventricular ejection fraction (LVEF) was lower (p=0,032). In a multivariate analysis, MI (OR 3,217; CI 95% 1,188-8,712; p=0,022) and LVEF value (OR 0,869; CI 95% 0,780-0,968; p=0,011) had a significant relationship with the PR interval prolongation (≥200 ms). The survival of patients of group I was 59,6%, group II — 18,2% (Log-rank test p<0,001). According to Cox regression model, the initial left ventricle end-systolic volume (OR 1,012; 95% CI 1,006-1,017; p<0,001), inferior wall MI (OR 1,690; 95% CI 1,131-2,527; p=0,011) and PR interval ≥200 ms (OR 2,179; 95% CI 1,213–3,915; p=0,009) were associated with long-term mortality. In patients with PR≥200 ms, survival rate was low, regardless of the QRS duration (21,4% in patients with QRS≥150 ms, 15,8% in patients with QRS<150 ms; Log-rank test p=0,698) In patients with PR<200 ms, the survival rate of patients with QRS≥150 ms was 72,7%, and for patients with QRS<150 ms — 36,8% (Log-rank test p=0,031).Conclusion. In HF patients, PR interval prolongation (≥200 ms) is associated with long-term mortality increase. The highest survival rates were observed in patients with PR<200 ms and QRS≥150 ms. In patients with QRS≥150 ms, the presence of PR≥200 ms should be considered as an additional criterion for CRT.


2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Mario Gruppo ◽  
Francesca Tolin ◽  
Boris Franzato ◽  
Pierluigi Pilati ◽  
Ylenia Camilla Spolverato ◽  
...  

Background. Although mortality and morbidity of pancreatoduodenectomy (PD) have improved significantly over the past years, the impact of age for patients undergoing PD is still debated. This study is aimed at analyzing short- and long-term outcomes of PD in elderly patients. Methods. 124 consecutive patients who have undergone PD for pancreas neoplasms in our center between 2012 and 2017 were analyzed. Patients were divided into two groups: group I (<75 years) and group II (≥75 years). Demographic features and intraoperative and clinical-pathological data were collected. Primary endpoints were perioperative morbidity and mortality; complications were classified according to the Clavien-Dindo Score. Secondary endpoints included feasibility of adjuvant treatment and overall survival rates. Results. A total of 106 patients were included in this study. There were 73 (68.9%) patients in group I and 33 (31.1%) in group II. Perioperative deceases were 4 (3.6%), and postoperative pancreatic fistulas were 34 (32.1%). Significant difference between two groups was demonstrated for the ASA Score (p=0.004), Karnofsky Score (p=0.025), preoperative jaundice (p=0.004), and pulmonary complications (p=0.034). No significance was shown for diabetes, radicality of resection, stage of disease, operative time, length of stay, postoperative complications according to the Clavien-Dindo Score, postoperative mortality, pancreatic fistula, and reoperation rates. 69.9% of the patients in group I underwent adjuvant treatment vs. 39.4% of the older ones (p=0.012). Mean overall survival was 28.5 months in group I vs. 22 months in group II (p=0.909). Conclusion. PD can be performed safely in elderly patients. Advanced age should not be an absolute contraindication for PD, even if greater frailty should be considered. The outcome of elderly patients who have undergone PD is similar to that of younger patients, even though adjuvant treatment administration is significantly lower, demonstrating that surgery remains the main therapeutic option.


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