Constitutional delay of growth and adolescence. Results of short-term and long-term treatment with GH

1992 ◽  
Vol 127 (5) ◽  
pp. 392-396 ◽  
Author(s):  
Jürgen R Bierich ◽  
Klaus Nolte ◽  
Konrad Drews ◽  
Gerd Brügmann
Keyword(s):  
Adult Height ◽  
Final Height ◽  
Term Treatment ◽  
Term Therapy ◽  
Short Term ◽  
Gh Treatment ◽  
Long Term Treatment ◽  
Constitutional Delay ◽  
Long Term Therapy

During recent years numerous reports on the favourable results of short-term trials with GH in patients with constitutional delay of growth and adolescence (CDGA) have been published, but it has been unclear whether such treatment affects final height. In the present study, the results of long-term therapy with GH in replacement doses have been evaluated in 15 patients who were treated with GH for several years (three years on average). At the start of treatment, 10 of the children were prepubertal and 5 were in puberty. All patients were followed up until final height was reached. Mean final height of the 13 male patients was 170.0±4.4 cm, i.e. −1.58 sds. In the two female patients, final height was 150.0 cm (−3.5 sds) and 164.0cm (−0.8 sds), respectively. Adult height of the patients lagged behind target height by 5.4±3.2 cm (mean±sd), Measured adult height corresponded to adult height as predicted prior to treatment. In conclusion, GH treatment of patients with CDGA did not increase final height.

Aspects of Long-Term Treatment with Neuroleptics Historical and Literature Review—Personal Experience with Fluspirilene and Penfluridol

1975 ◽  
Vol 3 (2) ◽  
pp. 114-124 ◽  
Author(s):  
Lucian Floru
Keyword(s):  
Side Effects ◽  
Literature Review ◽  
Personal Experience ◽  
Term Treatment ◽  
Term Therapy ◽  
Tabular Form ◽  
Long Term Effects ◽  
Long Term Treatment ◽  
Long Term Therapy

The literature on neuroleptics with substance-specific long-term effects (fluspirilene, penfluridol) is reviewed in tabular form. This is followed by a report of personal investigations on 76 schizophrenics who were treated with fluspirilene initially within the hospital and later on an out-patient basis, on 86 patients who were treated with it exclusively at the out-patients' department, as well as on 123 schizophrenic psychoses treated with penfluridol in the out-patients' department. The side-effects caused by the two substances are compared. Pre-requisites for effective long-term therapy with a few complications are discussed.

Secondary myelodysplastic syndrome following long-term treatment with azathioprine in patients with multiple sclerosis

2006 ◽  
Vol 12 (3) ◽  
pp. 363-366 ◽  
Author(s):  
Norman Putzki ◽  
Sabine Knipp ◽  
T im Ramczykowski ◽  
Susanne Vago ◽  
Ulrich Germing ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Term Treatment ◽  
Immunosuppressive Drug ◽  
Term Therapy ◽  
Secondary Myelodysplastic Syndrome ◽  
Long Term Treatment ◽  
Complete Blood Counts ◽  
Long Term Therapy ◽  
Dose Dependent

Azathioprine (Aza) is a widely used immunosuppressive drug in multiple sclerosis (MS) treatment. Recently, the incidence of secondary myelodysplastic syndromes (sMDS) associated with a poor prognosis was found to be elevated in patients treated with Aza for non-malign disorders. Three hundred and seventeen MS patients were retrospectively analysed and complete blood counts were examined for those exposed to Aza. We identified one case of sMDS (cumulative dose 627 g) in a young patient and two further malignancies (cumulative doses 27 g and 54 g) in the Aza group ( n=81; 3.7%). In the non-Aza ( n=236) group, five malignancies (2.1%, P=0.419) were identified. Including our patient, four cases of sMDS after long-term Aza therapy in MS have been reported so far. Cases suggest a time- and dose-dependent risk of sMDS in long-term therapy of MS with Aza. Long-term Aza therapy needs careful monitoring.

Practical Aspects of Long-Term Treatment with Lithium

1992 ◽  
Vol 6 (2_suppl) ◽  
pp. 330-333 ◽  
Author(s):  
Iain Glen
Keyword(s):  
Lithium Treatment ◽  
Depressive Illness ◽  
Term Treatment ◽  
Term Therapy ◽  
Manic Depressive Illness ◽  
Short Term Treatment ◽  
Manic Depressive ◽  
Long Term Treatment ◽  
Long Term Therapy

There is no increase in the overall mortality of patients undergoing long-term lithium treatment compared with those receiving short-term treatment. Lithium causes a reduction in the incidence of suicide in patients suffering from manic depressive illness. Long-term treatment with lithium is more effective than treatment with imipramine or amitriptyline. Drug interactions may cause problems during long-term therapy with lithium. A reduction in plasma levels of lithium should be considered in stable patients on long-term prophylaxis. Discontinuation of therapy often results in a relapse. The toxicity of lithium is related to its effects on calcium transport.

scholarly journals Dynamics of bone turnover in children with GH deficiency treated with GH until final height

2000 ◽  
pp. 549-556 ◽  
Author(s):  
GI Baroncelli ◽  
S Bertelloni ◽  
C Ceccarelli ◽  
D Cupelli ◽  
G Saggese
Keyword(s):  
Growth Rate ◽  
Bone Turnover ◽  
Final Height ◽  
Term Treatment ◽  
Bone Marker ◽  
First Year ◽  
Type I ◽  
Gh Treatment ◽  
Long Term Treatment

OBJECTIVE: To examine the dynamics of bone turnover in children with growth hormone deficiency (GHD) during long-term treatment. DESIGN: We longitudinally measured growth velocity and serum concentrations of osteocalcin (OC), carboxyterminal propeptide of type I procollagen (PICP), and cross-linked carboxyterminal telopeptide of type I collagen (ICTP) in 24 patients with GHD during long-term GH treatment until final height (age: 7.7+/-0.7 and 16.9+/-0.5 years at baseline and at final height respectively). RESULTS: At baseline, OC, PICP, and ICTP levels were significantly (P<0.0001) reduced in comparison with prepubertal bone age-matched controls (10.2+/-2.3 microgram/l and 22.5+/-7.6 microgram/l; 187.8+/-26.2 microgram/l and 328. 4+/-74.3 microgram/l; 7.7+/-2.0 microgram/l and 14.2+/-1.3 microgram/l respectively). During the first year of treatment mean levels of the bone markers increased significantly (P<0.0001) with a peak at 12 months. After the first year of treatment, OC and PICP levels progressively declined, whereas ICTP levels remained stable until the final height; in any case, bone marker levels remained significantly higher (P<0.03-P<0.0001) than baseline. The change in bone marker levels at 6 and 12 months of treatment with respect to the baseline values was not related to growth rate during long-term treatment or final height. CONCLUSIONS: The results show that children with GHD have reduced bone turnover at baseline, and that long-term GH treatment is associated with a stimulation of bone turnover. OC, PICP, and ICTP do not predict growth rate during long-term treatment or final height in children with GHD.

scholarly journals Effect of bisoprolol on central aortic systolic pressure in Chinese hypertensive patients after the initial dose and long term treatment

2021 ◽  
Author(s):  
Weiwei Zeng ◽  
Brian Tomlinson
Keyword(s):  
Systolic Pressure ◽  
Early Response ◽  
Term Treatment ◽  
Chinese Patients ◽  
Term Therapy ◽  
Open Label ◽  
Long Term Treatment ◽  
Highly Correlated ◽  
Long Term Therapy

We conducted a prospective open-label cohort study with the aim of examining the effects of the highly β1-selective agent bisoprolol on central aortic systolic pressure (CASP) after the first dose and after 6 weeks’ treatment and whether the CASP response could be predicted from the early response. Chinese patients with primary hypertension (BP ≥ 140/90 mmHg) on no therapy or background amlodipine were treated with bisoprolol 2.5 mg daily for 6 weeks. Brachial systolic BP (Br-SBP), resting heart rate (HR) and CASP were determined at baseline, 24h after the first dose, and pre-dose after treatment for 6 weeks using the BPro® device. In 42 patients (age 54 ± 9 years) the mean reductions in CASP and Br-SBP after 6 weeks of treatment were not significantly different from each other at -14.5 ± 12.7 and -15.4 ± 12.9 mmHg (both p<0.01), respectively. Changes in CASP and Br-SBP were highly correlated after the first dose (r = 0.964, p<0.01) and after 6 weeks (r = 0.963, p<0.01) and the reductions in CASP after 6 weeks were also associated with the reduction in CASP after the first dose (r = 0.577, p<0.01). Bisoprolol was shown to effectively reduce CASP and this effect was directly proportional to the reduction in Br-SBP and of a similar magnitude. More favourable CASP responses to long term therapy may be predicted by greater reductions in CASP after the first dose.

scholarly journals Adult Height in Patients with Permanent Growth Hormone Deficiency with and without Multiple Pituitary Hormone Deficiencies

2006 ◽  
Vol 91 (8) ◽  
pp. 2900-2905 ◽  
Author(s):  
Mohamad Maghnie ◽  
Linda Ambrosini ◽  
Marco Cappa ◽  
Gabriella Pozzobon ◽  
Lucia Ghizzoni ◽  
...  
Keyword(s):  
Adult Height ◽  
Gh Deficiency ◽  
Final Height ◽  
Tolerance Test ◽  
Term Treatment ◽  
Hormone Deficiency ◽  
Pituitary Hormone ◽  
Gh Treatment ◽  
Long Term Treatment ◽  
Height Gain

Abstract Context: It has been reported that patients with multiple pituitary hormone deficiencies (MPHDs) achieve a greater final height, compared with patients with isolated GH deficiency (IGHD). However, the outcome of patients with permanent GH deficiency (GHD) has not yet been reported. Objectives: The objectives of the study were to evaluate and compare adult height data and the effect of spontaneous or induced puberty after long-term treatment with GH in young adults with either permanent IGHD or MPHD. Design and Setting: This was a retrospective multicenter study conducted in university research hospitals and a tertiary referral endocrine unit. Patients and Methods: Thirty-nine patients with IGHD (26 males, 13 females) and 49 with MPHD (31 males, 18 females), diagnosed at a median age of 7.7 and 6.9 yr, respectively, were reevaluated for GH secretion after adult height achievement (median age 17.6 and 19.8 yr). The diagnosis of permanent GHD was based on peak GH levels less than 3 μg/liter after an insulin tolerance test or peak GH levels less than 5 μg/liter after two different tests. Fifteen subjects had idiopathic GHD and seventy-three had magnetic resonance imaging evidence of congenital hypothalamic-pituitary abnormalities. Height sd score (SDS) was analyzed at diagnosis, the onset of puberty (either spontaneous or induced), and the time of GH withdrawal. Results: The subjects with IGHD entered puberty at a median age of 12.6 yr (females) and 13.4 yr (males). Puberty was induced at a median age of 13.5 and 14.0 yr, respectively, in males and females with MPHD. Median height SDS at the beginning of puberty was similar in the IGHD and MPHD subjects. Total pubertal height gain was similar between patients with IGHD or MPHD. Median adult height was also not significantly different between IGHD and MPHD patients (males, 168.5 vs. 170.3 cm; females, 160.0 vs. 157.3 cm). The adult height SDS of the IGHD subjects was positively correlated with height at the time of diagnosis and with total pubertal height gain. Conversely, the adult height SDS of the MPHD subjects was positively correlated with both the duration of GH treatment and height SDS at the time of GHD diagnosis. Conclusions: Adult height in patients with permanent IGHD and spontaneous puberty is similar to adult height in patients with MPHD and induced puberty.

The long-term management of depression

1995 ◽  
Vol 9 (2_suppl) ◽  
pp. 191-198 ◽  
Author(s):  
Roger Lane
Keyword(s):  
Unipolar Depression ◽  
Term Treatment ◽  
Term Therapy ◽  
Continuation Therapy ◽  
Treatment Of Depression ◽  
Long Term Treatment ◽  
The Uk ◽  
Long Term Therapy ◽  
Term Management

The long-term outlook for patients with unipolar depression is often poor. As few as one-fifth will remain well and a similar number will suffer chronic depression. It is now standard practice to extend acute treatment into a 4–6 month period of continuation therapy, and the value of prophylactic treatment over longer periods is becoming more widely recognised. Care must, however, be exercised in choosing suitable long-term treatment. Relatively little work on the prophylactic efficacy of the tricyclic antidepressants has been carried out, although imipramine has been shown to be effective. The selective serotonin re-uptake inhibitors (SSRIs) have been studied extensively and may be the most suitable long-term treatment for depression. Sertraline is effective in preventing both relapse and recurrence of depression and was the first agent specifically indicated for the long-term treatment of depression in the UK. In addition to clinical efficacy, many other factors favour SSRIs in the long-term management of depression. The tolerability of a drug is of major importance in long-term therapy since it affects compliance. Other important considerations include toxicity, safety in overdose, drug interaction potential, psychomotor effects and accident liability.

Long-Term Treatment Goals: Enhancing Healthy Outcomes

CNS Spectrums ◽  
2003 ◽  
Vol 8 (S2) ◽  
pp. 26-28 ◽  
Author(s):  
Daniel E. Casey
Keyword(s):  
Psychosocial Functioning ◽  
Term Treatment ◽  
Term Therapy ◽  
Treatment Goals ◽  
Functional Rehabilitation ◽  
Long Term Treatment ◽  
Persons With Schizophrenia ◽  
Long Term Therapy ◽  
New Antipsychotics

ABSTRACTThe long-term management of schizophrenia with a goal of functional rehabilitation remains an enormous challenge to clinicians despite improvements in drug therapy, psychosocial treatments, and family and community interventions. The goals of long-term therapy are to preserve the gains made during acute treatment, prevent symptom exacerbation, enhance psychosocial functioning, and improve quality of life. Schizophrenia is an illness that disrupts broad areas of mental function, including thought, cognition, affect, and motor performance. The new antipsychotics should aid physicians in meeting higher treatment goals for persons with schizophrenia. These agents combine high efficacy with improved tolerability, mainly through a low liability for extrapyramidal symptoms and probably improve cognitive affect. Recent studies have demonstrated efficacy of these new antipsychotics in improving psychopathology and symptoms and in preventing relapse during long-term use. These drugs are likely to provide physicians with an increasingly viable option in the long-term treatment and rehabilitation of patients with schizophrenia.

scholarly journals Successful management of Kaposiform Hemangioendothelioma with long-term sirolimus treatment: a case report and review of the literature

2018 ◽  
Vol 10 (1) ◽  
pp. e2018043 ◽  
Author(s):  
Matteo Chinello ◽  
Daniela Di Carlo ◽  
Francesca Olivieri ◽  
Rita Balter ◽  
Massimiliano De Bortoli ◽  
...  
Keyword(s):  
Initial Response ◽  
Term Treatment ◽  
Term Therapy ◽  
Published Data ◽  
Retrospective Case ◽  
Kaposiform Hemangioendothelioma ◽  
Long Term Treatment ◽  
Life Threatening ◽  
Long Term Therapy

Background: Kaposiform Hemangioendothelioma (KHE) is a rare vascular tumour of the infancy and of the first decade of life. It is locally aggressive and potentially life threatening when associated to consumptive coagulopathy, known as Kasabach-Merritt syndrome (KMS). No consensus or guideline for the therapy has been reached because of the lack of prospective trials and the different standard care suggestions are based on retrospective case series.Case report: We report the case of a 9-month-old male with KHE and KMS in which the initial response, obtained with prednisone and vincristine, was subsequently consolidated and strengthened by long-term treatment with sirolimus, an mTOR inhibitor. A summary of the published data is presented as well.Conclusions: The inhibition of mTOR pathway represents the most important therapeutic innovation introduced in the last few years for KHE. Our case shows the effectiveness and good tolerance of long-term therapy with sirolimus.Keywords: Kaposiform Hemangioendothelioma, Kasabach-Merrit syndrome, sirolimus, prednisone, vincristine

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