DEVELOPMENT AND IMPLEMENTATION OF A PROGRAM OF PERSONALIZED APPROACH TO THE MANAGEMENT OF PATIENTS WITH CONSTITUTIONAL DELAY OF GROWTH AND PUBERTY

2021 ◽  
Vol 100 (6) ◽  
pp. 121-132
Author(s):  
N.Yu. Filina ◽  
◽  
K.A. Cherednikova ◽  
N.V. Bolotova ◽  
A.P. Averyanov ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Randomized Study ◽  
Statistical Processing ◽  
Bone Age ◽  
Thyroid Stimulating Hormone ◽  
Psychological Status ◽  
Exact Test ◽  
Constitutional Delay ◽  
Personalized Approach ◽  
Stimulating Hormone

Objective of the study: development and implementation of a program of personalized approach to the tactics of managing patients with constitutional delay of growth and puberty (CDGP). Materials and methods of research: a prospective, single-center, randomized study. The article presents the results of a comprehensive examination of 100 adolescent boys, of which the main group (n=70) – boys with CDGP at the age of 14–14.5 years and the comparison group (n=30) – healthy boys of 14–15 years. Clinical (SDS growth, SDS body mass index, orchiometry), laboratory (insulin-like growth factor 1, testosterone, luteinizing hormone, follicle-stimulating hormone, inhibin B, anti-Müllerian hormone, kisspeptin, thyroid stimulating hormone, thyroxin, prolactin), instrumental indicators (bone age, bioimpedansometry), indicators of psychological status (assessment of the quality of life, anxiety level, aggression level, depression level). Statistical processing: Statistica (Version 7 – Index, Stat. Soft Inc., USA) and Microsoft Exel, 2010. The following criteria were used: Mann–Whitney tests, Fisher's exact test, correlation analysis – Spearman® coefficient. In order to develop the algorithm, factor analysis is applied. Results: it was shown that patients with CDGP had a marked lag behind healthy peers in terms of clinical, metabolic and neuroendocrine indicators of physical and sexual development. With the help of factor analysis of the data obtained, a program of a personalized approach to the tactics of managing patients with CDGP has been developed. Various clinical applications of the program are presented. The sensitivity of the proposed method was 74.63%, 95% CI [62.51; 84.47%]; specificity of the method – 93%, 95% CI [77.93; 99.18%]; the accuracy of the diagnostic method – 80.4%, 95% CI [71.11; 87.78%].

scholarly journals Assesment of Iodine Deficiency in Patients with Nodular Goiter Living in the Precarpatian Region

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Lilija Rybchak
Keyword(s):  
Iodine Deficiency ◽  
Randomized Study ◽  
Nodular Goiter ◽  
State Institution ◽  
Iodine Concentration ◽  
Thyroid Stimulating Hormone ◽  
The State ◽  
Average Value ◽  
Iodine Excretion ◽  
Stimulating Hormone

The objective of the research was to assess the state of iodine supply of patients with nodular goiter living in the Precarpathian region. Materials and methods: 56 patients with nodular goiter were examined (38 women and 18 men), the average age of patients was 48 years. WHO / UNICEF / ICCIDD guidelines were used to assess the severity of iodine deficiency: goiter frequency according to palpation and ultrasound examinations, median of iodine excretion in urine, thyroid-stimulating hormone (TSH) and thyroglobulin levels. Determination of iodine concentration in urine was conducted by the method of “blind”, closed randomized study in single portions of urine according to the Sandell-Kolthoff reaction by the method of Dunn et al. in the laboratory of epidemiology of endocrine diseases at  the State Institution “V.P. Komisarenko Institute of Endocrinology and Metabolism” (supervisor – Professor VI Kravchenko). Results. According to the results of the study of iodine in the urine, the data with an average value of 85.9 μg/l were obtained. The median of thyroglobulin serum was in the range of 12.27 ng/L. Levels of thyroid-stimulating hormone were average in patients with nodular goiter of I and II grades constituting 3.13 mU/l (table 2). The level of thyroglobulin median was noted to be the highest in patients with thyroid size corresponding to grade II. Conclusions. The results of the study of iodine in the urine of patients with nodular goiter of grades I and II living in the Precarpathian region indicated a mild level of iodine deficiency. The presence of iodine deficiency necessitated both mass (the use of iodized salt by the population) and individual iodine prevention (prescribing potassium iodide).

A Prospective, Randomized Study of Testosterone Treatment of Constitutional Delay of Growth and Development in Male Adolescents

PEDIATRICS ◽  
1982 ◽  
Vol 69 (6) ◽  
pp. 681-687
Author(s):  
Ron G. Rosenfeld ◽  
Gregory B. Northcraft ◽  
Raymond L. Hintz
Keyword(s):  
Growth And Development ◽  
Randomized Study ◽  
Social Activity ◽  
Bone Age ◽  
Testosterone Enanthate ◽  
Annual Increment ◽  
Male Adolescents ◽  
Androgen Treatment ◽  
Constitutional Delay ◽  
One Year

The physiologic and psychological responses to androgen treatment of constitutional delay of growth and development were prospectively evaluated in 16 male adolescents, aged 14 to 17 years. Subjects were randomly assigned to a course of testosterone enanthate, 200 mg administered intramuscularly four times at three-week intervals or to observation. At one-year follow-up all subjects in the testosterone group exhibited excellent growth: 7.2 to 11.6 cm/yr (mean 9.2 cm/yr). Growth in control subjects was highly variable: 2.6 to 10.6 cm/yr (mean 6.0 cm/yr), significantly lower than that of the testosterone group (P < .02). The mean annual increment in bone age was 1.1 years for both groups. The Δ height age/Δ bone age ratio was slightly higher in the testosterone group (1.3 vs 1.1), and the treated subjects had a 1.7-cm increase in predicted adult height. Both groups showed improved self-image, and treated subjects also exhibited dramatic increases in both school-related and extraschool social activity. A brief course of testosterone enanthate appears to be an effective, safe means of promoting growth in select male adolescents.

Hypothyroidism With Thyroxine-Binding Gobulin Excess

PEDIATRICS ◽  
1989 ◽  
Vol 84 (1) ◽  
pp. 197-197
Author(s):  
ALEXANDER K. C. LEUNG ◽  
ROBERT G. MCARTHUR
Keyword(s):  
Clinical Features ◽  
Recent Article ◽  
Bone Age ◽  
Thyroid Stimulating Hormone ◽  
Growth Delay ◽  
Normal Range ◽  
Thyroxine Binding Globulin ◽  
Serum Thyroxine ◽  
Developmental And Growth Delay ◽  
Stimulating Hormone

Since our letter was printed in January 1989, we have come across an additional example of thyroxine-binding globulin (TBG) excess associated with hypothyroidism. In a recent article, Menon reported the case of a 21-month-old boy with developmental and growth delay and other clinical features of hypothyroidism. Investigations confirmed the diagnosis of hypothyroidism: serum thyroxine (T4) 28 nmol/L (normal range 60 to 140 nmol/L), thyroid-stimulating hormone (TSH) 100 mU/L (normal range 2 to 10 mU/L), and bone age 4 months.

CLINICAL EVALUATION OF THE THYROID STIMULATING HORMONE ACTIVITY IN EXOPHTHALMOS

1961 ◽  
Vol 38 (4) ◽  
pp. 577-584 ◽  
Author(s):  
Sven Erik Björkman ◽  
Torsten Denneberg ◽  
Inge Hedenskog
Keyword(s):  
Clinical Evaluation ◽  
Thyroid Stimulating Hormone ◽  
Significant Rise ◽  
Hormone Activity ◽  
Control Subjects ◽  
Long Duration ◽  
Stimulating Factor ◽  
Stimulating Hormone

ABSTRACT A method for demonstrating the presence of a thyroid stimulating factor in the blood of patients with progressive exophthalmos after thyroidectomy or after treatment with radioiodine is described. The method consists of transfusing freshly drawn blood from the patients to euthyroid recipients and subsequently following the PBI level of the recipients at regular intervals. Six exophthalmic patients tested in this manner were found to have such a factor in their circulating blood. After transfusion of their blood a significant rise in the PBI level of the recipients could be demonstrated. Two other patients, one with exophthalmos of long duration did not show this response nor did it occur after transfusion of blood from two control subjects. In one case the action of this factor was compared with that of animal thyrotrophin and found to be of the same magnitude.

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