ISSN:1068-3097    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1068-3097    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1068-3097    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1068-3097    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1068-3097    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Endocrine dysfunction, especially disturbances of growth and adolescent development, is common in children surviving brain tumors. Growth failure is especially likely with cranial irradiation and worse with craniospinal irradiation. The addition of chemotherapy to either modality further increases the severity of growth failure. Growth hormone treatment will increase the growth in children with growth hormone deficiency due to cranial or craniospinal irradiation, but a recent report suggests that final height outcome is poor despite growth hormone treatment. Cranial irradiation is also associated with both precocious puberty and gonadotropin insufficiency. Effective therapy is available for both precocious puberty and sexual infantilism. In children with precocious puberty and growth hormone deficiency following brain tumor treatment, therapeutic efforts to improve adult height include using growth hormone while restraining pubertal development. At this time, data are not sufficient to know if final height will be improved in children with brain tumor treated with combined growth hormone and gonadotropin-releasing hormone analogues. The consensus of several studies is that children with brain tumors treated with growth hormone are not at increased risk for tumor recurrence. However, there are many issues not answered by the currently available data regarding the safety of growth hormone treatment in children surviving brain tumors.

ISSN:1068-3097    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Osteoporosis is one of the leading health problems in the United States. Approximately half of the peak bone mass is acquired by the end of the second decade of life, making puberty both a critical period for acquisition of bone mineral and an important determinant of future skeletal health. Peak bone mass is largely determined by genetic factors. However, body mass, diet, hormones, and physical activity can all influence bone mass. This paper reviews the recent literature on normal bone acquisition during adolescence.

ISSN:1068-3097    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Multiple endocrine neoplasia types 1 and 2 (MEN 1 and MEN 2) are autosomal dominant disorders characterized by hyperparathyroidism; pituitary and islet cell tumors (MEN 1); and medullary thyroid cancer, pheochromocytoma, and hyperparathyroidism (MEN 2). Although there are two different mechanisms of tumorigenesis, these syndromes share some characteristics. Tumors are multicentric, recurrence is common, and treatment is difficult, a lifetime commitment. The identification of genetic loci for the MEN syndromes has ushered in a new era of diagnosis and treatment. MEN 1 has been mapped to chromosome 11q13 and genetic diagnosis is possible by linkage approaches. The mapping of the MEN 2 gene to chromosome 10q11.2 and identification of c-ret protooncogene mutations causative for this disorder have revolutionized the clinical approach to treatment of gene carriers. Better understanding of pathogenesis and early identification of carriers will likely improve outcome.

ISSN:1068-3097    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Turner syndrome affects approximately one in 2500 live female births. Although these patients have variable physical anomalies, nearly universal findings include short stature and ovarian failure. Final height data are just becoming available from worldwide studies investigating the effects of recombinant human growth hormone in Turner syndrome. We discuss the recent literature on final height after human growth hormone therapy, with reported gains of up to 8 to 10 cm over initial projected height. Response is augmented by the use of oxan-drolone therapy and may be compromised if estrogen therapy is initiated prematurely. We also discuss the importance of estrogen replacement therapy in women with Turner syndrome for optimal skeletal health, the difficulties in accurate interpretation of bone density data in Turner syndrome patients, and the controversy over whether estrogen is solely responsible for the apparent osteopenia. Minimal information has been published regarding body composition in Turner syndrome patients.

ISSN:1068-3097    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The term non-growth hormone deficient short stature is used to describe short children who have stimulated growth hormone levels above an arbitrary limit that was defined when the supplies of growth hormone were limited. The limit was set to give priority to the most severe cases of growth hormone deficiency. The treatment of short children with conventional dosages of growth hormone who have stimulated growth hormone levels above the limit, and who therefore do not meet the classic definition of growth hormone deficiency, results in acceleration of the rate of growth in most. The mean response to growth hormone in this group is somewhat less than to that observed in children with classic growth hormone deficiency. The group of children with non-growth hormone deficient short stature includes children with several clinical diagnoses. Some have limited genetic potential for height and limited ability to respond to growth hormone, resulting in either no response or a decrease in height velocity to pretreatment levels after several years of treatment. A comparison of mean height velocities between growth hormone-deficient and non-growth hormone deficient children may obscure the positive effect that is seen in most children with continued growth hormone therapy. None of the measures of growth or parameters of growth hormone secretion or action are sufficient to predict which children will respond to growth hormone therapy. At this time a clinical trial of growth hormone is the only reliable indicator of response, but such an attempt should not be made outside of controlled clinical trials. Growth hormone therapy is essentially without risk in this group, so the issue is costs versus benefits. The cost-benefit question may become less important in the future with treatments that rely on endogenous growth hormone production.

ISSN:1068-3097    

出版商:OVID    

年代:1997

数据来源: OVID