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1.
J Pediatr ; 161(6): 1116-9, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22727870

RESUMEN

OBJECTIVE: To evaluate the association between recombinant human growth hormone (rhGH) treatment and intraocular pressure (IOP) in children. STUDY DESIGN: This is an observational cohort study including comparison between children treated with rhGH for at least 12 months (treatment group), matched children prior to treatment (control group), and population age-adjusted normograms of IOP. All children underwent an ocular slit lamp assessment and Goldmann applanation tonometry. Charts were reviewed for cause of therapy, peak stimulated growth hormone level prior to therapy, treatment duration, insulin-like growth factor 1, and rhGH dosage. RESULTS: The treatment group included 55 children and the control group included 24 children. Mean age at examination was comparable at 11.4 ± 3.3 years and 10.3 ± 2.6 years, respectively (P = .13). Mean treatment duration was 37.5 ± 22.8 months and mean rhGH dose was 0.04 ± 0.01 mg/kg/d. Mean IOP was significantly increased in the treatment group compared with the control group and compared with age-matched normograms (16.09 ± 2.2 mm Hg, 13.26 ± 1.83 mm Hg and 14.6 ± 1.97 mm Hg, respectively, P < .001). IOP was positively correlated with treatment duration (r = 0.559, P < .001) and rhGH dosage (r = 0.274, P = .043). CONCLUSION: IOP in children treated with rhGH is increased compared with a similar population without treatment and compared with healthy population normograms. IOP is associated with longer treatment duration and higher dosages.


Asunto(s)
Hormona de Crecimiento Humana/efectos adversos , Presión Intraocular/efectos de los fármacos , Hipertensión Ocular/inducido químicamente , Adolescente , Niño , Estudios de Cohortes , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Femenino , Hormona de Crecimiento Humana/administración & dosificación , Humanos , Masculino , Hipertensión Ocular/diagnóstico , Proteínas Recombinantes/administración & dosificación , Proteínas Recombinantes/efectos adversos , Estándares de Referencia , Método Simple Ciego , Factores de Tiempo , Tonometría Ocular/normas
2.
J Pediatr ; 160(2): 308-13, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-21907353

RESUMEN

OBJECTIVE: To assess the interrelationship between extent of adrenarche at presentation in girls with precocious adrenarche (PA) born appropriate for gestational age and their growth pattern, pubertal course and adult height. STUDY DESIGN: We reviewed clinical and laboratory data from medical charts of 85 girls with PA aged 5.0 to 8.8 years at referral, stratified in 3 subgroups according to bone age (BA) minus chronological age (CA) ≤0 years; 0 1 year. RESULTS: Extent of pubarche and dehydroepiandrosterone-sulfate levels were greatest in the BA-CA >1 subgroup (P=.02, P=.008, respectively), who also were taller at diagnosis (P=.002) and during childhood (P=.01). In all subgroups, pubertal onset was within normal range; menarche occurred earlier than in control subjects (P<.02); all attained adult height within their mid-parental height range. Predicted adult height was overestimated in girls with BA ≤CA (P=.04) and underestimated with BA-CA >1 (P<.001). CONCLUSIONS: Although a more pronounced adrenarche and BA advancement at diagnosis in girls with PA born appropriate for gestational age had an impact on their pre-pubertal growth pattern, it was not associated with early and rapid progression of puberty or reduced adult height. This reassuring clinical course indicates that PA is a benign condition, irrespective of the extent of adrenarche at presentation. Adult height prediction is unreliable in PA.


Asunto(s)
Glándulas Suprarrenales/crecimiento & desarrollo , Adrenarquia/fisiología , Estatura/fisiología , Edad Gestacional , Menarquia/fisiología , Adulto , Determinación de la Edad por el Esqueleto , Factores de Edad , Desarrollo Óseo/fisiología , Niño , Preescolar , Femenino , Humanos , Registros Médicos , Embarazo
3.
J Pediatr ; 156(3): 466-71, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-19914634

RESUMEN

OBJECTIVES: To determine whether age at premature thelarche (PT) onset affects the clinical characteristics, course, and risk of progression to precocious puberty (PP). STUDY DESIGN: Data regarding course of growth and puberty were retrieved from the medical files of 139 girls with PT followed up from 1995 to 2005. Analysis was based on age at PT appearance (birth, 1-24 months, and 2-8 years); course was categorized as regressive, persistent, progressive, or cyclic. RESULTS: At diagnosis, height standard deviation score, bone age-chronological age ratio, and hormonal values were comparable in the 3 age groups. PT regressed in 50.8%, persisted in 36.3%, progressed in 3.2% and had a cyclic course in 9.7%. A progressive or cyclic course was significantly more prevalent among girls presenting after 2 years (52.6%) compared with girls presenting at birth (13.0%) or at 1 to 24 months (3.8%) (P < .001). PP occurred in 13% irrespective of age at PT presentation or clinical course. CONCLUSIONS: Clinical and anthropometric characteristics at admission and risk of PP were similar in all girls with PT, regardless of age at onset. There are currently no clinical or laboratory tests that can predict the risk of progression to PP at presentation.


Asunto(s)
Mama/crecimiento & desarrollo , Pubertad Precoz/etiología , Edad de Inicio , Niño , Preescolar , Progresión de la Enfermedad , Femenino , Hormona Folículo Estimulante/sangre , Humanos , Lactante , Recién Nacido , Hormona Luteinizante/sangre , Remisión Espontánea , Factores de Riesgo
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