One year treatment with clonidine in children with constitutional growth delay.

The therapeutic potential of clonidine was evaluated in 112 prepubertal children with short stature, delayed bone age and a growth velocity of 4.1 +/- 0.4 cm/yr in boys and 4.2 +/- 0.5 cm/yr in girls. The alpha 2 agonist was orally administered at 0.075 mg/m2 to 51 boys and 39 girls over a period of at least one year, and the effect compared to a vitamin treatment given to 10 age matched boys and 12 age matched females showing similar growth velocities. After one year of treatment growth velocity was increased to 6.6 +/- 1.2 cm/yr in boys and 6.50 +/- 1.0 cm/yr in girls treated with the drug, whereas in those given vitamins only 4.9 +/- 0.7 cm/yr in boys and 5 +/- 0.6 cm/yr in girls was recorded. Bone age remained 1.5 +/- 0.3 yr behind chronological age in both vitamin and clonidine treated groups. If only the 65% of patients that show a growth velocity increment of more than 2 cm/yr are considered the growth velocity reaches 7.20 +/- 0.82 cm/yr in boys and 6.68 +/- 0.75 cm/yr in girls, indicating that clonidine may be a useful pharmacological agent in the treatment of some patients with constitutional growth delay. The remaining 35% patients do not show any significant increase in growth velocity.

[Relations between Sheehan's syndrome and empty sella turcica. A functional study apropos of 6 cases]. / Relación entre síndrome de Sheehan y silla turca vacía. Estudio funcional a propósito de 6 casos.

We evaluated six patients in whom a diagnosis of Sheehan's syndrome had been made. The plasma levels of the following hormones were measured: basal thyroxine (T4), estradiol and cortisol; and also follicle-stimulating hormone (FSH), luteinizing hormone (LH), growth hormone (GH), thyrotropin (TSH), prolactin (PRL) and adrenocorticotropic hormone (ACTH), basally and after acute challenge with LH releasing hormone (LHRH), GRF (1-29)NH2 or insulin hypoglycemia, TSH releasing hormone (TRH) and lysine-8-vasopressin, respectively. Two patients underwent chronic LHRH stimulation by pulsatile subcutaneous administration with infusion pump. In 4 cases, computed tomography (CT) was performed although cranial X-ray study was normal. A severe and generalized pituitary involvement was found in all patients, 3 of whom had diabetes mellitus. Probably, more insidious cases go unnoticed. The presence of asymptomatic partial empty sella (ES) in all the CTs that were carried out raises the possibility that it is another evolutive feature of SS.

[The pulsatile administration of LHRH in the differential diagnosis of hypogonadotropic hypogonadism]. / Administración pulsátil de LHRH en el diagnóstico diferencial de los hipogonadismos hipogonadotróficos.

The results of the pulsating administration of LHRH (APLHRH) using a portable infusion pumps of national fabrication (TECENSA-AIP-GZ) at doses of 18.2 mcq every 90 min., via subcutanea, in abdominal anterior wall are presented. This was carried out in order to localise the hypogonadotropic hypogonadism. There were statistically significant differences between the group of hypothalamic origin and that of hypophyseal origin after the APLHRH administration. In the first group named, the response patterns of LH and FSH were similar to those obtained in adults, while in the second group there was no response. These differences were not observed at basal conditions nor with acute stimuli of LHRH. We concluded, highlighting the efficacy of this test to diagnose the different types of hypogonadotropic hypogonadism.

[The dynamics of pulsatile LHRH (GnRH) secretion]. / Dinámica de la secreción pulsátil de LHRH (GnRH).

A review of the features of RHLH, especially of the pulsating secretion, which is very important to the correct function of the reproduction system, is presented. Now it is accepted that this pulsating secretion is the producer of the episodic release of gonadotrophins, the gonadal steroids being the modulator of the frequency and the extent of the LHRH pulses. Several experiences showed that changes in the pulse frequency of GnRH, can dynamically modify the seric concentration of LH and FSH.

[Occurrence and clinical characteristics of thyroid cancer in a hospital population]. / Frecuencia y características clínicas del cáncer de tiroides en una población hospitalaria

The authors reviewed 83.250 clinical histories from the files of a hospital, among which they found 49 thyroid carcinomas whose characteristics they study. It is interesting to note the great incidence of papilliferous carcinoma (53 per cent of cases); a most marked incidence of the condition in female patients; the slight difference in the age of the patients with all types of carcinoma; and, above all, the atypicity of the onset symptoms in a large number of cases (28 per cent). According to these data, the authors suggest that it is advisable to bare in mind the possibility of the presence of thyroid carcinoma in patients with such unmatched pictures as suppurative thyroiditis, sciatica or cervical adenopathy, with absence of goiter, etc.