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- Albertsson-Wikland, Kerstin, 1947, et al.
(författare)
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Growth hormone dose-dependent pubertal growth : a randomized trial in short children with low growth hormone secretion
- 2014
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Ingår i: Hormone Research in Paediatrics. - : S. Karger AG. - 1663-2818 .- 1663-2826. ; 82:3, s. 158-170
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Growth hormone (GH) treatment regimens do not account for the pubertal increase in endogenous GH secretion. This study assessed whether increasing the GH dose and/or frequency of administration improves pubertal height gain and adult height (AH) in children with low GH secretion during stimulation tests, i. e. idiopathic isolated GH deficiency.Methods: A multicenter, randomized, clinical trial (No. 88-177) followed 111 children (96 boys) at study start from onset of puberty to AH who had received GH(33) mu g/kg/day for >= 1 year. They were randomized to receive 67 mu g/kg/day (GH(67)) given as one (GH(67x1); n = 35) or two daily injections (GH(33x2); n = 36), or to remain on a single 33 mu g/kg/day dose (GH(33x1); n = 40). Growth was assessed as height SDS gain for prepubertal, pubertal and total periods, as well as AH SDS versus the population and the midparental height.Results: Pubertal height SDS gain was greater for patients receiving a high dose (GH(67), 0.73) than a low dose (GH(33x1), 0.41, p < 0.05). AH(SDS) was greater on GH(67) (GH(67x1), -0.84; GH(33x2), -0.83) than GH(33) (-1.25, p < 0.05), and height SDS gain was greater on GH(67) than GH(33) (2.04 and 1.56, respectively; p < 0.01). All groups reached their target height SDS.Conclusion: Pubertal height SDS gain and AH SDS were dose dependent, with greater growth being observed for the GH(67) than the GH(33) randomization group; however, there were no differences between the once-and twice-daily GH(67) regimens. (C) 2014 S. Karger AG, Basel.
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| 2. |
- Chaplin, John, 1955, et al.
(författare)
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Improvements in Behaviour and Self-Esteem following Growth Hormone Treatment in Short Prepubertal Children
- 2011
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Ingår i: Hormone Research in Paediatrics. - : S. Karger AG. - 1663-2818 .- 1663-2826. ; 75:4, s. 291-303
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: To evaluate effects of growth hormone (GH) treatment on behaviour and psychosocial characteristics in short-stature children. Methods: 99 referred prepubertal non-familiar short-stature children (32 GH deficiency; 67 idiopathic short stature) aged 3-11 years, randomized to fixed or individual GH doses and their parents completed questionnaires (Child Behaviour Checklist, Birleson Depression Self-Report Scale, Abbreviated Parent-Teacher Questionnaire, I Think I Am, Well-Being Visual-Analogue Scales for Short-Stature Children) at baseline (BL) and after 3, 12, and 24 months. Results: At BL, children showed higher levels of internalizing behaviour (p < 0.001), lower levels of externalizing behaviour (p < 0.006) and self-esteem (p < 0.001) compared to reference values. During GH treatment, behavioural measures (p < 0.001) and depression (p < 0.01) changed towards the mean of the population within the first 3 months and remained improved to 24 months. Self-esteem improved at all time points (p < 0.001), and in all subgroups, as did well-being dimensions stability and mood (p < 0.05). Multiple regression analysis showed that greater improvements were related to lower BL value, height gain, higher maximal GH value, being older, and being male. Conclusion: On GH treatment, prepubertal short children significantly improved on behavioural, depression, and psychosocial evaluations over a 2-year period of GH treatment. Most change occurred within the first 3 months, which highlights this short period as important not only for growth and metabolic changes but also for behaviour and psychosocial improvements following GH treatment.
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| 3. |
- Elmund, Anna, et al.
(författare)
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Relation problems in internationally adopted juvenile delinquents
- 2007
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Ingår i: Upsala Journal of Medical Sciences. - 0300-9734 .- 2000-1967. ; 112:1, s. 105-121
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Internationally adopted delinquents are overrepresented in juvenile Swedish institutions. With the purpose of investigating possible reasons for this overrepresentation, this study compared adopted delinquent adolescents and internationally adopted controls in the structure and functioning of their current relations, especially with their parents. Methods: Internationally adopted adolescents admitted to institutional care (N=20) and non-delinquent internationally adopted controls (N=21) were compared through: a questionnaire; "family relations", a subscale in I think I am; "Family climate" ( from Karolinska Scale of Personality); Individual Schedule of Social Interaction; and an Attachment Test. Results: Bad relations with adoptive parents were more prevalent in internationally adopted delinquents compared to internationally adopted controls. Furthermore, the adopted delinquents and their parents blamed each other for the problems and the adopted delinquents reported physical and emotional abuse. Conclusions: Internationally adopted delinquents reported more problems in their relationships to their parents than adopted controls did.
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| 6. |
- Proos, Lemm A., 1943-, et al.
(författare)
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Increased perinatal intracranial pressure and brainstem dysfunction predict early puberty in boys with myelomeningocele
- 2011
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 100:10, s. 1368-1372
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Tidskriftsartikel (refereegranskat)abstract
- Background: Children with myelomeningocele (MMC) run an increased risk of developing early or precocious puberty (E/PP).Aim: To identify risk factors for E/PP in boys with MMC.Methods: Boys born between 1970 and 1992, treated for MMC at the University Children's Hospital, Uppsala, were identified. Thirty-eight boys were eligible to be included. Medical records were examined retrospectively. Early puberty was defined as pubertal signs before the age of 10 years and 2 months. Precocious puberty was defined as the appearance of these signs before 9 years of age. Increased intracranial pressure perinatally was defined as wide sutures, bulging fontanelles and increased/increasing head circumference at birth and/or during the first week after birth. Early brainstem dysfunction was defined as severe and persistent feeding and respiratory problems before the age of 3 months despite proper control of the hydrocephalus.Results: Of the 38 boys, 8 (21%) had E/PP, which was strongly associated with increased intracranial pressure perinatally and also with early brainstem dysfunction. Multivariate regression analysis showed early brainstem dysfunction to have the highest explanatory value regarding the occurrence of early puberty.Conclusion: Increased intracranial pressure perinatally and brainstem dysfunction early in life are strong predictors of E/PP in boys with MMC.
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| 7. |
- Proos, Lemm A., 1943-, et al.
(författare)
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Menarcheal age and growth pattern of Indian girls adopted in Sweden. I. Menarcheal age.
- 1991
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Ingår i: Acta paediatrica Scandinavica. - 0001-656X. ; 80:8-9, s. 852-8
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Tidskriftsartikel (refereegranskat)abstract
- The median menarcheal age of 107 girls adopted from India by families in Sweden was 11.6 years, which was significantly lower than in Swedish and most Indian studies. Five girls had menarche before the age of 9 years, the earliest at 7.3 years. Those who arrived at a later age had earlier menarche. No differences in menarcheal age were found with respect to geographic origin. The reasons for the earlier pubertal maturation are not clear. Factors associated with the rapid transition from an underprivileged to a privileged environment are probably involved, besides genetic determinants. The serious medical, social and emotional consequences of very early pubertal development necessitate further clarification of the underlying mechanisms.
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| 8. |
- Proos, Lemm A., 1943-, et al.
(författare)
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Menarcheal age and growth pattern of Indian girls adopted in Sweden. II. Catch-up growth and final height.
- 1991
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Ingår i: Indian Journal of Pediatrics. - 0019-5456 .- 0973-7693. ; 58:1, s. 105-14
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Tidskriftsartikel (refereegranskat)abstract
- Adopted girls (n = 107) previously studied regarding menarcheal age in relation to age at arrival, were analysed as to growth pattern and final height related to nutritional status at arrival and menarcheal age. It was found that most girls had catch-up growth regarding height and half of them regarding weight. Faster catch-up and later arrival age in Sweden were associated with earlier menarche. The catch-up growth was, however, incomplete, and lower the initial height for age, lower was the height for age at the succeeding measurements, and the final height. The mean final height was 154 cm, but 8% of the girls were 145 cm or shorter. The data suggest that linear growth and final height is influenced by the preadoptive nutritional condition, as well as by the degree and timing of subsequent catch-up growth, and the timing of puberty. Pubertal onset is related to the degree and timing of catch-up growth.
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