Disorders of Puberty - July 1, 1999 Jul 1, 1999 Table of Contents RICHARD D. BLONDELL, M.D., MICHAEL B. FOSTER, M.D., and KAMLESH C. DAVE, M.B.B.S., University of Louisville School of Medicine, Louisville, Kentucky Am Fam Physician. 1999 Jul 1;60(1):209-218. See related patient information handout on early and delayed puberty, written by the authors of this article. Normal puberty begins between eight and 14 years of age in girls and between nine and 14 years of age in boys. Puberty is a process leading to physical and sexual maturation that involves the development of secondary sexual characteristics as well as growth, changes in body composition and psychosocial maturation. Normal Development Two processes contribute to the physical manifestations of puberty: adrenarche and gonadarche. Pubertal Milestones in Girls Pubertal Milestones in Boys Evaluation of Abnormal Puberty The physical examination should focus on the neurologic and endocrine systems. Premature and Atypical Puberty View Large Delayed Puberty View Table
Prevention, treatment and prognosis of RDS Respiratory distress syndrome, RDS, is a multifactorial lung disease of premature infants. The main cause of RDS is a deficiency of pulmonary surfactant, a lipoprotein mixture required to reduce surface tension at the air-liquid interface and to prevent generalized atelectasis of the alveolar ducts and alveoli. Prematurity is the most important factor predisposing to RDS. During the past decade the number of multiple pregnancies has increased significantly as a result of diversified infertility treatments and advanced maternal age. Due to the considerably higher rate of preterm births of multiples compared to singletons, RDS is one of the major causes of morbidity among them. The objectives of the present research were to evaluate the incidence and risk factors of RDS in twins compared to singletons, and to assess the role of SP-A and SP-B gene variations and gene-environment interactions in the susceptibility to the disease in a population of preterm twins and higher order multiples.
developmental delay.htm What is Developmental Delay? Developmental delay is a term used to describe a baby or young child who is slower than expected in achieving the normal developmental milestones. This may affect gross and fine motor skills, speech and language skills, cognitive skills and/or social skills. A child diagnosed with global developmental delay will have delays in all their areas of development. All babies and children develop at different rates and in their own time. In some children, developmental delay is suspected soon after birth because of feeding difficulties or unusual muscle tone. Children with developmental delay may present with some of the following difficulties: Appears very floppy Muscles appear very tight, legs held stiff with little or no movement Problems holding head upright Unable to roll over by 6 months Unable to sit on the floor without support by 8 months Unable to crawl by 12 months Unable to walk independently by 18 months (back to top)
Growth and Failure to Thrive Synonym: weight faltering Failure to thrive (FTT) is defined as a significant interruption in the expected rate of growth compared with other children of similar age and sex during early childhood. It is a term that tends to be applied to young children, especially babies rather than older children or teenagers. FTT is a descriptive term or cause for concern. It is not a disease and an underlying cause must be considered. This definition of FTT does not specify being below the 2nd, 5th or 10th centile, as this would, by definition, include 2%, 5% or 10% of all babies, whether there was a problem or not. The World Health Organization (WHO) has proposed growth standards, based on healthy, relatively affluent, breast-fed infants from six countries. FTT, or weight faltering, is a description of a relatively common growth pattern. Repeated measurements of height and weight showing changes of centiles on charts are much more important than a single measurement. Look at the baby: Paediatrician
Radiology cases, Achondroplasia. Achondroplasia is the commonest disproportionate dwarfism. It is inherited as an autosomal dominent. 85% of case incidence is from a spontaneous mutation. The main feature is a symmetrical proximal limb shortening, rhizomelia, the humeri and femora are particularly affected. The other features are: Smaller square iliac bones, horizontal acetabular roofs, delayed appearance of ossification, pelvic tilt with lumbar lordosis, narrow sacro-iliac notch, flattened verebral bodies, occasional short a-p diameter of vertebrae or occasionial bullet shape to anterior vertebral border, spinal stenosis, posterior scalloping of vertebrae, small skull base, compensating large vault with appearance of frontal bossing, small foramen magnum, short ribs with widened anterior ends, Trident hand, similar lengths of generally shorter fingers. Neurological bladder and hydrocephalus may complicate the axial spinal stenoses. Some of the appearance is predictable.
Acromegaly Page - National Endocrine and Metabolic Diseases Information Service On this page: What is acromegaly? Acromegaly is a hormonal disorder that results from too much growth hormone (GH) in the body. The pituitary, a small gland in the brain, makes GH. In acromegaly, the pituitary produces excessive amounts of GH. Acromegaly is most often diagnosed in middle-aged adults, although symptoms can appear at any age. When GH-producing tumors occur in childhood, the disease that results is called gigantism rather than acromegaly. [Top] What are the symptoms of acromegaly? The name acromegaly comes from the Greek words for "extremities" and "enlargement," reflecting one of its most common symptoms-the abnormal growth of the hands and feet. Overgrowth of bone and cartilage often leads to arthritis. Other symptoms of acromegaly include What causes acromegaly? Acromegaly is caused by prolonged overproduction of GH by the pituitary gland. GH is part of a cascade of hormones that, as the name implies, regulates the physical growth of the body. Pituitary Tumors 2Rumboldt Z.
Growth hormone deficiency (children) - human growth hormone (replaced by TA188) Implementation tools and resources None available See this guidance in practice Patient The summary of the key recommendations in the guidance written for patients, carers and those with little medical knowledge and may be used in local patient information leaflets. Quick Reference Guide The quick reference guide presents recommendations for health professionals NICE Guidance
Growth Hormone Growth hormone is a protein hormone of about 190 amino acids that is synthesized and secreted by cells called somatotrophs in the anterior pituitary. It is a major participant in control of several complex physiologic processes, including growth and metabolism. Growth hormone is also of considerable interest as a drug used in both humans and animals. Physiologic Effects of Growth Hormone A critical concept in understanding growth hormone activity is that it has two distinct types of effects: Direct effects are the result of growth hormone binding its receptor on target cells. Keeping this distinction in mind, we can discuss two major roles of growth hormone and its minion IGF-I in physiology. Effects on Growth Growth is a very complex process, and requires the coordinated action of several hormones. IGF-I also appears to be the key player in muscle growth. Metabolic Effects Growth hormone has important effects on protein, lipid and carbohydrate metabolism. Control of Growth Hormone Secretion