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1.
J Law Med ; 27(1): 149-163, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31682347

RESUMO

The Family Court of Australia has stepped back from a previously perceived need for involvement in the approval of stage 1 and stage 2 treatments, for children requiring gender transformation. At present those children and their families who are in agreement need not seek authorisation of the Family Court to undertake either Stage 1 (pubarche blockade with gonadotrophin-releasing hormone agonists) or Stage 2 treatment (cross-hormone therapy such as oestrogen for transgender males). Stage 1 treatment to suppress pubarche would nowadays be commenced at Tanner stage 2 which commences as early as 9.96 years in girls and 10.14 years in boys. Suppression of puberty continues until the age of 16 years when cross hormonal treatment commences. This article questions the assertion that suppression of puberty by GnRH analogues either in cases of precocious puberty or gender dysphoria is "safe and reversible" and argues that it warrants ongoing caution, despite the Family Court having broadly accepted that assertion.


Assuntos
Disforia de Gênero , Austrália , Criança , Feminino , Identidade de Gênero , Humanos , Masculino , Puberdade , Maturidade Sexual
3.
Histochem Cell Biol ; 152(6): 423-437, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31630211

RESUMO

Wide application of gonadotropin-releasing hormone (GnRH) agonists and antagonists for clinical purposes determines their effects on ovarian signaling pathways. Our study aimed to determine the localization, expression levels of Wnt signaling members in the pubertal and adult mouse ovary and the impact of GnRH antagonist cetrorelix on these signaling members. 0.5 mg/kg of cetrorelix was injected to 3-and 6-week-old mice for 2 weeks. At the end of injection, ovaries from 5 (5Ce)- to 8-week (8Ce)-old mice were embedded in paraffin for immunohistochemistry and homogenized for western blot to compare with control (5C-8C) and sham groups (5S-8S). WNT2 and WNT4 showed higher expression in thecal and stromal cells in adult mouse ovaries and only WNT4 expression was affected by cetrorelix. FZD1 was localized mainly in oocytes of pubertal ovaries and granulosa cells and oocytes of adult ovaries. FZD1 was reduced by cetrorelix in pubertal ovaries. FZD4 was abundantly localized in thecal and stromal cells of all groups and protein level was not affected by cetrorelix. LRP-6 was expressed mainly in oocytes and stromal cells of pubertal, oocytes of adult ovaries and its expression was reduced by cetrorelix in adult ovaries. CTNNB1 intensity in granulosa cells was the lowest in pubertal and the highest in adult ovaries and its expression was decreased by cetrorelix in adult ovaries. Cetrorelix affected the expression of specific members of the Wnt signaling depending on the developmental stage of mice, pointing out its possible interaction with gonadotropins during pubertal and adult stages.


Assuntos
Hormônio Liberador de Gonadotropina/análogos & derivados , Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Antagonistas de Hormônios/farmacologia , Oócitos/efeitos dos fármacos , Puberdade/efeitos dos fármacos , Via de Sinalização Wnt/efeitos dos fármacos , Animais , Feminino , Hormônio Liberador de Gonadotropina/administração & dosagem , Hormônio Liberador de Gonadotropina/química , Hormônio Liberador de Gonadotropina/metabolismo , Hormônio Liberador de Gonadotropina/farmacologia , Antagonistas de Hormônios/administração & dosagem , Antagonistas de Hormônios/química , Camundongos , Camundongos Endogâmicos BALB C , Oócitos/metabolismo , Puberdade/metabolismo
4.
Niger J Clin Pract ; 22(10): 1417-1422, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31607733

RESUMO

Background: There is a mutual dynamic interaction between thyroid volume (TV), insulin-like growth factor-1 (IGF-1), and body mass index (BMI). These covariates undergo a change with the transition into puberty. The heterogeneity of the variates and study populations complicate the evaluation of the role of pure pubertal effect. Objective: The purpose of this study was to investigate the effect of puberty on IGF-1 and TV in a predetermined homogenous population such as obese children. Subjects and Methods: Three hundred and eighty children (202 girls and 178 boys) aged between 6 and 18 were enrolled in this prospective study. The children were assigned to two groups according to their pubertal status, i.e., prepubertal (n = 169) and postpubertal (n = 211). According to age and sex, the obese group (n = 222) was made up of children at and above the 95th percentile, and the control group (n = 158) of children under the 85th percentile. The following parameters were evaluated in all children: BMI, pubertal status, TV, and serum IGF-1, IGFBP-3, and IGF-1:IGFBP-3 molar ratio. Results: In comparison to the prepubertal obese group, the obese group at Tanner stage 2 had a larger mean TV (P = 0.008) and higher IGF-1 level (P = 0.033). There was a positive correlation between IGF-1 and TV both in the prepubertal and pubertal group (r169= 0.369, P = 0.001; r211= 0.316, P = 0.004, respectively), whereas there was no correlation between IGF-1 and BMI (r169= 0.99, P = 0.092; r211= 0.094, P = 0.088, respectively). Conclusion: This study showed that the TV and serum IGF-1 levels were increased in obese children in the early stage of puberty and that there was a positive correlation between these two variables in all children, which shows the specific effect of the early stage of puberty on the increase in TV and IGF-1 levels and suggests that increased TV is associated with the increase in IGF-1 levels in a homogenous group such as obese children.


Assuntos
Fator de Crescimento Insulin-Like I/metabolismo , Obesidade/sangue , Obesidade/fisiopatologia , Puberdade/fisiologia , Maturidade Sexual , Glândula Tireoide/fisiologia , Adolescente , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Humanos , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina , Masculino , Estudos Prospectivos , Proteínas Recombinantes
5.
Medicine (Baltimore) ; 98(40): e17374, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577740

RESUMO

RATIONALE: Prepubertal unilateral gynecomastia is extremely rare, whose etiology and management strategy are not familiar. We would like to present a case and a literature review of unilateral prepubertal gynecomastia. PATIENT CONCERNS: A 11-year old male patient with complaints of unilateral enlargement of breast tissue presented in our clinic, whose physical examination, biochemical, hormonal and oncologic findings were normal. DIAGNOSES: This patient was diagnosed as idiopathic unilateral prepubertal gynecomastia (IUPG) and self-abasement, social isolation and sensitive of interpersonal relationship. INTERVENTIONS: The patient received subcutaneous mastectomy. Histopathological examinations showed idiopathic gynecomastia of ductal epithelial hyperplasia and active interstitial fibrous hyperplasia, with no evidence of any pathological finding. Immunohistochemical examination showed estrogen receptor (ER)-α positive (70%), epidermal growth factor receptor (EGFR) positive, Her-2 positive (1+), Progesterone Receptor (PR) positive (80%). OUTCOMES: A remarkable improvement was observed both in the physical and mental conditions at the post-surgical 6-month follow-up visit, showing no evidence of recurrence. LESSONS: Further investigation is needed to clarify the pathogenesis of IUPG. All patients with IUPG should have a full endocrine and oncologic evaluation, and surgical excision may be the individually designed for each patient with the help of MRI of breast.


Assuntos
Ginecomastia/patologia , Puberdade , Criança , Receptores ErbB/biossíntese , Receptor alfa de Estrogênio/biossíntese , Ginecomastia/diagnóstico , Ginecomastia/cirurgia , Humanos , Masculino , Mastectomia/métodos , Receptor ErbB-2/biossíntese , Receptores de Progesterona/biossíntese
6.
J Abnorm Psychol ; 128(7): 658-670, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31535887

RESUMO

Familial resemblance in eating pathology is typically attributed to parents providing an environment that leads to the development of eating pathology. However, offspring raised by biological parents receive both their environment and genes from their parents, raising the possibility that genetic influences, environmental influences, and/or gene-environment interplay may account for familial resemblance. Past studies have not explored the possibility of parents' genes influencing the environment they provide (i.e., passive gene-environment correlations or "passive rGE"). If present, passive rGE is most likely to "hide" in estimates of shared environmental influence in classical twin models. The current study used a nuclear twin family design to explore the possibility of passive rGE during pre- and early puberty when past studies have demonstrated the importance of shared environmental influence. Additionally, the present study explored whether sibling-specific (i.e., influences specific to the twin generation) or family-specific (i.e., "cultural" influences within the home) environmental influences account for shared environmental influences found in past studies. Participants included preearly pubertal same-sex female twins and their biological parents (N = 547 families) from the Minnesota Twin Family Study and the Michigan State University Twin Registry. Disordered eating was assessed with self-report measures in the twins and parents. Pubertal status was determined using an established cut-off on a self-report measure. Passive rGE was not indicated in this study of pre- and early pubertal twins. Instead, sibling-specific shared environmental and nonshared environmental influences were most influential. Future research should work to identify the sibling-specific environmental influences that contribute to sibling similarity in disordered eating. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/genética , Interação Gene-Ambiente , Pais , Puberdade/psicologia , Gêmeos/genética , Criança , Doenças em Gêmeos/genética , Doenças em Gêmeos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Masculino , Sistema de Registros , Autorrelato , Gêmeos/psicologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-31398932

RESUMO

Obese children are exposed to short and long-term health consequences, such as dyslipidemia, hypertension and diabetes mellitus. For these reasons, the prevention and treatment of obesity in the pediatric population is a challenge for health care professionals. The aim of this study was to evaluate whether an intensive intervention based on diet and physical activity has a better impact on the auxological and biochemical parameters than standard care (intervention). The study included 20 children (six boys, 14 girls), of the mean age 8.9 (SD 1.4) before puberty. The participants were randomly assigned to two groups: Group I (starting treatment with intensive intervention), and II (starting treatment with standard intervention). After three months, the groups were switched. The comparison of the two interventions in the study group indicates a better effectiveness of intensive intervention in the improvement of anthropometric parameters and majority of biochemical ones (except for insulin concentration, HOMA IR index and LDL cholesterol). As the result of intensive intervention, the mean % of weight-to-height excess and hip circumference decreased significantly (p < 0.005). Our results confirm that complex intervention based on systematic control visits, including personalized dietitian counselling and physician care, during the weight reduction process is more effective than a one-off standard visit.


Assuntos
Terapia Comportamental/métodos , Exercício/fisiologia , Terapia Nutricional/métodos , Obesidade Pediátrica/prevenção & controle , Puberdade/fisiologia , Maturidade Sexual/fisiologia , Perda de Peso/fisiologia , Índice de Massa Corporal , Tamanho Corporal , Criança , Feminino , Humanos , Masculino , Polônia
8.
Georgian Med News ; (291): 145-150, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31418748

RESUMO

The purpose of the study was to identify the most optimal sign of a victim of non-violent sexual intercourse with a minor based on the analysis of approaches to the definition of such a sign in the criminal legislation of different countries, as well as the doctrinal provisions of medicine and jurisprudence. In the process of research, such methods of scientific knowledge were used as: a dialectical approach, a comparative law method, general logical methods (analysis, synthesis, induction, deduction, generalization), as well as a dogmatic method. The study of criminal legislation of a number of foreign countries and proposals expressed in criminal law science allowed to identify the main approaches to the definition of the sign of a victim, the presence or absence of which should have criminal law significance for qualifying the act as non-violent sexual intercourse with a minor. Such approaches are: 1) the age approach, according to which a person who has not attained a certain age is recognized as a victim; 2) the medical-physiological approach, which involves reaching a victim of puberty; 3) the mixed approaches: a) cumulative, providing for a person to reach puberty and a certain age; b) alternative, providing for a person to reach puberty or a certain age. The advantages and disadvantages of each approach are analyzed. It was concluded that there is no universal approach to determining the most optimal sign of a victim of non-violent sexual intercourse with a minor, since all the considered approaches have both advantages and disadvantages. A legislator in each particular state should independently determine which approach to use, the age of sexual consent to establish, taking into account the peculiarities of the mentality, traditions, culture, priorities of criminal law protection. Moreover, when choosing an age or one of the mixed approaches, it would be advisable to raise the issue of differentiating the age of sexual consent of boys and girls.


Assuntos
Coito/psicologia , Vítimas de Crime/legislação & jurisprudência , Vítimas de Crime/psicologia , Puberdade/psicologia , Adolescente , Fatores Etários , Criança , Abuso Sexual na Infância/legislação & jurisprudência , Abuso Sexual na Infância/psicologia , Feminino , Humanos , Masculino , Maturidade Sexual
9.
J Autism Dev Disord ; 49(12): 4807-4819, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31448383

RESUMO

Adolescence is a time of remarkable biopsychosocial change, which may be particularly challenging for youth with autism spectrum disorder (ASD), necessitating enhanced understanding and accurate assessment of pubertal maturation. The study compared physical examination to parent- and self-report measures in 200 participants (134 males and 66 females) ages 10.0-13.5 years. Both participants with typical development (TD, n = 78) and ASD (n = 122) were included. Concordance ranged from slight-to-fair for self-assessments (κ = .17-.32) and slight-to-moderate for parent-report (κ = .21-.44). Concordance of physical exam with self- and parent-report of the ASD group was somewhat lower than for the TD group. Findings indicate pubertal assessments by parent or child are not reliable indices of precise pubertal staging.


Assuntos
Transtorno do Espectro Autista/psicologia , Pais/psicologia , Exame Físico/normas , Puberdade/psicologia , Autorrelato/normas , Adolescente , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/fisiopatologia , Criança , Coleta de Dados/métodos , Coleta de Dados/normas , Feminino , Humanos , Estudos Longitudinais , Masculino , Exame Físico/métodos , Estudos Prospectivos , Puberdade/fisiologia , Autoavaliação
10.
Breast Cancer Res ; 21(1): 96, 2019 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-31429809

RESUMO

BACKGROUND: The long time from exposure to potentially harmful chemicals until breast cancer occurrence poses challenges for designing etiologic studies and for implementing successful prevention programs. Growing evidence from animal and human studies indicates that distinct time periods of heightened susceptibility to endocrine disruptors exist throughout the life course. The influence of environmental chemicals on breast cancer risk may be greater during several windows of susceptibility (WOS) in a woman's life, including prenatal development, puberty, pregnancy, and the menopausal transition. These time windows are considered as specific periods of susceptibility for breast cancer because significant structural and functional changes occur in the mammary gland, as well as alterations in the mammary micro-environment and hormone signaling that may influence risk. Breast cancer research focused on these breast cancer WOS will accelerate understanding of disease etiology and prevention. MAIN TEXT: Despite the plausible heightened mechanistic influences of environmental chemicals on breast cancer risk during time periods of change in the mammary gland's structure and function, most human studies of environmental chemicals are not focused on specific WOS. This article reviews studies conducted over the past few decades that have specifically addressed the effect of environmental chemicals and metals on breast cancer risk during at least one of these WOS. In addition to summarizing the broader evidence-base specific to WOS, we include discussion of the NIH-funded Breast Cancer and the Environment Research Program (BCERP) which included population-based and basic science research focused on specific WOS to evaluate associations between breast cancer risk and particular classes of endocrine-disrupting chemicals-including polycyclic aromatic hydrocarbons, perfluorinated compounds, polybrominated diphenyl ethers, and phenols-and metals. We outline ways in which ongoing transdisciplinary BCERP projects incorporate animal research and human epidemiologic studies in close partnership with community organizations and communication scientists to identify research priorities and effectively translate evidence-based findings to the public and policy makers. CONCLUSIONS: An integrative model of breast cancer research is needed to determine the impact and mechanisms of action of endocrine disruptors at different WOS. By focusing on environmental chemical exposure during specific WOS, scientists and their community partners may identify when prevention efforts are likely to be most effective.


Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Exposição Ambiental/efeitos adversos , Animais , Neoplasias da Mama/prevenção & controle , Suscetibilidade a Doenças , Feminino , Humanos , Exposição Materna/efeitos adversos , Menopausa , Gravidez , Puberdade , Pesquisa , Fatores de Risco , Fatores de Tempo
11.
Asia Pac J Ophthalmol (Phila) ; 8(4): 319-323, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31369407

RESUMO

PURPOSE: The aims of this study were to correlate diabetic retinopathy (DR) changes with insulin-like growth factor 1 (IGF-1) levels in patients with type 1 diabetes of pubertal age group and to correlate the level of retinopathy with IGF-1 levels. METHODS: This cross-sectional study was done over 2 years and involved patients with type 1 diabetes of age 8 to 25 years. Patients presenting to Ophthalmology OPD and inpatient department along with active recruitment from old pediatrics and endocrinology records were taken for the study. Fasting serum IGF-1 was calculated using enzyme-linked immunosorbent assay technique. Fasting blood sugar levels were taken. Detailed ophthalmic examination was done and DR was noted in all the patients and correlated with IGF-1 levels. RESULTS: A total of 46 patients with type 1 diabetes were recruited into the study. The mean age of the patients was 14.33 ±â€Š4.36 years, with a female-to-male ratio of 3:2. No relationship of IGF-1 with age of onset of diabetes (P = 0.7) or fasting capillary blood glucose (CBG) (P = 0.6) was found, but a significant relationship was found with duration of diabetes (P = 0.001) and low IGF-1 levels (P < 0.0001). CONCLUSIONS: Severity of DR in patients with type 1 diabetes is inversely related to serum IGF-1 levels. Low IGF levels are an indicator for closer follow-up and strict management of diabetes and retinopathy.


Assuntos
Diabetes Mellitus Tipo 1/complicações , Retinopatia Diabética/sangue , Fator de Crescimento Insulin-Like I/metabolismo , Puberdade , Adolescente , Adulto , Biomarcadores/sangue , Glicemia/metabolismo , Criança , Estudos Transversais , Diabetes Mellitus Tipo 1/sangue , Retinopatia Diabética/etiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Adulto Jovem
12.
Nutrients ; 11(7)2019 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-31337124

RESUMO

Alterations in pubertal timing have been associated with long-term health outcomes. While a few reports have shown that dietary intake of selenium is associated with fertility and testosterone levels in men, no human studies have considered the association between selenium and pubertal development in children. We examined the cross-sectional association of childhood dietary intake of selenium with pubertal development among 274 girls and 245 boys aged 10-18 years in Mexico City. Multiple logistic and ordinal regression models were used to capture the association between energy-adjusted selenium intake (below Recommended Dietary Allowance (RDA) vs. above RDA) and stages of sexual maturity in children, adjusted for covariates. We found that boys with consumption of selenium below the RDA had lower odds of a higher stage for pubic hair growth (odds ratio (OR) = 0.51, 95% confidence interval (95% CI): 0.27-0.97) and genital development (OR = 0.53, 95% CI: 0.28-0.99) as well as a lower probability of having matured testicular volume (OR = 0.37, 95% CI: 0.15-0.88) compared with boys who had adequate daily dietary intake of selenium (above RDA). No associations were found in girls. According to our results, it is possible that inadequate consumption of selenium may be associated with later pubertal development in boys, suggesting a sex-specific pattern. Future work with a larger sample size and measures of selenium biomarkers is needed to confirm our findings and improve understanding of the role of this mineral in children's sexual development.


Assuntos
Dieta , Puberdade/efeitos dos fármacos , Puberdade/fisiologia , Selênio/administração & dosagem , Maturidade Sexual/efeitos dos fármacos , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , México , Recomendações Nutricionais , Selênio/deficiência , Fatores Sexuais , Maturidade Sexual/fisiologia
13.
Life Sci ; 233: 116698, 2019 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-31356906

RESUMO

AIM: Type 1 diabetes (T1DM) is a common chronic disease in childhood. Increasing insulin resistance in puberty gives rise to higher doses of insulin usage in treatment. Of this reason new approaches in treatment are needed. Noopept researches suggest it to have anti-diabetic properties. We tried to determine the effects of noopept on pubertal diabetes. MAIN METHOD: The research was made with 60 prepubertal, 28 day-old, male, Sprague Dawley rats. The rats were divided into randomised 6 groups (n = 10/group). i) Control, ii) Diabetes Control, iii) Noopept Control, iv) Diabetes + Noopept, v) Diabetes + Insulin, vi) Diabetes + Insulin + Noopept. T1DM model was induced by streptozotocin on postnatal 28th day. 0.5 mg/kg noopept and 1 IU insulin were administered intraperitoneally for 14 days. Blood glucose and body weight measurements, puberty follow-up and MWM tests were performed. Hippocampus, hypothalamus and testis were evaluated histologically. Hypothalamic GnRH and kisspeptin were studied immunohistochemically. Serum LH, FSH and insulin, hippocampal homogenate NGF and BDNF levels were determined by ELISA. KEY FINDINGS: Delayed puberty was normalized by noopept (p < 0.05). Blood glucose levels were lower in noopept-administered diabetic groups (p < 0.05). Noopept decreased HOMA-IR in insulin administered diabetic group (p < 0.05). Number of degenerated cells in hippocampus and testis were higher in diabetes control group when compared with other groups (p < 0.05). GnRH immunoreactivity in Diabetes + Noopept group was increased when compared to insulin + noopept group (p = 0.018). There was no difference in kisspeptin, serum LH, FSH, hippocampal NGF-BDNF levels and spatial learning assessment among groups (p > 0.05). SIGNIFICANCE: Noopept may have positive effect in treatment of pubertal diabetes.


Assuntos
Cognição/fisiologia , Diabetes Mellitus Experimental/tratamento farmacológico , Dipeptídeos/farmacologia , Resistência à Insulina , Fármacos Neuroprotetores/farmacologia , Puberdade/fisiologia , Animais , Glicemia/metabolismo , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Cognição/efeitos dos fármacos , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/patologia , Insulina/metabolismo , Masculino , Fator de Crescimento Neural/metabolismo , Puberdade/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley
14.
Artigo em Chinês | MEDLINE | ID: mdl-31163523

RESUMO

Objective:To study the etiology of vertigo in children and analyze the relationship between the etiology of vertigo and the age category. Method:One hundred and forty-four cases of children with vertigo or dizziness were selected. All patients received the vertigo questionnaire, audiological, vestibular function and other related examinations. JMP 10.0 was used for statistical analysis. Result:Of 144 patients, 17 cases were preschool age (<6 years old), 101 cases were school age (6-12 years old) and 26 cases were puberty (>12 years old). All patients were mainly distributed between 6 and 10 years old. The most common diagnoses was benign paroxysmal vertigo. The second one was vestibular migraine. Incidence rate of the same disease in different ages was also different. Benign paroxysmal vertigo and vestibular migraine in preschool age, school age and puberty accounted for 58.8%, 42.6%, 0 and 0, 17.8%, 30.8%, respectively. Conclusion:Benign paroxysmal vertigo and vestibular migraine were the most common causes of vertigo in children. Prevalence rate and the etiology was various in different ages. Due to the physical and psychological development of children, analyzing the cause of vertigo in children should be fully considered these characteristics.


Assuntos
Vertigem Posicional Paroxística Benigna , Transtornos de Enxaqueca , Vestíbulo do Labirinto , Vertigem Posicional Paroxística Benigna/complicações , Vertigem Posicional Paroxística Benigna/epidemiologia , Criança , Pré-Escolar , Tontura , Humanos , Transtornos de Enxaqueca/complicações , Prevalência , Puberdade
16.
J Steroid Biochem Mol Biol ; 193: 105409, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31201927

RESUMO

New reference intervals need to be established for a new analytical method with improved sensitivity and specificity. We aimed to establish the new reference intervals from infancy to senescence of nine steroid hormones (cortisol, cortisone, progesterone, 17-hydroxyprogesterone (17-OHP), androstenedione, testosterone, estradiol, DHEAS, and aldosterone) for LC-MS/MS method. Serum samples from 4678 reference individuals (age range: 0.3-79 years) were measured with LC-MS/MS. Samples were collected between 7 a.m. and 10 a.m. Exclusion criteria were concomitant endocrine diseases and body mass index ≥ 33. Generalized additive model for location, scale and shape, the nonparametric or robust method was applied. We established the reference intervals of the nine steroid hormones by sex, age, and pubertal stage. Below the age of one, we observed the surge of androgen and estrogen which implied mini-puberty. At the same period of life, aldosterone and cortisone levels were very high reflecting physiological hyperaldosteronism. An increase of steroid hormones during the pubertal development and slow decrease towards senescence after the peak at early adulthood were observed. Due to the increase of CBG synthesis, cortisol levels were increased under oral contraceptives (OC) significantly (p < 0.0001), while OC suppressed progesterone, 17-OHP, androstenedione, and estradiol (p < 0.0001). Our results will facilitate the interpretation of patient data in routine diagnostics with the use of LC-MS/MS method. Since LC-MS/MS methods have shown good comparability among the different laboratories, our reference intervals can be further adopted in other laboratories equipped with LC-MS/MS, once the validation with a small number of reference samples is performed.


Assuntos
Envelhecimento/sangue , Caracteres Sexuais , Esteroides/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Cromatografia Líquida , Anticoncepcionais Orais/uso terapêutico , Feminino , Humanos , Lactente , Longevidade , Masculino , Pessoa de Meia-Idade , Puberdade/metabolismo , Valores de Referência , Espectrometria de Massas em Tandem , Adulto Jovem
17.
Dev Psychopathol ; 31(3): 1011-1022, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31064568

RESUMO

Early life stress (ELS) is a risk factor for the development of depression in adolescence; the mediating neurobiological mechanisms, however, are unknown. In this study, we examined in early pubertal youth the associations among ELS, cortisol stress responsivity, and white matter microstructure of the uncinate fasciculus and the fornix, two key frontolimbic tracts; we also tested whether and how these variables predicted depressive symptoms in later puberty. A total of 208 participants (117 females; M age = 11.37 years; M Tanner stage = 2.03) provided data across two or more assessment modalities: ELS; salivary cortisol levels during a psychosocial stress task; diffusion magnetic resonance imaging; and depressive symptoms. In early puberty there were significant associations between higher ELS and decreased cortisol production, and between decreased cortisol production and increased fractional anisotropy in the uncinate fasciculus. Further, increased fractional anisotropy in the uncinate fasciculus predicted higher depressive symptoms in later puberty, above and beyond earlier symptoms. In post hoc analyses, we found that sex moderated several additional associations. We discuss these findings within a broader conceptual model linking ELS, emotion dysregulation, and depression across the transition through puberty, and contend that brain circuits implicated in the control of hypothalamic-pituitary-adrenal axis function should be a focus of continued research.


Assuntos
Depressão/psicologia , Hidrocortisona/análise , Puberdade/psicologia , Estresse Psicológico/psicologia , Adolescente , Depressão/fisiopatologia , Emoções/fisiologia , Feminino , Lobo Frontal/diagnóstico por imagem , Humanos , Sistema Hipotálamo-Hipofisário/fisiopatologia , Sistema Límbico/diagnóstico por imagem , Masculino , Rede Nervosa/diagnóstico por imagem , Sistema Hipófise-Suprarrenal/fisiopatologia , Puberdade/fisiologia , Saliva/química , Estresse Psicológico/fisiopatologia , Substância Branca/diagnóstico por imagem
18.
Pediatr Ann ; 48(5): e187-e189, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31067332

RESUMO

A common scenario a pediatrician or general practitioner may encounter in the care of adolescent girls is menstrual concerns. A frequent complaint may be of irregular periods that may be coming twice a month or possibly only every other month. Sometimes the teenage patient may complain of heavy bleeding or prolonged periods lasting longer than 7 days. The typical patient with this complaint could be a 14-year-old girl with periods that started at age 13 years who has had no periods for 3 months after onset of menarche. However, once the second period comes, the patient complains of periods happening often, lasting for 5 days, and with the need to change feminine products about 3 times per day. She is otherwise healthy with no medical issues and no surgeries. The family may question if this is considered normal or if something is potentially wrong with the adolescent's pubertal development. [Pediatr Ann. 2019;48(5):e187-e189.].


Assuntos
Clínicos Gerais , Distúrbios Menstruais/diagnóstico , Distúrbios Menstruais/terapia , Papel do Médico , Adolescente , Criança , Feminino , Humanos , Menstruação/fisiologia , Distúrbios Menstruais/etiologia , Pediatras , Puberdade/fisiologia
19.
J Pediatr Endocrinol Metab ; 32(6): 569-576, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31085748

RESUMO

Introduction In large community-based studies of puberty, Tanner staging by a clinician is often not possible. We compared self-rated Tanner staging and other subjective ratings of pubertal development with serum hormone levels measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) to reassess the utility of self-rated pubertal stage using highly sensitive and specific hormone analysis. Methods Adolescents and their parents enrolled in the Adolescent Rural Cohort study of Hormones and health, Education, environments and Relationships (ARCHER) answered annual survey questions on pubertal development. Annually, adolescents provided blood samples for serum testosterone and estradiol measured by LC-MS/MS. Results Longitudinally, self-rated Tanner stage was positively associated with serum testosterone and estradiol levels in both sexes. Confirmation by adolescent and parent that puberty had commenced was associated with higher gonadal hormone levels in both sexes. Parent and adolescent responses demonstrated 'fair' to 'moderate' agreement. Conclusions Over a 3-year follow-up, self-rated Tanner staging and simple questions regarding pubertal onset and development are positively associated with adolescent gonadal hormone concentrations in serum measured by mass spectrometry. Thus, self-report of puberty stage still has a role in large community-based studies where physical examination is not feasible.


Assuntos
Estradiol/sangue , Hormônio Foliculoestimulante/sangue , Hormônio Luteinizante/sangue , Puberdade , Autoavaliação , Maturidade Sexual , Testosterona/sangue , Adolescente , Criança , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Prognóstico
20.
Medicina (Kaunas) ; 55(5)2019 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-31126164

RESUMO

Background and objectives: Studies indicate that genetic and lifestyle factors influence optimal bone development. Adaptations in bone mineral characteristics related to physical activity (PA) are most often observed in pre- and peri-puberty. Longitudinal associations between bone mineral accrual and objectively measured PA in puberty are poorly understood. The present study aims to investigate whether pubertal PA at different intensities is related to bone mineral characteristics in individuals at 18 years of age. Materials and Methods: Anthropometrics, pubertal stage, bone age and PA by accelerometer were measured in 88 boys at the mean age of 12.1 (T1), 13.1 (T2), 14.0 (T3) and 18.0 years (T4). Different bone mineral parameters were measured by dual-energy X-ray at T4. Stepwise multiple regression analysis was performed to determine the effect of bone age, body mass and PA characteristics on measured bone mineral parameters at 18 years of age. Results: Total PA in puberty together with mean pubertal body mass predicted 35.5% of total body (TB) bone mineral density (BMD), 43.0% of TB less head (LH) bone mineral content (BMC) and 48.1% of BMC/height in individuals at 18 years of age. Vigorous PA and body mass in puberty predicted 43.2% of femoral neck (FN) BMD; bone age at T1, vigorous PA and body mass in puberty predicted 47.3% of FN BMC at 18 years of age. No associations between pubertal PA levels and lumbar spine bone mineral characteristics in individuals at 18 years of age were found. Conclusions: Physical activity in puberty has a significant impact on bone mineral characteristics in individuals at 18 years of age, with total PA being a significant predictor of TB BMD and TB LH BMC as well as BMC/height, whereas vigorous PA is a significant predictor of FN BMD and FN BMC.


Assuntos
Densidade Óssea/fisiologia , Exercício/fisiologia , Colo do Fêmur/química , Minerais/análise , Puberdade/metabolismo , Adolescente , Antropometria/métodos , Colo do Fêmur/patologia , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Minerais/metabolismo , Puberdade/fisiologia
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