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1.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(11): 1161-1168, 2021 Nov 15.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34753549

RESUMO

OBJECTIVES: To systematically evaluate the effect of gonadotropin-releasing hormone analogue (GnRHa) treatment on the final adult height of children over 6 years of age with central precocious puberty (CPP) or early and fast puberty (EFP). METHODS: PubMed, MEDLINE, Embase, Cochrane Library, CNKI, and Wanfang Data were searched for related articles on GnRHa treatment for children with CPP or EFP. Stata 12.0 software was used to perform a Meta analysis of related data. RESULTS: A total of 10 studies were included, and the total sample size was 720 children, with 475 children in the GnRHa treatment group and 245 children in the control group. The Meta analysis showed that compared with the control group, the GnRHa treatment group had significantly better final adult height (WMD=3.30, 95%CI: 2.49-4.12, P<0.001), standard deviation score of final adult height (WMD=0.51, 95%CI: 0.29-0.73, P<0.001), and height gain (WMD=2.89, 95%CI: 2.17-3.60, P<0.001). No severe adverse events were reported in these studies. CONCLUSIONS: GnRHa treatment is safe and effective in improving the final adult height of children over 6 years of age with CPP or EFP.


Assuntos
Puberdade Precoce , Adulto , Estatura , Criança , Hormônio Liberador de Gonadotropina , Humanos , Puberdade , Puberdade Precoce/tratamento farmacológico
2.
Acta Biomed ; 92(5): e2021480, 2021 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-34738554

RESUMO

Sexual precocity refers to the appearance of physical and hormonal signs of pubertal development at an earlier age. It may be considered as the expression of secondary sexual characteristics prior to the pubertal age In central precocious puberty (CPP), which is gonadotropin-dependent, early maturation of the entire hypothalamic-pituitary-gonadal (HPG) axis occurs, with the full spectrum of physical and hormonal changes of puberty. True precocious puberty in girls must also be distinguished from premature thelarche (PT), usually with breast development before the age of 3 years, and premature pubarche (PA), with the isolated development of pubic hair. These conditions are not usually associated with accelerated growth rate or advancement in bone age. Clinical, laboratory and instrumental evaluations are necessary for the diagnosis. Pelvic ultrasound could serve as a complementary tool for the diagnosis, treatment and follow-up of CPP. The interpretation of clinical, laboratory and strumental data must be performed by an expert pediatric endocrinologist to maximize the diagnostic value in females with pubertal disorders.


Assuntos
Puberdade Precoce , Criança , Pré-Escolar , Feminino , Humanos , Puberdade , Puberdade Precoce/diagnóstico por imagem , Puberdade Precoce/terapia , Ultrassonografia
3.
Am J Occup Ther ; 75(3)2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-34781357

RESUMO

IMPORTANCE: Understanding occupational therapy practice patterns for adolescents who have autism spectrum disorder (ASD) provides a baseline to determine areas of need and effective interventions. OBJECTIVE: To identify puberty-related challenges addressed and interventions used by occupational therapy practitioners with adolescents ages 8-16 yr with ASD. DESIGN: A nonexperimental survey design with a stratified random sample was used. SETTING: The Occupational Therapy-Autism and Puberty Survey was distributed in the United States online through the Qualtrics platform (available October 2017-January 2018). PARTICIPANTS: Occupational therapists (89%) or occupational therapy assistants with experience with adolescents who have ASD were included. The 71 eligible respondents were primarily White women with an average 16 yr of experience. Outcomes and Measures: Nine key challenges and 11 interventions regarding puberty and ASD were identified. Hypotheses were generated before data collection. RESULTS: More practitioners (>47%) addressed emotional regulation and personal hygiene, and fewer (<26%) addressed menstruation, safety, and masturbation. Nearly all practitioners (>92%) reported using social learning approaches and behavioral strategies, and most (>80%) reporting having received education in these interventions. Significant differences were found between reported education and use of behavioral skills training incorporating applied behavioral analysis (p < .001), parent training (p = .002), and technology (p = .003). CONCLUSIONS AND RELEVANCE: Practitioners are neglecting to address puberty-specific challenges with adolescents who have ASD. Opportunities exist to expand the interventions used and challenges addressed by occupational therapy practitioners for adolescents with ASD. What This Article Adds: This article expands occupational therapy literature by giving a baseline understanding of the puberty-related challenges that practitioners are addressing with adolescents who have ASD. This information can assist the profession in developing effective interventions and educational opportunities to allow practitioners to successfully address puberty-specific challenges.


Assuntos
Transtorno do Espectro Autista , Terapia Ocupacional , Adolescente , Criança , Feminino , Humanos , Puberdade , Inquéritos e Questionários , Estados Unidos
4.
Georgian Med News ; (319): 36-41, 2021 Oct.
Artigo em Russo | MEDLINE | ID: mdl-34749320

RESUMO

The objective of this work was to identify prognostic factors of the environment and heredity in the families of girls with abnormal uterine bleeding during puberty. Clinical and genealogical analysis has been carried out according to P. Harper in the families of 70 girls with abnormal uterine bleeding (AUB) during puberty. The control group consisted of families of 30 healthy girls 12-18 years old with a regular menstrual cycle without severe somatic pathology, which have been selected during preventive examinations in educational institutions by specialists of the institute. Statistical analysis of the data has been carried out with the Student's t-test and χ2 for unequal samples using Excel and SPSS Statіstіcs 17.0. Prognostic signs have been selected using Valda's criterion. On the basis of the analysis, the family accumulation of multifactorial pathology has been revealed. The risk factors of AUB have been identified: hereditary burden for reproductive disorders, harmful working conditions and bad habits of parents before conceiving a child, maternal stress before pregnancy, early maternal age during pregnancy (up to 20 years), unfavorable course of pregnancy and childbirth, mixed feeding of infants, stress of girls at home and in an educational institution. The effectiveness of the selected features was 75.0%.


Assuntos
Puberdade , Hemorragia Uterina , Adolescente , Criança , Feminino , Humanos , Ciclo Menstrual , Exame Físico , Gravidez , Fatores de Risco
5.
Nutrients ; 13(10)2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34684321

RESUMO

Both vitamin D and insulin-like growth factor 1 (IGF-1) play essential roles in bone metabolism and may interact during prepubertal bone accrual. We investigated the association of low serum 25-hydroxyvitamin D (25(OH)D) (<20 ng/mL) with the circulating bone turnover markers, when compared to their interaction with IGF-1. SUBJECTS AND METHODS: Serum 25(OH)D, IGF-I, P1NP (N-terminal propeptide of type I procollagen), and CTX-1 (C-terminal telopeptide of type I collagen) were measured, and the bone turnover index (BTI) was calculated in 128 healthy children, aged 9-11 years. RESULTS: Mean 25(OH)D concentration was 21.9 ± 4.9 ng/mL, but in 30.5% of participants it was <20 ng/mL (<50 nmol/L). We observed a trend for higher P1NP (p < 0.05) and IGF-1 (p = 0.08), towards lower 25(OH)D in tertiles. Levels of P1NP in the lowest 25(OH)D tertile (<20 ng/mL) were the highest, while CTX and BTI remained unchanged. Additionally, 25(OH)D negatively correlated with IGF-1, while the correlation with P1NP was not significant. A strong positive correlation of IGF-1 with P1NP and BTI but weak with CTX was observed. Low 25(OH)D (<20 ng/mL) explained 15% of the IGF-1 variance and 6% of the P1NP variance. CONCLUSIONS: Low levels of 25(OH)D do not unfavorably alter bone turnover. It seems that serum 25(OH)D level may not be an adequate predictor of bone turnover in children.


Assuntos
Remodelação Óssea/fisiologia , Puberdade/sangue , Vitamina D/análogos & derivados , Criança , Feminino , Humanos , Fator de Crescimento Insulin-Like I/metabolismo , Modelos Lineares , Masculino , Vitamina D/sangue
6.
Biomed Res Int ; 2021: 6680316, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34485526

RESUMO

As one of the most common features of obesity, insulin resistance is central to the pathogenesis of the metabolic syndrome. Low insulin-like growth factor 1 (IGF-1) levels have been proven to be associated with many traditional cardiovascular risk factors, but it still remains controversial with the relationship between IGF-1 and insulin resistance. Accordingly, the main purpose of this study is to investigate the relationship between IGF-1 and insulin resistance in obese prepubertal boys. We used the whole-body insulin sensitivity index (WBISI) to represent insulin resistance. 70 obese prepubertal boys were included in the study, and the obese subjects were divided into two groups by using 1.285 as a threshold value for WBISI. Clinical examination and laboratory examinations were assessed for all participants. Among obese boys, the group of children with WBISI ≤ 1.285 had lower IGF-1 standard deviation scores (SDS) (p = 0.021) than the WBISI > 1.285 group. The results of multiple linear analyses show that lg WBISI was positively correlated with IGF-1 SDS (p = 0.031) after adjusting for traditional cardiovascular risk factors. IGF-1 SDS was negatively associated with insulin resistance in obese prepubertal boys, independent of other traditional cardiovascular disease risk markers.


Assuntos
Resistência à Insulina/fisiologia , Fator de Crescimento Insulin-Like I/metabolismo , Insulina/metabolismo , Síndrome Metabólica/sangue , Obesidade/sangue , Puberdade/sangue , Biomarcadores/sangue , Índice de Massa Corporal , Criança , Humanos , Insulina/sangue , Masculino , Síndrome Metabólica/patologia , Puberdade/fisiologia
7.
Acta Biomed ; 92(4): e2021386, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34487059

RESUMO

Sickle cell disease (SCD) is traditionally associated with growth failure and delayed puberty. Wasting and stunting are still prevalent in children and adolescents with SCD, especially in developing countries. In addition, sperm abnormalities are frequent in males with SCD, with high rates of low sperm density, low sperm counts, poor motility, and increased abnormal morphology.  Severe anemia, vaso-occlusive attacks with ischemic injury to different organs including the pituitary gland and testis, and nutritional factors are incriminated in the pathogenesis of defective growth, puberty, and spermatogenesis. There is great phenotypic variability among patients with SCD. The variability in the clinical severity of SCA can partly be explained by genetic modifiers, including HbF level and co-inheritance of α-thalassemia. In the past, severe disease led to early mortality. Advancements in treatment have allowed patients with SCD to have a longer and better quality of life. For most patients, the mainstays of treatment are preventive and supportive. For those with severe SCD, three major therapeutic options are currently available: erythrocyte transfusion or exchange, hydroxyurea, and hematopoietic stem cell transplantation. In this mini-review, the authors tried to recognize, delineate, and update knowledge on abnormalities due to SCD from those created by the use of different treatment modalities.


Assuntos
Anemia Falciforme , Hidroxiureia , Adolescente , Anemia Falciforme/complicações , Anemia Falciforme/tratamento farmacológico , Antidrepanocíticos , Transfusão de Sangue , Humanos , Hidroxiureia/uso terapêutico , Quelantes de Ferro , Masculino , Puberdade , Qualidade de Vida , Espermatogênese
8.
Acta Biomed ; 92(4): e2021319, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34487069

RESUMO

Juvenile ovarian granulosa cell tumors (JGCTs) are described infrequently in pediatrics, and their finding in infants is exceptional. We highlight the presenting symptoms, radiologic images, operative management, and histopathologic findings of a 9-month-old female with isosexual pseudopuberty. An updated revision of literature in infants below the age of 12 months is also reported.


Assuntos
Tumor de Células da Granulosa , Neoplasias Ovarianas , Puberdade Precoce , Criança , Feminino , Tumor de Células da Granulosa/complicações , Tumor de Células da Granulosa/diagnóstico por imagem , Tumor de Células da Granulosa/cirurgia , Humanos , Lactente , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/cirurgia , Puberdade
9.
PLoS One ; 16(9): e0257186, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34499672

RESUMO

OBJECTIVE: Polycystic ovary syndrome (PCOS) is a common endocrine disorder, with potential effects on offspring both genetically and through altered intrauterine environment. Metformin, which ameliorate hormonal disturbances in non-pregnant women with PCOS is increasingly used in pregnancy. It passes the placenta, and the evidence on potential consequences for offspring endocrine development is scarce. We explore the potential effects of maternal PCOS status and intrauterine metformin exposure on offspring steroid hormone levels. DESIGN: This is a follow-up study of 5-10 years old children from the PregMet-study-a randomized controlled trial comparing metformin (2000 mg/day) to placebo during PCOS pregnancies. Of the 255 children invited, 117 (46%) were included. METHODS: There was no intervention in this follow-up study. Outcomes were serum levels of androstenedione, testosterone, SHBG, cortisol, 17-hydroxyprogesterone, 11-deoxycortisol and calculated free testosterone converted to gender-and age adjusted z-scores from a Norwegian reference population. These were compared in i) placebo-exposed children versus children from the reference population (z-score zero) by the deviation in z-score by one-sample t-tests and ii) metformin versus placebo-exposed children by two-sample t-tests. Holm-Bonferroni adjustments were performed to account for multiple endpoints. RESULTS: Girls of mothers with PCOS (n = 30) had higher mean z-scores of androstenedione (0.73 (95% confidence interval (CI) 0.41 to 1.06), p<0.0001), testosterone (0.76 (0.51 to 1.00), p<0.0001), and free testosterone (0.99 (0.67 to 1.32), p<0.0001) than the reference population. Metformin-exposed boys (n = 31) tended to have higher 11-deoxycortisol z-score than placebo-exposed boys (n = 24) (mean difference 0.65 (95% CI 0.14-1.17), p = 0.014). CONCLUSION: Maternal PCOS status was associated with elevated androgens in 5- to 10-year-old daughters, which might indicate earlier maturation and increased risk of developing PCOS. An impact of metformin in pregnancy on steroidogenesis in children born to mothers with PCOS cannot be excluded. Our findings need confirmation in studies that include participants that have entered puberty.


Assuntos
Metformina/uso terapêutico , Síndrome do Ovário Policístico/tratamento farmacológico , Esteroides/metabolismo , Criança , Feminino , Glucose/metabolismo , Homeostase , Humanos , Masculino , Gravidez , Puberdade
10.
Ann Hematol ; 100(11): 2831-2841, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34536088

RESUMO

Since the survival rates of pediatric patients undergoing cancer treatment or hematopoietic stem cell transplantation (HSCT) have increased rapidly in recent decades, the late effects of treatment are now an important focus of patient care. Access to fertility preservation (FP) procedures as well as their financing differs considerably across Europe. However, some countries in Europe have recently changed the legal basis for financing FP procedures; therefore, the implementation of structures is mandatory to give patients access to FP. In this prospective cohort study, we characterized the process for establishing pediatric fertility counseling, including the development of an in-house standard procedure for recommendations regarding FP with potentially gonadotoxic treatment and valuating data from all FP counseling sessions. All data concerning patient characteristics (pubertal status, disease group) and recommendation of FP measures were prospectively collected and adoption of FP measures analyzed. Prior to the establishment of a structured process for FP in our pediatric oncology and stem cell transplantation center, there was no standardized FP counseling. We demonstrate that with the establishment of an inhouse standard procedure, it is possible to give consistent yet individualized FP counseling to approximately 90% of our patients facing gonadotoxic treatment, counseling over 200 patients between 2017 and 2019. This pilot study could potentially be adapted in other pediatric hematology, oncology, and stem cell transplantation centers to allow a more standardized handling of FP counseling for all patients facing gonadotoxic treatment.


Assuntos
Aconselhamento/métodos , Preservação da Fertilidade/métodos , Adolescente , Antineoplásicos/efeitos adversos , Criança , Pré-Escolar , Criopreservação , Feminino , Preservação da Fertilidade/economia , Preservação da Fertilidade/normas , Transplante de Células-Tronco Hematopoéticas , Humanos , Lactente , Infertilidade Feminina/induzido quimicamente , Infertilidade Feminina/etiologia , Infertilidade Feminina/prevenção & controle , Infertilidade Masculina/induzido quimicamente , Infertilidade Masculina/etiologia , Infertilidade Masculina/prevenção & controle , Masculino , Neoplasias/terapia , Recuperação de Oócitos , Ovário/transplante , Estudos Prospectivos , Puberdade , Lesões por Radiação/prevenção & controle , Radioterapia/efeitos adversos , Preservação do Sêmen , Condicionamento Pré-Transplante/efeitos adversos , Adulto Jovem
11.
Arch Endocrinol Metab ; 65(5): 632-639, 2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34591408

RESUMO

Objective: Patients with cystic fibrosis (CF) have a high incidence of pubertal and growth delay. In girls with CF, pubertal delay has an important psychological impact. Still, only a few studies have explored the occurrence of pubertal delay in girls with CF. The aims of this study were to compare the pubertal development of girls with CF compared with healthy controls regarding Tanner staging and pelvic ultrasound and, in girls with CF, correlate the findings with those of spirometry, body mass index, Shwachman-Kulczycki score (SKS), and genotyping. Methods: This was a cross-sectional, case-control study including 35 girls with CF aged 6-17 years and following up at the Pediatric Pulmonology Outpatient Clinic of a tertiary hospital. These patients were compared with 59 healthy controls who had undergone pelvic ultrasound as part of another study conducted by the same group. Girls with CF were consecutively enrolled in the study during their annual routine check-up visit. Data collected in the CF group included spirometry and anthropometric results, SKS values, bone age, occurrence of current cystic fibrosis-related diabetes (CFRD) and Pseudomonas aeruginosa colonization, history of meconium ileus, genotype, ultrasound parameters, and Tanner stage. Results: Pelvic ultrasound findings and Tanner stage reflected less pubertal development in girls with CF compared with healthy controls. Pubertal stage in patients with CF who presented CFRD (3.17 ± 1.16), had chronic colonization by Pseudomonas aeruginosa (3.10 ± 1.10), or were homozygous for the F508del mutation (1.91 ± 1.30) was more delayed than in controls (3.41 ± 1.41). Tanner stage correlated with age at menarche, bone age, and anthropometric and ultrasound data. Conclusion: Girls with CF presented a delay in pubertal development evaluated by Tanner stage and ultrasound parameters, which was more evident in the presence of comorbidities.


Assuntos
Fibrose Cística , Estudos de Casos e Controles , Estudos Transversais , Fibrose Cística/diagnóstico por imagem , Feminino , Humanos , Menarca , Puberdade , Ultrassonografia
12.
Best Pract Res Clin Endocrinol Metab ; 35(5): 101579, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34563408

RESUMO

Sexual maturation in humans is characterized by a unique individual variability. Pubertal onset is a highly heritable polygenic trait but it is also affected by environmental factors such as obesity or endocrine disrupting chemicals. The last 30 years have been marked by a constant secular trend toward earlier age at onset of puberty in girls and boys around the world. More recent data, although more disputed, suggest an increased incidence in idiopathic central precocious puberty. Such trends point to a role for environmental factors in pubertal changes. Animal data suggest that the GnRH-neuronal network is highly sensitive to endocrine disruption during development. This review focuses on the most recent data regarding secular trend in pubertal timing as well as potential new epigenetic mechanisms explaining the developmental and transgenerational effects of endocrine disrupting chemicals on pubertal timing.


Assuntos
Disruptores Endócrinos , Puberdade Precoce , Animais , Disruptores Endócrinos/toxicidade , Feminino , Humanos , Masculino , Obesidade/induzido quimicamente , Obesidade/epidemiologia , Obesidade/genética , Puberdade , Puberdade Precoce/induzido quimicamente , Puberdade Precoce/epidemiologia , Puberdade Precoce/genética , Maturidade Sexual
13.
J Appl Physiol (1985) ; 131(4): 1241-1250, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34473575

RESUMO

Due to the invasiveness of a muscle biopsy, there is fragmentary information on the existence and possible origin of a sexual dimorphism in the skeletal muscle concentrations of the energy delivery-related metabolites carnosine, creatine, and carnitine. As these metabolites can be noninvasively monitored by proton magnetic resonance spectroscopy, this technique offers the possibility to investigate if sexual dimorphisms are present in an adult reference population and if these dimorphisms originated during puberty using a longitudinal design. Concentrations of carnosine, creatine, and carnitine were examined using proton magnetic resonance spectroscopy in the soleus and gastrocnemius muscles of an adult reference population of female (n = 50) and male adults (n = 50). For the longitudinal follow-up over puberty, 29 boys and 28 girls were scanned prepuberty. Six years later, 24 boys and 24 girls were rescanned postpuberty. A sexual dimorphism was present in carnosine and creatine, but not carnitine, in the adult reference population. Carnosine was 28.5% higher in the gastrocnemius (P < 0.001) and carnosine and creatine were respectively 19.9% (P < 0.001) and 18.2% (P < 0.001) higher in the soleus of male when compared with female adults. Through puberty, carnosine increased more in male subjects compared with female subjects, both in the gastrocnemius (+10.43% and -10.83%, respectively; interaction effect: P = 0.002) and in the soleus (+24.30% and +5.49%, respectively; interaction effect: P = 0.012). No significant effect of puberty was found in either creatine (interaction effect: P = 0.307) or carnitine (interaction effect: P = 0.066). A sexual dimorphism in the adult human muscle is present in carnosine and creatine, but not in carnitine.NEW & NOTEWORTHY This is the first study to investigate sexual dimorphisms in skeletal muscle carnosine, creatine, and carnitine concentrations in a substantial adult reference population (n = 100). A sexual dimorphism is present in both carnosine and creatine at adult age. The origin of the sexual dimorphisms is investigated using a longitudinal design over puberty in 24 males and 24 females. The sexual dimorphism in carnosine originated partly during puberty for carnosine, but not for creatine.


Assuntos
Carnosina , Adulto , Carnitina , Creatina , Feminino , Seguimentos , Humanos , Masculino , Músculo Esquelético , Puberdade
14.
Clin Endocrinol (Oxf) ; 95(5): 702-715, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34368982

RESUMO

Puberty is a process of transition from childhood to adult reproductive capacity, governed by the reactivation of the hypothalamic-pituitary-gonadal axis after a long period of dormancy in mid-childhood. As such, the reproductive hormones are in a state of flux during the adolescent years, and interpretation of both the onset of healthy, concordant puberty and the differentiation of precocious, delayed or disordered puberty, can be challenging. This review is focused on the description of the endocrine axes in healthy puberty and the markers of disorders of puberty that can aid diagnosis and management for patients with these conditions. It will cover the hypothalamic, pituitary and gonadal hormone systems, the dynamic changes that occur during puberty, conditions leading to precocious, delayed or absent puberty and other syndromes with disordered puberty, and the biochemical diagnosis of these different disorders of puberty.


Assuntos
Puberdade Precoce , Adolescente , Adulto , Criança , Hormônio Foliculoestimulante , Hormônio Liberador de Gonadotropina , Humanos , Hormônio Luteinizante , Puberdade
15.
Glob Health Action ; 14(1): 1955492, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34338160

RESUMO

OBJECTIVE: To assess the perspectives of Bangladeshi teachers on the feasibility of delivery and potential for long-term sustainability of puberty and menstruation education in urban and rural schools. METHOD: We developed a multi-module puberty and menstrual hygiene management education curriculum that teachers piloted for six months in four urban and rural government and private schools in Bangladesh. We conducted monthly assessments during piloting, discussion for manual revision and four group discussions with 20 participating teachers to understand perceived benefits, barriers, and sustainability of puberty and menstruation education among school children. RESULTS: Teachers acknowledged the importance of school-based puberty and menstruation education to improve students' perception and preparedness. They found that the training and instructors' manual they received were useful tools for effectively communicating with students. Teachers noted school and community pressure to de-emphasize educational content not included on nationally standardized examinations, and insufficient time and pre-service training for teaching sensitive topics served as barriers to implementing the pilot curriculum. CONCLUSION: Pressure from school authorities and community may hinder the successful long-term delivery of school-based puberty and menstruation education programs that are external to the national curriculum. Our findings indicate that feasibly and sustainably improving education on these topics in Bangladeshi classrooms should be achieved through 1) revision of the current national curriculum to incorporate more comprehensive puberty and menstruation information including its physiology, management, and social context, 2) adequate training and support for teachers to deliver the content, and 3) incorporation of puberty and menstruation content into students' national examinations which may better ensure teachers are given the tools and opportunity to prioritize teaching this content.


Assuntos
Higiene , Menstruação , Criança , Feminino , Humanos , Projetos Piloto , Puberdade , Instituições Acadêmicas
16.
Int J Mol Sci ; 22(15)2021 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-34360747

RESUMO

Steroid hormones represent an amazing class of molecules that play pleiotropic roles in vertebrates. In mammals, during postnatal development, sex steroids significantly influence the organization of sexually dimorphic neural circuits underlying behaviors critical for survival, such as the reproductive one. During the last decades, multiple studies have shown that many cortical and subcortical brain regions undergo sex steroid-dependent structural organization around puberty, a critical stage of life characterized by high sensitivity to external stimuli and a profound structural and functional remodeling of the organism. Here, we first give an overview of current data on how sex steroids shape the peripubertal brain by regulating neuroplasticity mechanisms. Then, we focus on adult neurogenesis, a striking form of persistent structural plasticity involved in the control of social behaviors and regulated by a fine-tuned integration of external and internal cues. We discuss recent data supporting that the sex steroid-dependent peripubertal organization of neural circuits involves a sexually dimorphic set-up of adult neurogenesis that in turn could be relevant for sex-specific reproductive behaviors.


Assuntos
Encéfalo/metabolismo , Hormônios Esteroides Gonadais/metabolismo , Neurogênese , Puberdade/metabolismo , Caracteres Sexuais , Adulto , Animais , Feminino , Humanos , Masculino , Comportamento Sexual , Comportamento Social
17.
Nat Genet ; 53(9): 1360-1372, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34385710

RESUMO

Most aldosterone-producing adenomas (APAs) have gain-of-function somatic mutations of ion channels or transporters. However, their frequency in aldosterone-producing cell clusters of normal adrenal gland suggests a requirement for codriver mutations in APAs. Here we identified gain-of-function mutations in both CTNNB1 and GNA11 by whole-exome sequencing of 3/41 APAs. Further sequencing of known CTNNB1-mutant APAs led to a total of 16 of 27 (59%) with a somatic p.Gln209His, p.Gln209Pro or p.Gln209Leu mutation of GNA11 or GNAQ. Solitary GNA11 mutations were found in hyperplastic zona glomerulosa adjacent to double-mutant APAs. Nine of ten patients in our UK/Irish cohort presented in puberty, pregnancy or menopause. Among multiple transcripts upregulated more than tenfold in double-mutant APAs was LHCGR, the receptor for luteinizing or pregnancy hormone (human chorionic gonadotropin). Transfections of adrenocortical cells demonstrated additive effects of GNA11 and CTNNB1 mutations on aldosterone secretion and expression of genes upregulated in double-mutant APAs. In adrenal cortex, GNA11/Q mutations appear clinically silent without a codriver mutation of CTNNB1.


Assuntos
Neoplasias do Córtex Suprarrenal/genética , Adenoma Adrenocortical/genética , Aldosterona/biossíntese , Subunidades alfa de Proteínas de Ligação ao GTP/genética , beta Catenina/genética , Adolescente , Neoplasias do Córtex Suprarrenal/patologia , Adenoma Adrenocortical/patologia , Adulto , Feminino , Subunidades alfa Gq-G11 de Proteínas de Ligação ao GTP/genética , Humanos , Hiperaldosteronismo/patologia , Masculino , Menopausa/metabolismo , Pessoa de Meia-Idade , Gravidez , Puberdade/metabolismo
18.
J Sci Med Sport ; 24(12): 1290-1295, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34384683

RESUMO

OBJECTIVES: Young female athletes involved in high-speed cutting and change-of-direction sports are particularly susceptible to anterior cruciate ligament (ACL) injuries. Little is known if maturational changes in cutting technique contribute to the increased injury risk. Our objective was to examine longitudinal changes in cutting kinematics in female athletes as they matured through puberty. DESIGN: Longitudinal cohort study METHODS: High school female athletes (n=172) performed an unanticipated 45° cutting task in the biomechanics laboratory across two or more pubertal stages. Pubertal stages were classified using a modified Pubertal Maturational Observational Scale (pre-, mid-, or post-pubertal stages). Generalized linear mixed models were used to compare kinematics across pubertal stages. RESULTS: As girls matured through puberty, they displayed a decrease in sagittal-plane hip (1.8-2.6°, p<0.03) and knee range-of-motion (ROM) (2.7-2.9°, p≤0.01), and decreased peak hip (2.9-3.2°, p≤0.02) and knee flexion angles (2.7-2.9°, p≤0.01), which is indicative of greater quadriceps dominance. Peak knee abduction angles also increased as girls progressed through puberty (0.9-1.4°, p≤0.02), suggesting greater ligament dominance. In terms of trunk dominance, there were mixed findings with a decrease in trunk frontal- (2.5-5.7°, p≤0.03) and sagittal-plane ROM (2.0°, p≤0.01), but an increase in trunk transverse-plane ROM (2.8-3.6°, p≤0.02) observed as girls mature. Other significant changes in cutting technique were decreased peak trunk flexion (3.8-7.8°, p≤0.01), and decreased hip flexion (2.9-3.3°, p≤0.02) and knee flexion angles (2.0-3.0°, p≤0.03) at initial contact, suggesting a more upright and stiffer cutting posture. CONCLUSIONS: As girls mature through puberty, there is a change in cutting strategy characterized by greater quadriceps and ligament dominance.


Assuntos
Articulação do Quadril/fisiologia , Articulação do Joelho/fisiologia , Movimento/fisiologia , Exercício Pliométrico , Puberdade/fisiologia , Corrida/fisiologia , Adolescente , Lesões do Ligamento Cruzado Anterior/prevenção & controle , Fenômenos Biomecânicos , Criança , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais
19.
J Law Med ; 28(3): 632-644, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34369120

RESUMO

The decision of the High Court of England and Wales in Bell v Tavistock [2020] EWHC 3274 (Admin) raises important questions regarding best care for transgender and gender diverse (TGD) youth. In this section, I describe this case, its ruling, and its implications. The ruling is underpinned by the position that puberty suppression can only be ethically and legally permissible where the young person has not only provided their assent but has also been deemed capable to provide valid consent. I challenge this position on three grounds. First, it overlooks the key ethical question of whether puberty suppression is in the individual's best interests. Second, withholding puberty suppression until the young person can consent will likely result in harmful, irreversible consequences for them. Finally, puberty suppression is not sufficiently potentially harmful to justify the additional protection offered by requiring patient consent and court authorisation. For these reasons, I argue that an assent model should govern decisions about puberty suppression for TGD youth.


Assuntos
Pessoas Transgênero , Adolescente , Inglaterra , Identidade de Gênero , Humanos , Puberdade , País de Gales
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