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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hand radiographs in 10 male patients (eight white, two black) with isolated growth hormone deficiency were studied before and after treatment. The length of the second metacarpal was the most significantly depressed measurement when considered by chronologic age and responded most to treatment with human growth hormone. All patients had osteoporosis even when evaluated by height age. The bone mass improved with treatment by subperiosteal new bone apposition. Skeletal maturation was retarded with the carpals showing more severe retardation than the tubular bones and responding more dramatically to treatment. The depression in height age and carpal age was very similar, indicating that the carpal age may have the greatest correlation with height. The greater sensitivity of the carpal age deficiency of growth hormone and its greater response to treatment suggest that the carpal age and the phalangeal-metacarpal age should be considered independently during evaluation of skeletal maturation.
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PMID:Hand radiographic measurements in growth hormone deficiency before and after treatment. 19 44

Psychological studies in children with stunted growth have partly shown inconsistent results due to heterogeneity of samples and the use of non-standardized test procedures. We have examined patients with proven hypopituitarism using a selection of standardized and age-related psychological tests. Forty-eight patients, 32 male, 16 female, age 6 to 26 years with isolated growth hormone deficiency (n = 22) and multiple pituitary deficiencies (n = 26) were investigated. The patients had had hormonal substitution therapy for 0.1-16.8 years. Test procedures included evaluation of intelligence and various personality parameters. Full score IQ was in the average range. Despite these findings a high percentage of patients had delayed schooling or had to repeat a class. They were normal regarding emotional balance and frustration tolerance and did not show any tendency towards depression or psychosomatic disorders. Social behavior was characterized by an infantile attitude toward their personal environment. The patients showed a tendency to avoid aggressiveness in frustrating situations. In contrast to the results of these tests, a non-standarized interview demonstrated that the majority of patients had serious problems because of their short stature, including difficulties in finding social contacts. Continuous medical and psychological guidance is therefore recommended.
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PMID:Psychological aspects in children and adolescents with hypopituitarism. 238 56

Inasmuch as growth hormone is known to interact with the immune system, we studied immune functions including immunoglobulins, cell surface markers, mitogen responses, and polymorphonuclear cell function in eight children with growth hormone deficiency, ages 1 to 17 years, before and during treatment with human growth hormone for 12 to 16 months. Before treatment immune functions were normal in all children. Treatment with human growth hormone did not significantly affect serum immunoglobulins, polymorphonuclear cell function, or percent T cells. However, percent B cells decreased to subnormal levels in seven of seven patients. T helper/suppressor ratios decreased in all patients, to subnormal values in seven of eight patients; and mitogen responses decreased to below normal in all. The decline of percent B cells was transient in all patients, of T helper/suppressor ratios in seven of eight, and mitogen responses in five of eight patients. In vitro incubation of lymphocytes with growth hormone resulted in no changes in cell surface markers or mitogen responses. Although the depression of immune functions resulted in no increased rate of infections during the observation period, we do not know the possible effects of prolonged treatment and therefore caution against the indiscriminate use of human growth hormone. The effects of biosynthetically obtained growth hormone on immune function remain to be determined.
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PMID:Suppression of immune function in growth hormone-deficient children during treatment with human growth hormone. 348 89

The psychological aspects (personal traits, way of relating to the surrounding environment, perception of body image, degree of self-esteem) of eight adults with childhood onset growth hormone (GH) deficiency (GHD) were studied before and after 6 months of recombinant GH therapy. Each subject was evaluated using the following tests: the Bem Sex Role test, the non-verbal scales of the WAIS test for adults, the State-Trait Anxiety Inventory, the Experiential-World Inventory, the Image-Marking Method and the Draw-a-Person test; a psychoneurophysiological profile was also evaluated in order to monitor, by means of four neurophysiological variables (muscular tension, galvanic resistance, skin temperature and heart rate), the reactions to specific and aspecific stress. Before treatment, adults with GHD tended to underestimate their body size by an average of 30%, with peaks of 47% for the head area; furthermore, they showed a low level of self-esteem, a closed attitude towards social relationships, a pessimistic attitude with a tendency towards depression and a strong sense of detachment from the outside world. After 6 months of GH treatment, patients presented an overall improvement in relation to intellectual tasks, accompanied by a lower level of stress during their performance. A clear improvement was also observed in terms of emotional control during specific and aspecific stress, which might contribute a positive effect on their interrelationships. As expected, the treatment was not able to reduce the subjects' highly distorted perception of body image, due to the fact that GH treatment, despite a clear amelioration of lean/fat body mass ratio, did not change their body proportions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Growth hormone treatment in adults with childhood onset growth hormone deficiency: effects on psychological capabilities. 764 27

In order to establish whether reported psychological complaints in hypopituitary adults are related to growth hormone (GH) deficiency or other pituitary hormone deficiencies, emotional well-being and cognitive performance were evaluated in 31 men with multiple pituitary hormone deficiencies (MPHD) and in 17 men with isolated growth hormone deficiency (IGHD). Assessments included evaluation of somatic and psychological complaints, depression, fatigue, vigor, tension, state and trait anxiety, iconic memory, short-term memory, long-term memory and perceptual-motor skill. The control group consisted of 41 healthy men, matched for age. Growth hormone secretion was more severely impaired in MPHD than in IGHD patients. Despite oral replacement therapy, MPHD patients also had lower serum testosterone levels than IGHD subjects. The MPHD patients were found to have lower vigor scores, higher state anxiety scores, worse perceptual-motor skill and worse memory performance than controls. In contrast, IGHD patients only showed subnormal memory performance. It was concluded, therefore, that the cognitive impairment in both MPHD and IGHD was related to GH deficiency. The subnormal vigor scores in MPHD patients were attributed to the reduced testosterone levels. The worse perceptual-motor skill in MPHD patients might be related specifically to ACTH deficiency. Finally, the higher state anxiety in MPHD was attributed to a low self-esteem, which may be the psychological consequence of the hypogonadal appearance these patients have. We conclude that, from a psychological point of view, MPHD and IGHD adult patients are quite distinct groups.
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PMID:Cognitive impairments and mood disturbances in growth hormone deficient men. 881 29

The present study evaluates the effects of 2 years of growth hormone (GH) replacement therapy on psychological well-being and cognitive performance in adults with childhood-onset growth hormone deficiency (CO-GHD). A total of 48 GHD adult men (mean age: 27 years) were randomly assigned to one of four treatment groups: placebo treatment, or GH replacement in a dose of 1, 2, or 3 IU/m2, respectively. Placebo treatment was given for 6 months. Psychological assessments were made every 6 months. Assessments included somatic and psychological complaints, depression, fatigue, vigor, tension, state/trait anxiety, iconic memory, short-term memory, long-term memory and perceptual-motor skill. GH treatment was considered physiological if the observed insulin-like growth factor-I (IGF-I) levels were within the normal range. It was considered supraphysiological if serum IGF-I rose to a value exceeding the upper normal limit. During the placebo-controlled phase of the study the changes in memory performance were positively correlated to the GH induced changes in serum IGF-I concentration and, more weakly, to the daily GH substitution dose. At 6 months memory only had improved in the group receiving supraphysiological GH treatment, but not in the group of patients who had a normalization of serum IGF-I. However, after 1 year of treatment a normalization of memory functioning was found in both groups of patients and this was preserved during the 2nd year of treatment. No changes were observed in psychological well-being and perceptual-motor skill. We conclude that GH replacement improves memory function in adults with CO-GHD. It has no effect on psychological well-being or perceptual-motor skill. Supraphysiological treatment accelerates the recovery of memory performance. However, the long-term effects are not different from those achieved with physiological GH replacement.
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PMID:Cognitive changes during growth hormone replacement in adult men. 961 51

Social disabilities have been described in GHD patients. The aim of this study was to evaluate the social outcome of a group of adult hypopituitary patients diagnosed and treated during childhood. Seventy patients were interviewed at a mean age of 25.6 years (range 18-50 yr). They answered a semistructured questionnaire and the Beck Depression Inventory test. Patients were compared for academic achievement, marital status and employment with the nearest age sibling. We found high levels of school repeaters, school was often not completed, and around 50% were overprotected by teachers and teased by peers. 32% were unemployed, while 58% of those employed work with their families. 80% still live with their parents; only 16% are married and 9% have children. 44% had no dating experience and 52% had never had sexual intercourse. Depression was common, especially in hypogonadic subjects. Juvenilization was the most common complaint. We did not found differences in maximal educational achievements and levels of employment between patients and siblings, but significantly more married siblings were found. Depression, social isolation and dependent life style were found in GHD patients. Appropriate medical and psychological counseling should be included for patients and their families as part of treatment.
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PMID:Psychosocial outcome in growth hormone deficient patients diagnosed during childhood. 1077 95

Gomez-Lopez-Hernandez syndrome (cerebello-trigeminal-dermal dysplasia) is a condition that includes abnormalities of the cerebellum (rhombencephalosynapsis), cranial nerves (trigeminal anesthesia), and scalp (alopecia). Seven patients with this condition have been documented since 1979. We now report a male with Gomez-Lopez-Hernandez syndrome who, at the age of 19 years, is the oldest patient identified to date. He has been followed since birth, allowing us to report on the progression of his physical findings and psychiatric problems including hyperactivity, depression, self-injurious behavior and bipolar disorder. In addition, he has short stature and growth hormone deficiency.
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PMID:Gomez-Lopez-Hernandez syndrome: expansion of the phenotype. 1105 Jun 27

In order to describe the magnetic resonance imaging (MRI) findings in hypothalamic-pituitary area and its clinical relevance in patients with idiopathic growth hormone deficiency (IGHD), the MR imagings of 26 patients with IGHD were analyzed. On MRI, 24 out of 26 cases (92.3%) showed apparent pituitary upper margin depression; 8 out of 26 cases (30.8%) showed definite pituitary stalk transection; 22 out of 26 cases (84.6%) showed absence of the normal posterior pituitary bright spot. The bright lipidlike signal on T1W1 images at the median eminence distal to the breaking point (so-called ectopic posterior lobe) was found in 4 out of 26 cases (15.4%). According to the MRI findings of the pituitary stalks, the 26 cases were divided into three groups; group A of 8 cases (31%) characterized by the definite transaction of stalk; group B of 13 cases (50%) defined by the possible stalk transection; and group C of 5 cases (19%) with no definite stalk transection. MRI findings were consistent with the clinical and endocrine tests. The stalk transection was statistically significantly difference in insulin test, L-dopa/p test, and height standard deviation score (P < 0.05). The MRI of hypothalamic-pituitary area may differentiate partial IGHD form stalk-transected, doubtful transection and without transection.
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PMID:Magnetic resonance images of the hypothalamic-pituitary area in idiopathic growth deficiency. 1132 98

Existing studies of the relationship between depression and osteoporosis have been heterogeneous in their design and use of diagnostic instruments for depression, which might have contributed to the different results on the comorbidity of these two conditions. Nevertheless, these studies reveal a strong association between depression and osteoporosis. Endocrine factors such as depression-induced hypersecretion of corticotropin-releasing hormone and hypercortisolism, hypogonadism, growth hormone deficiency and increased concentration of circulating interleukin 6, might play a crucial role in the bone loss observed in subjects suffering from major depression.
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PMID:Depression: a major, unrecognized risk factor for osteoporosis? 1139 44


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