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Alan D. Rogol - One of the best experts on this subject based on the ideXlab platform.

  • Treatment of growth hormone deficiency in children, adolescents and at the transitional age
    Best practice & research. Clinical endocrinology & metabolism, 2016
    Co-Authors: Erick Richmond, Alan D. Rogol
    Abstract:

    Recombinant human growth hormone (rhGH) has been available since 1985. Before 1985 growth hormone (GH) was extracted from cadaveric pituitary glands, but this was stopped in most countries that year, following the recognition that it could transmit Creutzfeldt–Jacob disease. The primary goal of rhGH treatment in GHD patients is to normalize height during childhood and adolescence and attain an adult height within the normal range and within the target height range (genetic potential). Genome-wide association studies have been used increasingly to study the genetic influence on height. There is a wide response to rhGH therapy, likely due to compliance issues, severity of GH deficiency and patient's sensitivity to rhGH. While some Pediatric Endocrinologists will use a fixed dose of rhGH, most will use an auxology-based dosing approach. This will involve starting at the lower end of the dose range and then titrating upwards based on the patient's response to therapy with measurement of IGF-1 concentrations to ensure that the patient is not over treated or undertreated. Although treatment of children with GHD with rhGH has generally been safe, careful follow-up by a Pediatric Endocrinologist in partnership with the Pediatrician or primary care physician is recommended. The aim of this paper is to review the strategies and recommendations for treatment of GHD in children and patients in the transition to adult care.

  • Optimizing Potential for Fertility: Fertility Preservation Considerations for the Pediatric Endocrinologist
    Endocrinology and metabolism clinics of North America, 2009
    Co-Authors: Peter A. Lee, Alan D. Rogol, Christopher P. Houk
    Abstract:

    Whether for the prepubertal or pubertal child, the goal of fertility preservation is to obtain cells or tissues to be used to produce future children. For the prepubertal child, preservation efforts involve germ cells, earlier forms of sperm, and immature follicles, rather than mature spermatozoa or follicles. Options for prepubertal children include for boys freezing testicular tissue and extracting testicular sperm or for girls obtaining ovarian cortical or follicular tissue for storage. These procedures involve extraction and storage of immature gametes for subsequent in vitro maturation, although attempts for sperm currently involve only animal studies. For adolescent subjects who have sufficient gonadal development and reserve, sperm, oocytes, and ovarian cortex can be retrieved as among adults.

  • consensus statement on the diagnosis and treatment of children with idiopathic short stature a summary of the growth hormone research society the lawson wilkins Pediatric endocrine society and the european society for paediatric endocrinology worksho
    The Journal of Clinical Endocrinology and Metabolism, 2008
    Co-Authors: Pinchas Cohen, Alan D. Rogol, Cheri Deal, Paul Saenger, Edward O Reiter, Judith L Ross, Steven D Chernausek, M O Savage, J M Wit
    Abstract:

    Objective: Our objective was to summarize important advances in the management of children with idiopathic short stature (ISS). Participants: Participants were 32 invited leaders in the field. Evidence: Evidence was obtained by extensive literature review and from clinical experience. Consensus: Participants reviewed discussion summaries, voted, and reached a majority decision on each document section. Conclusions: ISS is defined auxologically by a height below −2 sd score (SDS) without findings of disease as evident by a complete evaluation by a Pediatric Endocrinologist including stimulated GH levels. Magnetic resonance imaging is not necessary in patients with ISS. ISS may be a risk factor for psychosocial problems, but true psychopathology is rare. In the United States and seven other countries, the regulatory authorities approved GH treatment (at doses up to 53 μg/kg·d) for children shorter than −2.25 SDS, whereas in other countries, lower cutoffs are proposed. Aromatase inhibition increases predicte...

  • Disorders of Growth and Development
    2002
    Co-Authors: Erick Richmond, Alan D. Rogol
    Abstract:

    This 4-yr-4-mo-old boy presented to the local Pediatric Endocrinologist for evaluation of accelerated growth velocity and development of pubic hair over the past year.

Codner Dujovne Ethel - One of the best experts on this subject based on the ideXlab platform.

  • Earlier puberty in boys with type 1 diabetes mellitus compared to a simultaneously recruited group of control adolescents
    'Wiley', 2019
    Co-Authors: Gaete Ximena, Vivanco Maritza, Lopez Patricia, Rocha Ana, Sepúlveda Carolina, Codner Dujovne Ethel
    Abstract:

    © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons LtdBackground: Recent studies have suggested that there is an earlier age of onset of puberty in healthy boys. However, no study has determined the age of pubertal development in boys with type 1 diabetes (T1D) and compared the results with a simultaneously recruited group of healthy children. Objective: The aim of this study was to evaluate the age of pubertal events in boys with TD1 and determine whether the duration of diabetes, metabolic control or insulin dose are associated with the age of puberty in boys with T1D. Methods: Boys aged 7 to 19 years with T1D (n = 148, age 12.9 ± 3.0 years) and healthy boys recruited from schools (n = 388 controls, age 12.8 ± 2.2 years) were studied. A Pediatric Endocrinologist evaluated pubertal development. Results: Boys at genital Tanner stage 2 and the final stages of puberty (genital Tanner 4 and 5) were younger than the control group (P = 0.005, P = 0.003, and P = 0.015, respectivel

  • Factors associated with post-menarcheal growth: results of a longitudinal study in Chilean girls from different socioeconomic statuses
    2016
    Co-Authors: Gaete Ximena, Codner Dujovne Ethel, López Romero, Patricia Eugenia, Unanue Nancy, Cavada Chacón Gabriel, Mericq Verónica
    Abstract:

    Background: Menarche is the last stage of pubertal development, which coincides, with the completion of longitudinal growth. Our aim was to evaluate, post-menarcheal growth and clinical variables proposed to be associated with this growth. Methods: In a prospective fashion, 106 healthy girls attending five different socioeconomic status (SES) schools of Santiago were randomly recruited. A Pediatric Endocrinologist obtained anthropometrics and registration of date at menarche every 6 months. The evolution of the girls' heights was assessed through mixed models adjusted to the SESes, parental height and body mass index (BMI). Results: Sixty-three girls from a high socioeconomic status (HSS) and 50 from a low socioeconomic status (LSS) were followed. Four years post menarche, the girls reached a growth plateau and the average height gain was 5.2 +/- 2.5 cm. This gain was not associated with SES, BMI, nor with parental height (p=0.744). The only variable that modulated this gain was age at menarche (r=-0.1997, p=0.0332). There was an inverse correlation between height at the moment of menarche and the height reached after 4 years of follow-up adjusted to parental height (r=-0302, p=0.0011). Conclusions: Post-menarcheal growth ends 4 years post-event and is inversely correlated with the age at menarche and with the height at the moment of menarche independent of BMI, parental height and SES

  • Age of onset of puberty in chilean boys according to testicular volume and tanner stage La pubertad en niños chilenos muestra un adelantamiento en el inicio del crecimiento testicular
    Sociedad Medica de Santiago, 2015
    Co-Authors: Gaete Ximena, García Roberto, Riquelme Joel, Codner Dujovne Ethel
    Abstract:

    © 2015, Rev Med Chile. All rights reserved. Background A secular trend towards a younger age of puberty onset has been reported in Chilean girls. Aim: To evaluate the age of onset of puberty and prevalence of early puberty in Chilean boys. Material and Methods: A Pediatric Endocrinologist examined 319 children attending schools in central Santiago. Pubertal development was assessed by testicular volume (TV) and genital inspection (GI) using Tanner graduation. Precocious and early puberty development was diagnosed if TV ≥ 4 ml or GI > stage 2 occurred in boys younger than 9 years and at 9-10 years of age, respectively. Results: Pubertal onset occurred at 10.2 ± 1.5 years according to TV and at 11.1 ± 1.6 years according to GI (p < 0.01). Before the age of nine, 15.2% of children had a VT ≥ 4 ml, 3% had genital changes in GI and only 3% had both changes simultaneously. Early puberty was observed in 23.8% of children according to TV and 9.5% according to GI. However, no child of less tha

  • Age of onset of puberty in Chilean boys according to testicular volume and Tanner stage
    SOC MEDICA SANTIAGO, 2015
    Co-Authors: Gaete Ximena, García Roberto, Riquelme Joel, Codner Dujovne Ethel
    Abstract:

    Artículo de publicación ISIBackground: A secular trend towards a younger age of puberty onset has been reported in Chilean girls. Aim: To evaluate the age of onset of puberty and prevalence of early puberty in Chilean boys. Material and Methods: A Pediatric Endocrinologist examined 319 children attending schools in central Santiago. Pubertal development was assessed by testicular volume (TV) and genital inspection (GI) using Tanner graduation. Precocious and early puberty development was diagnosed if TV >= 4 ml or GI > stage 2 occurred in boys younger than 9 years and at 9-10 years of age, respectively. Results: Pubertal onset occurred at 10.2 +/- 1.5 years according to TV and at 11.1 +/- 1.6 years according to GI (p = 4 ml, 3% had genital changes in GI and only 3% had both changes simultaneously. Early puberty was observed in 23.8% of children according to TV and 9.5% according to GI. However, no child of less than 11 years old had a TV >= 4 ml, genital changes and pubic hair simultaneously. Late pubertal stages occurred at the same age according to both criteria used. Body mass index z score was not associated with the age of pubertal onset. Conclusions: Testicular enlargement occurs one year earlier than changes in genitalia according to inspection. Testicular growth, but not late stages of puberty, are occurring one year earlier than previously reported in Chile 10 years ago

  • Age of onset of puberty in Chilean boys according to testicular volume and Tanner stage
    SOC MEDICA SANTIAGO, 2015
    Co-Authors: Gaete Ximena, García Roberto, Riquelme Joel, Codner Dujovne Ethel
    Abstract:

    Artículo de publicación ISIBackground: A secular trend towards a younger age of puberty onset has been reported in Chilean girls. Aim: To evaluate the age of onset of puberty and prevalence of early puberty in Chilean boys. Material and Methods: A Pediatric Endocrinologist examined 319 children attending schools in central Santiago. Pubertal development was assessed by testicular volume (TV) and genital inspection (GI) using Tanner graduation. Precocious and early puberty development was diagnosed if TV >= 4 ml or GI > stage 2 occurred in boys younger than 9 years and at 9-10 years of age, respectively. Results: Pubertal onset occurred at 10.2 +/- 1.5 years according to TV and at 11.1 +/- 1.6 years according to GI (p < 0.01). Before the age of nine, 15.2% of children had a VT >= 4 ml, 3% had genital changes in GI and only 3% had both changes simultaneously. Early puberty was observed in 23.8% of children according to TV and 9.5% according to GI. However, no child of less than 11 years old had a TV >= 4 ml, genital changes and pubic hair simultaneously. Late pubertal stages occurred at the same age according to both criteria used. Body mass index z score was not associated with the age of pubertal onset. Conclusions: Testicular enlargement occurs one year earlier than changes in genitalia according to inspection. Testicular growth, but not late stages of puberty, are occurring one year earlier than previously reported in Chile 10 years ago

Pinchas Cohen - One of the best experts on this subject based on the ideXlab platform.

  • diagnosis genetics and therapy of short stature in children a growth hormone research society international perspective
    Hormone Research in Paediatrics, 2019
    Co-Authors: Paulo Ferrez Collettsolberg, Geoffrey R Ambler, Philippe Backeljauw, Martin Bidlingmaier, Beverly M K Biller, Margaret C S Boguszewski, Pik To Cheung, Catherine S Choong, Laurie E Cohen, Pinchas Cohen
    Abstract:

    The Growth Hormone Research Society (GRS) convened a Workshop in March 2019 to evaluate the diagnosis and therapy of short stature in children. Forty-six international experts participated at the invitation of GRS including clinicians, basic scientists, and representatives from regulatory agencies and the pharmaceutical industry. Following plenary presentations addressing the current diagnosis and therapy of short stature in children, breakout groups discussed questions produced in advance by the planning committee and reconvened to share the group reports. A writing team assembled one document that was subsequently discussed and revised by participants. Participants from regulatory agencies and pharmaceutical companies were not part of the writing process. Short stature is the most common reason for referral to the Pediatric Endocrinologist. History, physical examination, and auxology remain the most important methods for understanding the reasons for the short stature. While some long-standing topics of controversy continue to generate debate, including in whom, and how, to perform and interpret growth hormone stimulation tests, new research areas are changing the clinical landscape, such as the genetics of short stature, selection of patients for genetic testing, and interpretation of genetic tests in the clinical setting. What dose of growth hormone to start, how to adjust the dose, and how to identify and manage a suboptimal response are still topics to debate. Additional areas that are expected to transform the growth field include the development of long-acting growth hormone preparations and other new therapeutics and diagnostics that may increase adult height or aid in the diagnosis of growth hormone deficiency.

  • consensus statement on the diagnosis and treatment of children with idiopathic short stature a summary of the growth hormone research society the lawson wilkins Pediatric endocrine society and the european society for paediatric endocrinology worksho
    The Journal of Clinical Endocrinology and Metabolism, 2008
    Co-Authors: Pinchas Cohen, Alan D. Rogol, Cheri Deal, Paul Saenger, Edward O Reiter, Judith L Ross, Steven D Chernausek, M O Savage, J M Wit
    Abstract:

    Objective: Our objective was to summarize important advances in the management of children with idiopathic short stature (ISS). Participants: Participants were 32 invited leaders in the field. Evidence: Evidence was obtained by extensive literature review and from clinical experience. Consensus: Participants reviewed discussion summaries, voted, and reached a majority decision on each document section. Conclusions: ISS is defined auxologically by a height below −2 sd score (SDS) without findings of disease as evident by a complete evaluation by a Pediatric Endocrinologist including stimulated GH levels. Magnetic resonance imaging is not necessary in patients with ISS. ISS may be a risk factor for psychosocial problems, but true psychopathology is rare. In the United States and seven other countries, the regulatory authorities approved GH treatment (at doses up to 53 μg/kg·d) for children shorter than −2.25 SDS, whereas in other countries, lower cutoffs are proposed. Aromatase inhibition increases predicte...

J M Wit - One of the best experts on this subject based on the ideXlab platform.

  • consensus statement on the diagnosis and treatment of children with idiopathic short stature a summary of the growth hormone research society the lawson wilkins Pediatric endocrine society and the european society for paediatric endocrinology worksho
    The Journal of Clinical Endocrinology and Metabolism, 2008
    Co-Authors: Pinchas Cohen, Alan D. Rogol, Cheri Deal, Paul Saenger, Edward O Reiter, Judith L Ross, Steven D Chernausek, M O Savage, J M Wit
    Abstract:

    Objective: Our objective was to summarize important advances in the management of children with idiopathic short stature (ISS). Participants: Participants were 32 invited leaders in the field. Evidence: Evidence was obtained by extensive literature review and from clinical experience. Consensus: Participants reviewed discussion summaries, voted, and reached a majority decision on each document section. Conclusions: ISS is defined auxologically by a height below −2 sd score (SDS) without findings of disease as evident by a complete evaluation by a Pediatric Endocrinologist including stimulated GH levels. Magnetic resonance imaging is not necessary in patients with ISS. ISS may be a risk factor for psychosocial problems, but true psychopathology is rare. In the United States and seven other countries, the regulatory authorities approved GH treatment (at doses up to 53 μg/kg·d) for children shorter than −2.25 SDS, whereas in other countries, lower cutoffs are proposed. Aromatase inhibition increases predicte...

Gaete Ximena - One of the best experts on this subject based on the ideXlab platform.

  • Earlier puberty in boys with type 1 diabetes mellitus compared to a simultaneously recruited group of control adolescents
    'Wiley', 2019
    Co-Authors: Gaete Ximena, Vivanco Maritza, Lopez Patricia, Rocha Ana, Sepúlveda Carolina, Codner Dujovne Ethel
    Abstract:

    © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons LtdBackground: Recent studies have suggested that there is an earlier age of onset of puberty in healthy boys. However, no study has determined the age of pubertal development in boys with type 1 diabetes (T1D) and compared the results with a simultaneously recruited group of healthy children. Objective: The aim of this study was to evaluate the age of pubertal events in boys with TD1 and determine whether the duration of diabetes, metabolic control or insulin dose are associated with the age of puberty in boys with T1D. Methods: Boys aged 7 to 19 years with T1D (n = 148, age 12.9 ± 3.0 years) and healthy boys recruited from schools (n = 388 controls, age 12.8 ± 2.2 years) were studied. A Pediatric Endocrinologist evaluated pubertal development. Results: Boys at genital Tanner stage 2 and the final stages of puberty (genital Tanner 4 and 5) were younger than the control group (P = 0.005, P = 0.003, and P = 0.015, respectivel

  • Factors associated with post-menarcheal growth: results of a longitudinal study in Chilean girls from different socioeconomic statuses
    2016
    Co-Authors: Gaete Ximena, Codner Dujovne Ethel, López Romero, Patricia Eugenia, Unanue Nancy, Cavada Chacón Gabriel, Mericq Verónica
    Abstract:

    Background: Menarche is the last stage of pubertal development, which coincides, with the completion of longitudinal growth. Our aim was to evaluate, post-menarcheal growth and clinical variables proposed to be associated with this growth. Methods: In a prospective fashion, 106 healthy girls attending five different socioeconomic status (SES) schools of Santiago were randomly recruited. A Pediatric Endocrinologist obtained anthropometrics and registration of date at menarche every 6 months. The evolution of the girls' heights was assessed through mixed models adjusted to the SESes, parental height and body mass index (BMI). Results: Sixty-three girls from a high socioeconomic status (HSS) and 50 from a low socioeconomic status (LSS) were followed. Four years post menarche, the girls reached a growth plateau and the average height gain was 5.2 +/- 2.5 cm. This gain was not associated with SES, BMI, nor with parental height (p=0.744). The only variable that modulated this gain was age at menarche (r=-0.1997, p=0.0332). There was an inverse correlation between height at the moment of menarche and the height reached after 4 years of follow-up adjusted to parental height (r=-0302, p=0.0011). Conclusions: Post-menarcheal growth ends 4 years post-event and is inversely correlated with the age at menarche and with the height at the moment of menarche independent of BMI, parental height and SES

  • Age of onset of puberty in chilean boys according to testicular volume and tanner stage La pubertad en niños chilenos muestra un adelantamiento en el inicio del crecimiento testicular
    Sociedad Medica de Santiago, 2015
    Co-Authors: Gaete Ximena, García Roberto, Riquelme Joel, Codner Dujovne Ethel
    Abstract:

    © 2015, Rev Med Chile. All rights reserved. Background A secular trend towards a younger age of puberty onset has been reported in Chilean girls. Aim: To evaluate the age of onset of puberty and prevalence of early puberty in Chilean boys. Material and Methods: A Pediatric Endocrinologist examined 319 children attending schools in central Santiago. Pubertal development was assessed by testicular volume (TV) and genital inspection (GI) using Tanner graduation. Precocious and early puberty development was diagnosed if TV ≥ 4 ml or GI > stage 2 occurred in boys younger than 9 years and at 9-10 years of age, respectively. Results: Pubertal onset occurred at 10.2 ± 1.5 years according to TV and at 11.1 ± 1.6 years according to GI (p < 0.01). Before the age of nine, 15.2% of children had a VT ≥ 4 ml, 3% had genital changes in GI and only 3% had both changes simultaneously. Early puberty was observed in 23.8% of children according to TV and 9.5% according to GI. However, no child of less tha

  • Age of onset of puberty in Chilean boys according to testicular volume and Tanner stage
    SOC MEDICA SANTIAGO, 2015
    Co-Authors: Gaete Ximena, García Roberto, Riquelme Joel, Codner Dujovne Ethel
    Abstract:

    Artículo de publicación ISIBackground: A secular trend towards a younger age of puberty onset has been reported in Chilean girls. Aim: To evaluate the age of onset of puberty and prevalence of early puberty in Chilean boys. Material and Methods: A Pediatric Endocrinologist examined 319 children attending schools in central Santiago. Pubertal development was assessed by testicular volume (TV) and genital inspection (GI) using Tanner graduation. Precocious and early puberty development was diagnosed if TV >= 4 ml or GI > stage 2 occurred in boys younger than 9 years and at 9-10 years of age, respectively. Results: Pubertal onset occurred at 10.2 +/- 1.5 years according to TV and at 11.1 +/- 1.6 years according to GI (p = 4 ml, 3% had genital changes in GI and only 3% had both changes simultaneously. Early puberty was observed in 23.8% of children according to TV and 9.5% according to GI. However, no child of less than 11 years old had a TV >= 4 ml, genital changes and pubic hair simultaneously. Late pubertal stages occurred at the same age according to both criteria used. Body mass index z score was not associated with the age of pubertal onset. Conclusions: Testicular enlargement occurs one year earlier than changes in genitalia according to inspection. Testicular growth, but not late stages of puberty, are occurring one year earlier than previously reported in Chile 10 years ago

  • Age of onset of puberty in Chilean boys according to testicular volume and Tanner stage
    SOC MEDICA SANTIAGO, 2015
    Co-Authors: Gaete Ximena, García Roberto, Riquelme Joel, Codner Dujovne Ethel
    Abstract:

    Artículo de publicación ISIBackground: A secular trend towards a younger age of puberty onset has been reported in Chilean girls. Aim: To evaluate the age of onset of puberty and prevalence of early puberty in Chilean boys. Material and Methods: A Pediatric Endocrinologist examined 319 children attending schools in central Santiago. Pubertal development was assessed by testicular volume (TV) and genital inspection (GI) using Tanner graduation. Precocious and early puberty development was diagnosed if TV >= 4 ml or GI > stage 2 occurred in boys younger than 9 years and at 9-10 years of age, respectively. Results: Pubertal onset occurred at 10.2 +/- 1.5 years according to TV and at 11.1 +/- 1.6 years according to GI (p < 0.01). Before the age of nine, 15.2% of children had a VT >= 4 ml, 3% had genital changes in GI and only 3% had both changes simultaneously. Early puberty was observed in 23.8% of children according to TV and 9.5% according to GI. However, no child of less than 11 years old had a TV >= 4 ml, genital changes and pubic hair simultaneously. Late pubertal stages occurred at the same age according to both criteria used. Body mass index z score was not associated with the age of pubertal onset. Conclusions: Testicular enlargement occurs one year earlier than changes in genitalia according to inspection. Testicular growth, but not late stages of puberty, are occurring one year earlier than previously reported in Chile 10 years ago