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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Archives of gynecology and obstetrics 232 (1981), S. 488-488 
    ISSN: 1432-0711
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Leukämie ; Non-Hodgkin-Lymphom ; Endgröße ; Körperproportionen ; Key words Leukemia ; Non-hodgkin lymphoma ; Final height ; Body proportions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Objectives: Children treated for acute lymphoblastic leukemia (ALL) or non-hodgkin lymphoma (NHL) show retarded growth. The question arose as to whether proportionate catch-up growth follows. Methods: Parameters determined in 41 adult, former ALL-/NHL-patients were: height, sitting height, head circumference, weight, height before therapy start, target height, growth hormone dependent factors, thyroid hormones and sexual steroids. (Prader standards) Results: Final height (mean −0.3 SDS; range: −2.7 to 1.9 SDS) was significantly lower (p〈0.001) than height before therapy (mean 0.3 SDS; range: −1.8 to 1.6 SDS). Nevertheless, 38 patients reached final height above the 3rd centile, only 2 patients failed to achieve target height. Height loss was marked in cranially irradiated patients. None of the patients showed complete hormone deficiency. In relation to height, sitting height was low (mean −1.0 SDS; range: −3.0 to 0.8 SDS), but head circumference normal. Conclusions: Although patients suffer growth impairment after ALL/NHL therapy, long-term height prognosis is good. Growth retardation of the trunk contributes considerably to height loss and results in disproportion.
    Notes: Zusammenfassung Fragestellung: Kinder, die wegen akuter lymphoblastischer Leukämie (ALL) oder Non-Hodgkin-Lymphom (NHL) hämatologisch behandelt werden, wachsen langsamer. Wir wollten überprüfen, ob es nach Therapieabschluß zu einem proportionierten Aufholwachstum kommt. Methode: Bei 41 erwachsenen ehemaligen ALL- und NHL-Patienten wurden Größe, Sitzhöhe, Kopfumfang, Körpergewicht, Ausgangsgröße vor Therapiebeginn, die familiäre Zielgröße, wachstumshormonabhängige Faktoren, Schilddrüsenhormone und Sexualsteroide bestimmt (Prader-Standards). Ergebnisse: Verglichen mit den Ausgangsgrößen (Mittelwert 0,3 SDS; Minimum −1,8 SDS, Maximum 1,6 SDS) sind die Endgrößen (Mittelwert −0,3 SDS; Minimum −2,7 SDS, Maximum 1,9 SDS) signifikant niedriger (p〈0,001). 38 Patienten erreichten trotzdem eine Endgröße über der 3. Perzentile, und nur 2 Patienten liegen größenmäßig unterhalb des familiären Zielgrößenbereichs. Die Größeneinbuße betrifft insbesondere ehemals schädelbestrahlte Patienten. Bei keinem wurde ein kompletter Hormonmangel festgestellt. Die Sitzhöhen der Patienten (Mittelwert −1,0 SDS; Minimum −3,0 SDS, Maximum 0,8 SDS) fanden sich bezogen auf die Endgrößen kurz, die Kopfumfänge normal. Schlußfolgerungen: Obwohl Patienten nach ALL- bzw. NHL-Therapie eine Wachstumsbeeinträchtigung erfahren, ist die Endgrößenprognose günstig. Die Wachstumsretardierung des Rumpfs trägt zur Größeneinbuße entscheidend bei und führt zur Disproportion.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Monatsschrift Kinderheilkunde 144 (1996), S. 1257-1259 
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Jodmangel ; Jodprophylaxe ; Umfrage bei Kinderärzten ; Key words Iodine deficiency ; Iodine prophylaxis ; Survey among paediatricians
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Despite the fact that, in Germany, valid laws allowing unrestricted use of iodine salt are available, iodine deficiency still exists. The foetus, newborns and pubertal children are particularly vulnerable to iodine deficiency. The role of the paediatrician is, therefore, an important one not only in guiding patients but also in disseminating knowledge towards the prevention of iodine deficiency. From the results of our survey, approximately 85 % of German paediatricians are of the opinion that iodine supply in children is unsatisfactory. It emerged that 90 % do hold iodine supplements in children to be necessary, whereas 8 % believe that iodine intake poses a risk to health. The high costs arising from goitre were, on the whole, underestimated. It can, therefore, be concluded that, firstly, there is consensus on the fact that iodine intake is low in Germany, and, secondly, that measures must be taken to improve this situation: The education of the public must continue to be given high priority in aiming to achieve increased intake of iodine salt and in allaying the fears of professionals and lay people.
    Notes: Zusammenfassung Der Jodmangel besteht in Deutschland trotz der gesetzlichen Voraussetzungen für eine breite Verwendung des Jodsalzes weiterhin. Besonders gefährdet durch den Jodmangel ist der Organismus während der Fetal- und Neugeborenenperiode und während der Pubertät. Kinderärzte und Kinderärztinnen spielen deshalb eine große Rolle bei der Aufklärung der Patienten und der Verbreitung der Kenntnisse über den Jodmangel und dessen Prävention in Deutschland. Vor diesem Hintergrund war es nun interessant, zu erfahren, wie die Meinung der Kinderärzte und Kinderärztinnen zum Thema Jodmangel und Jodprophylaxe ist. Nach dem Zufallsprinzip wurden Fragebögen an 600 Kinderärzte und Kinderärztinnen verschickt. 240 Antwortschreiben waren auswertbar. Etwa 85 % der Kinderärzte und Kinderärztinnen in Deutschland halten unseren Umfrageergebnissen zufolge das Jodangebot für Kinder für unzureichend, 90 % sehen ein zusätzliches Jodangebot an Kinder als erforderlich an. Maßnahmen, die zu ergreifen sind, werden angegeben. 8 % der antwortenden Ärzte und Ärztinnen halten dagegen eine Jodidgabe für gefährlich. Der Kostenaufwand, den Jodmangelstrumen verursachen, wird deutlich unterschätzt. Daraus läßt sich schließen, daß ein Konsens über das mangelnde Jodangebot in Deutschland und über die Maßnahmen, die zur Verbesserung der Situation beitragen können, besteht. Es wird jedoch weiterhin eine intensive Aufklärung der Bevölkerung notwendig sein, um eine breite Nutzung des Jodsalzes zu erreichen und unberechtigte Bedenken auch unter Ärzten und Ärztinnen aus dem Weg zu räumen.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Monatsschrift Kinderheilkunde 145 (1997), S. 502-505 
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Wachstumshormonbehandlung ; Therapie-Compliance ; Therapieakzeptanz ; Key words Growth hormone treatment ; Compliance ; Acceptance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary To get an idea on the compliance of our patients treated with growth hormone and on any problems relating to therapy administration we conducted an anonymous questionnaire in 204 patients/parents. 174 evaluable forms (85 %) were returned to us. The acceptance of treatment turned out to be satisfactory: 91 % of the families found the therapy practicable, but 15 % of mothers and 10 % of fathers expressed doubts on its effectiveness. 36 % of the families admitted to having left out injections occasionally. 88 % of the reasons offered for non-compliance were banal and unserious, and in only 6 % were there suggestions for therapy improvement indicating the need for more education and instruction. Thus, the day-to-day inconvenience appears to be an important aspect restricting therapy compliance. The intense medical care and education of patients and their families is essential in improving their compliance with treatment.
    Notes: Zusammenfassung Um die Therapie-Compliance unserer Patienten unter Wachstumshormonbehandlung zu überprüfen und die Kritikpunkte an der Therapiehandhabung zu erfahren, führten wir bei 204 Patientenfamilien eine anonyme Umfrage durch. 174 Fragebögen (85 %) wurden verwertbar ausgefüllt an uns zurückgesandt. Die Therapieakzeptanz erwies sich als zufriedenstellend: 91 % der Familien beschrieben die Therapie als praktikabel und einfach; allerdings gestanden 15 % der Mütter und 10 % der Väter, die Wirksamkeit der Therapie zu bezweifeln. 36 % der Familien gaben an, daß die Wachstumshormonspritze gelegentlich ausgelassen werde. 88 % der angeführten Auslaßgründe klingen banal, gravierende Therapiehindernisse wurden nicht erwähnt, und lediglich 6 % der Fragebögen enthielten Verbesserungsvorschläge, die auf einen weiteren Informations- und Aufklärungsbedarf der Patienten und deren Familien hinwiesen. Somit scheint nicht zuletzt die Alltagsbequemlichkeit einer konsequenten Therapie im Wege zu stehen. Der entscheidende Schritt zur Verbesserung der Patienten-Compliance besteht in der intensiven ärztlichen Betreuung und gründlichen Schulung der Betroffenen.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Wachstumshormon ; Kleinwuchs ; Therapie ; Demographie ; Pharmakoepidemiologie ; KIGS [Kabi] Pharmacia & Upjohn International Growth Study) ; Key words Growth hormone ; Short stature ; Therapy ; Demography ; Pharmaco-epidemiology ; KIGS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Recombinant growth hormone (rGH) therapy in the treatment of children with short stature was introduced 10 years ago, and experience has shown that progress in implementing this mode of therapy depends increasingly on analyses of large pharmaco-epidemiological studies. These studies prove that the diagnosis of growth hormone deficiency, whatever the cause or pathogenetic form, is the most frequent indication for GH therapy. The remaining problems are timely and precise diagnosis, and the best possible and individual therapy aiming at the projected height and taking safety and costs into account. We are closer to solving these problems today than ever before. Apart from this, the use of GH in treating short stature in Turner syndrome and renal insufficiency has led to its acceptance as a suitable therapy for these patients. Height improvement in a number of other growth disorders is, in certain cases, also possible through GH therapy. In the light of current experience, GH therapy can thus be attempted on a rational basis in individual cases. This form of treatment clearly holds wider possibilities and its implementation is likely to go beyond short stature in the future.
    Notes: Zusammenfassung 10 Jahre nach der Einführung von rekombinantem Wachstumshormon (WH) in die Therapie kleinwüchsiger Kinder werden unsere Erfahrungen zunehmend auch durch Analyse umfangreicher pharmako-epidemiologischer Beobachtungen geprägt. Wachstumshormonmangel: Diese zeigen, daß der Wachstumshormonmangel in seinen unterschiedlichen Ursachen und pathogenetischen Erscheinungsformen nach wie vor die häufigste Indikation für WH darstellt. Die Probleme bestehen weiterhin in der rechtzeitigen und rationellen Diagnostik und in der Optimierung und Individualisierung der Therapie zum Erreichen der Wachstumsziele unter ökonomischen Gesichtspunkten und bei gleichzeitiger therapeutischer Sicherheit. Diese Probleme sind für den WH-Mangel heute lösbar. Weitere Indikationen: Ferner zeigt sich, daß auch der Kleinwuchs beim Ullrich-Turner-Syndrom und bei der Niereninsuffizienz, für welche WH zugelassen ist, erfolgreich behandelt werden kann. Bei einer Vielzahl anderer Wachstumsstörungen ist die Möglichkeit zur Größenverbesserung im Einzelfall gegeben. Vor dem Hintergrund heutiger Erfahrungen kann ein individueller Heilversuch so auf eine rationale Basis gestellt werden. Zukunftsperspektiven: In Zukunft wird das breite Wirkpotential von Wachstumshormon über die Indikation des Kleinwuchses hinaus ausgeschöpft werden.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 157 (1998), S. 634-642 
    ISSN: 1432-1076
    Keywords: Key words Prader-Willi syndrome ; Weight ; Growth ; Final height ; Body mass index
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The spontaneous growth of 315 patients (109 girls and 208 boys) with Prader-Willi syndrome (PWS) was analysed in a mixed longitudinal and cross-sectional manner. 33 patients were seen in the department between 1970 and 1994; height and weight of 76 patients from Germany were evaluated by means of a questionnaire with detailed measuring instructions, and 206 definite cases were added from the literature. Mean (±SD) length of newborn babies with PWS was 50.2 ± 2.8 cm (145 boys) and 48.9 ± 3.3 cm (79 girls). Mean weight at birth was 2945 ± 570 g in boys and 2782 ± 594 g in girls. During the 1st year, the children's growth was nearly normal, thereafter short stature was present in approximately 50% of PWS patients. Between 3 and 13 years of age, the 50th percentile for height in PWS is roughly identical with the 3rd percentile in healthy controls. Body weight was normal for all boys and girls during the first 2 years. Thereafter, a rapid weight gain occurred; after an age of 10 years weight-for-height index in nearly all patients exceeded the normal range. The extent of pubertal growth was reduced for the group. Mean adult height was 161.6 ± 8.1 cm (23 males) and 150.2 ± 5.5 cm (21 females). Head circumference for age was normal for boys and girls. Conclusion Reference data on spontaneous development of growth and weight gain of children with Prader-Willi syndrome are described allowing a better counselling of patients and parents.
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  • 7
    ISSN: 1432-1076
    Keywords: Turner syndrome ; Growth
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The spontaneous growth of 150 patients with Turner syndrome from three German centers-90 with 45,X0 constitution, 60 with other chromosomal abnormalities-has been analyzed. The mean adult height was found to be (n=14) 146.8 cm. It was observed that growth in these patients can be divided into four phases: (1) Intrauterine growth, which is retarded; (2) Height development, which is normal up to abone-age of about 2 years; (3) Between a bone-age of 2 and 11 years when stunting of growth is most marked; (4) After a bone-age of 11 years—the time at which puberty should normally start—the growth phase is prolonged, but total height gain is only little below normal levels. No difference in height could be observed between cases with X0 karyotype and other chromosomal variants. The data are compared with those in the literature.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 142 (1984), S. 186-188 
    ISSN: 1432-1076
    Keywords: Pituitary dwarfism ; Pseudopituitary dwarfism ; Growth hormone ; Somatomedin ; Receptor defects
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The case of an infant is described who at birth was already small and postnatally grew extremely slowly. At age 3 the girl's height was 65 cm, weight 5.6 kg, bone age 21 months. Basal plasma GH was 36–66 ng/ml, basal SM activity was rather high, being around 2.0 U/ml. RIA- and RRA-SM were also increased. Prolonged GH administration did not raise plasma SM. There was a tendency for hypoglycemic episodes in the presence of low insulin levels. Receptor studies with skin fibroblasts showed a diminution of the specific binding of SM-C by 50%. Apparently only the specific IGF-receptor is defective whereas the insulin receptor responds to the increased SM with hypoglycemia. The observation that the high plasma SM did not suppress the enhanced GH-secretion suggests that perhaps the hypothalamic IGF-receptor was also defective.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1076
    Keywords: GRF ; Growth hormone deficiency ; Somatomedin C
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Growth hormone (GH) responses to GRF (1 μg/kg BW i.v.) were investigated. Comparison between GRF(1–40) and GRF(1–29)NH2 in 11 young adult volunteers gave identical results. One hundred and thirty-one children and adolescents (45 with idiopathic GHD) were tested with GRF (1–29)NH2. The maximal GH levels (max GH) in response to GRF during the 120 min test period were found suitable to characterize the response. In cases without GHD no correlation to age, sex and pubertal development was observed. A maximal GH level of above 10 ng/ml was found to be normal. In 3 out of 86 children without GHD (one with Turner syndrome; two with simple obesity) max GH fell short of 10 ng/ml, while 11 of 45 cases with GHD exceeded this margin. In GHD, max GH was inversely correlated with age. There was no difference in max GH between groups with or without perinatal pathology as a presumed cause of GHD. GH levels to GRF were positively correlated with maximal GH level during sleep in GHD, but not correlated with responses seen to insulin or arginine. The value of GRF testing for the confirmation of GHD is discussed in the light of other GH stimulatory tests and basal somatomedin C measurements. It is suggested that the combination of testing with GRF and the determination of a basal SmC level offers a safe and convenient way to diagnose GHD in clinically suspected cases, though in some cases further diagnostic tests may be needed.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 148 (1988), S. 220-227 
    ISSN: 1432-1076
    Keywords: Noonan syndrome ; Growth ; Ullrich-Turner syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We have analysed growth and the major clinical manifestations of 144 patients (89 males, 55 females) with Noonan syndrome from two West German centres. Size at birth was normal in both sexes. In both males and females, the mean height followed along the 3rd per centile until puberty, but decreased transiently due to an approximately 2 year delay in onset of puberty. Final height approaches the lower limits of normal at the end of the 2nd decade of life. The mean adult height was found to be (n=20) 162.5 cm in males and (n=13) 152.7 cm in females, respectively. Smoothed means and standard deviations for height were derived. These data may be used for the statistical evaluation of height of Noonan syndrome patients. Except for mental retardation and microcephaly, which are more frequent in males, the relative frequencies of minor anomalies and malformations were found to be similar in both sexes. The characteristic non-cyanotic heart defects in the Noonan Syndrome do not appear to have a major influence on growth. The auxological data were compared with those in the Ullrich-Turner syndrome.
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