EtOH disrupts female mammalian puberty: age and opiate dependence

The major drug of abuse among teenagers in the United States continues to be ethanol (EtOH), but use is seen in children as young as nine. In the studies reported here, the impact of EtOH on biologic and hormonal parameters of puberty was assessed in female rats. Rats were fed a liquid diet containing EtOH, pair fed an identical liquid diet containing dextrimaltose instead of EtOH, or fed a liquid diet not containing EtOH ad libitum. Feeding was started at 21, 25, or 28 d of age. EtOH markedly delayed the age at vaginal opening (34.5±0.5 d in controls vs 48.5±2.4 d in EtOH animals; p<0.001), delayed the age at first estrous (40.9±0.6 d in controls vs 61.2±2.6 d in EtOH animals; p<0.001), increased the length of the estrous cycle, and decreased the number of proestrous days. EtOH, concomitant with reduced ovarian and uterine weight, decreased serum estradiol and progesterone. Associated with these changes in ovarian hormones there was a selective increase in follicle-stimulating hormone, but not luteinizing hormone. EtOH consistently reduced insulin-like growth factor-1. In general, EtOH-induced disruption was more severe the younger the animals were at the start of feeding. Opiate receptor blockade with naltrexone completely prevented the EtOH-induced delay in vaginal opening. The impact of EtOH on female puberty is dramatic, is an emerging public health problem, and deserves more study.     

The role of physical activity,body mass index and maturity status in body-related perceptions and self-esteem of adolescents

Background: Adolescence represents a transitional period which is marked by physical, social and psychological changes. Changes in body shape and physical activity especially alter and shape the psychological well-being of adolescents.

Aim: The purpose of this study was to determine the role of physical activity level, body mass index and maturity status in body-related perception and self-esteem of 11–18 years old adolescents.

Subjects and methods: A total of 1012 adolescents participated in this study. The “Social Physique Anxiety Scale”, “Body Image Satisfaction Scale”, “Physical Self-Perception Profile for Children” and “Rosenberg Self-Esteem Inventory” were administered. Physical activity level and body mass index were assessed using the “Physical Activity Questionnaire” and “Bioelectrical Impedance Analyzer”, respectively.

Results: Regression analysis indicated that body mass index was the only predictor of perceived body attractiveness, social physique anxiety, body image satisfaction and self-esteem for female adolescents. For male adolescents, both physical activity and body mass index were correlated with perceived body attractiveness and social physique anxiety. Pubertal status were not correlated with self-esteem and body-related perceptions for both males and females adolescents.

Conclusion: In summary, body mass index and physical activity plays an important role in body-related perceptions and self-esteem of adolescents.     

Central precocious puberty in Klinefelter syndrome: A case report with longitudinal follow-up of growth pattern

We report idiopathic central precocious puberty in a boy with Klinefelter syndrome and describe the pattern of linear growth and body proportion from the onset of precocious puberty to final height. The patient was not treated for precocious puberty. He reached adequate adult height, for both general population and normative values of Klinefelter syndrome and normal body proportions. We conclude that precocious puberty in Klinefelter syndrome may result in normal body proportion by inducing a major growth spurt of the trunk rather than in the limbs, and that adult height prognosis is not altered by precocious puberty. Given the possible occurrence of precocious puberty in Klinefelter syndrome, we advise a karyotype analysis in boys with sexual precocity, mainly in those who show small rather than enlarged testes. © 1996 Wiley-Liss, Inc.     

Rupture du Moi-corps à l’adolescence

From the essential notion, clinical and theoretical “breakdown”, the authors present in this text the observation of a teenager aged fourteen. This young girl “triggers” at the beginning of her pubertal metamorphosis, at the age of twelve, paralysis of the lower limbs. The psychotherapeutic technical work undertaken reveals a massive, intrapsychic and intersubjective tension in the maternal and more largely family environment.     

Difference between bone age at the hand and elbow at the onset of puberty

In the pubertal period, bone age advances rapidly in conjunction with growth spurts. Precise bone-age assessments in this period are important, but results from the hand and elbow can be different. We aimed to compare the bone age between the hand and elbow around puberty onset and to elucidate the chronological age confirming puberty onset according to elbow-based bone age.A total of 211 peripubertal subjects (127 boys and 84 girls) who underwent hand and elbow radiographs within 2 months was enrolled. Two radiologists and a pediatric orthopedic surgeon assessed bone age. Hand bone age was graded using the Greulich–Pyle (GP) method, and elbow bone age was determined using the Sauvegrain method. The correlation of 2 methods was evaluated by Demining regression analysis, and the mean absolute difference (MAD) with chronological age was compared between pre-pubertal and pubertal subjects. Receiver-operating characteristic curve analysis was performed to determine the chronological age confirming puberty onset.There was a statistically significant difference in bone age revealed by the GP and Sauvegrain methods in the pubertal group. In the pubertal group, the MAD was 1.26 ± 0.90 years with the GP method and 0.61 ± 0.47 years with the Sauvegrain method in boys (P < .001), while in girls, the MAD was 0.84 ± 0.60 years and 0.53 ± 0.36 years with the same 2 methods (P = .033). The chronological age for confirming puberty onset using the elbow was 12.2 years in boys and 10.3 years in girls.The bone ages of hand and elbow were different at puberty, and the elbow was a more reliable location for bone-age assessment at puberty. Puberty onset according to elbow occurred slightly earlier than expected.     

中枢性性早熟临床实践指南的质量评价

目的 了解中枢性性早熟临床实践指南与共识的现状,评价和分析其质量,为中枢性性早熟临床决策和指南共识的修订与完善提供参考。方法 计算机检索PubMed、OVID、中国知网、万方数据库、国际指南联盟、Guidelines InternationalNetwork(GIN)、 NationalInstituteforHealthandCareExcellence(NICE)、 ScottishIntercollegiateGuidelines Network(SIGN)、American Society of Clinical Oncology(ASCO)、American Urological Association(AUA)等中英文数据库和相关网站;检索时间从建库到2021年5月;由2名研究人员严格按照纳入与排除标准进行文献筛选,纳入临床实践指南。运用指南研究与评价工具(Appraisal of Guidelines for Research&Evaluation Ⅱ,AGREE Ⅱ)评价和分析其质量,对药物治疗推荐意见进行比较总结。结果 本研究共纳入指南5篇。AGREE Ⅱ质量...     

Application of the assay of urine FSH β-subunit in patients with pubertal disorders

Objective: To evaluate the diagnostic predictive value in the identification of puberty disorders by means of ELISA of β-FSH subunit levels in successively collected urine samples compared to RIA of intact FSH in serum obtained from the normal control subjects and patients with puberty disorders, respectively.Subjects and Methods: Five male and four female volunteers were recruited as controls. Four patients with the hypogonadotropic hypogonadism, five patients with hypergonadotropic hypogonadism, four patients with the central precocious puberty and one patient with isosexual peripheral precocious puberty collected successively their early-morning urine samples for 30 to 32 days.The urine β-FSH subunit was assayed with the method of ELISA, then adjusted by creatinine (Cr) concentration.Results:Comparing with their cotemporary groups, patients with the hypogonadotropic hypogonadism had lower levels of urine β-FSH, and patients with idiopathic hypergonadism had higher levels with irregular fluctuation. Meanwhile, patients with the central precocious puberty had much higher levels of urine β-FSH with irregular peaks, and patients with isosexual peripheral precocious puberty had almost normal levels. The patterns were coincident with the clinical characteristics and serum FSH levels.Conclusion: The ELISA of urine β-FSH subunit possesses a number of advantages over the RIA of serum FSH level, such as low cost, simplicity and reliability in the clinical practice. It can be used for the diagnoses of puberty disorders. In addition, it is possible and much easier, comparing with blood samples, to collect successively urine samples for research of pathophysiological dynamics of FSH secretion in puberty disorders and other reproductive dysfunction.     

知柏地黄丸辅助治疗女童中枢性性早熟的系统评价

目的 系统评价知柏地黄丸辅助治疗女童中枢性性早熟（CPP）的临床疗效及安全性。方法 使用计算机对中国学术期刊全文数据库（CNKI）、维普中文科技期刊数据库（VIP）、万方数据库（Wanfang Date）、中国生物医学文献数据库（CBM）、Cochrane Library、PubMed和Web of Science等数据库进行文献检索,收集自建库起至2023年10月25日知柏地黄丸联合促性腺激素释放激素类似物（GnRHa）治疗女童CPP的临床随机对照试验（RCT）,使用RevMan 5.4软件进行Meta分析。结果 共纳入14项RCTs、包括1 101例患儿。Meta分析结果显示：试验组临床有效率高于对照组［RR＝1.19,95% CI（1.13,1.25）,P＜0.000 01］;试验组治疗后子宫容积［MD＝-0.75,95% CI（-0.93,-0.58）］、卵巢容积［MD＝-0.26,95% CI（-0.34,-0.17）］、卵泡直径［MD＝-0.68,95% CI（-0.85,-0.50）］等第二性征回缩优于对照组（均P＜0.000 01）;试验组治疗后血清促黄体生成素（LH）水平［MD＝-0.75,95% CI（-0.95,-0.54）］、血清卵泡刺激素（FSH）水平［MD＝-1.23,95% CI（-1.53,-0.94）］、血清雌二醇（E2）水平［SMD＝-1.07,95% CI（-1.54,-0.59）］均明显低于对照组（均P＜0.000 01）;治疗后骨龄指数（BAI）［MD＝-0.12,95% CI（-0.16,-0.08）,P＜0.000 01］的改善优于对照组;试验组的不良反应率低于对照组［RR＝0.64,95% CI（0.40,1.03）,P＝0.07］。结论 知柏地黄丸联合GnRHa治疗女童CPP临床疗效明显优于单用GnRHa组,且能够更有效的使患儿第二性征回缩,降低性激素水平,抑制下丘脑-垂体-性腺轴的发育,有效延缓生长发育,且安全性良好,不会增加不良反应发生。