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Biomedical subjects

C P Howard

Publications and source records attributed to C P Howard.

At least 19 recordsLinked to original sources
PubMed2000

Growth during and after a trial of growth hormone releasing hormone 1-29 in children with idiopathic short stature or growth hormone neurosecretory dysfunction.

The growth promoting effects of once nightly subcutaneous injections of growth hormone releasing hormone (GHRH) 1-29 (30 microg/kg) for 6 months were studied in 16 slowly growing prepubertal children with idiopathic short stature (ISS; Group 1) and 8 similar children with growth hormone neurosecretory dysfunction (GHND; Group 2). Each child underwent endogenous growth hormone evaluation using both pharmacological and physiological testing; each had stimulated values > 10 microg/l and were subsequently placed into one of two groups based on pooled 12-hour overnight GH of < or > or = 3 microg/l. Each patient was followed every three months for one year. There were no significant differences in the two groups throughout the study with the exception of the endogenous GH levels. Both groups responded to GHRH therapy with similar significant increases in their rates of growth. Although a subset of patients (6 of 21) continued to grow at a rate significantly greater than the pre-therapy rate of growth, overall rates of growth were not significantly different from the pre-therapy growth rates 6 months following the discontinuation of GHRH treatment. We conclude that GHRH 1-29, given in the doses provided, leads to similar changes in growth rates in short, slowly growing children who are GH sufficient and those with GHND. Despite prior reports to the contrary, GHND patients do not experience a sustained increased in growth rate upon discontinuation of GHRH.

Appetite↗
PubMed1995

"Low-dose" growth hormone therapy during peritoneal dialysis or following renal transplantation.

The minimal effective dose of growth hormone (GH) to promote growth in children on dialysis or following renal transplantation remains unsettled. In order to study the issue, "low-dose" GH was administered to children with end-stage renal disease (ESRD) receiving chronic automated peritoneal dialysis (APD, n = 6, 4 males, 2 females) or following renal transplantation (T, n = 9, 8 males, 1 female). No APD patient was GH deficient, while 1 T patient (no. 2) had data consistent with GH deficiency, although he was obese (body mass index = 34 kg/m2). The mean dose of GH after 6 and 12 months of treatment was 0.16 +/- 0.02 and 0.22 +/- 0.07 versus 0.16 +/- 0.03 and 0.27 +/- 0.21 mg/kg per week for APD and T patients, respectively. When analyzing all patients, there were no significant differences before or after 6 and 12 months of GH therapy within or between the two groups, in terms of height velocity, bone age, renal function (in the T group) and height Z-scores (Z-Ht). However, the height velocity Z-score (Z-HV) increased significantly at 6 and 12 months compared with baseline in the APD patients only (P < 0.05). When the 2 T patients with the most impaired renal function were excluded from the analysis, Z-HV also increased significantly in the T patients after 12 months of GH (P < 0.02). We conclude that following "low-dose" GH therapy, children with ESRD treated with APD or T have similar increases in HV, allowing maintenance of Z-Ht but not "catch-up" growth.

Adolescent↗
PubMed1995

Effects of long-term growth hormone releasing hormone 1-29 in significantly short children.

Seven children with significant idiopathic short stature (SISS) whose heights were significantly below the third percentile (SD score for height -2.5 to -3.5) and who had normal levels of growth hormone (GH) were treated with growth hormone releasing hormone (GH-RH) in a dose of 30 micrograms/kg/day. Therapy was discontinued if patients failed to increase their rates of growth by more than 2.0 cm/year over their pre-therapy growth rate. Treatment was discontinued in two of the patients after 12 months but was continued in the other five for 24 months. These data demonstrate that some patients with SISS grow well during the first 2 years of treatment with GH-RH.

Child↗
PubMed1988

The influence of oral contraceptives on hormonal and metabolic homeostasis in young adolescents.

In order to evaluate the effects of oral contraceptives on metabolic and endocrine function in teenagers, Norinyl 1/50 was begun in 46 12-17-year-old girls after a 16-hour-fasting blood sample was obtained for glucose, insulin, glucagon, growth hormone, luteinizing hormone, follicle-stimulating hormone, thyroid-stimulating hormone, prolactin, gluconeogenic substrates, total lipids, and cholesterol. Sampling was repeated at 6 and 12 months of therapy. Of the 46 patients enrolled in the study, 23 returned for follow-up after 6 months, and 13 completed the study. Blood sampling after 6 and 12 months of therapy demonstrated no significant changes (p greater than 0.05). Our results suggest that there were no changes in the metabolic or endocrine functions studied at 6 and 12 months on a medium-dose contraceptive agent.

Adolescent↗
PubMed1987

Neonatal genital reconstruction.

It is evident from studies of boys who suffered a surgical catastrophe at a young age and were then assigned a female sex role that cultural and environmental influence are a potent determinant of a child's gender identity. It is imperative that parents have their child's sex assignment firmly fixed in their minds as early as possible. Early surgical correction of a child with ambiguous genitalia to conform to the sex of assignment will serve greatly to reinforce appropriate behavior in the parent. Such surgical intervention for diagnostic and reconstructive purposes is both desirable and safe in the first weeks of life.

Disorders of Sex Development↗
PubMed1984

Comparison of growth and somatomedin C responses following growth hormone treatment in children with small-for-date short stature, significant idiopathic short stature and hypopituitarism.

Somatomedin-C (Sm-C) and growth hormone (GH) levels were determined before, during and after human growth hormone (hGH) treatment in 18 children with small-for-date short stature ( SDSS ), 7 children with significant idiopathic short stature ( SISS ) and 14 children with hypopituitarism. Data on the acute effects of hGH on Sm-C were compared to growth responses after 6 to 9 months therapy. Eleven of the 25 non-hypopituitary patients with normal basal and stimulated serum GH levels and normal basal Sm-C levels increased their rates of growth more than 3.0 cm/year. This compared with 11 of the 14 children with hypopituitarism who increased their rates of growth by at least 3.0 cm/year when treated with GH. Neither the basal somatomedin levels nor the GH-stimulated somatomedin levels correlated well with subsequent growth in the non-hypopituitary patients. These studies indicate that GH therapy may be effective in treating short stature in children without demonstrable GH deficiency.

Adolescent↗
PubMed1983

Eikenella corrodens as a cause of thyroid abscess.

Acute suppurative thyroiditis in children is rarely reported. It is generally associated with upper respiratory tract infections and is manifest as an acute febrile illness with swelling of the thyroid gland. Diagnosis is established by aspiration of the affected area, and cultures for both aerobic and anaerobic bacteria should be carried out. Therapy is based on drainage of the abscess and treatment with specific antimicrobial drugs, as determined by culture results. We describe a 3 1/2-year-old girl with a thyroid abscess from whom Eikenella corrodens, in addition to mixed flora, was recovered. No disturbance in thyroid function was observed. We review the pathogenesis of acute bacterial infections of the thyroid gland and the literature regarding the specific cause of these infections.

Abscess↗
PubMed1983

Skeletal changes following growth hormone treatment in a child with combined hypopituitarism and a skeletal dysplasia.

A child with combined hypopituitarism and an undefined skeletal dysplasia is described. The hypopituitarism was manifested by post-natal growth failure, excessive sc fat, micropenis, and poor growth hormone response to provocative tests. Disproportionately short limbs, especially distally, and skeletal radiographs showing generalized brachydactyly, cone epiphyses of the phalanges and ossification defects in the proximal femoral metaphyses characterized the skeletal dysplasia. In contrast to the normal structure of the endochondral growth plate seen in hypopituitarism, the growth plate in this child was structurally abnormal; there was no differentiation of chondrocytes into hypertrophic and degenerative cells. Treatment with hGH for 8 months was associated with the appearance of chondrocyte differentiation, the restoration of growth plate structure to almost normal and a substantial increase in growth rate. There was no change in his disproportion or improvement in his radiographic abnormalities. These observations suggest that hGH may influence growth plate structure in certain instances and that this may be associated with increased linear growth.

Age Determination by Skeleton↗
PubMed1981

Children with growth hormone deficiency. Intermittent treatment with somatropin and oxandrolone.

The effectiveness of a combination of somatropin (0.1 IU/kg in three doses per week) and oxandrolone (0.1 mg/kg/day) in the treatment of human growth hormone deficiency was evaluated. Twelve children with hypopituitarism were placed into two separate groups. Each group was treated for five 6-month periods, and anthropologic measurements and bone-age determinations were obtained at the end of each period. Both groups of children grew approximately 20 cm during the 30 months of treatment. Somatropin increased the growth rate significantly both when given alone and when given in combination with oxandrolone. Although the addition of oxandrolone may have diminished the waning effect often seen during somatropin therapy, the acceleration in bone age indicates the need for further long-term studies before oxandrolone can be recommended as an adjunct to treatment with somatropin.

Body Height↗
PubMed1980

Determination of leucine flux in vivo by gas chromatography-mass spectrometry utilizing stable isotopes for trace and internal standard.

A simple and reliable method is described for the determination of leucine flux in vivo using two stable isotopes of leucine and gas chromatography-mass spectrometry (GC-MS). [6,6,6-2H3]Leucine is administered as a primed-dose constant infusion in vivo and DL-[2H7]-leucine is added to plasma as an internal standard. Plasma leucine concentration and moles per cent enrichment of [2H3]leucine can be determined simultaneously by GC-MS and selected ion monitoring. Leucine flux calculated from the [6,6,6-2H3]leucine data was nearly identical to that obtained with L-[U-14C]leucine in dogs. This method is readily applicable to the study of leucine metabolism in humans of all ages and laboratory animals.

Animals↗
PubMed1978

Hypertrophic osteoarthropathy in association with pulmonary metastasis from osteogenic sacroma.

Hypertrophic osteoarthropathy in children is rare, especially when it is associated with lung metastsis. The patient reported herein had metastic osteogenic sarcoma and failed to respond to chemotherapy or thoractomy. There are several theories as to the pathogenesis of osteoarthropathy, but none is totally convincing. Vagotomy or transection of intercostal nerves has been advocated to relieve the symptoms of osteoarthropathy.

Child↗