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Biomedical subjects

R Brauner

Publications and source records attributed to R Brauner.

At least 145 records · Page 8Linked to original sources
PubMed1986

[Role of pelvic ultrasonography in the diagnosis, therapeutic indications and surveillance of central precocious puberty].

The use of pelvic ultrasonography was evaluated as a diagnostic and follow-up tool in girls with precocious puberty. Before treatment 23 of 33 patients with central precocious puberty presented an increased size of the uterus. In 10 cases with prepubertal size of the uterus, the precocious puberty was only beginning or of mild severity. During treatment with a LHRH analogue, changes in uterine size were slow in spite of a satisfactory and rapid control of estrogen secretion. At onset of treatment, transient ovarian cysts were seen in 2 patients. In our experience, pelvic ultrasonography did not provide significant information on the control of the disease by LHRH analogue therapy. Of 16 girls with presumed premature thelarche, 3 presented signs of estrogenic stimulation of the uterus. It remains a useful technique to rule out the presence of ovarian cysts or tumors at time of diagnosis.

Buserelin↗
PubMed1986

[Severe osteopenia in young children with hyperthyroidism. 2 cases].

The cases of 2 young children with Grave's disease and severe bone demineralization are reported. In one case, spontaneous fracture and a collapsed vertebra were noted. Increased serum alkaline phosphatase levels and normal 1.25-(OH)2D and 24-25 (OH)2D levels were observed when 25(OH)D levels were decreased. These anomalies, not described previously in young hyperthyroid children, should be kept in mind. Bone X-ray and calcium phosphorus metabolism investigations should be part of routine check-ups of young children with Grave's disease.

Calcium↗
PubMed1986

[Chemotherapy and ovarian function. Retrospective analysis in 17 girls treated for malignant tumor or hematologic disease].

Ovarian function was investigated in 17 patients aged 13 5/12 to 30 years who had received various types of combined chemotherapy without any irradiation. Ovarian insufficiency was found in 6 cases with amenorrhea (n = 5) or irregular menstruations (n = 1). There is a high risk of sterility in these cases although as described in one case, a normal pregnancy occurred in spite of evidence of ovarian failure. Cyclophosphamide seemed to be less harmful when given before puberty. Great variations in individual susceptibility for relatively low doses were observed with this drug. The combination with other drugs in some protocols might play a role in these cases. At variance with results reported in adults, the MOPP chemotherapy used in children with Hodgkin's disease did not induce ovarian dysfunction.

Adolescent↗
PubMed1985

Diabetes insipidus in children. III. Anterior pituitary dysfunction in idiopathic types.

Seventeen patients with idiopathic diabetes insipidus occurring in childhood were observed from 4 to 26 years (mean duration 15 1/2 years). The diagnosis of idiopathic diabetes insipidus was based on routine clinical examination and careful, repeated neuroradiologic investigations. Anterior pituitary dysfunction was present in some of these patients. Growth hormone deficiency was present in six children, insufficient thyroid stimulating hormone secretion after thyrotropin-releasing hormone stimulation was demonstrated in one, and abnormal response to a metyrapone test in two. Elevated prolactin and TSH values were present in three and two patients, respectively. Some of these abnormalities were transitory. The presence of anterior pituitary dysfunction in idiopathic diabetes insipidus indicates that the destructive process is not localized to vasopressin synthesizing cells but may also involve other parts of the hypothalamus.

Adolescent↗
PubMed1985

Long-term results of GnRH analogue (Buserelin) treatment in girls with central precocious puberty.

The GnRH analogue Buserelin was given for one year to six girls with central precocious puberty in a daily subcutaneous dose of 20 micrograms/kg/day. A decrease of plasma estradiol and vaginal maturation index to prepubertal values was obtained in 5 out of 6 cases. Bone maturation decreased and final predicted adult height improved significantly. This analogue of GnRH appears to be an effective medication for gonadotropin dependent precocious puberty in girls.

Buserelin↗
PubMed1985

Precocious puberty secondary to cranial irradiation for tumors distant from the hypothalamo-pituitary area.

This retrospective study is the first report of the occurrence of central precocious puberty in 6 children having received cranial irradiation. Pubertal development took place at a mean age of 7 5/12 years (6 10/12-7 10/12 years in 5 girls and at 9 years in 1 boy). They had received 2,400-4,500 rad at a mean age of 5 2/12 years. In addition, 5 children had GH deficiency so that their growth spurt was blunted and 3 of them were left with an extremely short stature. This condition would require a therapeutic approach combining the use of an LHRH analogue and hGH therapy when necessary in order to protect from too rapidly progressing bone maturation.

Adolescent↗
PubMed1985

[Statural growth following irradiation of the central nervous system for medulloblastoma of the posterior fossa. Retrospective analysis of 45 cases].

Treatment of medulloblastoma in children with head and spinal irradiation causes growth hormone deficiency and growth retardation. The present study deals with 45 patients presenting a follow-up time superior to 4 years; some of them having reached their final height. The mean final height is 3 standard deviations below normal mean. Growth retardation which occurred in 42 of 45 children, appears to be due to two major factors: 1) GH deficiency in 42 cases as assessed by the arginine insulin tolerance test. 2) Spinal lesions due to irradiation, causing early growth retardation and a reduced trunk length in most of these children. The response to hGH treatment (10 mg/kg/yr) was not sufficient in this group of patients.

Body Height↗
PubMed1984

[Analysis of diabetic microangiopathy using retinal angiography in 82 children].

Between 1979 and 1983, 116 retinal fluorescein angiographies were performed in 82 insulin-dependent diabetic children aged from 8 to 19 years. Abnormalities were observed in 7% of children with diabetes of less than 5 years duration. Retinal lesions were present in 30% of children with disease of 5-60 years duration. Most of the lesions encountered were capillary dilatations, fluorescein leakages and microaneurysms. The incidence and severity of these lesions increased with the duration of diabetes. Most of them, even of early onset, proved irreversible. It is therefore important to monitor their development by frequent angiographies (every 2 years) and to initiate an intensive treatment of diabetic children from the onset of the disease.

Adolescent↗
PubMed1983

Leydig-cell function in children after direct testicular irradiation for acute lymphoblastic leukemia.

To assess the effect of testicular irradiation on testicular endocrine function, we studied 12 boys with acute lymphoblastic leukemia who had been treated with direct testicular irradiation 10 months to 8 1/2 years earlier. Insufficient Leydig-cell function, manifested by a low response of plasma testosterone to chorionic gonadotropin or an increased basal level of plasma luteinizing hormone (or both), was observed in 10 patients, 7 of whom were pubertal. Two of these patients had a compensated testicular endocrine insufficiency with only high plasma concentrations of luteinizing hormone. Testosterone secretion was severely impaired in three pubertal boys studied more than four years after testicular irradiation. A diminished testicular volume indicating tubular atrophy was found in all pubertal patients, including three who had not received cyclophosphamide or cytarabine. These data indicate that testosterone insufficiency is a frequent complication of testicular irradiation, although some patients continue to have Leydig-cell activity for several years after therapy.

Adolescent↗
PubMed1982

Effect of hypothalamic and pituitary irradiation on pubertal development in children with cranial tumors.

The purpose of the present study was to report on gonadotropin function and puberty of a large group of children treated by cranial irradiation for cranial and neck tumors and medulloblastoma. Forty-five children of pubertal age were investigated. The mean interval time since radiation was 5 2/12 yr. Gonadotropin and gonadal function were evaluated by clinical criteria, plasma sex steroids, and plasma LH and FSH responses to LRH. Puberty was complete or progressing normally in 31 cases and was abnormal in 14 cases. Severe gonadotropin deficiency, with lack of or slow progression of puberty and decreased LH and FSH responsiveness to LRH, was observed in 5 cases; 2 of these had moderately elevated plasma PRL levels. Secondary amenorrhea or lack of pubertal progression was found in 5 other cases. GH deficiency was associated with gonadotropin deficiency in 9 of these 10 cases. Adrenal function, estimated by basal dehydroisoepiandrosterone, dehydroisoepiandrosterone sulfate, and estrone, was normal according to pubic hair stages. In conclusion, complete or partial gonadotropin deficiency can be the consequence of cranial irradiation in children receiving 6000 rads or less. It is usually associated with GH deficiency. The site of the damage on the pituitary gland or the hypothalamus remains to be demonstrated.

Adolescent↗
PubMed1982

[Precocious puberty. Comment on the diagnostic conditions and etiological aspects].

The present review is based on the retrospective study of 124 children with precocious puberty, 92 girls and 32 boys. In girls, the analysis of the clinical initial presentation has shown that premature pubarche (n = 18), premature adrenarche (n = 2) or isolated menstruations (n = 3) must be ruled out, as these symptoms can remain isolated for more than a year. However, in most cases the presence of growth acceleration and vaginal estrogenisation was of major diagnostic value. Bone maturation, although generally accelerated, can be normal in recently developed puberty. Precocious puberty may proceed by steps, with complete disappearance of physical signs in the intervals. Organic causes were found in 31% of the girls, and 44% of the boys with some characteristic features as rapid progression, and elevated LH response to LRF stimulation. Main causes were glioma of the optic chiasma (n = 11), 3rd ventricule invasive tumors, hamartoma (n = 8). The latter should be looked for by a non invasive procedure as the CT scan. In girls, precocious puberty with very high circulating estrogen levels was observed as part of a McCune-Albright syndrome. As the effect of precocious puberty on the final adult height is variable, the evaluation of therapeutic results remains uncertain. Medroxyprogesterone as well cyproterone acetate have not been fully efficient in controlling bone maturation. More recently, and still controversial, the treatment with long acting LRF analogues might provide a more satisfactory statural prognosis.

Bone Development↗
PubMed1981

[Hemodynamic parameters determined by impedance cardiography in hyperthyroidism].

The impedance-cardiography renders possible the recognition of central haemodynamic parameters on an unbloody way. For the judgment of the method 18 female patients with hyperthyreosis were examined before and during the thyreostatic treatment. At the same time the systolic time intervals were estimated and the results from the two methods were compared. Apart from the abbreviation of PEP and the decrease of the contractility index PEP/LVET the increase of the cardiac index and the reduction of the resistance index indicate the thyreotoxic effect on the cardiovascular system.

Cardiac Output↗