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Biomedical subjects

R Stanhope

Publications and source records attributed to R Stanhope.

At least 163 records · Page 9Linked to original sources
PubMed1986

Clinical diagnosis of disorders of puberty.

The authors emphasize the orderly sequence of events (consonance) characteristic of normal puberty. Loss of consonance of normal puberty indicates an underlying endocrine disorder.

Adenoma↗
PubMed1985

The treatment of central precocious puberty using an intranasal LHRH analogue (buserelin).

Eight girls and one boy with precocious puberty were treated with intranasal (D-Ser6)-LHRH (buserelin) for 0.5-2.3 years (mean 1.2 years). Treatment regimen varied between 17 and 40 microgram/kg/d in the girls to 10 micrograms/kg/d in the boy in two or three divided doses. Gonadotrophin-dependent clinical signs showed arrest or regression whereas those of adrenarche progressed. Serial pelvic ultrasound assessment was used to monitor treatment in four girls. Although peak stimulated gonadotrophins reduced to prepubertal levels, basal gonadotrophins became elevated on treatment. The mode of action of buserelin was the abolition of gonadotrophin pulsatility. Initial data suggest an improved growth prognosis. We concluded that intranasal therapy is an alternative route of administration of LHRH analogue in the treatment of precocious puberty.

Administration, Intranasal↗
PubMed1985

Alteration in the nocturnal pulsatile release of GH during the induction of puberty using low dose pulsatile LHRH: a case report.

A 16.4 year old girl with idiopathic hypogonadotrophic hypogonadism had successful induction of puberty by administration of low dose LHRH by pulsatile subcutaneous infusion at night. Peak serum GH was increased with therapy but more importantly, pulsatile secretion of GH which was minimal before treatment, was restored after one week of LHRH treatment.

Adolescent↗
PubMed1985

Spontaneous gonadotrophin pulsatility and ovarian morphology in girls with central precocious puberty treated with cyproterone acetate.

We have studied four girls with central precocious puberty treated with cyproterone acetate for a mean of 3.6 years (range 1.5-6.3 years). Pelvic ultrasound assessment demonstrated suppression of the ovarian morphology of central precocious puberty despite the presence of spontaneous pulsatile gonadotrophin secretion at night. We suggest that the previously reported effects on gonadotrophin secretion induced by cyproterone acetate therapy, administered in recommended doses, are minor and that the predominant effect of cyproterone acetate in the treatment of girls with central precocious puberty is direct inhibition of ovarian steroidogenesis.

Child↗
PubMed1985

Constitutional delay of growth and puberty in boys: the effect of a short course of treatment with fluoxymesterone.

17 boys with delayed growth spurt, 9 of whom also had late puberty, were treated with 2.5 to 5.0 mg of fluoxymesterone daily for 0.23-0.58 years. Mean increment of growth velocity was 4.5 cm/year during treatment and this was maintained at 3.8 cm/year over a post-treatment observation period of 0.22-1.3 years. Mean testicular volume at the end of the treatment period was 9.9 ml. Mean height for bone age standard deviation score remained unchanged at -1.2 to -1.4 (not significant). We conclude that a low dose of fluoxymesterone may be used in safety for a short time to induce a growth acceleration in adolescent boys with constitutional delay of growth and puberty.

Adolescent↗
PubMed1985

Ovarian ultrasound assessment in normal children, idiopathic precocious puberty, and during low dose pulsatile gonadotrophin releasing hormone treatment of hypogonadotrophic hypogonadism.

Ultrasound assessment of ovarian volume, follicular size, and uterine growth was undertaken in 40 normal premenarcheal girls aged 6 months to 14 years. Ovarian follicles were detected from 6 months of age and increased in size and number, so that after the age of 8.5 years there was a progressive increase in the incidence of 'megalocystic' appearance. Eight girls with idiopathic precocious puberty had large megalocystic ovaries which regressed on treatment with gonadotrophin releasing hormone analogue. These findings contrasted with those seen in two prepubertal patients with hypogonadotrophic hypogonadism in whom the natural sequence of ovarian development was greatly accelerated by pulsatile administration of native gonadotrophin releasing hormone.

Adolescent↗
PubMed1985

Oxandrolone in low dose for constitutional delay of growth and puberty in boys.

Twenty four boys with delayed pubertal growth spurt were treated with oxandrolone (2.5 mg daily) for 0.21 to 0.65 years. The mean increment of growth velocity was 4.4 cm/year during treatment, which was maintained at 3.7 cm/year after treatment. There was no significant change in height for bone age standard deviation scores.

Adolescent↗
PubMed1985

Problems in the use of pulsatile gonadotrophin-releasing hormone for the induction of puberty.

The induction of puberty by the administration of subcutaneous 15-micrograms pulses of gonadotrophin-releasing hormone (GnRH) every 90 min during day and night is described in two patients. Too rapid an induction of puberty occurred in one patient while initial progress in the other ceased after the development of pituitary desensitisation. We have attributed these results to the use of GnRH pulses in too high amplitude, and we suggest a more appropriate dose regimen.

Adolescent↗
PubMed1985

Disturbances of puberty.

The initiation and progress of puberty requires progressive pulsatile stimulation of the pituitary by GnRH and of the gonads by LH and FSH. Gonadal maturation continues throughout childhood and is not confined to puberty. We have discussed the events of normal puberty and emphasized the consonance of the acquisition of different components of sexual maturation, including growth acceleration. Departure from this consonance is a sign of abnormality. The method by which constitutional delay of growth and puberty can be distinguished from gonadotrophin deficiency has been discussed as well as the treatment options for both conditions. We have emphasized the significance of pulsatile gonadotrophin secretion and how the development of a multicystic ovarian morphology on ultrasound can be used as a non-invasive assessment of gonadotrophin pulsatility in girls. Pulsatile GnRH therapy mimics normal puberty. The converse of suppressing the clinical signs of central precocious puberty can be achieved by abolishing gonadotrophin pulsatility with GnRH analogue therapy. We now recognize qualitative pulse abnormalities of gonadotrophin secretion which occur in isolated premature thelarche and in some cases of delayed puberty. Although clinical assessment remains the key to the diagnosis of disorders of puberty, studies of gonadotrophin pulsatility have aided our understanding and treatment of these conditions.

Adolescent↗
PubMed1984

Gonadotrophin responses to GnRH in precocious puberty treated with GnRH analogue.

The gonadotrophin releasing hormone analogue Buserelin was given by intranasal spray to 13 children with precocious puberty. The LH responses to GnRH reverted to prepubertal levels in the boys on 200-400 micrograms daily of the analogue while doses of 400-1200 micrograms daily were needed to suppress the girls. The significance of this apparent sex difference is uncertain.

Buserelin↗
PubMed1984

Plasma C peptide in hyperinsulinaemic hypoglycaemia.

We describe two children with hypoglycaemia due to pancreatic beta cell hyperactivity. Both had low serum insulin but raised plasma C peptide concentrations when hypoglycaemic. Measurement of C peptide is valuable in the diagnosis of hyperinsulinaemic hypoglycaemia in children.

C-Peptide↗
PubMed1984

Hypoplastic optic nerves and pituitary dysfunction. A spectrum of anatomical and endocrine abnormalities.

Fourteen children with optic nerve hypoplasia associated with either mid-brain abnormalities or pituitary dysfunction, or both, are described. All patients were either partially sighted or blind. One case is reported in detail. The importance of hypoglycaemia in the neonatal period and later in childhood is emphasised in relation to diagnosis and developmental delay. Pituitary dysfunction is variable and may be progressive. Forty percent of the patients had a septum pellucidum and its presence or absence cannot be used as a radiological marker for the condition. Long term endocrine follow up of these patients is required.

Adolescent↗
PubMed1979

Hyponatraemia and mesothelioma.

Hyponatraemia was found in 18 (62%) of 29 patients with histologically proven mesothelioma. The mechanism for the development of the hyponatraemia is discussed. It is suggested that patients with mesothelioma should be monitored for electrolyte abnormalities. If hyponatraemia is found the syndrome of inappropriate secretion of antidiuretic hormone should be suspected as treatment with demethylchlortetracycline may improve the quality of life in an otherwise fatal illness.

Female↗