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Biomedical subjects

Z Zadik

Publications and source records attributed to Z Zadik.

97 records · Page 6Linked to original sources

The effect of hGH deficiency on the insulin response to glucagon after oral glucose loading.

Six children and adolescents (aged from 2 6/12 to 16 years) with isolated hGH deficiency were subjected to a standard oral glucose tolerance test (OGTT) followed by the administration of IV glucagon at 180 mins. Three of them underwent a second test after several months of hGH therapy. Nine patients underwent a separate IV glucagon test and two of these patients had both tests. As controls served 14 endocrinologically normal children and adolescents, who underwent both tests. It was found that the patients with isolated hGH deficiency had lower basal insulin and blood glucose levels and that their insulin response to IV glucagon even after oral glucose preloading was significantly lower than in the control group. This response was partially restored by several months of hGH treatment in the three patients tested. These findings are interpreted as further evidence for an insulinotrophic effect of hGH.

Adolescent↗

The effect of growth hormone and IGF-I on clonogenic growth of hematopoietic cells in leukemic patients during active disease and during remission--a preliminary report.

The number of survivors of childhood leukemia treated with growth hormone for growth retardation is increasing. The debate about the direct or indirect relationship of GH and insulin-like growth factor I (IGF-I) to the occurrence or recurrence of malignancy, especially in the case of GH therapy in patients with leukemia, is still unresolved. We, therefore, studied the effect of GH and IGF-I on bone marrow of patients with acute leukemia (ALL and AML) in diagnosis and recurrence and in chronic leukemia patients (CML) in remission. GH increased blast colony numbers by a mean of 68% and 77% at GH concentrations of 250 and 300 ng/ml, respectively. IGF-I increased blast colony numbers in ALL patients by 50, 93 and 105%, and in AML patients by 33, 58 and 65%, at IGF-I concentrations of 0.05, 0.25 and 0.5 ng/ml, respectively. In 3 CML patients in remission a granulocyte-macrophage colony forming assay did not reveal stimulation of peripheral blood blast colony formation by GH or IGF-I. Our in vitro data (as previously reported) suggest that GH and IGF-I may promote blast cell proliferation, and the supplemental administration of these peptides in leukemia patients in remission must be carefully monitored for early relapse. Additional studies on bone marrow cells of leukemic patients in remission are needed in order to examine the effects of GH and IGF-I on these cells.

Bone Marrow↗

Short stature: new challenges in growth hormone therapy.

Until recently, the limited supplies of pituitary derived growth hormone (GH) enabled us to treat only those patients who were classical GH deficient. With the unlimited supplies of recombinant GH available, there is no limitation to the number of patients we can treat. It becomes necessary, however, to select those patients who will most benefit from GH therapy. Our preliminary results demonstrate that the short-term growth response to growth hormone is not an all-or-none phenomenon. The lower the growth velocity and the growth hormone reserve, the better the growth response to therapy. On the other hand we do not recommend institution of GH therapy for children with a normal growth rate and a normal GH spontaneous secretion. In children with classical GH deficiency (GHD) and in children with a subnormal spontaneous secretion of GH (NSD) adult height prediction decreases when GH therapy is started at an age older than 12. We have found that GHD and NSD boys differ in their growth pattern. Pubertal maturation and bone age maturation progress more rapidly in NSD patients. Therefore special caution is needed in NSD patients older than 12 years. The older the patient and the longer the treatment period, the faster the pubertal process can advance. Further studies are needed before recommendations for therapy in non-classical GHD patients can be made. Until patients involved in clinical trials reach final height, recommendations for new indications cannot be made.

Body Height↗

Urinary free cortisol (UFC) values in newborns under stress.

UNLABELLED: Children with adrenocortical insufficiency are commonly instructed to increase three to five times baseline glucocorticoid replacement dose during periods of stress such as surgery or febrile illness. The present study was undertaken to determine whether these recommendations reflect the actual change in urinary free cortisol (UFC) output during stress in neonates and to test the effect of stress on the diurnal variation of cortisol in this age group. DESIGN AND PATIENTS: Twenty-four hour urinary free cortisol (UFC) excretion was determined in 75 neonates during the first 2 days of life. Thirty were healthy and 45 were neonates with respiratory distress. In 60 babies the 24-h UFC was collected in 6-h fractions for the determination of diurnal variation of urinary cortisol. RESULTS: The mean change in UFC was 4.5 times higher in the sick babies than in the controls. A distinct diurnal variation of UFC was noted in both healthy and sick babies. CONCLUSIONS: In contrast with previous publications a distinct diurnal pattern was noted in the majority of neonates.

Birth Weight↗

Cushing's disease presenting as pubertal arrest.

The clinical features of Cushing's disease in childhood are usually abnormal fat distribution, moon face, growth failure and hirsutism. Laboratory studies include evidence of cortisol and ACTH hypersecretion. This report concerns a boy who presented only with arrested puberty and growth failure as physical evidence of Cushing's syndrome and showed rapid progression of puberty once pituitary adenomas were removed.

Adenoma↗