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PubMed2005

Recombinant growth hormone therapy for X-linked hypophosphatemia in children.

BACKGROUND: Conventional treatment of X-linked hypophosphatemia with oral phosphate and calcitriol can heal rickets, but it does not always raise serum phosphate concentrations significantly, nor does it always normalize linear growth. Some clinical trials suggest that combining recombinant human growth hormone therapy with conventional treatment improves growth velocity, phosphate retention, and bone mineral density, but some clinical trials suggest that it appears to aggravate the pre-existent disproportionate stature of such children. OBJECTIVES: To determine whether recombinant human growth hormone therapy for children with X-linked hypophosphatemia is associated with changes in longitudinal growth, mineral metabolism, endocrine function, renal function, bone mineral density, body proportions, and also with any adverse effects. SEARCH STRATEGY: Relevant trials were identified from searching the Cochrane Central Register of Controlled Trials Issue 3, 2003 and Ovid MEDLINE 1966 to September 2003. Additional trials were identified from the reference lists of identified trials and other reviews. We also searched the Journal of Bone and Mineral Research (1986 to 2003) and proceedings of the American Society for Bone and Mineral Research Annual Meeting (1st to 24th). Date of most recent search: November 2003. SELECTION CRITERIA: All randomized controlled trials or quasi-randomized controlled trials comparing growth hormone (alone or combined with conventional treatment) with either placebo or conventional treatment alone in children with X-linked hypophosphatemia. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trials for methodological quality and extracted data from eligible trials. MAIN RESULTS: The searches identified five trials, of which one met the inclusion criteria, including a total of five participants. In this trial, rhGH therapy improved the height standard deviation score (z score), and transiently increased serum phosphate and tubular maximum for phosphate reabsorption. AUTHORS' CONCLUSIONS: We have found no conclusive evidence to indicate that the use of recombinant human growth hormone therapy in children with XLH is associated with changes in longitudinal growth, mineral metabolism, endocrine, renal function, bone mineral density, body proportions, but it does not appear to have any adverse effects.

Child↗
PubMed2002

Longitudinal study evaluating neuropsychological changes in so-called asymptomatic carriers of the Huntington's disease mutation after 1 year.

OBJECTIVES: To determine (1) whether the battery of neuropsychological tests was sufficiently sensitive to find differences between symptomatic patients with Huntington's disease (HD) and clinically asymptomatic individuals carrying the HD gene (AGC) and individuals without the HD gene (NGC) and (2) whether increasing cognitive impairment is found in AGC as compared with NGC. METHODS: A case-control, single-blind study comparing subjects with clinically manifest HD (n=21), AGC (n=12) or NGC (n=11) and a 1-year follow-up of AGC and NGC. Genotype for the HD gene was determined by molecular testing. A large battery of neuropsychological tests measuring several cognitive domains was performed. RESULTS: On most neuropsychological tasks, HD patients perform significantly worse than AGC and NGC. At baseline and follow-up examination, compared with NGC, AGC had lower scores on the symbol digit modalities test. Scores on a block span task declined more rapidly among AGC than among NGC. CONCLUSION: Cognitive impairments in HD patients are found when compared with clinically asymptomatic individuals carrying the HD mutation. Furthermore, our results suggest that subtle cognitive deficits are present in asymptomatic persons who have inherited the HD gene.

Adult↗
PubMed2005

Inhibin A and B as markers of menopause: a five-year prospective longitudinal study of hormonal changes during the menopausal transition.

OBJECTIVES: A more direct and precise hormonal marker of the menopause has been required for some time. The aim of this study was to identify the most accurate marker of the menopause, based on analyses of inhibin A and B, FSH, LH and estradiol (E(2)), among 59 healthy women without hormonal treatment during the perimenopause and early postmenopause. METHODS: Fifty-nine women, aged 46-56 years (mean age 51.2 years), were examined annually for 5 years during the menopausal transition and had venous blood drawn simultaneously for later analyses of the above-mentioned hormones. RESULTS: Inhibin A showed a steady decline from at least 4 years before the final menstrual period (FMP) until 1 year before menopause, whereas inhibin B had a shorter lasting decline from year 3 to year 2 before menopause, concomitant with a rise in FSH and LH. CONCLUSION: The present study confirmed previous observations that inhibin A had a continuous decline starting before the decline of inhibin B, suggesting that an increasing part of the cycle was anovulatory. The fall in inhibin B and the increase in FSH constitute markers of ovarian aging. One year prior to menopause neither inhibin A nor inhibin B could be detected. The disappearance of these peptide hormones is an important predictor of the approaching menopause.

Biomarkers↗
PubMed1995

Longitudinal study on the changes of maxillary arch dimensions in Japanese children with cleft lip and/or palate: infancy to 4 years of age.

The focus of this study was an analysis of maxillary arch growth changes prior to the time of cheiloplasty up to 4 years of age. Serial dental casts were obtained and measured in 95 children with cleft lip and palate, or both: 7 unilateral cleft lip and alveolus (CLA), 52 unilateral cleft lip and palate (UCLP), 24 bilateral cleft lip and palate (BCLP), and 12 isolated cleft palate (CP). The children were treated at the Kyushu University Dental Hospital. The results are as follows: (1) Prior to cheiloplasty, the maxillary buccal segments in the subjects with cleft lip and palate showed lateral displacement. The premaxilla in BCLP subjects was protruded. (2) Cheiloplasty influenced maxillary anterior arch width, but not posterior width. The operation caused posterior displacement of the premaxilla in BCLP subjects. (3) Palatoplasty affected the growth of the maxillary arch in the transverse and anteroposterior dimensions. (4) A variety of growth patterns observed in the patients (e.g., increasing or decreasing of the maxillary arch dimensions) suggests that maxillary arch dimensions were affected not only by surgery, but also by other individual factors such as genetic facial pattern and severity of the cleft.

Alveolar Process↗
PubMedDate not supplied

A longitudinal study of the change in resistance patterns and genetic relationship of oral Candida albicans from HIV-infected patients.

Candida albicans is an important opportunistic pathogen in the oral cavity of HIV-infected patients. C. albicans was isolated repeatedly over a period of 30 months from the mouth-swills of five males with category IV HIV infection who suffered from recurrent pseudomembranous oral candidosis and were being treated with fluconazole. C. albicans was identified by the germ tube test, carbon assimilation by the API 20C test (bioMerieux sa, Marcy, l'Etoile, France) and morphology on cornmeal Tween 20 agar. Sensitivity testing was performed with a disk diffusion method using neosensitabs (Rosco Diagnostica, Taasrup, Denmark) and the broth microdilution assay using RPMI 1640 medium. Isolates from the five patients taken between 14 and 30 months apart (mean = 23 months) showed the development of resistance to several antifungal agents, notably fluconazole, miconazole and itraconazole by the disc diffusion method and markedly higher minimum inhibitory concentrations (MICs) for fluconazole by the broth microdilution assay. Genetic relatedness of the C. albicans strains was assessed using the mixed-linker polymerase chain reaction method. Four patients had isolates which were genetically identical, while one patient had isolates of varying genetic type. This study has shown that in HIV-infected patients with recurrent oral pseudomembraneous candidosis, the development of drug resistance to antifungal agents may either be due to increased resistance of a single strain or replacement with a more resistant strain.

AIDS-Related Opportunistic Infections↗
PubMed1990

A comparative and longitudinal study on endocrine changes related to ovarian function in patients with anorexia nervosa.

Screening of androgens and estrogens in blood and a GnRH test were performed in 20 female patients with anorexia nervosa and in 10 lean and 10 normal weight healthy control subjects. Both control groups had regular ovulatory menstrual cycles. The investigation was performed in the mid-follicular phase. Several variables showed significant differences between the groups; the levels of PRL, estrone, estradiol, progesterone, testosterone, androstenedione, and LH were lowest in the patients with anorexia nervosa. The lean control group showed intermediate values for progesterone, androstenedione, and, to a smaller extent, testosterone. The FSH response to GnRH was significantly higher in the patient group, corresponding to the pattern of late prepubertal girls. Ten patients were seen in a follow-up study. Five had resumption of the menstrual cycle, and the others still had amenorrhea. The two subgroups did not differ in either weight gain or the basal hormonal variables investigated. After weight gain an increased LH response to GnRH was observed in both subgroups. Patients who had resumption of the menstrual cycle showed a higher response of LH to GnRH, both before and after weight gain. The mean increase in LH after GnRH administration was significantly different between the two subgroups. The results suggest that the GnRH test may be useful to assess the stage of the disease and to predict the outcome, especially with regard to restoration of the menstrual cycle.

Adult↗
PubMed2004

The application of multilevel modeling in the analysis of longitudinal periodontal data--part II: changes in disease levels over time.

BACKGROUND: The aim of this study was to investigate the longitudinal relationships between the outcome measurements of changes in lifetime cumulative attachment loss (cLCAL) and changes in probing depth (cPD) in relation to potential risk factors or other risk markers for periodontal disease progression from a cohort of 100 young males. In order to account for the hierarchical data structure, and to explore explicitly the site, tooth, and subject levels simultaneously, multilevel modeling was undertaken. METHODS: The analyses were undertaken in two parts. Within a previous article, the absolute levels of disease were analyzed in relation to potential risk factors; within this article, changes in disease are analyzed in relation to these factors. Each analytical approach yielded substantively different insights. RESULTS: Subject-level risk factors had limited predictive value for cLCAL/cPD throughout the 30-month observation period. Tooth position demonstrated a near linear relationship for both outcomes, with disease increasing from anterior to posterior teeth. Supragingival plaque had no significant effect on cLCAL/cPD, while subgingival calculus and bleeding on probing were negatively associated with cLCAL/cPD. In contrast to the outcomes LCAL/PD, supragingival calculus had no significant protective effect on cLCAL/cPD. There was no significant influence of smoking in this cohort. CONCLUSIONS: This study provides, for a relatively young cohort, considerable insights into the factors associated with longitudinal patterns of early-life periodontal disease at all levels of the natural hierarchy of sites within teeth within subjects. Furthermore, it is demonstrated how multilevel modeling can provide considerable insight into some of the inconsistencies and controversies found in the previous periodontal literature.

Adolescent↗
PubMed2004

Measuring temporal morphological changes robustly in brain MR images via 4-dimensional template warping.

Robustly measuring subtle longitudinal brain changes is a major challenge in computational neuroanatomy. This paper describes a method for measuring temporal morphological brain changes, by means of a 4-dimensional image warping mechanism. Longitudinal stability is achieved by considering all temporal MR images of an individual simultaneously, rather than by individually warping a template to an individual, or by warping the images of one time-point to those of another time-point. Following earlier work in 3D, a local morphological signature is attached to each voxel of a sequence of images, and it includes a set of image attributes reflecting morphological characteristics of the spatiotemporal structure around the respective voxel at different scales. This attribute vector forms the basis for searching in the 4-dimensional space for a counterpart that has similar morphological signature, thereby leading to automated detection of anatomical correspondence. Ambiguities in this process are reduced by constructing attribute vectors that are highly distinctive of respective voxels, and by using a hierarchical matching procedure in which reliable and easily distinguishable voxels are used to guide the 4D deformation process. The resultant deformations are smooth both in the spatial and temporal dimensions, and are shown to significantly improve warping accuracy over a series of independent 3D warpings, in longitudinal measurements.

Algorithms↗
PubMed2006

Adiposity in adolescents: change in actual BMI works better than change in BMI z score for longitudinal studies.

PURPOSE: Longitudinal epidemiologic studies often relate adiposity changes to suspected causal factors. In growing adolescents, this becomes complicated. Many investigators use within-child change in body mass index (BMI) z scores (Delta z) from sex- and age-specific BMI charts developed by the Centers for Disease Control and Prevention (CDC). These charts, derived from cross-sectional data, may not represent BMI growth patterns of real children. Furthermore, because cross-sectional BMIs are not Gaussian, these z scores are from month-specific transformed distributions, with possible unintended consequences when used longitudinally. Alternatively, we can directly analyze BMI change (Delta BMI). We compare these two widely used measures of change in adiposity. METHODS AND RESULTS: With real adolescent data, we show that annual Delta BMIs have nonlinear peaks that are inconsistent with the CDC curves. We also show that a specified Delta z represents a broad range of adiposity changes for children measured at the same two ages. To see how this affects power, we performed simulation studies confirming that analyzing Delta BMIs in models with hypothesized factors is more powerful than analyzing Delta zs. CONCLUSIONS: In longitudinal studies of adolescent adiposity, investigators should be encouraged to analyze Delta BMI rather than Delta z because analyses using BMI are more powerful and findings presented in BMI units are more interpretable.

Adipose Tissue↗
PubMed2000

Longitudinal age-related changes in motor activities and spatial orientation in CD-1 mice.

Female CD-1 mice were evaluated on three occasions over a nineteen month span in tests of exploration, motor coordination, and spatial orientation in a water maze. Aging decreased motor activity and exploration of specific environmental stimuli found in a hole-board and in a T-maze. Age-related deficits were also found in three motor coordination tasks (inclined grid, coat-hanger, and round bridge) and during retention but not acquisition of the hidden platform version of the water maze task. Performance on some motor coordination tests was linearly correlated with either motor activity or exploration, implying the existence of similar neurobiological pathways responsible for these age-related changes.

Aging↗
PubMed1984

Personality changes in the aged. A longitudinal study of psychogenic needs with the CMPS.

Psychogenic needs according to Murray were measured by means of the Cesarec Marke Personality Schedule in a representative sample of 70-year-olds in Gothenburg, Sweden. They were followed up when 75 and 79. A longitudinal study was carried out with regard to changes in means, standard deviations and sex differences. The levels at 70 among the surviving subjects and those who had died before the age of 79 were compared. Between 70 and 79 there were changes towards higher needs for order and acquiescence in both sexes, and towards lower exhibition, dominance and aggressive non-conformance, and higher succourance in women. The changes were small and most needs showed no changes at all. There were few changes in variability and sex differences. Men with higher needs of defence of status, and lower needs of exhibition and dominance at 70 had an increased mortality. Cross-sectional studies would have given misleading results on the development of psychogenic needs in these age groups.

Aged↗