Can we increase adolescent growth?

Abstract

Adolescent growth represents 15-20% of adult height and has been the focus of several treatment interventions, aiming at increasing the amplitude of the adolescent spurt. Importantly, pre-and early puberty are times when patients and families seek medical help and when estimates of adult height are more accurate than in younger children. We review the current approaches aimed at increasing pubertal growth in short children and knowledge about their results and risks. GnRH agonists, when used outside the context of precocious puberty, induce a modest gain (4 cm) when they are used for more than 3 years. Their effects on bone mass, body composition and possibly on psychosocial parameters limit their use. Several trials have now shown that GH can increase adult height of short adolescents with idiopathic short stature or born small for gestational age. However, the amplitude of the effect is modest and of dubious clinical significance. Lastly, the association of both approaches is rather popular among pediatric endocrinologists but still lacks a definite demonstration of its efficacy. In conclusion, we have gained insight in the median effects of some of these treatments and overoptimistic initial expectations are now refocused. However, we still have a long way to go before we truly evaluate the factors affecting the variable individual responses to these treatments, their clinical significance and their cost -benefit balance.European Journal of Endocrinology 151 U101-U108

Skin Cancer Knowledge and Preventive Behaviors among Patients with a Recent History of Cutaneous Squamous Cell Carcinoma

“…Over the past decades there has been a dramatic rise in the age-adjusted incidence of cutaneous squamous cell carcinoma (SCC) in Western countries [1,2,3], which has been associated with increased ultraviolet light exposure, due to lifestyle and global environmental changes [4,5,6]. Morbidity and costs associated with the treatment of cutaneous SCC have an important impact on health systems in areas with a higher incidence [7].…”

Final Height and Pubertal Development in 150 Children with Growth Hormone Deficiency in Algeria

“…Whether to increase GH doses in order to mimic the physiology of the pubertal growth (Blethen, 1997;Codner, 1997;Carel, 2004), or block puberty using similar LHRH (Hibi et al, 1989;Balducci et al, 1995;. The results are divergent.…”

Hormonal Treatment of Idiopathic Short Stature

“…Data from both KIGS [54] and the National Cooperative Growth Study [55, 56] have not demonstrated any benefit from the addition of gonadotropin-releasing hormone (GnRH) agonists to GH treatment regimens among a population largely comprised of GH-deficient patients, but probably with an intermingling of ISS patients. Although it is just as important to achieve substantial height gain during the prepubertal years among children with ISS as it is for GH-deficient patients [57], the added cost of additional therapy, along with the potentially negative impact associated with halting pubertal progression in a child already shorter and less mature than his/her peers, further diminish enthusiasm for such a delaying regimen.…”