End Of Puberty Research Articles

Strategies For The Treatment Of Chronic Bronchitis In Children, Taking Into Account Sexual Development

A study was carried out to study the characteristics of sexual development and measures of secondary prophylaxis in patients with chronic bronchitis. The study included 84 children with chronic bronchitis aged 10 to 16 years. Of them, 37 (44%) are girls and 47 (56%) are boys. Moderate - severe course of the disease was revealed in 43 (51,2%) children, severe - in 41 (48,8%). It was revealed that chronic bronchitis adversely affects the sexual development of children of both sexes. The pace of development of secondary sexual characteristics occurs gradually and does not complete until the end of puberty. The comprehensive stage-by-stage secondary prophylaxis we proposed for children with chronic bronchitis disease contributed to the improvement of both the underlying disease and sexual development.

Bracing of Pectus Carinatum in Children: Current Practices.

Although effective, compressive orthotic bracing (COB) in children with pectus carinatum is still not standardized. This study has aimed to analyze current practices amongst members of the Chest Wall International Group (CWIG). A web-based questionnaire was mailed to all CWIG members at 208 departments. It included 30 questions regarding diagnostic work-up, age for COB indication, type of COB used, daily wearing time, treatment duration, complications, and recurrence rate. Members from 44 departments have responded (institutional response rate 21.2%). A total of 93% consider COB as the first-line treatment for PC. A conventional COB (CC) is used in 59%, and the dynamic compression system (FMF) in 41%. The overall compliance rate is >80%. A total of 67% of responders consider COB to be indicated in patients <10 years. The actual wearing time is significantly shorter than the physician-recommended time (p < 0.01). FMF patients experience a significantly faster response than CC patients (p < 0.01). No recurrence of PC has been noted in 34%; recurrence rates of 10-30% have been noted in 61%. COB is the first-line treatment for PC with a high compliance rate. During puberty, the recurrence rate is high. Treatment standardization and follow-up until the end of puberty are recommended to enhance COB effectiveness.

Prepuberty is a window period for curcumin to prevent obesity in postnatal overfed rats.

Overnutrition in early life increases the risk of obesity and metabolic diseases. We investigated the effects and the window period of a curcumin (CUR) diet on postnatal overfed rats. Male rats aged 3 days were randomly divided into normal litters (NL, 10 pups/litter) and small litters (SL, 3 pups/litter). After weaning (Week 3, W3), NL rats were fed a normal diet (NL) and SL rats were fed a normal diet (SL) or 2% CUR diet from weaning (W3) (SL-CURW13), beginning of puberty (W6) (SL-CURW16), or end of puberty (W8) (SL-CURW18) for 10 weeks. Body weight, glucose intolerance and hyperlipidemia in the SL rats were higher than in the NL rats, especially after puberty. After the CUR intervention, SL-CURW13 and SL-CURW16 rats showed lower body weight gain, adipose tissue weight and mRNA level of C/EBPα in SAT, along with higher mRNA levels of β-catenin. There was no difference between SL and SL-CURW18 rats. Glucose tolerance, serum lipids and hepatic lipids recovered to normal in the SL-CURW13 rats, but only partially in the SL-CURW16 and SL-CURW18 rats. Prepuberty is a window period for CUR intervention to improve programmed outcomes in postnatal overfed rats. Overnutrition during the first 1000 days of life has persistent negative effects on metabolism. Strategies should be taken to prevent overnutrition in early life to reduce the risk of obesity and metabolic disease in later life. A small-litter rat model was utilized to simulate early-life overnutrition in humans. We investigated the different effects and critical period for curcumin intervention on postnatal overfed rats. Dietary curcumin intervention before puberty could effectively transform nutritional programming to reduce obesity and metabolic disorders caused by early-life overnutrition, and an earlier intervention might predict a better outcome.

Assessment of testicular function in boys and adolescents.

The hypothalamic-pituitary-testicular axis is characterised by the existence of major functional changes from its establishment in fetal life until the end of puberty. The assessment of serum testosterone and gonadotrophins and semen analysis, typically used in the adult male, is not applicable during most of infancy and childhood. On the other hand, the disorders of gonadal axis have different clinical consequences depending on the developmental stage at which the dysfunction is established. This review addresses the approaches to evaluate the hypothalamic-pituitary-testicular axis in the newborn, during childhood and at pubertal age. We focused on the hormonal laboratory and genetic studies as well as on the clinical signs and imaging studies that guide the aetiological diagnosis and the functional status of the gonads. Serum gonadotrophin and testosterone determination is useful in the first 3-6 months after birth and at pubertal age, whereas AMH and inhibin B are useful biomarkers of testis function from birth until the end of puberty. Clinical and imaging signs are helpful to appraise testicular hormone actions during fetal and postnatal life. The interpretation of results derived from the assessment of hypothalamic-pituitary-testicular in paediatric patients requires a comprehensive knowledge of the developmental physiology of the axis to understand its pathophysiology and reach an accurate diagnosis of its disorders.

SAT405 Bone Analysis Of Transgender Women Amateur Athletes Undergoing Gender-affirming Hormone Therapy

Abstract Disclosure: L.D. Santos: None. F.P. Nakamoto: None. R.E. Ferreira: None. R.C. Barbosa: None. L.H. Falcão: None. C.P. Cruz: None. G.B. Achkar: None. B.M. Sá: None. F.M. Lima: None. L.A. Alvares: None. Introduction: At the end of puberty, cisgender men (CM) have stronger bones and muscle mass than cisgender women (CW). Studies have shown a high prevalence of low bone mass in the general population of (transgender womenan) (TW). However, few articles are concerned with lean mass and bone mass in TW athletes. Objective: To assess the bone density of amateur volleyball TW athletes and compare them with CM and CW. Methods: A cross-sectional study was carried out with 8 TW (29 yo, range 27-36); BMI 24.1, range 19.3-31.7), 11 cisgender women (CW) and 8 cisgender men (CM) matched by age and BMI. The height (cm) of TW was 172 (range 164-181), that of CW was 176±0.1 and that of CM was 185±5.6. The TW had received hormone therapy for 3 (range 1-16) years. Measurements of BMD and body composition were taken with dual-energy X-ray absorptiometry. Results: The LS-BMD (lumbar spine) (g/cm2) of TW was 1.283 (range 0.9770-1.498), that of CW was 1.529±0.1614, and that of CM was 1.5115±0.1883 (TW vs. CW, p&amp;gt;0.05; TW vs. CM, p&amp;gt;0.05; CW vs. CM p&amp;gt;0.05). The FN-BMD (femur neck) (g/cm2) of TW was 1.203 (range 0.9660-1.332), that of CW was 1.337±0.1629, and that of CM was 1.4448±0.1334 (TW vs. CW, p&amp;gt;0.05; TW vs. CM, p&amp;lt;0.05; CW vs. CM p&amp;gt;0.05). Android/gynecoid (AG) ratio: TW: 0.85 (range 0.47-1.4); CW 0.73±0.13, CM 1.10±0.24. The lean corporal mass (kg) was 54.4 (range 44.3-66.9) in TW, 51.9±8.1 in CW, and 67.5±6.3 in CM (TW vs. CW, p&amp;gt;0.05; TW vs. CM, p&amp;lt;0.05; CW vs. CM p&amp;lt;0.05). Discussion: We observed lower bone density in TW amateur athletes undergoing gender-affirming hormone therapy, as well as in the general TW population. Despite the lack of statistical significance, probably as a consequence of the number of volunteers, the AG ratio was intermediate in TW. Lean mass was equal between TW and CW, unlike in the general TW population in other cohorts thay analyzed non-athelets. Conclusion: Despite their high volume of physical activity, there was a lower BMD in the TW group than in the other groups. Presentation: Saturday, June 17, 2023

Therapeutic exposures and pubertal testicular dysfunction are associated with adulthood milestones and paternity after childhood cancer.

Childhood cancer therapy may cause long-term effects. This cross-sectional study evaluated adulthood milestones in male childhood cancer survivors (CCS). The study population comprised 252 male CCS with 6 to 42years of survival diagnosed at the Children's Hospital in Helsinki (1964-2000) at the age of 0 to 17years. Sex-, age-, and area of residence-matched population controls were randomly selected from the Finnish national registries. Data on moving away from the parental home, marital status, offspring, and adoption in CCS were compared with the population controls. We analyzed the influence of chemotherapy and radiation exposures and testicular dysfunction (ever nontestosterone-substituted serum follicle stimulating hormone>15 IU/L, luteinizing hormone >15 IU/L, testosterone <2ng/mL (5nmol/L), need of testosterone replacement therapy, or testicular volume <12mL at the end of puberty) during pubertal maturation on long-term social outcomes. CCS moved away from their parental home as frequently as population controls (97.8% vs. 98.5%, p=.45). CCS were less likely to marry or live in a registered relationship (46.4% vs. 57.5%, p<.001), especially when diagnosed at a young age (<4years). Among those married, the probability of divorce was similar between CCS and population controls (27.4% vs. 23.8%, p=.41). Survivors were less likely to sire a child (38.5% vs. 59.1%, p<.001) and more likely to adopt (2% vs. 0.4%, p=.015). Lower probability of paternity was associated with hematopoietic stem cell therapy, testicular radiation dose >6Gy, pubertal signs of testicular dysfunction (nontestosterone-substituted serum follicle stimulating hormone>15 IU/L, luteinizing hormone >15 IU/L, testosterone <2ng/mL (5nmol/L), or need of testosterone replacement therapy during puberty, or testicular volume <12mL at the end of puberty) or azoospermia after puberty. This study emphasizes the value of pubertal monitoring of testicular function to estimate future probability of paternity. If no signs of dysfunction occurred during pubertal follow-up, paternity was comparable to population controls. Testicular radiation dose >6Gy appeared to be the strongest risk factor for decreased paternity. Treatment with intensive therapies, including hematopoietic stem cell therapy, testicular radiation dose >6Gy, and signs of testicular dysfunction, during puberty are important risk factors for lower rates of fertility. Intensive therapies and testicular dysfunction itself do not similarly hamper psychosocial milestones in adulthood; cancer diagnosis at a very young age (<4years) lower the probability of marriage. This study accentuates the importance of monitoring of pubertal development, emphasizing on testicular function, not only sperm analysis, to estimate future fertility among male childhood cancer survivors.

Environment- and epigenome-wide association study of obesity in 'Children of 1997' birth cohort.

Increasing childhood obesity is a global issue requiring potentially local solutions to ensure it does not continue into adulthood. We systematically identified potentially modifiable targets of obesity at the onset and end of puberty in Hong Kong, the most economically developed major Chinese city. We conducted an environment-wide association study (EWAS) and an epigenome-wide association study of obesity to systematically assess associations with body mass index (BMI) and waist-hip ratio (WHR) in Hong Kong's population-representative 'Children of 1997' birth cohort. Univariable linear regression was used to select exposures related to obesity at ~11.5 years (BMI and obesity risk n ≤ 7119, WHR n = 5691) and ~17.6 years (n = 3618) at Bonferroni-corrected significance, and multivariable regression to adjust for potential confounders followed by replicated multivariable regression (n = 308) and CpG by CpG analysis (n = 286) at ~23 years. Findings were compared with evidence from published randomized controlled trials (RCTs) and Mendelian randomization (MR) studies. At ~11.5 and~17.6 years the EWAS identified 14 and 37 exposures associated with BMI, as well as 7 and 12 associated with WHR, respectively. Most exposures had directionally consistent associations at ~23 years. Maternal second-hand smoking, maternal weight, and birth weight were consistently associated with obesity. Diet (including dairy intake and artificially sweetened beverages), physical activity, snoring, binge eating, and earlier puberty were positively associated with BMI at ~17.6 years, while eating before sleep was inversely associated with BMI at ~17.6 years. Findings for birth weight, dairy intake, and binge eating are consistent with available evidence from RCTs or MR studies. We found 17 CpGs related to BMI and 17 to WHR. These novel insights into potentially modifiable factors associated with obesity at the outset and the end of puberty could, if causal, inform future interventions to improve population health in Hong Kong and similar Chinese settings. This study including the follow-up survey and epigenetics testing was supported by the Health and Medical Research Fund Research Fellowship, Food and Health Bureau, Hong Kong SAR Government (#04180097). The DNA extraction of the samples used for epigenetic testing was supported by CFS-HKU1.

METABOLIC DYSFUNCTIONS OF PERIPUBERTAL PROTEIN RESTRICTION IN MALE RATS

The current study investigate sound effects of low-protein diet (LP) during peripubertal periodto induce metabolic dysfunctions. In our study (CEUA 2910011021), 30 days-old Wistar malerats received LP (4% protein) and control rats were fed a 20.5% protein diet, for 60 days (NPgroup). Biometric parameters was taken and glucose, total and HDL-cholesterol, andtriglycerides were evaluated from plasma samples. Glycemia homeostasis was evaluated byOGTT and ITT, while hepatic parameters, including quantitative analysis of fat, triglyceridesand cholesterol in the liver was evaluated ex vivo. At 60 days, LP rats showed inferior bodymass (P=0.003), food intake (P=0.05), and nose-tail length (P=0.0001), compared to NP.Regarding biochemical assays, LP rats showed higher serum glucose (P=0.008); however,triglyceride (P=0.002), total cholesterol (P=0.02), and HDL levels (P&amp;lt;0.0001) were lower inLP animals compared to NP group. LP rats also had minor glucose tolerance (P=0.02) andgreater insulin sensitivity (P=0.01). In the hepatic parameters, LP rats showed an increase inliver fat (P&amp;lt;0.0001), hepatic triglycerides (P&amp;lt;0.0001), cholesterol (P&amp;lt;0.0001), and liverweight (P&amp;lt;0.0001). Considering the present data, peripuberty protein restriction inducedmetabolic and hepatic dysfunctions at the end of puberty. Therefore, malnourished adolescentanimals are at higher risk of developing metabolic syndrome in adulthood.

Surgical strategies for hereditary colorectal cancer

Hereditary colorectal cancer (hCRC) represents amajor diagnostic and therapeutic challenge. In addition to the usual diagnostic methods, the family history, histological confirmation and mutation analysis play an important role in identifying the type of hereditary CRC. The diagnosis and classification of hCRC are carried out based on the anamnesis, clinical presentation and histology and the further treatment is determined depending on the underlying type of hCRC. For familial adenomatous polyposis (FAP) coloproctomucosectomy after the end of puberty is always recommended, whereas the treatment recommendations for other forms, such as attenuated FAP (aFAP), MUTYH-associated polyposis (MAP) and hereditary nonpolyposis colon cancer (HNPCC, Lynch syndrome), range from close surveillance and endoscopic control, through segmental resection up to colectomy. Irrespective of the type of hCRC, the treatment regimens necessitate an individualized approach and require close interdisciplinary cooperation. When colorectal resection is performed, minimally invasive procedures should principally be prioritized and some studies could demonstrate apotential benefit of robotic surgery compared to laparoscopy.

Circulating autotaxin levels in healthy teenagers: Data from the Vitados cohort.

Autotaxin (ATX) is a secreted enzyme with a lysophospholipase D activity, mainly secreted by adipocytes and widely expressed. Its major function is to convert lysophosphatidylcholine (LPC) into lysophosphatidic acid (LPA), an essential bioactive lipid involved in multiple cell processes. The ATX-LPA axis is increasingly studied because of its involvement in numerous pathological conditions, more specifically in inflammatory or neoplastic diseases, and in obesity. Circulating ATX levels gradually increase with the stage of some pathologies, such as liver fibrosis, thus making them a potentially interesting non-invasive marker for fibrosis estimation. Normal circulating levels of ATX have been established in healthy adults, but no data exist at the pediatric age. The aim of our study is to describe the physiological concentrations of circulating ATX levels in healthy teenagers through a secondary analysis of the VITADOS cohort. Our study included 38 teenagers of Caucasian origin (12 males, 26 females). Their median age was 13 years for males and 14 years for females, ranging from Tanner 1 to 5. BMI was at the 25th percentile for males and 54th percentile for females, and median blood pressure was normal. ATX median levels were 1,049 (450-2201) ng/ml. There was no difference in ATX levels between sexes in teenagers, which was in contrast to the male and female differences described in the adult population. ATX levels significantly decreased with age and pubertal status, reaching adult levels at the end of puberty. Our study also suggested positive correlations between ATX levels and blood pressure (BP), lipid metabolism, and bone biomarkers. However, except for LDL cholesterol, these factors were also significantly correlated with age, which might be a confounding factor. Still, a correlation between ATX and diastolic BP was described in obese adult patients. No correlation was found between ATX levels and inflammatory marker C-reactive protein (CRP), Body Mass Index (BMI), and biomarkers of phosphate/calcium metabolism. In conclusion, our study is the first to describe the decline in ATX levels with puberty and the physiological concentrations of ATX levels in healthy teenagers. It will be of utmost importance when performing clinical studies in children with chronic diseases to keep these kinetics in mind, as circulating ATX might become a non-invasive prognostic biomarker in pediatric chronic diseases.

Is there a secular trend regarding puberty in children with down syndrome?

There are very few studies on the age of onset and end of puberty in children with Down syndrome (DS). Also, data regarding the course of puberty in these children compared to their healthy peers is limited. Moreover, there is limited information regarding the effects of factors such as obesity and hypothyroidism on the puberty process in children with DS. Our aim in our study is to determine whether the pubertal development of children with DS differs from their healthy peers and from previous studies conducted with DS children. The medical records of DS children were examined retrospectively. The anthropometric measurements and the age of onset of pubertal stages, and menarche were recorded. The patients' age at puberty onset, the puberty processes, and age at menarche were compared with their healthy peers and previously published data on children with DS. Of the 140 Down syndrome patients followed in our clinic, 51 of whom with puberty constituted the study group. The mean age of onset of puberty was 10.3 ± 1.0 years in our group (10.0 ± 0.8 years for girls, 10.6 ± 1.2 years for boys, respectively). Obesity occurred in 46% of pubertal girls with DS. The age of menarche in girls with DS was 11.8 ± 0.7 years. The menarche age of girls with DS was significantly different from healthy girls. In the DS boys, only the Tanner V stage ages were different from the healthy children. True- precocious-puberty was detected in three children. Although breast development begins later in females with DS than in their healthy peers; menarche is detected earlier than in their peers and a tendency towards obesity in the whole population. While the age of pubertal onset was similar to healthy children in male patients, our findings suggest that their puberty duration is longer.

β Cell mass expansion during puberty involves serotonin signaling and determines glucose homeostasis in adulthood.

Puberty is associated with transient insulin resistance that normally recedes at the end of puberty; however, in overweight children, insulin resistance persists, leading to an increased risk of type 2 diabetes. The mechanisms whereby pancreatic β cells adapt to pubertal insulin resistance, and how they are affected by the metabolic status, have not been investigated. Here, we show that puberty is associated with a transient increase in β cell proliferation in rats and humans of both sexes. In rats, β cell proliferation correlated with a rise in growth hormone (GH) levels. Serum from pubertal rats and humans promoted β cell proliferation, suggesting the implication of a circulating factor. In pubertal rat islets, expression of genes of the GH/serotonin (5-hydroxytryptamine [5-HT]) pathway underwent changes consistent with a proliferative effect. Inhibition of the pro-proliferative 5-HT receptor isoform HTR2B blocked the increase in β cell proliferation in pubertal islets ex vivo and in vivo. Peripubertal metabolic stress blunted β cell proliferation during puberty and led to altered glucose homeostasis later in life. This study identifies a role of GH/GH receptor/5-HT/HTR2B signaling in the control of β cell mass expansion during puberty and identifies a mechanistic link between pubertal obesity and the risk of developing type 2 diabetes.

Gynecomastia: A systematic review of pharmacological treatments.

Pubertal gynecomastia (PG), a benign condition with varied reported prevalence, typically appears at 13-14 years-old and is mostly idiopathic and self-limited. Psychologic impairments are common among adolescents with gynecomastia. Surgical intervention is reserved to severe cases and is offered towards the end of puberty. Pharmacological treatment is seldom given by clinicians mainly due to insufficient published data. We conducted this systematic literature review to assess the efficacy, safety, side effects, and complications of pharmacological treatments published. MEDLINE, Embase, and Cochrane CENTRAL were searched for the terms "gynecomastia", "pubertal", and "adolescent" in conjunction with medications from the Selective Estrogen Receptor Modulator (SERM), aromatase inhibitors (AI), and androgens groups in different combinations to optimize the search results. Exclusion criteria included: studies based on expert opinion, similar evidence-based medicine levels studies, and studies which discuss gynecomastia in adults. Selected articles were assessed by two authors. Data collected included: the level of evidence, population size, treatment regimen, follow-up, outcomes, complications, and side effects. Of 1,425 published studies found and examined meticulously by the authors, only 24 publications met all the study research goals. These were divided into 16 publications of patients treated with SERM, of whom four had AI and four androgens. In general, the data regarding pharmacologic therapy for PG is partial, with insufficient evidence-based research. Tamoxifen and SERM drugs have long been used as treatments for PG. Tamoxifen was the chosen drug of treatment in most of the reviewed studies and found to be effective, safe, and with minimal side effects. Pharmacological treatment as a new standard of care has an advantage in relieving behavioral and psychological distress. Although high quality publications are lacking, pharmacological intervention with tamoxifen is appropriate in select patients. Conduction large-scale high-quality studies are warranted with various drugs.

Changes in sleeping habits during the pubertal years; A descriptive study conducted in Jordan

Background: There is limited information about changes in sleeping habits during the pubertal years of development among adolescents in Jordan. Objective: This study examined sleeping habits at the onset and end of puberty. Methods: This study utilized data from a nationwide survey in Jordan. Participants: Sleeping habits were obtained from 3,661 adolescents aged 11(onset of puberty) and 15 years (end of puberty) and their mothers using a self-reported questionnaire. The number of hours slept and bedtimes and wake-up times on both school and non-school days were examined. Results: On school days, 60% of 11-year-old and 34% of 15-year-old adolescents slept between 8:00-10:00 pm. On school days, the 11-year-old adolescent group reported sleeping significantly longer than the 15-year-old adolescent group, and the proportions of adolescents who met the minimal recommended sleeping hours were 64% and 54%, respectively. Sleeping hours were long for both groups attending government schools; for the 15-year-old adolescent group, sleeping hours varied with family income and maternal education. In the case of both groups, on non-school days sleeping hours varied with gender, family income, and type of school. Conclusion: At the end of pubertal years, adolescent sleeping habits differ significantly from those of adolescents at the onset of puberty. On school days, insufficient sleep is much evident in the case of both 11 and 15-year-old adolescent groups, but more pronounced in the latter. Nursing initiatives to address poor sleeping habits among adolescents are warranted, given their efficacy in promoting healthy growth and development within this age group.

Clinical and ultrasound characteristics of the health status of fertile aged women, who smoke and have metabolic syndrome

Objectives: to identify clinical and ultrasound indicators that can determine the need for further examination of fertile aged women who smoke and have metabolic syndrome (MS) regarding the risk of developing somatic pathology or diseases of the reproductive system.Materials and methods. 2 groups of women of fertile age were examined: the first group consisted of 20 women who smoked with MS, the second group included 20 women who smoked without MS. All women were interviewed using a specially designed general and reproductive health questionnaire. Ultrasound examination of the abdominal cavity and pelvic organs was performed using convex and transvaginal sensors according to existing examination protocols.Results. Women of the first group had a higher body mass index and other obesity parameters, which is typical for MS. Women of the second group smoked more cigarettes per day. The identified early onset of menstrual function in women with MS may be a manifestation of hormonal homeostasis disorders at the end of puberty with a predominance of estradiol secretion and insufficient progesterone synthesis in the second phase of the menstrual cycle. A significant amount of blood loss during menstruation and painful menstruation in women of the first group may be a manifestation of adenomyosis, which confirms by echo-positive and echo-negative inclusions in the myometrium and thickening of the uterine walls. In most patients with MS ultrasound showed multifollicular ovaries, which may point at polycystic ovary syndrome, given changes in body mass index and ovarian structure as a response on hyperestrogenemia. Prolonged manifestation of MS also negatively affected the abdominal organs, as evidenced by echo-positive inclusions in the liver and pancreas parenchyma, which is a manifestation of inflammatory diseases of these organs.Conclusions. The combination of prolonged smoking and metabolic syndrome leads to more pronounced changes in the reproductive system and abdominal organs, which in turn expands the range of recommended methods of instrumental examination for such women.

Mammoplastie d’augmentation des seins tubéreux hypotrophiques par implants. Stratégie chirurgicale en un temps sans dissociation cutanéo-glandulaire

Among congenital breast malformations, the incidence of tuberous breasts is large, the shape abnormality is often accompanied by hypoplasia of the mammary gland and asymmetry. The psychological impact of this malformation is particularly important in these young girls at the end of puberty, in transit between adolescence and adulthood. The indication for augmentation by implants must be systematically associated with breast remodeling in order to obtain a good fit between the breast and the prosthesis. The increase in breast volume by implant remains relevant when fat reserves are insufficient to consider fat self-transfer. On the other hand, Augmentation by implants is a real challenge to obtain a good result and requires thinking and understanding the anomaly in order to follow a rigorous strategy that treats the different problems step by step. It is this strategy that we will develop with an original approach to glandular redistribution and management of areolar prolapse. This strategy is illustrated by a series of 145 patients operated between 2000 to 2021.

Effects of treatment with clinically relevant valproate, carbamazepine, oxcarbazepine, topiramate, lamotrigine and levetiracetam on ovarian folliculogenesis in young rats

AimTo determine the effects of valproate (VPA), carbamazepine (CBZ), oxcarbazepine(OXC), topiramate (TPM), lamotrigine (LTG), and levetiracetam (LEV) on ovarian folliculogenesis in young rats. MethodsForty-nine female Wistar rats, aged 21–24 days, were divided equally into 7 experimental groups. These were given tap water over 21–24 days (control group), 300 mg/kg of VPA, 150 mg/kg of CBZ, 150 mg/kg of OXC, 100 mg/kg of TPM, 10 mg/kg of LTG, or 50 mg/kg of LEV daily in 2 doses via oral gavage until the end of puberty. At the end of the study, the estrous cycle of each rat was monitored daily, and those rats in pro-estrus or di-estrus were sacrificed and the ovaries removed. Serial sections obtained from the ovaries were stained with hematoxylin and eosin, and the corpora lutea and follicles were enumerated. Apoptotic cells were detected using the TUNEL technique. Various serial sections were immunohistochemically stained with proliferating cell nuclear antigen (PCNA), growth differentiation factor (GDF)-9, caspase-3, caspase-9, transforming growth factor beta 1 (TGF-1), and epidermal growth factor (EGF), and evaluated and photographed under a light microscope. Key FindingsThe number of corpora lutea was significantly increased in the VPA, CBZ, OXC, and LTG groups compared to the control group (p < 0.001). The number of TUNEL-positive ovarian follicles was 3.3 ± 1.1 (median, 3), 6.1 ± 0.9 (median, 6), and 5.7 ± 0.8 (median,6) in the control, OXC and LEV groups, respectively (p < 0.001). The number of TUNEL-positive granulosa cells was higher in all the groups treated with antiepileptics, with the exception of the TPM group, compared to the control group (p < 0.001). HSCOREs for immunohistochemical staining using PCNA, GDF-9, TGF-1 and EGF were significantly higher in the control group than in the others (p < 0.001). HSCORE for staining using caspase-3 was significantly higher in the VPA, CBZ, OXC and LEV groups, while the HSCORE was significantly lower in the TPM group than in the control group. HSCORE for staining using caspase-9 was significantly higher in the VPA, CBZ and OXC groups, while it was significantly lower in the TPM group than in the control group (p < 0.001). SignificanceExposure to VPA, CBZ, OXC, TPM, LTG and LEV caused different levels of impaired folliculogenesis in young rats.

Septoplasty and septorhinoplasty in children

Surgical correction of the nasal septum in childhood remains a controversial issue. Due to concerns that destruction of growth zones in the trapezius cartilage during the procedure may have a significant impact on the later growth of the nose and facial part of cranium, for many years ENT specialists approached the issue of septoplasty in children in a very conservative manner. However, many more recent reports indicate that a conservatively and correctly performed procedure does not pose a threat to the development of the nose and can be safely performed in children with severe septal deviation after 5–6 years of age. In case of the coexistence of deformities in the shape of the external nose, it is recommended to simultaneously correct it, which guarantees an optimal final result. These age restrictions do not apply to urgent cases, such as inter alia: septal hematoma and abscess, tumors and developmental disorders. Most importantly, no or sparing (with preservation of cartilage growth centers) resection of the quadrangular cartilage is essential to avoid nasal growth disorder. Rhinoplasties have been reported to have a higher rate of repair and lower patient aesthetic satisfaction. The decision if to perform surgical treatment and its scope should be made after analyzing the potential benefits and consequences on the one hand and leaving a deviated septum on the other hand. In case of doubt, the operation should be postponed until the end of puberty.

Habitual Phytoestrogen Intake Is Associated with Breast Composition in Girls at 2 Years after Menarche Onset.

High phytoestrogen intake during adolescence is associated with a reduced risk of breast cancer. Breast density (BD) is a strong predictor of breast cancer and can be considered an early marker. We aim to assess the association between the mean habitual intake of isoflavones, lignans, and total phytoestrogens intake during puberty until 2 years after menarche onset and absolute fibroglandular volume (AFGV) and percentage of fibroglandular volume (%FGV) in Hispanic girls at the end of puberty. Longitudinal study set up in the Growth and Obesity Chilean Cohort Study (GOCS). We included 329 girls with dietary data (multiple 24-hours recalls) from puberty until 2 years after menarche onset (81% had 2-4 recalls). Two international datasets were used to estimate isoflavones, lignans, and total phytoestrogens in the diet. Breast composition was measured by dual energy X-ray absorptiometry at 2 years after menarche. Multiple linear regression models were used to assess the association between isoflavones, lignans, and total phytoestrogens intake and AFGV and %FGV. The average total phytoestrogen intake was 1 mg/day and %FGV was 50.7% (SD = 15.2) and AFGV 218.8 cm3 (SD = 79.3). An inverse association was found between consumption of isoflavones and AFGV, as well as, with total phytoestrogens [Q4 vs. Q1 adjusted model ß = -49.2 cm3; 95% CI (-85.5 to -13.0)]. Girls with a higher intake of total phytoestrogens and isoflavones during puberty until 2 years after menarche onset had significantly lower AFGV. Although the intake of phytoestrogens is low in Western populations, higher consumption of them during a critical period of life like puberty could be beneficial to reduce breast cancer during adulthood.

Оцінка репродуктивного потенціалу дівчаток-підлітків із гінекологічною патологією, народжених із дефіцитом маси тіла

The timing of puberty depends on many genetic factors and external conditions: race and ethnicity, environmental characteristics, geographical location and even the nature of nutrition. Often the cause of functional delayed puberty is the syndrome of delayed fetal development. Purpose - to study the main indicators of development and formation of the reproductive system of adolescent girls with gynecological pathology, born with a deficit of body weight. Materials and methods. We examined 53 adolescent girls aged 13-18 years, who were divided into groups according to body weight at birth. Group 1 (main) - 26 girls born weighing less than 3000.0 grams. The second group (comparison) included 27 girls born with a body weight of 3000-3700.0 grams. The survey included analysis of anamnesis data, assessment of levels of physical and sexual development. Results. The mean age of the subjects was 14.5±1.8 years [12.7; 16.3]. For girls who were born with low body weight, during puberty there was a lower dynamics of annual weight gain and average body weight compared to girls in group 2. In all age periods there was a significant lag in growth in the 1st group compared to the 2nd group. The growth deficit in 13-14 years was 3.5 cm, in 15-16 years - 3.7 cm, and in 17-18 years - 4.2 cm. The largest increase in the external size of the pelvis compared to the previous age period is observed in 15-16 years. In the 1st and 2nd groups of the transverse dimensions of the pelvis d.cristarum increases most intensively, slightly less - d.trochanterica. Analyzing the indicators of the main external dimensions of the pelvis, we can conclude that at the age of 13-14 and 15-16 years in girls of the 1st group, the size of the pelvis did not differ from the parameters in the 2nd group. However, in 17-18 years, all the external dimensions of the pelvis lagged behind the data in the 2nd group by an average of 1 cm, which indicates a tendency to form a narrow pelvis in girls born with low body weight. The average total score of sexual development in the 1st group in all studied age periods was significantly lower than in the 2nd. Conclusions. For girls born with low body weight, there is a tendency to delay sexual development by the nature of pubic hair, but by the end of puberty, this feature is close to the parameters of peers born with normal body weight. Thus, by the age of 18, almost all girls born with normal body weight have a complete degree of secondary sexual characteristics, typical of women of childbearing age. While girls born with low body weight, there was a slowdown in the formation of secondary sexual characteristics in adolescence. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: puberty, reproductive potential, low birth weight, menarche.