Height Gain Research Articles

FRI598 Evolving Growth Hormone Deficiency: A Proof Of Concept

Abstract Disclosure: S. Chimatapu: None. S. Sethuram: None. J. Samuels: None. M. Savage: None. R. Rapaport: None. Introduction: Most cases of growth hormone deficiency (GHD) in pediatric patients are idiopathic, isolated and acquired. All acquired conditions commence with a period during which the diagnosis maybe unapparent. We document here evidence for evolution of GHD in a group of adolescent males who tested sufficient on initial GH stimulation test (GST) but tested deficient upon reevaluation. The rationale for repeat GST was ongoing growth failure. Hypothesis: We hypothesize that GHD in some individuals evolves with time and can be diagnosed by repeat testing (EGHD). We also postulate that their response to GH therapy is similar to other patients with GHD. Methods: We performed an IRB-approved retrospective chart review of children who presented for short stature (height less < 2SD for mean or < 2SD for mid-parental height) to pediatric endocrinology at Kravis Children’s Hospital at Mount Sinai, New York and who had 2 GST. GST were performed using two different stimuli (arginine and glucagon) and highly sensitive assay serum GH measurements were processed by the same laboratory, Esoterix. No patient had obesity, chronic illnesses, or any genetic conditions affecting growth. Data were collected from electronic medical records and analyzed using SPSS v28.0 once at least half the population studied reached adult height. We defined adult height as bone age ≥ 16 years and growth velocity ≤ 2 cm/year. Results: Of 42 charts analyzed, all male, 25 had EGHD. Their average GH peak on initial GST was 15.48 ± 4.92 ng/ml, mean age 10.07 ± 2.65 years, mean height -1.68 ± 0.56 SD , IGF-1 -1.00 ± 0.88 SD. After 2.23 ± 1.22 years, at 12.04 ± 2.41years, height decreased to -1.82 ± 0.63 SD and IGF-1 was -1.08 ± 0.84 SD. At repeat GST, GH peak was 7.59 ± 2.12 ng/mL and 28% were in puberty. All patients had MRI before starting GH therapy; 40% had small anterior pituitary glands. 12 males who reached adult height had a height of -1.88 ± 0.64 SD, IGF-1 of -1.15 ± 0.81 SD, with 42% pubertal and peak GH of 7.33 ± 2.47 ng/mL at repeat GST. They had a mean height gain of 1.83 ± 0.56 SD(p<0.005), with an adult height of 0.09 ± 0.70 SD after 4.64 ± 1.4years of treatment. They were 2.10 ± 4.20 cm taller than their mid-parental target heights. Discussion/Conclusions: We provide proof of concept for the diagnosis of EGHD. The diagnosis could be established by repeat GST in children with ongoing growth deceleration despite pubertal progression and a non-diagnostic initial GST. Our patients who reached adult height had a height gain consistent with that reported by KIGS for patients with growth hormone deficiency (1.7SD; Cutfield,1999) and indeed better than patients with ISS (0.7SD; Maghnie,2022). Presentation: Friday, June 16, 2023

THU168 PRMT7 Gene Mutation—A Rare Genetic Syndrome With Novel Endocrine Associations

Abstract Disclosure: K. Nutakki: None. S. Nalla: None. P. Deb: None. A. Vulpala: None. Background: Causes of short stature in children include pathologic causes (genetic diseases, underlying systemic disease, or growth hormone deficiency) and non-pathological variants such as familial and constitutional short stature. Genetic causes include Turner’s syndrome, SHOX mutations, Noonan’s syndrome and Silver- Russel syndrome besides others. Homozygous/compound heterozygous mutations in Protein Arginine Methyltransferase 7 (PRMT7) can result in Short Stature, Brachydactyly, Intellectual Developmental Disability and Seizures syndrome (SBIDDS) . Here, we report a child with SBIDDS syndrome who has associated endocrine manifestations of growth hormone deficiency and primary hypothyroidism. Case report: A 9-year-old male child, twin A of dichorionic diamniotic gestation, presented to the Endocrine OPD with short stature. There was a history of developmental delay, seizure disorder and mild intellectual deficit. Excessive weight gain was observed since 4 years of age. On examination, he was short with abdominal obesity, brachydactyly, simian crease and macroglossia. Height was below 3rd centile and weight at the 97th percentile. SMR was pre-pubertal. Investigations confirmed primary hypothyroidism.GH deficiency (peak GH after clonidine stimulation was less than 4 microgram/L) and reduced IGF-I levels were also found. Twin B was noted to have a normal height percentile. In both, skeletal maturation was consistent with chronological age. Twin A was treated with rGH and levothyroxine and responded well to rGH treatment. Whole exome sequencing revealed homozygosity for PRMT7 mutation in twin A with both parents heterozygous for the same gene mutation. His twin sibling, twin B was also found to be homozygous for the mutation, but he did not display any characteristics of the syndrome. Discussion: To the best of our knowledge, this is only the second reported case of SBIDDS syndrome (PRMT7 mutation) with documented growth hormone deficiency and only case with documented primary hypothyroidism. Height gain observed over the period of rGH treatment is suggestive of a possible role of GH/IGF-I axis alterations as contributors of growth impairment in these children. PRMT7 encodes for an arginine methyltransferase, involved in several biological processes, such as DNA transcription and repairing, RNA splicing, cell differentiation. We would like to propose that children with SBIDDS syndrome may be tested for GH deficiency as part of their overall assessment. Likewise, it should be further explored if PRMT7 gene mutation testing should be recommended in a child presenting with short stature and one or more manifestations of SBIDDS syndrome. Presentation: Thursday, June 15, 2023

THU164 Design Of The New InsiGHTS Trial: A Multicenter, Phase 2, Randomized, Open-label, Active Controlled Study To Investigate The Safety, Tolerability, And Efficacy Of Lonapegsomatropin In Prepubertal Individuals With Turner Syndrome

Abstract Disclosure: K.O. Klein: Advisory Board Member; Self; Abbvie, Tolmar. Consulting Fee; Self; Abbvie, Tolmar. Grant Recipient; Self; Arbor. Research Investigator; Self; Abbvie, Arbor. Speaker; Self; Abbvie. P. Backeljauw: Advisory Board Member; Self; Ascendis Pharma. Consulting Fee; Self; Novo Nordisk, Novartis Pharmaceuticals, Ascendis Pharma, BioMarin Pharmaceutical, Tolmar, Cavalry Biosciences, Ipsen. Research Investigator; Self; Novo Nordisk, Novartis Pharmaceuticals, Ipsen. Speaker; Self; Ascendis Pharma. S. Abdelrahman: Employee; Self; Ascendis Pharma. P. Lai: Employee; Self; Ascendis Pharma. M. Mao: Employee; Self; Ascendis Pharma. A. Shu: Employee; Self; Ascendis Pharma. Background: Turner syndrome (TS) is characterized by the complete or partial absence of one X chromosome. Common clinical features include skeletal disproportion (growth failure, skeletal dysplasia, and low bone mass) and premature ovarian insufficiency in addition to a range of comorbidities including increased risk of thyroid disease, heart abnormalities, and diabetes mellitus. At this time, individuals with TS are treated with daily somatropin (human growth hormone [hGH]) which is effective at promoting height gain and may improve body composition. However, daily somatropin therapy has been associated with poor adherence which may result in reduced therapeutic efficacy. Lonapegsomatropin, a once-weekly prodrug of somatropin, is currently FDA- and EMA-approved for the treatment of pediatric GHD, and safety and efficacy have been established in 3 phase 3 trials. Lonapegsomatropin uses TransCon® technology, which combines a parent drug transiently linked to an inert carrier to achieve sustained release of somatropin. The phase 2 New InsiGHTS trial investigates the safety, tolerability, and efficacy of once-weekly lonapegsomatropin in individuals with TS. Methods: In this phase 2, parallel arm, dose-finding study, eligible prepubertal individuals with TS (aged 1 to 10 years) from the US are planned for inclusion with the aim of randomizing 48 individuals, 1:1:1:1, to lonapegsomatropin (0.24, 0.30, 0.36 mg/kg/week) or daily somatropin (0.05 mg/kg/day [0.35 mg/kg/week], a dose consistent with treatment guidelines) and stratifying them by chronological age (<4 and ≥4 years). The primary objective is to compare once-weekly lonapegsomatropin to daily somatropin in promoting linear growth at 26 weeks. Secondary objectives include additional growth parameters, safety, adherence, and pharmacokinetic/ pharmacodynamic measures that will be assessed at specified timepoints over the 104 week treatment period. Enrolled individuals must be diagnosed with TS (confirmed by genetic testing), GH-treatment naïve, exhibit impaired growth, have bone age ≤ chronological age, and be biochemically euthyroid. Exclusion criteria include diagnosis of diabetes mellitus, history of celiac disease or known clinically significant congenital or acquired cardiac dysfunction that might interfere with growth, and treatment with growth-influencing medication, among others. Dose reductions will be allowed at any time if average insulin-like growth factor-1 standard deviation score > +2.5; and/or in case of adverse events. Conclusions: The phase 2 New InsiGHTS trial is the first time that once-weekly lonapegsomatropin will be studied in individuals with TS. New InsiGHTS will provide an opportunity to examine the impact of lonapegsomatropin in a population whose short stature is not due to GH deficiency. Presentation: Thursday, June 15, 2023

Effects of Lactobacillus rhamnosus Supplementation on Growth Performance, Immune Function, and Antioxidant Capacity of Newborn Foals.

This study aimed to explore the effects of Lactobacillus rhamnosus GG (LGG) supplementation on the growth performance, immune function, and antioxidant capacity of foals. Fifteen newborn foals with similar birth weight (51.67 ± 6.07 kg) and good health were randomly assigned to three groups: control group and test groups I and II, which were supplemented with 5.0 × 109 CFU/day and 1.0 × 1010 CFU/day LGG, respectively, for 150 days. LGG intake increased the daily body height (P < .01) and weight (P < .01) gain of foals aged 120 to 150 days. The foals' IgA (P < .05) and IgG (P < .01) plasma levels increased at 30 and 150 days, respectively, and IL-6 plasma level increased at 90 days (P < .01). Plasma total antioxidant capacity level was significantly higher in test group I than in the control and test group II at 30 days (P < .01), whereas glutathione peroxidase level was significantly higher in test group II than in the control and test group I at 30 days (P < .01). Both test groups had significantly higher superoxide dismutase level than the control group (P < .01) and significantly decreased malondialdehyde plasma level at 90 and 150 days (P < .05). Overall, our findings indicate that dietary supplementation of LGG can improve the growth performance, immune function, and antioxidant capacity of newborn foals.

Evaluation of ozonated olive gel in treatment of chronic osteomyelitis of the jaws in diabetic patients

Purpose This study was planned to evaluate clinically and radiographically the use of ozonated olive gel in the treatment of chronic osteomyelitis of the jaws in diabetic patients. Patients and methods This prospective study that was carried out on twenty controlled diabetic patients with osteomyelitis of the jaws and were divided randomly into two equal groups. Group 1 (study group): included 10 patients were treated by surgical debridement and systemic antimicrobial therapy with topical application of ozonated olive gel. Group II (control group): comprised of 10 patients were treated by surgical debridement and systemic antimicrobial therapy only. All Patients underwent regular follow-ups clinically and radiographically for six months. Results Clinically, there was a significant decrease in postoperative pain and enhancement of wound healing in the study group. There was no significant difference in edema between both groups. Radiographically, by CBCT there was a significant increase in bone height gain and bone density in the study group at P value &lt;0.05. Conclusion This study showed significant effect of ozone gel on pain, soft tissue healing and elimination of infection as well as significant increase in bone height gain and bone density.

Lateral access minimally invasive spine surgery in adult spinal deformity

BackgroundOblique lumbar interbody fusion (OLIF) and percutaneous posterior approach for screw fixation (PPS) is the latest minimal invasive treatment for spinal deformity in adult patients (ASD). This study aims to design and highlight key points for ASD correction. Materials and methodsWe retrospectively analyzed 54 patients who had undergone OLIF with PPS for ASD from October 2019 to January 2022 (average 71.5 ± 6.2 years-old, male 4, female 50) with a mean follow-up period of 29.2 months. Clinical outcomes are expressed by values including the Oswestry disability index (ODI) and visual analogue scale (VAS) for back pain. The imagistic assessment was also performed preoperatively and at 12, and 24 months postoperatively. For OLIF51, CT- MRI fusion images were obtained before surgery. ResultsPostoperative ODI and VAS were 30.5 ± 18.9% and 31.2 ± 6.9 mm, respectively. The average operating time and blood loss during the surgical exposure was 490.9 ± 85.4 min and 1195.2 ± 653.8 ml. Preoperative SVA, PI-LL, and PT were 96.5 ± 55.9 mm, 39.3 ± 22.1°, 34.5 ± 11.0°, respectively. Postoperatively, SVA and PT became normal (24.1 ± 39.0 mm, 17.1 ± 10.3°) and PI-LL was ideal (2.4 ± 12.6°). Postoperative ODI and VAS were 30.5 ± 18.9% and 31.2 ± 6.9 mm. For OLIF51, the results revealed gain in L5-S1 lordosis and intervertebral disc height 9.4° and 4.2 mm respectively. The complications consisted of PJK in 21 cases (38.9%), rod breakage in 5 cases (9.3%), deep or superficial wound infection in 2 cases (3.7%). ConclusionClinical and imagistic results of OLIF and PPS for ASD were excellent. The radiographic measurements revealed that OLIF51 created good L5-S1 lordosis and significant L5-S1 disc height. CT-MRI fusion images were very useful for evaluating vascular anatomy for OLIF51.

Influence of growth stimulants on the biometric indicators of four-year-old Khingam fir (white-bark) (&lt;i&gt;Abies nephrolepis&lt;/i&gt; (Trautv.) Maxim.) seedlings

Relevance. One of the main methods of reforestation is the use of growth stimulants, which are widely used in agriculture in Russia and abroad. In forestry, their use is carried out on an experimental basis. The increase in the sowing qualities of seeds, in the biometric indicators of seedlings is observed, their safety is activated. In this regard, the use of such growth stimulants as Zircon, HB-101, Root Super and Ferovit is relevant.Methods. The effect of root feeding with stimulants Zircon, HB-101, Root Super and Ferovit on the biometric parameters of four-year-old seedlings of Khingam fir (Abies nephrolepis (Trautv.) Maxim.) was studied. The experiments were carried out in the nursery of GTS — the branch of Federal Scientific Center of the East Asia Terrestrial Biodiversity FEB RAS. The growth of seedlings was studied in terms of stem height, height gain and root collar diameter.Results. It has been established that root fertilization with the stimulants Zircon and HB-101 has the greatest effect on the growth of fir seedlings. The increase in the height of seedlings is by 3.9–60.7%, in height gain — by 11.4–137.1%, as well as in the diameter of root collar — by 16.7-66.7% was noted. It was revealed that the use of the stimulator HB-101 in the solution concentration of 0,5 ml / 10 l has a more positive effect compared with the concentration of the drug solution of 0.5 ml / 5 l of water.

Gaining New Heights in Adult Deformity Surgery: Commentary on an article by Bassel G. Diebo, MD, et al.: "Height Gain Following Correction of Adult Spinal Deformity".

Gaining New Heights in Adult Deformity Surgery: Commentary on an article by Bassel G. Diebo, MD, et al.: "Height Gain Following Correction of Adult Spinal Deformity".

The impact of a complex school nutrition intervention on double burden of malnutrition among Thai primary school children: a 2-year quasi-experiment

ObjectiveThis study assessed the impacts of the Dekthai Kamsai programme on overweight/obesity, underweight and stunting among male and female primary school students. Study designA quasi-experiment was conducted in 16 intervention and 19 control schools across Thailand in 2018 and 2019. In total, 896 treated and 1779 control students from grades 1 to 3 were recruited. In intervention schools, a set of multifaceted intervention components were added into school routine practices. Anthropometric outcomes were measured at baseline and at the beginning and end of every school term. MethodsPropensity score matching with linear and Poisson difference-in-difference analyses were used to adjust for the non-randomisation and to analyse the intervention's effects over time. ResultsCompared with controls, the increases in mean BMI-for-age Z-score (BAZ) and the incidence rate of overweight/obesity were lower in the intervention schools at the 3rd, 4th and 8th measurements and the 3rd measurement, respectively. The decrease in mean height-for-age Z-score (HAZ) was lower at the 4th measurement. The decrease in the incidence rate of wasting was lower at the 5th, 7th and 8th measurements. The favourable impacts on BAZ and HAZ were found in both sexes, while the favourable impact on overweight/obesity and unfavourable impact on wasting were found in girls. ConclusionsThis intervention might be effective in reducing BAZ, overweight/obesity, poor height gain, but not wasting. These findings highlight the benefits of a multifaceted school nutrition intervention and a need to incorporate tailor-made interventions for wasting to comprehensively address the double burden of malnutrition.

Planting a Linear Vegetation Element in Landscape Using a Forestry and Landscaping Method—Can We Tell Which Deliver Greater Success?

Since the end of the 20th century, the Czech Republic has been developing an ecological network. Areas of ligneous greenery are being established throughout the landscape. The projects use different sizes of planting material: forestry seedlings and landscaping seedlings. In the South Moravian Region, in the vicinity of the village of Šardice, a series of measurements was carried out in 2016–2019 to compare the vitality of the greenery elements established by each of the methods. The height of the seedlings and trunk diameter were measured for the young trees while the shrubs were monitored for the seedling height only. Mortality was recorded successively for all the seedlings. The forestry method demonstrated greater growing vigour as indicated by the ratio of the trunk diameter increment to height while the landscaping method had lower mortality. In the forestry plantations, high mortality was found especially in poplars, oaks and hornbeams while in the landscaping plantations the poplars and oaks had the highest mortality. Elm, sycamore and poplar trees had the highest increments in the forestry plantations (but the latter was planted at different size). In the landscaping plantations, poplar trees (planted at a different size) delivered the best results, followed by maple, elm and lime trees. Shrub mortality was similar in both types of plantings. Hazel had a very high mortality while ivy, privet and honeysuckle had low mortality. Shrub height gain was higher in fenced forestry plantations. In unfenced landscaping plantations, damage by game was evident.

Clinico-radiological correlation of pituitary stalk interruption syndrome in children with growth hormone deficiency.

To analyze the clinical, hormonal, and radiological characteristics of Pituitary stalk interruption syndrome (PSIS) in children with growth hormone deficiency (GHD). This is a prospective cross-sectional study, conducted over a period of three years in a short stature clinic of tertiary care referral hospital. 57 severe short stature children with proven GHD were included in the study. Among 57 children with GHD, 14 (24%) were diagnosed as PSIS. The mean age at diagnosis was 11.8 ± 2.6years. The male to female ratio was 2.5:1. Nine (64%) children had multiple pituitary hormone deficiency (MPHD) and 5 (36%) had isolated growth hormone deficiency (IGHD). In spite of absent or ectopic posterior pituitary (EPP)in Magnetic Resonance Imaging (MRI) of PSIS cohorts, only one had Arginine vasopressin (AVP) deficiency. EPP was seen near median eminence in 6 (44%), elsewhere in 4 (28%), and absent in 4 (28%)children. The height gain following growth hormone therapy was better in PSIS cohorts as compared to non-PSIS. Male gender, breech presentation, external congenital anomalies like cryptorchidism, midline defects and nystagmus were more common in children with PSIS. MPHD were more frequently seen in PSIS whereas IGHD in non-PSIS cohort. AVP deficiency is very rare in PSIS despite of absent or ectopic posterior pituitary in MRI. High index of clinical suspicion in all severe short stature may lead to early diagnosis and prompt initiation of growth hormone treatment for better outcome.

Response of Nicandra physalodes (Linn.) Gaertn. and Its Rhizospheric Organisms to the Selective Pressures of High-Concentration Oxytetracycline, Ciprofloxacin, and Tobramycin

Antibiotics play an essential role in the treatment of infectious diseases in humans and animals. Despite their benefits, the release of an increasing amount of various antibiotics into the environment poses a potential threat to plants, soils, animals, and microorganisms. Here, an outdoor pot experiment was conducted to preliminarily evaluate high concentrations of three antibiotics (oxytetracycline, ciprofloxacin, and tobramycin) on Nicandra physalodes (Linn.) Gaertn. and its rhizospheric organisms. The results showed that the three antibiotics had different effects on the growth behavior (germination uniformity, average growing height gain per week, and thousand seed weight) and biomass (aboveground biomass and belowground biomass) of Nicandra physalodes (Linn.) Gaertn. After adding high concentrations of the three antibiotics to the soil of each test group, the earthworm extract in group A (oxytetracycline) significantly increased the coagulation parameters prothrombin time (PT) and thrombin time (TT). The PT significantly decreased (p &lt; 0.01), while the TT was not affected in group B (ciprofloxacin). For group C (tobramycin), the TT significantly decreased (p &lt; 0.01) and the PT was not affected compared to the CK group (control group). The application of the three antibiotics caused alterations in the general activity of enzymes, such as soil sucrase (SC), urease (UE), acid phosphatase (ACP), alkaline phosphatase (AKP), and nitrate reductase (NR). Different antibiotic groups influenced the rhizosphere bacterial diversity and community structure of Nicandra physalodes (Linn.) Gaertn. At the phylum level, Ignavibacteriae was only found in group C, and Parcubacteria and Ignavibacteriae were not present in the CK group. At the genus level, Parcubacteria_norank was not present in the CK group, and BSV40_norank was found in group C. Ultimately, the results suggested that high concentrations of oxytetracycline, ciprofloxacin, and tobramycin could affect the growth behavior and biomass of Nicandra physalodes (Linn.) Gaertn. and alter its rhizobacterial community structure, providing the scientific basis for the rational use of antibiotics in animal husbandry and veterinary science.

Late preterm birth and growth trajectories during childhood: a linked retrospective cohort study

BackgroundEvidence suggests that accelerated postnatal growth in children is detrimental for adult cardiovascular health. It is unclear whether children born late preterm (34–36 weeks) compared to full term (≥ 39 weeks), have different growth trajectories. Our objective was to evaluate the association between gestational age groups and growth trajectories of children born between 2006–2014 and followed to 2021 in Ontario, Canada.MethodsWe conducted a retrospective cohort study of children from singleton births in TARGet Kids! primary care network with repeated measures of weight and height/length from birth to 14 years, who were linked to health administrative databases. Piecewise linear mixed models were used to model weight (kg/month) and height (cm/month) trajectories with knots at 3, 12, and 84 months. Analyses were conducted based on chronological age.ResultsThere were 4423 children included with a mean of 11 weight and height measures per child. The mean age at the last visit was 5.9 years (Standard Deviation: 3.1). Generally, the more preterm, the lower the mean value of weight and height until early adolescence. Differences in mean weight and height for very/moderate preterm and late preterm compared to full term were evident until 12 months of age. Weight trajectories were similar between children born late preterm and full term with small differences from 84–168 months (mean difference (MD) -0.04 kg/month, 95% CI -0.06, -0.03). Children born late preterm had faster height gain from 0–3 months (MD 0.70 cm/month, 95% CI 0.42, 0.97) and 3–12 months (MD 0.17 cm/month, 95% CI 0.11, 0.22).ConclusionsCompared to full term, children born late preterm had lower average weight and height from birth to 14 years, had a slightly slower rate of weight gain after 84 months and a faster rate of height gain from 0–12 months. Follow-up is needed to determine if growth differences are associated with long-term disease risk.

Growth Performance and Fecal Microbiota of Dairy Calves Supplemented with Autochthonous Lactic Acid Bacteria as Probiotics in Mexican Western Family Dairy Farming.

Probiotic supplementation in dairy cattle has achieved several beneficial effects (improved growth rate, immune response, and adequate ruminal microbiota). This study assessed the effects on the growth parameters and gut microbiota of newborn dairy calves supplemented with two Lactobacillus-based probiotics, individually (6BZ or 6BY) or their combination (6BZ + 6BY), administrated with the same concentration (1 × 109 CFU/kg weight) at three times, between days 5 and 19 after birth. The control group consisted of probiotic-unsupplemented calves. Growth parameters were recorded weekly until eight weeks and at the calves' ages of three, four, and five months. Fecal microbiota was described by high-throughput sequencing and bioinformatics. Although no significant effects were observed regarding daily weight and height gain among probiotic-supplemented and non-supplemented calves, correlation analysis showed that growth rate was maintained until month 5 through probiotic supplementation, mainly when the two-strain probiotics were supplied. Modulation effects on microbiota were observed in probiotic-supplemented calves, improving the Bacteroidota: Firmicutes and the Proteobacteria ratios. Functional prediction by PICRUSt also showed an increment in several pathways when the two-strain probiotic was supplemented. Therefore, using the three-administration scheme, the two-strain probiotic improved the growth rate and gut microbiota profile in newborn dairy calves. However, positive effects could be reached by applying more administrations of the probiotic during the first 20 days of a calf's life.

Early Puberty Suppression and Gender-Affirming Hormones do not Alter Final Height in Transgender Adolescents.

Early puberty suppression (ePS; Tanner stage 2-3) through Gonadotropin-Releasing Hormone agonists (GnRHa) and gender-affirming hormones (GAH) interferes with growth and may impact final height (FH). To investigate the impact of ePS and GAH on FH in trans boys and trans girls. Retrospective study, including 10 trans boys and 22 trans girls at FH. Bone age (BA) was determined at start of ePS and at start of GAH according to Greulich & Pyle; predicted adult height (PAH) was calculated according to Bayley & Pinneau's tables; target height (TH) was calculated as adjusted mean of maternal and paternal height. TH, PAH and BA were determined according to sex registered at birth (SRAB) and experienced gender (EG). The age at start of PS was 12.37 ± 0.74 years in trans boys and 13.10 ± 1.12 years in trans girls. Total height gain since start of ePS in trans boys was 14.62 ± 4.08 cm, with 70% achieved before start of GAH. In trans girls it was 20.68 ± 7.66 cm, with 61% achieved before GAH. TH for SRAB was the most accurate predictor for FH in both trans boys and girls: the difference with FH was 1.57 cm ± 3.1 (p = 0.168) and -0.98 cm ± 4.17 (p = 0.319) respectively. Also the difference between FH and PAH at the start of PS for SRAB was non-significant in both trans boys and girls (2.62 cm ± 3.79, p = 0.056 and -2.35 cm ± 5.2, p = 0.051, respectively). ePS and GAH do not impact FH, supporting the safety of the treatment; however trans adolescents achieve a FH in line with SRAB, rather than EG.

PEMODELAN PERTAMBAHAN TINGGI BADAN BALITA STUNTING DI KABUPATEN SOLOK DENGAN METODE REGRESI TOBIT KUANTIL BAYESIAN

This study analyzes the model of stunting toddler height gain and its influencing factors with Bayesian Tobit Quantile Regression (BTQR). The data used in this study are secondary data in the form of height data for stunting toddlers in Solok Regency, West Sumatra in calculations conducted in August 2021 and February 2022 obtained from the Solok Regency Health Office, West Sumatra. After analyzing the height gain data with the BTQR method, it was found that the model at quantile 0.50 was the best model because it produced smaller MAE and RMSE values than other quantiles in estimating parameters with the BTQR method and it was found that the exclusive breastfeeding variable and the Immunization variable had a significant effect on the height gain of stunting toddlers

Clinical success of guided tissue regeneration for treating vertical bone and furcation defects in dogs.

This study evaluated the clinical success rate of guided tissue regeneration (GTR) for treating advanced periodontal disease in a large canine cohort. A total of 112 GTR procedures performed from 2003-2021 were retrospectively evaluated, including pre- and post-treatment (3-12 months) periodontal probing depths of 104 treated teeth, dental radiographs of 73 treated teeth, and both diagnostic modalities in 64 treated teeth. Probing depth, radiographically apparent bone height, bone graft material, barrier membrane material, and tooth extraction adjacent to the GTR site were investigated as factors affecting success. Vertical bone defects were evaluated separately from furcation defects. GTR was clinically successful, defined as objective improvement in probing depth, objective decrease in radiographic vertical bone defect, and subjective radiographic gain in bone height in 90.3% of vertical bone defects. Success was significantly associated with the magnitude of initial probing depth and the type of barrier membrane used. GTR was clinically successful, defined as objective improvement in furcation probing and subjective radiographic improvement of the bone in the furcation in 22.2% of furcation defects. When F3 lesions were excluded, GTR was successful in 64.3% of furcation defects. GTR is an appropriate treatment to maintain teeth in the oral cavity of dogs with proper client counseling and patient selection, but it is most likely to be successful in vertical defects.

Influence of parental anthropometry and gestational weight gain on intrauterine growth and neonatal outcomes: Findings from the MAI cohort study in rural India.

Poor foetal growth and subsequent low birth weight are associated with an increased risk for disease later in life. Identifying parental factors that determine foetal growth are important to curbing intergenerational malnutrition, especially among disadvantaged populations in the global south where undernutrition rates are high. The objective of this study was to assess the relationships between parental biometry, intrauterine growth and neonatal outcomes, while factoring in socioeconomic status of historically disadvantaged households in rural India. Using data from the prospective longitudinal cohort, pregnant women from rural Pune, India (n = 134) were assessed between August 2020 and November 2022. Data on socio-demography, ultrasound measurements, parental and foetal anthropometry were collected. Multiple linear regression models were run to predict determinants of foetal intrauterine and neonatal growth (p value<0.05). The dependent variables were ultrasound measurements and neonatal biometry, and independent variables were gestational weight gain, parental and mid-parental height. Mean(±SD) maternal age, maternal height, paternal height and mid-parental height were 22.8±3.7 years, 153.6±5.5cm, 165.9±6.5cm and 159.1±8.7cm, respectively. Pre-pregnancy body mass index and gestational weight gain was 20.5±4.0 kg/m2 and 9.8±3.7kg respectively. Mid-parental height and gestational weight gain were strongly correlated with neonatal growth and foetal intrauterine growth (p<0.05); however, the correlation peaked at 28 weeks of gestation (p<0.05). Gestational weight gain (B = 28.7, p = 0.001) and mid-parental height (B = 14.3, p = 0.001) were identified as strong determinants of foetal-intrauterine growth and neonatal anthropometry at birth. Maternal height was found to influence length of male neonate (B = 0.18, p = 0.001), whereas, paternal height influenced length of the female neonate (B = 0.11, p = 0.01). Parental socio-economic status, biometry and maternal gestational weight gain influence growth of the child starting from the intrauterine period. Our study underlines the need for interventions during pre-pregnancy, as well as during pregnancy, for optimal weight gain and improved foetal and neonatal outcomes.

Growth Hormone Dosing Estimations Based on Body Weight Versus Body Surface Area

Both body weight (BW)- and body surface area (BSA)-based dosing regimens have been recommended for growth hormone (rhGH) replacement. The aim was to compare the two regimens to determine if either resulted in inadequate treatment depending on anthropometric factors. The retrospective study included children diagnosed with idiopathic isolated growth hormone deficiency. BW-based dosing in mcg/kg/day was converted to BSA in mg/m2/day to determine the equivalent amounts of the given rhGH. Those with a BW-to-BSA ratio of more than 1 were allocated to the “relatively over-dosed group”, while the remaining patients with a ratio of less than 1 were assigned to the “relatively under-dosed” group. Patients with a height gain greater than 0.5 standard deviation score (SDS) at the end of one year were classified as the height gain at goal (HAG), whereas those with a height gain of less than 0.5 SDS were assigned as the height gain not at goal (NHAG). The study included 60 patients (18 girls, 30%). Thirty-six (60%) patients were classified as HAG. The ratio of dosing based on BW-to-BSA was positively correlated both with the ages and body mass index (BMI) levels of the patients, leveling off at the age of 11 at a BMI of 18 kg/m2. The relative dose estimations (over- and under-dosed groups) differed significantly between the patients classified as HAG or NHAG. Fifty-six percent of NHAG compared to 44% of HAG patients received relatively higher doses, while 79% of HAG compared to 21% of NHAG received relatively lower doses (p=0.006). When the patients were subdivided according to their pubertal status, higher doses were administrated mostly to the pubertal patients in both the NHAG and HAG groups. In the pre-pubertal age group, 73% of NHAG compared to 27% of HAG received relatively higher doses, while 25% of NHAG compared to 75% of HAG received relatively lower doses (p=0.01). Dosing based on BW may be preferable in both prepubertal and pubertal children who do not show adequate growth responses. In prepubertal children, relatively lower doses calculated based on BW rather than BSA provide similar efficacy at lower costs.

Effect of Home-Made Formula on Growth Performance of Malnourished Pre-School Children (24-36 Months of Age) in Yobe State Nigeria

Aim: The insurgency in the north-east zone of Nigeria has aggravated rate of malnourished children and many are roaming the streets unattended. This study determined the effect of home-made formula on growth performance of malnourished pre-school children in Yobe State, Nigeria.&#x0D; Study Design: A factorial experiment.&#x0D; Place and Duration of Study: Yobe state, Nigeria, 6 weeks.&#x0D; Methodology: Three local Government Areas (LGA) of Yobe state, Nigeria (Bade, Bursari and Potiskum) used. A formulated home-made formula (HMF) was compared with therapeutic milk powders (TMPs). Twenty malnourished pre-school children were purposefully selected in each LGA and were grouped into two. Each group was randomly allotted to a dietary treatment, a child stood as replicate. At commencement children with complications were treated in the hospital. They were fed at 16.88 ml/kg body weight at 3 hours interval daily throughout a 6th week study using plastic cups. Parameters studied included weight, height, mid-upper arm circumference (MUAC) and W/HZ-score. A SPSS statistical package was used to analyze the results.&#x0D; Results: All the parameters were (p&gt;0.05) affected with dietary treatments among districts. However, children fed HMF had higher final MUAC (127.50±2.04mm), higher height gain (3.45±0.18cm) and higher MUAC gain (13.76±0.22mm) among districts while those fed TMPs had higher final weight (10.74±0.25kg), higher final height (83.77±0.16cm) and higher weight gain (2.11±0.01kg). Based on average, the children fed HMF had higher final MUAC (127.50±2.04mm), height gain (3.45±0.18cm) and MUAC gain (13.76±0.22mm) while their counterparts fed TMPs had higher final weight (10.74±0.25kg), final height (83.77±0.83) and weight gain (2.11± 0.01kg). The children fed TMPs had slightly higher daily weight gain (50.23g) than those fed HMF (48.81g); and all the children were discharged with -2&lt;z-score. &#x0D; Conclusion: It can be concluded that HMF was effective in managing malnutrition in pre-school children. Therefore, it is recommended as alternative therapeutic food.