Rebound Growth Research Articles

Research review: Racial and ethnic disparities in the pharmacologic management of diabetes mellitus among long-term care facility residents

The present study compared growth parameters of girls' and boys' body mass index (BMI) trajectories from infancy to middle childhood and evaluated these parameters as predictors of cardiovascular disease (CVD) risk in adolescence.Using 657 children from the NICHD Study of Early Child Care and Youth Development, quadratic growth curve analyses were conducted to establish growth parameters (intercept, slope, and quadratic term) for girls and boys from age 15 months to 10.5 years. Parameters were compared across gender and evaluated as predictors of a CVD risk index at the age of 15 years, controlling for characteristics of the adiposity rebound (AR) including age at which it occurred and children's BMI at the rebound.Boys had more extreme trajectories of growth than girls with higher initial BMI at age 15 months (intercept), more rapid declines in BMI before the AR (slope), and sharper rebound growth in BMI after the rebound (quadratic term). For boys and girls, higher intercept, slope, and quadratic term values predicted higher CVD risk at the age of 15 years, controlling for characteristics of the AR.Findings suggest that individuals at risk for developing CVD later in life may be identified before the AR by elevated BMI at 15 months and slow BMI declines. Because of the importance of early intervention in altering lifelong health trajectories, consistent BMI monitoring is essential in identifying high-risk children.

All angiogenesis is not the same: Distinct patterns of response to antiangiogenic therapy in experimental neuroblastoma and Wilms tumor

Background/Purpose: Neuroblastoma and Wilms tumor exhibit different patterns of metastasis, invasion, and therapeutic response. Vascular endothelial growth factor (VEGF) is an angiogenic factor expressed in both tumors. The authors hypothesized that because the clinical behavior of these tumors differs, the response to anti-VEGF therapy would be distinct, and tumor vascular architectures would reflect this distinction. Methods: Xenografts were induced by intrarenal injection of cultured cells in athymic mice. After 1 week, anti-VEGF antibody or vehicle were administered for 5 weeks before sacrifice. Additional animals were maintained for 3 weeks after termination of antibody injections to assess rebound growth of tumors. Fluorescein angiography was performed in selected animals. Results: Neuroblastoma control and treated tumor weights were not significantly different (1.48 g v 0.77 g, P =.34). By comparison, as previously reported, antibody-treated Wilms tumors were growth inhibited. Angiograms of treated (but not control) neuroblastomas displayed novel rounded structures at vessel branches, which the authors term terminal vascular bodies (TVBs). Wilms tumor vessels displayed no such alteration. Conclusions: Neuroblastoma xenografts are less effectively suppressed by anti-VEGF antibody than Wilms tumors. Neuroblastoma vascular architecture displays a novel alteration during antibody administration, which attenuates when antibody is withdrawn. These studies suggest that angiogenesis is differently regulated in experimental neuroblastoma and Wilms tumor. J Pediatr Surg 36:287-290. Copyright © 2001 by W.B. Saunders Company.

Cimetidine treatment for recurrent respiratory papillomatosis

Effective adjuvant treatment for recurrent respiratory papillomatosis (RRP) is at present limited to alpha-interferon, which may have significant side effects including rebound growth of papillomata following its withdrawal, is given by injection and is expensive. High dose cimetidine is known to have immunomodulatory side effects and has been reported as a useful treatment for cutaneous warts. We report a case of very advanced RRP with tracheo-bronchial-pulmonary involvement treated with adjuvant cimetidine at a dose of 40 mg/kg for 4 months. The patient enjoyed a remarkable improvement in her clinical condition following treatment. The literature regarding cimetidine treatment for cutaneous warts is reviewed.

Medial physeal stapling for primary and secondary genu valgum in late childhood and adolescence

We report the results of medial physeal stapling in 16 knees with primary genu valgum and 27 with secondary genu valgum. In the primary group, stapling was undertaken at a mean chronological age of 12 years in girls and 13 years in boys. The medial femoral physis was stapled in ten knees and the medial femoral and tibial physes in six knees. At skeletal maturity, all patients had excellent or good leg alignment. Secondary genu valgum is due to skeletal dysplasia, haematological or endocrine disorders, or to juvenile chronic arthritis. Stapling was at a mean chronological age of 11 years in girls and 14 years in boys. The medial femoral physis was stapled in 13 knees, the medial tibial physis in three and both in 11 knees. At skeletal maturity, 85% had excellent or good leg alignment, and correction had occurred within one year. Two of the poor results were due to staple extrusion from osteoporotic bone, and two to overcorrection. Rebound growth was minimal and unpredictable after the removal of staples. Medial physeal stapling is a suitable method of treatment for both primary and secondary genu valgum in late childhood and in adolescence. At least one year of knee growth is required to achieve correction, and care is needed to avoid overcorrection of the secondary genu valgum.

Radical approach in the treatment of neurofibroma

The infiltrating character of plexiform and diffuse neurofibroma poses a difficult surgical challenge. The conventional approach of multiple partial resections of the tumor, and the soft character of the remaining tumor with additional changes in the surrounding tissue leave poor cosmetic results. In addition, the frequent rebound growth of the tumor after each partial resection creates a serious functional problem.The case presented here illustrates a classical clinical appearance and evolution of neurofibroma in the oculo-adnexal region in generalized neurofibromatosis (von Recklinghausen's disease). The conventional surgical approach consisting of repeated partial resections of the tumor resulted in a rebound growth to the stage of a total hemifacial disfigurement. The radical surgical approach applied then, and the subsequent plastic restorations, have not only eliminated the tumor but also restored the normal contour of the face. This case illustrates that the patient could have benefited from a radi...

THE EFFECT OF THE STIMULANT DRUGS DEXTROAMPHETAMINE AND METHYLPHENDIATE ON GROWTH HORMONE SECRETION IN HYPERACTIVE CHILDREN

Recent reports that prolonged use of the stimulant drugs dextroamphetamine and methylphendiate (Ritalin) in high doses can suppress growth in hyperactive children and that rebound growth occurred after cessation of therapy, prompted us to test whether these two drugs could provoke growth hormone (GH) secretion. The effect of L-dopa (l25–500 mg) and 15 mg of amphetamine on GH secretion was studied in 10 hyperactive children. Each of the children had both tests performed on alternate days, and serum GH was determined at 0, 30, 60, 90, 120 and 180 min. Individuals with a peak serum GH level of less than 6 ug/ml were considered “non-responders”. There were two non-responders to each drug, and one child did not respond to either test. Peak GH response occured at 60 min in both tests with a mean peak CH level of 11.7 ug/ml after L-dopa and 9.8 ug/ml after amphetamine. There were no significant differencesbetween the mean values at any time of sampling. Preliminary data indicate that methylphendiate also can provoke GH secretion to similar extent as amphetamine. We are now in progress to retest the effect of these drugs on GH secretion in children who have been on methylphendiate treatment for 6 months or more.

Effect of adrenergic receptor blockade on nicotinic acid-induced plasma FFA rebound

Nicotinic acid administration causes an initial depression in plasma free fatty acids (FFA) followed by a rebound above baseline concentrations. Beta adrenergic blockade with propranolol had no effect on the FFA rebound. Alpha adrenergic blockade with phentolamine completely abolished the FFA rebound and also partially inhibited the initial plasma FFA depression. No relationship between FFA rebound and plasma growth hormone levels was observed. A significant correlation was demonstrated between FFA depression and rebound following nicotinic acid administration. It is proposed that the abolishment of the FFA rebound by alpha adrenergic blockade is related to its inhibition of the initial FFA depression which in turn may be related to antagonistic effects of alpha adrenergic blockers and nicotinic acid on adenyl cyclase activity.