Determinants of menarche

Menarche is a milestone in a woman's life as it denotes the start of reproductive capacity. Aim of this report is to review the recent developments and the current knowledge in the neuroendocrinology of pubertal onset and the factors, genetic and environmental, that influence menarcheal age. We also review the implications of early or late menarcheal age on a young woman's life

Determinants of menarche

Menarche is a milestone in a woman’s life as it denotes the start of reproductive capacity. Aim of this report is to review the recent developments and the current knowledge in the neuroendocrinology of pubertal onset and the factors, genetic and environmental, that influence menarcheal age. We also review the implications of early or late menarcheal age on a young woman’s life

Therapeutic trends and outcome of acromegaly: a single center experience over a 40-year period

OBJECTIVE: To evaluate the therapeutic trends and long-term outcome of treatment modalities for acromegaly in our center over a 40-year period. DESIGN: We retrospectively studied 321 acromegalic patients (145 males/176 females) diagnosed and treated from the 1970s until September 2013. Patients were divided into two subgroups: group A consisted of 166 patients diagnosed before 1990 and group B of 155 patients diagnosed after 1990. Outcome was assessed with GH (random and/or post OGTT) and IGF1 measurements. RESULTS: More group A than group B patients were submitted to radiotherapy (57.8% vs 16.8% patients, respectively, p <0.001). In contrast, more patients of group B were offered surgery (70.3% vs 42.1% in group A, p <0.001) and/or medical treatment (70.3% vs 23.4% in group A, p <0.001). At latest follow-up, 68.4 % of patients in group B achieved GH <2.5 μg/l after treatment vs 39.8% in group A, p=0.001, 46.9% of patients in group B achieved GH <1 μg/l vs 20.3% in group A, p=0.001 and 47.1% of patients in group B achieved during OGTT GH nadir <0.4 μg/l vs 18.6% in group A, p=0.001. CONCLUSIONS: Transsphenoidal resection and medical treatment resulted in improved outcome in acromegalic patients treated over the last 20 years. However, the disease still remains uncontrolled in a considerable number of patients.ΣΚΟΠΟΣ: Η αξιολόγηση των θεραπευτικών τάσεων και της μακροχρόνιας έκβασης των θεραπευτικών χειρισμών της μεγαλακρίας στο κέντρο μας σε μια περίοδο 40 ετών. ΣΧΕΔΙΑΣΜΟΣ: Μελετήσαμε αναδρομικά 321 μεγαλακρικούς ασθενείς (145 άνδρες/176 γυναίκες) που διαγνώσθηκαν και έλαβαν αγωγή από τις αρχές του 1970 μέχρι και το Σεπτέμβριο του 2013. Οι ασθενείς χωρίστηκαν σε δύο ομάδες: στην ομάδα Α συμπεριλήφθηκαν 166 ασθενείς που διαγνώσθηκαν πριν το 1990 και στην ομάδα Β 155 ασθενείς που διαγνώσθηκαν μετά το 1990. Η έκβαση αξιολογήθηκε με μέτρηση της GH (τυχαία και/ή μετά OGTT) και του IGF1. AΠΟΤΕΛΕΣΜΑΤΑ: Περισσότεροι ασθενείς της ομάδας Α σε σχέση με τους ασθενείς της ομάδας Β υποβλήθηκαν σε ακτινοθεραπεία (57,8% έναντι 16,8% αντίστοιχα, p<0,001). Αντίθετα, περισσότεροι ασθενείς της ομάδας Β υποβλήθηκαν σε χειρουργείο (70,3% έναντι 42,1% στην ομάδα Α, p<0,001) και/ή φαρμακευτική θεραπεία (70,3% έναντι 23,4% της ομάδας Α, p<0,001). Στην τελευταία παρακολούθηση, 68,4 % των ασθενων της ομάδας B είχαν GH <2,5 μg/l μετά τους θεραπευτικούς χειρισμούς έναντι 39,8% των ασθενών της ομάδας A, p=0,001, 46,9% των ασθενών της ομάδας B είχαν GH <1 μg/l έναντι 20,3% της ομάδας A, p=0,001 και 47,1% των ασθενών της ομάδας Β πέτυχαν ναδίρ GH <0.4 μg/l μετά OGTT έναντι 18,6% των ασθενών της ομάδας A, p=0,001. ΣΥΜΠΕΡΑΣΜΑΤΑ: Η διασφηνοειδική αδενωματεκτομή και η φαρμακευτική θεραπεία βελτίωσαν την έκβαση των ασθενών με μεγαλακρία τα τελευταία 20 χρόνια. Ωστόσο, ένας σημαντικός αριθμός ασθενών δεν επιτυγχάνει έλεγχο της νόσου

Congenital Bilateral Amazia Associated With Bilateral Choanal Atresia

Congenital absence of breast development is a very rare abnormality. It may present as an isolated finding or it may be accompanied by other congenital anomalies. Here we report on a 13.5-year-old girl presented to our pediatric endocrinology clinic because of lack of breast development. She had pubarche since the age of 10 years and was regularly menstruating since the age of 12 years. The patient’s medical history was positive for bilateral complete choanal atresia that was diagnosed and corrected soon after birth. Physical examination was unremarkable except for bilateral amazia, that is, absence of palpable breast tissue and hypoplastic areolae, whereas both nipples were formed. Renal ultrasonography and chest radiography were normal. The coexistence of congenital bilateral amazia and bilateral complete choanal atresia suggests that these rare disorders may be related etiologically. The patient is scheduled for breast augmentation. (C) 2009 Wiley-Liss, Inc