Academic literature on the topic 'Non-GHD'
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Journal articles on the topic "Non-GHD"
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Ibba, Anastasia, Francesca Corrias, Chiara Guzzetti, Letizia Casula, Mariacarolina Salerno, Natascia di Iorgi, Gianluca Tornese, et al. "IGF1 for the diagnosis of growth hormone deficiency in children and adolescents: a reappraisal." Endocrine Connections 9, no. 11 (November 2020): 1095–102. http://dx.doi.org/10.1530/ec-20-0347.
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A number of studies have evaluated the role of IGF1 measurement in the diagnosis of growth hormone deficiency (GHD). This study aimed to evaluate the accuracy and the best cut-off of IGF1 SDS in the diagnosis of GHD in a large cohort of short children and adolescents. One-hundred and forty-two children and adolescents with GHD ((63 organic/genetic (OGHD), 79 idiopathic (IGHD)) and 658 short non-GHD children (median age 10.4 years) were included in the analysis. The two groups were subdivided according to age (G1 <6, G2 6 <9, G3 9 <12, G4 ≥12) and to pubertal status. Serum IGFI was measured by the same chemiluminescence assay in all samples and expressed as age- and sex-based SDS. Receiver operating characteristic (ROC) analysis was used to evaluate the optimal IGF1 SDS cut-off and the diagnostic accuracy. Median IGF1 SDS was significantly lower in the GHD than in non-GHD patients. The area under the curve (AUC) was 0.69, with the best IGF1 cut-off of −1.5 SDS (sensitivity 67.61%, specificity 62.62%). The AUC was 0.75 for OGHD and 0.63 for IGHD. The accuracy was better in the pubertal (AUC = 0.81) than the prepubertal group (AUC = 0.64). In our cohort, IGF1 measurement has poor accuracy in discriminating GHD from non-GHD. Our findings confirm and reinforce the belief that IGF1 values should not be used alone in the diagnosis of GHD but should be interpreted in combination with other clinical and biochemical parameters.
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Kaplowitz, Paul B., Janna Manjelievskaia, Lorena Lopez-Gonzalez, Cynthia D. Marrow, Pisit Pitukcheewanont, and Alden Smith. "Economic Burden of Growth Hormone Deficiency in a US Pediatric Population." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A675. http://dx.doi.org/10.1210/jendso/bvab048.1376.
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Abstract Pediatric GHD is a rare disorder of short stature that is currently treated with daily injections of GH. In addition to short stature, GHD is associated with other comorbidities such as impaired musculoskeletal development, cardiovascular disease, and decreased quality of life. The objective of this study was to analyze GH utilization, adherence, and healthcare costs among children with GHD who had either Medicaid or commercial health insurance. Children (age <18 years) with a diagnosis of GHD between January 1, 2007, and December 31, 2017 were identified in the IBM Marketscan Commercial and Medicaid Databases. Children with GHD were direct matched (1:3) to controls without GHD (or other short stature-related disorder) on age, gender, plan type, region, and race (Medicaid only). The index date was set as the date of the first GHD diagnosis during the selection window for GHD patients and using random assignment for controls. Patients were followed for the 12 months prior to the index date until the end of continuous database enrollment or December 31, 2018. Baseline comorbidities and medications were measured during the 12 months pre-index. Treatment patterns and all-cause and GHD-related healthcare costs were measured during the variable follow-up period. Multivariable modeling was used to compare costs between GHD patients and controls and between GH treated and untreated GHD patients while adjusting for baseline characteristics. There were 6,820 Medicaid and 14,070 commercial patients with GHD who met the study inclusion criteria. Mean (SD) age at index was 9.5 (4.5) years for Medicaid patients and 11.1 (3.7) years for commercial patients. A majority of patients were male (>65%) and followed for at least 3.7 years. Overall, 63.2% of Medicaid and 68.4% of commercial patients were treated with GH during follow-up. Among Medicaid patients, the treatment rate was highest among white males and lowest among black females. Adherence, as measured by proportion of days covered, was low, with 18.4% of Medicaid patients and 32.3% of commercial patients considered “adherent” (PDC ≥ 0.8). Nearly half (49.1%) of treated Medicaid patients and 24.3% of commercial patients discontinued GH therapy before age 13. After adjusting for baseline characteristics, all-cause non-GH costs were 5.7times higher (Δ$19,309) for Medicaid patients and 5.5 times higher (Δ$12,305) for commercial patients than matched non-GHD controls. Adjusted all-cause non-GH costs were 0.6 times lower (Δ$14,416) for treated Medicaid patients and 0.7 times lower (Δ$7,650) for treated commercial patients than for untreated patients. Pediatric GHD presents a significant healthcare burden, and many patients remain untreated or undertreated. Untreated GHD was associated with higher non-GH healthcare costs than treated GHD. Strategies to improve adherence may reduce the healthcare burden faced by these patients.
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Hoybye, Charlotte, Peter Jönsson, John P. Monson, Maria Kołtowska-Häggström, Václav Hána, Mitchell Geffner, and Roger Abs. "Impact of the primary aetiology upon the clinical outcome of adults with childhood-onset GH deficiency." European Journal of Endocrinology 157, no. 5 (November 2007): 589–96. http://dx.doi.org/10.1530/eje-07-0364.
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AbstractObjectiveThe impact of the aetiology of childhood-onset GH deficiency (CO-GHD) on the clinical presentation during adulthood and the response to GH replacement has been poorly defined. Our study aims to characterize CO-GHD in adults due to different aetiologies and evaluate the effect of 2 years of GH replacement therapy.Design and methodsData from 353 adults with CO-GHD from Pfizer International Metabolic Database KIMS were retrospectively grouped according to GHD aetiology: non-organic disorder (n=147), organic pituitary disease (n=159), and brain tumour (n=47). Extent of pituitary dysfunction, IGF-I concentration, lipid concentrations and quality-of-life (QoL) were assessed at baseline and after 2 years of GH replacement.ResultsGHD was diagnosed at a later age in the organic pituitary group than in the other groups, resulting in a shorter duration of GH treatment during childhood. However, the final height was greater in the organic pituitary group. Panhypopituitarism was most common in the non-organic disorder and in the organic pituitary groups, while isolated GHD was more prominent in the brain tumour group. Serum IGF-I levels were the lowest in the non-organic group. QoL was the poorest in the brain tumour group. Lipid profile and QoL improved significantly during GH replacement.ConclusionThe adverse consequences of CO-GHD in adulthood vary between aetiologies, but improve similarly with GH treatment. It is, therefore, important to consider retesting all patients with CO-GHD in early adulthood and, if persistent severe GHD is confirmed, recommence GH replacement.
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Garner, Terence, Adam Stevens, Andrew James Whatmore, Peter Ellis Clayton, and Philip G. Murray. "Diagnosis of Childhood and Adolescent Growth Hormone Deficiency Using Transcriptomic Data." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A674—A675. http://dx.doi.org/10.1210/jendso/bvab048.1375.
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Abstract Background: We have shown that gene expression (GE) data have promise as a novel tool to aid in the diagnosis of childhood growth hormone deficiency (GHD)1. Our previous study compared GE data in children with GHD to healthy control children of normal stature. The aim of this study was to assess the utility of GE data in the diagnosis of GHD in childhood and adolescence using non-GHD short stature children as a control group. Methods: GE data were obtained from patients undergoing growth hormone stimulation testing via a sample of blood taken at the start of the test. Arginine and glucagon stimulation tests with a cut-off for peak GH of <7mcg/L (IDS iSYS assay) were used for the diagnosis of GHD. GE was assessed in peripheral blood mononuclear cells via RNA-seq using the Illumina HiSeq 4000 platform. Data were taken for the 271 genes whose expression was utilised in our previous study. The synthetic minority oversampling technique was used to balance the dataset and a random forest algorithm applied to predict GHD status. Boruta was used to assess which of the genes were contributing to the predictive capacity. Results: Twenty-four patients were recruited to the study, with eight subsequently diagnosed with GHD. Of the eight patients diagnosed with GHD, three had two stimulation tests and five had one stimulation test with anterior pituitary hypoplasia (in addition one patient had an arachnoid cyst and another a thin stalk). Median (range) peak GH was 2.5 (0.1 - 5) mcg/L in the GHD group and 11.0 (7.4 - 31) mcg/L in the non-GHD group. There were no significant differences in gender, age, auxology (height SDS, weight SDS, BMI SDS) or biochemistry (IGF-I or IGFBP-3 SDS) between the GHD and non-GHD subjects. 82 of the 271 genes used in our previous study were above the threshold of detection for RNA-seq in this study. A random forest algorithm using these 82 genes gave an AUC of 0.97 (95% CI 0.93 - 1.0) for the diagnosis of GHD. Boruta was able to identify 65/82 genes with predictive capacity greater than permuted data within the dataset. Using a gene ontology approach the top fifty biological processes generated 16 clusters by affinity propagation which included regulation of TORC1 signalling and inositol phosphate metabolism. Conclusion: This study demonstrates highly accurate diagnosis of childhood GHD using a combination of GE data and random forest analysis and validates the findings of our original study. 1Murray etal (2018) JCI Insight 3(7): e93247
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Kołtowska-Häggström, Maria, Mitchell E. Geffner, Peter Jönsson, John P. Monson, Roger Abs, Václav Hána, Charlotte Höybye, and Hartmut A. Wollmann. "Discontinuation of Growth Hormone (GH) Treatment during the Transition Phase Is an Important Factor Determining the Phenotype of Young Adults with Nonidiopathic Childhood-Onset GH Deficiency." Journal of Clinical Endocrinology & Metabolism 95, no. 6 (June 1, 2010): 2646–54. http://dx.doi.org/10.1210/jc.2009-2013.
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Abstract Context: Little is known about the impact of childhood-onset GH deficiency (GHD), in particular the duration of GH cessation during the transition phase, on adult phenotype. Objective: We investigated the association between the manifestations and management of GHD during childhood/adolescence and the clinical features of GHD in adulthood. Design/Setting/Patients/Intervention: Patients with reconfirmed childhood-onset GHD who resumed GH treatment as adults were identified from two sequential databases (n = 313). The cohort was followed up longitudinally from GH start in childhood to reinitiation of treatment in adulthood and 1 yr beyond. Analyses were performed in the total cohort and in subgroups of patients with idiopathic GHD (IGHD) and non-IGHD. The cohorts were stratified based on duration of GH cessation (short, ≤2 yr; long, >2 yr). Main Outcome Measures: Regimen of pediatric GH administration, duration of GH interruption, IGF-I sd score, lipid concentrations, and quality of life were measured. Results: Mean duration of GH interruption was 4.4 yr. IGF-I sd score in adulthood was related to severity of childhood GHD. In non-IGHD patients, a longer duration of GH interruption was associated with a worse lipid profile (P < 0.0001). Non-IGHD patients who gained more height during childhood GH treatment reported better quality of life than those who gained less height (P < 0.05). Conclusions: Pediatricians should tailor GH treatment, not only for its beneficial effect on growth but also for future health in adulthood. In adults with reconfirmed GHD, particularly those with non-IGHD, early recommencement of GH should be considered.
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Ebuchi, Yuki, Toshihide Kubo, Mahoko Furujo, Yousuke Higuchi, Shoko Fujinaga, Hiroki Tsuchiya, Naoko Urata, et al. "Effect of growth hormone therapy on thyroid function in isolated growth hormone deficient and short small for gestational age children: a two-year study, including on assessment of the usefulness of the thyrotropin-releasing hormone (TRH) stimulation test." Journal of Pediatric Endocrinology and Metabolism 33, no. 11 (November 26, 2020): 1417–23. http://dx.doi.org/10.1515/jpem-2020-0151.
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AbstractBackgroundThe relationship between growth hormone (GH)-replacement therapy and the thyroid axis in GH-deficient (GHD) children remains controversial. Furthermore, there have been few reports regarding non-GHD children. We aimed to determine the effect of GH therapy on thyroid function in GHD and non-GHD children and to assess whether thyrotropin-releasing hormone (TRH) stimulation test is helpful for the identification of central hypothyroidism before GH therapy.MethodsWe retrospectively analyzed data from patients that started GH therapy between 2005 and 2015. The free thyroxine (FT4) and thyroid-stimulating hormone (TSH) concentrations were measured before and during 24 months of GH therapy. The participants were 149 children appropriate for gestational age with GHD (IGHD: isolated GHD) (group 1), 29 small for gestational age (SGA) children with GHD (group 2), and 25 short SGA children (group 3).ResultsIn groups 1 and 2, but not in group 3, serum FT4 concentration transiently decreased. Two IGHD participants exhibited central hypothyroidism during GH therapy, and required levothyroxine (LT4) replacement. They showed either delayed and/or prolonged responses to TRH stimulation tests before start of GH therapy.ConclusionsGH therapy had little pharmacological effect on thyroid function, similar changes in serum FT4 concentrations were not observed in participants with SGA but not GHD cases who were administered GH at a pharmacological dose. However, two IGHD participants showed central hypothyroidism and needed LT4 replacement therapy during GH therapy. TRH stimulation test before GH therapy could identify such patients and provoke careful follow-up evaluation of serum FT4 and TSH concentrations.
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Courtillot, Carine, Roselyne Baudoin, Tatiana Du Souich, Lucile Saatdjian, Isabelle Tejedor, Graziella Pinto, Juliane Léger, et al. "Monocentric study of 112 consecutive patients with childhood onset GH deficiency around and after transition." European Journal of Endocrinology 169, no. 5 (November 2013): 587–96. http://dx.doi.org/10.1530/eje-13-0572.
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ObjectivesOur aim was to analyze a large cohort of childhood onset GH deficiency (CO-GHD) adults from a unique adult center, in order to analyze their clinical management and to study the metabolic and bone status in relation to GHD and to the other pituitary deficits, and to evaluate these parameters during the long-term follow-up.Design and methodsObservational retrospective cohort study on 112 consecutive CO-GHD adults transferred to our unit from 1st January 1994 to 1st March 2012. Evaluation of GHD in pediatrics and after transition was conducted following consensus guidelines. Data recorded from pediatric and adult files were GH doses, pituitary magnetic resonance imaging and function, and metabolic and bone status.ResultsMost patients presented with severe CO-GHD (64%) associated with other pituitary deficits (66%). CO-GHD was acquired in 56%, congenital in 33%, and idiopathic in 11% cases. Most patients (83%) stopped GH before transfer, at 16.3 years (median), despite persistence of GHD. Median age at transfer was 19.4 years. After transfer, GHD persisted in 101 patients and four of the 11 resolutive GHD were non idiopathic. IGF1 level was <−2 SDS in 70% of treated patients at transfer and in 34% of them after 3 years of treatment. Follow-up showed improvement in lipid profile and bone mineral density in severely persistent GHD patients under GH therapy. In multivariate analysis, the associated pituitary deficits seemed stronger determinant factors of metabolic and bone status than GHD.ConclusionsThis study raises concern about discontinuation of GH replacement therapy in pediatrics in severely persistent GHD patients and about the often insufficient dose of GH in the treatment of adult patients.
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RUDD, B. T., P. H. W. RAYNER, and P. H. THOMAS. "Observations on the role of GH/IGF-1 and sex hormone binding globulin (SHBG) in the pubertal development of growth hormone deficient (GHD) children." Acta Endocrinologica 113, no. 4_Suppl (December 1986): S164—S169. http://dx.doi.org/10.1530/acta.0.112s164.
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Abstract SHBG concentrations in GHD and non GHD children of both sexes were studied in relation to their weight and androgen status. SHBG was inversely related to age in short and control children, but not for GHD. Correction for body weight restored the inverse relationship in these children and improved the correlation for the other groups. DHAS concentrations were similar in GHD and short children, suggesting GH per se does not influence adrenal androgen synthesis. The mean free testosterone in GHD children 12.7 pmol/L, was similar to that in short children, 14.3 pmol/L, and lower than controls 21.2 pmol/L, but consistent with their pubertal status. The Linear regression of SHBG on IGF-1 was r = -0.605 (P <0.01). It was postulated that IGF-1 and free testosterone may regulate SHBG synthesis. Administration of native and synthetic GH to prepubertal GHD children lowered SHBG without a significant change in TBG, albumin or free testosterone. The fall in SHBG concentration after HGH in GHD children is suggested as a selective mechanism which may lead to improved pubertal development. It is now recognised that many of the biochemical actions of administered human growth hormone (HGH), notably linear growth, protein synthesis and turnover, recorded in the classical studies of Prader et al. (1964), Hubble (1966) and Brown et al. (1967) are mediated by the generation of somatomedin C (IGF-1) (Van Wyk et al., 1974). Less certain is the role that IGF-1 may play in the timing of the growth spurt and subsequent pubertal development. It is documented however, (Laron and Sarel, 1970), that clinical signs of poor genital development in male patients with growth hormone deficiency may be reversed by HGH therapy, but the mechanism is unknown. A specific carbohydrate rich dimeric binding protein, sex hormone binding globulin, with a high Ka for testosterone and oestradiol-17β is present in serum (Anderson, 1974). Levels are raised prepubertally and fall progressively in both sexes as puberty advances (Lee et al., 1985). This fall is a trigger for increased levels of free testosterone and oestradiol-17β which may play a part in the activation of the hypothalamic-pituitary-gonadal axis. Preliminary reports (Rudd et al., 1985), have shown that some GHD children had raised SHBG values for chronological and bone age. These observations suggested that concentrations of non-protein bound sex steroids may be inappropriately low because of a raised In this paper, the weight and the androgen status of GHD SHBG. children is studied in relation to compared to similar data for short addition, the effect of native and Sweden) GH on SHBG and non-protein GHD patients, is examined. their SHBG concentrations and is children and controls. In synthetic (Somatonorm S - Kabi, bound testosterone in the serum of
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Daux, V., I. Garcia de Cortazar-Atauri, P. Yiou, I. Chuine, E. Garnier, E. Le Roy Ladurie, O. Mestre, and J. Tardaguila. "An open-database of Grape Harvest dates for climate research: data description and quality assessment." Climate of the Past Discussions 7, no. 6 (November 15, 2011): 3823–58. http://dx.doi.org/10.5194/cpd-7-3823-2011.
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Abstract. We present a dataset of grape harvest dates (GHD) series that has been compiled from international and non-translated French and Spanish literature and from unpublished documentary sources from public organizations and from wine-growers. As of June 2011, this GHD dataset comprises 378 series mainly from France (93% of the data) as well as series from Switzerland, Italy, Spain and Luxembourg. The series have variable length and contain gaps of variable sizes. The longest and most complete ones are from Burgundy, Switzerland, Southern Rhône valley, Jura and Ile-de-France. The GHD series were grouped into 27 regions according to their location, to geomorphological and geological criteria, and to past and present grape varieties. The GHD regional composite series (GHD-RCS) were calculated and compared pairwise to assess the quality of the series. Significant (p-value < 0.001) and strong correlations exist between most of them. As expected, the correlations tended to be higher when the vineyards are closer, the highest correlation (R = 0.91) being obtained between the High Loire Valley and the Ile-de-France GHD-RCS. The strong dependence of vine cycle on temperature and, therefore, the strong link between GHD and the temperature of the growing season was also used to test the quality of the GHD series. The strongest correlations are obtained between the GHD-RCS and the temperature series of the nearest weather stations. Moreover, the GHD-RCS/temperature correlation maps show spatial patterns similar to temperature correlation maps. The stability of the correlations over time is explored. The most striking feature is their generalized deterioration at the late 19th–early 20th turning point. The possible effects on the GHD of the phylloxera crisis, which took place at this time, are discussed. The median of the standardized GHD-RCS was calculated. The distribution of the extreme years of this general synthetic series is not homogenous. Extremely late years all occur during a two-century long time-window from the early 17th to the early 19th century, while extremely early years are frequent during the 16th and since the mid-19th century. The dataset is made accessible for climate research through the Internet. It should allow a variety of climate studies, including reconstructions of atmospheric circulation over Western Europe.
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Gujral, K., A. Petryk, L. Steffen, K. Baker, J. Perkins, A. S. Kelly, X. Zhou, A. Sinaiko, A. Moran, and J. Steinberger. "Growth hormone deficiency and cardiovascular risk factors in childhood cancer survivors." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): 6614. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.6614.
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6614 Background: Childhood cancer survivors (CCS) have a high frequency of growth hormone deficiency (GHD) and risk of early cardiovascular disease (CVD). This study examined the relations between GHD and risk factors for CVD in CCS. Methods: Anthropometrics, blood pressure, lipids, growth hormone (GH) stimulation test, dual-energy x-ray absorptiometry, abdominal CT, and insulin resistance (IR) (euglycemic, hyperinsulinemic clamp - low M/lbm signifies IR) were obtained in 174 CCS, mean age 15±2 years and 89 healthy sibling controls, mean age 13.5±3 years. Linear regression evaluated the relations between GHD and CVD risk factors, adjusted for sex, age, pubertal stage, and body mass index (BMI) or visceral fat. Results: 62 CCS (36%) had GHD. There were no significant measurement differences between non-GHD CCS and controls. Compared to controls, GHD CCS who never received GH (N = 34) had greater BMI (24.8 vs 20.8 kg/m2, p < 0.0001), percent body fat (36.1% vs 25.8%, p < 0.0001), visceral fat (34.8 vs 19.6 cm2, p < 0.0001), and triglycerides (TG) (120.2 vs 83.8 mg/dL, p = 0.001) and were more IR (M/lbm 11.1 vs 14.2 mg/kg/min, p = 0.0006). Adjustment for BMI and visceral fat did not change the IR or TG results. GHD CCS currently on GH had lower BMI (21.9 kg/m2, p = 0.02), percent body fat (31.2%, p = 0.08), and visceral fat (26.5 cm2, p = 0.03) compared to those not treated. IR and TG were not different between treated and not treated GHD CCS. Conclusions: GHD is a common finding in CCS and is significantly associated with adiposity, IR, and elevated TG.There is a suggestion that GH treatment had a positive impact on adiposity, but not IR and TG levels. These study findings imply that CVD risk factors are present in CCS with GHD independent of body fatness, suggesting that the cancer diagnosis or treatments received may lead to early cardiovascular disease in childhood cancer survivors. No significant financial relationships to disclose.
Dissertations / Theses on the topic "Non-GHD"
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Lundberg, Elena. "Growth hormone responsiveness in children : results from Swedish multicenter clinical trials of growth hormone treatment." Doctoral thesis, Umeå universitet, Pediatrik, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-134569.
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The general aims of the thesis were to study GH responsiveness by estimation of pharmacokinetics and bioavailability of injected recombinant human GH (rhGH), of growth response as gain in heightSDS during childhood and puberty, and IGF-I response as change in circulating IGF-ISDS and IGFBP3SDS. Methods Short children were recruited during 1988–1999 into two national randomized multicentre clinical trials on growth until adult height. A group of 117 GHD patients who had been treated from prepuberty with a single GH dose of 33μg/kg/day for at least 1 year were randomized at onset of puberty either to remain on this dose regimen or to an increased dose, GH67μg/kg/day, administered once daily or divided into two doses, GH33x2μg/kg/day. Data on IGF-ISDS and IGF binding protein 3 (IGFBP3)SDS were available from 111 patients and analysed as stated below. The 151 short prepubertal non-GHD patients were randomized into three groups: untreated controls, GH33 or GH67μg/kg/day. A subpopulation from both trials, 128 patients examined annually in Gothenburg, formed the study sample on GH uptake. They received sc GH injections to obtain 16–24 hour GH curves and the GH pharmacokinetics and bioavailability was calculated. Results: A dose-dependent effect on Cmax was found with great intra- and inter-individual variability. Of the Cmax variability, 43% was explained by the rhGH dose and proxies for injection depth. Median bioavailability of the injected dose was 71%, with great variation, mainly dependent on injection depth. In the IGHD group a dose-dependent difference in pubertal gain in heightSDS was found, with mean of 0.8 for the GH67 group and 0.4 for GH33, p<0.01. The mean total gain in heightSDS during treatment was 1.9 for GH67 and 1.4 for GH33, p<0.01. A dose-dependent pubertal ΔIGF-ISDS was 0.5 vs −0.1, p=0.007, correlating to pubertal gain in heightSDS, p=0.003; and was the most important variable to explain the variation in pubertal gain in heightSDS. In the non-GHD group the ΔIGF-ISDS from baseline to mean study level was dose-dependent 2.07 vs 1.20, p=0.001; and correlated negatively with baseline values of IGF-ISDS, rho= -0.56 for GH67, p=0.001, vs rho= -0.82 for GH33, p=0.0001, and correlated positively with gain in heightSDS in both GH-treated groups, rho= 0.42, p<0.001. In multivariable regression analyses, ΔIGF-ISDS was always an important explanatory variable for long-term growth response from the prepubertal period until adult height, while the IGF-ISDS study level per se was not. Conclusion: Growth response to GH treatment was dose dependent with great variability between patients. More pubertal growth was attained by an increased rhGH dose, mimicking the physiology of healthy children, in whom GH secretion rate increases during puberty. This resulted in a gain in IGF-ISDS closely correlating to pubertal gain in heightSDS in both IGHD and non-GHD patients. A broad range in GH responsiveness was found for both growth and IGF response in both diagnostic groups, but lower in the non-GHD group. Higher uptake of a given GH dose was observed after a deep injection and a higher GH concentration. These results are clinically applicable for individuals who remain short close to onset of puberty; by identifying and deeply injecting a rhGH dose that accounts for individual responsiveness, we can stimulate an increment in IGF-ISDS that correlates to gain in heightSDS during puberty.
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Karabin, Svyatoslav. "Generalized hydrodynamics of a class of integrable quantum field theories with non-diagonal scattering." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2019. http://amslaurea.unibo.it/18009/.
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In questo lavoro di tesi abbiamo analizzato alcuni modelli conformi con perturbazioni integrabili, in particolare il modello di Ising tri-critico e i successivi modelli minimali. Abbiamo costruito un protocollo che realizza questi modelli in un regime fuori dall'equilibrio termodinamico. Questo sistema è stato ottenuto connettendo due sistemi semi-infiniti termalizzati a due diverse temperature. In tempi e spazi grandi ci si aspetta che questo sistema evolva verso uno stato stazionario indipendente dal tempo. Le quantità fisiche di nostro interesse sono le correnti stazionarie generate in tale situazione. Per studiare questo sistema abbiamo utilizzato strumenti di integrabilità come il Bethe ansatz termodinamico, concetti di idrodinamica generalizzata e l'insieme di Gibbs generalizzato. Finora questo schema è stato formulato per le teorie di campo con un'interazione tra le particelle data da una matrice S diagonale, ovvero per i modelli con lo spettro di quasi-particelle prive di gradi di libertà interni. In questa tesi abbiamo proposto un'estensione di questo metodo a un modello dotato di uno spettro contenente quasi-particelle organizzate in multipletti di simmetrie e quindi dotate di gradi di libertà interni detti magnoni con processi d'urto descritti da matrici S non diagonali. Abbiamo quindi risolto numericamente le equazioni differenziali che descrivono il sistema di non equilibrio e abbiamo discusso questi risultati.
Book chapters on the topic "Non-GHD"
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Viswanathan, Vidhya, Stephen J. Pongonis, Lisa A. Clift, Jennifer M. Katzenstein, Brenna C. McDonald, and Emily C. Walvoord. "Children with Untreated Growth Hormone Deficiency (GHD) Have Cognitive Abnormalities When Compared to Short Non-GHD Controls." In CLINICAL/TRANSLATIONAL - Growth Disorders, P1–758—P1–758. The Endocrine Society, 2011. http://dx.doi.org/10.1210/endo-meetings.2011.part2.p19.p1-758.
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"Classical Stationary States and non-Einsteinian Time Dilation: Generalized Hamiltonian Dynamics (GHD)." In Breaking Paradigms in Atomic and Molecular Physics, 71–91. WORLD SCIENTIFIC, 2015. http://dx.doi.org/10.1142/9789814619936_0004.
Full textReports on the topic "Non-GHD"
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Kelly, Luke. Characteristics of Global Health Diplomacy. Institute of Development Studies (IDS), June 2021. http://dx.doi.org/10.19088/k4d.2021.09.
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This rapid review focuses on Global Health Diplomacy and defines it as a method of interaction between the different stakeholders of the public health sector in a bid to promote representation, cooperation, promotion of the right to health and improvement of health systems for vulnerable populations on a global scale. It is the link between health and international relations. GHD has various actors including states, intergovernmental organizations, private companies, public-private partnerships and non-governmental organizations. Foreign policies can be integrated into national health in various ways i.e., designing institutions to govern practices regarding health diplomacy (i.e., health and foreign affairs ministries), creating and promoting norms and ideas that support foreign policy integration and promoting policies that deal with specific issues affecting the different actors in the GHD arena to encourage states to integrate them into their national health strategies. GHD is classified into core diplomacy – where there are bilateral and multilateral negotiations which may lead to binding agreements, multistakeholder diplomacy – where there are multilateral and bilateral negotiations which do not lead to binding agreements and informal diplomacy – which are interactions between other actors in the public health sector i.e., NGOs and Intergovernmental Organizations. The US National Security Strategy of 2010 highlighted the matters to be considered while drafting a health strategy as: the prevalence of the disease, the potential of the state to treat the disease and the value of affected areas. The UK Government Strategy found the drivers of health strategies to be self-interest (protecting security and economic interests of the state), enhancing the UK’s reputation, and focusing on global health to help others. The report views health diplomacy as a field which requires expertise from different disciplines, especially in the field of foreign policy and public health. The lack of diplomatic expertise and health expertise have been cited as barriers to integrating health into foreign policies. States and other actors should collaborate to promote the right to health globally.