The Evidence Base for Growth Hormone Effectiveness in Children

2010 ◽  
pp. 23-39
Author(s):  
Christopher J.H. Kelnar
Keyword(s):  
Growth Hormone ◽  
Evidence Base

Standardization of the IMMULITE systems growth hormone assay with the recombinant IS 98/574

2008 ◽  
Vol 45 (6) ◽  
pp. 598-600 ◽  
Author(s):  
Julian H Barth ◽  
Paul E C Sibley
Keyword(s):  
Growth Hormone ◽  
Evidence Base ◽  
Similar Relationship ◽  
Gh Secretion ◽  
Before And After ◽  
Stimulation Tests ◽  
Standardized Reporting ◽  
Firm Evidence ◽  
Permit Compliance ◽  
Dynamic Stimulation

Background The diagnosis of disorders of growth hormone (GH) secretion is based on the measurement of GH before and after dynamic stimulation or suppression tests. Over the years, specific cut-off values have been proposed without taking account of the considerable variation in results obtained using different methods for analysing GH. Recent publications have recommended the standardization of GH assays using IS 98/574, which is calibrated in mass and units (U). The IMMULITE range of GH assays have been recalibrated using this standard. Methods We analysed 745 samples using the current and the restandardized GH assay kits. This series of samples contained 90 stimulation tests and seven suppression tests. Results The data comparing the current and restandardized assays show a similar relationship for both basal and stimulated GH values for all IMMULITE platforms. There is a negative bias by the restandardized assay above approximately 20 μg/L. A conversion can be derived from this study which would mean that patient GH results expressed in milliunits per litre of IMMULITE in-house derived standard will be approximately three-fold of that expressed in micrograms per litre of IS 98/574. Conclusion Use of IS 98/574 offers standardized reporting in microgram per litre IS 98/574. This will permit compliance with the consensus recommendations and the development of a firm evidence base for defining decision-making GH values.

Association of pituitary adenoma with neuronal christoma: A TEM study

1994 ◽  
Vol 52 ◽  
pp. 232-233
Author(s):  
Eva Horvath ◽  
Kalman Kovacs ◽  
B. W. Scheithauer ◽  
R. V. Lloyd ◽  
H. S. Smyth
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenoma ◽  
Pituitary Tumor ◽  
Nervous Tissue ◽  
Alternative Explanation ◽  
Growth Hormone Releasing Hormone ◽  
Cell Hyperplasia ◽  
Releasing Hormone ◽  
Secretory Neurons

The association of a pituitary adenoma with nervous tissue consisting of neuron-like cells and neuropil is a rare abnormality. In the majority of cases, the pituitary tumor is a chromophobic adenoma, accompanied by acromegaly. Histology reveals widely variable proportions of endocrine and nervous tissue in alternating or intermingled patterns. The lesion is perceived as a composite one consisting of two histogenetically distinct parts. It has been suggested that the neuronal component, morphologically similar to secretory neurons of the hypothalamus, may initiate adenoma formation by releasing stimulatory substances. Immunoreactivity for growth hormone releasing hormone (GRH) in the neuronal component of some cases supported this view, whereas other findings such as consistent lack of growth hormone (GH) cell hyperplasia in the lesions called for alternative explanation.Fifteen tumors consisting of a pituitary adenoma and a neuronal component have been collected over a 20 yr. period. Acromegaly was present in 11 patients, was equivocal in one, and absent in 3.

Classifying Disfluencies in Preschool- and School-Age Spanish–English Bilinguals Who Do Not Stutter: An Exploratory Study

2020 ◽  
Vol 5 (1) ◽  
pp. 119-130
Author(s):  
Raúl Rojas ◽  
Farzan Irani
Keyword(s):  
Exploratory Study ◽  
Evidence Base ◽  
Medium Effect ◽  
Bilingual Children ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Total Percentage ◽  
Narrative Production ◽  
Language Measures ◽  
Mean Length Of Utterance

Purpose This exploratory study examined the language skills and the type and frequency of disfluencies in the spoken narrative production of Spanish–English bilingual children who do not stutter. Method A cross-sectional sample of 29 bilingual students (16 boys and 13 girls) enrolled in grades prekindergarten through Grade 4 produced a total of 58 narrative retell language samples in English and Spanish. Key outcome measures in each language included the percentage of normal (%ND) and stuttering-like (%SLD) disfluencies, percentage of words in mazes (%MzWds), number of total words, number of different words, and mean length of utterance in words. Results Cross-linguistic, pairwise comparisons revealed significant differences with medium effect sizes for %ND and %MzWds (both lower for English) as well as for number of different words (lower for Spanish). On average, the total percentage of mazed words was higher than 10% in both languages, a pattern driven primarily by %ND; %SLDs were below 1% in both languages. Multiple linear regression models for %ND and %SLD in each language indicated that %MzWds was the primary predictor across languages beyond other language measures and demographic variables. Conclusions The findings extend the evidence base with regard to the frequency and type of disfluencies that can be expected in bilingual children who do not stutter in grades prekindergarten to Grade 4. The data indicate that %MzWds and %ND can similarly index the normal disfluencies of bilingual children during narrative production. The potential clinical implications of the findings from this study are discussed.

Bang for Your Buck: A Single-Case Experimental Design Study of Practice Amount and Distribution in Treatment for Childhood Apraxia of Speech

2019 ◽  
Vol 62 (9) ◽  
pp. 3160-3182 ◽  
Author(s):  
Edwin Maas ◽  
Christina Gildersleeve-Neumann ◽  
Kathy Jakielski ◽  
Nicolette Kovacs ◽  
Ruth Stoeckel ◽  
...  
Keyword(s):  
Single Case ◽  
Evidence Base ◽  
Distributed Practice ◽  
Single Subject ◽  
Single Subject Design ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Opposite Pattern ◽  
Massed Practice ◽  
Treatment Conditions

Purpose The aim of this study was to examine 2 aspects of treatment intensity in treatment for childhood apraxia of speech (CAS): practice amount and practice distribution. Method Using an alternating-treatments single-subject design with multiple baselines, we compared high versus low amount of practice, and massed versus distributed practice, in 6 children with CAS. Conditions were manipulated in the context of integral stimulation treatment. Changes in perceptual accuracy, scored by blinded analysts, were quantified with effect sizes. Results Four children showed an advantage for high amount of practice, 1 showed an opposite effect, and 1 showed no condition difference. For distribution, 4 children showed a clear advantage for massed over distributed practice post treatment; 1 showed an opposite pattern, and 1 showed no clear difference. Follow-up revealed a similar pattern. All children demonstrated treatment effects (larger gains for treated than untreated items). Conclusions High practice amount and massed practice were associated with more robust speech motor learning in most children with CAS, compared to low amount and distributed practice, respectively. Variation in effects across children warrants further research to determine factors that predict optimal treatment conditions. Finally, this study adds to the evidence base supporting the efficacy of integral stimulation treatment for CAS. Supplemental Material https://doi.org/10.23641/asha.9630599

Inclusion of Transgender Voice and Communication Training in a University Clinic

2017 ◽  
Vol 2 (10) ◽  
pp. 109-115 ◽  
Author(s):  
Jennifer Oates ◽  
Georgia Dacakis
Keyword(s):  
Training Program ◽  
Clinical Education ◽  
Well Being ◽  
Evidence Base ◽  
Communication Training ◽  
Speech Language Pathology ◽  
Transgender People ◽  
Language Pathology ◽  
Effectiveness Of Training ◽  
Negative Impacts

Because of the increasing number of transgender people requesting speech-language pathology services, because having gender-incongruent voice and communication has major negative impacts on an individual's social participation and well-being, and because voice and communication training is supported by an improving evidence-base, it is becoming more common for universities to include transgender-specific theoretical and clinical components in their speech-language pathology programs. This paper describes the theoretical and clinical education provided to speech-language pathology students at La Trobe University in Australia, with a particular focus on the voice and communication training program offered by the La Trobe Communication Clinic. Further research is required to determine the outcomes of the clinic's training program in terms of student confidence and competence as well as the effectiveness of training for transgender clients.

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