By H.A. Delemarre-van de Waal, P.-E. Mullis
This ebook on abnormalities in puberty offers an outline at the most up-to-date wisdom at the mechanisms of the developmental methods of puberty. even though the precise mechanisms of reawakening of the GnRH pulse generator on the onset of puberty nonetheless must be elucidated, many genetic and environmental components were pointed out to play a huge function. issues mentioned in person chapters comprise the endocrine and metabolic matters concerning the 'developmental beginning of grownup sickness' speculation and polycystic ovary syndrome in addition to abnormalities in GnRH controlling genes, GnRH-secreting hamartoma as a version for the onset of puberty, event at the software of GnRH analogues within the therapy of valuable precocious puberty, and the psychosocial results of an early puberty. This quantity presents the paediatrician, endocrinologist, gynaecologist and surgeon with underlying details in addition to functional tokens on tips to deal with a number of the stipulations of a disturbed means of puberty.
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Additional info for Abnormalities in puberty : scientific and clinical advances
Both have its origin during the intra-uterine period [55, 61–69]. Modification of GnRH neurons at the hypothalamic level may cause an impaired gonadotropin secretion leading to delayed puberty. On the other hand, we cannot exclude gonadal impairment since a disturbance in LH receptor production of the Leydig cell may cause in impaired sexual development as well . The important phases of gonadal development in the male rat and the human male almost take place during the same periods [71, 72].
Birth weight is only a crude index of early growth and reveals nothing about the success of a fetus at achieving its growth potential. Both the role of IUGR and mechanisms behind the initiation of puberty are still elusive. A key area of future research will be to identify markers of early growth restriction which may be of future diagnostic use as early predictors of adult disease. However, it must be kept in mind that there is a mutual dependency of genetic and environmental factors. In order to judge between them, research on pubertal development in monozygotic and dizygotic twins discordant for birth weight is of great interest.
It is possible that differences in methodology could contribute to some of these discrepancies. Methodological Considerations A single blood measurement of cortisol or ACTH level provides a poor estimate of adrenal function because cortisol secretion is pulsatile. 00 h . Potential confounding factors that may raise fasting cortisol levels include longer duration of fasting, mild infection, and fear of venepuncture. Other methods for assessing cortisol secretion include 24-hour plasma cortisol profiles, and timed urine collections for measurement of total cortisol metabolites.
Abnormalities in puberty : scientific and clinical advances by H.A. Delemarre-van de Waal, P.-E. Mullis