Abstract:
:Delayed puberty (DP) is defined as the lack of pubertal development by an age that is 2-2.5 SDs beyond the population mean. Although it generally represents a normal variant in pubertal timing, concern that DP could be the initial presentation of a serious underlying disorder has led to a diagnostic approach that is variable and may include tests that are unnecessary and costly. In this review, we examine available literature regarding the recommended diagnostic tests and aetiologies identified during the evaluation of youth with DP. We view this literature through the prism of the seemingly otherwise well adolescent. To provide further clinical context, we also evaluate the clinical and laboratory data from patients seen with DP in our centre over a 2-year period. The literature and our data reveal wide variability in the number of tests performed and raise the question of whether tests, other than gonadotropins, obtained in the absence of signs or symptoms of an underlying disorder are routinely warranted. Together this information provides a pragmatic rationale for revisiting recommendations calling for broad testing during the initial diagnostic evaluation of an otherwise healthy adolescent with DP. We highlight the need for further research comparing the utility of broader screening with a more streamlined approach, such as limiting initial testing to gonadotropins and a bone age, which, while not diagnostic, is often useful for height prediction, followed by close clinical monitoring. If future research supports a more streamlined approach to DP, then much unnecessary testing could be eliminated.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
Abitbol L,Zborovski S,Palmert MRdoi
10.1136/archdischild-2015-310375subject
Has Abstractpub_date
2016-08-01 00:00:00pages
767-71issue
8eissn
0003-9888issn
1468-2044pii
archdischild-2015-310375journal_volume
101pub_type
杂志文章,评审abstract:OBJECTIVE:To study the relation between traumatic birth and the development of permanent facial palsy in the newborn. DESIGN:Retrospective case control study of children with 'congenital' facial palsy. SETTING:Two tertiary referral centres for patients with facial palsy. SUBJECTS:61 children with established facial ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.74.1.56
更新日期:1996-01-01 00:00:00
abstract::Seventy-three low birthweight babies were independently assessed for gestational age using the scoring system of Dubowitz et al. (1970) and 5 neurological reflexes described by Robinson (1966). The results obtained by the 5 reflexes were compared with those obtained by the scoring system and were found to be accurate ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.53.6.509
更新日期:1978-06-01 00:00:00
abstract::36 parents of infants who had died suddenly did not differ in frequency of atopic symptoms, immediate skin tests, IgE, IgE antibody, immunoglobulin G, A, and M, or yeast opsonisation, from 36 matched controls, although atopy was common (about half had atopy in both groups. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.55.11.876
更新日期:1980-11-01 00:00:00
abstract:OBJECTIVE:To define better the adult phenotype and natural history of Noonan syndrome. DESIGN:A prospective observational study of a large cohort. RESULTS:Data are presented for 112 individuals with Noonan syndrome (mean age 25.3 (range 12-71) years), who were followed up for a mean of 12.02 years. Mutations in PTPN1...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2006.104547
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To examine and compare the characteristics of food protein-induced enterocolitis syndrome (FPIES) caused by rice and cow's milk/soy. DESIGN:Retrospective study of children presenting with FPIES to the Children's Hospital at Westmead, NSW, Australia, over a 16-year period. RESULTS:There were 14 children with...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2008.145144
更新日期:2009-03-01 00:00:00
abstract:AIMS:To determine whether current and postpartum maternal depression and low maternal intelligence are risk factors for malnutrition in children. METHODS:In rural South India 72 children with malnutrition were identified from a central register; 72 controls were matched for age, gender, and residence. RESULTS:Major d...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2002.009738
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Sodium phenylbutyrate (NaPB) is used as a treatment for urea cycle disorders (UCD). However, the available, licensed granule form has an extremely bad taste, which can compromise compliance and metabolic control. OBJECTIVES:A new, taste-masked, coated-granule formulation (Luc 01) under development was chara...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2012-302398
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:In volume guarantee ventilation with the Dräger Babylog 8000 ventilator, inspiratory and expiratory flows are monitored and the expiratory tidal volume calculated following each inflation. The pressure for the next inflation is modified to ensure the expired tidal volume is close to the set value. AIM:To in...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2004.061390
更新日期:2005-08-01 00:00:00
abstract::Interleukin-2 (IL-2) and T cell subpopulations were evaluated in children with rheumatic heart disease (RHD). Three groups were included: 13 patients with active RHD, 12 with non-active RHD, and 14 control children. Serum IL-2 and T cell subpopulations were measured by radioimmunoassay and monoclonal antibodies respec...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.67.11.1373
更新日期:1992-11-01 00:00:00
abstract::Metabolic rhythms were studied over 24 hours in eight adolescent diabetic patients during treatment with porcine insulin and after transfer to human insulin. Despite an increase in dose with human insulin no significant changes were found in fasting blood glucose, 24h mean blood glucose, or glycosylated haemoglobin co...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.61.4.341
更新日期:1986-04-01 00:00:00
abstract::Twenty five patients with encephalitis were studied prospectively, and their clinical and virological features compared with outcome. Among 22 patients with laboratory confirmation of virus infection, evidence of direct effect on the central nervous system by the virus occurred significantly more often both in those w...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.62.11.1156
更新日期:1987-11-01 00:00:00
abstract:BACKGROUND:Children with severe malnutrition (SAM) present to hospital with an array of complications, resulting in high mortality despite adherence to WHO guidelines. Diagnostic resources in developing countries are limited and bedside tests could help identify high-risk children. Dipstick urinalysis is a bedside scre...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2009.168211
更新日期:2010-06-01 00:00:00
abstract:AIM:Ketamine is used for post-operative analgesia. There has been recent disruption in it's supply. It is usually prescribed by patient's weight (3 mg/kg in 50 ml 0.9% saline) at a rate of 1-5 ml/hr (1-5 microgram/kg/minute). To conserve ketamine supplies our policy was changed to a concentrated "standardised" concentr...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2016-311535.12
更新日期:2016-09-01 00:00:00
abstract::Necrotising enterocolitis occurred in 3 infants after angiography at cardiac catheterisation. It is suggested that hypertonic contrast medium might have been responsible and that this complication could be avoided by the use of nonionic contrast media. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.55.1.66
更新日期:1980-01-01 00:00:00
abstract::The cases are described of eight children, five of them girls, who had epilepsy with myoclonic absences. The mean age of onset was 4.9 years. Brief episodes of loss of awareness with bilateral clonic jerking of the upper limbs were associated with rhythmic 3 cycles/second spike-wave discharges on electroencephalogram....
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.70.4.288
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVE:To review the clinical features, treatment, and outcome of children in the UK with Down's syndrome and acute myeloid leukaemia (AML). DESIGN:A retrospective study of 59 children with Down's syndrome and AML presenting between 1987 and 1995. Data were obtained from hospital case notes, trial records, and by q...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.81.1.32
更新日期:1999-07-01 00:00:00
abstract::A trial was conducted using sequential analysis by pairs to compare the efficacy of corticosteroids and salicylates in the treatment of acute rheumatic carditis. The results show a significantly favourable effect of steroid treatment both in clinical response and in reduction of the erythrocyte sedimentation rate. In ...
journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章
doi:10.1136/adc.59.5.410
更新日期:1984-05-01 00:00:00
abstract:OBJECTIVES:To investigate the prevalence of infant crying and maternal soothing techniques in relation to ethnic origin and other sociodemographic variables. DESIGN:A questionnaire survey among mothers of 2-3 month old infants registered at six child health clinics in Amsterdam, the Netherlands. SUBJECTS:A questionna...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.79.4.312
更新日期:1998-10-01 00:00:00
abstract::Published reports on the treatment of large strawberry naevi have been reviewed. It is suggested that they should normally be left untreated, and that corticosteroids, given for a short period only, should be reserved for massive naevi close to the eye, or interfering with respiration or suckling, or associated with t...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.51.2.138
更新日期:1976-02-01 00:00:00
abstract::Obesity is becoming a common clinical headache for child health professionals, as the increase in professional and media concern has not been matched by effective clinical solutions. Added to this is considerable confusion about both the definitions of obesity and about which groups of children and adolescents actuall...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.2004.062224
更新日期:2005-04-01 00:00:00
abstract::The role of inflammation in adult asthma is well known, involving a cascade of immunological stimulation in which mast cells and eosinophils play pivotal roles. However, the assessment of airway inflammation in children is more difficult as the invasive methods used in adults cannot ethically be used for this purpose ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.82.suppl_2.ii6
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:A subnormal cortisol response (30 min level (C30min)<550 nmol/L) to synthetic adrenocorticotrophic hormone/Synacthen test (SDST) in all infants does not necessarily indicate underlying or persistent hypothalamic-pituitary-adrenal axis pathology. METHODS:We retrospectively evaluated the diagnoses and outcome...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2017-313819
更新日期:2018-10-01 00:00:00
abstract::A combined test of anterior pituitary function was used on 21 normal children. It shows that a comprehensive evaluation can be made of growth hormone, thyroid stimulating hormone, adrenocorticotrophic hormone, and gonadotrophin reserve. Simultaneous assessment of those peripheral glands associated with the anterior pi...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.53.4.301
更新日期:1978-04-01 00:00:00
abstract::Real time ultrasonography of the pelvic organs was performed on 114 normal premenarcheal girls aged between 2 years and 13 years 11 months. Values were obtained for total uterine length, anteroposterior diameters of the corpus and cervix, corpus/cervix ratio, and uterine and ovarian volumes and the resultant data were...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.60.2.120
更新日期:1985-02-01 00:00:00
abstract:OBJECTIVE:To assess the benefit of nebulised amiloride added to the standard inpatient treatment of a respiratory exacerbation in cystic fibrosis. DESIGN:Prospective, randomised, double blind, placebo controlled trial. SUBJECTS:27 cystic fibrosis patients (mean age 12.8 years). SETTING:Two hospitals in Leeds, UK. R...
journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/adc.73.5.427
更新日期:1995-11-01 00:00:00
abstract::In 3-day fat balances, 7 of 8 infants had appreciably more steatorrhoea when they were fed Cow and Gate V formula than when they were fed SMA. The mean fat excretion (+/- SEM) expressed as a percentage of the amount ingested on Cow and Gate V was 28-1 +/- 3-9 compared with 10-5 +/- 2-3 on SMA. Gas-liquid chromatograph...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.50.8.654
更新日期:1975-08-01 00:00:00
abstract:BACKGROUND AND AIMS:Following recent reports of increased numbers of adolescents being diagnosed with the adult or type 2 form of diabetes we aimed to describe the prevalence of both type 2 and other forms of diabetes in an urban population of children and young people in northern England. METHODS:A hospital based cro...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,多中心研究
doi:10.1136/adc.88.8.676
更新日期:2003-08-01 00:00:00
abstract:OBJECTIVE:Sudden Infant Death Syndrome (SIDS) is associated with prone sleeping, and circulatory failure has been hypothesised to be a factor in the fatal event. We aimed to determine the effect of prone sleeping on heart rate (HR) and blood pressure (BP) control over the first 6 months of life. SUBJECTS:Term infants ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2007.132860
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:We systematically evaluated health and nutrition programmes to identify context-specific interventional packages that might help to prioritise the implementation of programmes for reducing stunting in low and middle income countries (LMICs). METHODS:Electronic databases were used to systematically review the...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2016-311050
更新日期:2017-10-01 00:00:00
abstract::One hundred and eleven children admitted with suspected gastro-oesophageal reflux were studied, with 24 hour oesophageal pH monitoring as the first line of investigation. Barium swallow examination, or oesophagoscopy, or both, were carried out only in children with abnormal pH, who subsequently had a trial of 1-12 mon...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.64.10.1421
更新日期:1989-10-01 00:00:00