Abstract：
:Disorders of puberty can profoundly impact physical and psychosocial well-being. Precocious puberty is pubertal onset before eight years of age in girls and before nine years of age in boys. Patients with early isolated pubertal changes, prepubertal linear growth, and no worrisome neurologic symptoms typically have a benign pattern of development and should be monitored in the appropriate clinical context. Among patients with true precocious puberty, or full activation of the hypothalamic-pituitary-gonadal axis, most girls have an idiopathic etiology, whereas it is commonly due to identifiable pathology on imaging in boys. History and physical examination should be followed by measurements of serum follicle-stimulating hormone, luteinizing hormone, and testosterone (boys) or estradiol (girls); thyroid function testing; and bone age radiography. Brain magnetic resonance imaging should be performed in girls younger than six years, all boys with precocious puberty, and children with neurologic symptoms. Delayed puberty is the absence of breast development in girls by 13 years of age and absence of testicular growth to at least 4 mL in volume or 2.5 cm in length in boys by 14 years of age. Constitutional delay of growth and puberty is a common cause of delayed puberty; however, functional or persistent hypogonadism should be excluded. History and physical examination should be followed by measurements of serum follicle-stimulating hormone, luteinizing hormone, and testosterone (boys) or estradiol (girls); and bone age radiography. Abnormal growth velocity necessitates assessment of serum thyroid function, prolactin, and insulinlike growth factor I. Boys 14 years and older and girls 13 years and older may benefit from sex steroid treatment to jump-start puberty. Referral to a pediatric endocrinologist may be warranted after the initial evaluation.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Klein DA,Emerick JE,Sylvester JE,Vogt KSsubject
Has Abstractpub_date
2017-11-01 00:00:00pages
590-599issue
9eissn
0002-838Xissn
1532-0650pii
d13253journal_volume
96pub_type
杂志文章,评审abstract：:In the guideline developed by the American College of Cardiology and the American Heart Association, the management of suspected unstable angina and non-ST-segment elevation myocardial infarction (UA/NSTEMI) has four components: initial evaluation and management; hospital care; coronary revascularization; and hospital...
journal_title：American family physician
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更新日期：2004-08-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1997-02-15 00:00:00
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更新日期：1980-04-01 00:00:00
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更新日期：1980-01-01 00:00:00
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journal_title：American family physician
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journal_title：American family physician
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doi：
更新日期：1981-02-01 00:00:00
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journal_title：American family physician
pub_type： 杂志文章
doi：
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journal_title：American family physician
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journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2004-07-15 00:00:00
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journal_title：American family physician
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doi：
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journal_title：American family physician
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doi：
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journal_title：American family physician
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doi：
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journal_title：American family physician
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journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1992-01-01 00:00:00
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journal_title：American family physician
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更新日期：1979-01-01 00:00:00
