Adult height in girls with central precocious puberty treated with gonadotropin-releasing hormone analogues and growth hormone.

Pasquino AM, Pucarelli I, Segni M, Matrunola M, Cerroni F.

Source

Pediatric Department, University La Sapienza, Rome, Italy.

Erratum in

J Clin Endocrinol Metab 1999 Jun;84(6):1978. Cerrone F [corrected to Cerroni F].

Abstract

GnRH analogues (GnRHa) represent the treatment of choice in central precocious puberty (CPP), because arresting pubertal development and reducing either growth velocity (GV) or bone maturation (BA) should improve adult height. However, in some patients, GV decrease is so remarkable that it impairs predicted adult height (PAH); and therefore, the addition of GH is suggested. Out of twenty subjects with idiopathic CPP (treated with GnRHa depot-triptorelin, at a dose of 100 microg/kg im every 21 days, for at least 2-3 yr), whose GV fall below the 25th percentile for chronological age, 10 received, in addition to GnRHa, GH at a dose of 0.3 mg/kg x week s.c., 6 days weekly, for 2-4 yr; and 10 matched for BA, chronological age, and duration of GnRHa treatment, who showed the same growth pattern but refused GH treatment, served to evaluate the efficacy of GH addition. No patient showed classical GH deficiency. Both groups discontinued treatment at a comparable BA (mean +/- SEM): 13.2 +/- 0.2 in GnRHa plus GH vs. 13.0 +/- 0.1 yr in the control group. At the conclusion of the study, all the patients had achieved adult height. Adult height was considered to be attained when the growth during the preceding year was less than 1 cm, with a BA of over 15 yr. Patients of the group treated with GH plus GnRHa showed an adult height significantly higher (P < 0.001) than pretreatment PAH (160.6 +/- 1.3 vs. 152.7 +/- 1.7 cm). Target height (TH) was significantly exceeded. The group treated with GnRH alone reached an adult height not significantly higher than pretreatment PAH (157.1 +/- 2.5 vs. 155.5 +/- 1.9 cm). TH was just reached but not significantly exceeded. The gain in centimeters obtained, calculated between pretreatment PAH and final height, was 7.9 +/- 1.1 cm in patients treated with GH combined with GnRHa; whereas in patients treated with GnRHa alone, the gain was just 1.6 +/- 1.2 cm (P = 0.001). Furthermore, no side effects have been observed either on bone age progression or ovarian cyst appearance and the gynecological follow-up in the GH-treated patients (in comparison with those treated with GnRHa alone). In conclusion, a gain of 7.9 cm in adult height represents a significant improvement, which justifies the addition of GH for 2-3 yr during the conventional treatment with GnRHa, especially in patients with CPP, and a decrease in GV so marked as to impair PAH, not allowing it to reach even the third centile.

PMID: 10022399     [PubMed – indexed for MEDLINE]  Free full text

From PubMed study link HERE

J Clin Endocrinol Metab. 2000 Feb;85(2):619-22.

Adult height in short normal girls treated with gonadotropin-releasing hormone analogs and growth hormone.

Pasquino AM, Pucarelli I, Roggini M, Segni M.

Source
Pediatric Department, University La Sapienza, Rome, Italy.

Abstract

Combined treatment with GH and GnRH analogs (GnRHa) has been proposed to improve final adult height in true precocious puberty, GH deficiency, and short normal subjects with early or normal timing of puberty with still controversial results. We treated 12 girls with idiopathic short stature and normal or early puberty with GH and GnRHa and followed them to adult height; 12 girls comparable for auxological and laboratory characteristics treated with GH alone served to better evaluate the efficacy of addition of GnRHa. At the start of combined treatment, the chronological age of the girls (CA; mean +/- SD) was 10.2 +/- 0.9 yr, bone age (BA) was 10.6 +/- 1.9 yr, height SD score for BA was – 1.81 +/- 0.8, PAH was 146.3 +/- 5.0 cm. PAH was significantly lower than target height (TH 152.7 +/- 3.6 cm; P < 0.005). GH was given at a dose of 0.3 mg/kg x week, sc, 6 days weekly, and GnRHa (depot-triptorelin) was given at a dose of 100 microg/kg every 21 days, im. The 12 girls were treated with GH alone at the same dose; at the start of therapy their CA was 10.7 +/- 1.0, BA was 10.1 +/- 1.4 yr, height SD score for BA was – 1.65 +/- 0.8, PAH was 145.6 +/- 4.4 cm, and TH was 155.8 +/- 4.6 cm. Pubertal Tanner stage in both groups was B2P2 or B3P3. LHRH test and pelvic ultrasound showed the beginning of puberty. The GH response to standard provocative tests was 10 g/L or more. The mean period of treatment was 4.6 +/- 1.7 yr in the group treated with GH plus GnRHa and 4.9 +/- 1.4 yr in the group treated with GH alone; both groups discontinued treatment at comparable CA and BA. Adult height was considered to be attained when growth during the preceding year was less than 1 cm, with a BA of over 15 yr. Patients in the group treated with GH plus GnRHa showed an adult height significantly higher (P < 0.001) than the pretreatment PAH (156.3 +/- 5.9 vs. 146.3 +/- 5 cm); the gain in centimeters calculated between pretreatment PAH and adult height was 10 +/- 2.9 cm, and 7 of 12 girls had a gain over 10 cm. Target height was significantly exceeded. Height SD score for BA increased from – 1.81 +/-0.8 to -0.85 +/- 1.0. The GH alone group reached an adult height higher than the pretreatment PAH (151.7 +/- 2.7 vs. 145.6 +/- 4.4 cm); the gain in final height vs. pretreatment PAH was 6.1 +/- 4.4 cm, and 5 of 12 girls did not gain more than 4 cm. TH was even not reached. The height SD score did not significantly change. No adverse effects were observed in either group. All of the girls showed good compliance and were satisfied with the results. Our experience suggests that the combination of GH and GnRHa is significantly more effective in improving adult height than GH alone in girls with idiopathic short stature, early or normal onset of puberty, and low PAH well below the third percentile and TH. As the cost-benefit of such invasive treatment must be seriously considered, further studies are needed due to the small sample of our patients as well as in other studies reported to date.

Comment in

Final adult height in short healthy children treated with growth hormone and gonadotropin-releasing hormone analogs. [J Clin Endocrinol Metab. 2001]

PMID: 10690865  [PubMed – indexed for MEDLINE]     Free full text

Differential effects of hGH and IGF-I on body proportions.

Note: This post will be one of those that will be continuously edited and added upon as the site goes on

To enhance your life, life quality, and life expectancy, these are very nice resource websites or forum boards you can checkout which I have found throughout the internet space. They deal with nutrition, supplements, and

1. Life-Enhancement.com

2. TheLimitlessMan.com

3. LongCity.Com

4. AnabolicMinds.com

5.

To enhance your mind, cognitive ability, mental fitness, memory, intelligence, power of focus and concentration, and everything else related, these are the resource that I have found which I think are rather informative and good.

1. BrainMeta.com

2. MindNutrition.com

3. NootropicSupplements.com

4.

5.

Me: For Mind Hack XV, I found this amazing interview a past memory champion Joshua Foer did on his journey and process to learn the ways and techniques to make one’s mind better at memorization and thinking. I highly recommend the interview since it is very insightful. If you don’t have the time to watch the video, I will outline the major points they bring up in the video.

You can train yourself to do unbelievable feats.The memory champions in memory competition are using their brains differently so you can learn what they are doing..

In Ancient times like in Greece, there were many well known memory techniques and tools for the scholar. We have totally forgotten about these techniques.

Major Technique #1: Creating a memory palace – Most people have terrific spatial memory. If we can use that spatial memory to remember stuff that we actually want to remember, it gives you an extraordinary advantage. The memory palace is an imaginary building in your mind’s eye that you are intimately familiar with. You walk through it in your imagination creating images of the stuff that you wish to remember.

By putting imagery in a specific location in the memory palace, you are attaching it in an order, in a spatial arrangement,

Idea: If you can create images that are so weird, so bizzarre, so strange, gory, raunchy, etc. something that is so emotionally resonant, where you use all of your senses to embrace the image, that will be a memory you will not be able to shake away from your memory.

• Interesting fact #1: The term “In the first place” actually is referring to the “First Place” in your memory palace.
• Interesting fact #2: The word “Topic” comes from the Greek word “Topos” which means “place”.

Idea: The things that we remember are the things that are …

• 1. NEW,
• 2. STRANGE,
• 3. UNUSUAL,
• 4. THINGS THAT MAKE AN IMPRESSION ON US,
• 5. THINGS THAT GRAB OUR ATTENTION

We can will our brains to remember.

Idea: We can change our brain through memory. Remembering a lot like cab drivers enlarges the hippocampus which is what controls spatial memory.

Our working memory capacity has a clear limit. We can only hold roughly 7 things in our head at one time. The idea and key is then to see how we can package and put as much stuff in those 7 parts as possible.

Chunking – The process of packaging large sets of data and information into smaller parts to make it easier to recall.

Baker-Baker Paradox (from psychology): A person who is asked to remember a guy’s name is Baker is less likely to remember than a guy who is asked to remember that a guy’s profession is a baker. 

The name “Baker” does not mean anything. It is not associated or attached to anything in our memory as a hook. The word Baker however does have something we can associate with. There is a whole network of meaning that the word “baker” is attached with it.

The entire trick to remembering other people’s names is to take their names, turn it into something that they can associate with, in a visual way that would give it more meaning.

Most of the memory techniques uses a concept from psychology called elaborative encoding – You take information and make it memorable by embedding it in other information we already know.

William James – “We structure our experience of time around chronological landmarks” – Exciting things that happen in our life helps shape the passage of time. As we grow older, our lives get less interesting. We are doing less new stuff everyday. Things start to become routine. They become rote….And as a result, time starts to feel like it is flying by….So, literally our life is becoming less memorable.”

Solution: To live a life that is memorable. To do things that are new, different, exotic.

Case with EP (patient): Struck with viral disease that ate away a significant part of his brain, the hippocampus. Lead to him being fully functional except not remembering short term memory and long term memory up to a certain point. Does not even realize that he even has a memory problem. Is content and happy because he can’t remember the past and does not worry about the future.

Memory is very costly due to energy consumption: Brain uses up to around 20% of all the Oxygen and 25% of the glucose that is available in the body. We need memory to shape our perceptions of the present, our ability to make sense of the present, to plan for the future.

Our identity can be defined as our memories. EP could be considered to be an empty vessel and incapable of telling you anything about time.

Thinking is not so much about remembering, but actually about forgetting – processing what things do they not need to remember.

Even at elite memorizing level, everyone has a weakness. Conversely, almost everyone has a great memory for something. Thus, the things that we are fascinated with and become experts in, we develop an extraordinary memory for the details of that field of study.

With great expertise comes memory. People are structuring memory differently. Theya re seeing the world differently. and as a result are remembering better.

True knewledge is having an understanding of the world, make sense of it, find meaning in its structure.

We are probably all better off not having to remember numbers and facts which we can find easily through books and google.

The Latin word inventio is the source or root word for two modern words, invention and inventory.

We should be teaching kids better how their memories work. If you teach kids how to think about thinking, they think better. The principles behind the memory devices and techniques like the memry palace are crucial in helping us do well in the world.

The best way to learn something is to space out the information over time. When we start learning, we will start forgetting.

The single best piece of advice for a person who just wants to improve their memory: The art of remembering is the art of paying attention. To be mindful..

The difference between natural memory and artificial memory – natural memory is what we are born with in terms of raw talent, artificial memory is what we can develop through learning and using structuring for information processing.

Grit and tenaciousness is very good at creating success

The YouTube link where the source is found is HERE

Me: This is one of those posts which I felt was extremely insightful in its wisdom on how the modern male in Western developed countries should be living his life. As always, this type of advice should never be used as gospel and not questioned but to be critically reviewed for its practically, usefulness, and value.

The reason why I felt this video is so powerful is because it tells us young men still in our 20s how to avoid some of the biggest traps which can sap away our resources. In our 20s, whether we have been to college or graduate school, most men are very busy at trying to achieve, win, and climb the corporate ladder in making a name for themselves in the world. We have the energy, ambition, and motivation to try to, as Steve Jobs put it, “put a dent in the universe”. Whether we ultimate succeed in whatever endeavor we have set for ourselves, that is still need to be proven. However there are some clear decisions we make which will make us far less likely to succeed.

On a side note, I would like to state that in many polls done on people in their 40s, they would say that the #1 decision which will determine the quality of their later years, whether it is in the area of health, finances, or relationships is the person they choose to marry, is they ever do get married ever at all. One’s decision on who will be one’s life partner is far greater in determining one’s happiness and success in life than almost anything else. We find from many reports that divorce is not just an emotional and mental negative event, but also for one’s finances too. So besides the tips that Tim will tell you, I wanted to give 4 tipes of my own.

• Tip #1: Be extremely careful on who you choose to spend your life with. Your emotional health and financial health will depend on it later on.
• Tip #2: It is important to realize that the two most common causes for personal bankruptcy is a major health issue racking up healthcare costs or divorce.
• Tip #3: Having a child is extremely expensive, and be wise about having children.
• Tip #4: Things become harder to do as one gets older so go ahead in your younger years, go crazy and have fun, and try to reach for one’s dreams. If you want to do something, do it now. You will definitely regret on doing trying it out later in life if you don’t try and go for what you want.

This video is taken from Youtube link HERE…

To Be Edited.