No abstract

No abstract

This study aimed to evaluate the time interval to menarche after gonadotropin-releasing hormone agonist (GnRHa) treatment in females with central precocious puberty (CPP) and identify factors contributing to timing of menarche.Methods:We retrospectively reviewed medical records of 39 females with CPP who reached menarche after GnRHa treatment (leuprolide or histrelin). CPP diagnostic criteria were: breast development <8 years, pubertal luteinizing hormone and/or estradiol concentrations, and bone age advancement.Indications to treat are advanced bone age and psychosocial concerns. Descriptive summaries were reported as frequency and proportion for categorical variables and mean and standard deviation for continuous measures. Linear regression models were performed to evaluate the association between clinical factors with the time interval to menarche.Results:Mean age was 9.4±1.6 years at treatment onset and treatment duration was 2.2±1.4 years.Menarche occurred at 12.6±1.1 years, which was 1.04±0.5 years after treatment discontinuation. This was negatively associated with Tanner stage of breast development and bone age at treatment onset, and change in bone age during treatment. No association was seen between time interval to menarche and treatment duration, medication, or body mass index. Conclusions:We found the average time interval to menarche after GnRHa treatment in our population of female patients with CPP was 1.04±0.5 years and this is in agreement with other reports. Tanner stage of breast development and bone age at treatment onset, and change in bone age were negatively associated with time interval to menarche. This data provide clinical correlates that assist providers during anticipatory guidance of patients with CPP after GnRHa treatment.

Prejudice has long occupied a place of central concern among social theorists in the traditions of psychology, sociology, and most notably their juncture – social psychology. This entry traces the historical origins and central figures involved in shaping theoretical models of prejudice, as well as transitions in theory and research over time. Core assumptions undergirding various theoretical traditions – concerning the nature and source of prejudice in human behavior – are also discussed.

Objective The objectives were: 1) to explore the discordance between the Patient Global Health Assessment (PtGA) scores, the Physician Global Health Assessment (PhGA) scores, and Pain scores; and 2) to explore whether the PtGA during disease remission is associated with future disease flare in pJIA. Methods Data from an NIH funded clinical trial (NCT00792233) evaluating flare were used (N = 137). PtGA, PhGA, and Pain scores were assessed. Flare was defined as any active arthritis. Spearman’s correlation coefficients were calculated, and multivariable logistic regression was performed. Results 122 patients had records of flare status, of which 63 developed flare, and 42 of these patients had a visit immediately prior to flare. For study subjects with a visit immediately prior to flare, the PtGA, pain scores, and PhGA all increased at time of flare. For every unit increase in PtGA and Pain scores, there was a 9% and 23% higher odds of developing flare, respectively (p = 0.76, p = 0.40). For every unit increase in the PhGA score, there was a substantially lower odds of developing flare (p = 0.05). Conclusion Our results demonstrate that the PtGA and Pain scores are strongly correlated with each other and increased at the visit prior to flare, while the PhGA scores are not. Further, the PtGA and Pain score have some predictive value for flare, while the PhGA does not. These findings highlight the value of patient input in medical care and decision-making, and support the development and use of more sophisticated PROs in the care of JIA patients.