Tall girls: A survey of 15 years of management and treatment

Daniel, William A.; Wettenhall, H. N. B.; Cahill, Christine; Roche, Alex F.

doi:10.1016/s0022-3476(75)80162-4

Cited by 77 publications

(7 citation statements)

References 25 publications

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“…The study examined a broad range of health and psychosocial outcomes in women treated with high dose oestrogens as adolescents in an attempt to reduce their adult height and compared them with women who were assessed but not treated for tall stature. While the short-term side-effects of this treatment, including weight gain, menstrual irregularities, nausea, night cramps and limb pains, benign breast disease, excessive vaginal discharge, thrombosis and ovarian cysts were well documented [2-5], nothing was known about the long-term health and psychosocial outcomes of this treatment. The study contributed to a broader understanding of the associations of high levels of oestrogen in adolescence on reproductive [1] and other outcomes [6-9].…”

Section: Introductionmentioning

confidence: 99%

“…Most treating clinicians considered treatment acceptable if a girl’s adult height was predicted to be above the 97 th percentile or two standard deviations above the mean female adult height in the given population [2,4]. Determination of predicted adult height involved estimating bone age after an x-ray of the hand and wrist and assessing the remaining growth potential [14-16].…”

Section: Introductionmentioning

confidence: 99%

“…During the 1970s, Australian girls with a predicted adult height of ≥177cm were eligible for treatment [2]; in the US, girls whose predicted adult height was above 173cm [20] or 182.9cm [21] were also treated; and in Germany and the Netherlands the treatment criterion was a predicted height of ≥180cm [22,23]. Age at initiation and duration of treatment also varied considerably and was strongly associated with overall treatment effectiveness.…”

Section: Introductionmentioning

confidence: 99%

“…The clinical challenge was that the accuracy of predicting adult height increased after the age of ten years (or closer to puberty) however the potential height reduction diminished [24]. Some clinicians waited until girls grew to an arbitrary height before initiating treatment: 167cm in Australia [2]; 169.5cm in the US [24]; and 170cm in Europe [25]; while others waited until girls reached puberty when they were more likely to be psychologically ready for the effects of treatment on their development but when treatment may be less effective [26]. Duration of treatment varied but was generally two to four years [2,23,27].…”

Section: Introductionmentioning

confidence: 99%

“…Some clinicians waited until girls grew to an arbitrary height before initiating treatment: 167cm in Australia [2]; 169.5cm in the US [24]; and 170cm in Europe [25]; while others waited until girls reached puberty when they were more likely to be psychologically ready for the effects of treatment on their development but when treatment may be less effective [26]. Duration of treatment varied but was generally two to four years [2,23,27]. Treatment regimes varied considerably and initially were a combination of oestrogen and testosterone [11].…”

Section: Introductionmentioning

confidence: 99%

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Looking back in time: conducting a cohort study of the long-term effects of treatment of adolescent tall girls with synthetic hormones

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ObjectivePublic health research is an endeavour that often involves multiple relationships, far-reaching collaborations, divergent expectations and various outcomes. Using the Tall Girls Study as a case study, this paper will present and discuss a number of methodological, ethical and legal challenges that have implications for other public health research.ApproachThe Tall Girls Study was the first study to examine the long-term health and psychosocial effects of oestrogen treatment for tall stature.ResultsIn undertaking this study the research team overcame many hurdles: in maintaining collaboration with treating clinicians and with the women they had treated as girls - groups with opposing points of view and different expectations; using private practice medical records to trace women who had been patients up to forty years earlier; and exploring potential legal issues arising from the collection of data related to treatment.ConclusionWhile faced with complex challenges, the Tall Girls Study demonstrated that forward planning, ongoing dialogue between all stakeholders, transparency of processes, and the strict adherence to group-developed protocols were keys to maintaining rigour while undertaking pragmatic research.ImplicationsPublic health research often occurs within political and social contexts that need to be considered in the planning and conduct of studies. The quality and acceptability of research findings is enhanced when stakeholders are engaged in all aspects of the research process.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Looking back in time: conducting a cohort study of the long-term effects of treatment of adolescent tall girls with synthetic hormones

et al. 2011

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Attenuating Growth in Children With Profound Developmental Disability

Gunther

Diekema

2006

Arch Pediatr Adolesc Med

122

106

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Caring for children with profound developmental disabilities can be difficult and demanding. For nonambulatory children with severe, combined neurologic and cognitive impairment, all the necessities of life must be provided by caregivers, usually parents, and these tasks become more difficult as the child grows to adolescence and adulthood. Many parents would like to continue caring for their child with special needs at home but find it difficult to do so as the child increases in size. If growth could be permanently arrested while the child was still small, both child and parent would likely benefit because this would facilitate the option of continued care in the home. Treatment of the child with high-dose estrogen, initiated at an early age, could provide this option. High-dose estrogen both inhibits growth and rapidly advances maturation of the epiphyseal growth plates, bringing about permanent attenuation in size after a relatively short period of treatment. We present a case report and discuss the medical and ethical considerations of such an intervention strategy. We suggest that after proper screening and informed consent, growth-attenuation therapy should be a therapeutic option available to these children should their parents request it.

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Clinical applications of physical anthropology

Robinow

1982

Am. J. Phys. Anthropol.

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In recent decades physical anthropology has moved from its more traditional confines into many areas of clinical interest including growth and development, nutrition, clinical medicine, dysmorphology, and physical fitness. The "clinical applications" of physical anthropology is a broad topic, given the space limitations of a review. Hence, selected clinical applications, emphasizing anthropometry at the expense of physiology and genetics, are considered. Since the author is a pediatrician, the review concentrates largely on areas dealing with children.In the nineteenth century, physical anthropologists were largely limited to a few measuring tools: anthropometer, weighing scales, calipers and measuring tapes, and were handicapped by somewhat primitive statistics. Modern workers have enlarged their inventory of measuring tools, improved their methodology, and greatly refined the statistical treatment of data.Earlier physical anthropologists concentrated on a rather limited group of study areas: (1) the dimensions of the human body and their variation with age, sex and race, and, to a lesser extent, with occupation and social class; (2) prehistory and human evolution; (3) taxonomy of human races; and (4) the relationship between cranial dimensions and intelligence.Contemporary physical anthropologists continue to study the first two topics. In the third area, emphasis has changed from "racial" to "ethnic" differences. Racial taxonomies by anthropometric criteria have proved futile. "It is difficult to define races and the usefulness of this concept, at least as applied to man, is doubtful" (Carmelli and Cavalli-Sfoma, 1979, p. 41). Genetic affinities between populations are better expressed in terms of blood group and plasma protein polymorphisms. Interest in the fourth area waned after Pearson (1906) showed the extremely low correlations between head size and intelligence, though occasional studies in this area continue to surface (Susanne, 1979).Perhaps a major change in recent decades has been the impressive growth in the application of physical anthropology to clinical problems. For purposes of this review, the following areas of clinical application have been selected: (1) growth and development; (2) nutrition and public health; (3) clinical medicine; (4) dysmorphology; and (5) physical fitness and sports. GROWTH AND DEVELOPMENTThe late 1920s saw a rather sudden burst of interest in the causes of individual differences, both mental and physical. It was hoped that long-term studies of children 0096-848X/82/2501-0169$03.50 cc)

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Tall girls: A survey of 15 years of management and treatment

Cited by 77 publications

References 25 publications

Looking back in time: conducting a cohort study of the long-term effects of treatment of adolescent tall girls with synthetic hormones

Looking back in time: conducting a cohort study of the long-term effects of treatment of adolescent tall girls with synthetic hormones

Attenuating Growth in Children With Profound Developmental Disability

Clinical applications of physical anthropology

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