Precocious

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MariaMandese

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Precocious Puberty By: Maria , Taylor, Meghan Figure 2

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Precocious puberty is defined as the development of pubertal signs at a younger age than the accepted lower limits for the onset of puberty. In girls, breast development before the age of 8 years, appearance of sexual pubic hair before the age of 8 years or beginning menses before the age of 9.5 years is traditionally considered as precocious puberty. This is accompanied by rapid growth rate, advanced skeletal maturation and increased levels of gonadotropins and/or sex steroids.

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Congenital hypothyroidism (CH) ranks very high among the most common disorders treated in a paediatric endocrinology clinic. In the Western world, CH is detected in 1:3,500 to 1:4,000 newborns (1) by the neonatal thyroid screening (NTS) programme. The main goal of NTS commenced in the 1970s is an early diagnosis of CH and prompt initiation of ongoing thyroxine replacement therapy, to be administered regularly for the affected infants. This measure is aimed to avoid the inevitable outcome of permanent neurological handicap in untreated children or in whom the onset of treatment was considerably delayed. When treated early, CH is also one of the most common preventable causes of mental retardation. In this regard, while emphasizing the role of NTS in early diagnosis, it is worthy of note that the incidence of CH reported from NTS carried out in various centers in India is much higher, viz., 1:1,200 to 1:1,500 newborns. (2). Naturally, it follows that NTS must be universally available in India to identify all affected infants by prompt diagnosis to begin regular replacement therapy in the initial two weeks of life (3).

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PHYSICAL AND COGNITIVE DEVELOPMENT IN ADOLESCENCE CHAPTER 11 Copyright © 2011 Pearson Education, Inc. All rights reserved. * Learning Objectives *Explain: These are the questions we will consider as we begin our study of adolescence. PHYSICAL MATURATION * Physical Manifestations of Puberty *Start of physical maturation:Begins when the pituitary gland in the brain signals other glands in children's bodies to begin producing the sex hormones, androgens (male hormones) or estrogens (female hormones), at adult levels. Males and females produce both types of sex hormones, but males have a higher concentration of androgens and females a higher concentration of estrogens.) Pituitary gland also signals body to increase production of growth hormones that interact with the sex hormones to cause the growth spurt and puberty. In addition, the hormone leptin appears to play a role in the start of puberty. Growth during Adolescence: The Rapid Pace of Physical and Sexual Maturation Adolescent growth spurtWeight increase Skeletal changes Accelerated Asynchronicity in growth *Adolescence is the developmental stage that lies between childhood and adulthood. It is generally viewed as starting just before the teenage years and ending just after them. It is a transitional stage. Adolescents are considered no longer children, but not yet adults. It is a time of considerable physical and psychological growth and change.One aspect of this transformation is the adolescent growth spurt, a period of very rapid growth in height and weight. On average, boys grow 4.1 inches a year and girls 3.5 inches a year. Some adolescents grow as much as 5 inches in a single year.Boys’ and girls’ adolescent growth spurts begin at different times. As you can see in Figure 11-1, girls begin their spurts around age 10, while boys start at about age 12. During the 2-year period starting at age 11, girls tend to be taller than boys. But by the age of 13, boys, on average, are taller than girls—a state of affairs that persists for the remainder of the life span. Wt and ht increase due to simultaneous release of growth hormone, thyroid hormones, and and androgens; peak height velocity at adolescence and toddler yearsIn general two years earlier in girls; girls taller between 11 and 13Changes in composition of skeletal structure; closing of long bones; ethnic differencesHeight changes in torso rather than leg lengthAccelerated growth spurtextremities first (head, hands, feet) arms and legs torso and shoulder growth Growth Pattern Patterns of growth are depicted in two ways. The first figure shows height at a given age, while the second shows the height increase occurs from birth through the end of adolescence. Notice that girls begin their growth spurt around age 10, while boys begin the growth spurt at about age 12. However, by the age of 13, boys ...

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