Beclomethasone diproprionate reduced airway inflammation without adrenal suppression in young children with cystic fibrosis: a pilot study.

Inhaled corticosteroids are commonly used in cystic fibrosis (CF), but there are few studies evaluating their safety in young children. We, therefore, prospectively administered beclomethasone diproprionate (BDP) to 12 clinically stable young children with CF to examine the safety of this therapy with respect to adrenal suppression and airway infection. To determine potential mechanisms of corticosteroid action in CF, we also examined airway markers of inflammation before and after inhaled steroid treatment.

Anterior cruciate ligament injuries. Operative and rehabilitative options.

Injury to the ACL carries significant morbidity and it is an injury that afflicts and disables those enjoying a demanding active lifestyle. A decision on the most appropriate treatment is a difficult one and should be taken seriously because all treatment options require dedication and hard work for a successful outcome.

Measurement of brake response time after right anterior cruciate ligament reconstruction.

Recommendations on safe driving after anterior cruciate ligament (ACL) reconstruction have been largely intuitive. This study evaluated 12 male patients who underwent ACL reconstruction with subsequent outpatient rehabilitation and compared them with 10 subjects who had no knee dysfunction. The following clinical measures were assessed every 2 weeks for 10 weeks: brake response time (BRT), 6-meter walk time (6MWT), knee range of motion (ROM), pain (visual analog scale), and joint effusion.

Measurement of brake response time after right anterior cruciate ligament reconstruction.

Objective: Recommendations on safe driving after anterior cruciate ligament (ACL) reconstruction have been largely intuitive. We studied brake response time in patients who participated in outpatient rehabilitation after right ACL reconstruction.

Design: Prospective, repeated measures design comparing 14 patients post-ACL reconstruction with 21 subjects with normal knees.

A comparison of isokinetic strength testing and gait analysis in patients with posterior cruciate-retaining and substituting knee arthroplasties.

Fourteen patients with a posterior-stabilized prosthesis in one knee and a posterior cruciate-retaining prosthesis in the contralateral knee and both scoring good or excellent on the Hospital for Special Surgery (HSS) knee scale were evaluated by isokinetic muscle testing and comprehensive gait analysis at a mean follow-up of 98 months after arthroplasty. The average HSS knee score (93 points) and the average Knee Society score (94 points) were the same for the cruciate-retaining and posterior-stabilized knees. No differences were noted between the cruciate-retaining and the posterior stabilized knees with respect to isokinetic muscle testing parameters (peak torque, endurance, angle of peak torque, and torque acceleration energy) for both quadriceps and hamstrings.

Growth hormone therapy of Turner's syndrome: beneficial effect on adult height.

Objective: To carry out a multicenter, prospective, randomized trial of human growth hormone (GH), alone or in combination with oxandrolone (OX), in patients with Turner's syndrome (TS).

Methods: In an initial phase lasting 12 to 24 months, 70 girls with TS, verified by karyotype, were randomly assigned to one of four groups: (1) observation, (2) OX, (3) GH, or (4) GH plus OX. After completion of the first phase, group 3 subjects continued to receive GH only.

A dynamic test of lower extremity function following anterior cruciate ligament reconstruction and rehabilitation.

It is essential to assess the functional status of patients with surgically reconstructed and rehabilitated anterior cruciate ligaments prior to discharge. This study established a testing paradigm for functional force production and absorption. Data were obtained from 100 healthy subjects for maximal hops, controlled leaps, and hopping and leaping symmetry.

Comprehensive gait analysis in posterior-stabilized knee arthroplasty.

Sixteen patients implanted with a posterior-stabilized prosthesis (Insall-Burstein PS II, Zimmer, Warsaw, IN) and 32 age-matched control subjects were evaluated by isokinetic muscle testing and comprehensive gait analysis at a mean 46 months following the index arthroplasty. The contralateral knee was normal in 13 patients and an asymptomatic total knee arthroplasty in 3 patients. No significant differences (P > .

Electrical stimulation effect on extensor lag and length of hospital stay after total knee arthroplasty.

The effects of electrical stimulation in conjunction with traditional physical therapy, on knee extensor lag and length of hospital stay among patients recovering from total knee arthroplasty were assessed. Forty patients who underwent total knee replacement (TKR) were randomly assigned to either an electrical stimulation group (16 females, 5 males), or a control group (15 females, 4 males). Both groups received conventional physical therapy including continuous passive motion (CPM) to the affected limb, ambulation training, range of motion exercises, and activities of daily living (ADL) training.

Six-year results of a randomized, prospective trial of human growth hormone and oxandrolone in Turner syndrome.

Seventy girls with Turner syndrome, verified by karyotype, were randomly assigned to observation or treatment with human growth hormone (hGH), oxandrolone, or a combination of hGH plus oxandrolone for a period of 12 to 24 months, to assess the effect of treatment on growth velocity and adult height. Subsequently, all subjects received either hGH alone or hGH plus oxandrolone. Data are presented for 62 subjects treated for a period of 3 to 6 years.

Effect of extended use of single anabolic steroids on urinary steroid excretion and metabolism.

Long-term use of single anabolic steroids by weightlifters and body builders at dosages greater than or equal to 25 mg per 24 h resulted in reduced excretion of urinary androgen metabolites, androsterone and etiocholanolone, compared to values prior to anabolic use. The excretion of major urinary metabolites of glucocorticoids was not affected by anabolic use. Urinary excretion of anabolic steroids or anabolic metabolites averaged 20-25% of total anabolic steroid administered.

Three-year results of a randomized prospective trial of methionyl human growth hormone and oxandrolone in Turner syndrome.

Seventy girls with Turner syndrome, 4 to 12 years of age, participated in a prospective, randomized study to determine the effects on growth of methionyl human growth hormone (met-hGH) or oxandrolone. Subjects were randomly assigned to receive either no treatment (control) or met-hGH (0.125 mg/kg three times per week), oxandrolone (0.

Comparison of hypothalamus-pituitary-adrenal axis suppression from superpotent topical steroids by standard endocrine function testing and gas chromatographic mass spectrometry.

We evaluated 38 males who had psoriasis vulgaris for evidence of hypothalamus-pituitary-adrenal axis suppression (HPAS) during treatment with superpotent topical glucocorticosteroids. All men were treated with 49 g per week of either Betamethasone Diproprionate in an optimized vehicle or Clobetasol Proprionate ointment. Three methods used to assess HPAS were compared.

Methionyl human growth hormone and oxandrolone in Turner syndrome: preliminary results of a prospective randomized trial.

Seventy girls with Turner syndrome, 4 to 12 years of age, were randomly assigned to receive either no treatment (control) or methionyl human growth hormone (0.125 mg/kg three times per week), oxandrolone (0.125 mg/kg/day), or combination hGH plus oxandrolone therapy.

The role of steroid metabolic profiling as an aid in the diagnosis of familial precocious puberty, a subgroup of true precocious puberty.

We report the results of a study of a rare form of true precocious puberty in a family with a history of the condition. Only the male members manifest the trait, whereas it appears to be carried by both males and females. Routine urinary steroid analysis rapidly eliminated most of the classical enzyme defects associated with premature sexual maturation.

Assessing normal growth.

Guidelines are provided to help the physician differentiate growth patterns that are normal from those that are not. Basic tools and clinical findings are described, including proper measurement of height and plotting of data on growth charts.

A comparison of clonidine and standard provocative agents of growth hormone.

To evaluate the effectiveness of clonidine on growth-hormone (GH) release in prepubertal children, and to distinguish between a central alpha-adrenergic effect and a corticotropin-cortisol-mediated response, we measured serum glucose, corticotropin, cortisol, and GH concentrations following levodopa, arginine hydrochloride, and clonidine hydrochloride stimulation in 15 euthyroid children who had short stature. We found that clonidine is an effective and safe stimulator of GH release and provided a clearer distinction between GH-deficient and non-GH-deficient young persons than levodopa or arginine. The action of clonidine is not corticotropin-cortisol mediated.

Spontaneous feminization and menstrual function developing during puberty in Turner's syndrome.

An 18-year-old patient with Turner's syndrome presented with cyclical vaginal bleeding and spontaneous development of secondary sexual characteristics. She demonstrated classic features of Turner's phenotype, and a culture of blood lymphocytes revealed a 45,XO karyotype. The patient's plasma and urinary estrogen concentrations were similar to those in normal adult women in the late proliferative phase.

Lack of dietary regulation of jejunal glycolytic enzymes and disaccharidases in obesity: the role of insulin.

Dietary regulation of jejunal glycolytic regulatory enzymes and disaccharidases were studied in 9 obese subjects, aged 9 to 18 years. These subjects were divided into two groups on the basis of altered carbohydrate metabolism as measured by circadian insulin levels and flux of glucose, inorganic phosphorus, and insulin measured during a 5-hr oral glucose tolerance test. Those patients with nocturnal hyperinsulinemia and abnormal carbohydrate flux showed no adaptation of jejunal enzymes.