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Growth and development
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
Tanner stage IV penile and pubic hair development indicates onset of puberty. At this stage the testicular size is more than 4 ml. Asymmetrical breast development is normal in both sexes. Congenital adrenal hyperplasia results in precocious puberty. As fusion of tibial and fibular epiphyses is complete in boys by the age of 16 years, further significant increase in height is unlikely. Sexual precosity is accompanied by an increase in bone age.
Assessment and Diagnosis of the Male Infertility Patient
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Muhannad M. Alsyouf, Cayde Ritchie, David Kim, Edmund Ko
Genital examination should be performed in all patients with focus on urethral meatus, penis, and testis. The Tanner stage should be noted because an adult that is not stage V may have an underlying endocrinological or genetic abnormality as the cause of their underdevelopment and infertility. Findings of a hypospadic urethra or pathologic penile curvature can be discovered on examination and can be the cause of infertility due to abnormal sperm expulsion. Testicular examination should include palpation and sizing. Volume estimation can be performed using a pachymeter or an orchidometer (Figure 2.1). Testicular hypertrophy may be seen in both primary and secondary testicular failure. The epididymis should be evaluated for complete development and the presence or absence of cysts, masses, and enlargement. The absence of part of the epididymis may be related to an absent vas deference on the ipsilateral side and further evaluation is warranted.
Problems with puberty and its onset
Published in David J Cahill, Practical Patient Management in Reproductive Medicine, 2019
Precocious puberty is more prevalent in females than males, 20 per 10,000 in girls compared with <5 per 10,000 for boys (9). The normal age range of pubertal onset, the age at which 95% of children attain Tanner stage 2, is between 8 and 13 years in girls, and between 9 years 6 months and 13 years 6 months in boys.
Moyamoya syndrome in a male pseudohermaphrodite patient with congenital adrenal hyperplasia – a rare association. Case report and review of literature
Published in British Journal of Neurosurgery, 2023
Remesh Chirayil Vasudevan, Reshma Vachali Madayi, Rohit Ravindranath Nambiar
A 42-year-old patient presented with an intraventricular bleed. Digital subtraction angiography (DSA) of cerebral vessels was suggestive of moyamoya vasculopathy (Figure 1). He was hypertensive, tall and had primary amenorrhea. Secondary sexual characteristics were poorly developed and he had ambiguous genitalia. Breast development was Tanner stage 3. There was rudimentary vagina. Nobody else in the patient’s family had moyamoya disease/syndrome or endocrinological problems. Investigation revealed persistent hypokalemia. Considering primary amenorrhea, persistent hypokalemia, hypertension and ambiguous genitalia, CAH was thought of as a possibility. Hormone profile was also suggestive of CAH. Karyotyping revealed a 46XY pattern. Abdominal ultrasound revealed hyperplasia of the adrenal glands (Figure 2), absent uterus and ovaries and ectopic testicles in inguinal canals (Figure 3). He was put on steroids and underwent orchidectomy to prevent possible development of malignancy. The patient’s blood pressure is now under control and he has had no new neurological event for the last 5 years.
A Latent Profile Analysis of Sleep, Anxiety, and Mood in Youth with Craniopharyngioma
Published in Behavioral Sleep Medicine, 2022
Sara M. Witcraft, Molly E. Wickenhauser, Kathryn M. Russell, Belinda N. Mandrell, Heather M. Conklin, Thomas E. Merchant, Valerie McLaughlin Crabtree
The study sample included 80 patients between 2 and 20 years of age (Mage = 9.78 ± 4.44 years, 64.1% White, 53.8% female) with craniopharyngioma. Amongst the 80 patients included in this analysis, 46 had histologically confirmed adamantinomatous craniopharyngioma; the remainder were diagnosed based on imaging criteria and/or intraoperative findings. The majority of the sample (73.8%) were at Tanner stage 1. Tanner stage of 1 corresponds to pre-pubescent and progresses to Tanner stage of 5, which corresponds to final adult pubertal development. The study sample included patients newly diagnosed and those who were initially treated with surgery and observed until progression. The average time since diagnosis was 303.90 (SD = 529.56) days, with 33 patients (41.3%) fewer than 90 days from diagnosis and 47 patients (58.8%) 90 or more days from diagnosis. There was no significant association between time since diagnosis and any of the measures described below.
Sleep Difficulties among Mexican Adolescents: Subjective and Objective Assessments of Sleep
Published in Behavioral Sleep Medicine, 2022
Astrid N. Zamora, Laura Arboleda-Merino, Martha Maria Tellez-Rojo, Louise M. O’Brien, Libni A. Torres-Olascoaga, Karen E. Peterson, Margaret Banker, Erica Fossee, Peter X. Song, Kirstyn Taylor, Alejandra Cantoral, Elizabeth F. S. Roberts, Erica C. Jansen
Trained physicians implemented standard methods for Tanner staging during the in-person visit to assess sexual maturation status (Chavarro et al., 2018). Participants were divided into two pubertal groups: transitioning (Tanner Stage 1 through Tanner Stage 4 in both pubic hair and gonadal development) and mature (Tanner Stage 5 in both pubic hair and gonadal development). We also obtained information on smoking and alcohol behavior. We classified smoking and alcohol behavior into dichotomous variables; for smoking, whether they self-reported having ever tried smoking (yes or no), and for alcohol, whether they had ever consumed an alcoholic drink (yes or no). Physical activity status was assessed using a self-reported questionnaire adapted for and validated among Mexican adolescents (Hernandez et al., 2000). We estimated average hours of physical activity per week by summing the self-reported hours spent participating in all potential physical activities, such as soccer, volleyball, running, etc. We then categorized the average number of weekly hours spent doing physical activity into tertiles.