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Biomedical subjects

J Waelkens

Publications and source records attributed to J Waelkens.

9 recordsLinked to original sources
PubMed1997

Growth response and levels of growth factors after two years growth hormone treatment are similar for a once and twice daily injection regimen in girls with Turner syndrome. (Dutch Working Group on Growth Hormone).

UNLABELLED: GH is known to improve height velocity in girls with Turner syndrome (TS) but the optimal dosage regimen has yet to be defined. OBJECTIVE: We attempted to improve the growth response by trying to mimic normal pulsatile GH secretion more closely. DESIGN: In a 2-year study the effect of fractionated twice daily (BID) was compared with once daily (OD) s.c. injections of a total GH dose of 6 IU/m2/day. BID injections were administered as two-thirds at bedtime and one-third in the morning. The subjects concurrently received low dose ethinyl oestradiol (0.05 mg/kg/day, orally). SUBJECTS: Nineteen girls with TS aged 11 years or over, who were previously involved in a 10-week GH cross-over study. MEASUREMENTS: Height and bone age were evaluated in relation to untreated Turner reference data. Final height (FH) was predicted using the Bayley and Pinneau (BP) method, the modified index of Potential Height (mIPHRUS), and a recently developed Turner-specific method (PTSRUS) based on regression coefficients for height (H), chronological age (CA) and bone age (BA). Plasma levels of GH, GHBP, IGF-1, and IGFBP-3 were determined by RIA. RESULTS: After 2 years treatment the growth response expressed as HV, HVSDS, the change in HSDSCA, the gain in height over estimated untreated values and in FH prediction all showed significant improvements. Although mean values tended to be higher with OD injections, significant differences between groups were not found. Bone maturation was similar between groups and compared with untreated estimated values. Independent of treatment group, the change in HSDSCA after 2 years of GH treatment was related negatively to the baseline CA and HSDSCA, and positively to BA delay at baseline. After 18 months of GH treatment the significant decrease in GHBP plasma levels observed after 6 months was no longer significant. In contrast, IGF-1 and IGFBP-3 plasma levels and the IGF-1 to IGFBP-3 ratio increased significantly during 18 months GH therapy. None of these growth related factors showed a difference between groups in their 18 months change. Relevant side-effects were not observed during the first 2 years of GH treatment. CONCLUSIONS: The present growth data are in conformity with the data of the earlier 24-hour GH profiles. The growth response and plasma levels of growth related factors after 2 years GH on a total dose of 6 IU/m2/day in combination with low-dose oestrogens were not significantly different between the once daily and the twice daily GH injection regimen.

Adolescent↗
PubMed1996

Final height in central precocious puberty after long term treatment with a slow release GnRH agonist.

OBJECTIVE: To study the resumption of puberty and the final height achieved in children with central precocious puberty (CPP) treated with the GnRH agonist triptorelin. PATIENTS: 31 girls and five boys with CPP who were treated with triptorelin 3.75 mg intramuscularly every four weeks. Girls were treated for a mean (SD) of 3.4 (1.0) years and were followed up for 4.0 (1.2) years after the treatment was stopped. RESULTS: The rate of bone maturation decreased during treatment and the predicted adult height increased from 158.2 (7.4) cm to 163.9 (7.5) cm at the end of treatment (p < 0.001). When treatment was stopped bone maturation accelerated, resulting in a final height of 161.6 (7.0) cm, which was higher than the predicted adult height at the start of treatment (p < 0.001). Height at the start of treatment was the most important factor positively influencing final height (r = 0.75, p < 0.001). Bone age at cessation of treatment negatively influenced final height (r = -0.52, p = 0.03). A negative correlation between bone age and height increment after discontinuation of treatment was observed (r = -0.85, p = 0.001). Residual growth capacity was optimal when bone age on cessation of treatment was 12 to 12.5 years. Body mass index increased during treatment and remained high on cessation. At final height, the ratio of sitting height to subischial leg length was normal. Menarche occurred at 12.3 (1.1) years, and at a median (range) of 1.1 (0.4 to 2.6) years after treatment was stopped. The ovaries were normal on pelvic ultrasonography. CONCLUSIONS: Treatment of CPP with triptorelin increases final height, with normal body proportions, and seems to increase body mass index. The best results were achieved in girls who were taller at the start of treatment. Puberty was resumed after treatment, without the occurrence of polycystic ovaries.

Body Height↗
PubMed1988

The sensorium of the migraineur.

The occurrence of perceptual disturbances in migraineurs, particularly during the headache-free interval, has been scrutinized rather rarely. This subject was studied via a mail survey in 134 patients presenting perceptual changes before or during their migraine attacks. The patients had to complete a 5-part questionnaire covering history, events before, during as well as after the attack, and the attack-free interval. Sensory alterations during the headache-free interval were not reported by 36.6% of the patients. Alterations of equilibrium and/or spatial orientation, mainly susceptibility to motion sickness, were present in 47.8%, increased sensitivity to cold or heat in 40.3%, intolerance of tight clothes or being touched in 34.3%, altered visual function in 32.8%, changes in olfactory acuity in 31.1%. These percentages show that these 5 types of interictal sensory disturbances may not be rare in migraineurs. The exact frequency of these symptoms and how they correlate with perictal phenomena, sex, age and disease characteristics has to be further studied.

Adult↗
PubMed1985

Warning symptoms in migraine: characteristics and therapeutic implications.

The characteristics of warning symptoms preceding the migraine headache attack in 49 patients with complete migraine are described. These symptoms are divided into non-evolutive and evolutive warning symptoms, based on specific characteristics of each. Non-evolutive symptoms precede the attack by 8 to 48 h in 88% of our patients and have a constant and modest intensity. Evolutive warning symptoms appear within a few minutes up to 6 h before the attack. These symptoms become more and more pronounced towards the onset of the headache. There was no striking similarity between symptoms during the attack and the warning symptoms. In a number of patients with complete migraine, migraine attacks can be prevented by taking domperidone, a peripheral dopamine antagonist, at the time of the non-evolutive warning symptoms. These data suggest that the mechanism leading to a migraine attack can be operative 8-48 h before the headache begins and is possibly dopaminergically mediated.

Adolescent↗
PubMed1984

Dopamine blockade with domperidone: bridge between prophylactic and abortive treatment of migraine? A dose-finding study.

The feasibility of a "last moment" prevention of migraine with the selective dopamine receptor blocker domperidone (Motilium) was evaluated in patients who experience typical, but minor prodromes several hours before the attack. Following a previous placebo-controlled trial, a dose-response study was done. In a randomized, double-blind cross-over setting, oral doses of 20 mg, 30 mg or 40 mg of domperidone were each given twice to 19 patients who were able to predict their attack several hours in advance. Taken at the very first appearance of the early warning symptoms, 20 mg, 30 mg and 40 mg prevented respectively 30%, 58% and 63% of the (imminent) attacks. Part of the attacks still occurring after domperidone, particularly after 20 mg, were reduced in severity. Irrespective of the dose given, the best response was observed when domperidone was taken 6 h, and even better, 12 h before the attack. Migraine-associated hypersensitivity of dopamine receptors might explain why dopamine blockade with domperidone is of benefit to the patient.

Adolescent↗