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Chiara Jongerius Amsterdam UMC, Location AMC, Medical Psychology, Amsterdam, The Netherlands
Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands

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Marij A Hillen Amsterdam UMC, Location AMC, Medical Psychology, Amsterdam, The Netherlands
Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands

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Ellen M A Smets Amsterdam UMC, Location AMC, Medical Psychology, Amsterdam, The Netherlands
Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands

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Mathijs J Mol Amsterdam UMC, Location AMC, Medical Psychology, Amsterdam, The Netherlands

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Eefje S Kooij Amsterdam UMC, Location AMC, Medical Psychology, Amsterdam, The Netherlands

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Maria A de Nood Amsterdam UMC, Location AMC, Medical Psychology, Amsterdam, The Netherlands

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Edwin S Dalmaijer MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom

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Eric Fliers Department of Endocrinology & Metabolism, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands

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Johannes A Romijn Department of Medicine, Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands

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Daniel S Quintana University of Oslo, Department of Psychology, Oslo, Norway
Department of Rare Disorders and Disabilities, Oslo University Hospital, NevSom, Oslo, Norway
University of Oslo, Norwegian Centre for Mental Disorders Research (NORMENT) and KG Jebsen Centre for Neurodevelopmental Disorders, Oslo, Norway

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–physician communication and may therefore affect the quality of the relationship. Sub-optimal levels of eye gaze between physicians and patients can negatively affect patient–physician relationships, including the reduced trust of patients in their physicians ( 6 , 11

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Srdjan Pandurevic Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Ilaria Mancini Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
Unit of Gynecology and Obstetrics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy

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Dimitri Mitselman Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Matteo Magagnoli Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Rita Teglia Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Roberta Fazzeri Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Paola Dionese Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Carolina Cecchetti Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Massimiliamo Caprio Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, Rome, Italy
Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele, Rome, Italy

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Costanzo Moretti Department of Systems Medicine, Unit of Endocrinology, University of Rome Tor Vergata, Rome, Italy

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Justyna Sicinska Dermatology Clinic of CSK MSWiA Hospital, Warsaw, Poland

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Alessandro Agostini Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy

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Domenica Gazineo Teaching Hospital, S. Orsola Hospital, Bologna, Italy

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Lea Godino Teaching Hospital, S. Orsola Hospital, Bologna, Italy

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Ignacio Sajoux Epigenomics in Endocrinology and Nutrition Group, Instituto de Investigacion Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago (CHUS/SERGAS), Spain
Medical Department Pronokal Group, Barcelona, Spain

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Flaminia Fanelli Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Cristina M Meriggiola Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
Unit of Gynecology and Obstetrics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy

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Uberto Pagotto Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Alessandra Gambineri Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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, there have been no studies on the impact of VLCKD on distress or quality of life in PCOS. However, previous studies that highlighted the psychological benefits of short-term LCD in obese PCOS even without an amelioration in hirsutism, used other

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E M Winter Leiden University Medical Center, Department of Internal Medicine, Division of Endocrinology, Center for Bone Quality, Leiden, the Netherlands

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A Ireland Musculoskeletal Science and Sports Medicine Research Centre, Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom

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N C Butterfield Molecular Endocrinology Laboratory, Department of Metabolism, Digestion and Reproduction, Imperial College London, Commonwealth Building, DuCane Road, London, United Kingdom

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M Haffner-Luntzer Institute of Orthopaedic Research and Biomechanics, University Medical Center Ulm, Ulm, Germany

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M-N Horcajada Nestlé Research, Department of Musculoskeletal Health, Innovation EPFL Park, Lausanne, Switzerland.

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A G Veldhuis-Vlug Leiden University Medical Center, Department of Internal Medicine, Division of Endocrinology, Center for Bone Quality, Leiden, the Netherlands
Jan van Goyen Medical Center, Department of Internal Medicine, Amsterdam, the Netherlands

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L Oei Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands

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G Colaianni Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy

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N Bonnet Nestlé Research, Department of Musculoskeletal Health, Innovation EPFL Park, Lausanne, Switzerland.

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energy expenditure from decreased physical activity. Accordingly, there is little change in diet quality and only a small increase in energy intake during pregnancy and early lactation ( 4 , 5 ) without substantial alterations in calcium intake. Despite

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Nardin Aslih Department of Obstetrics and Gynecology, MDIVF Unit, Hillel Yaffe Medical Center, IsraelTechnion – Israel Institute of Technology, Hadera, Haifa, Israel

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Mediea Michaeli Department of Obstetrics and Gynecology, MDIVF Unit, Hillel Yaffe Medical Center, IsraelTechnion – Israel Institute of Technology, Hadera, Haifa, Israel

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Diana Mashenko Department of Obstetrics and Gynecology, MDIVF Unit, Hillel Yaffe Medical Center, IsraelTechnion – Israel Institute of Technology, Hadera, Haifa, Israel

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Adrian Ellenbogen Department of Obstetrics and Gynecology, MDIVF Unit, Hillel Yaffe Medical Center, IsraelTechnion – Israel Institute of Technology, Hadera, Haifa, Israel

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Oshrit Lebovitz Department of Obstetrics and Gynecology, MDIVF Unit, Hillel Yaffe Medical Center, IsraelTechnion – Israel Institute of Technology, Hadera, Haifa, Israel

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Yuval Atzmon Department of Obstetrics and Gynecology, MDIVF Unit, Hillel Yaffe Medical Center, IsraelTechnion – Israel Institute of Technology, Hadera, Haifa, Israel

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Einat Shalom-Paz Department of Obstetrics and Gynecology, MDIVF Unit, Hillel Yaffe Medical Center, IsraelTechnion – Israel Institute of Technology, Hadera, Haifa, Israel

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E2/total oocyte ratio is not believed to affect embryo quality and development based on donor oocyte treatment cycles ( 2 ). Several studies have reported the ideal ratio of peak E2 concentration to collected oocytes (E2/oocyte) in agonist down

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Brendan J Nolan Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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Aviva S Frydman Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia

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Shalem Y Leemaqz College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia

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Meg Carroll Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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Mathis Grossmann Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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Jeffrey D Zajac Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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Ada S Cheung Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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. We hypothesised that progesterone would improve sleep quality, reduce psychological distress, and enhance breast development. Materials and methods We conducted a prospective 3-month case–control study at Austin Health, a tertiary referral

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Qianqian Pang Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
Musculoskeletal Research Laboratory and Bone Quality and Health Assessment Centre, Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong

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Yuping Xu Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
Department of Endocrinology, The First Affiliated Hospital of Shanxi Medical University, Taiyuan, Shanxi, China

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Xuan Qi Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China

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Yan Jiang Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China

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Ou Wang Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China

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Mei Li Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China

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Xiaoping Xing Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China

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Ling Qin Musculoskeletal Research Laboratory and Bone Quality and Health Assessment Centre, Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong

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Weibo Xia Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China

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Background

Primary hypertrophic osteoarthropathy (PHO) is a rare genetic multi-organic disease characterized by digital clubbing, periostosis and pachydermia. Two genes, HPGD and SLCO2A1, which encodes 15-hydroxyprostaglandin dehydrogenase (15-PGDH) and prostaglandin transporter (PGT), respectively, have been reported to be related to PHO. Deficiency of aforementioned two genes leads to failure of prostaglandin E2 (PGE2) degradation and thereby elevated levels of PGE2. PGE2 plays an important role in tumorigenesis. Studies revealed a tumor suppressor activity of 15-PGDH in tumors, such as lung, bladder and breast cancers. However, to date, no HPGD-mutated PHO patients presenting concomitant tumor has been documented. In the present study, we reported the first case of HPGD-mutated PHO patient with soft tissue giant tumors at lower legs and evaluated the efficacy of selective COX-2 inhibitor (etoricoxib) treatment in the patient.

Methods

In this study, we summarized the clinical data, collected the serum and urine samples for biochemical test and analyzed the HPGD gene in our patient.

Results

A common HPGD mutation c.310_311delCT was identified in the patient. In addition to typical clinical features (digital clubbing, periostosis and pachydermia), the patient demonstrated a new clinical manifestation, a giant soft tissue tumor on the left lower leg which has not been reported in HPGD-mutated PHO patient before. After 6-month treatment with etoricoxib, the patient showed decreased PGE2 levels and improved PHO-related symptoms. Though the soft tissue tumor persisted, it seemed to be controlled under the etoricoxib treatment.

Conclusion

This finding expanded the clinical spectrum of PHO and provided unique insights into the HPGD-mutated PHO.

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Mark R Postma Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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Pia Burman Department of Endocrinology, Skane University Hospital Malmö, University of Lund, Lund, Sweden

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André P van Beek Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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also associated with a reduced quality of life. AGHD is usually caused by pituitary adenomas, recently also termed pituitary neuroendocrine tumours (PitNETs) ( 1 ), or the consequences of treatment of these tumours, including surgery and/or irradiation

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Yongli Fu Department of Endocrinology, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, Heilongjiang Province, People’s Republic of China

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Yaowu Sun Higher Education Research and Teaching Quality Assessment Center, Qiqihar Medical College, Qiqihar, Heilongjiang Province, People’s Republic of China

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Jiankun Zhang Department of Clinical Laboratory, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, Heilongjiang Province, People’s Republic of China

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Yu Cheng Department of Nutrition and Food Hygiene, School of Public Health, Qiqihar Medical College, Qiqihar, Heilongjiang Province, People’s Republic of China

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This meta-analysis aims to update the evidence for the effects of intensive glucose control (IGC) on the outcomes among critically ill patients. We performed a systematic literature review from inception through December, 2017 by two independent authors by searching PubMed, EMBASE and Cochrane Library. Randomized clinical trials of the effects of IGC compared with conventional glucose control were selected. Random-effect models were applied to calculate summary relative risks (RRs) for the related outcomes. Of 4247 records identified, we abstracted data from 27 relevant trials for meta-analysis. Compared with patients receiving conventional glucose control (controls), patients with IGC did not have significantly decreased risk of short-term mortality (in-hospital mortality or intensive care unit (ICU) mortality) (RR 0.99, 95% CI 0.92–1.06) or 3- to 6-month mortality (RR 1.02, 95% CI 0.97–1.08). These results remained constant among different study settings including surgical ICUs, medical ICUs or mixed ICUs. Similarly, we also found that patients with IGC did not have significantly lower risk of sepsis (RR 1.00, 95% CI 0.89–1.11) or new need for dialysis (RR 0.97, 95% CI 0.84–1.11). However, patients with IGC had almost 4-fold increase in risk of hypoglycemia (RR 4.86, 95% CI 3.16–7.46). In conclusion, in this updated meta-analysis of published trials, critically ill patients receiving IGC were found to be at neutral risk for short-term or 3- 6-month mortality, risk of sepsis or new need for dialysis, but at higher risk of hypoglycemia.

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Ziting Liang Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China

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Mengge Yang Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China

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Changjuan Xu Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China

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Rong Zeng Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China

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Liang Dong Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China

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( 27 ). Assessment of study quality and risk of bias The Newcastle–Ottawa Scale ( 28 ) and Critical Appraisal Skills Programme ( http://www.casp-uk.net/ ) were used to evaluate the quality of each observational study and randomized controlled

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M Ahmid Developmental Endocrinology Research Group, Royal Hospital for Children, School of Medicine, University of Glasgow, Glasgow, UK

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C G Perry Department of Endocrinology, Queen Elizabeth University Hospitals, Glasgow, UK

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S F Ahmed Developmental Endocrinology Research Group, Royal Hospital for Children, School of Medicine, University of Glasgow, Glasgow, UK

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M G Shaikh Developmental Endocrinology Research Group, Royal Hospital for Children, School of Medicine, University of Glasgow, Glasgow, UK

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research over the past two decades that has demonstrated deficits in bone health and cardiac function, together with impaired quality of life in adults with CO-GHD after completion of childhood treatment ( 3 , 4 , 5 , 6 ), has questioned this practice

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