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Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, UK
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Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, UK
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radiation on a tumour cell. Radiation exposure often causes DNA strand breaks in the tumour cell, typically leading to cell death ( 3 ). Figure created with BioRender.com. The hypothalamic–pituitary axis Within the brain, the hypothalamus and
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Hypogonadism is a clinical syndrome resulting from failure to produce physiological concentrations of sex steroid hormones with accompanying symptoms, such as slowed growth and delayed pubertal maturation. Hypogonadism may arise from gonadal disease (primary hypogonadism), dysfunction of the hypothalamic–pituitary axis (secondary hypogonadism) or functional hypogonadism. Disrupted puberty (delayed or absent) leading to hypogonadism can have a significant impact on both the physical and psychosocial well-being of adolescents with lasting effects. The diagnosis of hypogonadism in teenagers can be challenging as the most common cause of delayed puberty in both sexes is self-limited, also known as constitutional delay of growth and puberty (CDGP). Although an underlying congenital cause should always be considered in a teenager with hypogonadism, acquired conditions such as obesity, diabetes mellitus, other chronic diseases and medications have all been associated with low sex steroid hormone levels. In this review, we highlight some forms of functional hypogonadism in adolescents and the clinical challenges to differentiate normal variants from pathological states.
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specialists. Topics will cover bone health, growth hormone deficiency, the impact of different radiotherapy techniques on the hypothalamic–pituitary axis, risk assessment for second cancers, as well as strategies for international collaboration and different
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Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
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5 Brosnan PG. The hypothalamic pituitary axis in the fetus and newborn . Seminars in Perinatology 2001 25 371 – 384 . ( doi:10.1053/sper.2001.29038 ) 10.1053/sper.2001.29038 11778908 6 McLean M Smith R. Corticotrophin
Princess Máxima Center for Pediatric Oncology, AB Utrecht, The Netherlands
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Princess Máxima Center for Pediatric Oncology, AB Utrecht, The Netherlands
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Princess Máxima Center for Pediatric Oncology, AB Utrecht, The Netherlands
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decreased thyroid function due to the injury of the thyroid gland itself rather than the hypothalamic–pituitary axis that controls it. Primary hypothyroidism has been reported in 14.7% of CCS and may occur after thyroid surgery or radiation to the neck ( 30
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necessary to induce negative feedback on adrenocorticotropic hormone (ACTH) secretion in hypothalamic–pituitary axis regulation ( 10 ). The discrepancy between pure receptor binding and the biological effect might be explained in part by the fact that
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Introduction The fetal adrenal gland and hypothalamic–pituitary axis (HPA) play important roles during pregnancy. Between weeks 32 and 34 of gestation, there is a rapid maturation of the fetal adrenal cortex, allowing development of a variety of
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Neurofibromatosis Outpatient Reference Center, Department of Nutrition, Federal University of Minas Gerais, Department of Medical Clinic, Federal University of Minas Gerais, Department of Preventive and Social Medicine, Federal University of Minas Gerais, Department of Internal Medicine, Federal University of Minas Gerais, The Neurofibromatosis Institute, Federal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, Brazil
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Hegedus B Yeh TH Lee DY Emnett RJ Li J Gutmann DH . Neurofibromin regulates somatic growth through the hypothalamic–pituitary axis . Human Molecular Genetics 2008 17 2956 – 2966 . ( doi:10.1093/hmg/ddn194 ). 29 van de Sande-Lee SV
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used various cortisol measurement techniques (morning plasma, salivary, post-dexamethasone suppression, 24-h urine) that assess distinct aspects of the hypothalamic–pituitary–axis. An emerging new technique that may also be of use is measurement of hair
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presentation includes reddish purple striae, plethora, proximal muscle weakness and metabolic disorders (central obesity, hypertension, diabetes mellitus and dyslipidemia). The inhibitory effect of hypercortisolemia on the hypothalamic–pituitary axis is most