RESUMO
BACKGROUND/AIMS: There are many controversies regarding side effects on craniofacial and extremity growth due to growth hormone (GH) treatment. Our aim was to estimate GH action on craniofacial development and extremity growth in GH-deficient patients. METHODS: Twenty patients with GH deficiency with a chronological age ranging from 4.6 to 24.3 years (bone age from 1.5 to 13 years) were divided in 2 groups: group 1 (n = 6), naive to GH treatment, and group 2 (n = 14), ongoing GH treatment for 2-11 years. GH doses (0.1-0.15 U/kg/day) were adjusted to maintain insulin-like growth factor 1 and insulin-like growth factor binding protein 3 levels within the normal range. Anthropometric measurements, cephalometric analyses and facial photographs to verify profile and harmony were performed annually for at least 3 years. RESULTS: Two patients with a disharmonious profile due to mandibular growth attained harmony, and none of them developed facial disharmony. Increased hand or foot size (>P97) was observed in 2 female patients and in 4 patients (1 female), respectively, both not correlated with GH treatment duration and increased levels of insulin-like growth factor 1. CONCLUSIONS: GH treatment with standard doses in GH-deficient patients can improve the facial profile in retrognathic patients and does not lead to facial disharmony although extremity growth, mainly involving the feet, can occur.
Assuntos
Extremidades/crescimento & desenvolvimento , Transtornos do Crescimento/tratamento farmacológico , Hormônio do Crescimento Humano/deficiência , Hormônio do Crescimento Humano/uso terapêutico , Crânio/crescimento & desenvolvimento , Adolescente , Adulto , Cefalometria , Criança , Pré-Escolar , Face/anatomia & histologia , Feminino , Pé/crescimento & desenvolvimento , Mãos/crescimento & desenvolvimento , Humanos , Masculino , Desenvolvimento Maxilofacial/efeitos dos fármacos , Desenvolvimento Maxilofacial/fisiologia , Modelos Biológicos , Adulto JovemAssuntos
Hormônio do Crescimento/uso terapêutico , Desenvolvimento Maxilofacial/efeitos dos fármacos , Criança , Estudos Transversais , Relação Dose-Resposta a Droga , Feminino , Pé/crescimento & desenvolvimento , Hormônio do Crescimento/administração & dosagem , Hormônio do Crescimento/deficiência , Mãos/crescimento & desenvolvimento , Humanos , Masculino , Fatores Sexuais , Crânio/anatomia & histologia , Crânio/crescimento & desenvolvimento , Fatores de TempoRESUMO
Recent experimental work has suggested that increased lip pressure and scar contraction following lip repair with wide soft-tissue undermining may, in part, contribute to midfacial growth inhibition. The present study was designed to test this hypothesis through the application of pharmacologic agents reported to minimize scar contraction. Thirty-six 6-week-old rabbits were divided into six groups: unoperated controls, rabbits with surgically created defects left unrepaired (surgical controls), and four groups of rabbits with surgically created defects with lip repair and wide undermining on the maxillary surface. Animals with lip repair received either no injections or labial subcutaneous injections of distilled water (route-of-injection controls), normal saline, or papaverine hydrochloride for 2 weeks postoperatively. Rabbits with lip repair and saline or papaverine injections showed significantly (p less than 0.05) decreased lip pressure, relatively hypotonic orbicularis oris muscle EMG activity on the cleft lip side, and greater anteroposterior facial growth (assessed radiologically) from 2 to 24 weeks postoperatively compared with rabbits with lip repair and postoperatively compared with rabbits with lip repair and no injections or distilled water injections. Preliminary results suggest that wound contraction following lip repair and soft-tissue undermining may contribute to mid-facial growth inhibition, which may be reduced by pharmacologic manipulations in the rabbit model.
Assuntos
Fenda Labial/cirurgia , Contratura/prevenção & controle , Desenvolvimento Maxilofacial/efeitos dos fármacos , Papaverina/farmacologia , Cicatrização/efeitos dos fármacos , Análise de Variância , Animais , Fenda Labial/fisiopatologia , Modelos Animais de Doenças , Eletromiografia/efeitos dos fármacos , Músculos Faciais/efeitos dos fármacos , Feminino , Masculino , Pressão , Coelhos , Cloreto de Sódio/farmacologia , Fatores de TempoRESUMO
The body weights evolution and the development of mandible were analyzed in rats that received 0.25 mg F contained into a commercial product, during 30 and 60 days consecutively, beginning at birth. The study presented the following conclusions: 1. The treated animals showed body weights always inferior to the controls, with more evident difference at 60 days period; 2. Analysis showed a reduction in the horizontal linear measurements, but not in the length of the mandibular diastem. No influence was observed in relation to the verticals.