AS MUDANÇAS QUE OCORREM NO ORGANISMO FEMININO NA PUBERDADE: o primeiro sinal de puberdade no sexo feminino, conforme observado por estudos longitudinais, é um aumento da velocidade de crescimento que marca o início do estirão de crescimento puberal. Entretanto, como cada ser humano é único, não existe um padrão rigoroso de estatura longitudinal ou linear que este estirão eventualmente pode alcançar, em outras palavras, pode ser um crescimento inferior ou até não ocorrer o tão esperado estirão que é dependente dos fatores individuais. Normalmente as meninas não são examinadas com uma frequência suficiente para demonstrar esta mudança na prática clínica, de modo que o desenvolvimento mamário é o primeiro sinal observado pela maioria dos examinadores. O desenvolvimento mamário é estimulado principalmente pela secreção de estrogênio ovariano, apesar de outros hormônios também poderem interferir nessa função. O tamanho e o formato das mamas podem ser determinados por fatores genéticos e nutricionais, mas as características dos estágios são similares em todas as mulheres.
%2BMUDAN%C3%87AS%2BFEMININAS.jpg)
Existem padrões para as alterações do diâmetro da aréola (mamilo) durante a puberdade; o diâmetro do mamilo sofre poucas alterações do estágio B1 para o B3 (média de 3 a 4 mm), porém aumenta substancialmente nos estágios subsequentes (média de 7,4 mm no estágio B4 até 10 mm no estágio B5), presumivelmente como resultante do aumento da secreção de estrogênio no momento da menarca. As aréolas tornam-se mais pigmentadas e eréteis à medida que progride o desenvolvimento.
MUDANÇAS QUE OCORREM NA PUBERDADE NO ORGANISMO DO MENINO E O ESTIRÃO DE CRESCIMENTO: com o aumento acentuado da velocidade de crescimento na puberdade (estirão de crescimento puberal) encontra-se sob um controle rígido endocrinológico complexo onde envolve diversos hormônios como é o caso do hormônio tireoidiano, hormônio de crescimento-GH, incluindo o estrógeno. O hipotireoidismo reduz ou simplesmente elimina o estirão de crescimento. A amplitude da secreção de GH aumenta durante a puberdade, assim como a produção do fator de crescimento insulina símile (IGF-1); picos de concentrações séricas de IGF-1 são alcançados aproximadamente após um ano do pico de velocidade de crescimento, e os níveis séricos de IGF-1. O GH e o estrogênio são significativamente importantes no estirão de crescimento puberal, quando existe deficiência de um deles ou de ambos, não tenha dúvidas, o estirão é diminuído ou ausente e este é um dos motivos frequentes em que profissionais e pais ao aguardarem um possível estirão que possa ocorrer mas infelizmente não ocorre, lamentavelmente desencadeando a baixa estatura definitiva que é levada para a vida adulta, por não terem efetuado um exame propedêutico por profissional na época adequada enquanto as epífises ósseas ainda estavam abertas e eventualmente poderiam ganhar alguns preciosos cm com segurança.
GROW UP AND SHUT EPIPHYSES: ENDOGENOUS AND EXOGENOUS FACTORS CAN CHANGE THE AGE OF THE PUBERTAL BEGINNING: IN CHILD AND YOUTH.
WHILE THE OBESITY CAN ANTICIPATE THE ONSET OF PUBERTY WHAT IS A BIG PROBLEM, CHRONIC DISEASES AND MALNUTRITION OFTEN DELAY YOUR PUBERTY :
PHYSIOLOGY-ENDOCRINOLOGY-NEUROENDOCRINOLOGY-GENETICS-ENDOCRINE-PEDIATRICS (SUBDIVISION OF ENDOCRINOLOGY): DR. JOÃO SANTOS CAIO JR. ET DRA. HENRIQUETA VERLANGIERI CAIO.
There is a significant correlation of age at menarche between mothers and daughters and between different ethnic groups, indicating the influence of genetic factors. Recent studies of the genetic loci associated with age of onset of puberty observed the existence of several genes that are probably involved at menarche and puberty. The physical changes associated with puberty descriptive standards proposed by Tanner for the assessment of pubertal development in males and females and are widely used (called stages of sexual maturation or frequently “Tanner stages”). They consider specific details of the examination and allow to objectively recording the subtle progression of secondary sexual development that could be neglected. The self-assessment of pubertal development by individuals using photo reference is used in clinical trials, but the reliability is lower than that achieved by physical examination. The female changes of puberty: the first sign of puberty in females, as observed by longitudinal studies is an increase in growth velocity that marks the beginning of the pubertal growth spurt. However, as each human being is unique, there is no strict standard linear or longitudinal height that it can spurt eventually reach, in other words, the growth can be lower or even not dependent on individual factors occur. Normally girls are not examined with sufficient to demonstrate this change in clinical practice so often that breast development is the first sign noticed by most observers. Mammary development is driven primarily by the secretion of ovarian estrogen, although other hormones may also play a role. The size and shape of the breasts may be determined by genetic and nutritional factors, but the characteristics of the stages are similar in all women.
There are patterns to the changes in the diameter of the areola (nipple) during puberty, the diameter of the nipple suffers little change of stage B1 to B3 (average of 3 to 4 mm), but substantially increases in subsequent stages (average of 7.4 mm to 10 mm stage B4 in stage B5), presumably as a result of increased secretion of estrogens at the time of menarche. The areola becomes more pigmented erectile as development progresses. THE BOY AND THE GROWTH SPURT with the sharp increase in growth velocity in puberty (pubertal growth spurt) is under tight control complex which involves several endocrine hormones such as thyroid hormone, GH, including estrogen. Hypothyroidism reduces or simply eliminates the growth spurt. The amplitude of GH secretion - GH increases during puberty as well as the production of insulin-like growth factor-1 (IGF-1) factor; peak serum concentrations of IGF-1 are reached approximately one year after the peak of growth rate and serum levels of IGF-1. GH and estrogen are significantly important in the pubertal growth spurt; when there is GHD and estrogen deficiency or both of them, do not doubt, the growth spurt is reduced or absent, this is one of the common reasons that professionals and parents to await a possible spurt that may not occur, and trigger a pitifully low final height in adulthood, because they have not become a clinical examination performed by a professional at the appropriate time while the bony epiphyses were still open and could eventually earn a few precious inches safely.
GROW UP AND SHUT EPIPHYSES: ENDOGENOUS AND EXOGENOUS FACTORS CAN CHANGE THE AGE OF THE PUBERTAL BEGINNING: IN CHILD AND YOUTH.
WHILE THE OBESITY CAN ANTICIPATE THE ONSET OF PUBERTY WHAT IS A BIG PROBLEM, CHRONIC DISEASES AND MALNUTRITION OFTEN DELAY YOUR PUBERTY :
There is a significant correlation of age at menarche between mothers and daughters and between different ethnic groups, indicating the influence of genetic factors. Recent studies of the genetic loci associated with age of onset of puberty observed the existence of several genes that are probably involved at menarche and puberty. The physical changes associated with puberty descriptive standards proposed by Tanner for the assessment of pubertal development in males and females and are widely used (called stages of sexual maturation or frequently “Tanner stages”). They consider specific details of the examination and allow to objectively recording the subtle progression of secondary sexual development that could be neglected. The self-assessment of pubertal development by individuals using photo reference is used in clinical trials, but the reliability is lower than that achieved by physical examination. The female changes of puberty: the first sign of puberty in females, as observed by longitudinal studies is an increase in growth velocity that marks the beginning of the pubertal growth spurt. However, as each human being is unique, there is no strict standard linear or longitudinal height that it can spurt eventually reach, in other words, the growth can be lower or even not dependent on individual factors occur. Normally girls are not examined with sufficient to demonstrate this change in clinical practice so often that breast development is the first sign noticed by most observers. Mammary development is driven primarily by the secretion of ovarian estrogen, although other hormones may also play a role. The size and shape of the breasts may be determined by genetic and nutritional factors, but the characteristics of the stages are similar in all women.
Dr. João Santos Caio Jr.
Endocrinologia – Neuroendocrinologista
CRM 20611
Dra. Henriqueta V. Caio
Endocrinologista – Medicina Interna
CRM 2890
1. Em muitos casos, os achados físicos são adequados no momento da avaliação a fim de permitir um diagnóstico, como no caso da doença celíaca e da enterite regional, em que a baixa estatura e a redução do crescimento podem preceder sinais óbvios de desnutrição e doença gastrointestinal...
http://hormoniocrescimentoadultos.blogspot.com
2. Em alguns casos, o crescimento longitudinal ou linear é apenas atrasado, podendo ser recuperado espontaneamente, já em outros, o crescimento pode ser aumentado por uma melhora da nutrição, como no caso de pacientes com doenças gastrointestinais, doenças renais e outras doenças crônicas que podem ser beneficiadas de nutrição parenteral noturna...
http://longevidadefutura.blogspot.com
3. A fibrose cística combina várias causas que atrasam o crescimento adequado longitudinal ou linear: a doença pulmonar impede a oxigenação adequada predispondo a infecções crônicas, à doença gastrointestinal que reduz a disponibilidade dos nutrientes e anormalidades no desenvolvimento do pâncreas endócrino ocasionando diabetes mellitus...
http://imcobesidade.blogspot.com
AUTORIZADO O USO DOS DIREITOS AUTORAIS COM CITAÇÃO
DOS AUTORES PROSPECTIVOS ET REFERÊNCIA BIBLIOGRÁFICA.
Referências Bibliográficas:
Caio Jr, João Santos, Dr.; Endocrinologista, Neuroendocrinologista, Caio,H. V., Dra. Endocrinologista, Medicina Interna – Van Der Häägen Brazil, São Paulo, Brasil; Gottsch ML, Cunningham MJ, Smith JT, et al. A role for kisspeptins in the regulation of gonadotropin secretion in the mouse. Endocrinology 2004;145(9):4073–7; Ojeda SR, Prevot V, Heger S, et al. Glia-to-neuron signaling and the neuroendocrine control of female puberty. Ann Med 2003;35(4):244–55; Biro FM, McMahon RP, Striegel-Moore R, et al. Impact of timing of pubertal maturation on growth in black and white female adolescents: the National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr 2001;138(5):636–4; Wang Y. Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls. Pediatrics 2002;110(5): 903–10; Gore AC. Environmental toxicant effects on neuroendocrine function. Endocrine 2001;14(2):235–46; young Puerto Rican girls with premature breast development. Environ Health Perspect 2000;108(9):895–900; Tiwary CM. Premature sexual development in children following the use of estrogen- or placenta-containing hair products. Clin Pediatr 1998; 37(12):733–9; Setchell KD, Zimmer-Nechemias L, Cai J, et al. Exposure of infants to phyto-oestrogens from soy-based infant formula. Lancet 1997; 350(9070):23–7; Greim HA. The endocrine and reproductive system: adverse effects of hormonally active substances? Pediatrics 2004;113(Suppl 4):1070–5; Kaplowitz P. Clinical characteristics of 104 children referred for evaluation of precocious puberty. J Clin Endocrinol Metab 2004;89(8):3644–50; Bridges NA, Christopher JA, Hindmarsh PC, et al. Sexual precocity: sex incidence and aetiology. Arch Dis Child 1994;70 (2):116–8.
www.vanderhaagenbrazil.com.br
www.clinicavanderhaagen.com.br
www.crescimentoinfoco.com
www.obesidadeinfoco.com.br
http://drcaiojr.site.med.br
http://dracaio.site.med.br
João Santos Caio Jr
http://google.com/+JoaoSantosCaioJr
Vídeo
http://youtu.be/woonaiFJQwY
Google Maps:
http://maps.google.com.br/maps/place?cid=5099901339000351730&q=Van+Der+Haagen+Brasil&hl=pt&sll=-23.578256,46.645653&sspn=0.005074,0.009645&ie =UTF8&ll=-23.575591,-46.650481&spn=0,0&t = h&z=17
Referências Bibliográficas:
Caio Jr, João Santos, Dr.; Endocrinologista, Neuroendocrinologista, Caio,H. V., Dra. Endocrinologista, Medicina Interna – Van Der Häägen Brazil, São Paulo, Brasil; Gottsch ML, Cunningham MJ, Smith JT, et al. A role for kisspeptins in the regulation of gonadotropin secretion in the mouse. Endocrinology 2004;145(9):4073–7; Ojeda SR, Prevot V, Heger S, et al. Glia-to-neuron signaling and the neuroendocrine control of female puberty. Ann Med 2003;35(4):244–55; Biro FM, McMahon RP, Striegel-Moore R, et al. Impact of timing of pubertal maturation on growth in black and white female adolescents: the National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr 2001;138(5):636–4; Wang Y. Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls. Pediatrics 2002;110(5): 903–10; Gore AC. Environmental toxicant effects on neuroendocrine function. Endocrine 2001;14(2):235–46; young Puerto Rican girls with premature breast development. Environ Health Perspect 2000;108(9):895–900; Tiwary CM. Premature sexual development in children following the use of estrogen- or placenta-containing hair products. Clin Pediatr 1998; 37(12):733–9; Setchell KD, Zimmer-Nechemias L, Cai J, et al. Exposure of infants to phyto-oestrogens from soy-based infant formula. Lancet 1997; 350(9070):23–7; Greim HA. The endocrine and reproductive system: adverse effects of hormonally active substances? Pediatrics 2004;113(Suppl 4):1070–5; Kaplowitz P. Clinical characteristics of 104 children referred for evaluation of precocious puberty. J Clin Endocrinol Metab 2004;89(8):3644–50; Bridges NA, Christopher JA, Hindmarsh PC, et al. Sexual precocity: sex incidence and aetiology. Arch Dis Child 1994;70 (2):116–8.
Contato:
Rua
Estela, 515 - Bloco D - 12º andar - Conj 121/122
Paraiso - São Paulo - SP - Cep 04011-002.
Site Van Der Häägen BrazilParaiso - São Paulo - SP - Cep 04011-002.
www.vanderhaagenbrazil.com.br
www.clinicavanderhaagen.com.br
www.crescimentoinfoco.com
www.obesidadeinfoco.com.br
http://drcaiojr.site.med.br
http://dracaio.site.med.br
João Santos Caio Jr
http://google.com/+JoaoSantosCaioJr
Vídeo
http://youtu.be/woonaiFJQwY
Google Maps:
http://maps.google.com.br/maps/place?cid=5099901339000351730&q=Van+Der+Haagen+Brasil&hl=pt&sll=-23.578256,46.645653&sspn=0.005074,0.009645&ie =UTF8&ll=-23.575591,-46.650481&spn=0,0&t = h&z=17
