Takeo Kuribayashi

Systemic effects of transdermal testosterone for the treatment of microphallus in children

Abstract Objectives : To elucidate the metabolic effects of topical testosterone for the treatment of microphallus in children.

Precocious Puberty Resulting from Congenital Hypothalamic Hamartoma: Persistent Darkened Areolae After Birth as the Hallmark of Estrogen Excess

C entral precocious puberty due to congenital hypothalamic hamartoma may cause isosexual precocity from early infancy. Failure to recognize the physical findings occasionally delays the diagnosis of the disease until the patient is more than 1 to 2 years old.14 This delay may reduce the patients potential for adult height because of remarkably advanced skeletal age that is induced by the bone-maturing action of estrogen.5-7 To emphasize the importance of early diagnosis of this disease, we present a patient in whom persistent darkened areolae from birth, a hallmark of estrogen excess, was overlooked.

Discrepancies between Physician and Parent Perceptions of Psychosocial Problems of GHD Children Undergoing GH Therapy in Japan

This study examined discrepancies between the perceptions of physicians treating short children with GH deficiency (GHD) using GH replacement therapy (GHRT) and the perceptions of the parents of these children and identified the major causes of parental anxiety. Three attending pediatric endocrinologists and the parents of 31 GHD children participated in this study. The physicians and parents completed a specially designed questionnaire to rate the types and degrees of psychosocial problems that GHD children might experience. For 6 of the first 11 questions, the physicians rated psychological problems differently than the parents did, tending to over- or underestimate parental concerns. This discrepancy did not disappear with treatment. However, the difference in the perception of anxiety between the physicians and parents changed for issues regularly discussed between them. Physicians and nurses were ranked as the most reliable providers of information. The parents of children who had previously undergone GHRT were a highly desired source of information. Psychosocial problems remain largely unaddressed by endocrinologists. Endocrinologists treating short stature are encouraged to be more involved in understanding parents’ anxieties, evaluation of misperceptions concerning parents’ expectations, and addressing these issues in future communication with parents. Support by experienced psychologists may help endocrinologists with this issue.