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Book: Deciphering growth

Carel, Jean-Claude

with 14 tables

(Research and perspectives in endocrine interactions)

2005

Author's details	Meeting, entitled Deciphering Growth (Paris, December 6, 2004). J.-C. Carel ... (eds.)
Series title	Research and perspectives in endocrine interactions
Keywords	Growth Substances / physiology ; Growth / physiology ; Body Size / physiology ; Wachstum ; Wachstumsfaktor ; Somatotropin
Subject	Somatropin ; Genotropin ; CAS 12629-01-5 ; HGH ; Somatotropes Hormon ; STH ; Wachstumshormon ; Menschliches Wachstumshormon ; Growth Hormone ; GH
Language	English
Size	XIII, 155 S. : Ill., graph. Darst.
Publisher	Springer
Publishing place	Berlin u.a.
Publishing country	Germany
Document type	Book
HBZ-ID	HT014811644
ISBN	3-540-26192-3 ; 978-3-540-26192-6
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Article ; Online: Fetal and Neonatal Thyroid Dysfunction.

Léger, Juliane / Delcour, Clemence / Carel, Jean-Claude

The Journal of clinical endocrinology and metabolism

2021 Volume 107, Issue 3, Page(s) 836–846

Abstract: Fetal and neonatal dysfunctions include rare serious disorders involving abnormal thyroid function during the second half of gestation, which may persist throughout life, as for most congenital thyroid disorders, or be transient, resolving in the first ... ...

Abstract	Fetal and neonatal dysfunctions include rare serious disorders involving abnormal thyroid function during the second half of gestation, which may persist throughout life, as for most congenital thyroid disorders, or be transient, resolving in the first few weeks of life, as in autoimmune hyperthyroidism or hypothyroidism and some cases of congenital hypothyroidism (CH) with the thyroid gland in situ. Primary CH is diagnosed by neonatal screening, which has been implemented for 40 years in developed countries and should be introduced worldwide, as early treatment prevents irreversible neurodevelopmental delay. Central CH is a rarer entity occurring mostly in association with multiple pituitary hormone deficiencies. Other rare disorders impair the action of thyroid hormones. Neonatal Graves' disease (GD) results from the passage of thyrotropin receptor antibodies (TRAbs) across the placenta, from mother to fetus. It may affect the fetuses and neonates of mothers with a history of current or past GD, but hyperthyroidism develops only in those with high levels of stimulatory TRAb activity. The presence of antibodies predominantly blocking thyroid-stimulating hormone receptors may result in transient hypothyroidism, possibly followed by neonatal hyperthyroidism, depending on the balance between the antibodies present. Antithyroid drugs taken by the mother cross the placenta, treating potential fetal hyperthyroidism, but they may also cause transient fetal and neonatal hypothyroidism. Early diagnosis and treatment are key to optimizing the child's prognosis. This review focuses on the diagnosis and management of these patients during the fetal and neonatal periods. It includes the description of a case of fetal and neonatal autoimmune hyperthyroidism.
MeSH term(s)	Adult ; Autoantibodies/blood ; Autoantibodies/immunology ; Female ; Fetal Diseases/diagnosis ; Fetal Diseases/immunology ; Fetal Diseases/physiopathology ; Humans ; Infant, Newborn ; Neonatal Screening ; Thyroid Diseases/diagnosis ; Thyroid Diseases/immunology ; Thyroid Diseases/physiopathology ; Thyroid Gland/immunology ; Thyroid Gland/physiopathology ; Thyrotropin/immunology
Chemical Substances	Autoantibodies ; Thyrotropin (9002-71-5)
Language	English
Publishing date	2021-10-12
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgab747
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Article ; Online: Response to Letter to the Editor from De Zegher and Ibanes: On the rising incidence of early breast development.

Léger, Juliane / Delcour, Clemence / de Roux, Nicolas / Carel, Jean-Claude

European journal of endocrinology

2021 Volume 185, Issue 1, Page(s) L3–L4

MeSH term(s)	Adiposity ; Breast ; Female ; Humans ; Incidence ; Obesity ; Puberty
Language	English
Publishing date	2021-05-28
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	1183856-5
ISSN	1479-683X ; 0804-4643
ISSN (online)	1479-683X
ISSN	0804-4643
DOI	10.1530/EJE-21-0445
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Article ; Online: Social inequalities in access to care at birth and neonatal mortality: an observational study.

Michel, Morgane / Alberti, Corinne / Carel, Jean-Claude / Chevreul, Karine

Archives of disease in childhood. Fetal and neonatal edition

2021 Volume 107, Issue 4, Page(s) 380–385

Abstract: Objective: To look at the association of socioeconomic status (SES) with the suitability of the maternity where children are born and its association with mortality.: Design: Retrospective analysis of a prospective cohort constituted using hospital ... ...

Abstract	Objective: To look at the association of socioeconomic status (SES) with the suitability of the maternity where children are born and its association with mortality. Design: Retrospective analysis of a prospective cohort constituted using hospital discharge databases. Setting: France POPULATION: Live births in 2012-2014 in maternity hospitals in mainland France followed until discharge from the hospital. Main outcome measure: Unsuitability of the maternity to newborns' needs based on birth weight and gestational age, early transfers (within 24 hours of birth) and in-hospital mortality. Results: 2 149 454 births were included, among which 155 646 (7.2%) were preterm. Preterm newborns with low SES were less frequently born in level III maternities than those with high SES. They had higher odds of being born in an unsuitable maternity (OR=1.174, 95% CI 1.114 to 1.238 in the lowest SES quintile compared with the highest), and no increase in the odds of an early transfer (OR=0.966, 95% CI 0.849 to 1.099 in the lowest SES quintile compared with the highest). Overall, newborns from the lowest SES quintile had a 40% increase in their odds of dying compared with the highest (OR=1.399, 95% CI 1.235 to 1.584). Conclusions: Newborns with the lowest SES were less likely to be born in level III maternity hospitals compared with those with the highest SES, despite having higher prematurity rates. This was associated with a significantly higher mortality in newborns with the lowest SES. Strategies must be developed to increase health equity among mothers and newborns.
MeSH term(s)	Child ; Female ; Health Services Accessibility ; Humans ; Infant Mortality ; Infant, Newborn ; Pregnancy ; Prospective Studies ; Retrospective Studies ; Socioeconomic Factors
Language	English
Publishing date	2021-10-16
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	2007331-8
ISSN	1468-2052 ; 1359-2998
ISSN (online)	1468-2052
ISSN	1359-2998
DOI	10.1136/archdischild-2021-321967
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Article ; Online: MANAGEMENT OF ENDOCRINE DISEASE: Arguments for the prolonged use of antithyroid drugs in children with Graves' disease.

Léger, Juliane / Carel, Jean-Claude

European journal of endocrinology

2017 Volume 177, Issue 2, Page(s) R59–R67

Abstract: Graves' disease is an autoimmune disorder. It is the leading cause of hyperthyroidism, but is rare in children. Patients are initially managed with antithyroid drugs (ATDs), such as methimazole/carbimazole. A major disadvantage of treatment with ATD is ... ...

Abstract	Graves' disease is an autoimmune disorder. It is the leading cause of hyperthyroidism, but is rare in children. Patients are initially managed with antithyroid drugs (ATDs), such as methimazole/carbimazole. A major disadvantage of treatment with ATD is the high risk of relapse, exceeding 70% of children treated for duration of 2 years, and the potential major side effects of the drug reported in exceptional cases. The major advantage of ATD treatment is that normal homeostasis of the hypothalamus-pituitary-thyroid axis may be restored, with periods of drug treatment followed by freedom from medical intervention achieved in approximately 40-50% of cases after prolonged treatment with ATD, for several years, in recent studies. Alternative ablative treatments such as radioactive iodine and, less frequently and mostly in cases of very high volume goiters or in children under the age of 5 years, thyroidectomy, performed by pediatric surgeons with extensive experience should be proposed in cases of non-compliance, intolerance to medical treatment or relapse after prolonged medical treatment. Ablative treatments are effective against hyperthyroidism, but they require the subsequent administration of levothyroxine throughout the patient's life. This review considers data relating to the prognosis for Graves' disease remission in children and explores the limitations of study designs and results; and the emerging proposal for management through the prolonged use of ATD drugs.
MeSH term(s)	Antithyroid Agents/administration & dosage ; Child ; Disease Management ; Drug Administration Schedule ; Graves Disease/diagnosis ; Graves Disease/drug therapy ; Humans ; Recurrence ; Time Factors ; Treatment Outcome
Chemical Substances	Antithyroid Agents
Language	English
Publishing date	2017-04-05
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1183856-5
ISSN	1479-683X ; 0804-4643
ISSN (online)	1479-683X
ISSN	0804-4643
DOI	10.1530/EJE-16-0938
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Article: Les indications des traitements freinateurs de la puberté en pédiatrie.

Carel, Jean-Claude

Bulletin de l'Academie nationale de medecine

2012 Volume 196, Issue 2, Page(s) 345–355

Abstract: Precocious pubertal development is frequent and requires rigorous investigations to avoid unnecessary treatment. Central precocious puberty is by far the most frequent form and raises the issue of GnRH agonist therapy. It is essential first to determine ... ...

Title translation	Indications of GnRH agonist therapy during childhood.
Abstract	Precocious pubertal development is frequent and requires rigorous investigations to avoid unnecessary treatment. Central precocious puberty is by far the most frequent form and raises the issue of GnRH agonist therapy. It is essential first to determine if pubertal development is truly precocious, as there is currently a downwards trend in the average age of normal onset. The mechanism needs to be identified In particular, increased gonadotropin secretion must be documented in central precocious puberty. It is also essential to recognize non progressive forms of precocious puberty, which have an excellent prognosis and should not be treated. Long-acting GnRH agonists are indicated for proven central precocious puberty. Their use and long-term results are discussed.
MeSH term(s)	Child ; Female ; Gonadotropin-Releasing Hormone/agonists ; Humans ; Male ; Puberty, Precocious/diagnosis ; Puberty, Precocious/drug therapy ; Puberty, Precocious/psychology
Chemical Substances	Gonadotropin-Releasing Hormone (33515-09-2)
Language	French
Publishing date	2012-02
Publishing country	Netherlands
Document type	English Abstract ; Journal Article
ZDB-ID	213227-8
ISSN	0001-4079
ISSN	0001-4079
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Article ; Online: Diagnosis and management of congenital hypopituitarism in children.

Castets, Sarah / Thomas-Teinturier, Cécile / Villanueva, Carine / Amsellem, Jessica / Barat, Pascal / Brun, Gilles / Quoc, Emmanuel Bui / Carel, Jean-Claude / De Filippo, Gian Paolo / Kipnis, Clara / Martinerie, Laetitia / Vergier, Julia / Saveanu, Alexandru / Teissier, Natacha / Coutant, Régis / Léger, Juliane / Reynaud, Rachel

Archives de pediatrie : organe officiel de la Societe francaise de pediatrie

2024 Volume 31, Issue 3, Page(s) 165–171

Abstract: Hypopituitarism (or pituitary deficiency) is a rare disease with an estimated prevalence of between 1/16,000 and 1/26,000 individuals, defined by insufficient production of one or several anterior pituitary hormones (growth hormone [GH], thyroid- ... ...

Abstract	Hypopituitarism (or pituitary deficiency) is a rare disease with an estimated prevalence of between 1/16,000 and 1/26,000 individuals, defined by insufficient production of one or several anterior pituitary hormones (growth hormone [GH], thyroid-stimulating hormone [TSH], adrenocorticotropic hormone [ACTH], luteinizing hormone [LH], follicle-stimulating hormone [FSH], prolactin), in association or not with diabetes insipidus (antidiuretic hormone [ADH] deficiency). While in adults hypopituitarism is mostly an acquired disease (tumors, irradiation), in children it is most often a congenital condition, due to abnormal pituitary development. Clinical symptoms vary considerably from isolated to combined deficiencies and between syndromic and non-syndromic forms. Early signs are non-specific but should not be overlooked. Diagnosis is based on a combination of clinical, laboratory (testing of all hormonal axes), imaging (brain magnetic resonance imaging [MRI] with thin slices centered on the hypothalamic-pituitary region), and genetic (next-generation sequencing of genes involved in pituitary development, array-based comparative genomic hybridization, and/or genomic analysis) findings. Early brain MRI is crucial in neonates or in cases of severe hormone deficiency for differential diagnosis and to inform syndrome workup. This article presents recommendations for hormone replacement therapy for each of the respective deficient axes. Lifelong follow-up with an endocrinologist is required, including in adulthood, with multidisciplinary management for patients with syndromic forms or comorbidities. Treatment objectives include alleviating symptoms, preventing comorbidities and acute complications, and optimal social and educational integration.
MeSH term(s)	Adult ; Child ; Infant, Newborn ; Humans ; Comparative Genomic Hybridization ; Hypopituitarism/diagnosis ; Hypopituitarism/etiology ; Hypopituitarism/therapy ; Pituitary Gland/pathology ; Human Growth Hormone ; Adrenocorticotropic Hormone
Chemical Substances	Human Growth Hormone (12629-01-5) ; Adrenocorticotropic Hormone (9002-60-2)
Language	English
Publishing date	2024-03-27
Publishing country	France
Document type	Practice Guideline
ZDB-ID	1181947-9
ISSN	1769-664X ; 0929-693X
ISSN (online)	1769-664X
ISSN	0929-693X
DOI	10.1016/j.arcped.2024.01.003
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Article ; Online: Central Precocious Puberty - Management and Long-term Outcomes.

Léger, Juliane / Carel, Jean-Claude

European endocrinology

2015 Volume 11, Issue 1, Page(s) 45–46

Abstract: Central precocious puberty (CPP) results from premature re-activation of the gonadotropic axis. CPP is much more common in girls than in boys and is idiopathic in most cases. In boys, precocious puberty is more likely to be linked to hypothalamic lesions ...

Abstract	Central precocious puberty (CPP) results from premature re-activation of the gonadotropic axis. CPP is much more common in girls than in boys and is idiopathic in most cases. In boys, precocious puberty is more likely to be linked to hypothalamic lesions (≈40%). Recent studies have implicated the inactivation of
Language	English
Publishing date	2015-04-11
Publishing country	England
Document type	Editorial
ISSN	1758-3780
ISSN (online)	1758-3780
DOI	10.17925/EE.2015.11.01.45
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Article ; Online: Socioeconomic Status of Newborns and Hospital Efficiency: Implications for Hospital Payment Methods.

Michel, Morgane / Alberti, Corinne / Carel, Jean-Claude / Chevreul, Karine

Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research

2019 Volume 23, Issue 3, Page(s) 335–342

Abstract: Objectives: Studies have shown a consistent impact of socioeconomic status at birth for both mother and child; however, no study has looked at its impact on hospital efficiency and financial balance at birth, which could be major if newborns from ... ...

Abstract	Objectives: Studies have shown a consistent impact of socioeconomic status at birth for both mother and child; however, no study has looked at its impact on hospital efficiency and financial balance at birth, which could be major if newborns from disadvantaged families have an average length of stay (LOS) longer than other newborns. Our objective was therefore to study the association between socioeconomic status and hospital efficiency and financial balance in that population. Methods: A study was carried out using exhaustive national hospital discharge databases. All live births in a maternity hospital located in mainland France between 2012 and 2014 were included. Socioeconomic status was estimated with an ecological indicator and efficiency by variations in patient LOS compared with different mean national LOS. Financial balance was assessed at the admission level through the ratio of production costs and revenues and at the hospital level by the difference in aggregated revenues and production costs for said hospital. Multivariate regression models studied the association between those indicators and socioeconomic status. Results: A total of 2 149 454 births were included. LOS was shorter than the national means for less disadvantaged patients and longer for the more disadvantaged patients, which increased when adjusted for gestational age, birth weight, and severity. A 1% increase in disadvantaged patients in a hospital's case mix significantly increased the probability that the hospital would be in deficit by 2.6%. Conclusions: Reforms should be made to hospital payment methods to take into account patient socioeconomic status so as to improve resource allocation efficiency.
MeSH term(s)	Budgets ; Databases, Factual ; Female ; France ; Health Care Rationing/economics ; Health Services Needs and Demand/economics ; Hospital Charges ; Hospital Costs ; Hospitalization/economics ; Hospitals, Maternity/economics ; Humans ; Infant, Newborn ; Length of Stay/economics ; Male ; Models, Economic ; Needs Assessment/economics ; Patient Admission/economics ; Patient Discharge/economics ; Pregnancy ; Pregnancy Complications/diagnosis ; Pregnancy Complications/economics ; Pregnancy Complications/therapy ; Retrospective Studies ; Social Class ; Time Factors
Language	English
Publishing date	2019-12-04
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1471745-1
ISSN	1524-4733 ; 1098-3015
ISSN (online)	1524-4733
ISSN	1098-3015
DOI	10.1016/j.jval.2019.10.008
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Article ; Online: Association of Pediatric Inpatient Socioeconomic Status With Hospital Efficiency and Financial Balance.

Michel, Morgane / Alberti, Corinne / Carel, Jean-Claude / Chevreul, Karine

JAMA network open

2019 Volume 2, Issue 10, Page(s) e1913656

Abstract: Importance: In health care systems in which hospital reimbursement is based on a national mean length of stay (LOS), disadvantaged patients with an increased LOS may be a source of inefficiency. This implication has been reported in adult patients, but ... ...

Abstract	Importance: In health care systems in which hospital reimbursement is based on a national mean length of stay (LOS), disadvantaged patients with an increased LOS may be a source of inefficiency. This implication has been reported in adult patients, but pediatric data have been scarce. Objective: To examine the association of patient socioeconomic status with hospital efficiency and financial balance in pediatrics. Design, setting, and participants: This cohort study obtained data from the French national hospital discharge database covering a 3-year period, from January 1, 2012, to December 31, 2014. Statistical analyses were performed between June 2016 and December 2018. All inpatient stays in hospital pediatric wards in mainland France by children older than 28 days or younger than 18 years (n = 4 121 187) were included. Admissions with coding errors or missing values for social disadvantage and/or cost calculations were excluded. Exposure: Social disadvantage was estimated with an ecological indicator, the FDep, available at the patient's postcode of residence and divided into national quintiles. Main outcomes and measures: Efficiency was assessed through the variations in patient LOS compared with different national mean LOS (for pediatric patients, pediatric patients with a similar condition, and pediatric patients with a similar condition and severity level). Hospital financial balance was assessed at the admission level through the ratio of production costs to revenues and at the hospital level through the difference between aggregated revenues and production costs. Multivariate regression models examined the association between these indicators and socioeconomic status. Results: A total of 4 121 187 admissions were included (2 336 540 [56.7%] male; mean [SD] age, 7.4 [5.8] years). In all, 1 561 219 patients (37.9%) were in the 2 most disadvantaged quintiles. Patient LOS was shorter than the national mean LOS (mean [SD], 1.73 [4.21] days) for patients in the least disadvantaged quintile and longer for those in the more disadvantaged quintile (mean [SD], 1.67 [4.33] days vs 1.82 [4.14] days). This difference was higher for diagnosis related groups that included both adult and pediatric patients (mean [SD], 1.46 [4.22] days vs 1.61 [4.13] days) compared with those dedicated to pediatric patients (2.22 [4.13] days vs 2.12 [4.53] days). Patients in the most disadvantaged quintile were associated with a 3.2% increase in LOS (odds ratio, 1.0322; 95% CI, 1.0302-1.0341) compared with the national mean LOS. Social disadvantage was also associated with a significant increase in financial deficit for hospitals with 20% to 60% of patients in the 2 most disadvantaged quintiles (estimate: -€146 389; 95% CI, -€279 566 to -€13 213). Conclusions and relevance: Patient socioeconomic status appears to be statistically significantly associated with an increase in LOS and cost in French hospitals with pediatric departments. This finding suggests that initiating reform in hospital payment methods may improve resource allocation efficiency and equity in access to pediatric care.
MeSH term(s)	Adolescent ; Child ; Child, Preschool ; Cohort Studies ; Diagnosis-Related Groups/economics ; Economics, Hospital/statistics & numerical data ; Efficiency, Organizational ; Female ; France ; Health Care Costs/statistics & numerical data ; Hospitals ; Humans ; Infant ; Inpatients ; Length of Stay/economics ; Length of Stay/statistics & numerical data ; Male ; Pediatrics ; Social Class ; Socioeconomic Factors
Language	English
Publishing date	2019-10-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2019.13656
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