tailieunhanh - Charles H. Hood Foundation Child Health Research Awards Program

The central government has almost exclusive power to formulate strategic direction and to issue and enforce regulations. It exercises strict control over revenue collection, as well as in determining the benefits package, setting uniform requirements for provider reports, setting budgets, allocating financial resources, and engaging in contracting and payment. Local governments own most hospitals and other health care facilities and are responsible for the capital cost of health services and for ensuring the provision of care. Private entrepreneurs and businesses play a central role in primary and pharmaceutical care and an increasing one in specialist care. The use of private. | Charles H. Hood Foundation Child Health Research Awards Program lanuary 2013 Award Recipients Yee-Ming Chan . . Postdoctoral Research Fellow Boston Children s Hospital Kisspeptin as a Novel Tool for the Evaluation of Delayed Puberty Key Words Delayed Puberty Adolescence Reproductive Hormones The evaluation of the adolescent with delayed puberty is a vexing diagnostic challenge for pediatricians and pediatric endocrinologists. Delayed puberty is most often due to constitutional delay of puberty CDP a self-limited condition in which puberty starts late but then proceeds normally. In contrast some adolescents with delayed puberty have isolated GnRH deficiency IGD a permanent disorder caused by the inability to produce or respond to the master reproductive hormone GnRH gonadotropinreleasing hormone . Currently the two conditions can only be distinguished retrospectively by waiting to see if an adolescent eventually enters puberty spontaneously. The lack of a prospective method to diagnose IGD or CDP delays the definitive treatment of IGD thereby prolonging psychosocial distress and increasing the risk of osteoporosis due to sex-hormone deficiency. Conversely the specter of the diagnosis of IGD contributes to the anxiety of adolescents with CDP who until they finally enter puberty spontaneously are left to wonder whether they have a permanent medical condition. The hormone kisspeptin was recently found to be a direct and specific stimulus for the secretion of GnRH. Over the past 2 years the PI of this proposal has administered kisspeptin to healthy men healthy women and adult patients with IGD as the first-available in vivo probe of GnRH neuronal function. This proposal extends these human studies to pediatric populations to explore the first clinical application of kisspeptin distinguishing IGD from CDP. Through an FDA-and IRB-approved protocol this study will administer kisspeptin to adolescents with delayed puberty to kisspeptin. The responses of adolescents .