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    Epidemiology of Post-Traumatic Brain Injury-Induced Hypothalamic Pituitary Dysfunction in Arizona AHCCCS Patients

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    Author
    Sukhina, Alona
    Affiliation
    The University of Arizona College of Medicine - Phoenix
    Issue Date
    2018-04-09
    Keywords
    traumatic brain injuries
    children
    Adolescents
    Teenagers
    Female Adolescent
    Male Adolescent
    Endocrine Diseases
    growth hormone deficiency
    Pituitary Insufficiency
    endocrine dysfunction
    MeSH Subjects
    Hypopituitarism
    Brain Injuries, Traumatic
    Child
    Child, Preschool
    Adolescent
    Endocrine System Diseases
    Epidemiology
    Mentor
    Lifshitz, Jonathan
    
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    Rights
    Copyright © is held by the author. Digital access to this material is made possible by the College of Medicine - Phoenix, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
    Collection Information
    This item is part of the College of Medicine - Phoenix Scholarly Projects 2018 collection. For more information, contact the Phoenix Biomedical Campus Library at pbc-library@email.arizona.edu.
    Publisher
    The University of Arizona.
    Abstract
    Introduction: Traumatic brain injury (TBI) in children can result in cognitive, emotional and somatic neurological impairments. In adults, post-traumatic hypopituitarism can extend or exacerbate these impairments, likely due to mechanical damage to the pituitary and hypothalamus. The pituitary in the pediatric brain likely suffers similar mechanical damage, inducing endocrinopathies as in adults, but injury-induced endocrinopathies are infrequently reported in children. Unrecognized hypopituitarism may lead to elevated risks of metabolic syndrome, diabetes, delayed or absent puberty, short stature, and other endocrinopathies. However, screening for endocrine deficiencies in susceptible patients and initiating appropriate hormone replacement therapy may prevent these sequelae and improve the prospects for recovery. Results: We determined that TBI victims were 3.18-times higher risk of developing a central endocrinopathy compared with the general population (CI=0.264), pediatric AHCCCS patients with a central endocrinopathy had a 3.2-fold higher odds of a history with TBI than those without a central endocrinopathy (CI=0.266), of the central endocrinopathy in TBI victims is attributable to the TBI, and the number of patients who need to be exposed to a TBI for 1 patient to develop an endocrinopathy was 154.2 (CI=7.11). We also determined that more males than females presented with central endocrinopathies after TBI compared with the general population of TBI victims.
    Description
    A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
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