Testosterone priming increased growth hormone peak levels in the stimulation test and suppressed gonadotropin secretion in three Japanese adolescent boys

Antimicrobial Resistance in the Context of Animal Production and Meat Products in Poland-A Critical Review and Future Perspective

The prevalence of antimicrobial-resistant bacteria in meat and meat products is a significant public health challenge, largely driven by the excessive and inappropriate use of antimicrobials in animal husbandry. In Poland, a key meat producer in Europe, antibiotic-resistant pathogens such as Campylobacter spp., Staphylococcus spp., Enterococcus spp., Listeria monocytogenes, and Enterobacterales have been detected in meat, posing serious risks to consumers. This review examines the use of antimicrobial agents in meat production and the resulting antimicrobial resistance (AMR) in microorganisms isolated from meat products in Poland. The mechanisms of AMR, genetic factors, and prevalence in Poland are presented. It highlights key factors contributing to AMR, such as antibiotic misuse in livestock farming, and discusses the legal regulations governing veterinary drug residues in food. This review emphasizes the importance of monitoring and enforcement to safeguard public health and calls for further research on AMR in the meat industry. Antimicrobial resistance in meat and meat products in Poland is a huge challenge, requiring stricter antibiotic controls in animal husbandry and improved surveillance systems. Additionally, the impact of husbandry practices on the environment and food requires further research. Future efforts should focus on nationwide monitoring, alternative strategies to reduce antibiotic use, and stronger enforcement to combat antimicrobial resistance and protect public health.

Sex steroid priming for growth hormone stimulation testing in children and adolescents with short stature: A systematic review

OBJECTIVE

Growth hormone stimulation testing (GHST) is used to diagnose growth hormone deficiency (GHD) in children. As sex steroids impact on anterior pituitary function, there is concern around the efficacy of GHST in peripubertal children, where endogenous sex steroid levels are low. Sex steroid priming before GHST is thought to improve test efficacy in these children, however evidence to support its use in clinical practice is limited. In this systematic review, we addressed the following research questions: Does priming increase GH stimulation test efficacy in peripubertal children? Does priming identify those who would benefit most from treatment in terms of final height? Is there evidence for an optimal sex-steroid priming regimen?

DESIGN, PATIENTS, MEASUREMENTS

The study was registered with PROSPERO and conducted according to PRISMA guidelines. We searched Medline, Cochrane-Library, Scopus, EMBASE and Web-of-Science and included all studies that included GHST in both primed and unprimed children. A GH cut-off of 7 µg/L was used as a threshold for GHD. Study quality was assessed using the Risk-Of-Bias in Non- Randomized Studies (ROBINS-I) tool or the revised Cochrane risk-of-bias tool for Randomised trials.

RESULTS

Fifteen studies met our inclusion criteria, of which 4/15 (27%) were randomised control trials. The majority (9/15) of the studies indicated that priming increases growth hormone response upon GHST in peripubertal children, increasing test specificity. Two studies investigated final height after treatment based on the results of primed versus unprimed GHST. These results indicate that growth hormone treatment based on results of a primed GHST improve outcomes compared with treatment based on an unprimed test.

CONCLUSION

Sex-steroid priming increases the growth hormone response during GHST, resulting in fewer patients meeting the threshold required for a diagnosis of GHD. Unnecessary GH treatment may be avoided in some patients without a detrimental effect on final height. Numerous sex-steroid priming regimens have been used in clinical practice and the majority appear to be effective, but an optimal regimen has not been determined.

Growth Hormone Stimulation Testing: To Test or Not to Test? That Is One of the Questions

The evaluation of children with short stature includes monitoring over a prolonged period to establish a growth pattern as well as the exclusion of chronic medical conditions that affect growth. After a period of monitoring, evaluation, and screening, growth hormone stimulation testing is considered when the diagnosis of growth hormone deficiency (GHD) is entertained. Though flawed, growth hormone stimulation tests remain part of the comprehensive evaluation of growth and are essential for the diagnosis of growth hormone (GH) deficiency. Variables including testing length, growth hormone assay and diagnostic cut off affect results. Beyond the intrinsic issues of testing, results of GH stimulation testing can be influenced by patient characteristics. Various factors including age, gender, puberty, nutritional status and body weight modulate the secretion of GH.