Pregnant adolescents in chemical dependency treatment. Description and outcomes

This study examines the treatment, maternal and infant outcomes of pregnant adolescents (16-19 years) enrolled in an adult perinatal chemical dependency treatment program. Twenty-one adolescent subjects were compared to 323 adult women (mean age, 27.4 years) after enrollment into a randomized treatment trial consisting of intensive outpatient or short-term residential conditions. The results show a similar treatment retention rate. Adolescents differed from adult women on marital status, drugs of choice (alcohol, marijuana vs. opiates and cocaine) and method of administration, with no injection drug users in the adolescent cohort. Tobacco use was high (> 85%) in both groups. Obstetric, maternal, and infant outcomes to 1 year were comparable. Older adolescents who are chemically dependent and pregnant have treatment needs similar to adult women and can benefit from programs designed to treat older women. Recruitment difficulties for adolescents in need of treatment is discussed.

Use of false ID cards and other deceptive methods to purchase alcoholic beverages during high school

Altered motor vehicle drivers's licenses or other falsified or counterfeit photo identification cards are widely and illegally used by teenagers to obtain beer and other alcohol beverages. We obtained information on the methods currently used by teenagers to purchase beer and wine by asking nine hundred teenagers, between 16-19 years old to complete a brief, confidential questionnaire. High school students most often obtained alcoholic beverages by requesting someone of legal age to purchase it for them. College students used borrowed, altered, or counterfeit identification (ID) more often than high school students. Photo IDs purchased through mail order from a magazine advertisement were used infrequently and when use was attempted, they were sometimes (25%) unsuccessful. Fifteen percent of high school students, 14% of college freshmen, and 24% of teenage drug abusers were able to purchase beer by the case with borrowed, altered, or fake ID. Suggestions to reduce sales of alcohol-containing beverages to minors include universal "carding" of prospective purchasers, use of two view or hologram photos on a drivers' license, requiring three different ID cards at the point of purchase, and penalties to stores that fail to make a good effort to identify underage customers.

Incarcerated adolescents in Washington state. Health services and utilization

This study describes the health services for incarcerated adolescents in Washington State and their utilization, in 12 juvenile detention facilities statewide, including six state (long-term, postadjudication) and six county (short-term, preadjudication) facilities. Findings differed by facility type, with youth at county facilities having more total visits to emergency rooms and more health care visits per inmate for health problems presenting acutely, such as sexually transmitted disease, pregnancy, urologic problems, and trauma. More were on suicide watch and on psychiatric medication. Health care used by youth at state facilities tended to be for more chronic conditions such as dental, dermatologic, nutritional, and respiratory problems. When utilization was analyzed by size of facility, small facilities had fewer health care visits and fewer nursing hours per inmate. According to our findings, there are at least 14 pregnant adolescents and 2 HIV-infected adolescents incarcerated in this state at any time.

Phylogenetic analysis of the genus Corynebacterium based on 16S rRNA gene sequences

The 16S rRNA gene sequences of 30 strains representing 23 validated Corynebacterium species and 7 currently non-valid Corynebacterium species were determined. These sequences were aligned with the sequences of other Corynebacterium species and related actinomycete taxa. A comparative sequence analysis revealed that there is considerable phylogenetic depth and internal structure in the genus Corynebacterium. Turicella otitidis and the amycolate species Corynebacterium amycolatum were located at the periphery of the genus Corynebacterium. It was evident that the species of the genus Corynebacterium form a monophyletic association and, together with other chemotype IV and mycolic acid-containing taxa (including the genera Dietzia, Gordona, Mycobacterium, Nocardia, Rhodococcus, and Tsukamurella), form a natural suprageneric group.

Smoking patterns and cessation motivations during adolescence

With increased knowledge of effective prevention of adolescent smoking, there is a concomitant lack of research on effective adolescent smoking cessation. This study surveyed 77 adolescents (mean age 15.8 years) at a youth detention center in Seattle, Washington, about smoking patterns, cessation attempts, and motivations as well as withdrawal symptoms from nicotine. The results revealed that the majority of smokers had previously attempted smoking cessation (72%). The most common reasons for wanting to quit were for health concerns. Only 30.8% abstained for more than 1 month, and 35.9% abstained for less than 3 days. Nicotine craving was the most severe and most commonly reported withdrawal symptom.

Phylogenetic evidence that the gram-negative nonsporulating bacterium Tissierella (Bacteroides) praeacuta is a member of the Clostridium subphylum of the gram-positive bacteria and description of Tissierella creatinini sp. nov

The 16S rRNA gene sequence of the type strain of Tissierella praeacuta (formerly Bacteroides praeacutus) was determined by PCR direct sequencing. A comparative sequence analysis showed that T. praeacuta is a member of the Clostridium subphylum of the gram-positive bacteria and has a close phylogenetic affinity with the species that form Clostridium cluster XII (M. D. Collins, P. A. Lawson, A. Willems, J. J. Cordoba, J. Fernandez-Garayzabal, P. Garcia, J. Cai, H. Hippe, and J. A. E. Farrow, Int. J. Syst. Bacteriol. 44:812-826, 1994). Although T. praeacuta is gram negative and does not produce endospores, 16S rRNA sequence data showed that it is closely related genealogically (level of sequence similarity, 99.9%) to Clostridium hastiforme. On the basis of our results and the results of previous studies, a second species of Tissierella, Tissierella creatinini sp. nov., is described.

Pregnant teens in prison. Prevalence, management, and consequences

To estimate the number of pregnant and parenting teens currently incarcerated and to assess the correctional health care and social services provided to this target population, we surveyed 430 juvenile detention and long-term correctional facilities in the United States that incarcerate adolescent girls. Of these, 261 (61%) institutions responded and are included in the analysis. Of these facilities, 68% estimated that they were holding 1 to 5 pregnant adolescents on a given day, with a reported yearly (September 1991 to September 1992) census of 2,000 pregnant teenagers and 1,200 teenaged mothers. Nearly half of the facilities (45%) continue to incarcerate after it is determined that a youth is pregnant. Of those institutions that incarcerate pregnant adolescents, 31% provide no prenatal services and 70% provide no parenting classes. Of these facilities, 60% reported at least 1 obstetric complication in their pregnant population. A substantial number of pregnant and parenting adolescents are in custody in the United States. General community standards of health and social services for pregnant and parenting teenagers are not being met by the institutions that incarcerate them.

"Streptococcus milleri" strains displaying a gliding type of motility

Isolates belonging to the "Streptococcus milleri" species group that appear to exhibit a gliding type of motility, which is expressed as spreading growth on certain types of agar media, are described. These strains resembled a biotype of "S. milleri" that is usually isolated from genitourinary sources and is notable for its ability to ferment a wide array of carbohydrates. This biotype, which is currently included in the species Streptococcus anginosus, has been implicated in cases of neonatal infection. The "S. milleri" isolates which we studied lacked any observable organelles of motility and gave negative results when they were tested in conventional motility test medium stab cultures. Colonies growing on certain agar media, however, spread over the surfaces of plates and increased in area with increasing time of incubation. Chocolate agar supported maximum spreading, while this characteristic was barely discernible on blood agar. Electron microscopy studies revealed that there was more production of extracellular glycocalyx by motile strains than by a nonmotile isolate having a similar biotype. The results of an analysis of 16S rRNA gene sequences suggested that the motile strains are closely related to S. anginosus and represent a distinct rRNA population within the "S. milleri" species complex.

The phylogeny of the genus Clostridium: proposal of five new genera and eleven new species combinations

The 16S rRNA gene sequences of 34 named and unnamed clostridial strains were determined by PCR direct sequencing and were compared with more than 80 previously determined clostridial sequences and the previously published sequences of representative species of other low- G + C-content gram-positive genera, thereby providing an almost complete picture of the genealogical interrelationships of the clostridia. The results of our phylogenetic analysis corroborate and extend previous findings in showing that the genus Clostridium is extremely heterogeneous, with many species phylogenetically intermixed with other spore-forming and non-spore-forming genera. The genus Clostridium is clearly in need of major revision, and the rRNA structures defined in this and previous studies may provide a sound basis for future taxonomic restructuring. The problems and different possibilities for restructuring are discussed in light of the phenotypic and phylogenetic data, and a possible hierarchical structure for the clostridia and their close relatives is presented. On the basis of phenotypic criteria and the results of phylogenetic analyses the following five new genera and 11 new combinations are proposed: Caloramator gen. nov., with Caloramator fervidus comb. nov.; Filifactor gen. nov., with Filifactor villosus comb. nov.; Moorella gen. nov., with Moorella thermoacetica comb. nov. and Moorella thermoautotrophica comb. nov.; Oxobacter gen. nov., with Oxobacter pfennigii comb. nov.; Oxalophagus gen. nov., with Oxalophagus oxalicus comb. nov.; Eubacterium barkeri comb. nov.; Paenibacillus durum comb. nov.; Thermoanaerobacter kivui comb. nov.; Thermoanaerobacter thermocopriae comb. nov.; and Thermoanerobacterium thermosaccharolyticum comb. nov.

Phylogenetic interrelationships of round-spore-forming bacilli containing cell walls based on lysine and the non-spore-forming genera Caryophanon, Exiguobacterium, Kurthia, and Planococcus

The 16S rRNA gene sequences of "Bacillus aminovorans" and several species considered to be phylogenetically related to the group 2 bacilli of Ash et al. (C. Ash, J. A. E. Farrow, S. Wallbanks, and M. D. Collins, Lett. Appl. Microbiol. 13:202-206, 1991) were determined. A comparative analysis of the sequence data revealed that the round-spore-forming group 2 bacilli, together with some asporogenous taxa (the genera Caryophanon, Exiguobacterium, Kurthia, Planococcus), form a phylogenetically distinct cluster that is only remotely related to Bacillus subtilis, the type species of the genus Bacillus. Within this cluster, planococci, kurthiae, Caryophanon spp., and two lines defined by Bacillus sphaericus and Bacillus fusiformis and by Sporosarcina ureae, Bacillus pasteurii, Bacillus globisporus, and Bacillus psychrophilus were found to be distinct genera. Exiguobacterium aurantiacum and Brevibacterium acetylicum were found to form a distinct clade, which was peripherally related to this cluster. "B. aminovorans" exhibited no specific relationship with the group 2 bacilli or with any of the other reference species examined.

Youth in detention and handguns

The objective of this work was to describe the frequency and correlates of handgun ownership and firearm injury experiences among youth in a detention facility. A convenience sample of 89 males detained in the King County Youth Services Center, a short-term holding facility, voluntarily completed an anonymous survey. Results showed that 59% of the youth reported owning a handgun. Firearm experiences included carrying a gun to school (46%); firing at another person (68% of handgun owners); firearm injury to self (27%); death of a close friend or family member to firearm homicide or suicide (35%). Personal safety far exceeded recreational use of guns as motivation for self-arming (52% versus 4%). Handgun ownership was more common among youth who reported problem behaviors. Adjusting for age and controlling for covariation of the problem behaviors, gang membership [odds ratio (OR) 6.7; 95% confidence interval (CI) 1.7-26.1], committing assault and battery (OR 7.7; 95% CI 2.2-26.8) and selling drugs (OR 3.6; 95% CI 0.99-13.4) were associated with handgun ownership. Our conclusion was that firearm experiences for youth in detention pose health risks equal to or far exceeding other high-risk behaviors in this population.

The adolescent male with an eating disorder

While it is clear that males and females with eating disorders share more features in common than dissimilarities, males are distinctive in their past histories of obesity, sexual identity concerns, defensive dieting, and dieting in relationship to sports participation. All adolescents with an eating disorder are likely to be guarded in terms of disclosing items affecting their psychological state. Young men may be more so. In light of this fact, diagnosis of these disorders in adolescent male patients still depends on ruling out possible organic etiologies, thoroughly assessing the adolescent's mental status, and looking for underlying psychiatric symptoms. The association between mood disorders, namely depression, and obsessive-compulsive disorder as well as other anxiety disorders is as strong in young males with eating disorders as with females. Assessment of developmental and nutritional status is key to the diagnosis and is helpful in monitoring recovery. Standards of monitoring other than weight are important and have been outlined. Lastly, family psychodynamics must be addressed in order to provide the eating-disordered young man with more control as well as more independence in order that he take more personal responsibility for a healthier lifestyle.

Phylogenetic analysis of the genera Planococcus, Marinococcus and Sporosarcina and their relationships to members of the genus Bacillus

A phylogenetic analysis based on 16S rRNA was performed on the genera Planococcus, Marinococcus, Sporosarcina and endospore-forming rods. In agreement with earlier 16S rRNA cataloguing data, Planococcus citreus and Sporosarcina ureae clustered with Bacillus pasteurii and other bacilli containing lysine in their cell walls. Sporosarcina halophila was shown to be genetically distinct from S. ureae and formed a loose association with the main Bacillus subtilis grouping. Marinococcus halophilus (formerly Planococcus halophilus) exhibited low levels of relatedness to all reference species examined and formed a distinct line of descent.

Adolescent drug and alcohol usage: a comparison of urban and suburban pediatric practices

Few pediatric practice-based drug and alcohol surveys have been conducted with adolescent patients. This study reports on similarities and differences in adolescent drug and alcohol use between urban (95% black) pediatric practices and a suburban (89% white) pediatric practice. While there were greater similarities between patient substance use and reported problems than differences, a number of significant differences emerged. White suburban youth were heavier users of tobacco products, alcohol, and inhalants, and experienced more difficulties with blackouts, family conflict, school absence, suicidal ideation, and loss of peer relationships. Other racial/ethnic and practice site differences are discussed. This study highlights characteristics of youth drug abuse in the private pediatric practice setting and implications for the pediatrician in caring for adolescents.

Comparative analysis of Bacillus anthracis, Bacillus cereus, and related species on the basis of reverse transcriptase sequencing of 16S rRNA

The primary structures of the 16S rRNAs of Bacillus anthracis, Bacillus cereus, Bacillus mycoides, and Bacillus thuringiensis were determined by using the reverse transcription-dideoxy sequencing method. All of the strains exhibited very high levels of sequence similarity (greater than 99%) that were consistent with the close relationships shown by previous DNA hybridization studies. The sequences of B. anthracis Sterne and B. cereus emetic strain NCTC 11143 were found to be identical for a continuous stretch of 1,446 bases and differed from the sequence of B. cereus NCDO 1771T (T = type strain) by only a single nucleotide. The 16S rRNA sequences of B. mycoides and B. thuringiensis differed from each other and from the sequences of B. anthracis and B. cereus by four to nine nucleotides.

Risk factors for attempted suicide in gay and bisexual youth

Studies of human sexuality have noted high rates of suicidality among homosexual youth, but the problem has not been systematically examined. This work was undertaken to identify risk factors for suicide attempts among bisexual and homosexual male youth. Subjects were 137 gay and bisexual males, 14 through 21 years of age, from the upper Midwest and Pacific Northwest. Forty-one subjects (41/137) reported a suicide attempt; and almost half of them described multiple attempts. Twenty-one percent of all attempts resulted in medical or psychiatric admissions. Compared with non-attempters, attempters had more feminine gender roles and adopted a bisexual or homosexual identity at younger ages. Attempters were more likely than peers to report sexual abuse, drug abuse, and arrests for misconduct. The findings parallel previous studies' results and also introduce novel suicide risk factors related to gender nonconformity and sexual milestones.

Tattooing behavior in adolescence. A comparison study

We characterize associations with and motivations for tattooing in adolescents through data from a controlled, three-group comparison of adolescents from a substance abuse treatment program, detention center, and private pediatric practice. We surveyed 474 adolescents (12 to 18 years old) with tattoos (12%) and without tattoos (88%). The private pediatric practice was the control site. A 34-item questionnaire was used to profile the three groups and their primary associations with tattooing with respect to race, drug use, school attendance, school grades, parental marital status, family income, tattooing by family members, criminal activity, and involvement with satanic rituals. Tattooing was significantly (P less than .005) associated with all of these variables in the ways described, as was knowledge of its association with human immunodeficiency virus infection. No interventions were made. Tattooing is common in adolescents and is associated with low self-esteem, delinquency, drug abuse, family and peer modeling, and participation in satanic rituals. Addressing the behavior as a health problem is discussed.

Assessment of pubertal maturity in boys, using height and grip strength

A method is described for the convenient, noninvasive assessment of pubertal maturity in boys, which is intended for use in studies of developmentally related sports injury. Ninety-eight boys were evaluated for Tanner stage, age, height, weight, body mass index, and maximum (right or left hand) and average grip strength. Height and average grip strength were selected by discriminate analysis as independent predictors of maturity. Immature boys (Tanner stages 1-3) fell below average grip strength of 25 kg and were less than 65 inches (165 cm) in height, whereas boys who exceeded both of these measurements were mature (Tanner stage 4 or 5). This method was validated in a second sample of 99 boys with 100% specificity and sensitivities of 93.5% (immature boys) and 81% (mature boys). A subset of mature boys met the height criterion but did not achieve the average grip strength criterion for maturity. We propose the use of height and grip strength as a practical, noninvasive method to classify physical maturity in boys. In addition, we speculate that the subset of boys who are tall, but weak, may be at increased risk for certain types of sports injuries.

Adolescent chemical dependency

Adolescent chemical dependency is now a recognized, diagnosable entity. In most respects, it mimics the diagnosis in adults. The practicing physician has some obligation to be familiar with changing trends in drug use and should have the skills to define problem use and assess risk. The physician should also address the issue as part of routine clinical interactions with patients and be aware of community resources for further assessment and treatment. Finally, the physician should be an advocate of the young patient and be helpful to parents in understanding the problem, but he or she should not be the parent's agent when asked to commit the adolescent for treatment or carry out drug abuse screening. The problem of adolescent substance abuse is a pre-eminent social problem. The problem must be addressed on many fronts. The role of the physician provides a key component of the solution.

Risk for DWI: a new look at gender differences in drinking and driving influences, experiences, and attitudes among new adolescent drivers

Adolescent drivers are over-represented in fatal auto accidents, especially those involving alcohol (DWI). Young male drivers appear to be at higher risk than adolescent female drivers because of a variety of important influencing factors. The current study takes a new look at the gender differences in these factors as they relate to driving behavior. Three hundred forty-three tenth-grade students (mean age: 15.8 years; 52% male, 48% female) were studied measuring demographics, family characteristics and influences, drug and alcohol use, perception of driving skill, sensation-seeking, other personality factors and responses to DWI vignettes for decision-making skill. Female respondents more often had difficulty with parents (p = 0.03) than males and more often used drugs and alcohol (p = 0.05). Boys more often attended speed competitions (p = 0.003), had legal problems (p = 0.004), and dated at a younger age (p less than 0.001). Males perceived greater driving skill in risky situations and used the automobile to enhance self-efficacy more than females (p = 0.001/p = 0.05). Male drivers scored higher on anger/hostility and sensation-seeking scales (p = 0.05). There were few significant gender differences in the way respondents analyzed risky DWI situations. Even though female subjects used more alcohol/drugs and came from more disturbed family backgrounds, their attitudes and behavior with respect to DWI appear more socially acceptable. Speculation as to some of the reasons for this effect are discussed with implications for prevention and further research.

The pregnant adolescent prostitute

The issue of teenage pregnancy is one of paramount concern and has been covered extensively in the professional literature. Teenage prostitution, as well, has drawn attention from medical and social science researchers. An increasing number of teenage prostitutes are becoming pregnant and delivering infants. These young women constitute a high-risk group that merits professional investigation and requires sensitive clinical approaches. We describe the pregnancy and early postpartum outcomes of 61 teenage prostitutes (age range, 13 to 18 years) in Seattle, Wash, during the period from January 1987 to February 1988. The subjects' environment, prenatal care, drug use, contraceptive practices, repeated pregnancies, and risk for sexually transmitted diseases (including acquired immunodeficiency syndrome) are discussed. Two case examples are used for illustration.

16S ribosomal ribonucleic acid sequence analyses of lactococci and related taxa. Description of Vagococcus fluvialis gen. nov., sp. nov

The phylogenetic status of members of the genus Lactococcus and some motile strains which react with Lancefield group N antiserum was examined by reverse transcriptase sequencing of 16S ribosomal ribonucleic acid. In agreement with earlier nucleic acid hybridization and immunological studies of superoxide dismutase the 16S sequence data clearly demonstrate that the lactococci represent a distinct phylogenetic group equivalent in rank to the genera Enterococcus and Streptococcus. The motile group N strains from chicken faeces and river water, however, were found to be phylogenetically unrelated to lactococci but displayed a closer, albeit loose, association with members of the genus Enterococcus. On the basis of the present sequence data and earlier chemotaxonomic studies it is proposed that the motile group N strains be classified in a new genus Vagococcus, as Vagococcus fluvialis sp. nov. The type strain of V. fluvialis is NCDO 2497.

Enterococcus raffinosus sp. nov., Enterococcus solitarius sp. nov. and Enterococcus pseudoavium sp. nov

Deoxyribonucleic acid base composition, deoxyribonucleic acid-deoxyribonucleic acid hybridization, and biochemical studies were performed on some enterococci from clinical sources of uncertain taxonomic position. Our results indicate that 6 human strains, a single clinical isolate and a strain from bovine mastitis are genetically distinct from each other and all other previously described Enterococcus species and constitute three new species, for which the names Enterococcus raffinosus, Enterococcus solitarius and Enterococcus pseudoavium are proposed.

Use of a leukocyte esterase dipstick to detect Chlamydia trachomatis and Neisseria gonorrhoeae urethritis in asymptomatic adolescent male detainees

We tested 91 asymptomatic adolescent male detainees in a short-stay detention facility in Seattle, Washington for the presence of leukocyte esterase in first-catch urine and for Chlamydia trachomatis and Neisseria gonorrhoeae infection. C. trachomatis was isolated from 10 subjects (11 per cent) and N. gonorrhoeae from five (5 per cent). Dipsticks detected leukocyte esterase in the urine of all 15 subjects with either infection and of 13 subjects with neither infection. Detection of leukocyte esterase was 100 per cent sensitive, 83 per cent specific, and 54 per cent predictive for the presence of either organism.

Young driver risk taking: a description of dangerous driving situations among 16- to 19-year-old drivers

Dangerous drinking and driving situations contribute heavily to morbidity and mortality among older adolescents. One hundred ninety-two high school drivers related 662 dangerous driving incidents (430 by males, 232 by females) in which they were involved in the preceding 6 months. Dangerous driving incidents were characterized by reckless intent, driving late at night, riding with other peers involving alcohol and drugs, reporting impaired driving, and distractions in the car. Adolescent drivers are commonly involved in dangerous drinking-driving situations with peers and without significant consequences. There are points along the continuum leading up to, during, and after such events that offer opportunities for significant prevention and intervention. Such strategies are reviewed.

Health, developmental, and nutritional status of adolescent alcohol and marijuana abusers

The impact of alcohol and marijuana abuse on the physical health and nutritional status of adolescents has not been well documented. The health consequences of alcoholism and chemical abuse in adults may not relate to the pediatric population. Forty-nine adolescent boys (mean age 15.8 years) with varying degrees of alcohol and marijuana use by self-report were evaluated as to their general health, pubertal development and nutritional status using health and dietary history, physical examination, anthropometrics, and biochemical assays of liver function and tissue nutrients. Thirteen (27%) were alcohol and marijuana abusers, 20 (41%) marijuana abusers, and 16 (32%) nonusers. There were significant differences between alcohol and marijuana abusers and marijuana abusers compared to nonusers with respect to endorsing symptoms of nutritional deficiency (muscle weakness, bleeding gums, tiredness, etc) (P less than .001). There were no significant differences between subgroups in other nutritional measures except plasma zinc concentration which was low in marijuana abusers (mean 85 micrograms/dL). All adolescents reported consuming adequate nutrients, although alcohol and marijuana abusers reported eating more snack foods and less fruit, vegetables, and milk than other groups. There were no significant differences in hematologic status (complete blood cell count, transferrin, folate), liver function (gamma-glutamyltranspeptidase), or anthropometric and sexual maturational indices of growth. There were no chronic signs of chemical abuse by physical examinations. It appears that health and nutritional disability from chemical abuse in adolescents relates more to poor dietary habits and symptomatic deterioration in general health than to specific effects on growth or nutritional status. Studies with larger numbers of subjects need to document these findings.

The use of vignette analysis of dangerous driving situations involving alcohol to differentiate adolescent DWI offenders and high school drivers

Adolescent drivers are commonly involved in a variety of dangerous driving situations involving alcohol and drug use. Both situational and personality factors contribute to the adolescent DWI phenomenon. Little is known about young drivers' ability to analyze common potentially dangerous alcohol-involved driving situations, or in what respects differing patterns of analysis differentiate adolescent drivers at risk for DWI. Three groups of adolescent drivers (N = 153) completed an analysis of vignettes questionnaire to assess their decision-making skills and attitudes with respect to drinking and driving. The three comparison groups consisted of high school drivers, young DWI offenders, and juvenile offenders without DWI citations. Subjects were demographically similar except for academic performance, employment, family intactness, car ownership, and drug and alcohol use, with DWI offenders and non-DWI offenders showing significant differences in these measures (p less than .001). Situation analysis showed that adolescent DWI offenders more often than controls drink prior to driving (p less than .001), associate alcohol with many social events and dating (p less than .001), become angry when questioned about driving ability (p less than .001), play drinking games (p = .1), drive fast to resolve stress (p = .001), are less likely to recruit parents when faced with driving intoxicated (p less than .001), and a number of other situational characteristics indicating differential risk between groups for DWI. In many cases, other juvenile offenders matched responses of DWI offenders. Important aspects of these findings are discussed in the context of intervention strategies and the use of vignette analysis as one tool to identify high-risk adolescent drivers for DWI.

An approach to the management of sexual dysfunction in the adolescent male

Sexual dysfunction in the adolescent male appears to be increasing. Erectile dysfunction (impotence) and premature ejaculation are the most common. Illustrated by three cases, a review of the prominent causes of sexual dysfunction is provided along with a discussion of an approach to adequate sexual history taking, physical evaluation, and treatment.

Drinking and driving behaviors of 16 to 19 year-olds

A total of 192 high-school-age drivers (67 girls) were interviewed with respect to their drinking and driving behavior and academic performance. Although traffic violations and citations were correlated with increases in risky driving behavior and alcohol and drug use, much dangerous driving and social drinking went without consequence. It is suggested that the young male driver is at significantly greater risk for involvement in dangerous driving and drinking. Contributing developmental, situational and personality factors are discussed.

Sexually transmitted diseases in females in a juvenile detention center

Of 37 female adolescent prostitutes and 63 other females held in the King County, Washington, juvenile detention facility, 81 (81%) complained of vaginal discharge, and only eight (8%) had no genitourinary symptoms. The prevalence of genital infections among prostitutes and nonprostitutes was similar. Neisseria gonorrhoeae was found in 18 (18%) of 98 detainees tested, and Chlamydia trachomatis was found in 17 (20%) of 86 detainees tested; either organism was found in 27 (32%) of 85 tested for both organisms. Also, 38 (48%) of 80 tested had trichomoniasis. No detainees had syphilis. Sixty-seven (68%) of 98 responding detainees used no contraception. Such populations deserve the attention of public programs for control of sexually transmitted diseases and for family planning.

A note on the heterofermentative Lactobacillus isolated from kefir grains

Heterofermentative lactobacilli have been isolated from kefir grains obtained from four different sources. A number of these isolates ferment only L-arabinose and gluconate and are similar to the species 'Lactobacillus desidiosus'. The DNA of these isolates, however, have 85-109% homology with 'L. caucasicus' NCDO 190 which is now regarded as L. kefir. The relationship between these strains is discussed.

Penicillinase-producing Neisseria gonorrhoeae infection in adolescent prostitutes in detention

In the first quarter of 1983, four (17%) of 24 cases of Neisseria gonorrhoeae infection diagnosed in female adolescent detainees in King County, Washington were caused by penicillinase-producing (PPNG) strains. Twelve (3%) of 397 reported cases of female gonorrhea in the rest of King County during this time were caused by PPNG strains (p less than 0.01). All the detainees with PPNG infection were prostitutes. Their case histories are presented here. Three had signs and symptoms suggestive of pelvic inflammatory disease. In areas with endemic PPNG, all isolates of N. gonorrhoeae from female adolescent detainees should be tested for pencillinase production, and all prostitutes with genitourinary symptoms suggestive of gonorrhea should be treated with an antimicrobial resistant to pencillinase.

DNA base composition, DNA-DNA homology and long-chain fatty acid studies on streptococcus thermophilus and Streptococcus salivarius

DNA base composition, DNA-DNA homology and long-chain fatty acid studies were performed on Streptococcus thermophilus and Streptococcus salivarius. These species possess similar mol % G + C values (about 37 to 41), long-chain fatty acid profiles and belong to a single DNA homology group. On the basis of the present and earlier studies it is proposed that Streptococcus thermophilus (Orla-Jensen) be reclassified as Streptococcus salivarius subsp. thermophilus comb. nov.

Streptococcus garvieae sp. nov. and Streptococcus plantarum sp. nov

Biochemical and chemotaxonomical studies were performed on some streptococci from frozen peas and bovine mastitis in an attempt to clarify their taxonomy. The results of the present and earlier studies indicate the pea and mastitis isolates represent two new species of the genus Streptococcus. The isolates from frozen peas are named Streptococcus plantarum sp. nov. and those from mastitis, Streptococcus garvieae sp. nov. The type strains are NCDO 1869 and NCDO 2155, respectively.

Taxonomic studies on some group D streptococci

Biochemical, menaquinone, fatty acid and DNA analyses were conducted on a number of streptococci of serological group D. The results indicate that S. faecalis, S. faeclum, S. casseliflavus and taxa previously designated 'S. avium', 'S. durans' and "S. faecalis var. malodoratus' are distinct species. Strains previously labelled 'S. faecium var. mobilis' were shown to be identical with S. casseliflavus. The results also indicate that some group D streptococci recently isolated from chickens constitute a new species.