Post-traumatic stress disorder in physically abused adolescents

OBJECTIVE

In an investigation of the prevalence of post-traumatic stress disorder (PTSD), other Axis I psychiatric disorders, and social and behavioral difficulties, 27 physically abused adolescents were compared with 27 nonabused controls who were recruited through random-digit dialing procedures.

METHOD

The Structured Clinical Interview for Diagnosis (PTSD module), Kiddie-Schedule for Affective Disorders and Schizophrenia, and Youth Self-Report were administered to all subjects; mothers were interviewed regarding their adolescent's behavior using the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children and Child Behavior Checklist.

RESULTS

The three physically abused adolescents who received a diagnosis of PTSD on the PTSD module of the Structured Clinical Interview for Diagnosis reported their PTSD symptoms were in reaction to extrafamilial sexual assaults and not to physical abuse. In contrast, the abused adolescents showed significantly higher prevalence rates of depression, conduct disorder, internalizing and externalizing behavior problems, and social deficits.

CONCLUSIONS

Findings suggest that physically abused adolescents may be more at risk for behavioral and social difficulties than for PTSD.

Difficult tracheal intubation in obstetrics

Difficult intubation has been classified into four grades, according to the view obtainable at laryngoscopy. Frequency analysis suggests that, in obstetrics, the main cause of trouble is grade 3, in which the epiglottis can be seen, but not the cords. This group is fairly rare so that a proportion of anaesthetists will not meet the problem in their first few years and may thus be unprepared for it in obstetrics. However the problem can be simulated in routine anaesthesia, so that a drill for managing it can be practised. Laryngoscopy is carried out as usual, then the blade is lowered so that the epiglottis descends and hides the cords. Intubation has to be done blind, using the Macintosh method. This can be helpful as part of the training before starting in the maternity department, supplementing the Aberdeen drill.

The temporal relationship between the secretion of luteinizing hormone and testosterone in man

It has been suggested recently that testosterone secretion by the human testis may be controlled by factors other than luteinizing hormone (LH). In order to re-examine this hypothesis, plasma LH and testosterone concentrations were determined throughout the day in eight studies. A new method of data analysis revealed that the levels of the two hormones were closely related, but that the testicular response to LH was sluggish. These results explain some inconsistencies in the literature. It was demonstrated that average values for LH varied throughout the day, with a morning maximum and an evening minimum. It was also shown that injections of LH releasing hormone in man resulted in an increase in plasma testosterone above control levels. These results are consistent with the concept that LH controls the major changes in testosterone secretion in men. They do not exclude, however, the possible existence of other factors which might affect the peripheral concentration of testosterone, such as changes in testicular blood flow.

Temporal variations of testosterone levels in the peripheral blood plasma of men

Testosterone was measured in the peripheral blood plasma of normal men by radioimmunoassay. The results were analysed to test for the possible existence of a circadian rhythm, for fluctuations superimposed on any such rhythm, and for day-to-day variations. Unequivocal evidence of a circadian rhythm was found in all but one of the subjects studied and the cycle appeared to be accompanied by a series of fluctuations of lower amplitude lasting for 1–2 h. Samples taken from the same subjects on consecutive days showed marked variation between days, but no regular cyclic pattern. The possible existence of such a cycle is not, however, eliminated. On the basis of all the data obtained a regime is suggested for the collection of blood samples from individuals whose androgenic status is to be assessed.