The Second Chance Club: repeat adolescent pregnancy prevention with a school-based intervention

The Second Chance Club, a high school-based intervention for pregnant and parenting adolescents, was evaluated to determine the repeat birth rate among participants. A retrospective case-controlled cohort study was conducted (participants, n = 50; control subjects, n = 255) over 3 years after enrollment in the intervention. Repeat births occurred in 3/50 (6%) of participants and 95/255 (37%) of controls (p <.05).

Adolescent medicine in pediatric practice: a survey of practice and training

This study was designed to assess the relation between training in adolescent medicine, during and after residency, and self-reported practice of adolescent medicine. This is a cross-sectional study. A questionnaire was mailed to all members of the South Carolina Chapter of the American Academy of Pediatrics. After 2 mailings, 198 (83%) questionnaires were returned. Adolescent medicine training in residency was associated with more adolescent patients enrolled in a practice (P < 0.01) and more adolescent patient visits (P < 0.01) but not with an increase in perceived competence in the practice of adolescent medicine. Adolescent medicine continuing medical education was associated with seeing more adolescent patients and with increased competence in many areas, including contraceptives, suicide, and school problems (P < 0.05). training in adolescent medicine during and after residency is associated with treating more adolescent patients. Continuing medical education also is associated with increased perceived competence in areas related to adolescents.

Calcium needs of adolescents

Adolescents grow at the greatest rate of any age group after infancy and accumulate 37% of their total bone mass during this growth spurt. Because maximum bone mass is acquired during adolescence, the calcium deposited during adolescence determines the risk of osteoporosis and fracture in adulthood. Bone mass is dependent on calcium intake, growth and pubertal development, exercise, and genetic and racial factors. Unfortunately, during this time of tremendous calcium need, most adolescents eat a diet that is very deficient in calcium. Girls are twice as likely to be deficient as boys (85% vs 43%). Other factors contributing to poor bone mineralization include adolescent pregnancy, anorexia nervosa, excessive exercise, and various chronic medical conditions. To avoid osteoporosis in later life, adequate dietary calcium intake should be recommended and calcium supplementation considered in all adolescent patients.

Glutathione metabolism in normal and cystinotic fibroblasts

Intracellular concentrations of glutathione and activities of the enzymes gamma-glutamylcysteine synthetase, glutathione synthetase, and gamma-glutamyl transpeptidase were measured in confluent cultured human fibroblasts cell lines from 14 normal cell lines and four cystinotic cell lines. gamma-Glutamyl transpeptidase had a wide range of variability while the glutathione synthetic enzymes, gamma-glutamylcysteine synthetase and glutathione synthetase, had narrower variations and also exhibited no apparent relationship to glutathione content. No differences in the activities of these enzymes were found between normal and cystinotic cells in confluent cell cultures. The activities of the above enzymes and the cell number and content of glutathione, cystine, DNA, and total protein in two normal and two cystinotic fibroblast cell lines were measured during growth. The following growth-dependency patterns were observed: (1) gamma-glutamylcysteine synthetase activity increased markedly in lag and early log phases in both normal and cystinotic cells and decreased rapidly to low confluent levels thereafter. (2) gamma-Glutamyl transpeptidase showed the same wide range of activity noted at confluency but activities decreased in the log phase of growth, a pattern also seen in cystinotic cells. (3) Glutathione synthetase activity remained relatively constant during growth of normal cells but exhibited a peak of activity during lag and early growth of cystinotic cells. (4) Comparative glutathione levels of normal and cystinotic cells were not significantly different and exhibited similar fluctuations with time. (5) The cystine content of normal and cystinotic cells unexpectedly rose to high levels in the lag phase, then decreased to 0.1 nmol 1/2 cystine/mg protein in normal cells and to 0.3 to 1.2 nmol 1/2 cystine/mg protein in cystinotic cells during the log phase. As confluency was approached, normal cell cystine remained at low levels while cystinotic cell cystine rose to characteristically high levels of 50- to 100-fold greater than normal cells at late confluency. These studies extend our understanding of the regulation of glutathione and cystine content in cultured fibroblasts and suggest that glutathione content is closely controlled throughout the cell cycle in the face of varying activities of its anabolic and catabolic enzymes.

Ferroelectric Polarization-Modulated Interfacial Fine Structures Involving Two-Dimensional Electron Gases in Pb(Zr,Ti)O3/LaAlO3/SrTiO3 Heterostructures

Interfacial fine structures of bare LaAlO₃/SrTiO₃ (LAO/STO) heterostructures are compared with those of LAO/STO heterostructures capped with upward-polarized Pb(Zr_0.1,Ti_0.9)O₃ (PZT_up) or downward-polarized Pb(Zr_0.5,Ti_0.5)O₃ (PZT_down) overlayers by aberration-corrected scanning transmission electron microscopy experiments. By combining the acquired electron energy-loss spectroscopy mapping, we are able to directly observe electron transfer from Ti⁴⁺ to Ti³⁺ and ionic displacements at the interface of bare LAO/STO and PZT_down/LAO/STO heterostructure unit cell by unit cell. No evidence of Ti³⁺ is observed at the interface of the PZT_up/LAO/STO samples. Furthermore, the confinement of the two-dimensional electron gas (2DEG) at the interface is determined by atomic-column spatial resolution. Compared with the bare LAO/STO interface, the 2DEG density at the LAO/STO interface is enhanced or depressed by the PZT_down or PZT_up overlayer, respectively. Our microscopy studies shed light on the mechanism of ferroelectric modulation of interfacial transport at polar/nonpolar oxide heterointerfaces, which may facilitate applications of these materials as nonvolatile memory.

Illness and injuries at summer camp

Children at summer camp are at risk of injury and illness. The American Academy of Pediatrics and the American Camping Association have specific guidelines for the medical care of children in summer residential camps. This report describes the types of illnesses and injuries seen in 730 children attending camp for 2 weeks, use of the infirmary, and difference in the onset of infectious diseases compared with injuries during the camp session. During the month studied, there were 921 infirmary visits. The most common diagnoses were injuries and infectious disease. Girls and boys were equally likely to be seen in the infirmary and had the same distribution of diagnoses. Infectious disease (gastroenteritis) had a later mean day of onset during the camp session than did injuries and was increasing in frequency at the end of each session. Potential common camp medical problems (sunburn, otitis externa) were prevented by simple medical preventive care.

Bulimia and dextromethorphan abuse. A case study

The comorbidity of bulimia and substance abuse is significant. The substance that is abused may vary and the abuse potential for nonillicit substances may be overlooked. This paper presents the first case reported of dextromethorphan abuse and bulimia. It demonstrates the complexity of assessment and treatment of bulimia and substance abuse of over-the-counter medications.

Assessment and significance of Arthur Conan Doyle's medical writings

Doyle's medical writings represent a valuable contribution to both the scientific and nonscientific aspects of medicine of the late 19th Century. Up to the present, accounts of these writings have been few, and none of them have been evaluative of their scientific merit. Analysis of Doyle's writings on infectious diseases in particular reveals a remarkable insight, for the 1880s, into the bacterial causation of disease and prevention through immunization.

Pulmonary embolus in an adolescent on oral contraceptives

Deep venous thrombosis with pulmonary embolus is a rare complication of oral contraceptives, which generally occurs in adult women and becomes more common with increasing age. These complications are believed to be less common with low dose oral contraceptives than with the higher dose forms. This is a case report of a deep venous thrombosis presenting with a life-threatening pulmonary embolus in an adolescent on low dose triphasic oral contraceptives.

Arthur Conan Doyle, Joseph Bell, and Sherlock Holmes. A neurologic connection

Neurologists, like physicians in several other medical specialties, can lay claim to Sherlock Holmes as one of their own. This assertion is validated by the number of neurologic conditions, such as seizures, stroke, syncope, encephalopathies, and head trauma, that are mentioned in the stories and novels. In addition, the article reviews the powers of observation and the deductive approach utilized by Conan Doyle and Joseph Bell, the models for Sherlock Holmes, and how these skills can be applied to medical problems.

William Osler and Arthur Conan Doyle versus the antivivisectionists: some lessons from history for today

Reaction against vivisection for research reached its height in the last two decades of the 19th century and the first two of the 20th, and a resurgence began in the 1960s. Antivivisectionism was and is related, in part, to emphasis on humanitarian sentiments. Two humanitarian physicians defended vivisection as essential. Dr. Arthur Conan Doyle in 1886 justified the killing of rabbits to relieve human suffering from hydrophobia. In 1910, he objected to the antihuman campaign of the antivivisectionists. Dr. William Osler reacted similarly to the threat to vivisection. He gave emphatic evidence to investigative committees in the United States in 1900 and in Britain in 1907. Osler also performed vivisection. His experimentation included studies of pig typhoid and tapeworm cysts in pigs and of the fate of india ink injected into the lungs of kittens. Osler and Conan Doyle were but two of the many prominent physicians who helped stem the tide of antivivisection legislation near the turn of the century. A review of the elements that fostered antivivisectionism in the society of their time is relevant in understanding and reacting to similar sentiments in the present era.

Humanism and values in the medical short stories of Arthur Conan Doyle

In 1894 Arthur Conan Doyle published 15 medical short stories under the title of Round the Red Lamp, a red lamp being the symbol for a physician's office in Victorian England. These 19th-century vignettes do not indulge in scientific descriptions of diseases, their processes, or their treatment. Instead, they are based upon the effects of illness on the lives, sentiments, and emotions of the afflicted, their families, and their physicians. The stories are suffused with romance and humor. Conan Doyle's medical fiction of almost 100 years ago constitutes a superbly written and engaging collection that ranges from the comic to the pathetic. They contain universal themes that are especially appropriate today when humanistic elements are being usurped by rampant technology in both medical education and medical practice. These tales can make a significant contribution in related seminars for both students and practitioners.

The Mayo Clinic author catalog: a living repository of medical knowledge

Since 1907 records have been kept of publications by staff members of the Mayo Clinic, and this information has been invaluable. The Author Catalog has proved itself such a useful tool for the Mayo Clinic that other libraries, large and small, may wish to consider adopting such a service. The Mayo medical complex is a large institution with more than 500 staff and faculty members engaged in the publication of clinical, educational, and research findings. The great amount of cross-disciplinary cooperation and interdepartmental research makes essential an up-to-date record of what is going on. The Mayo Clinic Library developed a comprehensive computerized method for identifying research and for identifying and indexing publications of Mayo staff members. At the end of 1971 more than 25,000 citations had been stored on computer tape.

Kindred souls: the meeting of Drs. Arthur Conan Doyle and Thomas Hamilton

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