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Biomedical subjects

C J Hobbs

Publications and source records attributed to C J Hobbs.

At least 37 records · Page 2Linked to original sources
PubMed1992

The effects of sex hormone binding globulin (SHBG) on testosterone transport into the cerebrospinal fluid.

The movement of testosterone (T) from blood across the blood-brain barrier (BBB) is thought to reflect the combined effects of T's lipid solubility and the presence of circulating binding proteins for T such as albumin or sex hormone binding globulin (SHBG). Since the adult rat lacks a circulating specific high affinity sex steroid binding protein, examination of the disappearance from serum and uptake into cerebrospinal fluid (CSF) of [3H]T before and after SHBG or albumin infusion should provide insight into the function of these two proteins with respect T transport. Three groups of adult male Sprague-Dawley rats were cannulated at the femoral vein and cisterna magna. In a control group (n = 8), [3H]T was given as an intravenous bolus beginning at time zero; multiple serum and CSF collections were assayed for counts per min (cpm) during the subsequent 45 min. Data from these animals were then compared to those seen in animals that received either purified human SHBG (hSHBG) (n = 7) or human albumin (hALB) (n = 6) 10 min prior to the [3H]T infusion. High performance liquid chromatography was used to monitor the metabolic fate of the steroid infusate at the end of each study period. Infusion of hSHBG increased serum concentrations from undetectable to 93.8 nM/l (mean +/- SEM, n = 6). Administration of hALB significantly increased (25.0 +/- 1.2 g/l at baseline, 33.4 +/- 1.6 g/l post-infusion, mean +/- SEM, P less than 0.03, n = 5) the circulating albumin concentration. Comparison of data from each group of animals demonstrated that (1) following an i.v. injection of radiolabeled T, the initial decline in serum [3H]T was significantly reduced (P less than 0.03) in the presence of hSHBG, (2) hALB did not affect the movement of [3H]T out of serum, (3) the time to peak appearance of [3H]T in the CSF was significantly delayed (P less than 0.02) by the presence of circulating hSHBG, and (4) the net quantity of [3H]T found in the cSF under steady-state conditions was not affected by serum SHBG or albumin levels. This study demonstrates that high-affinity steroid binding proteins do modulate the transport of sex steroids across the BBB. Specifically, SHBG delays the clearance of T from serum and slows the rate of T uptake into the CSF during non-equilibrium conditions.(ABSTRACT TRUNCATED AT 400 WORDS)

Analysis of Variance↗
PubMed1990

The sexually abused battered child.

A total of 130 children were identified in whom both evidence of sexual abuse and non-accidental, non-genital physical injuries (bruises, fractures, scratches, burns and scalds, including failure to thrive) were found. There were 77 girls and 53 boys with mean ages 5.7 and 6.8 years respectively and the peak age between the second and seventh birthdays; this reflects previous reports indicating that physical and sexual abuse predominantly involves young children. Patterns of injury that suggested sexually motivated assault included bruises, scratches, and burns around the lower trunk and genitalia, thighs, buttocks, and upper legs including knees. Pinch and grip marks were found where the child was held. The sexual abuse often involved attempted or achieved penetration of mouth, vagina, or anus, and physical signs were seen relatively more often than in sexually abused children as a whole. Four children died and sexual aggression and child death in the domestic setting may be linked. One in six of 769 physically abused children (16.9%) and one in seven of 949 sexually abused children (13.6%) have suffered both forms of abuse.

Adolescent↗
PubMed1989

Sexual abuse of English boys and girls: the importance of anal examination.

Child sexual abuse is attracting increasing attention in the United Kingdom. In Leeds this is reflected in the work of two pediatricians who receive multiagency, direct referrals for children of all ages. Over two years 1,368 referrals were received for all kinds of abuse and neglect, including 608 for suspected sexual abuse (Hobbs & Wynne, 1987a), of which 337 (243 girls, 94 boys) were confirmed or probable cases. The abuses included genital touching, masturbation, oral, vaginal and anal penetration. Of these abuses, 30% (which were frequently multiple) involved and penetration by finger or penis; and 42% of 337 children exhibited one or more anal findings, rising to 60% of 115 children in the 0-5 years of age group. The diagnosis of abuse was made from results of multidisciplinary assessment including medical examination. Genital findings were present in 3% of boys and 50% of girls. Anal findings included erythema; swelling (tyre); laxity; shortening or eversion; reflex anal dilatation (dilatation); fissures; venous congestion; reversible and permanent skin changes; twitching; funnelling; hematoma and bruising; as well as signs of infection. The pattern of anal signs varied with the age of the child and chronicity of abuse, as judged from the history. Healing and resolution of anal physical findings on follow-up were observed from days to months after initial examination. The general absence of these findings in the group of children judged not to have been sexually abused supports a cause and effect hypothesis, but further research is required. Medical examination of every child where symptoms, signs, or situation raise the possibility of abuse or neglect must include anal inspection, but instrumental or digital examination is not recommended.

Adolescent↗
PubMed1988

Mistakes in diagnosing non-accidental injury: 10 years' experience.

Fifty children who were referred to the child abuse team in Leeds over the 10 years 1976-86 with suspected non-accidental injury were found to have conditions which mimicked non-accidental injury. These included impetigo (nine children) and blue spots (five children). Five children who presented with multiple bruising had haemostatic disorders. Eight children had disorders of the bone. Five children had been previously abused physically. Four showed evidence of neglect. One had evidence of non-accidental injury as well as the condition mimicking abuse. It is emphasised that when child abuse is suspected a sensitive and thorough assessment should be carried out by a paediatrician who is experienced in this.

Adolescent↗
PubMed1987

Child sexual abuse--an increasing rate of diagnosis.

In 2 years in Leeds, two paediatricians diagnosed sexual abuse in 94 boys and 243 girls. 38% were under 5 at diagnosis and the mean age was 8.0 years. 39% presented following disclosure by the child. 83% of boys and 25% of girls had anal signs and 58% of girls had genital signs. 60% of abusers were related to the child and half of these were natural fathers. 25% of all abusers were teenagers and 5% were women. The abuser was convicted in 25% of cases and protective legal orders were sought in 36%. Sexual abuse is emerging as a major child and mental health problem that requires new resources in training and personnel.

Adolescent↗
PubMed1986

Buggery in childhood--a common syndrome of child abuse.

18 girls and 17 boys, aged 14 months to 8 years, with a history and physical signs of buggery were selected from a large series of sexually abused children seen by two paediatricians in Leeds, child population 146 000, over 8 months. In 27 children disclosure of abuse by the child or perpetrator (most commonly the father) was recorded. Anal findings on inspection included fissures, dilatation and reflex dilatation, loss of sphincter, shortening and eversion of the anal canal, external venous congestion, and generalised reddening and thickening of perianal tissues. Vaginal signs of dilatation or marked redness were found in 14 girls but penile penetration of the vagina was uncommon. Associated findings included non-accidental injury, emotional deprivation and failure to thrive, developmental delay, and behavioural disturbance. Buggery in young children, including infants and toddlers, is a serious, common, and under-reported type of child abuse.

Adult↗
PubMed1986

When are burns not accidental?

One hundred and ninety five children aged up to 6 years with burns and scalds (30 non-accidental and 165 accidental) were studied retrospectively. The history, presentation, and other typical injuries assisted the diagnosis of abuse. Scalds accounted for 81% of accidents and 25% of the cases of abuse, and burns for 17% and 44%, respectively. Scalds usually followed spillage from kitchen containers in accidents and forced tap water immersion in cases of abuse. Burns in cases of both accidents and abuse resulted from contact with a wide range of household appliances, including room heaters. Attention is drawn to the back of the hand as an important site in cases of abuse, as well as the legs, buttocks, and feet. It is speculated that the low level of reporting of this form of child abuse reflects failure of diagnosis.

Accidents, Home↗
PubMed1984

Skull fracture and the diagnosis of abuse.

Eighty nine children under 2 years of age with skull fracture were studied retrospectively--29 children with definite non-accidental injury serially recorded by the Departments of Paediatrics and Forensic Medicine, and 60 children consecutively admitted to hospital with skull fractures after accidents. There were 20 deaths including 19 among abused children. Multiple injuries and an inadequate history assisted in diagnosing abuse. Fracture characteristics found considerably more often in abused children were: multiple or complex configuration; depressed, wide, and growing fracture; involvement of more than a single cranial bone; non-parietal fracture; and associated intracranial injury including subdural haematoma. No fractures measuring more than 5.0 mm on presentation were found after accidents, but 6 of these 'growing fractures' were found in abused children. Accidents usually resulted in single, narrow, linear fractures most commonly of the parietal, with no associated intracranial injury. The results suggest that in skull fracture in young children where a minor fall is alleged, it is possible to recognise abuse by consideration of the fracture alone.

Accidents↗