Appearance of the hymen in adolescents is not well documented.
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Adolescent↗
Biomedical subjects
C San Lazaro
Publications and source records attributed to C San Lazaro.
Concurrence of Pendred syndrome, autoimmune thyroiditis, and simple goiter in one family.
Pendred syndrome is the autosomal recessively transmitted association of familial goiter and congenital deafness. There is no specific biochemical marker of this disease, and the diagnosis depends upon the demonstration of the triad of congenital sensorineural hearing loss, goiter, and abnormal perchlorate discharge test. Pendred syndrome is caused by mutations within the putative ion transporter gene (PDS gene), located on chromosome 7q. A wide variation in the clinical presentation of this condition, and its well documented phenotypic overlap with other thyroid disorders (such as Hashimoto's thyroiditis), can lead to diagnostic difficulties. The potential for misdiagnosis increases when these disorders occur coincidentally in the same family. We describe a kindred in which Pendred syndrome, autoimmune thyroiditis, and simple goiter coexisted, to highlight these diagnostic pitfalls and to illustrate the use of mutational analysis in resolving diagnostic confusion.
Adult↗
Outcome of criminal investigation into allegations of sexual abuse.
The aim was to study the outcome of criminal investigation into allegations of sexual abuse made by 160 children assessed over a two year period in a specialist paediatric unit in the North of England. In all, 141 of the 160 children (88%) were female, and 99 (62%) were aged under 12 years. There were 145 males and nine females named by children in allegations of sexual abuse. Fathers formed the largest single group of alleged male perpetrators (56/176). None of the nine alleged female abusers was prosecuted. Of the 145 males, 57 reached trial; 49 were convicted, an 86% conviction rate of those sent to trial and a rate of proven sexual offence (including cautions) of 44% (54/124) among men originally interviewed by the police. Twenty five per cent of children (17/68) who could have testified did so, most giving evidence against someone who was known to them. Pragmatic selection of cases for prosecution resulted in an outcome highly vindicating of the decision to prosecute. The possible effects of this process are discussed.
Adolescent↗
Sending parents outpatient letters about their children: parents' and general practitioners' views.
Parents' cooperation is essential to ensuring implementation of effective healthcare management of children, and complete openness should exist between paediatricians and parents. One method of achieving this is to send parents a copy of the outpatient letter to the general practitioner (GP) after the child's outpatient consultation. To determine the views of parents and GPs a pilot survey was conducted in two general children's outpatient clinics in hospitals in Newcastle upon Tyne. In March and April 1991 a postal questionnaire was sent to 57 parents of children attending the clinics, and a similar questionnaire to their GPs to elicit, respectively, parents' understanding of the letter and perception of its helpfulness, and GPs' views on the value of sending the letters to parents. Completed questionnaires were received from 34(60%) parents and 47(82%) GPs; 26(45%) respondents were matched pairs. 27(79%) parents said they understood all of the letter, 19(56%) that it helped their understanding, 32(94%) felt it was a good idea, and 31(91%) made positive comments. In all, 29(61%) GPs favoured the idea and six (13%) did not. Eleven (23%) said they would be concerned if this became routine practice, and 20(74%) of the 27 providing comments were doubtful or negative; several considered that they should communicate information to parents. The views in the matched pairs were dissimilar: parents were universally in favour whereas many GPs had reservations. The authors concluded that sending the letters improved parents' satisfaction with communication, and they recommend that paediatricians consider adopting this practice.
Adult↗