Management of sexually abused children by non-forensic sexual abuse examiners

Physicians who do not intend to examine children suspected of having been sexually abused still need information about the disorder and its management. A history from the caretaker and child is vital to determine the safety of the child from further abuse and the urgency of a physical evaluation for health and forensic purposes. The disclosure interview of a young child in Arkansas generally should be by an agency investigator to avoid multiple interviews, after a legally mandated report to the Child Abuse Hotline. The physical evaluation can be delayed when the conditions listed in the Table are met, and a referral to a secondary or tertiary level examiner would follow. Otherwise, immediate referral likely will be to a primary level examiner, such as in an emergency department; the child will receive an examination and tests for acute findings and possible referral to a secondary or tertiary level examiner for a more thorough examination. The child and frequently an adult family member should be referred for counseling.     

Inter-relationships between HIV infection and other sexually transmitted diseases

The HIV is a typical sexually transmitted disease (STD) agent which depends for its transmission through sex on contact between raw body tissues of infected and uninfected individuals independent of sexual inclination. The dynamics of HIV transmission and its control in a community can be inferred from studying the socio-cultural and epidemiological aspects of acute STD. There is strong evidence to suggest that the main cause of rampant heterosexual transmission of the HIV in sub-Saharan Africa in contrast to the rarer heterosexual HIV transmission in Europe and the USA is the high prevalence of ulcerative STD in Africa. Studying the trend and response to treatment of conventional acute STD are quick and indirect ways of assessing the impact of control measures against AIDS and HIV infection in an HIV endemic area. Further research is needed to determine the extent and detailed mechanism of interaction between HIV infection and other STDs as well as studying the efficacy of AIDS control through control of other STDs.     

Sexual abuse of children in Leeds

Temporal trends in physical and sexual abuse of children within a geographically defined area were examined, and cases of suspected sexual abuse referred to paediatricians during 1984 were studied in detail. After remaining static for four years referrals due to all types of abuse trebled between 1979 and 1984, and referrals due to sexual abuse increased from none to 50 a year. In 1984, 50 children (39 girls) aged 1-16 were referred because of possible sexual abuse. Abuse was confirmed or considered to be likely in 30 (28 girls). The perpetrator was a male relative or family friend in 17 cases and a man participating in a child sex ring in seven cases. Physical examination often did not show anything remarkable, but three girls had venereal infections. These figures suggest that paediatricians and child psychiatrists will increasingly be presented with cases of sexual abuse in children.     

When children shoot children. 88 unintended deaths in California

Between 1977 and 1983, eighty-eight California children 0 to 14 years of age were unintentionally shot and killed either by other children or by themselves. The majority of cases occurred while children were playing with guns they had found. Easy accessibility to guns, the resemblance of guns to toys, and gun malfunctions were all contributing factors. Handguns, particularly those of .22 caliber, were frequently involved.     

Aids risk in Irish homosexual men associated with other sexually transmitted diseases

THIS study looked at the relationship between human immunodeficiency virus (HIV) antibody status and the presence of other sexually transmitted diseases (STD) in 179 homosexual men who attended a Dublin STD clinic. Sixteen men were found to be HIV antibody positive and there was a high incidence of other STD in this group. In particular, evidence of past or present infection with syphilis or hepatitis B was a strong indicator of a probable positive HIV antibody test.     

孕妇梅毒合并其它性传播疾病感染情况分析

目的 掌握孕妇梅毒感染其它性传播疾病的情况。方法 对深圳市龙岗区2003年7月～2004年7月所发现的184例孕妇梅毒，分别进行SrD、淋病、支原体、衣原体等性病实验检查。结果 184例孕妇梅毒中，淋病感染3例，占1．63％，衣原体11例，占5．98％，解脲支原体13例，占7．06％，衣原体加解脲支原体6例，占3．26％，尖锐湿疣5例，占2．72％，生殖器疱疹7例，占3．80％。结论 孕妇梅毒患者不仅是单一病原体感染，而且还存在着多种病原体的混合感染，因此，对于孕妇梅毒必须进行全面性病病原体检查。     

Sexual abuse of children. Detection and management

Detection of sexual abuse in children involves careful history-taking, complete physical examination, and most importantly, a high index of suspicion. Primary care physicians play an important role, since they are likely to be the first persons consulted. Complete management includes immediate attention to physical care, prophylactic measures, psychological evaluation and treatment, and collection of medicolegal evidence. For the protection of the child, one person must assume responsibility to coordination of treatment and adequate follow-up.