Sexual assault: review of a national model protocol for forensic and medical evaluation. New Hampshire Sexual Assault Medical Examination Protocol Project Committee.

A national hospital/community model protocol was developed for the forensic and medical examination of victims of sexual assault. This review is designed to assist states in the development of sexual assault protocols. Controversial issues were addressed, including the collection of hair evidence, the importance of semen, mandatory reporting, pregnancy testing and prophylaxis, and sexually transmitted diseases including human immunodeficiency virus. The current role of DNA profiling is reviewed. These issues at the interface of medicine, forensic science, victim advocacy, and the law are analyzed. Representatives of the medical, legal, law enforcement, victim advocacy, and forensic science communities contributed to the development of the protocols at the national and state levels. The importance of a collaborative effort is emphasized. The broad protocol goals are to minimize the physical and psychological trauma to the victim while maximizing the probability of collecting and preserving physical evidence for potential use in the legal system.     

Xanthoderma: an unusual presentation of hypothyroidism.

A young woman presented with progressive yellowing of her skin over a period of six months. Liver function tests were requested by her general practitioner and the results prompted the Chemical Pathology Department to instigate further tests to reach the final diagnosis. Hypercarotenaemia had caused her yellow skin, and various other biochemical abnormalities pointed towards primary hypothyroidism as an underlying cause. Thyroxine replacement treatment successfully corrected all the biochemical abnormalities including hypercarotenaemia. As far as is known, yellow skin as a sole presenting feature of hypothyroidism is extremely rare.     

Stage II carcinoma of the ovary: an analysis of survival after comprehensive surgical staging and adjuvant therapy.

Ninety-three women with FIGO stage II epithelial ovarian carcinoma underwent comprehensive surgical staging and were randomized prospectively to therapy consisting of either intraperitoneal radioactive phosphorus or oral melphalan. No patient had gross residual disease at the time of randomization. Ten of the forty-five women treated with melphalan experienced severe bone marrow depression at some time during therapy and two women expired from leukemia. Four of the forty-eight women treated with intraperitoneal phosphorus required surgical reexploration for intestinal obstruction or bowel injury. Twenty-one women died of their disease. Survival was not statistically different between the two treatment arms. The 5-year actuarial survival was 78%.     

An interesting case presentation: a possible new route for perinatal acquisition of Chlamydia.

Chlamydia trachomatis is currently the most common sexually transmitted disease in the United States. The prevalence in pregnant women ranges between 2% and 47%. It is well known that C trachomatis can be transmitted from the genital tract of an infected mother to her newborn infant, causing conjunctivitis or pneumonia or both, along with their longstanding complications. A review of the literature failed to show, however, conclusive evidence of transmission of infection to the newborn infant when the infant was born by cesarean section with intact amniotic membranes. We present a case of a young black woman with a history of chlamydia cervicitis during pregnancy whose infant was delivered by cesarean section because of failure to progress. She gave birth to a healthy term infant who developed ophthalmia neonatorum on the 3rd day of life. Examinations of conjunctival scrapings with direct fluorescent staining (chlamydia MicroTrak) performed on the 1st and 3rd day of life were positive. The initial test was performed because of the maternal history. The infant was mildly symptomatic at the time the study was repeated for confirmation. Our findings strongly suggest the possibility of either transmembrane or transplacental route of infection in the pathogenesis of neonatal chlamydia infection. Further study is needed to confirm this possibility.     

Investigation of a whole-body receiver coil operating at liquid nitrogen temperatures

This communication describes the design and application of a receiver coil operating at liquid nitrogen temperature and intended as a surface coil in a whole-body imager. Its particular application is seen as the external receiver for parasitic internal or implanted detectors.     

Portion Sizes in Dietary Assessment: Issues and Policy Implications

Accurate estimates of energy and nutrient intake of individuals and populations are contingent on the reliability of information obtained about food intake, food composition, and portion size. This article reviews issues related to the definition, determination, and use of portion sizes in dietary assessment and public education.