A British sample of sexually abusive adolescents: abuser and abuse characteristics

This paper describes some of the background characteristics and sexually abusive behaviour of 100 British sexually abusive male adolescents aged between 11 and 18 years. A retrospective file review and clinical assessment provided relevant information on all subjects who had a documented history of sexual assault or abuse against others. Subjects came from a variety of sources including residential child care centres, secure facilities and an adolescent psychiatry outpatient clinic. Demographic characteristics and abuser characteristics are described, including the family environment, history of involvement with health and social services, school adjustment and performance, history of non-sexual antisocial behaviour, and also the adolescents’ own prior experiences of physical and sexual abuse. Abuse and victim characteristics are also described, including duration of abusive behaviour, types of sexually abusive behaviour exhibited, sex offence convictions, method of overcoming victim resistance, location where abuse took place, sex and age of victims, and abuser—victim relationship. These abuser and abuse characteristics were found to be consistent with those described in the North American literature. The implications of these findings are discussed in relation to the aetiology, management and treatment of sexually abusive behaviour in British adolescents.     

EVALUATION OF KEYED FILLERS ON TEC VAPORIZERS

Single and dual port versions of the keyed fillers fitted toTEC4 and TEC3 vaporizers, respectively, were examined. The singleport filler performed satisfactorily, provided that it was correctlyused and properly maintained. Design deficiencies in the dual-portkeyed filler were found which accounted for many of the problemsdescribed by users. The keyed bottle adaptor could be improvedby an increase in its length and the provision of two openingsinto the outer tube at the bottle ends.     

The treatment of normospermic infertility by gamete intrafallopian transfer (GIFT)

Summary. Gamete intrafallopian transfer (GIFT) was applied in 207 treatment cycles in 73 couples. The pregnancy rate in cycles with only one (2/21, 9·5%) or two (2/29, 6·9%) oocytes transferred was significantly less than that in which four oocytes (36/116, 31·0%) were replaced. The collection of more than four oocytes did not influence the pregnancy rate in that treatment cycle. The overall pregnancy rate was 24·2% (50 of 207) and was similar in the four infertility groups studied (non-occlusive tubal disorders, endometriosis, cervical factor and unexplained infertility) with 28 (56%) of the pregnancies delivered at 20 weeks. The pregnancy wastage included 4 (8%) ectopic pregnancies and 3 (6%) late pregnancy losses. The 12 multiple pregnancies occurred following the transfer of three and four oocytes.     

Successful treatment of acute subdural haemorrhage with continuous intravenous infusion of factor VIII in a 17 year old with haemophilia A

Intracranial haemorrhage is a common complication of haemophilia, occurring in 2–8% of sufferers [1]. Half of the cases give a history of trauma and despite developments in the management of acute bleeding the condition still carries a mortality of approximately 30% [2]. Surgery may be required, most commonly for evacuation of a subdural haematoma which carries a mortality of up to 40% [3]. We present the case of a 17-year-old haemophiliac with a traumatic subdural haemorrhage, who was treated with a continuous intravenous infusion of factor VIII and made a complete recovery without recourse to surgery. We have found no reference in the world literature of such treatment for acute subdural haemorrhage in a haemophiliac.     

Total Parathyroidectomy Alone or with Autograft for Renal Hyperparathyroidism?

Seventy-six patients underwent parathyroidectomy for renal hyperparathyroidism.There were 10 subtotal parathyroidectomies, 49 total parathyroidectomieswith implantation of part of one gland as an autograft, ninetotal parathyroidectomies with no autograft, and eight patientsin whom only three parathyroid glands were found. In 34 dialysis patients who underwent total parathyroidectomywith an autograft there was a high rate of recurrent hyperparathyroidismafter 6 years in those remaining on dialysis. Fifty per centhad asymptomatic recurrent hyperparathyodism and 30 per centrequired partial autograft excision for symptomatic hyperparathyroidism.In contrast, recurrent hyperparathyroidism was rare in renaltransplant recipients with good renal function. This favourableoutcome did not depend upon whether parathyroid surgery wasperformed before or after transplantation, or on the type ofparathyroidectomy. Total parathyroidectomy without an autograftwas performed in nine dialysis patients without any short-termadverse effects, and with clinical and pathological improvementin bone disease. In summary, the results of surgery for renal hyperparathyroidismwere excellent in patients who received a successful renal transplant.However, there was a high incidence of recurrent hyperparathyroidismin patients who remained on long-term dialysis. Total parathyroidectomywithout an autograft may be the treatment of choice in patientsunlikely to receive a renal transplant.