Prevalence and patterns of intimate partner violence among adolescent mothers during the postpartum period

OBJECTIVE: To examine prevalence, frequency, severity, and patterns of intimate partner violence (IPV) during the first 24 months' post partum within a multiethnic cohort of adolescents. DESIGN: A prospective study of adolescent girls followed up for 24 months into the postpartum period. Follow-up surveys were completed at 3, 6, 12, 18, and 24 months' post partum. Overall, 74% completed at least 4 of the 5 follow-up surveys. SETTING: Postpartum unit at a university teaching hospital in Galveston, Tex. PARTICIPANTS: A total of 570 adolescents (18 years or younger; 219 Mexican Americans, 182 African Americans, and 169 European Americans) completed face-to-face interviews within 48 hours of delivery and returned at least 4 of 5 follow-up surveys. MAIN OUTCOME MEASURES: Prevalence of IPV and frequent and severe IPV. RESULTS: Prevalence of IPV was highest at 3 months' post partum (21%) and lowest at 24 months (13%). The percentage of assaulted mothers who experienced severe IPV increased from 40% to 62% across this period. Seventy-five percent of mothers reporting IPV during pregnancy also reported IPV within 24 months following delivery. Of importance, 78% who experienced IPV during the first 3 postpartum months had not reported IPV before delivery. Ethnic differences in IPV were observed at 3, 6, and 18 months' post partum. CONCLUSIONS: Adolescents are at high risk for experiencing IPV during the postpartum period. Frequent screening for IPV by health care practitioners is critical to maximize detection.     

Violence in the lives of young women: clinical care and management

Millions of female children, adolescents, and young adults from all socioeconomic segments of society will experience physical or sexual violence perpetrated by someone close to them at some point in their lives. Knowledge of risk factors and sequelae associated with interpersonal violence, and of specific screening tools and procedures designed to detect violence, can help clinicians identify potential victims of assault. Careful management and referral of victims is critical. The use of anticipatory guidance to prevent physical and sexual violence is also advised.     

Differential characteristics of two newly established human breast carcinoma cell lines

Two human breast carcinoma cell lines, EP and MW, were established in culture from malignant pleural effusions. In addition to producing tumors in antithymocyte serum-immunosuppressed mice, both cell lines showed epithelial characteristics and anchorage-independent growth in soft agar. EP and MW differed in morphology (spindle-shaped versus round), chromosomal mode (hyperdiploid versus near triploid), estrogen receptor content (43.8 versus 5.1 fmol/mg protein), cloning efficiency (0.24 versus 15%), and activities (milliunits/10(6) cells) of creatine phosphokinase (25.7 versus 62.6) and lactate dehydrogenase (346.7 versus 778.5). Electron microscopy revealed that MW cells had more perinuclear filamentous material and more frequent intracytoplasmic vacuole formation than did EP cells. While having no effect on MW cells at the concentrations studied (10(-5) to 10(-11) M), beta-estradiol (10(-7) M) stimulated the growth of EP cells by 106% over the hormone-depleted control. In a variety of systems, EP was consistently the more drug sensitive of the two lines. In vitro, EP was significantly (p less than 0.001) more sensitive to methotrexate, vincristine, and 5-fluorouracil, respectively. In antithymocyte serum-mouse xenografts, EP displayed a greater response to three different dosages of a combination of cyclophosphamide, methotrexate, and 5-fluorouracil. One such dosage (cyclophosphamide, 32.0 mg/kg/day; methotrexate, 13.0 mg/kg/day; 5-fluorouracil, 190.0 mg/kg/day; for 1 day) reduced EP and MW tumor weights to 5.9 and 41% of controls, respectively. These results correlated well with the clinical responses.     

Nuclear shape: An independent predictor of survival in patients with ovarian carcinoma

Geisler JP, Geisler HE, Wiemann MC, Givens SS, Zhou Z, Miller GA. Nuclear shape: An independent predictor of survival in patients with ovarian carcinoma. Int J Gynecol Cancer 1998; 8 : 164–167.
Since nuclear morphometry has recently been shown to be of prognostic value in several malignancies, including endometrial cancer, the authors attempted to see if those same morphometric features of nuclear size, shape and summed optical density had an impact on survival in patients with epithelial malignancies of the ovary. Eighty-three consecutive patients with epithelial malignancies of the ovary had their tumors studied in a quantitative manner evaluating nuclear size (NUSZ), shape (NUSH), and summed optical density (NUSD). Touch preps from this tissue were made. Patient records were examined for FIGO stage, grade, histology, as well as level of cytoreduction. The mean follow-up was 37 months (median 30 months, range 24–55 months). Multivariate analysis proved that the level of cytoreduction ( P = 0.0002), FIGO stage ( P = 0.025), and NUSH ( P = 0.036) were independent predictors of survival. NUSH ( P = 0.018) and NUSD ( P = 0.020) were significantly different among the different histologic grades. Additionally, NUSH ( P = 0.007) and NUSD ( P = 0.001) were significantly different between patients who did and did not survive. NUSZ was not significantly related to survival, stage, grade or level of cytoreduction. In conclusion, NUSH and NUSD both appear to be important morphometric features in epithelial ovarian carcinoma. Further study concerning their applicability as prognostic factors is warranted.     

Pregnant Adolescents: Experiences and Behaviors Associated with Physical Assault by an Intimate Partner

Objective: To better understand the experiences and behaviors of battered pregnant adolescents and the characteristics of their intimate partners. Methods: As part of a longitudinal multiracial/ethnic study of drug use among pregnant and parenting adolescents, 724 adolescents 18 years of age completed face-to-face interviews on the postpartum unit between April 1994 and February 1996. Adolescent mothers reported on demographic characteristics, social support and peer contact, level of substance use before and during pregnancy, nonconforming behaviors, and both lifetime and concurrent exposure to violence. Information about the father of her baby included his level of substance use, gang and police involvement, and intimate partner violence. Chi-square and Student's t tests were used to identify victim, partner, and relationship characteristics associated with being assaulted by the father of her baby during the preceding year. Results: Eighty-six (11.9%) adolescents reported being physically assaulted by the fathers of their babies. Assaulted adolescents were significantly more likely than nonassaulted adolescents to have been exposed to other forms of violence over the same 12-month period, including verbal abuse, assault by family members, being in a fight where someone was badly hurt, reporting fear of being hurt by other teens, witnessing violence perpetrated on others, and carrying a weapon for protection. A history of nonconforming behavior and frequent or recent substance use was more common among both battered adolescents and their perpetrator partners. The age and race/ethnicity of the pregnant adolescent and the length of her relationship with the father of her baby were not associated with assault status. Conclusions: Pregnant adolescents who are assaulted by intimate partners appear to live in violence-prone environments and to have partners who engage in substance use and other nonconforming behaviors. Comprehensive assessments are critical for all adolescent females at risk of assault, and direct questions about specific behaviors or situations must be used.     

Daytime acid secretion after a single dose of ranitidine and cimetidine — a double blind crossover study

Summary The purpose of the study was to evaluate the duration of inhibition of acid secretion by single oral doses of cimetidine and ranitidine. Basal and postprandial acid secretion in 6 healthy volunteers were measured for 14 h by intermittent aspiration and prolonged intragastric titration. 400 mg cimetidine reduced daytime acid secretion by 22% and 150 mg ranitidine produced 38% inhibition. Although the elimination half lives of the drugs were similar, ranitidine led to more pronounced inhibition of acid secretion during the later part of the day. The longer duration of pronounced acid inhibition by ranitidine appears to be due solely to its greater potency.