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F C Verhulst 《Nederlands tijdschrift voor geneeskunde》1992,136(50):2453-2456
Recently the Dutch Health Council published a report on the medical aspects of sexual abuse of children. The questions underlying this report reflect an attempt to arrive at hard indices of sexual abuse in children through the assessment of physical symptoms. For the medical assessment, the authors refer to the Dutch translation of an English report entitled Physical signs of sexual abuse in children, published by The Royal College of Physicians. The hazards connected with the exclusive focus on physical symptoms are recognized, and the authors stress that medical examination should be part of a much broader assessment of the child and his/her family. However, instead of confining themselves to assessment issues of physical symptoms, the authors add a rather meagre account of behavioural and emotional factors relevant to the diagnosis of sexual abuse of children. Unfortunately, this approach seems to aggravate the problems underlying misdiagnosis rather than to increase diagnostic accuracy and improve adequate care for sexually abused children. 相似文献
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Marjolein Wals Jim van Os Catrien G Reichart Manon H J Hillegers Johan Ormel Frank C Verhulst Willem A Nolen 《American journal of medical genetics. Part B, Neuropsychiatric genetics》2004,(1):35-41
The aim of our study was to determine whether familial loading of unipolar disorder, bipolar disorder, and substance use disorder are associated with DSM-IV mood disorders in adolescents at risk for bipolar disorder. One hundred and forty adolescents aged 12-21 years of 86 bipolar parents participated in the study. Lifetime DSM-IV diagnoses of the bipolar offspring were assessed with the Schedule for Affective Disorders and Schizophrenia for School Age Children Kiddie-SADS-Present and Lifetime Version (SADS-PL). Parents were interviewed using the Family History Research Diagnostic Criteria (FH-RDC) which were used to calculate a continuous familial loading score (FL) for unipolar disorder, bipolar disorder, and for substance use disorder in first- and second-degree relatives of the adolescents. FL for unipolar disorder and substance use disorder were strong and independent predictors for lifetime mood disorders in the adolescents. The gender adjusted hazard ratios for mood disorders in the children were 1.5 (95% confidence interval (CI) = 1.2-2.0) for FL of unipolar disorder and 1.8 (95% CI = 1.3-2.4) for FL of substance use disorder. Expression of mood disorders in children of bipolar parents varies with the degree of additional FL of unipolar disorder and substance use disorder in the extended family. 相似文献
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Comparison of chlorhexidine and tincture of iodine for skin antisepsis in preparation for blood sample collection
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Rates of contamination of blood cultures obtained when skin was prepared with iodine tincture versus chlorhexidine were compared. For iodine tincture, the contamination rate was 2.7%; for chlorhexidine, it was 3.1%. The 0.41% difference is not statistically significant. Chlorhexidine has comparable effectiveness and is safer, cheaper, and preferred by staff, so it is an alternative to iodine tincture. 相似文献
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Anderson RA; Wallace AM; Kicman AT; Wu FC 《Human reproduction (Oxford, England)》1997,12(8):1657-1662
Administration of supraphysiological doses of testosterone to normal men
causes inhibition of spermatogenesis, but while most become azoospermic,
30-55% maintain a low rate of spermatogenesis. We have investigated whether
there are differences in endogenous androgen production, of testicular and
adrenal origin, which may be related to the degree of suppression of
spermatogenesis. Thirty-three healthy Caucasian men were given weekly i.m.
injections of 200 mg testosterone oenanthate (TE), 18 became azoospermic,
while 15 remained oligozoospermic. Urinary excretion of epitestosterone, a
specific testicular product, was reduced to <10% of pretreatment values,
with no differences between the groups. Similar results were obtained for
other markers of testicular steroidogenesis. Urinary and plasma adrenal
androgens were also reduced during TE treatment: a statistically
significant decrease in both (P < 0.001 and P < 0.05 respectively)
was seen in the azoospermic but not oligozoospermic responders. These
results suggest that testicular steroidogenesis is decreased to <10% by
the administration of supraphysiological doses of exogenous testosterone.
Differences in the degree of ongoing steroidogenesis in the testis do not
appear to account for incomplete suppression of spermatogenesis, thus
differences in androgen metabolism may underlie this heterogeneous
response. A small but significant reduction in secretion of adrenal
androgens was also detectable, the relevance of which is unclear.
相似文献
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Bilateral salpingectomy does not compromise ovarian stimulation in an in-vitro fertilization/embryo transfer programme 总被引:9,自引:5,他引:9
Verhulst Guy; Vandersteen Nadia; Van Steirteghem Andre C.; Devroey Paul 《Human reproduction (Oxford, England)》1994,9(4):624-628
The question whether salpingectomy has a negative influenceon ovarian function and the outcome of pregnancy in an in-vitrofertilization (IVF) and embryo transfer treatment programmeis not yet answered. We performed a retrospective case-controlstudy to investigate the possible negative effect of salpingectomyon ovarian response to human menopausal gonadotrophins (HMG)during IVF and embryo transfer. The study group was composedof 26 patients with bilateral salpingectomy. In 67 cycles weanalysed different parameters of ovulation such as the numberof days of ovarian stimulation, numbers of ampoules of HMG,pre-ovulatory oestradiol concentrations and the numbers of oocytesretrieved. These parameters were compared to a control groupof 134 cycles in 134 women with healthy Fallopian tubes. Nodifferences were found. Implantation ratio, pregnancy rate andoutcome were the same in both groups. We conclude that bilateralsalpingectomy had no detrimental effect on ovarian performanceduring IVF and embryo transfer treatment nor on the outcome. 相似文献
10.
This study was designed to investigate associations between emotional and behavioural problems in adolescence and psychopathology in young adulthood.Seven hundred and six 11- to 16-year-olds from the Dutch general population were followed across a period of 8 years and 8 months. Subjects were initially assessed using the Child Behaviour Checklist (CBCL). At follow-up, a subsample of 131 subjects were assessed for DSM-III-R Axis 1 diagnoses with the SCAN (a semi-structured interview), while the Global Assessment of Functioning scale and the Groningen Social Disabilities Schedule were used to assess functioning in daily life. Scores on the CBCL scales Withdrawn, Anxious/Depressed, Somatic Complaints, Social Problems and Thought Problems in adolescence were associated with DSM-III-R symptomatology or dysfunctioning in young adulthood. 相似文献