Sex differences in indicators of well-being in adolescents.

The 1999 Youth Risk Behavior Survey, administered to 964 females and 852 males in randomly selected high schools in a midwestern state, indicated significantly greater negative indicators of mental and physical well-being for adolescent girls than adolescent boys. Results of the 1997 survey finding that significantly more adolescent girls reported engaging in several high risk sexual and drug behaviors such as having their first drink of alcohol at an earlier age, driving a vehicle in the past 30 days when they had been drinking, smoking at an earlier age, smoking more cigarettes per day, and using over-the-counter drugs to get high more often, were supported and enlarged.

Maternal immunity to measles and infant immunity at less than twelve months of age relative to maternal place of birth.

Sera from infants aged 5 to 11 months and from their mothers were used to investigate the level and duration of transplacentally derived measles antibody. The infants of foreign-born, inner-city mothers were more likely to have measles antibody and were less likely to get measles. Infants of foreign-born mothers, because they are less likely to respond to measles vaccine, may require different vaccine strategies than infants of mothers born in the United States.

A secure end colostomy technique.

A secure end colostomy technique preventing the common complications of intestinal prolapse and paracolostomy hernia is presented. Prosthetic mesh is fitted and secured to the intestine and the underside of the abdominal wall, giving considerable strength to the area and avoiding complications.

Benzidine activation in the Ames test: roles of hepatic N-acetyltransferase and other cytosolic and microsomal factors.

Benzidine (BZ) is a known animal and human carcinogen, and is mutagenic in the Ames test using strain TA 98. Several workers have shown that hepatic S9 fraction from hamster is much more effective than is rat S9, as an activation system for BZ in the Ames test. We show that rat microsomal fraction inhibits hamster S9 activation of BZ. Hamster microsomal fraction, supplemented with glucose-6-phosphate dehydrogenase (G6PdeH), gives a BZ dose-dependent mutagenic response, in the absence of cytosolic fraction. Rat microsomal fraction, in contrast, gives relatively little activation, under comparable conditions. Activation was enhanced when hamster or rat cytosol was added back to a mixture of hamster microsomes and G6PdeH. When strain TA 98 was replaced by strain TA 98/1,8-DNP6, very little activation of BZ was observed. Partially purified mouse liver acetyltransferase effectively activated BZ to mutagenic products in the presence of acetyl coenzyme A (CoASAc)/hamster microsomes/G6PdeH. Hamster and rat liver cytosol contain a CoASAc-dependent as well as a CoASAc-independent cytosolic activating factor of BZ. Hamster but not rat microsomal activation of BZ is enhanced in the presence of CoASAc. The biochemical mechanisms of BZ activation in the Ames test are discussed in light of these results.

Factors related to eating disorders in young adolescent girls.

The objective of this study was to identify factors related to eating disorders in young adolescent girls. Three hundred eighty-five girls who were attending a career conference at a midwestern university completed the Eating Disorder Instrument (EDI) along with a biographical data sheet. The EDI is designed for the assessment of psychological and behavior traits common in eating disorders. While 81% of the young subjects were assessed to be within the range for ideal weight or were underweight, 78% preferred to weigh less. Only 14% were satisfied with their current weight. Findings for each of the subscales used revealed significant differences among the girls based on intact versus broken family; subjects' actual and preferred weight; whether the family ate meals together; average grades; age and grade in school; fathers' occupation; future career plans; place of residence; and feelings toward their mothers.

Hernia of the inferior lumbar space. A cause of back pain.

Twenty hernias of incarcerated fat at the inferior lumbar space were seen during a 23-year period. The usual complaint was a painful mass that caused a backache. The condition was more common in women and girls than in men (18 v two). The wider female pelvis creates a larger inferior lumbar space, which predisposes to the hernia. The hernia appears through a defect of the covering lumbodorsal fascia. Increased physical activity in young women seemed to be a causative factor. One patient had acute strangulation of incarcerated fat. Nineteen of the 20 hernias were treated with surgical excision and repair of the lumbodorsal fascial defect. Results of treatment were good. Though rare, hernias of the inferior lumbar space should be considered when back pain is present, particularly in a young, athletic woman.

Pathomechanics, gait deviations, and treatment of the rheumatoid foot: a clinical report.

This article describes the five major foot deformities or problems often seen in patients with rheumatoid arthritis: hallux valgus, pronation of the foot, depression of the metatarsal heads, hammer or claw toes, and tendocalcaneal bursitis or subplantar spur formation. These deformities contribute to the development of common rheumatoid gait deviations such as decreased velocity, cadence, and stride length; poor heel-toe pattern; and abnormal patterns of weight bearing. Nonsurgical treatment for these problems includes joint protection methods, assistive gait devices, orthotic intervention, and physical therapy procedures. Surgical intervention provides stability for the weight-bearing joints of the foot and reduces pain. Consideration of these problems and an early intervention effort may help to prolong the ambulatory status of the patient with rheumatoid arthritis.

The potential of the teaching hospital for the development of prepaid group practices.

This paper deals with the development of a hospital based prepaid group practice at Long Island Jewish-Hillside Medical Center. The paper provides an historical perspective of the factors leading to the decision to develop such a Medical Group practice, the difficulties encountered in obtaining conceptual approval from the Medical Center's Board of Trustees and its medical staff, the negotiations between the Medical Center and Blue Cross-Blue Shield of Greater New York as the insurance company which agreed to market the program and to subsidize it in its developmental stage, factors relating to the contractual negotiations between the Medical Center and Blue Cross, the key elements of the negotiated contract from the standpoint of the prepaid group, and the nature of the subsidies provided to ensure a healthy fiscal beginning. The paper highlights the methods used in achieving the desired goals and the development of the Group, sets forth the resistance which other, similar hospitals might anticipate in undertaking such a venture of their own, and highlights the nature and the degree of commitment necessary to bring such a program into being.

Satisfaction with medical care during pregnancy and delivery.

Societal attitudes toward the medical profession are apparently undergoing a change from awe and total respect to a more critical assessing of accountability and credibility. Based on mass media reports and the increasing number of malpractice suits, it would appear that a rational, unbiased review of medical doctors, hospital personnel, and care received is in order. This review should be concerned with technical aspects of medicine as determined by highly competent professionals and the consumer's view of the medical care he receives. The latter review should logically be taken directly to the consumers of medical care to determine their satisfaction with the care they received. Because of the varied areas of specialty within the medical profession, there are different types of relationships between doctors and their patients. The obstetrician, for instance, is usually associated with pregnancy as a joyful event, in contrast to a surgeon whose diagnosis may seldom be accompanied by joy. Satisfaction with medical care could thus be expected to vary according to the area of specialty and may be related to factors over which doctors have no control, factors which initially bring the patient to the doctor for care. The degree of anxiety related to the patient's condition could also be expected to contribute to the degree of satisfaction expressed by the patient.