College men's health in practice: a multidisciplinary approach.

After a needs assessment indicated that male students underutilized campus health services, the San Francisco State University Student Health Service developed a coordinated complement of outpatient health services for men. The authors review their experience in developing, implementing, operating, and evaluating this ongoing clinical service. The needs assessment and subsequent program evaluation data suggest that male students on a large, culturally diverse, urban campus would respond favorably to targeted, multidisciplinary health initiatives that incorporate the principles of health promotion and disease prevention.

Dehydroepiandrosterone antagonizes the suppressive effects of dexamethasone on lymphocyte proliferation.

Administration of dehydroepiandrosterone (DHEA) appears to have physiological effects opposing those of glucocorticoids in several animal models. Recently, immunomodulatory effects of treatment with DHEA have been described. This paper reports the effects of DHEA treatment on splenocyte blastogenic responses as well as thymic and spleen weights in C3H/HeN mice. Pretreatment of mice with sc DHEA (60 mg/kg.day) for 3 days in vivo antagonized the profound suppression of in vitro blastogenic responses seen in T- and B-lymphocytes after a single injection of dexamethasone (DEX; 60 mg/kg). Pretreatment with DHEA also significantly reduced dexamethasone-induced thymic and splenic atrophy. Splenic lymphocytes from DHEA-treated mice were markedly more resistant to in in vitro suppression of blastogenesis by DEX at 10(-6)-10(-8) M compared to lymphocytes from control mice. However, DHEA added to lymphocyte cultures in vitro over a concentration range from 10(-7)-10(-8) M failed to protect against suppression of mitogenic responses caused by addition of DEX to cultures. In summary, DHEA given in vivo antagonizes the suppressive actions of DEX on lymphoid target tissues in mice.

The medical care of street youth.

Our clinical contacts with street youth support the view that their numbers are growing and that their medical needs are largely neglected. We describe our experience in providing medical care to street youth in Seattle, with attention to their medical presentations and patterns of health care utilization. We address aspects of adolescent street life that are unique to that particular mode of living or importantly formative in the lives of persons drawn to it.

Partial anomalous pulmonary venous drainage associated with 45,X Turner's syndrome.

Turner's syndrome has well-described associations with congenital heart disease. Up to one third of patients with karyotype 45,X may have coarctation of the aorta. In addition, patients with hypertrophic cardiomyopathy, septal defects, dextrocardia, and anomalous pulmonary venous drainage have been reported anecdotally. Twenty-one consecutive patients with Turner's syndrome were prospectively evaluated. All patients underwent examination by a pediatric cardiologist, electrocardiogram, chest radiograph, and echocardiogram. Three patients with evidence of right ventricular volume overload had cardiac catheterization. Of 12 patients with karyotype 45,X 3 had partial anomalous pulmonary venous drainage with intact atrial septum. One of the 3 also had moderate aortic stenosis. Two additional patients with 45,X had coarctation of the aorta and bicuspid aortic valve, and 4 other patients had minor cardiac defects. Of 9 patients with mosaic karyotype, 1 had a minor cardiac defect. The observations suggest that there may be a significant association of 45,X Turner's syndrome and partial anomalous pulmonary venous drainage.