Identifying depressed and suicidal adolescents in a teen health clinic.

PURPOSE: This study examined the 6-month prevalence of depression and suicidal probability among new referrals to an adolescent health clinic. METHODS: All subjects (n = 104) completed the Beck Depression Inventory (BDI) and the Suicide Probability Scale (SPS) prior to being seen by a physician and were categorized according to presenting problem (physical complaints only, psychological complaints only, and physical and psychological complaints combined). RESULTS: Fifty-nine percent of the sample was depressed with 21% falling in the moderate range and 21% falling within the severe range of depression. Almost 23% of the sample demonstrated significant suicidal probability. The BDI and SPS were highly correlated (r = .73, p < .001) and 22% of the sample met criteria for both moderate to severe depression and suicidal probability. A significantly greater proportion of patients presenting with physical and psychological complaints combined (60%) met BDI criteria for depression than was found for the other two groups. Suicidal probability was most prevalent in patients presenting with psychological complaints only (26%) and moderate to severe depression and significant suicidal probability also coexisted to a greater extent within this group (26%). CONCLUSIONS: Results suggest that depression and suicidal probability represent significant mental health problems within the adolescent clinic and the identification of high-risk individuals can be achieved through comprehensive screening practices.

The pediatric patient in the post anesthesia care unit.

This article provides an overview of pediatric post anesthesia care. It highlights important aspects of care that are frequently encountered in practice or have the potential for being problematic. These include airway management, fluid maintenance, the treatment of seizures, thermoregulation, the management of malignant hyperthermia, the identification and treatment of emergence delirium, and the availability of appropriate emergency equipment and medications.

Post-operative bacterial endophthalmitis.

This paper critically reviews current practice in the United Kingdom in the presence of post-operative bacterial endophthalmitis. An appropriate therapeutic regime is suggested and the value of vitrectomy is emphasised together with the importance of the administration of intra-vitreal and intra-venous antibiotics.

Postoperative pain in ophthalmology.

A survey of 100 consecutive patients suggests that, overall, ophthalmic surgery is not as painful postoperatively as general surgery. Cataracts are largely painless. Retinal detachments may sometimes give rise to postoperative pain like that in general surgery, but the numbers available are not yet sufficient for statistical analysis. Routine postoperative analgesia for encirclement procedures in retinal detachment patients should be considered for at least the first 18 hours after operation.

Reported adverse effects of oral contraceptives on the eye.

PIP: 112 cases of ocular complications related to oral contraceptive therapy have been reported in Great Britain since 1964 for an overall prevalence of 0.07%. These have been divided into 6 main groups: 15 cases of cerebro-vascular disturbances with ocular symptoms; 23 apparently neurological cases with signs and symptoms localized to the eye and orbit; 21 cases of localized vascular disease, including occlusion of a retinal arteriole and of retinal veins; 34 cases of visual disturbances of mild localized symptomatology; 5 cases of contact lens intolerance, 4 after 10-14 months use of oral contraceptives; and a miscellaneous group of 14 cases of a spectrum of ocular disturbances. Some of the adverse effects reported have been related to oral contraceptives (1) by experimental evidence (examples: retinal vascular involvement, vertebro-basilar stroke syndrome) or (2) because they also occur with pregnancy (optic neuritis). There seems to be a connection between migraine and focal cerebral ischemia and patients taking oral contraceptives. A history of migraine or intraocular vascular disease is considered a contraindication to oral contraceptive therapy. Prospective studies have not shown a relationship of oral contraceptives to ocular abnormalities. Incidence of these disturbances may be so low that large numbers of patients will have to be studied before a relationship, if any, is established.^ieng