The significance of childhood sexual abuse for adult psychiatry.

Childhood sexual abuse is now recognized as a common occurrence, and it has been accepted that in a substantial number of cases victims suffer lasting psychological damage. Many such people are now speaking out and seeking help for the first time. They require sensitive assessment and understanding.

A study of the effect of introducing a restrictive cervical screening policy on laboratory workload and cervical cancer detection rates.

This study examines the effect of a change in screening policy on the detection rate of severe dyskaryosis. During 1987 a total of 423 cases of severe dyskaryosis were identified by the Avon Screening Programme. Eleven per cent of these abnormal smears were repeat smears taken without clinical indication within the recommended 5 year recall period (interval smears).

Terodiline: a dose titrated, multicenter study of the treatment of idiopathic detrusor instability in women.

Idiopathic detrusor instability is a common cause of lower urinary tract symptoms at all ages and in both sexes. Treatment initially is conservative and often includes drug therapy. Terodiline has the theoretical advantage of being a drug with anticholinergic and calcium channel blocking effects.

Mononeuritis multiplex and occipital infarction complicating giant cell arteritis.

A 67-year-old lady with giant cell arteritis presented with a normal erythrocyte sedimentation rate (ESR) and developed occipital infarction and mononeuritis multiplex shortly after being started on high dose steroids.

Delayed diagnosis of traumatic rupture of the spleen--a warning of the use of thoracic epidural analgesia in chest trauma.

Epidural analgesia is useful in controlling the pain from chest injuries. However, a case is presented where analgesia delayed the diagnosis of a splenic haematoma. Diagnosis was complicated by an initial negative peritoneal lavage.

How useful is riboflavin as a tracer of medication compliance?

A quantitative spectrofluorometer assay of urinary riboflavin is described. Using the method, levels produced by prescribed riboflavin are reliably distinguished from normal background levels without requiring dietary restrictions. The method is successfully used to verify the intake of a single 50-mg dose of riboflavin.

Postoperative sore throat related to the use of a Guedel airway.

Eighty-eight patients in ASA classes 1 or 2 and aged between 18-65 years, who were to undergo anaesthesia, were allocated randomly to a group with or without an airway. Methohexitone, nitrous oxide, alfentanil and enflurane were used, with the patients breathing spontaneously. This study showed that there was no significant difference between the two groups in the incidence of sore throat, or any other related symptom, and concludes that the use of an oropharyngeal airway does not increase morbidity among nonintubated patients.

Shift system for senior house officer on call duties on a neonatal intensive care unit.

To reduce the number of hours that senior house officers in the neonatal department at Southmead Hospital, Bristol, have to work continuously a new on call rota was devised. The rota changed the traditional one in three system of 24 and 32 hour periods on call to one with two shifts each day, and it spread the workload more evenly among the personnel. The continuity of care of the patients was improved, no extra staff were recruited, and the new system was favoured by senior and junior medical and nursing staff.