Stress in social and family relationships during the medical residency.

A study of stress during residency training involved data analysis of questionnaires completed by 108 residents and fellows in internal medicine. Over 40 percent of the respondents experienced important problems with their spouse or partner. Of these, 72 percent believed that these problems were due to the residency, and 61 percent reported that their spouse or partner agreed with this assessment. Only 21 percent of the residents with relationship problems felt that their hospital work was being affected negatively. A multiple regression analysis showed that 10 variables accounted for 50 percent of the variance in predicting relationship stress. The results suggest that scheduling and structural changes in residencies are necessary in order to reduce stress among residents. Perhaps equally important is the finding that stress can be buffered by family relationships and social contact. The authors conclude that social support systems need to be fostered during the residency.

Comparison of the morbidity of tetanus toxoid boosters with tetanus-diphtheria toxoid boosters.

A double-blind randomized trial was performed to compare the subjective morbidity of tetanus toxoid (T) with that of tetanus-diphtheria toxoid (Td). Symptoms occurred in 46 (48%) of 93 patients who received T, and in 75 of 100 patients who received Td (chi 2 = 12.3; P less than .001). The effectiveness of immunization is clear, but with shift from use of T to Td as recommended, adherence to immunization guidelines and taking of adequate immunization histories becomes even more important.

Primary squamous ovarian carcinoma. A case report and review of the literature.

A case of pure primary squamous cell carcinoma of the ovary is presented and the literature is reviewed. Unlike both previously reported cases, this case was not associated with antecedant carcinoma of the cervix. Possible origins of squamous ovarian neoplasm are discussed.