Advice on the Management of Ambiguous Genitalia to a Young Endocrinologist from Experienced Clinicians

The birth of a child with ambiguous genitalia is a challenging and distressing event for the family and physician and one with life-long consequences. Most disorders of sexual differentiation (DSD) associated with ambiguous genitalia are the result either of inappropriate virilization of girls or incomplete virilization of boys. It is important to establish a diagnosis as soon as possible, for psychological, social, and medical reasons, particularly for recognizing accompanying life-threatening disorders such as the salt-losing form of congenital adrenal hyperplasia. In most instances, there is sufficient follow-up data so that making the diagnosis also establishes the appropriate gender assignment (infants with congenital adrenal hyperplasia, those with androgen resistance syndromes), but some causes of DSD such as steroid 5 alpha-reductase 2 deficiency and 17 beta-hydroxysteroid dehydrogenase deficiency are associated with frequent change in social sex later in life. In these instances, guidelines for sex assignment are less well established.

Figures of equilibrium for tidally deformed non-homogeneous celestial bodies

Abstract (2,250 Maximum Characters): Several theories of tidal evolution, since the theory developed by Darwin in the XIX century, are based on the figure of equilibrium of the tidally deformed body. Frequently the adopted figure is a Jeans prolate spheroid. In some case, however, the rotation is important and Roche ellipsoids are used. The main limitations of these models are (a) they refer to homogeneous bodies; (b) the rotation axis is perpendicular to the plane of the orbit. This communication aims at presenting several results in which these hypotheses are not done. In what concerns the non-homogeneity, the presented results concerns initially bodies formed by N homogeneous layers and we study the non sphericity of each layer and relate them to the density distribution. The result is similar to the Clairaut figure of equilibrium, often used in planetary sciences, but taking into full account the tidal deformation. The case of the rotation axis non perpendicular to the orbital plane is much more complex and the study has been restricted for the moment to the case of homogeneous bodies.