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Pediatricians should obtain access to the Internet because it contains much of interest and value to them. The Internet permits many different types of communication, including text, pictures and graphs. E-mail permits communication between individuals. Listservs are programs that provide access to special interest discussion groups. Both e-mail and Listservs allow the pediatrician to consult with colleagues around the world. File Transfer Protocols, Telnet, and the World Wide Web permit access to many different sources of medical information. There are programs that allow the user to search for areas of interest. Specific information is given for sites of interest to pediatricians and how to access them. Two warnings: the pediatrician must cross-check information for accuracy, and the pediatrician must be aware of the legal ramifications of giving medical advice or consulting on cases.

Mistreatment of Gay Medical Students TO THE EDITOR: I read with great interest the report by Dr Baldwin and colleagues concerning medical students' perceptions of mistreatment during their training. (1) [...]

DENOUEMENT AND DISCUSSION OTA'S NEVUS MANIFESTATIONS Ota's nevus is a disorder of pigmentation characterized by macular lesions that may be tan, brown, slate gray, blue, purple, or black in color and that resemble a mongolian spot in appearance. Involvement is usually unilateral and affects areas innervated by the first, second, and occasionally the third division of the trigeminal nerve.Approximately two thirds of the patients have scleral involvement ranging from small patchy lesions to an almost completely blue "spilt-ink" staining of the affected eye. Hyperpigmentation of the orbit and associated structures may also occur in the iris, cornea, ocular fundus, optic papilla, retrobulbular fat, periosteum of the orbital bone, or the optic nerve. Glaucoma of the involved eye has been reported.Other areas of involvement include the mucous membranes of the nose and mouth, tympanic membrane, external auditory canal, neck, and rarely the leptomeninges.It occurs more commonly in Oriental and black individuals and affects females

• Neonatal infections have been caused by Streptococcus bovis, a nonenterococcal group D Streptococcus. A recent case of neonatal meningitis caused by this organism prompted a literature review regarding appropriate antibiotic therapy. Although most reports suggested penicillin therapy alone for S bovis meningitis, isolates of this organism that were as resistant to the lethal effect of penicillin as the enterococcus have been recovered. Therefor, it was recommended that until the results of minimal inhibitory concentration and minimal bactericidal concentration tests are known both an aminoglycoside and a penicillin be used simultaneously. Proved susceptibility to the penicillin would justify discontinuation of the aminoglycoside therapy. Physicians caring for neonates with S bovis should be aware that some strains may be resistant to the lethal effect of penicillin.(Am J Dis Child 133:1149-1150, 1979)

In Reply.—We were quite surprised that a letter such as Dr Jones' would be printed in AJDC. The Pediatric Forum is a place for the rational discussion of issues of current concern and importance for children's health. All Biblical references in Dr Jones' letter were written before the birth of Christ or very shortly thereafter.Times were very different then. Humanity was struggling with a number of issues that no longer exist. New problems have arisen, problems of perplexing difficulty, that were unknown to the very inspired but ancient people who set down the text of the Bible.Since the writing of the passages quoted by Dr Jones, much has occurred in the history of humanity. There has been a Renaissance, a Reformation, an Industrial Revolution, an American Revolution, a Civil War, two world wars, a Civil Rights Movement, a Women's Rights Movement, and a Gay Rights Movement. All of these

In Reply.—Sedlis needs to realize that a great many gay and lesbian teens are killing themselves. They feel isolated and alone. They hear too many negative messages about their sexual orientation.Most gay, lesbian, or bisexual adolescents will not bring up the subject of their sexual orientation with their pediatrician. Only by validating and celebrating a boy's gayness, a girl's lesbianism, or a person's bisexuality, will the message of true acceptance be brought across, thereby potentially saving the life of one wonderful human person.If Sedlis and the other pediatricians who strongly support "traditional families and mores" cannot bring themselves to accept the wholesomeness of gayness, lesbianism, or bisexuality, they should not be treating gay, lesbian, or bisexual teens.

In Reply.—We wholeheartedly agree with Dr Willbanks' concerns about unsafe sexual practices. It is clearly the duty of health care providers to instruct all patients, whether straight or gay, about reducing high-risk behavior.Dr Willbanks is apparently confusing gayness with promiscuity and risky sexual behavior. There exists no intrinsic link between persons' sexual orientation and the number of sexual partners with whom he or she ultimately will connect. The link between gayness and promiscuity is a vicious myth perpetuated by homophobic and ignorant individuals who, hopefully, will find the time to better educate themselves. Let it be clearly understood that in our practice of pediatric medicine, the vast majority of sexually transmitted disease occurs in heterosexual adolescents. Let it also be known that the particular sexual orientation of each of our adolescents is respected, validated, and celebrated.Finally, we wish to direct attention to the fact that a permanent, monogamous, gay

Sir.—We read with great interest and careful attention the two articles1,2 that appeared in the June issue of AJDC highlighting preventive aspects of pediatric injury, including suicide. Both of these well-written and researched reports placed great emphasis on the preventability of injury, as well as intervention strategies and suggestions for further research. Indeed, such emphasis is a most significant aspect of pediatric and adolescent medical practice, and much of our office time is devoted to the education of children, teenagers, and their parents.During our study of these articles, we found the omission of a most important topic, one that brings into focus the existence of the gay (homosexual) teenager. Although adolescent suicide, including the causes and suggestions for prevention, is discussed, the gay adolescent was not mentioned.Gay teenagers most certainly exist. At least 10% of our country's population is gay, and there are approximately 2.9 million

Sir.—The study of RBCs done by Stockman and Oski (Journal 1980;134:945-946) demonstrated that mean corpuscular volume (MCV) of low-birth-weight infants progressively declined with age. No etiologic factor for this decline could be determined.The MCV was determined by electronic counting, and therefore no distinction could have been made between reticulocytes and mature RBCs, as only an average MCV is recorded.1 Thus, a high peripheral blood reticulocyte count, as occurs normally in the perinatal period,2 may contribute to a high MCV, even though the mature RBCs may be of smaller size.I suggest that the high values of MCV and the subsequent decline with age may be, at least in part, an artifact of electronic counting, secondary to the normal decline of the reticulocyte count in the perinatal period.Correspondence pertaining to material published in the JOURNAL will be published, if found suitable, as space permits. Submit double-spaced