Preoperative cervical screening of 1,193 women undergoing first-trimester induced abortions yielded Chlamydia trachomatis in 11.7%, Neisseria gonorrhoeae in 0.8%, Mycoplasma hominis in 22.1%, Ureaplasma urealyticum in 10.1%, herpes simplex virus in 0.9% and Group B streptococci (GBS) in 2.9%. C. trachomatis and N. gonorrhoeae were especially frequent among teenagers. A total of 2.2% (26 women) developed postoperative pelvic inflammatory disease (PID) and 0.9% (13 women) endometritis. PID developed significantly more often in untreated chlamydia-positive (22.7%), M. hominis-positive (8.1%) and GBS-positive (6.1%) women than in women without these microbes (0.5%) (p less than 0.05). Prompt treatment of the chlamydia infection before or in connection with the abortion procedure significantly decreased the likelihood of developing chlamydial PID from 22.7% to 2.1% (p less than 0.001). The study confirms the importance of preoperative screening for chlamydia and suggests screening for M. hominis and GBS as well. The results of screening should be available before the abortion, allowing patients to be treated pre- or peroperatively.

Abortion, Induced↗

PubMedDate not supplied

Nutrient intake and blood lipids in children.

Nutrient intake and serum total cholesterol (C T), serum high density lipoprotein cholesterol (HLD), triglycerides (TG) and fatty acids were evaluated from 692 3-year, 8-year and 12-year-old children in different areas in Finland. Serum/plasma TC concentrations varied from 4.8 to 5.0 mmol/l, HDL from 1.3 to 1.5 mmol/l and TG from 0.70 to 0.87 mmol/l. 12-year-old boys consumed significantly more energy than girls at the same age. In the 8-year-old boys the quality of fat used on the bread and quality of milk drunk influenced on the serum fatty acid composition, the proportion of linoleic acid being greater in those children who used margarine and/or low fat milk. The 3-year-old children at the highest quartiles of TC concentration used less wheat products and their intake of riboflavin was less than children in the lowest quartile. HDL concentration was associated with the intake of thiamine. The 12-year-old children having their TC concentrations in the highest quartile used more saturated fats and got more saturated fatty acids than children in the lowest quartile. The higher the sugar consumption and sucrose intake were, the lower was the HDL concentration. The prevalence of obesity increased with the age, being 0.5%, 5.0% and 8.5% in the 3-year, 8-year and 12-year-old children respectively. Urban children were more commonly obese than rural children, the prevalence being 8.0% versus 2.2% (p less than 0.01).

Child↗

PubMedDate not supplied

Management of late-onset tibia vara in the obese patient by using circular external fixation.

Previously published series of surgery for late-onset tibia vara reported a significant number of complications and fair or poor results. Obesity in many of these patients makes surgical intervention an even more daunting prospect. Circular external fixation is applicable to almost any limb size and allows weight bearing as tolerated, with gradual adjustment of alignment. Twenty-five tibiae in 17 patients who exceeded their ideal body weight by > or =50% underwent correction of late-onset tibia vara with the Ilizarov technique. Average age at surgery was 11 years 7 months (range, 7 years 8 months to 15 years 11 months). Mean varus deformity was 27 degrees (range, 10-55 degrees). Treatment time averaged 12 weeks in patients without lengthening and 16.9 weeks in those requiring lengthening (mean, 3.5 cm). All patients achieved alignment within 5 degrees of normal. Complications included one delayed union, premature consolidation in one, and two residual limb-length inequalities. There were no cases of osteomyelitis, compartment syndrome, or nerve palsy. These results are a significant improvement over reports of traditional methods in these difficult patients.

Adolescent↗

PubMedDate not supplied

Nurses: an image change still needed.

In Australia the image of nurses has not changed, despite advances in nursing practice, education and research. The stereotyped image affects how nurses practice and the future of the nursing profession. Below, a look at how the nurses' image affects nursing practice and suggestions on how this image can be improved.

Australia↗