A lower reduction in umbilical artery pulsatility in mid-pregnancy predicts higher infant blood pressure six months after birth.

AIM: The Norwegian-based Cardiovascular Risk Reduction Diet in Pregnancy study found that a cholesterol-lowering diet during pregnancy was associated with an accentuated reduction in the umbilical artery pulsatility index. This follow-up study assessed the possible association between the index and the infants' blood pressure at six months of age. METHODS: In the original study, pregnant women consumed an anti-atherogenic or usual diet from gestational weeks 17-20 to birth and underwent Doppler velocimetry at 24, 30 and 36 gestational weeks. In this follow-up study, blood pressure was measured in 105 mother-infant pairs in the intervention group and 106 mother-infant pairs in the control group six months after birth. RESULTS: Mean systolic and diastolic blood pressures were not significantly different between both groups. When the groups were combined, multivariate linear analyses showed that a lower versus higher reduction (≥-0.17 versus <-0.17) in the umbilical artery pulsatility index between gestational weeks 24 and 30 and maternal diastolic blood pressure at six months postpartum were significant predictors of higher infant systolic blood pressure (p = 0.03, 0.01, respectively). CONCLUSION: A lower reduction in umbilical pulsatility index in mid-pregnancy was associated with higher infant blood pressure at six months of age. This suggests that fetoplacental intrauterine factors may influence future cardiovascular risk.

Experimental gingivitis in women using oral contraceptives.

Oral contraceptives (OC) have historically been considered a risk factor for gingival diseases. We set out to investigate this premise further, given that, over recent years, hormone concentrations in OC have been substantially reduced. Using a prospective, split-mouth, experimental gingivitis model, pre-menopausal women either taking (n 14) or not taking (n = 16) OC refrained from all oral hygiene practices in one maxillary (test) quadrant while continuing to perform normal oral hygiene activities in the contralateral (control) quadrant. Mean increases in plaque index (PI), gingival index (GI), and gingival crevicular fluid (GCF) volume from days 0 to 21 were significant in test quadrants (P < 0.05) but did not differ regardless of whether subjects received OC (P > 0.05). PI, GI, and GCF volume did not vary in control quadrants over the course of the study (P > 0.05). Analysis of these data suggests that current OC formulations do not affect the inflammatory response of the gingiva to dental plaque.

[Not using contraception among women requesting abortion]. / Manglende prevensjonsbruk blant abortsøkende kvinner.

The aim of this survey was to examine the number of abortion applicants not using contraception at the time of conception, to shed light on the reasons for this, and to acquire information about the knowledge of postcoital anticonception in this patient group. The registered data is collected from precoded medical records at the University Hospital of Trondheim comprising 2,074 women applying for abortion in the period 1.1. 1995-15.7. 1997. The 291 applying for abortion 15.1-15.7. 1997, and who had not used contraception were given a questionnaire. 160 (55%) answered the questionnaire. During the period of 2.5 years 57.4% had not used contraception at the time of conception. The tendency of non-use has increased significantly during the last 2.5 years. Concern about sideeffects was the most common reason for not using contraceptives (36%). One third trusted the rhythm method and coitus interruptus. The postcoital pill was known by 93%; of the 61 women who had considered using it, 67% thought of it too late. To prevent unwanted pregnancies, it is important to focus on the positive health effects of oral contraception. Information efforts should especially be aimed at young and single women, who represent the majority of the non-users. The cost is no great impediment to the use of contraception. Availability of emergency contraception should be improved.

PIP: Precoded medical records of 2074 women seeking abortion at the University Hospital of Trondheim, Norway, during the period of January 1, 1995, to July 15, 1997, were analyzed to find out which women had not used contraceptives. In 1995 a total of 413 (51.8%) out of 798 women did not use contraception; in 1996 a total of 487 (59.4%) out of 820 women did not use contraception; and in 1997 a total of 291 (63.8%) out of 456 women did not use contraception. This was a significantly increasing trend (p 0.001). During the period of January 15 to July 7, 1997, a total of 447 provided information about contraceptive use: 156 (34%) used contraceptives and 291 (64%) did not. 50 of 63 adolescents (79%) did not use contraception. In the 25-34 age group there were significantly more contraceptive users than in the 15-24 age group (p = 0.003) and in the 35 age group (p = 0.026). 160 women (55%) out of 291 women who did not use contraception during the first half of 1997 answered a questionnaire. 51 women (32%) thought that they could not get pregnant because of various causes of infertility (childbirth, safe period, or abdominal infections). 55 women (34%) relied on coitus interruptus or safe periods. Here there was a significantly increasing trend with advancing age (p 0.01). Condom use was undesired in 41 cases (26%), and 25 women (16%) reported unavailability of contraception. 148 women (93%) had heard about postcoital contraceptives and 61 women (38%) figured that they would use them.

A retrospective of normal oral healthcare procedures vs. power brush/jet lavage with a corroborative study.

The efficacy of power brushes and/or oral irrigating devices in comparison to manual brushing has been the subject of study and controversial results for some thirty years. Recently, a well-designed study has reported that carefully taught, consistently reinforced and monitored toothbrushing combined with necessary professional intervention is as effective as power brushing with and without oral lavage. Because the usual individual in the work-a-day world cannot or will not indulge regularly in these elaborate procedures, a simple, small sample test of comparative efficacy was done and submitted to a paired analysis. Results demonstrated that not only are these power devices as good as demonstrated by the reported studies, but also are superior for the type of patient most often encountered in daily practice--the person who does not or who cannot comply completely with instructions and who cannot constantly be monitored for compliance.

Quality control does improve the performance of laboratory practice in primary health care.

Quality control surveys combined with teaching courses and expert consultations were offered to laboratories serving general practitioners in the county of Sør-Trøndelag, Norway. Fifty-one laboratories participated in the programme and the surveys during 1988-89. During the study period the number of laboratories having acceptable accuracy of their haemoglobin determination increased from approximately 80% to more than 90%. A similar increase was found also in precision where CV declined from 6.7% to approximately 2%. Additional positive effects were more close co-operation and more fruitful dialogues between the specialist laboratory and that of the general practitioners. The results offer promising perspectives to the control of laboratory performance in primary health care and the optimal use of laboratory tests.