Pediatric short bowel syndrome: pathophysiology, nursing care, and management issues.

ISSUES AND PURPOSE: A comprehensive overview of the etiology, pathophysiology, nursing care, and medical and surgical management of the child with short bowel syndrome (SBS), which follows massive anatomical or functional loss of the small intestine. CONCLUSIONS: The outlook for children with SBS has improved due to recent advances in parenteral and enteral nutrition, pharmacologic interventions, and surgical options. PRACTICE IMPLICATIONS: Nurses whose practice reflects an in-depth knowledge of the etiology, pathophysiology, medical and surgical management, nursing interventions, and complications of SBS will be equipped to provide quality care for children and families affected by SBS.

The efficacy of an endocervical brush in obtaining adequate Papanicolaou smears.

A total of 249 consecutive women attending a family planning clinic were entered in a study to determine the efficacy of the endocervical brush versus the cotton swab in obtaining routine Papanicolaou smears. Also investigated were whether the experience level of the smear taker contributed to the adequacy of the sample and whether simultaneous sampling by means of the spatula (an ectocervical sampling method) was justified. The use of the endocervical brush in place of the swab was found to improve cell collection by reducing the frequency of inadequate smears. The experience of the sample taker appeared not to be a factor in obtaining adequate smears. In 9% of the samples, only the ectocervical specimen was found to be satisfactory, indicating that use of the spatula should not be abandoned.

Professional Medical Conduct Reform Bill.

This new law closes the many loopholes in the previous statute. Physicians should review the entire law; it is readable and fairly understandable.

The role of Chlamydia trachomatis in Bartholin's gland abscess.

Chlamydia trachomatis is becoming increasingly known for its ability to cause severe injury to the female genital tract. Little investigation has been done in its role in diseases of Bartholin's glands. We present what we believe to be the first case report of an abscess of a Bartholin's gland in which Chlamydia trachomatis was a major pathogen. This communication also review the literature concerning the microbiology of Bartholin's gland abscess.

The value of laparoscopy in general surgical problems.

Laparoscopy offers a simple, rapid and safe way to evaluate and diagnose definitively intra-abdominal disease. An analysis of 65 consecutive patients supports this contention and demonstrates the real advantages and safety of this readily available modaility. A 90 per cent success rate, defined as accomplishing the diagnosis, was achieved in this study. There were no complications and no deaths. Local anesthesia was almost exclusively used and is strongly recommended. Laparoscopy represents an underused diagnostic modality which, when properly performed, can effect significant medical and fiscal economies in patient care.

Angiodysplasia of the colon: diagnosis and treatment.

Gastrointestinal hemorrhage of obscure origin remains a difficult clinical problem, but newer methods of study, particularly endoscopy and angiography, have made inroads into this morass of diagnostic dilemmas. Vascular malformations represent entities that are relatively infrequent of occurrence and also difficult of detection. These characteristics render them particularly refractory to recognition. Once diagnosed, however, they are quite readily treated surgically, without resort to "blind" resections or multiple bowel entries. This report deals with three instances of obscure but important persistent blood loss into the gastrointestinal tract. In each instance, identification by customary diagnostic methods was unsuccessful, but was finally made through endoscopy and promptly cured through surgery. The bleeding in all 3 cases proved pathologically to have been caused by vascular malformations, which we have subsumed under the term "angiodysplasia."