Recommendation for collection of skin puncture blood from children, with special reference to production of reference values.

Reliable reference values need to be collected under standardized conditions. In order to enable comparison of values observed on patients with reference values, it is also desirable to use the same standardized conditions on patients. The present recommendation was produced as a joint effort of representatives of the clinical chemists and paediatricians of Scandinavia and describes the following details. Preparation of the child before specimen collection (food intake, time of day, physical activity, posture, environment), preparation of skin puncture site (warming, disinfection, ointment), instruments for blood collection (lancet, blood collection vessel), site of puncture (plantar surface of foot, finger, ear lobe), collection of emerging blood and handling and storage of the specimen.

[Why does a woman decide on a abortion?]. / Mikä saa naisen valitsemaan abortin?

PIP: This study consists of 99 patients, all over age 18, who chose an induced abortion (group 1) and 100 patients who delivered a full-term baby (group 2). The mean age was 26.0 years in the abortion group and 26.4 years in the delivery group. Of those in group 1, 33 were married and of those who delivered their baby, 75 were married and 25 gave birth to a child out-of-wedlock. The difference is social background between the groups is statistically highly significant (p0.001). Only 3% of women in group 1 belonged to the 4 highest strata of society as compared with 26 in group 2. The previous use of contraceptive methods was similar in both groups. However, there was a clear difference between the 2 groups in the pattern of their relationship with the other sex. The patients in the abortion group had their 1st intercourse significantly earlier (p0.01). In the abortion group, 12% had their 1st coitus prior to age 15 and 46% before the age of 18. The corresponding percentages in the delivery group were 2% and 29%. The women in the abortion group had more partners than the women in the delivery group. The most common motivations for abortion were economic difficulties alone or together with poor housing conditions. These were responsible for 36% of the abortions in the case of married women and in 48% when the women were not married. In the group of unmarried women, 12% had not completed their education and therefore wished to have an abortion. Among the married women, 9% stated that the sexual partner in the intercourse leading to the present pregnancy was not their husband, thus the motivation to have the abortion. The number of previous children was not reported to be a reason for abortion. The women who decided to deliver the baby considered their marriages very happy (more than 2/3) or at least fairly happy. The patient's own childhood did not affect the decision in favor of or against abortion in this group of women. The decision was influenced by the actual life situation and thus this finding differs from the previous studies on adolescent abortions. (author's modified)^ieng

Effect of caries in mentally handicapped children of addition of fluoride and bicarbonate-phosphate to dietary sugar products.

Mentally handicapped children, aged 5--15 years and living in institutions, received fluoride supplement in several sugar products of their diet; in candies, marmalades, jams, fruit juices and in sweet desserts corresponding to 10 mg F as NaF per kg of the sugar (sucrose or glucose) of each product. To two of the four daily candies was also added a NaHCO3 + KH2PO4 mixture (mole ratio 9.8/l, resp.) to substitute for 2.5% of the sugar of the candy. The control children received the respective products without the additives. After stepwise exclusions of subjects for various reasons, e.g. for the absence of permanent teeth, low initial caries activity, strong medication, Down's syndrome, etc., the mean DMFS-increment in the remaining 43 control subjects was 4.5 and in the 41 test subjects 2.6 lesions/100 surfaces at risk, i.e. 42% reduction. Caries arrestment had occurred in these test subjects after the first year, while in the respective controls it was continuously increasing. Among numerous oral and body parameters studied, only surface enamel fluoride in primary teeth was increased by the fluoride supplements and urinary phosphate and calcium excretion decreased.

Nutrition survey of Finnish rural children. IV. Serum cholesterol values in relation to dietary variables.

In connection with a survey of child nutrition in Finland a study was carried out on the serum cholesterol concentration in childhood and its relationship to dietary and other variables. The material consisted of 1496 children ages 5, 9, and 13 years from 14 local districts in Finland. Total cholesterol was determined from nonfasted venous serum samples by a modification of the p-toluenesulfonic acid reaction. Food consumption was investigated by the 24-hr recall method and nutrient intakes determined from these results using food composition tables. For analysis, children in each age group were classified into low, medium, and high cholesterol groups. The serum cholesterol concentrations of the 5, 9, and 13 year olds were 6.03 +/- 1.03, 6.16 +/- 1.04, and 6.08 +/- 1.01 mmole/liter (233 +/- 40, 238 +/- 40, and 235 +/- 39 mg/100 ml), respectively. Of the children 10% had serum cholesterol concentrations of 7.4 mmole/liter (286 mg/100 ml) or more. Serum cholesterol concentration was not correlated with sex, relative body weight, or systolic or diastolic blood pressure. High cholesterol concentrations appeared to be associated with traditional dietary habits and especially with a high proportion of saturated fats in the diet.

Medical and social aspects of pregnancy among adolescents. Part II. Comparative study of abortions and deliveries.

Socio-medical aspects concerning 193 pregnant patients under the age of 18 were analysed. Of these patients 131 had an interruption of the pregnancy and 62 gave birth to a baby. All the abortion patients were unmarried. The mean age in the abortion group was 16.8 years and in the delivery group 17.2 years. The girls of this study had their first experience of sexual intercourse very early, 32% under the age of 15. The frequency of complications after abortion was 18.5%. In the delivery group the prematurity and prenatal mortality were at least twice as great as in the general population. The girls who gave birth to their babies often came from lower social strata and the relationships in their families were more harmonious than in those who had had abortions. The birth of the baby or the decision to have an abortion is not accidental. The different behaviour patterns have a different background regarding both the personal and the environmental characteristics. The decision of the patient whether to abort or not was influenced by the attitude of the immediate family. The relations between family members were better in the homes of the girls who had a baby than in the homes of those who belonged to the abortion group. In both groups more than 40% of the subjects had suffered the risk of being emotionally deprived because of environmental conditions, including crowded housing and limited economic means. Almost all the subjects knew about the means of prevention, although they may not have had proper instruction and sufficient knowledge of their use. The services given by the goverment to adolescent pregnant patients are insufficient and require immediate attention by society.

Serum growth hormone and gonadotrophins and urinary steroids in adolescent girls.

In a series of 146 school girls and nurses in the serum levels of growth hormone (GH), follicle stimulating hormone (FSH), and luteinizing hormone (LH) were determined in the afternoon after 4-5 hours' fast. Blood specimens of the menstruating girls were taken on the 7th to 10th day from the beginning of the preceding menstrual bleeding. From the 24-hour urines collected on the previous day the excretion of total oestrogens, 17-ketosteroids and 17-hydrocorticosteroids was determined. The series was grouped according to skeletal age which varied from 8.0 years to the adult stage. In the girls aged 11-13 years the GH curve showed a significant rise parallel with the mean height curve. The FSH values at the early age of 8-9 years corresponded to the follicular phase of adult women. The LH level increased syteeply up to the 15th year of bone age and mean values of adults were found to be about three times those of childhood. The excretion of total oestrogens and 17-ketosteroids increased steadily up to the full maturity of skeletal age. In the oldest group of girls the excretion was about four times that of the group aged 8-9 years. The hormonal maturation seems to continue until late puberty. The 17-OHCS, on the other hand, reached the adult level in the group with a bone age of 13 years. The excretion of 17-OHCS shows a steep rise from the age of 11 to 12 years and this acceleration of excretion perhaps exceeds the increase in surface area.