Reproductive and sexual health at the school-based/school-linked health center: an analysis of services provided by 180 clinics.

PURPOSE: This article reports on the reproductive and sexual health services available on site to clients at school-based and school-linked health centers as reported in a 1993 survey of these centers. The study reviews the range of services and contraceptives available, length of time since opening that contraceptive services were made available and restrictions on contraceptive availability based on the setting (on or off campus), geographic location, grade levels served, sponsor and length of operation. METHOD: One hundred and eighty (180) administrators completed a self-administered mail survey of health center operations. One section of the survey focused on questions regarding the reproductive and sexual health services provided on the health center site. RESULTS: Reproductive health services make up 20 percent of all health center visits. Centers in operation at least 10 years, located in urban and suburban areas or off campus, provided the broadest range of services. Thirty-three percent of centers made at least one contraceptive method available; most of these centers initiated the service at the center's opening. Restrictions on contraceptive services (reported by 82 percent of respondents) came mainly from school district policy. CONCLUSIONS: School-based and school-linked health centers offer a promising mechanism to deliver reproductive health services to young people. To date, however, external and internal policies restrict the availability and scope of these services.

Pseudallescheria boydii brain abscess: association with near-drowning and efficacy of high-dose, prolonged miconazole therapy in patients with multiple abscesses.

Brain abscess caused by Pseudallescheria boydii is a highly lethal infection, usually seen in immunosuppressed patients. Five patients with P. boydii brain abscesses are described. Four of these patients acquired their infection after near-drowning; 1 patient developed an abscess after penetrating head trauma. Two patients survived their infections, which included involvement of other body sites (lung, eye, bone) as well as multiple undrained brain abscesses, after prolonged courses of high-dose parenteral miconazole (80-90 mg/kg/d). Progressive increases in miconazole dosage during the treatment periods were required to produce serum levels above the minimum inhibitory concentrations of the fungal isolates.