Tried, true, and new: public health nursing in a county substance abuse treatment system.

The Milwaukee Target Cities (MTC) project was the only site within 19 federally funded Target Cities programs to feature a public health nursing model as its sole means of providing comprehensive health-related services to indigent substance abuse clients. We first describe MTC's implementation process, focusing on the public health nursing component, and then present a program evaluation section with selected findings from the ongoing qualitative evaluation. Initially, misunderstandings about the nurses' community-based, family-centered strategy of assuring access to health care through cross-system service linkage dogged the nurses' efforts to explain their roles and mission to federal funders, project management, coworkers, and treatment providers.

Natural history of distal spinal agenesis.

We studied the natural course in patients with distal spinal agenesis (DSA). Specifically, we compared children with different types of DSA (Renshaw sacral agenesis types I-IV) and determined their maximum ambulatory abilities, identified patients at risk for decubiti, determined the average number of operations per patient, described associated congenital anomalies, and sought a correlation between different types of DSA and the risk of back pain and development of scoliosis. Through a retrospective analysis, we concluded that there are definite correlations between the specific type DSA and the natural course with regard to all these entities.

A newborn with bilateral hip flexion contractures and clubfeet.

The following case is presented to illustrate the roentgenographic and clinical findings of a condition of interest to the orthopaedic surgeon. Initial history, physical findings, and roentgenographic examinations are found on the first page. The final clinical and roentgenographic differential diagnoses are presented on the following pages.

Radiodense lines and subclinical infection in pediatric hip surgery.

A subtle radiolucency with surrounding sclerosis was seen in 14 of 129 hip implant removals in 90 children. Five of these implants were cultured, and all five grew Staphylococcus epidermidis. The other nine were not cultured.