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Background: Staphylococcus aureus is a frequent cause of serious infections. Methicillin-resistant S. aureus (MRSA) are resistant to almost all types of beta-lactam antibiotics and therefore represent a substantial medical problem., Material and Method: In April 2006, the Department of Obstetrics at the Asker and Baerum hospital had an outbreak of MRSA that affected four newborns. The source for the infection was sought among family members, other patients and employees, and eradication was attempted., Results: An employee was identified as the probable infectious source. Subsequent investigation identified 13 individuals infected by the same MRSA clone, which was Panton-Valentine-leukocidin (PVL) positive and therefore clearly a pathogen. 10 of the patients had MRSA disease, with 21 months between the first and the last identified case. For 5 of 13 patients MRSA was still detectable after the first attempt of eradication. For 2 patients, including one of the newborns, eradication has so far been unsuccessful and a third patient has acquired a new abscess after one year., Interpretation: Issues connected to MRSA-screening of close contacts and eradication are resource-demanding and require careful consideration of strategy, especially for small children and families with chronic MRSA carriers. Updated detailed national guidelines for MRSA management are needed.

Background: Rupture of the anal sphincter during childbirth is a major cause of faecal incontinence among women, a condition with considerable psychosocial consequences. The reported incidences show large variations, from 0.36% to 24%. Definitions and classifications vary as much. Also, reports on the persisting subjective problems of the women afflicted demonstrate diversity., Material and Methods: Over a 2(1/2) year period from January 2000, all women with partial or total rupture of the anal sphincter during delivery were invited to a follow up consultation after 6 months and interviewed about their subjective discomfort., Results: Over the period in question we registered 147 ruptures of the anal sphincter among 6124 vaginal deliveries (2.4%); 109 (1.7%) were partial ruptures, 38 (0.7%) total ruptures. Among the 137 women who came in for a consultation 6 months after delivery, 92 (67%) had no complaints at all. Five women (4%) had some degree of leakage for liquid stools. None of them had incontinence for solid stools., Interpretation: The reported incidence is in keeping with most of the previous registrations in the Nordic countries, but not with those giving the lowest figures. Improved delivery technique might reduce the incidence. The incidence of discomfort and complaints we found at 6 months was lower than expected on the basis of previous reports.

From 1987, patients waiting for treatment in Norwegian hospitals are given different degrees of priority, from zero to five. As from 1990, patients in priority group two are placed on a special list, and a report is made if they have not been treated within six months. There is a considerable variation in the frequency with which the patients are given this treatment guarantee in the different Norwegians counties. In the case of gynaecological patients the frequency varies from one to 94%, of urological patients from 43 to 100%, of orthopaedic patients from 21 to 89% and of otorhinolaryngological patients from 21 to 89%. The same variations are also seen within a single region of the country, and between departments. The reason for this discrepancy may be varying composition of the population, different extents of day surgery or different economic strategic thinking. Probably the main reason is that the criteria for giving a waiting list guarantee are not accepted as operational. This leads to different medical judgments when evaluating the applications for treatment in hospital.

A scoring form has been developed, based upon the system of priorities used in Norway when deciding among patients waiting for investigation and treatment in hospital. This scoring form was used to evaluate 40 different case histories in gynaecological, orthopaedic, urologic and oto-rhino-laryngological departments. There was much disagreement when evaluating the different case histories. Using this scoring form did not result in greater agreement among the physicians using it than among another group of physicians who evaluated the same case histories without using the form.

Smoking in pregnancy is unequivocally harmful to both foetal and maternal health. Earlier investigations in Norway among pregnant women who smoke have demonstrated a prevalence of smoking of around 40% and that some women stop smoking as soon as the pregnancy is confirmed (around 20%). This investigation reports only 16% smokers among pregnant women registered at 18th week of pregnancy in the two municipalities of Asker and Baerum. Average daily consumption was 8.6 cigarettes, and 65% of the women stated that they smoked more than five cigarettes per day. 97% expressed a positive interest in quitting smoking, and 76% had tried to quit earlier. 77% had a partner who was a daily smoker. An assessment of level of education showed that 82% had completed 12 years of schooling and 23% reached a higher educational level. We conclude that the relatively low incidence of daily smoking among pregnant women in these two municipalities should inspire the initiation of active intervention programmes.

Over a period of 12 months, 96 women who sought legal abortion and 52 of their male partners answered a questionnaire about contraception and abortion. Almost none of them had wanted a pregnancy from the start. Nevertheless two thirds had not used any contraceptives, mainly because they thought the chance of pregnancy was very small. Many stated that they had intended to use a condom, yet they did not do so. The majority of the women told their male partner about the pregnancy as soon as they knew of it themselves. A quarter of the women and about half of the men stated that both partners agreed that she should choose abortion. Two fifths of the women and about half of the men said that the woman's decision weighed most heavily. Many of the women said that the attitude of the partner to the pregnancy was important for their choice. Half of the women, however said that they would have chosen an abortion independent of the attitude of their partner.