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Purpose To determine whether patients with hypercho-lesterolemia were being treated according to the updated 2001 National Cholesterol Education Program (NCEP) clinical guide-lines and whether a difference existed between internists and cardiologists in the implementation of these guidelines. Data Sources This retrospective study used data obtained from a review of 200 patient charts that were compared with the NCEP guidelines. Conclusions Results indicated that 67% of internal medicine patients and 71% of cardiology patients who qualified for pharmaceutical treatment received prescriptions for cholesterol-lowering medications. The difference between internal medicine and cardiology physicians was not statistically significant. Implications for Practice Like physicians, nurse practitioners should become familiar with and utilize the updated guidelines as standards of practice to promote and improve patient outcomes over the life span.

To determine patterns of bone mineral acquisition in children and young adults with cystic fibrosis (CF) and to identify clinical and laboratory correlates of change in bone mineral density (BMD).Bone mineral and clinical status were assessed in 41 patients with CF (26 female, aged 9 to 50 years) at baseline and 1.5 years later. Bone mineral content of the lumber spine, femoral neck, and whole body was determined by dual-energy x-ray absorptiometry and expressed as BMD and bone mineral apparent density (BMAD). Changes in weight, height, pubertal status, glucocorticoid use, physical activity, disease severity, and biochemical markers of bone turnover were examined for associations with changes BMD and BMAD.Mean BMD Z-scores (adjusted for age and sex) were reduced at the spine, hip, and whole body at baseline in both adults and youths, and decreased further at all sites among youths at follow-up (-0.4 at spine, p0.05; -0.3 at hip, p0.10; -0.5 for whole body, p0.0005). These data indicate failure to gain bone mineral at the expected rate. BMAD was also reduced at follow-up, suggesting that the observed osteopenia could not be explained by small bone size. Bone loss at multiple sites was observed in four youths and two adults. In general glucocorticoid use, change in body mass, physical activity, and disease severity were the most significant correlates for change in BMD and in BMD Z-score.Osteopenia in CF generally reflects inadequate gains in bone mineral, although bone loss may occur, particularly in patients requiring glucoc therapy. Late gains in bone mineral may accompany weight gain and pubertal development, but the catch-up appears to be incomplete.

The self-care (or latchkey) arrangement for children with a chronic illness is an important topic for pediatric nurses. This article reviews the impact of self-care for children's development, examines the effectiveness of teaching self-care skills to latchkey children, and provides assessment and intervention information to help pediatric nurses who are working with parents and children with chronic illness who are in self-care.