Risk factors for suicide in psychiatric outpatients: a 20-year prospective study

To determine the risk factors for suicide, 6,891 psychiatric outpatients were evaluated in a prospective study. Subsequent deaths for the sample were identified through the National Death Index. Forty-nine (1%) suicides were determined from death certificates obtained from state vital statistics offices. Specific psychological variables that could be modified by clinical intervention were measured using standardized scales. Univariate survival analyses revealed that the severity of depression, hopelessness, and suicide ideation were significant risk factors for eventual suicide. A multivariate survival analysis indicated that several modifiable variables were significant and unique risk factors for suicide, including suicide ideation, major depressive disorder, bipolar disorder, and unemployment status.     

A 20-year follow-up study of 64 subjects with M-components

Sixty-four persons with M-components in serum were detected in a health survey of 6995 subjects in 1964. After 20 years, data could be obtained on all 64. The 45 who had died included two cases of myeloma and one of malignant lymphoma. One of the myeloma cases had started as chronic lymphatic leukemia. Three of the 19 persons alive had an increase in the size of the M-component and depression of the background immunoglobulin, but they could not be diagnosed as myeloma cases. One had a rather large but not increasing M-component and an excess of light chains. She could be a third case of myeloma in this series.     

Histopathological study of early lesions of pancreatoduodenal cancer

The early lesions of pancreatoduodenal cancer, which was defined as those in which the site of origin is confined in a single certain anatomical part and the mode of early extension can be pursued, were found in 28 of 52 surgical specimens examined; 12 in the pancreatic portion of the common bile duct (PCBD), 12 in the common channel, 1 each in the terminal portion of the common bile duct and the terminal portion of the pancreatic duct, and 2 in the peripapillary zone of the duodenum. There were roughly two types of tumor growth; one annular flat-raised, histologically scirrhous tubular adenocarcinoma, principally found in PCBD and the other polypoid, histologically papillary or papillotubular adenocarcinoma, found everywhere. The staining properties of mucin was of no value in differential diagnosis for the site of origin. One typical carcinoid was observed in PCBD. The surface spread of carcinoma beyond the originating part was seen in 10 cases (36%), lymphatic invasion in 23 cases (82%), node metastasis in 9 cases (32%), and venous invasion in 6 cases (21%). Only 2 cases were mucosal carcinomas. From these figures it can be concluded that the carcinoma of this region is of high grade malignancy.     

Breast cancer in the young

Breast cancer in the young is rare. Some cases can be treated with modest surgical intervention and prognosis is good. We present a report of a 17-year-old black girl with adenocarcinoma of the breast. In our case, the disease pursued a devastatingly rapid course in spite of treatment and the patient died within 6 months of diagnosis. The literature relating to clinical experience with various types of breast carcinoma seen in pre- and postpubertal patients is also reviewed. We conclude that this case, and certain other cases cited, demonstrates the need for a high index of suspicion and earlier and more aggressive intervention in young patients with axillary breast masses.     

Intergenerational transmission of partner violence: a 20-year prospective study

An unselected sample of 543 children was followed over 20 years to test the independent effects of parenting, exposure to domestic violence between parents (ETDV), maltreatment, adolescent disruptive behavior disorders, and emerging adult substance abuse disorders (SUDs) on the risk of violence to and from an adult partner. Conduct disorder (CD) was the strongest risk for perpetrating partner violence for both sexes, followed by ETDV, and power assertive punishment. The effect of child abuse was attributable to these 3 risks. ETDV conferred the greatest risk of receiving partner violence; CD increased the odds of receiving partner violence but did not mediate this effect. Child physical abuse and CD in adolescence were strong independent risks for injury to a partner. SUD mediated the effect of adolescent CD on injury to a partner but not on injury by a partner. Prevention implications are highlighted.     

Dyscirculatory Encephalopathy in Chernobyl Disaster Clean-Up Workers (a 20-year study)

Results obtained over 20-years of following 536 Chernobyl clean-up workers and 436 control subjects are presented. Dyscirculatory encephalopathy developed more frequently in persons exposed to radiation at age 30 years. As compared with the control group, workers were characterized by early onset of disease, faster progression, stable symptomatology for 5–6 years, and further progression of disease in the form of autonomic dysfunction, psycho-organic syndrome, and epilepsy. Major strokes were also more common in clean-up workers.     

Frequent attenders in general practice: a retrospective 20-year follow-up study.

We describe a 20-year retrospective study of 58 patients with a cross-matched control group in one practice, who initially attended more than 12 times in 1975. The study establishes that frequent attendance is not consistent; the majority of high-attending patients in general practice revert over a short period of time to a normal consulting pattern. Diseases, rather than patients, appear to dictate high consulting rates. Consistent high attendance is largely owing to multiple pathology.     

20-year morpholoogical findings in the study of medical aftereffects of the Chernobyl accident

Presented are the results of morphological studies of radiation sickness, congenital malformations and malignant tumors which have developed in Chemobyl victims. Until now consequences of the accident remain a subject of practical and research medicine. Scope of relevant topical problems the pathologists will have to investigate in the future is discussed.     

Increasing incidence of candidemia: results from a 20-year nationwide study in Iceland

A nationwide study on candidemia was conducted in Iceland from 1980 to 1999. The annual incidence increased from 1.4 cases/100,000 inhabitants/year between 1980 and 1984 to 4.9 cases/100,000 inhabitants/year between 1995 and 1999 (P < 0.0001). Candidemia episodes at university hospitals increased from 0.15/1,000 admissions to 0.55/1,000 admissions (P < 0.0001). Candida albicans was the predominant species responsible (64.4%). The national import of fluconazole increased approximately fourfold during the second half of the study, but increased resistance to this agent was not observed.     

Physiological consequences of acculturation: a 20-year study of fitness in an Inuit community

Surveys in 1969/1970, 1979/1980, and 1989/ 1990 assessed physical fitness among adult Inuit living in Igloolik, Northwest Territories, Canada, during a period of rapid acculturation to a sedentary lifestyle. MANOVA for age, cohort, and age-cohort effects indicated significant trends to greater skinfold readings [male (M) and female (F)] and body mass (F only), a lower handgrip and knee extension force (M and F), and lower step test predictions of aerobic power (M and F) in the more recent cohorts, with no change of forced vital capacity, 1-s forced expiratory volume, or hemoglobin level. By 1989/1990, continuing hunters tended to have thicker skinfolds than other villagers, and showed no advantage of aerobic power. The average fitness of the sample when tested in 1989/1990 was comparable with that of sedentary populations in Southern Canada, but a minority of villagers who now practiced regular sport had conserved the high levels of fitness that were observed in 1969/1970. We conclude that the fitness of this community appears to have deteriorated markedly as it has become more sedentary, and we thus recommend that health authorities develop methods of promoting an active lifestyle that are culturally appropriate to the populations of circumpolar settlements.     

The associations between psychopathology and being overweight: a 20-year prospective study

BACKGROUND: Psychiatric disorders and being overweight are major health problems with increasing prevalence. The purpose of this study was to test the hypothesis that being overweight is associated with a range of psychiatric conditions including minor and atypical depressive disorders, binge eating, and aggression. METHOD: Prospective community-based cohort study of young adults (n = 591) followed between ages 19 and 40. Information derived from six subsequent semi-structured diagnostic interviews conducted by professionals over twenty years. Outcomes were being overweight [body-mass index (BMI)> 25] and average yearly weight change between ages 20 and 40 (BMI slope). RESULTS: 18.9 % of the participants were classified as being overweight. Being overweight turned out to be a stable trait: 77.7% of subjects were assigned to the same weight class at each interview. Atypical depression and binge eating were positively associated with both, increased weight gain and being overweight, while psychiatric conditions associated with aggressive behaviors (aggressive personality traits, sociopathy) were positively associated with being overweight, but were not related to the rate of weight change. Generalized anxiety disorder was negatively associated with overweight. These results persisted after controlling for substance use, levels of physical activity, demographic variables and family history of weight problems. CONCLUSIONS: This study shows relatively strong associations between eating-related and aggressive psychopathology and being overweight. Given the high prevalence rates of these conditions, this study encourages further research on the causality of psychopathology-overweight associations that might provide insight on novel preventive approaches for major health problems.     

Mamillary-body lesions and visual recognition in monkeys

Summary Cynomolgus monkeys with complete bilateral destruction of the medial mamillary nucleus exhibited little, if any, deficit in object recognition, although they did show evidence of impairment in spatial memory. The pattern of effects thus resembled that found previously after either hippocampal ablations or transections of the fornix and suggests that, like such damage, mamillary-body damage alone is insufficient to produce the global amnesia attributed to it in clinical cases.     

Breast self examination for early detection of breast cancer

Breast cancer is the commonest form of cancer in women in Western countries and second most common in women of developing countries like India. In the absence of an exact aetiological agent for breast cancer, the most appropriate way of controlling it is by early detection and treatment. Of the various methods of screening for breast cancer, mammography is the method of choice but its use is limited due to high cost and unavailability. Considering this, breast self examination (BSE) is an ideal method which can be done by every woman at her leisure time with little training. Medical and paramedical professionals can act as trend setters in promoting BSE for control of breast cancer in the community.     

Breast vibro-acoustography: initial experience in benign lesions

Background

Functional magnetic resonance imaging (fMRI) analysis is commonly done with cross-correlation analysis (CCA) and the General Linear Model (GLM). Both CCA and GLM techniques, however, typically perform calculations on a per-voxel basis and do not consider relationships neighboring voxels may have. Clustered voxel analyses have then been developed to improve fMRI signal detections by taking advantages of relationships of neighboring voxels. Mean-shift clustering (MSC) is another technique which takes into account properties of neighboring voxels and can be considered for enhancing fMRI activation detection.

Methods

This study examines the adoption of MSC to fMRI analysis. MSC was applied to a Statistical Parameter Image generated with the CCA technique on both simulated and real fMRI data. The MSC technique was then compared with CCA and CCA plus cluster analysis. A range of kernel sizes were used to examine how the technique behaves.

Results

Receiver Operating Characteristic curves shows an improvement over CCA and Cluster analysis. False positive rates are lower with the proposed technique. MSC allows the use of a low intensity threshold and also does not require the use of a cluster size threshold, which improves detection of weak activations and highly focused activations.

Conclusion

The proposed technique shows improved activation detection for both simulated and real Blood Oxygen Level Dependent fMRI data. More detailed studies are required to further develop the proposed technique.