www.Accurate information for varicose vein patients.com?

INTRODUCTION: The aim of this study was to review the information available to the public regarding the treatment of varicose veins on dedicated UK-based websites. PATIENTS AND METHODS: Websites were identified by using the Google search engine. All identified websites were examined, noting the range of treatments explained and their stated potential complications. Website ownership was also recorded. RESULTS: A total of 49 websites were identified, belonging to individual physicians (21), private clinics or groups (15), national institutions (4) and device/drug manufacturers (4). Five websites were simply redirecting portals and, hence, were excluded from further analysis. Treatment methods discussed were conventional surgery (32), endovenous laser [EVLA] and/or radiofrequency ablation [RFA] (31), and ultrasound-guided foam sclerotherapy [UGFS] (27). Only 19 websites (43%) discussed all treatment methods. Complications mentioned following surgery were: cutaneous nerve damage (56%), recurrence (56%), infection (53%), bleeding (41%) and venous thrombo-embolism (38%). Complications following EVLA/RFA were: cutaneous nerve damage (42%), recurrence (42%), venous thrombo-embolism (39%) and burns (35%). Complications following UGFS were: pigmentation (59%), venous thrombo-embolism (48%), ulceration (41%), recurrence (41%), allergy (26%) and visual disturbance (26%). CONCLUSIONS: Over 50% of the websites examined did not mention all the management methods now available for varicose veins. More importantly, the majority of the websites did not warn of the common complications of intervention. Currently, information on the Internet cannot be relied upon to supplement informed consent and may actually generate unrealistic patient expectations.

The role of primary care in the prevention of suicide and accidental deaths among young men: an epidemiological study.

BACKGROUND: Despite generally falling mortality and suicide rates, among young men the rates of violent death from accidents and suicide continue to rise. Most research has focused upon suicide, and the potential for effective interventions, particularly in primary care, remains controversial. AIMS: To compare health service contacts prior to suicidal and accidental deaths among young men. DESIGN OF STUDY: Examination of inquest data, postmortem and toxicology reports, and general practitioner (GP) and hospital records. SETTING: All sudden, unexpected, violent or unnatural deaths involving young men aged between 15 and 39 years and reported to the four coroner's offices of Merseyside and Cheshire during 1995. METHOD: We compared data on the timing and nature of final GP contacts before death among young men with a verdict of accident or misadventure and suicide or undetermined death. RESULTS: Out of a total of 268 violent deaths, 130 received verdicts of accident/misadventure and 97 received verdicts of suicide/undetermined death. Information on the final contact with a GP was available for 172 deaths. Although there was a significant difference between the proportion of suicide cases (56%) and that of cases of accidental death (41%) who had seen their GP during the 3 months before death, this was not significant at 1 month (38% versus 30%, respectively). Suicide cases were more likely to have seen a mental health professional at some time (27% for suicides versus 13% for accidental deaths). CONCLUSION: These findings confirm that relatively few young men consult their GP during the period before death from suicide or accidents. Prevention strategies must extend beyond suicide risk assessment, and consider ways to encourage young men to consult GPs when they are experiencing emotional distress or problems related to mental health or substance misuse.

Embryonic origins of a motor system: motor dendrites form a myotopic map in Drosophila.

The organisational principles of locomotor networks are less well understood than those of many sensory systems, where in-growing axon terminals form a central map of peripheral characteristics. Using the neuromuscular system of the Drosophila embryo as a model and retrograde tracing and genetic methods, we have uncovered principles underlying the organisation of the motor system. We find that dendritic arbors of motor neurons, rather than their cell bodies, are partitioned into domains to form a myotopic map, which represents centrally the distribution of body wall muscles peripherally. While muscles are segmental, the myotopic map is parasegmental in organisation. It forms by an active process of dendritic growth independent of the presence of target muscles, proper differentiation of glial cells, or (in its initial partitioning) competitive interactions between adjacent dendritic domains. The arrangement of motor neuron dendrites into a myotopic map represents a first layer of organisation in the motor system. This is likely to be mirrored, at least in part, by endings of higher-order neurons from central pattern-generating circuits, which converge onto the motor neuron dendrites. These findings will greatly simplify the task of understanding how a locomotor system is assembled. Our results suggest that the cues that organise the myotopic map may be laid down early in development as the embryo subdivides into parasegmental units.