The weekend effect in status epilepticus: a national cohort study.

Higher mortality following admission to hospital at the weekend has been reported for several conditions. It is unclear whether this variation is due to differences in patients or their care. Status epilepticus mandates hospital admission and usually critical care: its study might provide new insights into the nature of any weekend effect. We studied 20,922 adults admitted to UK critical care with status epilepticus from 2010 to 2015. We used multiple logistic regression to evaluate the association between weekend admission and in-hospital mortality, comparing university hospitals with other hospitals. There were 2462 in-hospital deaths (12%). There was no difference in mortality after weekend admission to university hospitals, adjusted odds ratio (95%CI) 0.99 (0.84-1.16), p = 0.89. Mortality was less after weekend admission than after admissions Monday to Friday in hospitals not associated with a university, adjusted odds ratio (95%CI) 0.74 (0.64-0.87), p = 0.0001. There is no evidence that adults admitted to UK critical care at the weekend in status epilepticus are more likely to die than similar patients admitted during the week.

Does low socioeconomic status in early life protect against multiple sclerosis? A multinational, case-control study.

BACKGROUND AND PURPOSE: The findings from existing research on the association between socioeconomic status (SES) and multiple sclerosis (MS) are inconsistent. Most previous studies are limited to one country and do not adequately adjust for other risk factors for the disease. METHODS: The association between SES and MS was examined using data from the multinational Environmental Risk Factors in Multiple Sclerosis (EnvIMS) case-control study, comprising 2144 cases and 3859 controls from Norway, Canada and Italy. Multiple logistic regression was used to estimate the odds ratios and 95% confidence intervals for the association between early life SES, measured by parental educational level, and MS. Analyses were adjusted for age, sex, sunlight exposure, history of infectious mononucleosis, smoking, obesity and family size. RESULTS: Relative to those whose parents had primary school education or below, the adjusted odds ratio (95% confidence interval) for MS amongst individuals with university-educated parents, and the P value for trend across education levels, were 1.45 (1.03-2.05) in Canada (P for trend 0.030), 1.09 (0.85-1.39) in Norway (P for trend 0.395) and 0.65 (0.39-1.07) in Italy (P for trend 0.158). CONCLUSION: There is no consistent association between parental SES and MS risk in Norway, Canada and Italy, with a protective effect of low SES only found in Canada.

Changes in newspaper coverage of mental illness from 2008 to 2014 in England.

OBJECTIVE: This study evaluates English newspaper coverage of mental health topics between 2008 and 2014 to provide context for the concomitant improvement in public attitudes and seek evidence for changes in coverage. METHOD: Articles in 27 newspapers were retrieved using keyword searches on two randomly chosen days each month in 2008-2014, excluding 2012 due to restricted resources. Content analysis used a structured coding framework. Univariate logistic regression models were used to estimate the odds of each hypothesised element occurring each year compared to 2008. RESULTS: There was a substantial increase in the number of articles covering mental health between 2008 and 2014. We found an increase in the proportion of antistigmatising articles which approached significance at P < 0.05 (OR = 1.21, P = 0.056). The decrease in stigmatising articles was not statistically significant (OR = 0.90, P = 0.312). There was a significant decrease in the proportion of articles featuring the stigmatising elements 'danger to others' and 'personal responsibility', and an increase in 'hopeless victim'. There was a significant proportionate increase in articles featuring the antistigmatising elements 'injustice' and 'stigma', but a decrease in 'sympathetic portrayal of people with mental illness'. CONCLUSION: We found a decrease in articles promoting ideas about dangerousness or mental illness being self-inflicted, but an increase in articles portraying people as incapable. Yet, these findings were not consistent over time.

Is high socioeconomic status a risk factor for multiple sclerosis? A systematic review.

High socioeconomic status (SES) is generally associated with better health outcomes, but some research has linked it with an increased risk of multiple sclerosis (MS). The evidence for this association is inconsistent and has not previously been systematically reviewed. A systematic review of cohort and case-control studies in any language was conducted looking at the association between MS and SES. MEDLINE and EMBASE were searched for articles in all languages published up until 23 August 2013. Twenty-one studies from 13 countries were included in the review. Heterogeneity of study settings precluded carrying out a meta-analysis, and a qualitative synthesis was performed instead. Five studies, all from more unequal countries, reported an association between high SES and MS. Thirteen studies reported no evidence of an association, and three studies reported an association with low SES. These 16 studies largely came from more egalitarian countries. The evidence for an association between high SES and increased MS risk is inconsistent but with some indication of a stronger effect in countries and time periods with higher inequality. Firm conclusions are hampered by the failure of most studies to control for other important risk factors for MS.

Evaluation of a method for cryogenic storage of cytological specimens.

A technique for long-term storage of cytological specimens at -70 degrees C was evaluated with a range of nongynaecological cytology specimens. The effects of frozen storage on the cellularity, morphology, ultrastructure, and reactivity to cytochemical and immunochemical stains were investigated. These parameters were compared in preparations made from specimens processed conventionally and after frozen storage. No significant deterioration in the quality of subsequent preparations was apparent after storage. The method is technically simple and has proven successful for storing a range of specimens, including serous effusions, urine samples, and fine-needle aspirates. This technique allows storage of material until initial microscopic evaluation is complete. If required, the relevant adjuvant procedure, such as cell blocking, may then be carried out using the stored material. Wastage of cytological material on unnecessary preparations is minimised, and material may be stored over years for research or confirmation procedures.

Intra-operative diagnosis of lymph node metastases in gynaecological practice using imprint cytology.

The technique of imprint cytology has been described for the assessment of malignancy and correlates well with histology. Despite the simplicity, speed and excellent cellular detail the technique has still not been fully appreciated. We describe the value of the technique applied to intra-operative diagnosis of lymph node metastases in gynaecological malignancy. Four hundred and seventy five lymph nodes were examined using imprint cytology followed by routine histology. The technique of imprint cytology was found to have a zero false negative rate, 0.6% false positive rate and an accuracy of 99.3%. We advocate the consideration of this technique for the evaluation of cases with gynaecological malignancy as an alternative to frozen section histology.