JAMA : the journal of the American Medical Association
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The relation of hopelessness to levels of depression and suicidal intent was explored both psychometrically and clinically. The results of an investigation of 384 suicide attempters support previous reports that hopelessness is the key variable linking depression to suicidal behavior. This finding has direct implications for the therapy of suicidal individuals. By focusing on reducing the sources of a patient's hopelessness, the professional may be able to alleviate suicidal crises more effectively than in the past.
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A 40-year-old woman was admitted with upper airway obstruction; chest roentgenogram with tomograms, laryngoscopy, and bronchoscopy verified the presence of a subglottic tumor. Spirometry disclosed a maximum inspiratory flow rate more reduced than in the maximum expiratory flow rate, suggestive of upper airway obstruction. ⋯ The patient underwent tracheostomy and total laryngectomy with an uneventful recovery. No evidence of local extension or distant metastases were evident at time of surgery.
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Case Reports
Geophagia. A cause of life-threatening hyperkalemia in patients with chronic renal failure.
Geophagia has been associated with life-threatening hyperkalemia in five patients with chronic renal failure. All five patients were black and had been born in the southeastern United States. ⋯ Since riverbed clay contains as much as 100 mEq of potassium in 100 gm of clay, much of which is exchangeable at acid pH, the mechanism of geophagia-induced hyperkalemia appears to be the absorption of potassium released from clay after ingestion. After discontinuing geophagia, no new hyperkalemic episodes occurred in these patients.