Connecticut medicine
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While there is a public perception that gun violence is associated with mental illness we present evidence that it is a complex public health problem which defies simple characterizations and solutions. Only a small percentage of individuals with mental illness are at risk for extreme violence and they account for only a small percentage of gun-related homicides. Individuals who are at risk for gun violence are difficult to identify and successfully treat. ⋯ We make a case for Connecticut physicians to study gun violence at the state level. We recommend that Connecticut physicians promote and expand upon the American Academy of Pediatrics' recommendation for creating a "safe home environment. "We suggest that guns be secured in all homes in which there are children. In addition we suggest that guns be voluntarily removed from homes in which there are individuals with a history of violence, threats of violence, depression, drug and/or alcohol abuse, and individuals with major mental illnesses who are not cooperating with therapy.
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Connecticut medicine · Sep 2014
A simple scoring tool for the evaluation of patients in an emergency department chest pain unit.
There are multiple risk scores to determine the prognosis of high-risk patients presenting with acute coronary syndromes (ACS) to emergency departments (ED) and chest pain units (CPU), however, there are few options for patients without ACS (no diagnostic ST-segment deviation or positive biomarkers). ⋯ This new clinical risk score is simple to use, predicts a clinically relevant outcome to ED physicians, and the results of noninvasive testing are additive.
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Connecticut medicine · Sep 2014
Psychosurgery: past, present, and future, including prefrontal lobotomy and Connecticut's contribution.
Psychosurgery, a subspecialty of functional neurosurgery, has been used in the treatment of psychiatric illness, intractable pain, and, controversially, as ameans to control and modify violent human behavior. Prefrontal lobotomy, a procedure developed in the 20th century, arose as a result of pioneering research, includingwork done atYaleUniversity in New Haven. ⋯ New technology has provided improved accuracy with less morbidity. The progressive replacement of ablative procedures with deep-brain stimulation and restorative neurosurgery offers new perspectives in the treatment of some psychiatric conditions.