Research has identified misleading and stigmatizing popular beliefs about schizophrenia, but little is known about media images corresponding to these beliefs. Building on Susan Sontag's exploration of cancer in the 1978 book Illness as Metaphor, the authors hypothesize that "schizophrenia" is now more commonly misused. A total of 1740 newspaper articles from 1996 or 1997 that mentioned schizophrenia or cancer were randomly selected and then coded for contextual and metaphorical use. Only 1 percent of articles that mentioned cancer used that illness in a metaphorical way, compared with 28 percent of the articles that mentioned schizophrenia. Results differed by newspaper but not by region. The authors suggest that these inaccurate metaphors in the media contribute to the ongoing stigma and misunderstandings of psychotic illnesses.
Background
Acute appendicitis is the most common non‐obstetric surgical presentation during pregnancy. There were concerns that laparoscopic appendicectomy increases the risk of foetal loss compared to an open approach. Therefore, with recent advances in perioperative care, it is likely the risk has changed. Here, we performed an updated meta‐analysis assessing the safety of laparoscopic appendicectomy in pregnant women.
Methods
A meta‐analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. A search was undertaken between 2000 and 2017 on Ovid Medline and Embase. The primary outcome measures were foetal loss and preterm delivery, whereas secondary outcome measures were operative time and hospital length of stay. A random‐effect model was performed to pool odds ratio (OR) and standardized mean difference (SMD).
Results
Seventeen observational studies were included, with 1886 patients in the laparoscopic and 4261 patients in the open group. Comparing laparoscopic versus open appendicectomy, there were 54 (5.96%) and 136 (3.73%) foetal losses, respectively. However, preterm delivery was much higher in the open approach (8.99%) compared to laparoscopic approach (2.84%). Pooled OR for foetal loss was 1.84 (95% confidence interval (CI) 1.31–2.58, P < 0.001), whereas OR for preterm delivery was 0.39 (95% CI 0.27–0.55, P < 0.001). There was no significant difference between both approaches for operative time (SMD −0.07; 95% CI −0.43 to 0.30, P = 0.71) or hospital length of stay (SMD −0.34; 95% CI −0.83 to 0.16, P = 0.18).
Conclusion
In a pooled analysis of level III evidence, laparoscopic appendicectomy posed a higher risk of foetal loss but lower risk of preterm delivery. Caution and informed consent are crucial when offering a laparoscopic approach.
Faecal incontinence (FI) is debilitating and common, affecting 11.2%-12.4% of the population [1]. FI may actually be even more prevalent as it is often underreported by patients due to embarrassment and perceived social stigma [2]. The management of this condition initially involves lifestyle changes (diet, pelvic floor physiotherapy, biofeedback therapy) and simple pharmacological measures (antidiarrhoeal agents), escalating to injection of bulking agents and surgical procedures, such as sphincteroplasty and sacral nerve neuromodulation. However, passive FI is particularly difficult to treat.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.