Full moon and crime

Moonlight surgery: no influence of moon phase or Friday 13th on outcomes of total knee arthroplasty

OBJECTIVES

The purpose of the present study was to investigate associations between revision-free survival and functional scores of total knee arthroplasty (TKA) and moon phase on the day of surgery, as well as operations performed on a Friday 13th.

PARTICIPANTS

The data of all patients that received TKA between 2003 and 2019 were extracted from the Tyrol arthroplasty registry. Patients that had undergone previous total or partial knee arthroplasty as well as patients that had missing pre- or post-operative WOMAC were excluded. Patients were allocated to one of the following four groups according to moon phase on the day of surgery: new, waxing, full and waning. Patients operated on a Friday 13th were also identified and compared to patients operated on any other days/dates. A total of 5923 patients met the inclusion criteria, with mean age of 69 ± 9 years, and comprising 62% women.

RESULTS

There were no significant differences in revision-free survival among the four moon phase groups (p = 0.479), and no significant differences in preoperative and postoperative total WOMAC (p = 0.260, p = 0.122), There were no significant differences in revision-free survival patients operated on Friday 13th vs. other days/dates (p = 0.440). The preoperative total WOMAC was significantly worse for patients operated on a Friday 13th (p = 0.013), which was observed in the pain (p = 0.032) and function (p = 0.010) subscales. There were no significant differences in postoperative total WOMAC at 1 year follow-up (p = 0.122).

CONCLUSIONS

Neither moon phase on the day of surgery nor Friday 13th were associated with revision-free survival or clinical scores of TKA. Patients operated on a Friday 13th had significantly worse preoperative total WOMAC but similar postoperative total WOMAC at 1-year follow-up. These findings could help reassure patients that TKA renders consistent outcomes regardless of the preoperative pain or function, and in spite of bad omens or moon phases.

Using Weather, Lunar Cycles, and Time of Year to Predict Trauma Incidents in an Urban, Level I Pediatric Trauma Center

BACKGROUND

Trauma patterns in adults are influenced by weather conditions, lunar phases, and time of year. The extent to which these factors contribute to pediatric trauma is unclear.

OBJECTIVE

The present study aimed to review patients from a single Level I pediatric trauma center to determine the influence of weather, the lunar cycle, and time of year on trauma activity.

METHODS

A retrospective review of trauma activations (n = 1,932) was conducted from 2015 to 2017. Injury type and general demographics were collected. Weather data and lunar cycles were derived from historical databases.

RESULTS

Days with no precipitation increased the total number of injuries of all types compared with those with precipitation (p < .001). Blunt and penetrating injuries were more likely to occur during full moons, whereas burn injuries were significantly higher during new moons (p < .001). Blunt trauma was significantly higher in September than all other months, F(11, 1,921) = 4.25, p < .001, whereas January had a significantly higher number of burns than all other months (p < .001).

CONCLUSIONS

Pediatric trauma trends associated with external factors such as weather, lunar cycles, and time of year can inform hospital staffing decisions in anticipation of likely injuries and help direct injury prevention efforts.

Effects of lunar cycle on fasting plasma glucose, heart rate and blood pressure in type 2 diabetic patients

The purpose of this study was to investigate the influence of lunar phases on fasting plasma glucose, heart rate, and blood pressure in type 2 diabetic patients. The present cross-sectional study was carried out during four phases, i.e., full moon (FM), first quarter (FQ), new moon (NM), and third quarter (TQ), of the lunar month. The study was conducted on 42 randomly selected patients (22 males and 20 females) from the Diabetes Clinic of Calcutta Medical College. Fasting plasma glucose (FPG) of each subject was determined and heart rate (HR) and blood pressure (BP) were measured at rest and during static exercise conditions, i.e., performance of a standard handgrip dynamometer test. The FPG level during the NM and FM was significantly higher (p < .001) than during the TQ and FQ for both males and females, respectively. The mean HR during static exercise during the NM and FM for both males and females was significantly higher than that during the FQ (p < .05) and TQ (p < .01). It appears from the present study that lunar phases may affect fasting plasma glucose level and cardiovascular functions of aged type 2 diabetic patients both at rest and during exercise.

The influence of foehn winds on the incidence of severe injuries in southern Bavaria - an analysis of the TraumaRegister DGU®

Background

Foehn describes a wind which occurs in areas with close proximity to mountains. The presence of foehn wind is associated with worsening health conditions.

This study analyzes the correlation between a foehn typical circulation and the incidence for suffering a severe trauma.

Methods

This is a retrospective, multicentre observational register study. The years from 2013 to 2016 were analyzed for the presence of foehn winds. A logistic regression analysis with the number of daily admitted trauma patients as the primary target value was performed in dependence of foehn winds.

Southern Bavaria is a typical foehn wind region. Individuals were treated in 37 hospitals of Southern Bavaria which participate in the TraumaRegister DGU®, an international register that includes all severe trauma patients, mainly in Germany.

We analyzed patients with an Injury Severity Score (ISS) of at least nine with admission to intensive care units or prior death in the emergency room.

Results

6215 patients were enrolled in this study. A foehn-typical circulation was present on 65 days (4.5%). 301 patients (5%) suffered a trauma with an ISS ≥ 9 on a foehn day. The mean ISS was 20.2 (9–75). On average, 4.3 patients (0–15 patients) were admitted on a daily basis due to a severe trauma.

The multivariate regression analysis revealed a daily increase of 0.87 individuals (p = 0.004; 95% CI 0.23–1.47) on foehn days. During spring 1.07 patients (p = < 0.001; 95% CI 0.72–1.42), in summer 1.98 patients (p = < 0.001; 95% CI 1.63–2.32), in fall 0.63 (p = < 0.001; 95% CI 0.28–0.97) and on Saturdays, 0.59 patients (p = < 0.001; 95% CI 0.24–0.93) were additionally admitted due to severe trauma.

Conclusion

Foehn winds are significantly associated with severe trauma in trauma centers of the TraumaNetzwerk DGU®.

Lunar cycle in homicides: a population-based time series study in Finland

OBJECTIVE

To test whether homicides in Finland vary according to moon phases.

DESIGN

A time series study.

SETTING

Finland.

PARTICIPANTS

6808 homicides committed in 1961-2014.

OUTCOME

Daily numbers of homicides.

METHOD

The daily numbers of homicides were related to eight moon phases and the illuminated percentage of the moon disc using negative binomial regression. To identify lunar patterns, piecewise linear terms of lunar days were used, together with changes from one moon phase to another. Homicides were similarly regressed on quintiles of the illuminated percentage of the moon disc. A periodic term of length 29.53 days was included to detect cyclic patterns. The results were adjusted for sex, age, secular trend, distance from the moon, seasons, weekday, major holidays and temperature.

RESULTS

During the full moon, 15% less homicides were committed than during the new moon (RR 0.85; 95% CI 0.77 to 0.94) and 86% less during the lightest quintile of illumination compared with the darkest quintile (RR 0.14; 95% CI 0.04 to 0.50). Adjustments did not change the results. Piecewise linear regressions showed a significant decline in homicides at the full moon and a rise thereafter. The full moon drop in homicides was directionally similar for seasons, weekdays, sex, age and time periods, and it was particularly pronounced in the early part of period studied (1961-1974). Periodic regression showed a regular cyclic pattern of length 29.53 days (p~0.035).

CONCLUSIONS

Contrary to current scientific opinion, an association exists between moon phases and homicides, and contrary to what has been previously assumed, homicides declined during the full moon, especially in earlier decades. However, the causality of the association remains elusive.

Moon phases and moon signs do not influence morbidity, mortality and long-term survival, after living donor kidney transplantation

Background

Approximately 11% of the German population are convinced that certain moon phases and moon signs may impact their health and the onset and clinical course of diseases. Before elective surgery, a considerable number of patients look to optimize the timing of the procedure based on the lunar cycle. Especially patients awaiting living donor kidney transplantation (LDKT) commonly look for an adjustment of the date of transplantation according to the moon calendar. This study therefore investigated the perioperative and long-term outcome of LDKT dependent on moon phases and zodiac signs.

Methods

Patient data were prospectively collected in a continuously updated kidney transplant database. Two hundred and seventy-eight consecutive patients who underwent LDKT between 1994 and December 2009 were selected for the study and retrospectively assigned to the four moon phases (new-moon, waxing-moon, full-moon, and waning-moon) and the corresponding zodiac sign (moon sign Libra), based on the date of transplantation. Preexisting comorbidities, perioperative mortality, surgical outcome, and long-term survival data were analyzed.

Results

Of all LDKT procedures, 11.9, 39.9, 11.5, and 36.5% were performed during the new, waxing, full, and waning moon, respectively, and 6.2% during the moon sign Libra, which is believed to interfere with renal surgery. Survival rates at 1, 5, and 10 years after transplantation were 98.9, 92, and 88.7% (patient survival) and 97.4, 91.6, and 80.6% (graft survival) without any differences between all groups of lunar phases and moon signs. Overall perioperative complications and early graft loss occurred in 21.2 and 1.4%, without statistical difference (p > 0.05) between groups.

Conclusion

Moon phases and the moon sign Libra had no impact on early and long-term outcome measures following LDKT in our study. Thus, concerns of patients awaiting LDKT regarding the ideal time of surgery can be allayed, and surgery may be scheduled independently of the lunar phases.

Relationship between lunar cycle and haemorrhagic complication rate in surgery

BACKGROUND

The aim of this study was to evaluate a possible relationship between lunar cycles and haemorrhagic complication rate in surgery.

MATERIALS AND METHODS

The possible relationship between moon phases and surgical outcome was tested by evaluating the haemorrhagic complication rate for 18,760 patients who underwent surgery between January 2001 and December 2008 at the National Institute for Cancer Research in Genoa. A total of 103 lunar phases were considered using Chi-square (χ²) test analysis, and patients were allocated a surgery date.

RESULTS

One hundred and sixty-seven haemorrhagic complications were observed. Three hundred and nine new moon phase days were analysed and 12 incidences of complications detected, with a 3.9% complication rate per day. In the waxing moon phase, 1184.5 d were analysed with 68 incidences of complications at a daily rate of 5.7%. In the full moon phase there was a 4.9% complication rate per day (15 incidences in 309 d), whereas in the waning moon phase, the 6% percentage rate per day resulted from 72 incidences in 1184.5 d.

CONCLUSIONS

No statistically significant correlations were found between moon cycles and postoperative haemorrhagic complications (p = .50).

External factors and the incidence of severe trauma: time, date, season and moon

BACKGROUND

To detect whether external factors (time of day, day of week, month and season, lunar phases) influence incidence and outcome of severely injured trauma patients.

PATIENTS AND METHODS

A retrospective cohort analysis of the TraumaRegister DGU(®) (TR-DGU) was carried out over a period of 10 years (January 2002-December 2011). Data of 35,432 primary admitted patients from Germany with a severe trauma (Injury Severity Score (ISS) >15) were analysed in this study. For the outcome evaluation transferred patients were excluded as well as those who did not have a valid Revised Injury Severity Classification (RISC) prognostic score. The outcome analysis could be performed in 31,596 (89.2%) patients. Incidence, demographics and injury pattern were analysed. For outcome analysis the observed hospital mortality was compared with the expected prognosis.

RESULTS

Time of day was the factor that showed the highest variation in trauma incidence due to rush hours. Saturday was the day with the highest accident rate. Most accidents in the night happened on weekends. June and July were the months with the highest trauma rate with a large portion of two-wheel drivers. The days of year with the lowest trauma incidence rate were those between Christmas and New Year, and the highest rate was observed on May 1st. The outcome of the trauma patients was close to the prognosis in all investigated subgroups.

CONCLUSION

There are clear differences in incidence but not in outcome of the patients due to external factors.

The lunar cycle, sunspots and the frequency of births in Germany, 1920-1989

Based on multivariate linear regression models, we analyze the effect of the lunar cycle and the number of sunspots occurring on a particular day on the number of births using social security data and controlling for a number of other potential confounders. The daily numbers of births between 1920 and 1989 have been calculated from the full sample of individuals who have been registered at least once in the German social security system. While the lunar cycle does not affect the number of births, the number of sunspots is positively correlated to the number of births. The empirical results may be explained by medical technological progress making natural influences on births less important over time. This interpretation is supported by the results on the intertemporal influence of weekends and holidays on the frequency of daily births.

A study on the physical fitness index, heart rate and blood pressure in different phases of lunar month on male human subjects

The gravitational pull of the moon on the earth is not the same in all phases of the lunar month, i.e. new moon (NM), first quarter (FQ), full moon (FM) and third quarter (TQ), and as a result the amplitude of tide differs in different phases. The gravitational pull of the moon may have effects on the fluid compartments of the human body and hence the cardiovascular system may be affected differentially in the different phases of the lunar month. In the present study resting heart rate (HR) and blood pressure (BP), physical fitness index (PFI), peak HR and BP immediately after step test, and recovery HR and BP after step test were measured during different phases of the lunar month in 76 male university students (age 23.7 ± 1.7 years). At rest, both systolic and mean arterial BP were ∼5 mmHg lower in NM and FM compared to FQ and TQ, but resting HR was not significantly different between phases. Further, peak HR and peak systolic BP after step test were lower (∼4 beat/min and ∼5 mmHg, respectively) in NM and FM compared to FQ and TQ. PFI was also higher (∼5) in NM and FM compared to FQ and TQ. Recovery of HR after step test was quicker in NM and FM compared to that of FQ and TQ. It appears from this study that gravitational pull of the moon may affect the cardiovascular functions of the human body. Moreover, the physical efficiency of humans is increased in NM and FM due to these altered cardiovascular regulations.

Lunar phase does not influence perioperative complications in total hip arthroplasty

INTRODUCTION

Lunar calendars, publishing recommendations for daily life, are gaining more and more attention in Germany, where 10.5% of the population believe in lunar effects on disease. A widespread and often heard belief is that a full moon has the most negative effects on surgical outcome. The present study evaluates the effects of lunar phase on perioperative complications in total hip arthroplasty.

MATERIAL AND METHODS

We performed a retrospective study with 305 patients being provided with a primary hip arthroplasty. To identify possible influences of the lunar phase on perioperative complications we investigated data such as operation length, blood loss and course of C-reactive protein that were collected during the patients' stay in the hospital and allocated them to moon illumination.

RESULTS

There were no significant differences in all collected data concerning the lunar phase (p > 0.05). Although not statistically significant, there were fewer operations during the full moon phase.

CONCLUSIONS

Therefore there is no evidence that lunar phase has an effect on perioperative complications in total hip arthroplasty. Fewer, though not significantly fewer, operations were performed during the full moon phase. Although this was not a prospective randomized trial, the statistical magnitude of the results does not support any recommendations for scheduling patients for total hip arthroplasty at any particular day of the lunar phase.

Canine and Feline Epileptic Seizures and the Lunar Cycle: 2,507 Seizures (2000–2008)

Epileptic seizures in 211 canine and feline patients diagnosed with idiopathic epilepsy were evaluated for temporal significance in relation to the lunar cycle. Seizure counts were compared among each of the eight individual lunar phases, among each of eight exact lunar phase dates, and by percent of lunar illumination using generalized estimating equations. No statistical significance was found in any of these comparisons excluding a relationship between the onset of epileptic seizures and the phases of the moon. Alteration in anticonvulsant treatment or monitoring of canine and feline patients with idiopathic epilepsy at large was not warranted based on the lunar cycle.

Lunar phase cycle and psychiatric hospital emergency visits, inpatient admissions and aggressive behavior

INTRODUCTION

We examined the correlation between lunar cycles and the number of psychiatric emergency visits, patients' gender, aggressive behavior, need for inpatient admission, legal referral and need for involuntary chemical restraint in a period of one calendar year.

METHOD

Charts of all psychiatric emergency room patients were reviewed retrospectively. Arabic calendar lunar months were divided based on three different models: Two 15 days sections, three 10 days, and six 5 days parts in the third model.

RESULTS

5431 patients were seen in the psychiatric emergency service (PES) during a one year period. We did not find a relationship between the visit time (day or night), gender, and legal referral in relation to moon cycles. A higher number of visits during full moon period which was not statistically significant (P>0.05) was found. Highest frequency of inpatient admissions was discovered in the first and last parts of the three part model and in the first and last segments of the six part model followed by second and fifth parts (P-values: 0.000).

CONCLUSION

This study revealed a slight increase in number of visits to psychiatric emergency room during full moon periods. In addition a highly significant increase in the severity of illness and aggressive behaviors and agitation in the beginning and end of the moon cycles were noticed. Some of the underlying possible causes such as changes in intra/extracellular fluids, neural and endocrine cell functions, hemodynamic and biological responses and changes in social dynamics and support are discussed.

Relationship between lunar phases and serious crimes of battery: a population-based study

OBJECTIVE

The hypothesis of a lunar influence on human abnormal behavior is still widespread, although research has led to conflicting findings. Therefore, a population-based study to assess the influence of lunar phases on violent crimes was conducted.

METHODS

The study included all serious crimes of battery (aggravated assaults) committed in Middle Franconia (Bavaria, Germany) between 1999 and 2005 (n = 23 142). Data were analyzed regarding lunar phase, sex, and place of crime scene (outdoor vs indoor).

RESULTS

No significant associations between full, absent, and the moon's interphases and serious crimes of battery could be detected. Furthermore, a Fourier analysis was conducted that failed to produce an association between violence and the moon's phases.

DISCUSSION

Several possible explanations for the presented results are discussed including biological and social mechanisms.

CONCLUSIONS

The present study fails to find a significant association between lunar phases and crimes of battery.

The epidemiology and chronobiology of epistaxis: an investigation of Scottish hospital admissions 1995-2004

OBJECTIVES

This study aimed at investigating aspects of the epidemiology and chronobiology of emergency admissions with epistaxis in Scotland between 1995 and 2004. In particular, we sought to examine the epidemiology of hospital admission with epistaxis and effects of factors such as day of week, time of year and lunar cycle.

DESIGN

A statistical analysis, in terms of descriptive statistics, logistical regression and linear regression, was carried out on data obtained from the Scottish Morbidity Records related to emergency Ear, Nose and Throat (ENT) admissions.

SETTING AND PARTICIPANTS

All emergency inpatient admissions for Scottish residents to ENT wards in Scottish NHS hospitals during the 10-year period, between 1st January 1995 and December 31st 2004 were studied. This study only looked at admissions and thus excludes Accident and Emergency attendances caused by epistaxis.

MAIN OUTCOME MEASURES

Age, gender, year, month and day of the week of admission were considered, as was relationship to the moon phase.

RESULTS

During the study period, the mean daily admission rate with epistaxis was six. Epistaxis accounted for 33% of all ENT emergency admissions. The average age of non-epistaxis ENT emergency admission was 31 years. For epistaxis emergency admissions the median age was 70 years. There were fewer admissions in the summer months [August RR: 0.59 (95% CI: 0.54-0.65) P < 0.001]. There were more admissions at the weekends and on non-weekend public holidays [RR: -0.115 (95% CI -0.160-0.071) P < 0.001]. There was a trend towards a reduction in admission rates from the year 2001. Despite the fluctuations with season and weekday, there was no relationship with phase of the moon [RR: 0.98 (95% CI: 0.88-1.09) for day of the full moon compared with non-full moon weekday].

CONCLUSIONS

This study underlines the importance of epistaxis as the single most frequent emergency diagnosis in ENT. The frequency and patterns of admission show pronounced fluctuations. The observed increase in winter admissions confirms earlier work and may have implications for health resource allocation. Relationships between weekends/public holidays and increased admissions with epistaxis may correspond with social patterns of alcohol use (a known aetiological factor). The lunar cycle does not have an effect on the frequency of epistaxis admissions.

Labour ward activity and the lunar cycle

To refute the commonly held belief by the general public that the lunar cycle affects labour, we studied 10 027 deliveries over an 18-month period in a large maternity unit in Ireland. There was no increase in the total number of deliveries during the times of a full moon compared with other times. The caesarean section, instrumental vaginal delivery, and pre-term delivery rate remained unchanged over the times of a full moon. We conclude that the lunar cycle has no influence on labour ward activity.

Effect of lunar cycle on temporal variation in cardiopulmonary arrest in seven emergency departments during 11 years

OBJECTIVE

To determine the effect of the phase of the full and new moon on the variation in the number of daily cardiopulmonary resuscitations.

DESIGN

A retrospective analysis of a computerized billing database of emergency department visits in a cohort of seven northern New Jersey (USA) emergency departments.

PARTICIPANTS

Consecutive patients seen by emergency department physicians over an 11-year period (1 January 1988 to 31 December 1998). We determined the timing of full and new moon days from the National Oceanographic and Aeronautic Administration website.

INTERVENTIONS

Time series regression estimated the independent effect of full and new moon days on the daily variation in cardiopulmonary resuscitations. Tests of statistical significance were made at alpha=0.05.

RESULTS

A total of 2 370 233 emergency department visits were made during the 4018-day period of study. A total of 6827 had an emergency department diagnosis of cardiopulmonary resuscitation. We found no significant difference in the occurrence of cardiopulmonary resuscitations during the full moon (P=0.97). On average there were 6.5% fewer cardiopulmonary resuscitations during new moon days (P=0.02; 95% confidence interval 1.3-11.7%).

CONCLUSION

Contrary to the traditional belief that more cardiopulmonary resuscitations occur during the full moon, we were unable to identify a significant effect during full moon days. However, there were on average 6.5% fewer cardiopulmonary resuscitations during new moon days than other days.

The moon and its relationship to oral and maxillofacial emergencies

OBJECTIVE

To study the relationship between the full moon and oral and maxillofacial emergencies.

STUDY DESIGN

Retrospective analysis of 2416 referrals to the Department of Oral and Maxillofacial Surgery, St. Bartholomews and The Royal London Hospital, London, over a 16-month period (17 lunar months). Frequency distributions were used to assess emergency workload during the week of the full moon.

RESULTS

There was a rise in referrals in the latter part of the 7-day period surrounding the full moon. There was a persistent reduction in emergency workload in the 3-day period leading up to the full moon. The results approach but do not reach significance.

CONCLUSIONS

The effect of the moon on oral and maxillofacial referrals cannot be proven.

Moon cycles and violent behaviours: myth or fact?

We formulated the hypothesis that lunar phases, identified by the fraction of the illuminated visible surface of the moon, have a relationship with the frequency of victims of aggression seen in an emergency department. If such a relationship exists, an increase in the frequency of incidents with the phases of full moon or new moon would be expected. In order to test this hypothesis, the daily frequency of victims of violent behaviour seen in the emergency department was used to create a temporal series of data. This was then correlated with a temporal series of lunar luminosity data from the same time period. Crossed correlations in the delay range -7 to +7 days showed coefficient values ranging between -0.102 and +0.034, demonstrating weak correlations without statistical significance. Despite the attractiveness of the popular belief that the moon influences human behaviour, the analysis of our data does not support an association between lunar phases and frequency of violent behaviour. That is, we cannot predict the frequency of cases from a knowledge of lunar luminosity, at least in the period over which our study was performed.

Do animals bite more during a full moon? Retrospective observational analysis

OBJECTIVE

To test the hypothesis that the incidence of animal bites increases at the time of a full moon.

DESIGN

Retrospective observational analysis.

SETTING

Accident and emergency department at a general hospital in an English city.

SUBJECTS

1621 consecutive patients, irrespective of age and sex.

MAIN OUTCOME MEASURES

Number of patients who attended an accident and emergency department during 1997 to 1999 after being bitten by an animal. The number of bites in each day was compared with the lunar phase in each month.

RESULTS

The incidence of animal bites rose significantly at the time of a full moon. With the period of the full moon as the reference period, the incidence rate ratio of the bites for all other periods of the lunar cycle was significantly lower (P <0.001).

CONCLUSIONS

The full moon is associated with a significant increase in animal bites to humans.

Barking mad? another lunatic hypothesis bites the dust

OBJECTIVE

To assess whether dog bites requiring hospital admission occur more at the full moon.

DESIGN

Review of dates of admission for dog bites to accident and emergency departments, June 1997 to June 1998, compared with dates of the full moon.

SETTING

All public hospitals in Australia.

MAIN OUTCOME MEASURES

Admissions for dog bites.

RESULTS

12 peak clusters of admissions were unrelated to the time of the full moon.

CONCLUSION

Dog bites are no more frequent on full moons than at any other time of the month. Sceptics rejoice.

The full moon and ED patient volumes: unearthing a myth

To determine if there is any effect of the full moon on emergency department (ED) patient volume, ambulance runs, admissions, or admissions to a monitored unit, a retrospective analysis of the hospital electronic records of all patients seen in an ED during a 4-year period was conducted in an ED of a suburban community hospital. A full moon occurred 49 times during the study period. There were 150,999 patient visits to the ED during the study period, of which 34,649 patients arrived by ambulance. A total of 35,087 patients was admitted to the hospital and 11,278 patients were admitted to a monitored unit. No significant differences were found in total patient visits, ambulance runs, admissions to the hospital, or admissions to a monitored unit on days of the full moon. The occurrence of a full moon has no effect on ED patient volume, ambulance runs, admissions, or admissions to a monitored unit.

Psychopharmacology of lycanthropy

OBJECTIVE

To develop pharmacotherapies for the orphan disease lycanthropy through the pursuit of the etiologic hypothesis of a genetically determined hypersecretion of endogenous lycanthropogens.

DESIGN

Quadruple-blind, Rubik's Cube matrix analysis.

SETTING

Community practice and malpractice.

PARTICIPANTS

Subjects selected from inbred Ruficolla populations in Mississippi, Georgia, North Carolina and Minnesota. All who entered the study finished it.

INTERVENTIONS

Chemical screening of blood samples over a hypothesized secretory cycle of lycanthropogen peaking on the day of maximum lunar illumination. Administration of synthetic lycanthropogens for behavioural testing. Experimental lycosomatization through the illumination method of Kirschbaum.

OUTCOME MEASURES

None were post hoc, but some are still in hock.

MAIN RESULTS

Two putative lycanthropogens were isolated from the blood samples. Structural elucidation and synthesis permitted animal and clinical trials; in each of these, behavioural dysfunction was observed. Antilycanthropogen strategies included application of the principle of caged compounds and generation of a therapeutic immunoglobulin. The effects of a newly developed antihirsutic agent seemed promising. An interaction of the lycanthropogen-secretion system and ethanol was noted, which may explain behavioural aspects of alcoholism.

CONCLUSIONS

The incidence of lycomania in North America is underestimated. Soon-to-be-available pharmacotherapies should promote its early detection and treatment. Full control may depend upon advances in gene therapy.

Hypnosis in the 1990s--and beyond

For this Presidential Address, I accepted the challenge to discuss my perception of the future directions of hypnotherapy. I believe that the next decade will bring increased attention to the mind/body relationship and how hypnosis can be most effectively employed in this area. As an oncologist, one of the most exciting areas of current research is in psychoneuroimmunology. The role of communication in the practice of the health sciences is receiving more emphasis. Training in hypnosis is helpful in recognizing spontaneous trance states which may modify the effects of "nocebos." The use of hypnoanesthesia for surgery would be ideal in third world and developing countries. I believe there will be increased interest in the use of hypnosis in self-care, in the forensic area, and in the use of self-hypnosis by the general population. Finally, I expect that in the next decade the ASCH and SCEH will cooperate more closely in many areas of significance to hypnosis.

Urinary retention and the lunisolar cycle: is it a lunatic phenomenon?

OBJECTIVE

To determine whether a relation between urinary retention and temporal rhythms exists.

DESIGN

Retrospective analysis of patients presenting over three years.

SETTING

Urology departments in two hospitals.

PATIENTS

815 Patients presenting as emergency admissions with urinary retention and requiring immediate decompression of the bladder.

MAIN OUTCOME MEASURES

Calendar date of each admission to determine circadian, monthly, and seasonal periodicity.

RESULTS

No association was found between urinary retention and circadian, monthly, or seasonal rhythms. A significantly higher (p less than 0.001) incidence of urinary retention was observed during the new moon in comparison with other phases of the lunar cycle.

CONCLUSIONS

Urinary retention is periodic in nature. This should be considered when the workload of a specialist urological department is organised.

Trauma and the full moon: a waning theory

There exists a popular belief in the causal relationship between the moon's phase and the incidence of major trauma. In this retrospective study we reviewed 1,444 trauma victims admitted to the hospital during one calendar year. Full moons were defined as three-day periods in the 29.531-day lunar cycle, with the middle day being described in the world almanac as the full moon. Victims of violence included those patients sustaining blunt assault, gunshot wounds, and stabbings. There was no statistical difference in number of trauma admissions between the full moon, 129 patients per 36 days (mean, 3.58), and nonfull moon days, 1,315 patients per 330 days (mean, 3.98). Mortality rate, 5.4% versus 10.3%; mean Injury Severity Score, 13 versus 15; and mean length of stay, ten versus 12 days, were not significantly different during the full moon and nonfull moon days. Victims of violence were admitted at a similar frequency on full moon, 16 patients per 36 days (mean, 0.444), and nonfull moon days, 183 patients per 330 days (mean, 0.555). We conclude that the belief in the deleterious effects of the full moon on major trauma is statistically unfounded.