Profile of cases suspected of attempted suicide by exogenous intoxication

Objective: To characterize the profile of patients suspected of attempting suicide, based on cases reported by the Toxicological Information Center of the University hospital of Southern Brazil.Methods: This is a retrospective aggregate study, based on the analysis of medical records and files between January 2009 and December 2012, aiming to collect information that would create the profile of patients suspected of attempting suicide, from the cases notified by the Toxicological Information Center.Results: Regarding the physical consequences and the danger of the suicide attempt, 97% of the suicide attempts did not present life threatening (n = 1,605); 85.4% were not referred to any professional service (n = 1,412). The year 2012 was the year with the highest number of suicide attempts that the other years.Conclusions: It is considered important to improve the notification form for poisoning injuries, to better detect information about suicide attempts.

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Analysis of Deliberate Self-Wrist-Cutting Episodes Presenting to the Emergency Department

Crisis ◽

10.1027/0227-5910/a000361 ◽

2016 ◽

Vol 37 (2) ◽

pp. 155-160 ◽

Cited By ~ 2

Author(s):

Jin Kim ◽

Han Joon Kim ◽

Soo Hyun Kim ◽

Sang Hoon Oh ◽

Kyu Nam Park

Keyword(s):

Emergency Department ◽

Medical Records ◽

Attempted Suicide ◽

Suicide Attempts ◽

Psychiatric Interview ◽

Clinical Variables ◽

Completed Suicide ◽

Number Of Patients ◽

Group A ◽

Efficacy Of Treatment

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.

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Epidemiological Trends in Attempted Suicide in Adolescents and Young Adults Between 1996 and 2004

Crisis ◽

10.1027/0227-5910.30.3.115 ◽

2009 ◽

Vol 30 (3) ◽

pp. 115-119 ◽

Cited By ~ 10

Author(s):

Stephanie De Munck ◽

Gwendolyn Portzky ◽

Kees Van Heeringen

Keyword(s):

Young Adults ◽

Attempted Suicide ◽

Suicide Attempts ◽

Epidemiological Studies ◽

Adolescents And Young Adults ◽

University Hospital ◽

International Studies ◽

Suicide Attempters ◽

Increased Risk ◽

Epidemiological Trends

Background: Notwithstanding the epidemiological studies indicating an increased risk of attempted suicide among adolescents and young adults, there is a scarcity of international studies that examine long-term epidemiological trends in rates and characteristics of this vulnerable group. Aims: This article describes the results of a 9-year monitoring study of suicide attempts in adolescents and young adults referred to the Accident and Emergency Department of the Gent University Hospital (Belgium). Methods: Between January 1996 and December 2004, trends, sociodemographic, and methodrelated characteristics of suicide attempts were assessed by a psychiatrist on data sheets. Results: Attempted suicide rates declined from 1996 to 2001 and then rose until 2004, but did not exceed previous rates. During the 9 years of monitoring, there was a preponderance of female suicide attempters, except for 1997. Rates of attempts and of fatal suicide were negatively correlated. Significantly more males than females deliberately injured themselves. Younger attempters, especially females, significantly more often poisoned themselves with analgesics. In nearly one in five attempts, alcohol was used in combination with other methods, and alcohol intake was more commonly observed in older suicide attempters. Nearly half of the adolescents were identified as repeaters. Conclusions: The results of this study warrant further monitoring of trends and characteristics of young suicide attempters.

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Role of SatO2, PaO2/FiO2 Ratio and PaO2 to Predict Adverse Outcome in COVID-19: A Retrospective, Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182111534 ◽

2021 ◽

Vol 18 (21) ◽

pp. 11534

Author(s):

Stefano Sartini ◽

Laura Massobrio ◽

Ombretta Cutuli ◽

Paola Campodonico ◽

Cristina Bernini ◽

...

Keyword(s):

Respiratory Failure ◽

Adverse Outcome ◽

University Hospital ◽

Rt Pcr ◽

Threatening Condition ◽

Life Threatening ◽

Group A ◽

Group B ◽

The University

COVID-19 respiratory failure is a life-threatening condition. Oxygenation targets were evaluated in a non-ICU setting. In this retrospective, observational study, we enrolled all patients admitted to the University Hospital of Genoa, Italy, between 1 February and 31 May 2020 with an RT-PCR positive for SARS-CoV-2. PaO2, PaO2/FiO2 and SatO2% were collected and analyzed at time 0 and in case of admission, patients who required or not C-PAP (groups A and B) were categorized. Each measurement was correlated to adverse outcome. A total of 483 patients were enrolled, and 369 were admitted to hospital. Of these, 153 required C-PAP and 266 had an adverse outcome. Patients with PaO2 <60 and >100 had a higher rate of adverse outcome at time 0, in groups A and B (OR 2.52, 3.45, 2.01, respectively). About the PaO2/FiO2 ratio, the OR for < 300 was 3.10 at time 0, 4.01 in group A and 4.79 in group B. Similar odds were found for < 200 in any groups and < 100 except for group B (OR 11.57). SatO2 < 94% showed OR 1.34, 3.52 and 19.12 at time 0, in groups A and B, respectively. PaO2 < 60 and >100, SatO2 < 94% and PaO2/FiO2 ratio < 300 showed at least two- to three-fold correlation to adverse outcome. This may provide simple but clear targets for clinicians facing COVID-19 respiratory failure in a non ICU-setting.

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Low adherence to pneumococcal vaccination in lung cancer patients in a tertiary care university hospital in Southern Germany

10.21203/rs.3.rs-906318/v1 ◽

2021 ◽

Author(s):

Arno Mohr ◽

Mia Kloos ◽

Christian Schulz ◽

Michael Pfeifer ◽

Bernd Salzberger ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Medical Records ◽

Hepatitis A ◽

Tertiary Care ◽

Pneumococcal Vaccination ◽

University Hospital ◽

Lung Cancer Patients ◽

Tick Borne Encephalitis ◽

The University

Abstract IntroductionThe aim of this study was to investigate the adherence to vaccinations, especially pneumococcal vaccinations, in lung cancer patients.MethodsThe study was performed at the University Hospital Regensburg, Germany. All patients with a regular appointment scheduled between December 1, 2020, and April 29, 2021, and who provided informed consent were included. Available medical records, vaccination certificates and a questionnaire were analyzed.Results136 lung cancer patients (NSCLC n = 113, 83.1%, SCLC n = 23, 16.9%) were included. A correct pneumococcal vaccination according to national recommendations was performed in 9.4% (12/127) of patients.A correct vaccination was performed for tetanus in 50.4% (6/131), diphtheria in 34.4% (44/128), poliomyelitis in 25.8% (33/128), tick-borne encephalitis in 40.7% (24/59), hepatitis A in 45.5% (7/11), hepatitis B in 38.5% (5/13), shingles in 3.0% (3/101), measles in 50.0% (3/6), pertussis in 47.7% (62/130), influenza in 54.4% (74/136) and meningococcal meningitis in 0% (0/2).ConclusionAdherence to pneumococcal vaccinations, as well as other vaccinations, is rather low in lung cancer patients.

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Fetal Profile Markers for the Detection of Robin Sequence in Fetuses with Retrognathia

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-1659-2499 ◽

2021 ◽

Author(s):

Cornelia Wiechers ◽

Christian Poets ◽

Markus Hoopmann ◽

Karl Oliver Kagan

Keyword(s):

Normal Population ◽

False Positive Rate ◽

University Hospital ◽

Robin Sequence ◽

Profile Line ◽

Positive Rate ◽

Life Threatening ◽

Matched Case ◽

The University ◽

Control Study

Abstract Objective To determine whether the prefrontal space ratio (PSFR), inferior facial (IFA) and maxilla-nasion-mandible angle (MNM), and the fetal profile line (FPL) are helpful in identifying fetuses with Robin sequence (RS) in cases with isolated retrognathia, and thus better predict the likelihood of immediate need for postnatal respiratory support. Methods This was a retrospective matched case-control study of fetuses/infants with isolated retrognathia with or without RS receiving pre- and postnatal treatment at the University Hospital of Tübingen, Germany between 2008 and 2020. The PFSR, IFA, MNM, and FPL were measured in affected and normal fetuses according to standardized protocols. Cases were stratified into isolated retrognathia and RS. Results 21 (n=7 isolated retrognathia, n=14 RS) affected fetuses and 252 normal fetuses were included. Their median gestational age at ultrasound examination was 23.6 and 24.1 weeks, respectively. In fetuses with isolated retrognathia and RS, the PSFR, IFA, and FPL were significantly different from the normal population. At a false-positive rate of 5%, the detection rate was 76.2% for the PFSR, 85.7% for the IFA, and 90.5% for both parameters combined. However, all parameters failed to distinguish between isolated retrognathia and RS. Conclusion PSFR and IFA are simple markers for identifying retrognathia prenatally. However, they are not helpful for the detection of RS in fetuses with isolated retrognathia. Therefore, delivery should take place in a center experienced with RS and potentially life-threatening airway obstruction immediately after birth.

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Generalized myoclonus in COVID-19

Neurology ◽

10.1212/wnl.0000000000009829 ◽

2020 ◽

Vol 95 (6) ◽

pp. e767-e772 ◽

Cited By ~ 23

Author(s):

Pablo Rábano-Suárez ◽

Laura Bermejo-Guerrero ◽

Antonio Méndez-Guerrero ◽

Javier Parra-Serrano ◽

Daniel Toledo-Alfocea ◽

...

Keyword(s):

Medical Records ◽

Startle Response ◽

Respiratory Arrest ◽

University Hospital ◽

Voluntary Movements ◽

Inflammatory Phase ◽

Immune Mediated ◽

The University ◽

Order Structures ◽

Rule Out

ObjectiveTo report 3 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who developed generalized myoclonus.MethodsPatient data were obtained from medical records from the University Hospital “12 de Octubre,” Madrid, Spain.ResultsThree patients (2 men and 1 woman, aged 63–88 years) presented with mild hypersomnia and generalized myoclonus following the onset of the so-called inflammatory phase of coronavirus disease 2019 (COVID-19). All of them had presented previously with anosmia. Myoclonus was generalized with both positive and negative jerks, predominantly involving the facial, trapezius, sternocleidomastoid, and upper extremities muscles. These myoclonic jerks occurred spontaneously and were extremely sensitive to multisensory stimuli (auditive and tactile) or voluntary movements, with an exaggerated startle response. Other causes of myoclonus were ruled out, and none of the patients had undergone respiratory arrest or significant prolonged hypoxia. All of them improved, at least partially, with immunotherapy.ConclusionsOur 3 cases highlight the occurrence of myoclonus during the COVID-19 pandemic as a post- or para-infectious immune-mediated disorder. However, we cannot rule out that SARS-CoV-2 may spread transneuronally to first- and second-order structures connected with the olfactory bulb. Further investigation is required to clarify the full clinical spectrum of neurologic symptoms and optimal treatment.

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Caring for “Socially Undesirable” Patients

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s0963180100007398 ◽

1996 ◽

Vol 5 (4) ◽

pp. 500-510 ◽

Cited By ~ 6

Author(s):

Nancy S. Jecker

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Metabolic Acidosis ◽

Renal Insufficiency ◽

Suicide Attempts ◽

University Hospital ◽

Healthcare Team ◽

Local Hospital ◽

The University ◽

Osmolar Gap

Mr. Bernard was a homeless man, aged 58. His medical history revealed alcohol abuse, seizure disorder, and two suicide attempts. Brought to the emergency room at a local hospital after being found “semi-comatose,” his respiratory distress led to his being intubated and placed on a ventilator. The healthcare team suspected the patient ingested antifreeze. Transferred from that hospital to the intensive care unit (ICU) of the university hospital, his diagnosis was “high osmolar gap with high-anion gap metabolic acidosis, most likely secondary to ethylene glycol ingestion and renal insufficiency.”

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Odontogenic phlegmon of the mouth floor: a case report

Progress in Health Sciences ◽

10.5604/01.3001.0009.5166 ◽

2016 ◽

Vol 6 (2) ◽

pp. 0-0

Author(s):

P. Bortnik ◽

P. Wieczorek ◽

P. Załęski ◽

P. Kosierkiewicz ◽

A. Siemiątkowski ◽

...

Keyword(s):

Case Report ◽

Antibiotic Therapy ◽

Plastic Surgery ◽

Successful Treatment ◽

Surgical Intervention ◽

University Hospital ◽

Local Complication ◽

Life Threatening ◽

Ludwig’S Angina ◽

The University

Odontogenic phlegmon of the mouth floor—Ludwig's angina (phlegmonae fundi cavi oris seu angina Ludovici)—is a rare, life-threatening, local complication in most cases of odontogenic inflammation. This study presents the case of a patient treated in the Department of Maxillofacial and Plastic Surgery of the University Hospital in Białystok due to phlegmon of the mouth floor resulting from odontogenic inflammation with a dynamic course. Quick diagnostics, surgical intervention as well as antibiotic therapy contributed to its efficient and successful treatment.

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Drugs that can cause respiratory depression with concomitant use of opioids

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2017.04.060 ◽

2017 ◽

Vol 16 (1) ◽

pp. 186-186

Author(s):

B.D. Sigmarsdottir ◽

Th.K. Gudmundsdottir ◽

S. Zoäga ◽

P.S. Gunnarsson

Keyword(s):

Respiratory Depression ◽

Medical Records ◽

Medical Condition ◽

University Hospital ◽

Drug Classes ◽

Threatening Condition ◽

Life Threatening ◽

Using Data ◽

Medical Records System ◽

Sedative Drugs

Abstract Aims Respiratory depression is a serious life threatening condition and a known adverse event of opioids. Little is known about the use of the opioid antidote naloxon in Iceland, and the additive effects of other potentially respiratory depressive drugs administered with opioids. The aim of the study was to review the literature on drugs that may cause respiratory depression and to assess medication use in patients receiving parenteral naloxone in Landspítali University Hospital. Methods A review and analysis of drugs that can cause respiratory depression based on information from the scientific literature, medicine databases and clinical guidelines. A retrospective study was performed using data collected from the electronic medical records system of Landspítali University Hospital for all patients, 18 years and older that had parenteral naloxon administered in the years 2010–2014. Information about the type of opioid and other respiratory depressive drugs was collected and the data was further investigated in regards to age, gender, and type of service. Results The most potential drugs and drug classes that can cause respiratory depression when used concomitantly with opioids are benzodiazepines and other anxiolytics, hypnotics and sedatives, antipsychotics, antiepileptics, antihistamins and anesthetics. When use was examined (N=138) morphine was the most frequent opioid given (49%). Concomitant use of opioids and other respiratory depressive drugs was seen in 63% of cases, and benzodiazepines were the most frequent drugs given with opioids (33%). Conclusions The concomitant use of benzodiazepines and other sedative drugs with opioids is frequent, despite the known risk of additive respiratory depression as described in the literature. Other patient risk factors such as medical condition, general health and consciousness should be considered in context with drugs used.

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Suicidal Career in Severe Depression among Long-Term Survivors: In a Followup after 37–53 Years Suicide Attempts Appeared to End Long before Depression

Depression Research and Treatment ◽

10.1155/2013/610245 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Lisa Crona ◽

Alexander Mossberg ◽

Louise Brådvik

Keyword(s):

Suicide Attempt ◽

Depressive Episode ◽

Medical Records ◽

Attempted Suicide ◽

Suicide Attempts ◽

Healing Process ◽

Severe Depression ◽

Long Term Survivors ◽

Course Of Depression

Objective. To describe the suicidal career in the long-term course of severe depression.Subjects and Method. Seventy-five former in-patients were interviewed by telephone about course of depression and suicide attempts 37–53 years after index admission. Medical records were read in many cases.Results. 29 subjects had attempted suicide, 13 repeated, 10 made severe, and 13 violent attempts. The risk of suicide attempt decreased by 10% for every decade spent depressed. Suicide attempts were made early in course of depression, and more time was spent depressed after suicide attempts than before.Conclusions. A healing process of the suicidal career, which may occur long before the end of the last depressive episode (sometimes decades), is proposed.

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