Predicting frequency of suicide attempts of adolescent outpatients at Weskoppies Hospital using clinical and demographic characteristics

The prevention of suicide, particularly adolescent suicide, remains one of the biggest challenges in psychiatry. OBJECTIVES: To ascertain: (i) clinical and demographic characteristics; and (ii) possible associations between these characteristics and suicide attempt frequency in a selected patient group at Weskoppies Hospital over 4 months. METHODS: Fifty adolescent outpatients aged between 13 and 17 years with a history of one or more suicide attempts were interviewed to obtain demographic and clinical features. Chi-square and Fisher's exact tests assessed associations between these features and suicide attempt frequency. RESULTS: Of the subjects, 79% were aged between 15 and 17 years; they were predominantly female (62%) and Caucasian (83%). Mainstream and special education schools were equally represented. Three-quarters had reached grades 8 - 10, and 14% lived with both biological parents, 33% in places of safety and 37% with one divorced parent. The minority of caregivers had a history of alcohol abuse and other substance use. Twenty-nine per cent of the subjects had attempted suicide on more than 10 occasions and 23% had made a single attempt. The most common methods were wounding (74%), tablet overdose (34%) and hanging (20%). Psychiatric diagnoses included major depressive disorder (64%), bipolar disorder (38%), alcohol abuse (18%) and other substance abuse (24%). Familial features included depression, substance abuse, antisocial behaviour and suicide. Familial suicidal behaviour included suicide attempts by parents (85%), siblings (36%), aunts and uncles (31%) and cousins (44%). Physical and sexual abuse was reported in 52% of families. CONCLUSION: Many findings and profiles of other studies were confirmed and point to school and home environments, family psychopathology and psychiatric diagnoses as factors associated with adolescent suicide attempts. Associations between the frequency of suicide attempts and the demographic and clinical characteristics were statistically inconclusive.http://www.sajp.org.za/index.php/saj

The influence of DNA repair on neurological degeneration, cachexia, skin cancer and internal neoplasms: autopsy report of four xeroderma pigmentosum patients (XP-A, XP-C and XP-D)

BACKGROUND: To investigate the association of DNA nucleotide excision repair (NER) defects with neurological degeneration, cachexia and cancer, we performed autopsies on 4 adult xeroderma pigmentosum (XP) patients with different clinical features and defects in NER complementation groups XP-A, XP-C or XP-D. RESULTS: The XP-A (XP12BE) and XP-D (XP18BE) patients exhibited progressive neurological deterioration with sensorineural hearing loss. The clinical spectrum encompassed severe cachexia in the XP-A (XP12BE) patient, numerous skin cancers in the XP-A and two XP-C (XP24BE and XP1BE) patients and only few skin cancers in the XP-D patient. Two XP-C patients developed internal neoplasms including glioblastoma in XP24BE and uterine adenocarcinoma in XP1BE. At autopsy, the brains of the 44 yr XP-A and the 45 yr XP-D patients were profoundly atrophic and characterized microscopically by diffuse neuronal loss, myelin pallor and gliosis. Unlike the XP-A patient, the XP-D patient had a thickened calvarium, and the brain showed vacuolization of the neuropil in the cerebrum, cerebellum and brainstem, and patchy Purkinje cell loss. Axonal neuropathy and chronic denervation atrophy of the skeletal muscles were observed in the XP-A patient, but not in the XP-D patient. CONCLUSIONS: These clinical manifestations and autopsy findings indicate advanced involvement of the central and peripheral nervous system. Despite similar defects in DNA repair, different clinicopathological phenotypes are seen in the four cases, and therefore distinct patterns of neurodegeneration characterize XP-D, XP-A and XP-C patients

Changes in the CFC inventories and formation rates of upper Labrador Sea Water, 1997-2001

Chlorofluorocarbon (component CFC-11) and hydrographic data from 1997, 1999, and 2001 are presented to track the large-scale spreading of the Upper Labrador Sea Water (ULSW) in the subpolar gyre of the North Atlantic Ocean. ULSW is CFC rich and comparatively low in salinity. It is located on top of the denser “classical” Labrador Sea Water (LSW), defined in the density range σΘ = 27.68–27.74 kg m−3. It follows spreading pathways similar to LSW and has entered the eastern North Atlantic. Despite data gaps, the CFC-11 inventories of ULSW in the subpolar North Atlantic (40°–65°N) could be estimated within 11%. The inventory increased from 6.0 ± 0.6 million moles in 1997 to 8.1 ± 0.6 million moles in 1999 and to 9.5 ± 0.6 million moles in 2001. CFC-11 inventory estimates were used to determine ULSW formation rates for different periods. For 1970–97, the mean formation rate resulted in 3.2–3.3 Sv (Sv ≡ 106 m3 s−1). To obtain this estimate, 5.0 million moles of CFC-11 located in 1997 in the ULSW in the subtropical/tropical Atlantic were added to the inventory of the subpolar North Atlantic. An estimate of the mean combined ULSW/LSW formation rate for the same period gave 7.6–8.9 Sv. For the years 1998–99, the ULSW formation rate solely based on the subpolar North Atlantic CFC-11 inventories yielded 6.9–9.2 Sv. At this time, the lack of classical LSW formation was almost compensated for by the strongly pronounced ULSW formation. Indications are presented that the convection area needed in 1998–99 to form this amount of ULSW exceeded the available area in the Labrador Sea. The Irminger Sea might be considered as an additional region favoring ULSW formation. In 2000–01, ULSW formation weakened to 3.3–4.7 Sv. Time series of layer thickness based on historical data indicate that there exists considerable variability of ULSW and classical LSW formation on decadal scales

Becoming Gentlemen: Women\u27s Experiences at One Ivy League Law School

In this Article we describe preliminary research by and about women law students at the University of Pennsylvania Law School—a typical, if elite, law school stratified deeply along gender lines. Our database draws from students enrolled at the Law School between 1987 and 1992, and includes academic performance data from 981 students, self-reported survey data from 366 students, written narratives from 104 students, and group-level interview data of approximately eighty female and male students.\u27 From these data we conclude that the law school experience of women in the aggregate differs markedly from that of their male peers

International collaborative study to assess cardiovascular risk and evaluate long-term health in cats with preclinical hypertrophic cardiomyopathy and apparently healthy cats:The REVEAL Study

Background: Hypertrophic cardiomyopathy is the most prevalent heart disorder in cats and principal cause of cardiovascular morbidity and mortality. Yet, the impact of preclinical disease is unresolved. Hypothesis/Objectives: Observational study to characterize cardiovascular morbidity and survival in cats with preclinical nonobstructive (HCM) and obstructive (HOCM) hypertrophic cardiomyopathy and in apparently healthy cats (AH). Animals: One thousand seven hundred and thirty client-owned cats (430 preclinical HCM; 578 preclinical HOCM; 722 AH). Methods: Retrospective multicenter, longitudinal, cohort study. Cats from 21 countries were followed through medical record review and owner or referring veterinarian interviews. Data were analyzed to compare long-term outcomes, incidence, and risk for congestive heart failure (CHF), arterial thromboembolism (ATE), and cardiovascular death. Results: During the study period, CHF, ATE, or both occurred in 30.5% and cardiovascular death in 27.9% of 1008 HCM/HOCM cats. Risk assessed at 1, 5, and 10 years after study entry was 7.0%/3.5%, 19.9%/9.7%, and 23.9%/11.3% for CHF/ATE, and 6.7%, 22.8%, and 28.3% for cardiovascular death, respectively. There were no statistically significant differences between HOCM compared with HCM for cardiovascular morbidity or mortality, time from diagnosis to development of morbidity, or cardiovascular survival. Cats that developed cardiovascular morbidity had short survival (mean \ub1 standard deviation, 1.3 \ub1 1.7 years). Overall, prolonged longevity was recorded in a minority of preclinical HCM/HOCM cats with 10% reaching 9-15 years. Conclusions and Clinical Importance: Preclinical HCM/HOCM is a global health problem of cats that carries substantial risk for CHF, ATE, and cardiovascular death. This finding underscores the need to identify therapies and monitoring strategies that decrease morbidity and mortality

Time to Osteoporosis and Major Fracture in Older Men

For older men who undergo bone mineral density (BMD) testing, the optimal osteoporosis screening schedule is unknown. Time-to-disease estimates are necessary to inform screening intervals

Time to Osteoporosis and Major Fracture in Older Men

For older men who undergo bone mineral density (BMD) testing, the optimal osteoporosis screening schedule is unknown. Time-to-disease estimates are necessary to inform screening intervals

Predicting Phenotype and Emerging Strains among Chlamydia trachomatis Infections

Single nucleotide polymorphisms can be used for epidemiologic and evolutionary studies worldwide

Comparative Effectiveness of Oxaliplatin vs Non–Oxaliplatin-containing Adjuvant Chemotherapy for Stage III Colon Cancer

The addition of oxaliplatin to adjuvant 5-fluorouracil (5-FU) improves survival of patients with stage III colon cancer in randomized clinical trials (RCTs). However, RCT participants are younger, healthier, and less racially diverse than the general cancer population. Thus, the benefit of oxaliplatin outside RCTs is uncertain