Frequency Of Attempts Research Articles

Past 12-month history of single and multiple suicide attempts among a national sample of school-going adolescents in Tonga.

Suicide attempt may be common among adolescents. Less is known about this in the Pacific Island country, Tonga. Therefore, this analysis estimated the frequency of suicide attempts as well as its associated factors among adolescents in Tonga. Cross-sectional data of 3333 adolescents (median age=14 years) that took part in the "2017 Tonga Global School-Based Student Health Survey (GSHS)" were analyzed. Almost one in seven students (16.5%) had attempted suicide in the past year (8.8% once and 7.7% more than once). Female sex, loneliness, having no close friends, often bullied, frequently in a physical fight, frequently truant from school, ever amphetamine use, and past-month tobacco use were associated with ≥2 suicide attempts. Multiple suicide attempts increased with an increase in psychosocial distress, health risk behaviors, and social-environmental factors. Almost one in seven students attempted suicide in the past year and several risk variables were found.

Tail Docking of Piglets 2: Effects of Meloxicam on the Stress Response to Tail Docking.

Simple SummaryPrevious research has shown that tail docking causes an acute stress response and tail docking using the cauterisation procedure may be less aversive than the clipper procedure. This experiment examined the efficacy of meloxicam in mitigating acute stress responses to tail docking. Cauterisation was less aversive than the clipper procedure based on the stress response after docking. Meloxicam mitigated the cortisol response at 30 min after tail docking with the clipper and the behavioural response in the first 60 min after tail docking with the clipper. The commercial viability and implementation of meloxicam requires consideration before it is recommended for use compared to cauterisation alone, as it requires additional handling of piglets and higher costs.This experiment assessed the efficacy of the cauterisation procedure with or without pain relief (injectable meloxicam) in mitigating the acute stress response to tail docking. Male piglets (n = 432) were allocated to the following treatments at 2-d post-farrowing: (1) no handling, (2) sham handling, (3) tail docked using clippers, (4) tail docked using a cauteriser, (5) meloxicam + clipper, and (6) meloxicam + cauteriser. Meloxicam treatments used Metacam® at 5 mg/mL injected i.m. 1 h prior to tail docking. Blood samples were collected at 15 and 30 min post-treatment and analysed for total plasma cortisol. Behaviours indicative of pain such as escape attempts, vocalisations and standing with head lowered were measured. The duration of vocalisations and frequency of escape attempts during treatment were greater in all tail docking treatments compared to the sham treatment. Piglets in the clipper treatment had higher (p < 0.05) cortisol concentrations at 30 min but not 15 min after treatment and stood for longer (p < 0.001) with head lowered in the first 60 min after treatment than those in the cauterisation treatment. Meloxicam reduced (p < 0.05) both the cortisol response at 30 min after tail docking with the clipper as well as the behavioural response in the first 60 min after tail docking with the clipper. In comparison to the sham treatment, cortisol concentrations at 15 min were higher in the two tail docking treatments whereas the tail docking treatments with meloxicam were similar to the sham handling treatment. In comparison to the sham handling treatment, cortisol concentrations at 30 min post-docking were higher (p < 0.05) only in the clipper treatment. While cauterisation appears to be less aversive than the clipper procedure, the administration of meloxicam did not mitigate the behavioural response during tail docking using either procedure, but reduced standing with head lowered in the first hour after docking for both methods. The commercial viability of administration of meloxicam requires consideration before it is recommended for use compared to cauterisation alone, as it requires additional handling of piglets and costs.

Increased frequency of intentional weight loss associated with reduced mortality: a prospective cohort analysis

BackgroundDue to the high prevalence of obesity and the difficulty in maintaining weight loss, repeated bouts of weight loss are a common occurrence. However, there are inconsistencies in epidemiological studies regarding repetitive weight fluctuations being associated with increased risk of mortality. Therefore, the purpose of this prospective cohort analysis was to determine the long-term association of the frequency of weight loss attempts on mortality.MethodsThis prospective cohort study used data collected from adult AARP members living in 6 states (California, Florida, Louisiana, New Jersey, North Carolina, or Pennsylvania) or 2 metropolitan areas (Atlanta, Georgia, or Detroit, Michigan) and participating in the National Institutes of Health–AARP Diet and Health Study between 2004 and 2006. Self-reported data were analyzed for 161,738 middle-aged adults. During an average 7 years of follow-up, 21,194 deaths were recorded. Hazard ratios of all-cause, cardiovascular, and cancer mortality were estimated adjusting for demographic, lifestyle, and behavioral risk factors.ResultsIncreased frequency of weight loss attempts of at least five pounds was associated with lower mortality (ptrend < 0.010). Multivariate hazard ratios (95% confidence intervals) for all-cause death among individuals who successfully attempted weight loss compared with those who did not make any attempts were 0.94 (0.90–0.98) for 1–2 attempts, 0.96 (0.91–1.01) for 3–4 attempts, 0.91 (0.85–0.96) for 5–6 attempts, 0.91 (0.85–0.98) for 7–8 attempts, 0.87 (0.80–0.95) for 9–10 attempts, and 0.88 (0.82–0.94) for 11+ attempts. Similar results were noted for men and women, participants with healthy weight and overweight/obesity, and even among those who gained weight over time. Protective associations were also observed for deaths due to cardiovascular disease and cancer.ConclusionsIncreased frequency of intentionally losing at least five pounds in mid-life was associated with a lower risk of future death. Repeated attempts with moderate amounts of weight loss may provide benefit in terms of longevity.Trial registration numberClinicalTrials.gov number, NCT00340015

The Vacuum-Assisted Closure Device Increases Value in the Treatment of Gustilo Grade IIIb Open Tibia Fractures in Children.

BackgroundWound management associated with Gustilo grade IIIb open tibia fractures in children often requires muscle flaps, skin grafts, and amputations. The purpose of this study is to report the outcomes and complications of vacuum-assisted closure (VAC) treatment, as well as discuss its role in optimizing value when treating these injuries.MethodsA retrospective review of medical records and imaging studies was performed from 2008-2015. Six pediatric patients with Gustilo grade IIIb fractures managed with the VAC were identified. The time to treatment, frequency of VAC changes, VAC size, and closure attempts, including muscle flaps and skin grafts, were documented. Fracture fixation methods, the incidence of delayed union or nonunion, as well as the occurrence of deep tissue infection and compartment syndrome were detailed.ResultsFive patients were male and one was female with an average age of 12 years (range 8-15 years). All patients sustained a Gustilo IIIb open tibia fracture and were treated with irrigation, debridement, intravenous (IV) antibiotics, fixation, and a VAC as a wound care adjunct. Three patients required both a muscle flap and a skin graft. One patient required a skin graft. There was one case of deep tissue infection. Three patients were treated successfully with the VAC alone and did not require any flap procedures.ConclusionsWound care for Gustilo grade IIIb open tibia fractures in children traditionally involved potentially painful twice-daily dressing changes with solutions such as dilute bleach or iodine. The implementation of VAC markedly reduced the frequency of dressing changes every three days. In the current study, the open wound gradually closed with only a VAC in 50% of Gustilo grade IIIb open pediatric tibia fractures. In summary, the VAC is an adjunct that increases value in the care of pediatric patients with Gustilo grade IIIb open tibia fractures (Value = Outcomes/Cost).Level of evidenceTherapeutic level IV

The effects of patient personality traits and family cohesion on the treatment delay for patients with first-episode schizophrenia spectrum disorder.

The duration of untreated psychosis (DUP) is an important prognostic indicator of schizophrenia. We explored the effects of patient personality and family relationships on delayed schizophrenia treatment. We prospectively included data from 169 patients diagnosed with first-episode schizophrenia. Personality traits were investigated using the Big Five Inventory (BFI-10) and family relationship was assessed employing the Family Adaptability and Cohesion Evaluation Scale-III (FACES-III). We explored patient clinical characteristics using the Positive and Negative Syndrome Scale (PANSS) and the Social and Occupational Functioning Scale (SOFAS). The DUP was defined as the time between the first appearance of psychotic symptoms and commencement of adequate antipsychotic treatment. Subjects were divided into two groups by the 3-month median DUP cutoff. The average and median DUPs were 12 and 3months, respectively. A longer DUP was associated with older age, a higher PANSS score, and a lower SOFAS score. The frequency of suicide attempts tended to be higher in the delayed treatment group (P=.055). The delayed treatment group scored significantly higher in conscientiousness factor of the BFI-10 and scored significantly lower family cohesion and adaptability factors of the FACES-III. Logistic regression showed that a longer DUP was significantly associated with higher-level conscientiousness on the BFI-10 and poorer family cohesion on the FACES-III. Treatment delay was associated with reduced family cohesion and higher patient conscientiousness, suggesting that the family plays a crucial role in terms of patient access to mental health services when early psychotic symptoms appear.

Ghost fishing impacts on hydrocorals and associated reef fish assemblages

Ghost fishing is a threat to many marine environments, as lost or discarded fishing gear (e.g., fishing lines, nets) continues to fish by entangling, damaging or killing various organisms. Among the benthic organisms that live on tropical reefs, the group probably most affected, due to their shape, are the branching corals. These corals provide refuge, foraging and breeding sites, especially for fishes and therefore impacts on coral structure could compromise the ecology of associated species. We tested if fishing lines entangled on the branching coral Millepora alcicornis would result in an increase in colony mortality, decrease in abundance and richness of fishes and changes in the behavior of associated reef fish. In the field, we estimated the volume of M. alcicornis colonies and its mortality percentages, and videos were recorded to evaluate abundance and richness of fish assemblages and fish behavior. Our results showed that coral mortality increased with increasing amounts of entangled fishing lines. Fish assemblages were similar in M. alcicornis colonies with or without entangled fishing lines. Nevertheless, we observed a significant decrease in the frequency of feeding attempts in two herbivore fish species (Acanthurus bahianus and Ophioblennius trinitatis) that play an important role in coral-reef dynamics, controlling algae abundances. Therefore, ghost fishing has negative impacts on shallow reef ecosystems, directly affecting branching corals and important coral-fish interactions. Management of tropical shallow reef environments should consider regulation and monitoring of coastal fisheries to ensure reef integrity.

Suicide Attempts Among a Cohort of Transgender and Gender Diverse People

Transgender and gender diverse people often face discrimination and may experience disproportionate emotional distress that leads to suicide attempts. Therefore, it is essential to estimate the frequency and potential determinants of suicide attempts among transgender and gender diverse individuals. Longitudinal data on 6,327 transgender and gender diverse individuals enrolled in 3 integrated healthcare systems were analyzed to assess suicide attempt rates. Incidence was compared between transmasculine and transfeminine people by age and race/ethnicity and according to mental health status at baseline. Cox proportional hazards models examined rates and predictors of suicide attempts during follow-up. Data were collected in 2016, and analyses were conducted in 2019. During follow-up, 4.8% of transmasculine and 3.0% of transfeminine patients had at least 1 suicide attempt. Suicide attempt rates were more than 7 times higher among patients aged <18 years than among those aged >45 years, more than 3 times higher among patients with previous history of suicide ideation or suicide attempts than among those with no such history, and 2-5 times higher among those with 1-2 mental health diagnoses and more than 2 mental health diagnoses at baseline than among those with none. Among transgender and gender diverse individuals, younger people, people with previous suicidal ideation or attempts, and people with multiple mental health diagnoses are at a higher risk for suicide attempts. Future research should examine the impact of gender-affirming healthcare use on the risk of suicide attempts and identify targets for suicide prevention interventions among transgender and gender diverse people in clinical settings.

Mental health in a sample of transgender people

Transgender population is at a higher risk of suffering mental health problems than cisgender population (people whose sex and gender identity are in agreement) and other sexual minorities (gays, lesbians, and bisexuals), partly due to the greater stress that they suffer or for being victims of sexual prejudice. To describe positive and negative mental health indicators in a sample of transgender people living in Chile. An intentional sample of 377 transgender individuals older than 18 years, living in the country's northern, center and southern zones were studied. Sociodemographic and well-being features, negative emotional symptoms, suicidal behavior, and substance consumption were assessed. A precarious mental health was confirmed among participants. A high frequency of depression, ideation and suicide attempts, and high levels of depression, anxiety, and stress symptoms were identified. Also, a high frequency of substance abuse was found. These mental health indicators varied according to the sex assigned at birth and gender self-identification. Transgender people experience precariousness and vulnerability in their mental health.

Frequency of suicide attempts and attitudes toward suicidal behaviour among doctors and nurses in Lagos, Nigeria.

BackgroundCompetence and attitudes toward suicidal behaviour affect practice. These attitudes may influence the consideration of suicide during personal crisis among doctors and nurses.AimThe attitudes of doctors and nurses towards suicidal behaviour was assessed using the Attitudes Toward Suicide Scale (ATTS), which was validated in another study by the authors, evaluated for the possible factors affecting this relationship and estimated the frequency of suicide attempts among doctors and nurses.SettingLagos State University Teaching Hospital Lagos, Nigeria.MethodsThe cross-sectional survey about attitudes toward suicide was done among 226 doctors and nurses working at a tertiary institute hospital in Lagos, Nigeria, using the ATTS. Sociodemographic profile and self-rated competence, commitment, empathy and irritation toward suicide were obtained. Stratified random sampling was used, data were analysed using Statistical Package for Sociological Sciences. Data was summarised, reliability of the ATTS was assured and variables compared by t-test and ANOVA. Independent predictors were identified via multiple regression (p ≤ 0.05).ResultsFrequency of suicide attempts of 7.50% was found among respondents with a mean age of 35.84 ± 6.76 years. Attitudes toward suicidal behaviour were slightly positive (77.92 ± 9.90) and the independent predictors of less positive attitudes were nursing profession (β = 0.025, p < 0.001) and high self-rated irritation toward suicide (β = 0.18, p < 0.01).ConclusionThe frequency of suicide attempts is higher among doctors and nurses when compared to the general population. Doctors and nurses reported slightly positive attitudes toward suicidal behaviour with significant differences in the type of profession and levels of self-rated irritation toward suicide.

Suicide ideation and suicide attempts of undergraduate students in South Korea: Based on the interpersonal psychological theory of suicide

This study attempted to explain suicide ideation and suicide attempts among undergraduate students in South Korea based on the Interpersonal Psychological Theory of Suicide. Data were collected through an online questionnaire survey of 402 university students (178 men, 224 women, average age 21.19 years old [SD = 2.06]) in South Korea. As a result of a hierarchical multiple regression analysis, while adjusting sex, socioeconomic level, and depression, thwarted belongingness and perceived burdensomeness significantly explained the suicide ideation. However, the effect of the interaction of thwarted belongingness and perceived burdensomeness on suicide ideation was not significant. Suicide ideation and acquired capability for suicide significantly predicted the frequency of suicide attempts, and the interaction between suicide ideation and acquired capability for suicide had a significant effect on suicide attempt frequency. These findings suggest that the feeling of being worthless to society and burdensome to others is a major risk factor affecting the suicide rates of undergraduate students in South Korea. It also suggests that in order to assess suicide risk and to prevent and intervene in suicide, the acquired capability for suicide, which is the ability to commit lethal suicide, along with suicide ideation should be considered.

The relationship between negative school gossip and suicide intention in Chinese junior high school students: The mediating effect of academic burnout and gender difference

Previous studies have shown that negative school gossip are associated with suicide intention, but the psychological mechanism of the relationship is still unclear. We tested the relationship among negative school gossip, academic burnout and suicide intent in junior high school students. A sample of 1811 junior high school students (mean age = 13.22 ± 0.97 years) were enrolled in our survey. The adaption of Negative workplace gossip scale, School burnout inventory, and items of suicidal ideation and frequency of suicide attempts were used to test negative school gossip, academic burnout, and suicide intention. Results showed that negative school gossip positively correlated with suicide intention, and it increased participants’ suicide intention via increasing academic burnout. The results of this study suggest that academic burnout played a partial mediating role between negative school gossip and suicide intention in Chinese junior high school students, and the relationship between academic burnout and adolescents' suicide intention was moderated by gender. The present study revealed the harm of negative school gossip to the development of adolescents and provided empirical supports for the prevention and intervention of adolescent suicide. The limitations and implications were discussed.

A clinical study of suicide in patients admitted in psychiatry unit in Assiut University

BackgroundThis study was performed for clinical study of suicide including risk factors in psychiatric patients admitted in psychiatric unit of Assiut University Hospital (AUH).ResultsWe found that frequency of suicidal attempts is more in MDD (major depressive disorder), bipolar disorders followed by schizophrenia. And frequency of suicidal attempts in patients with multiple previous attempts before this one was higher in patients with mood disorders (53.8%) than psychotic and substance-induced disorders (32.3%, 13.8% respectively), with statistically significant difference in patients with MDD as well as there was significant treatment outcome on suicidal behavior.ConclusionThe frequency of suicidal attempts is more in MDD (major depressive disorder), bipolar disorders followed by schizophrenia. There was significant severity of suicidal behavior in patients with psychotic disorders in comparison to patients with substance-induced disorder or mood disorders.

Feasibility of Nasogastric Tube Insertion in Conscious Patients: Conventional Method vs. SORT Method.

BackgroundNasogastric tube (NGT) insertion is one of the most common procedures in the Emergency Department (EDs).ObjectivesThis study aimed to evaluate the ease of NGT installation using the conventional method and the SORT method.MethodsWe conducted a randomized clinical trial in a university hospital on 200 patients who required NGT insertion during Mar-Sep, 2019. The patients were randomly divided into two groups of 100 patients each, receiving the SORT and conventional methods. Finally, the feasibility of NGT insertion was examined in the two groups using the frequency of NGT insertion attempts, pain during insertion (based on the VAS score of 1 - 10), patient satisfaction with the procedure (rating of 1 - 10), and incidence of complications.ResultsThere was no significant difference between the two groups in terms of age, body mass index, sex, and history of NGT use. However, the mean patient satisfaction score was higher (P < 0.05), whereas the mean pain score was lower (P < 0.05) in the group receiving the conventional method compared to the other group. Moreover, there was no statistically significant difference in complications (P > 0.05).ConclusionsThe study showed that using the conventional method in comparison with the SORT method was significantly better for NGT insertion in conscious patients in terms of patient satisfaction and pain relief. Therefore, it is recommended not to use the SORT method in conscious patients.

Сравнительная оценка диагностических подходов при искусственных гнойно-воспалительных заболеваниях мягких тканей

This article discusses the effectiveness of the application of confrontational and non-confrontational approaches in determining the presence of artificial pyoinflammatory diseases of the soft tissues (APIDST) in 302 young patients. It was revealed that the use of a confrontational approach as compared to a non-confrontational approach in determining the presence of APIDST allowed a statistically significant (p&lt;0,05) reduction in the frequency of attempts to prolong hospitalization from 45,6 % to 17,6 %, and a tendency to misconduct from 43,3 % to 24,4 % and reduce the frequency of repeated hospitalizations with this pathology from 7,6 % to 2,3 %. At the same time, the frequency of recognition of self-mutilation in confrontational and non-confrontational approaches was practically the same and corresponded to 76,3 % and 70,2 % (p&gt;0,05). Moreover, a average length of hospitalization of patients with confrontational and non-confrontational approaches also did not differ, amounting to 38,4±7,2 and 39,1±8,4 days, respectively.

Suicidality in Childhood and Adolescence.

The suicide of minors in Germany is rare in absolute numbers: there were only 212 suicides among persons aged 10 to 20 in Germany in 2017. Nonetheless, in school surveys, 36.4-39.4% of those surveyed reported suicidal ideation, and 6.5-9% reported suicide attempts. Suicide among children and adolescents is thus a clinically and societally relevant problem. This review is based on pertinent articles retrieved by a selective literature search in the PubMed and PsycInfo databases (April 2019) employing the search terms "suicidality," "suicidal*," and "suicide," and on further information from several textbooks (1991-2017). In children and adolescents with a mental illness, the risk of suicide is higher by a factor of 3 to 12. Mobbing experiences increase the suicide risk as well (odds ratio [OR] = 2.21, p <0.05). Non-suicidal self-injurious behavior (NSSB) is also a risk factor for both suicidal ideation (OR = 2.95) and suicide attempts (hazard ratio [HR] = 2.00). Intoxication with medications is the most common method of attempted suicide (67.7%). Most suicides are preceded by early warning signs. Psychiatric hospitalization is indicated for children and adolescents who are in acute danger of doing harm to themselves. Specific types of treatment, family-centered methods in particular, have been found to lessen the frequency of suicidal ideation and suicide attempts. The administration of antidepressant drugs to children and adolescents is controversial, as there is evidence of increased suicidality (but not mortality) for single medications. Antidepressant drugs should not, however, be withheld for this reason, if indicated. The prerequisite in all cases is close observation. To prevent suicide and improve outcomes, risk factors for suicide must be considered, and the indications for primary and secondary preventive and therapeutic measures must be established. Online therapeutic modalities may become more widely used in the near future, particularly among young patients, who are well versed in the use of the Internet.

Editors' note: Risk factors for suicidality in Huntington disease: An analysis of the 2CARE clinical trial

In “Risk factors for suicidality in Huntington disease: An analysis of the 2CARE clinical trial,” McGarry et al. reviewed 5 years of data on 609 patients with early Huntington disease included in a randomized clinical trial of coenzyme Q10 and found that time to suicidal ideation or attempt was related to depression, anxiety, bipolar disorder, antidepressant/anxiolytic use, and previous suicide attempt. Rato and Ferreira question the interpretation and use of the findings by McGarry et al. noting that (1) unstable psychiatric illness was an exclusion criterion for the trial, (2) the frequency of suicide attempts was only 3.4% in the study cohort, and (3) the predictors identified are relevant to the population at large, not just patients with Huntington disease or those enrolled in a trial. McGarry agrees that there are limitations to their findings but notes that it is important to know that standard risks for suicidality persist among patients with Huntington disease. Both McGarry et al. and Rato and Ferreira feel that further research into suicidality and risk mitigation in patients with Huntington disease and patients enrolled in clinical trials is warranted. In “Risk factors for suicidality in Huntington disease: An analysis of the 2CARE clinical trial,” McGarry et al. reviewed 5 years of data on 609 patients with early Huntington disease included in a randomized clinical trial of coenzyme Q10 and found that time to suicidal ideation or attempt was related to depression, anxiety, bipolar disorder, antidepressant/anxiolytic use, and previous suicide attempt. Rato and Ferreira question the interpretation and use of the findings by McGarry et al. noting that (1) unstable psychiatric illness was an exclusion criterion for the trial, (2) the frequency of suicide attempts was only 3.4% in the study cohort, and (3) the predictors identified are relevant to the population at large, not just patients with Huntington disease or those enrolled in a trial. McGarry agrees that there are limitations to their findings but notes that it is important to know that standard risks for suicidality persist among patients with Huntington disease. Both McGarry et al. and Rato and Ferreira feel that further research into suicidality and risk mitigation in patients with Huntington disease and patients enrolled in clinical trials is warranted.

Suicide Screening in Sturge-Weber Syndrome: An Important Issue in Need of Further Study

BackgroundSturge-Weber syndrome is a neurocutaneous disorder associated with epilepsy, glaucoma, cognitive impairments, and a port-wine birthmark. Although individuals with Sturge-Weber syndrome are vulnerable to known risk factors for suicide, including chronic illness and physical differences (port-wine birthmark), frequency of suicidal ideation and attempts, and the clinical factors associated with suicide risk, in patients with Sturge-Weber syndrome is unknown. MethodsAs a part of routine hospital practice, all outpatients aged eight years and older underwent suicide risk screening during nursing triage using a standardized suicide screening tool. Suicide risk screening results, demographic variables, and medical history (as available) for patients with Sturge-Weber syndrome (N = 34; median age = 15.5; range = 8 to 47 years, 44% male) and other neurological conditions seen at the same institution (N = 369; median age = 14; range = 8 to 78 years, 66% male) were used for retrospective within- and between-group analysis. ResultsIn the combined sample of Sturge-Weber syndrome and neurologically involved patients, a positive suicide risk screen was related to Sturge-Weber syndrome diagnosis (P = 0.043); analysis by sex showed increased risk of Sturge-Weber syndrome diagnosis in males (P = 0.008), but not in females. Within the Sturge-Weber syndrome group, use of a selective serotonin reuptake inhibitor (P = 0.019) was related to a positive risk screen. ConclusionPeople with Sturge-Weber syndrome may be at greater risk of suicidal thoughts or behaviors than those with other neurological conditions. Further study of suicide risk in patients with Sturge-Weber syndrome is needed.

Effect of Transcutaneous Electrical Nerve Stimulation on the Pain Intensity During Insertion of Needle in Patients Undergoing Spinal Anesthesia: A Randomized Controlled Study

Background and objectivesNeedle insertion pain during spinal anesthesia is an unpleasant experience for patients. This study aimed to investigate the effects of Transcutaneous Electrical Nerve Stimulation (TENS) on the pain intensity during the insertion of spinal needles in patients undergoing spinal anesthesia. Materials and methodsIn a double-blind clinical trial, 60 candidates for elective Trans Ureteral Lithotripsy surgery under spinal anesthesia were randomly divided into intervention and control groups. The electrodes of the TENS device were placed in the space between L3-L4 and L5-S1 vertebrae. The intensity of pain during insertion of the spinal needle by Visual Analog Scale and the frequency of attempts were recorded. ResultsThe mean age of the study samples was 34.26 ± 5.07 and 32.8 ± 5.28 in the control and intervention group, respectively. The pain intensity during insertion of spinal needles was less significant in the intervention group compared to the control group (p = 0.001). The number of attempts to insert the spinal needle between the two groups was not statistically significant (p = 0.51). The duration of spinal anesthesia implementation procedure by physician in the intervention group was significantly shorter than that of the control group (p = 0.001). ConclusionThe use of TENS effectively reduced the pain of spinal needle insertion. Considering these beneficial effects, it is suggested that this procedure be used to relive pain in patients with spinal anesthesia.

Association between objectively measured sleep duration, adiposity and weight loss history

An association between sleep and obesity has been suggested in several studies, but many previous studies relied on self-reported sleep and on BMI as the only adiposity measure. Moreover, a relationship between weight loss history and attained sleep duration has not been thoroughly explored. The study comprised of 1202 participants of the European NoHoW trial who had achieved a weight loss of ≥5% and had a BMI of ≥25 kg/m2 prior to losing weight. Information was available on objectively measured sleep duration (collected during 14 days), adiposity measures, weight loss history and covariates. Regression models were conducted with sleep duration as the explanatory variable and BMI, fat mass index (FMI), fat-free mass index (FFMI) and waist-hip ratio (WHR) as response variables. Analyses were conducted with 12-month weight loss, frequency of prior weight loss attempts or average duration of weight maintenance after prior weight loss attempts as predictors of measured sleep duration. After adjusting for physical activity, perceived stress, smoking, alcohol consumption, education, sex and age, sleep duration was associated to BMI (P < 0.001), with the highest BMI observed in the group of participants sleeping <6 h a day [34.0 kg/m2 (95% CI: 31.8-36.1)]. Less difference in BMI was detected between the remaining groups, with the lowest BMI observed among participants sleeping 8-<9 h a day [29.4 kg/m2 (95% CI: 28.8-29.9)]. Similar results were found for FMI (P = 0.008) and FFMI (P < 0.001). We found no association between sleep duration and WHR. Likewise, we found no associations between weight loss history and attained sleep duration. In an overweight population who had achieved a clinically significant weight loss, short sleep duration was associated with higher BMI, with similar associations for fat and lean mass. We found no evidence of association between weight loss history and attained sleep duration.

Evaluation of Poisoning Cases Admitted to the Emergency Service of a District State Hospital

Introduction: Poisoning is the emergence of unwanted signs and symptoms in an organism after exposure to potentially harmful chemical, physical, or organic materials. We performed this study to evaluate the cases admitted to the emergency service due to poisoning. Materials and Methods: This descriptive study included 167 poisoning cases who were admitted to Bigadic State Hospital Emergency Service. We retrospectively assessed the patients by using forms of poisoning after obtaining the necessary permits. Results: The gender of 56.3% of the cases were female. Besides, 53.5% of the patients admitted within a day during the study period were women. The poisoning incident was for suicidal purposes in 17.4% of patients. However, %80.8 of poisoning cases were accidental. Conclusion: As a result, our study is remarkable for demonstrating poisoning events to be seen as more frequent and to have a critical place, especially in forensic cases in our region. The higher frequency of suicide attempts by self-poisoning among young women was striking. We, moreover, determined accidental poisoning cases to be more prevalent in childhood.