Suicidality and its relationship with depression, alcohol disorders and childhood experiences of violence: results from the ESEMeD study.

BACKGROUND: Suicidality constitutes a major health concern in many countries. The aim of the present paper was to analyse 10 of its risk factors and their interdependence. METHODS: Data on suicidality, mental disorders and experience of childhood violence was collected from 8796 respondents in the European Study of the Epidemiology of Mental Disorders (ESEMeD). The CIDI was used to assess mental disorders. Individuals were randomly divided into two subgroups. In one, a Graphical Markov model to predict suicidality was constructed, in the second, predictors were cross-validated. RESULTS: Lifetime suicidality was predicted mainly by lifetime depression and early experiences of violence, with a pseudo R-square of 12.8%. In addition, alcohol disorders predicted suicidality, but played a minor role compared with the other risk factors in this sample. CONCLUSION: In addition to depression, early experience of violence constitutes an important risk factor of suicidality. LIMITATIONS: This is a cross-sectional and retrospective study assessing risk factors for suicidality, not for suicide itself.

Treatment of facial vascular lesions with intense pulsed light.

BACKGROUND: Various lasers, particularly the flashlamp-pulsed dye laser, have been proven to be effective in the treatment of facial vascular lesions. Nevertheless, the post-treatment side effects, such as pronounced purpura and changes in pigmentation, have been a matter of concern to patients. OBJECTIVE: To test the efficacy of an alternative treatment option that uses intense pulsed light to provide patients with a more tolerable post-treatment outcome. METHODS: A total of 200 patients were treated with an intense pulsed light source (PhotoDerm VL) using various treatment parameters. The patients were treated for facial veins (primarily telangiectasia), facial hemangiomas, rosacea and port wine stains. RESULTS: Of the 188 patients who returned for follow-up after 2 months, 174 achieved 75% to 100% clearance in one to four treatment sessions. The post-treatment side effects were minimal and well tolerated by the patients. There were no instances of scarring or other permanent side effects. CONCLUSION: The PhotoDerm VL provides a highly effective and safe alternative to the laser for treatment of facial vascular lesions. The device may achieve improved results for lesions that are resistant to laser therapy. The rate and degree of cosmetic side effects are considerably less than with laser treatment.

Vapor-permeable membrane therapy for ulcers of osteomyelitis.

Two patients with chronic ulcerations secondary to arterial insufficiency of the distal extremities were found to have concomitant osteomyelitis immediately beneath the ulcers. An adjunctive would care regimen is described in which local excision or debridement of the involved bone with subsequent systemic antibiotic therapy was the initial treatment. The resultant cutaneous defect was then covered with a vapor-permeable membrane and allowed to close by secondary intention. Rapid and complete healing occurred in both cases in spite of the compromised arterial supply to both areas. This technique is a useful adjunct to the treatment of ulcerations associated with chronic osteomyelitis.