RESUMO
OBJECTIVE: To assess the scope of diagnostic screening for suicide prevention in general hospital patients. METHODS: Retrospective medical record review of general hospital patients who committed suicide and matched-control subjects who did not commit suicide shortly after being discharged from the hospital. RESULTS: The suicide rate was 32 per 100 000 patient-years. Eight (73%) of 11 patients who committed suicide were diagnosed with depression, substance use disorder, or both at their last hospital admission compared with 11 (33%) of the controls (P<.05). Only 1 of 44 patients (both cases and controls) was referred for psychiatric consultation. CONCLUSIONS: The suicide rate in general hospital patients was almost 3-fold higher than in the general population. Depression and/or substance use disorders were risk factors for suicide. Screening for those disorders may be beneficial for suicide prevention in the general hospital population, but will likely benefit more patients who will not commit suicide.
Assuntos
Transtorno Depressivo/diagnóstico , Hospitais Gerais , Hospitais Universitários , Programas de Rastreamento/métodos , Programas de Rastreamento/normas , Alta do Paciente/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Prevenção do Suicídio , Suicídio/estatística & dados numéricos , Adulto , Idoso , Alabama/epidemiologia , Transtorno Depressivo/complicações , Transtorno Depressivo/tratamento farmacológico , Diagnóstico Duplo (Psiquiatria) , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/complicaçõesRESUMO
The effect of vitamin E (D-alpha-tocopherol acetate) on glycosylated hemoglobin levels was investigated in streptozotocin-diabetic rats. The animals were divided into four groups: (a) Group 1: control group, (b) Group 2: diabetic group, (c) Group 3: diabetic group treated with low-dose vitamin E and (d) Group 4: diabetic group treated with high-dose vitamin E. Starting 24 hr after streptozotocin injections (60 mg/kg), Groups 3 and 4 received intraperitoneal injections of vitamin E on days 1, 4, 7, 11, 14, 18 and 21 at doses of 500 mg/kg and 1,000 mg/kg respectively. Vitamin E treatment did not prevent weight loss or improve glycemic control in diabetic animals but significantly suppressed the increase in glycosylated hemoglobin in Group 4 (7.7 +/- 0.6 mumols fructose/g hemoglobin versus 5.5 +/- 0.2 mumols fructose/g hemoglobin in Group 2 and Group 4 respectively). These levels were still significantly higher than the levels in healthy control group animals (2.6 +/- 0.1 mumols fructose/g hemoglobin). Further studies on the suppressive effect of vitamin E are warranted.