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1.
Int J Legal Med ; 134(6): 2167-2176, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32719959

ABSTRACT

The aim of the present study was a refined analysis of neuroinflammation including TMEM119 as a useful microglia-specific marker in forensic assessments of traumatic causes of death, e.g., traumatic brain injury (TBI). Human brain tissue samples were obtained from autopsies and divided into cases with lethal TBI (n = 25) and subdivided into three groups according to their trauma survival time and compared with an age-, gender-, and postmortem interval-matched cohort of sudden cardiovascular fatalities as controls (n = 23). Brain tissue samples next to cortex contusions and surrounding white matter as well as samples of the ipsilateral uninjured brain stem and cerebellum were collected and stained immunohistochemically with antibodies against TMEM119, CD206, and CCR2. We could document the highest number of TMEM119-positive cells in acute TBI death with highly significant differences to the control numbers. CCR2-positive monocytes showed a significantly higher cell count in the cortex samples of TBI cases than in the controls with an increasing number of immunopositive cells over time. The number of CD206-positive M2 microglial cells increased survival time-dependent. After 3 days of survival, the cell number increased significantly in all four regions investigated compared with controls. In sum, we validate a specific and robustly expressed as well as fast reacting microglia marker, TMEM119, which distinguishes microglia from resident and infiltrating macrophages and thus offers a great potential for the estimation of the minimum survival time after TBI.


Subject(s)
Brain Injuries, Traumatic/pathology , Membrane Glycoproteins , Membrane Proteins , Microglia/metabolism , Receptors, CCR2 , Receptors, Immunologic , Adolescent , Adult , Aged , Aged, 80 and over , Autopsy , Biomarkers , Cerebellum/cytology , Child , Child, Preschool , Female , Forensic Pathology , Humans , Immunohistochemistry , Male , Middle Aged , Pons/cytology , White Matter/cytology , Young Adult
2.
Int Rev Psychiatry ; 31(1): 60-74, 2019 02.
Article in English | MEDLINE | ID: mdl-31041871

ABSTRACT

As a result of scientific publications indicating that the last two decades have seen an increase in the number of suicides in the US Armed Forces, the topic of suicide in the military of other countries, such as Germany, has also received a lot of attention in media and science alike. Risk factors for suicidal behaviour and suicide were identified in several research projects in the US, Canada, the UK, and Germany. Until now, German suicide research among military service personnel has mainly focused on epidemiological aspects of suicides and suicidality, individual risk factors, sub-groups at risk for suicide, suicides and deployment abroad, and associations of suicide and suicide attempts with acute mental disorders. The key findings are summarized in this review article. Efforts should be made to develop and evaluate risk group-focused and occupation-focused prevention and intervention programs. Future multinational studies should address potential differences between risk groups for fatal and non-fatal suicidal behaviour.


Subject(s)
Military Personnel/statistics & numerical data , Suicide Prevention , Germany/epidemiology , Humans , Risk Factors , Suicide, Attempted/statistics & numerical data
3.
Suicide Life Threat Behav ; 49(5): 1497-1509, 2019 10.
Article in English | MEDLINE | ID: mdl-30556592

ABSTRACT

BACKGROUND: The last 10 years have seen an increase in the number of suicides in the US Armed Forces. Accordingly, the topic of suicides in the German military has received a lot of attention in media and science alike. METHODS: This study retrospectively examined all suicides (N = 107) committed by active, nonretired German military personnel from 2010 to the end of 2014, analyzing archived medical records. In a second step, these data were compared to a representative German Armed Forces survey conducted in 2012 (N = 1,549). RESULTS: The following risk groups for suicide were identified: male (OR = 9.6), single (OR = 7.8), aged over 45 years (OR = 4.0), short period of service (<2 years; OR = 2.7), and low level of education (OR = 2.2). Surprisingly, military personnel with little experience in deployments abroad (<2 missions) showed double the risk (OR = 2.0) compared to those who had been deployed more than once. DISCUSSION: Multiple robustness checks show that being single, aged over 45 years, and having obtained a low level of education exhibit the most robust effects on suicide risk. CONCLUSION: Efforts should be made to develop and evaluate risk group-focused prevention programs. We conclude, that further studies should be initiated to show differences of risk groups between lethal and nonlethal suicidal behavior.


Subject(s)
Military Personnel , Suicide Prevention , Suicide , Adult , Educational Status , Female , Germany/epidemiology , Humans , Male , Middle Aged , Military Personnel/psychology , Military Personnel/statistics & numerical data , Registries/statistics & numerical data , Retrospective Studies , Risk Factors , Single Person/psychology , Single Person/statistics & numerical data , Suicide/statistics & numerical data , Surveys and Questionnaires/statistics & numerical data , Time Factors
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