ABSTRACT
INTRODUCTION: Different parameters of suicide attempts treated since the implementation of the Attention to Suicide Risk Program (ARSUIC) in 2012 at the Hospital Ramón y Cajal in Madrid Region are described in this paper. METHOD: The sample was composed of 107 patients and the information was collected through a questionnaire created ad hoc with the following variables: type of suicidal ideation; drug use immediately prior to the attempt; method (in case of drug overdosing: drug/s used); location; accessibility to rescue; planning; intentionality; criticism; and brakes. RESULTS: Descriptive statistics were obtained and a comparison by gender was made through the χ2 and contingency coefficients tests. The data from the retrospective longitudinal study showed that the most common profile was of patients with unstructured ideas of death and no previous drug use who took an unplanned drug overdose in the family home, with the intention of self-harm or avoidance of discomfort, especially with benzodiazepines. Patients tend to ask for help afterwards and criticise the attempt, but potential restraints are often not recorded in the clinical report. Regarding the dissimilarities based on gender, statistically significant differences were found in prior alcohol consumption, in favour of men and in the overdose method, specifically with benzodiazepines, in favour of women. CONCLUSIONS: Knowing the types of attempts at self-harm is essential for improving prevention, understanding and patient management.
Subject(s)
Drug Overdose , Hospitals, Public , Suicide, Attempted , Humans , Suicide, Attempted/statistics & numerical data , Male , Spain , Female , Adult , Retrospective Studies , Drug Overdose/epidemiology , Middle Aged , Young Adult , Longitudinal Studies , Surveys and Questionnaires , Sex Factors , Suicidal Ideation , Adolescent , AgedABSTRACT
OBJETIVO: realizar una revisión de la evidencia relacionada con la seguridad del gadolinio como medio de contraste utilizado en la resonancia magnética en los procedimientos de diagnóstico. MÉTODO: revisión narrativa en la que se realiza una búsqueda bibliográfica de la literatura, mediante protocolo estandarizado, en las bases de datos Medline, PubMed y Cochrane Lybrary. Se utilizaron las palabras clave 'seguridad', 'reacciones adversas' y 'gadolinio' y se emplearon los operadores boleanos OR y AND. Se seleccionaron estudios con fecha de enero de 2006 a febrero de 2014.Los criterios para la selección fueron revisiones sistemáticas, guías de práctica clínica, ensayos clínicos aleatorizados y estudios de pruebas diagnósticas, tanto en inglés como en castellano. RESULTADOS: se obtuvieron finalmente 11 artículos, tomados en cuenta por los siguientes criterios de inclusión: en estudios enseres humanos mayores de 18 años, revisiones sistemáticas y originales donde se estudiara la seguridad en la administración del contraste gadolinio en pruebas radiológicas. Se identificaron tres categorías de análisis, referidas a los cuidados enfermeros antes, durante y después de la administración del gadolinio. CONCLUSIONES: se concluyó que esta es una práctica segura sise conocen los riesgos potenciales de su utilización y se llevan a cabo los cuidados para prevenir su aparición y/o contrarrestar su efecto en caso de que ocurran, ya que la actuación adecuada por parte del profesional sanitario constituye una importante labor al depender de él que el proceso sea el correcto
OBJECTIVE: to conduct a review of evidence regarding the safety of gadolinium as a contrast agent used in magnetic resonance imaging for diagnostic procedures. METHOD: narrative review conducting a bibliographic search in literature, through standard protocol, in the Medline, PubMed and Cochrane Library databases. The key words 'safety', 'adverse reactions' and 'gadolinium' were used, as well as the bolean operators OR and AND. Studies were selected from January,2006 to February, 2014. Selection criteria were: systematic reviews, clinical practice guidelines, randomized clinical trials and diagnostic test studies, both in English and in Spanish. RESULTS: eleven articles were ultimately obtained, considered through the following inclusion criteria: studies on humans over18-years-old, systematic and original reviews studying safety in the administration of gadolinium contrast in radiologic tests. Three analysis categories were identified, regarding nursing care before, during and after the administration of gadolinium. CONCLUSIONS: the conclusion was that this is a safe practice if there is awareness of the potential risks of its use, and necessary care is taken in order to prevent these risks and/or counteract their effects in case they occur; an adequate action by the healthcare professional will represent an important activity, because the adequate process will depend on them
Subject(s)
Humans , Gadolinium , Nursing Care/methods , Contrast Media/analysis , Patient Safety , Evidence-Based Medicine , Gadolinium/adverse effectsABSTRACT
New neurons are generated in the adult hippocampus of many species including rodents, monkeys, and humans. Conditions associated with major depression, such as social stress, suppress hippocampal neurogenesis in rodents and primates. In contrast, all classes of antidepressants stimulate neuronal generation, and the behavioral effects of these medications are abolished when neurogenesis is blocked. These findings generated the hypothesis that induction of neurogenesis is a necessary component in the mechanism of action of antidepressant treatments. To date, the effects of antidepressants on newborn neurons have been reported only in rodents and tree shrews. This study examines whether neurogenesis is increased in nonhuman primates after antidepressant treatment. Adult monkeys received repeated electroconvulsive shock (ECS), which is the animal analog of electroconvulsive therapy (ECT), the most effective short-term antidepressant. Compared with control conditions, ECS robustly increased precursor cell proliferation in the subgranular zone (SGZ) of the dentate gyrus in the monkey hippocampus. A majority of these precursors differentiated into neurons or endothelial cells, while a few matured into glial cells. The ECS-mediated induction of cell proliferation and neurogenesis was accompanied by increased immunoreactivity for the neuroprotective gene product BCL2 (B cell chronic lymphocytic lymphoma 2) in the SGZ. The ECS interventions were not accompanied by increased hippocampal cell death or injury. This study demonstrates that ECS is capable of inducing neurogenesis in the nonhuman primate hippocampus and supports the possibility that antidepressant interventions produce similar alterations in the human brain.