ABSTRACT
OBJECTIVE: Repetitive acute self-poisoning takes great part of all admissions at the Emergency Department including self-harm as one of the main reasons. The aim of this study is to analyze the characteristics of the patients treated for repetitive self-poisoning with suicidal intent (RSP-SI) in Vojvodina (Serbia), in order to propose preventative strategy and better management of the issue. PATIENTS AND METHODS: The retrospective study included data regarding patients treated for RSP-SI during a 5-year period in Vojvodina, Serbia. RESULTS: Repetitive self-poisoning was determined in 485 patients, of whom 35.05% reported suicidal intention. Mean number of RSP-SI per patient was 3.61±3.08. The mean period between two RSP-SI in group of females and males was 9.69±13.60 and 6.95±11.02 months, respectively. Almost two thirds (65.29%) of them were unemployed. Most of the patients had mental and behavioral disorders due to psychoactive substance use (ICD F10-19; 51.18%) and anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (ICD F40-48; 33.53%). The sole etiological agent was identified in 39.15% attempts. In 58.08% of the attempts more than one substance was detected (2.50±0.73 per attempt). The co-ingestion of alcohol and benzodiazepines was the most common combination (19.41%). Psychiatry intervention was needed in 70.31% of the patients. Five of all patients with RSP-SI (2.94%) committed suicide. CONCLUSIONS: The recognition and the treatment of mental disorders as well as the control of psychiatric medications prescribing could represent one of the most important preventive strategies for repetitive suicidal behavior.
Subject(s)
Psychotropic Drugs , Suicide, Attempted , Benzodiazepines , Female , Humans , Male , Retrospective Studies , Serbia/epidemiology , Suicide, Attempted/psychology , YugoslaviaABSTRACT
BACKGROUND: The optic nerve (ON), a major component of the visual system, is divided into four segments: the intrabulbar (IB), the intraorbital (IO), the intraca- nalicular (ICn) and the intracranial (ICr). The ICr ends with the two nerves partially decussating in the optic chiasm (OCh). The purpose of this study is to provide a detailed description of the dimensions of the OC (the diameter and the surface area of its foramina and the central segment, as well as the length of the OC and the thickness of its walls) as well as the ON (the length of the ON segments, the diameter of the ICn segment of the ON, the angle of decussation in the OCh, as well as the distance between the two ON at the cranial foramen of the OC). MATERIALS AND METHODS: The acquired data was then used to estimate the volu- me of the OC and the ICn segment of the ON. The morphometric research was performed on 25 cadavers (17 male and 8 female) and 30 skulls. RESULTS: The surface area of the central segment of the OC was significantly smaller than the cranial foramen (p = 0.02) and the orbital foramen (p = 0.009). The inferior wall of the OC was significantly shorter than the other OC walls (p < 0.0001). The IO segment of the ON was the longest, where the difference to the ICn and ICr was statistically significant (p < 0.0001). The surface area of the ON at the cranial foramen was significantly larger than the surface area at the central segment of the OC (p = 0.02) and orbital foramen (p < 0.0001). The difference between the surface areas of the ON at the orbital foramen and the central segment of the OC was also statistically significant (p = 0.01). The estimated volume of the OC was calculated to be 190.72 mm3, and the volume of the ICn segment of the ON was estimated to be 50.25 mm3. CONCLUSIONS: It is absolutely crucial to open the central segment of the OC when decompressing the ON, due to the narrowing of the OC in this segment.
ABSTRACT
The brachial plexus represents a field of many anatomical variations with impor- tant clinical implications, especially in the diagnosis and treatment of the thoracic outlet syndrome (TOS). The case described in this paper presented a novel bilateral variation in the relation of the upper trunk of the brachial plexus to the anterior scalene muscle. The ventral rami of the C5 and C6 spinal nerves perforated the anterior scalene muscle simultaneously through a common opening, and joined to form the upper trunk. Previous literature reports described variations of the brachial plexus and the scalene muscles, as well as the embryological basis for their presence. The case reported herein helps to improve the comprehension of the TOS, as well as the diagnostic and therapeutical approach to this syndrome.