Effects of media stories featuring coping with suicidal crises on psychiatric patients: Randomized controlled trial.

BACKGROUND: Accumulating evidence suggests beneficial effects of media stories featuring individuals mastering their suicidal crises, but effects have not been assessed for psychiatric patients. METHODS: We randomized n = 172 adult psychiatric patients (n = 172, 97.1% inpatients) to read an educative article featuring a person mastering a suicidal crisis (n = 92) or an unrelated article (n = 80) in a single-blind randomized controlled trial. Questionnaire data were collected before (T1) and after exposure (T2) as well as 1 week later (study end-point, T3). The primary outcome was suicidal ideation as assessed with the Reasons for Living Inventory; secondary outcomes were help-seeking intentions, mood, hopelessness, and stigmatization. Differences between patients with affective versus other diagnoses were explored based on interaction tests. RESULTS: We found that patients with affective disorders (n = 99) experienced a small-sized reduction of suicidal ideation at 1-week follow up (mean difference to control group [MD] at T3 = -0.17 [95% CI -0.33, -0.03], d = -0.15), whereas patients with nonaffective diagnoses (n = 73) experienced a small-sized increase (T2: MD = 0.24 [95% CI 0.06, 0.42], d = 0.19). Intervention group participants further experienced a nonsustained increase of help-seeking intentions (T2: MD = 0.53 [95% CI 0.11, 0.95], d = 0.19) and a nonsustained deterioration of mood (T2: MD = -0.14 [95% CI -0.27, -0.02], d = -0.17). CONCLUSIONS: This study suggests that patients with affective disorders appear to benefit from media materials featuring mastery of suicidal crises. More research is needed to better understand which patient groups are at possible risk of unintended effects.

Claudicacao do estomago apos vagotomia superseletiva seguida de antrectomia. / Stomach claudication post superselective vagotomy followed by antrectomy

O autor apresenta um caso de vagotomia superseletiva ou gastrica proximal, onde houve recidiva de ulcera. Apos fracasso medicamentoso, efetuou-se uma antrectomia.Apos tres meses a paciente apresentou-se com sintomas de claudicacao gastrica.Valoriza o exame gastroscopico que apresenta palidez da mucosa sem vasos, e a arteriografia seletiva associados a sintomatologia. Chama atencao para os raros casos de ma circulacao da pequena curvatura e a possivel claudicacao do estomago resultante neste tipo de cirurgia

Complicacoes pos-operatorias imediatas em gastrectomias parciais eletivas. / Immediate post-operative complication of elective partial gastrectomies

Os autores fazem uma analise das complicacoes pos-operatorias imediatas em gastrectomias parciais eletivas. A complicacao mais frequente e a infeccao respiratoria que e favorecida pelo fumo, sonda nasogastrica, anestesia endotraqueal, intervencao em abdome superior. A gastrectomia e uma cirurgia de grande porte e o paciente deve ser preparado para tal, principalmente em sua funcao respiratoria. A boa tecnica cirurgica contribui para diminuir o numero de complicacoes pos-operatorias