New study provides insights on increased risk of suicide in young patients

Source:https://www.elsevier.com/ Reviewed by James Ives, M.Psych. (Editor)Dec 17 2018Identifying patterns in medical encounters prior to self-directed violence events can help shape screening and prevention strategies, according to a new study in the American Journal of Preventive Medicine A new study published in the American Journal of Preventive Medicine provides detailed insights on the increased risk of self-directed violence that patients aged 15-29 years visiting the emergency department (ED) for medical complaints subsequently experience. This underscores the importance of EDs in suicide prevention. The broad number of physical health conditions associated with an increased risk of self-directed violence may serve to support expanded or broader screening among teens and young adults.Suicide is the second leading cause of death for youth, with mental disorders and substance abuse as the two leading risk factors. Approximately 40 percent of suicide decedents aged 16 and older visit EDs in the year prior to their deaths; 60 percent of them receive medical diagnoses other than mental health or substance abuse.”Young people presenting to the ED for certain medical conditions are at an increased risk of subsequent self-directed violence,” explained lead investigator Jing Wang, MD, MPH, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA, in the study’s findings. “An awareness of these medical encounters may help guide screening efforts for suicide prevention in clinical settings.”This study addresses important gaps in prior research by identifying the medical reasons triggering youth ED visits that are associated with higher risk of subsequent suicidal behavior. Using 2011-2013 data from six states (Florida, New York, Nebraska, Vermont, Iowa, and Massachusetts) from databases sponsored by the Agency for Healthcare Research and Quality, investigators followed more than two million teens and young adults (aged 15-29) who visited EDs for medical reasons during 2012-2013. Of that group, nearly 8,500 subsequently engaged in self-directed violence within six months of the initial visit; anyone who exhibited suicidal behavior in 2011 was excluded from the study.Related StoriesBridging the Gaps to Advance Research in the Cannabis IndustryAMSBIO offers new, best-in-class CAR-T cell range for research and immunotherapySchwann cells capable of generating protective myelin over nerves finds researchTeens and young adults who presented with diagnoses of epilepsy or seizures, or visited two or more times for various types of pain, syncope (fainting), or vomiting had a 3-9 fold increased risk of suicidal behavior in the following six months. Individuals who visited three or more times for dental complaints were also found to be more likely to engage in subsequent self-directed violence. ED visitors in the group who received diagnoses of minor infections served as a reference group.The findings also showed that half of the self-directed violence events occurred within 42 days of the initial ED visit. Identification of the heightened risk for suicide following visits for these medical conditions provides ED clinicians with a critical window of opportunity for detection, assessment, and intervention. The broad number of physical health conditions associated with an increased risk of subsequent suicidal behavior may help inform and support expanded screening and suicide prevention strategies in EDs.A limitation of the study is that about 70 percent of people who engage in self-directed violence do not seek medical assistance.​ read more

Duration of thrombectomies proves crucial in success of the procedure

first_img Source:http://www.musc.edu/ Reviewed by Kate Anderton, B.Sc. (Editor)Apr 15 2019The “Stroke Belt” refers to the swath of states in the Southeast where rates of stroke death are high, and according to the Department of Health and Environmental Control, South Carolina comes in at number six for the nation’s highest rates of stroke death.A stroke occurs when blood flow to a particular area of the brain is cut off, which could be due to a clot, a blood vessel leak or the bursting of a brain aneurysm. Without enough oxygen, the cells in that part of the brain begin to die and can leave behind motor and cognitive deficits.But while a stroke can be caused by vessel blockages or bleeding into the brain, the most common form is ischemic, meaning it is caused by a clot rather than a bleed, and is responsible for 87% of all strokes, according to the National Stroke Association.Timely removal of the blockage is vital when treating a stroke, and while the acceptable time to treatment has slowly lengthened with more effective thrombectomy techniques, physicians and surgeons must still act within 24 hours of the onset of stroke. Researchers at the Medical University of South Carolina (MUSC) report in a recent paper in the Journal of the American College of Cardiology that the current standard of care for stroke should also factor in procedure time when considering surgical intervention.”People will try once to remove the clot,” said Ali Alawieh, M.D, Ph.D., neurosurgery researcher at MUSC who worked on the study under the direction of MUSC’s Division of Neuroendovascular Surgery Director Alejandro Spiotta, M.D. “They’ll then try two, three and even four times or more hoping for a successful attempt. The idea of the paper is to quantify that, to look for a limit where you start doing more harm than good.”By studying the number of attempts and the amount of time spent performing procedures, this team of researchers concluded that the likelihood of completing an endovascular thrombectomy without significantly increasing the risk for the patient decreases dramatically after the first 30-60 minutes, depending on the technique used.Endovascular thrombectomies are performed using either stent retrievers or aspiration thrombectomy (ADAPT). By comparing both techniques, Alawieh and Spiotta found that the most important detail to consider was the time spent manipulating the vessel. Conducting the procedure with an SR means it takes the surgeon longer to get to the vessel than with ADAPT, but the factor that influences patient outcomes is the amount of time needed once the surgical team reaches the clot. Using SRs, the golden time for the procedure is at the hour mark, and using ADAPT, it is a half-hour.Related StoriesResearchers report how a popular antidepressant drug could rewire the brainSugary drinks linked to cancer finds studyNew protein target for deadly ovarian cancer”We had noticed this trend at MUSC, but we wanted to know if it extended nationally,” said Alawieh. “As it turns out, it does. After that 30- to 60-minute mark, depending on the procedure, surgeons should pause and reassess if the procedure is worth continuing.”Prior studies have shown that extending the duration of mechanical thrombectomies past 60 minutes, and more recently past 35 minutes, decreases the chance a patient will show few-to-no neurological disabilities after 90 days and increases the chance of a postprocedural hemorrhage. This study supports those findings at a multicenter national level and shows complication rates increase by the minute and were not dependent on the treatment center.Because they are in the Stroke Belt, physicians at MUSC perform some of the largest numbers of endovascular thrombectomies in the country, totaling over 200 procedures a year. Endovascular thrombectomy remains an important area of study with guidelines changing every year, and surgical teams at MUSC have already begun contributing to and incorporating the new guidelines into their surgeries.If a procedure is taking longer than the intended 30 to 60 minutes and a surgeon decides not to continue with the endovascular thrombectomy, the patient will be treated using medical intervention. While rates of positive outcomes are highest with successful surgical intervention, patients may still recover some of the deficits with medical management.This work involved a collaboration between MUSC and other centers across the country who are part of the Stroke Thrombectomy and Aneurysm Registry (STAR), a collaborative effort coordinated and initiated by MUSC to monitor outcomes in stroke patients nationally. To date, there are more than 12 centers across the U.S.”Stroke intervention procedures have improved dramatically in recent years, and they are so effective in helping patients, that it’s difficult for the physician to give up on a procedure when it’s not successful,” said Spiotta. “The major impact of this work is that it provides a potential stopping point for surgeons where the procedure can cause more harm than good.”last_img read more

San Francisco set to ban sales of ecigarettes

first_img This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente. Reviewed by Kate Anderton, B.Sc. (Editor)Jun 25 2019 San Francisco’s Board of Supervisors is slated to vote Tuesday to ban the sale and distribution of e-cigarettes in the city. The city is the corporate home of Juul Labs, the biggest producer of e-cigarettes in the country.The ordinances would make the sale of e-cigarettes illegal in brick-and-mortar stores and online when shipping to San Francisco addresses.San Francisco Mayor London Breed has 10 days to sign the legislation, which she has said she will do. The law will be enforced seven months from that date, in early 2020.San Francisco Supervisor Shamann Walton, who co-authored the legislation, sees it as part of a long-term battle against the effects of smoking.”We spent a few decades fighting big tobacco in the form of cigarettes,” Walton said. “Now we have to do it again in the form of e-cigarettes.”Under federal law, the minimum age to buy tobacco products is 18.  California and 15 other states, however, have raised that age to 21 or passed measures that will set it to 21 by 2021. Despite this, use of e-cigarettes, or vaping, has skyrocketed among teenagers nationally.Last year, 1 in 5 high school seniors reported vaping in the past month. That’s almost double the number from the year before. Even eighth graders are vaping in record numbers.These increases come after years of declines in teenagers smoking traditional cigarettes.Public health officials are concerned about the rising number of teenagers using e-cigarettes, as nicotine can harm a young person’s developing brain. The Centers for Disease Control and Prevention warns that young people who vape may be more likely to start smoking traditional cigarettes.Walton said he’s disgusted with the actions of Juul and similar companies, who he said are “putting profits before the health of young people, and people in general.”Despite the tobacco age limit, Walton noted that vaping devices are commonly confiscated from students in the city’s middle and high schools.The ordinance is accompanied by another that prevents the manufacture, distribution and sale of e-cigarettes on San Francisco property. The ordinance takes direct aim at Juul Labs, which leases space from the city on San Francisco’s Pier 70. The ordinance is not retroactive, so it would not remove Juul from the company’s current space, but it would prevent other e-cigarette makers from renting city property in the future. In a statement, Juul spokesman Ted Kwong wrote that, regardless, the company does not “manufacture, distribute or sell our product from this space.”Juul’s vaping device was introduced in 2015. It’s small, sleek and discreet, looking similar to a flash drive. The company now controls 70% of the vaping market.In a statement, Juul Labs said it shares the city’s goal of keeping e-cigarettes away from young people. The company said it has made it harder for underage buyers to purchase Juul off its website and has shut down Juul accounts on Facebook and Instagram.Related StoriesStudies show no evidence of fall in cigarette consumption due to WHO’s FCTCStudy finds increase in cigarette smoking among minority teens after college affirmative action bansCollege affirmative action bans may increase smoking rates among minority high school studentsBut, the company argues that “the prohibition of vapor products for all adults in San Francisco will not effectively address underage use and will leave cigarettes on shelves as the only choice for adult smokers, even though they kill 40,000 Californians every year.”Walton doesn’t buy that argument, however. He said that’s simply “trading one nicotine addiction for another.” What’s more, he’s concerned that for every adult that might benefit, dozens of young people could become addicted.San Francisco resident Jay Friedman said the complete e-cigarette ban goes too far. The software engineer smoked a pack of cigarettes a day for 20 years, and smoking e-cigarettes has reduced his regular cigarette habit to two to three a day. He said he feels better physically.Friedman supported a ban on flavored tobacco that city voters passed last year. “I feel like it was good to get rid of the fruit flavors for kids,” he said, “but this feels like maybe a step too far.”If e-cigarettes are banned, he said, he would try to quit nicotine altogether. But, “there would be a point in a moment of weakness where I’d just end up buying a pack of smokes again and then it’s just a slippery slope from there.”Small businesses in San Francisco are concerned the ban will hurt their bottom line.Miriam Zouzounis and her family own Ted’s Market, a convenience store near downtown San Francisco. She said e-cigarettes are an “anchor” product: They draw people into the store.”When people come and want to purchase something at the store and we don’t have that exact item that they want, they’re not going to buy the rest of the items that they might on that trip: a drink or a sandwich,” Zouzounis said.She said sales from e-cigarettes account for at least $200 to $300 a day in sales. As a board member of the Arab American Grocers Association, she said she believes laws like this mostly affect businesses owned by immigrants.Abbey Chaitin is a 15-year-old lifelong San Francisco resident. She isn’t drawn to using e-cigarettes, she said, because she has seen peers become addicted to them.”I’ll see them in class fidgeting,” Chaitin said. “They need it to focus, to function.”And Chaitin predicted that, regardless of a ban, young people will still get their hands on e-cigarettes: “People my age can find a way around that if they really need to,” she said.Meanwhile, Juul is collecting signatures for a November ballot initiative to override the ban.This story is part of a partnership that includes KQED, NPR and Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.last_img read more

Electronics giant Philips posts mixed results in Q3

first_img This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. Explore further Dutch electronics giant Philips, which is focusing its business on medical equipment and services, on Monday posted higher third quarter sales but profits dipped due to currency headwinds. Citation: Electronics giant Philips posts mixed results in Q3 (2018, October 22) retrieved 17 July 2019 from https://phys.org/news/2018-10-electronics-giant-philips-results-q3.html © 2018 AFP Electronics giant Philips posts 27% drop in Q1 profits Sales rose 4.0 percent to 4.3 billion euros ($4.9 billion) year-on-year and orders for the Amsterdam-based group’s medical diagnostic and treatment machines grew 11 percent.Net profit in the three months to September fell to 292 million euros from 423 million euros a year earlier.”While I am pleased with the continued strong 11 percent order intake growth in the quarter, operational improvements were partly offset by foreign exchange headwinds,” Philips chief executive Frans van Houten said.Philips chief financial officer Abhijit Bhattacharya told a teleconference Philips was particularly hit by falls in the Turkish lira and Argentine peso.Best known for the manufacture of light bulbs, electrical appliances and television sets, Philips has gradually pulled out of these activities in face of fierce competition from Asia.It focuses now more on high-end medical and health technology, such as computer tomography and molecular imaging, as well as household appliances.The group, which sold its first light bulb a few years after it was founded in 1891, moved to list its Philips Lighting division, now known as Signify, in mid-2016 which joined the Amsterdam stock exchange, the top-tier AEX, in March this year.Philips reiterated its objective of increasing sales by 4.0-6.0 percent in the 2017-2020 period.The group however said in view of growing tensions in international trade, it planned to promote local production further, for instance in China, to try to avoid the fallout from tit-for-tat trade wars between Beijing and Washington.”It’s good to know that Philips distributes production activities in a uniform way around the world, with about one-third in Europe, one-third in China and one-third in the US,” Philips spokesman Ben Zwirs told AFP.”This creates flexibility.”last_img read more

Air strikes Opposition supports Centres moves

first_imgUnion Home Minister Rajnath Singh, Congress leader Ghulam Nabi Azad and other leaders at an all-party meeting convened by External Affairs Minister Sushma Swarajin New Delhi on Tuesday   –  AP Published on SHARE SHARE EMAIL The Centre has told leaders of all parties that there is no military tension with Pakistan and what happened in Balakot, “80 miles beyond the Line of Control”, was not a military action, but an anti-terrorist attack. At a meeting of leaders of various political parties, the Union Ministers also confirmed that more than 300 terrorists were at the camp when the air strike took places. A source who attended the meeting, however, said the Centre has not confirmed the total number of terrorists killed but said no civilians or Pakistan Army personnel were killed in the strike.The meeting, convened by External Affairs Minister Sushma Swaraj, was attended by Home Minister Rajnath Singh, Finance Minister Arun Jaitley and Parliamentary Affairs Minister Narednra Singh Tomar and senior officials such as the secretaries of the Department of Defence, External Affairs and Home. No defence personnel were present in the meeting. In the event of a meeting of Pakistan’s nuclear command on Tuesday, the officials said there are efforts from the other side to escalate the matter but they will not be successful in doing so.‘Intelligence inputs’The Centre said it got intelligence input that more than 300 terrorists belonging to Jaish-e-Mohammed are camped in Balakot to plan another attack on the country and the defence forces thought it is best to attack, so that such plans are busted. The Centre also told them that the strike was successful.Later, talking to reporters, Opposition leader in Rajya Sabha Ghulam Nabi Azad said the strike was a clean operation. “We will support our security forces in their endeavour to finish terrorism entering into India from outside. The good part was that it was a very clean operation,” he said.In the meeting, the Centre, however, had to face tough questions. Based on Jammu and Kashmir Governor Satya Pal Malik’s statement that it was intelligence failure which led to the Pulwama attacks, the Opposition members asked why such a lapse occurred after Pathankot and the Urisurgical strike. The Opposition also reminded the Centre that Indian Air Force officers were present when the Centre briefed the Opposition about the Uri strikes, but they were not there for Monday’s official meeting. Finance Minister Jaitley told the meeting that IAF was not present as the details of the Balakot strike are a secret.On assault on KashmirisThere were also questions on the reported attacks against Kashmiri students across the country and move to do away with 35-A of the Constitution, which confers the power to the Jammu and Kashmir Assembly to define who are permanent residents and their rights. There were also questions that why the number of local youth who have joined terrorism from Kashmir increased in the last five years. A meeting of the Opposition parties will discuss the matter on Wednesday. Pakistan February 26, 2019 SHARE COMMENTS COMMENT defence terrorism (crime)last_img read more

Consolidation of core voters not Muslim vote to benefit Mahagathbandhan in western

first_imgSHARE SHARE EMAIL April 24, 2019 COMMENTS If the BJP’s sweep in 2014, in the three neighbouring constituencies of Moradabad, Sambhal and Rampur, where 48-52 per cent of the electorate is Muslim did not point to the phenomenon of fragmentation in the minority vote, the massive popular response to a young poet who debuted in the ongoing Lok Sabha elections on a Congress ticket from Moradabad confirms that the “Muslim vote monolith” is a bit of a myth.Imran Pratapgarhi, the Congress’ fresh-faced candidate from Moradabad, is a popular poet. An outsider to this massive constituency with about 19 lakh voters, Pratapgarhi’s campaign was mainly run by friends and a handful of idealists from Jawaharlal Nehru University (JNU), who believe in the triumph of the proletariat (working class) in the Hindi heartland.And yet, Pratapgarhi’s fresh appeal has convinced many people, especially in Moradabad town, that the youngster should get a chance. A conversation started on the need for young idealists in Parliament. The SP, which holds two of the five Assembly constituencies that constitute the Moradabad Lok Sabha seat, scurried around and unleashed all the local stalwarts to stop the “division of votes”.“Just because people come to hear a poet, it does not mean they would vote for him. This time, the Gathbandhan (an alliance of the SP, the BSP and the RLD) would sweep the seat,” said SP MLA from Moradabad(Rural) Haji Iqram Qureshi. Anxiety among supportersOthers supporting the alliance were anxious till the last minute. “Muslims are divided among caste lines and different choices. That is why the BJP won from here last time. What is different this time is that the Gathbandhan’s core voters — the Jatavs, the Yadavs and the Jats — will vote on one side and the SP can be somewhat certain of victory,” said Nadeem Khan, a handicraft exporter in Moradabad.In Rampur, with over 52 per cent Muslim voters, the BJP’s Nepal Singh trounced his nearest rival Naseer Ahmad Khan of the Samajwadi Party by 23,435 votes in 2014. This time, the BJP has fielded former MP and actor Jaya Prada from the constituency. She is confident of winning not just because a lot of people are upset with the SP strongman Azam Khan but because she believes that the Muslim vote “is not one block”. There were others who agreed with Jaya Prada but believed that the Gathbandhan arithmetic still tilted the scales in Azam Khan’s favour.“Azam Khan is a Pathan, who has managed to annoy the Turks. Their vote is about 1.5 lakh and they are not going to support him. Then there are the Shias, who traditionally support the Congress because it has always fielded members of the family of Nawab of Rampur who is a Shia. They may still vote for the Congress even though it has fielded a Khatri, former MLA Sanjay Kapoor. Still, just because Azam Khan is standing in elections and there is 52 per cent Muslim vote, you cannot say he would win. He is helped by the core vote of Mayawati, Mulayam Singh Yadav and Ajit Singh,” said Tamkeen Faiyyaz, a journalist in Rampur. Uttar Pradesh national electionscenter_img COMMENT Lok Sabha Published on SHARElast_img read more