Suicide attempts by adolescents assisted in an emergency department: a cross-sectional study

OBJECTIVES

to identify and characterize the care provided to adolescents admitted to an emergency department due to a suicide attempt.

METHODS

an observational, cross-sectional, descriptive study with a retrospective approach, carried out with medical records of adolescents aged 10 to 19 admitted for suicide attempts, between January 2015 and July 2020, in an emergency department. Data were subjected to descriptive and inferential analysis.

RESULTS

eighty-eight service occurrences were identified, mainly to females, exposed to multiple risk factors. Exogenous intoxication was the main method used, occurring at home and on weekdays. There were systemic repercussions, requiring multiple interventions and hospitalizations. Only 26% of cases were notified.

CONCLUSIONS

adolescents treated for suicide attempts were exposed to multiple risk factors, with intoxication as the main means used. There is concern about the underreporting of cases and the logic of clinical care and medicalization.

Effects of red clover on perimenopausal and postmenopausal women's blood lipid profile: A meta-analysis

The study aimed to perform a systematic review with meta-analysis of randomized controlled trials (RCTs) to access the effects of red clover isoflavones on the blood lipid profile of both perimenopausal and postmenopausal women. PubMed, Web of Science, Scopus, SciELO, and Cochrane Library were searched for the terms 'red clover', 'Trifolium pratense', and 'randomized controlled trial' during November 2017. Summary measures were reported as weighted mean differences (WMD) with 95% confidence interval (CI). Fixed or random effects models were used for meta-analyses, according to heterogeneity. Risk of bias was measured with the Cochrane tool. Twelve RCTs (totalizing 1284 perimenopausal and postmenopausal women receiving red clover isoflavones for 4 weeks-18 months) resulted in a significant decrease in total cholesterol (WMD = -12.34 mg/dl; 95% CI: -18.21, -6.48), low-density lipoprotein cholesterol (WMD = -10.61 mg/dl; 95% CI: -15.51, -5.72), and triglycerides (WMD = -10.18 mg/dl; 95% CI: -16.23, -4.13) together with a significant increase in high-density lipoprotein cholesterol (WMD = 1.60 mg/dl; 95% CI: 0.17, 3.03). In conclusion, the results demonstrate that the ingestion of red clover may have a beneficial effect on the lipid profile of perimenopausal and postmenopausal women.

Percepção dos profissionais da estratégia saúde da família sobre as necessidades de saúde da população

Objetivos: Identificar a percepção dos profissionais das equipes de saúde da família sobre as necessidades de saúde da população e analisar como essas necessidades são atendidas. Métodos: Pesquisa descritiva, qualitativa. Foram entrevistados 29 profissionais de saúde em 5 unidades de saúde da família, incluindo 6 profissionais de cada unidade, 1 de cada categoria profissional. A coleta de dados foi realizada por meio de entrevista oral e da aplicação de um formulário sociodemográfico. O conteúdo das entrevistas foi organizado em discursos do sujeito coletivo, e para a análise dos discursos foi utilizada a análise temática de conteúdo. Resultados: As necessidades de saúde percebidas refletiram aspectos das condições de vida, do acesso às tecnologias de saúde, da criação de vínculos e da construção da autonomia. Ações descritas pelos participantes, como trabalhos educativos em grupo, projetos, parcerias, trabalho em equipe multiprofissional para melhorar a saúde como um todo e iniciativas para aumentar o vínculo com a comunidade revelam uma apreensão mais abrangente das necessidades de saúde. No entanto, há dificuldade de interpretação da determinação social do processo saúde-doença por alguns profissionais entrevistados, que relataram ações centradas na doença e práticas educativas prescritivas como forma de atender às necessidades de saúde. Conclusão: A prática permeada pelo modelo assistencial curativo no qual prevalece o olhar para a dimensão biológica do processo saúde-doença precisa ser superada, o que implica, por parte das equipes, em esforço de tradução e atendimento às necessidades trazidas pela população, garantindo assim a integralidade da atenção.

Halting the fuse discharge propagation using optical fiber microwires

We report and analyze the halting of the fuse effect propagation in optical fiber microwires. The increase of the mode field diameter in the tapered region decreases the optical intensity resulting in the extinction of the fuse effect. This fiber element presents a low insertion loss and can be introduced in the optical network in order to protect the active equipment from the damage caused by the fuse effect.

[Hormonal dysfunction of nonpituitary lesions from midline and perisellar area]

OBJECTIVE

To analyse clinical and/or laboratorial preoperative hormonal dysfunction, of the nonpituitary intracranial lesions from midline and parasellar area.

METHOD

Forty-four patients were evaluated with nonpituitary intracranial lesions, who had images studies (computed tomography or magnetic resonance) and preoperative basal hormonal level; 16 had preoperative hypothalamus-hypophysial function tests (megatests). These patients were divided in two groups. Group I - 34 lesions from midline: 11 craniopharyngiomas, 8 meningiomas, 3 germinomas, 3 tumors of sphenoid sinus, 2 empty sella syndrome, 2 pylocitic astrocytomas, 1 giant aneurysm, 2 mucoceles, 1 III ventricle diverticulum and 1 Rathke's cleft cyst; Group II - 10 lesions from parasellar area: 9 meningiomas and 1 giant aneurysm.

RESULTS

In group I, 25/34 (73.5%) patients showed laboratorial hormonal deficit (14 without clinical manifestations) 18/34 (52.9%) hyperprolactinemia (5 with galactorreia) and 8 (53.3%) showed growth hormone deficiency in 15 megatests available in this group; 3 (8.8 %) patients presented central diabetes insipidus (CDI). In group II, 6/10 (60%) patients showed laboratorial hormonal deficit (5 without clinical manifestations), 1 (10%) hyperprolactinemia and 1 growth hormone deficiency (single megatest realized in this group); no patient had preoperative CID.

CONCLUSIONS

The presence of nonspecific or poorly valorized clinical manifestations, does not indicate absence of hormonal dysfunction; in this present serie, 19/38 (50%) patients with laboratorial abnormalities, didn't show clinical manifestations. Hormonal dysfunction is frequent in sellar and perisellar nonpituitary lesions, specially involving midline.

Reversal of severe SPECT asymmetry after venous extra-intracranial high flow bypass in a patient submitted to therapeutic internal carotid occlusion: case report

Therapeutic occlusion of the internal carotid artery is the main option for the treatment of the symptomatic intracavernous internal carotid artery aneurysms, but the issue of the best way of doing the balloon test occlusion (BTO) regarding prediction of future ischemic events remains debatable. Single photon emission computerized tomography (SPECT) has been offered as one of the best option of monitoring regional cerebral blood flow (rCBF) during the BTO, where severe asymmetry is predictive of delayed ischemia. We describe a case of important SPECT asymmetry during BTO clinically negative and its complete reversal with carotid occlusion after extra-intracranial bypass with high flow safenous vein bypass between the cervical carotid artery and the middle cerebral artery.