[The profile of the autolytic critical patient compared to proper suicider]. / Profilul pacientului critic autolitic in comparatie cu al suicidarului vero.

UNLABELLED: Out of all the patients with nonlethal self-injuries, only a low percentage inflict on themselves lesions that are severe enough to endanger their lives. The purpose of the paper is to analyze whether this smaller category of patients comes close to the profile of the genuine suicide or it remains within the pattern of the patients with non-lethal self-injurious behaviour. MATERIAL AND METHOD: Between January 1, 2005 and December 31, 2006, 656 patients with non-lethal autolytic acts came to the Emergency Hospital (UPU). Only 39 (5.94%) of them had lesions that were so severe as to require their hospitalization in the reanimation unit. During the same period of time, 188 suicial attempts were recorded in Iasi County. The parameters studied were: sex, age, living background and the autolytic method used, since these were the only data to be wholly collected from all the subjects. The information was introduced in the SPSS 8.0 software for Windows. RESULTS: The proportion women: men was higher in the case of sucide attempts (58.8% vs. 38.4%) in comparison to proper suicides (52.7% vs. 46.8%). The division according to age groups shows an almost Gaussian distribution of the suicides, with a peak at the 45-54 years old group whereas, in the case of suicidal attempts, there is a more uniform representation with a peak at the 25-34 years old group. As far as the background and living conditions are concerned, the suicides came mainly from the rural areas in comparison to the others belonging to the urban areas, and, in the case of the methods employed, the former preferred physical methods (87%), while the latter appealed mostly to intoxications (92.3%). CONCLUSIONS: The profile of critical patients hospitalized in the reanimation unit from autolytic lesions partially coincides with that of the subjects who committed suicide. There are similarities concerning their sex or age distribution. There is also a congruence between our data and the specialized literature regarding their distribution according to living areas, but not betweent:he two lots under study. There are major differences in the methods used by the subjects of the two groups we studied.

[Bleeding control in stab wounds to the great vessels at the neck base]. / Controlul hemoragiei în leziunile vaselor mari de la baza gâtului produse prin arme albe.

Stab wounds of the neck are a great challenge for every surgeon. Approximately 25% of penetrating neck injuries results in a vascular lesion. Wounds being situated below the cricoid cartilage are associated with the great mortality and morbidity, having a global mortality between 12-20%. 2/3 of the vascular wounds at this level have a tragic end. We are going to present 3 cases of cervical stab wounds in zone 1 of the neck, with vascular lesions, in which we succeeded to control the hemorrhages throw a midline sternotomy combined with different extensions. After this small experience we think that in patients with wounds situated in zone 1 of the neck, who reach the hospital hemodynamically unstable or with active bleeding, urgent midline sternotomy combined with cervicotomy, or section of the clavicle, is the best way to control the hemorrhages. Using blunt digital dissection we can avoid unpleasant situations that can appear using instrumental dissection into the mediastinal hematoma.