Análisis de los aspectos epidemiológicos de las tentativas de suicidio en un área sanitaria desde la perspectiva de un servicio de urgencias / Epidemiology of suicide attempts in a public health care area: the perspective of an emergency medical service

Objetivos: Determinar la tasa de tentativas de suicidio del Área Sanitaria do Salnés atendidas en su servicio de urgencias de referencia y analizar diferentes variables epidemiológicas Método: Estudio retrospectivo en el que se registraron todas las tentativas de suicidio durante un periodo de 5 años atendidas en urgencias, de las cuales se recogió el día y la horade la atención en urgencias, así como la edad, el sexo, los antecedentes de la patología psiquiátrica, el alcoholismo, la toxicomanía y los intentos de suicidio previos en el paciente. Resultados: Se registraron 285 tentativas de suicidio (tasa de 76,1 por 100.000 habitantes y año): la edad media fue de 35 ± 15 años y el 58,9% eran mujeres. Se detectaron antecedentes psiquiátricos en el 74,4% de los pacientes, y el 46,7% tenía antecedentes de intento de suicidio, y estos antecedentes se concentraban más en las edades medias de la vida (18-65 años). Las mujeres fueron más proclives a realizar tentativas y, entre los hombres que lo intentaron, el antecedente de politoxicomanía y alcoholismo estuvo más presente que en las mujeres. Se detectó una menor probabilidad de intento de suicidio en el mes de febrero y los miércoles. Conclusiones: Los servicios de urgencias permiten calcular las tasas de tentativas de suicidio de su área de referencia y establecer las características fundamentales de dichas tentativas (AU)

Objectives: To determine the rate of attempted suicide in the health care area of Salnés, Spain, attended by the assigned emergency medical service (EMS) provider and to analyze epidemiologic variables. Methods: Retrospective study of all suicide attempts attended by the EMS over a 5-year period. Data analyzed were day and time emergency care was given, age of the patient, sex, history of psychiatric disease, alcoholism, drug abuse, and history of attempted suicide. Results: A total of 285 attempts were on record (annual incidence, 76.1/100 000 population). The mean (SD) age was 35 (15)years and 58.9% were women. A history of psychiatric disease was present in 74.4% of the patients, and 46.7% had attempted suicide before. This history was more common in patients in the age range of 18-65 years. Women attempted suicide more often than men. A history of multiple drug abuse and alcoholism was more common in the men who attempted suicide than in the women. Fewer attempts occurred in February and on Wednesdays (AU)

Reduction of rat brain levels of the endogenous dopaminergic proneurotoxins 1,2,3,4-tetrahydroisoquinoline and 1,2,3,4-tetrahydro-beta-carboline by cigarette smoke.

1,2,3,4-Tetrahydroisoquinoline (TIQ) and 1,2,3,4-tetrahydro-beta-carboline (THbetaC) are two endogenous or exogenous dopaminergic proneurotoxicants supposedly involved in the etiology of Parkinson's disease. We investigated whether the chronic administration of a twice daily dose of a cigarette smoke solution might modify the endogenous concentrations of TIQ and THbetaC in rat brain. Using gas chromatography/mass spectrometry (GC-MS) we found a significant reduction in the brain levels of both proneurotoxins after 30 days of treatment. The reduction in the brain levels of both compounds was more significant using Burley rather than Bright tobacco. These results suggest that cigarette smoke may prevent the accumulation of these proneurotoxins in the brain, which corroborate the involvement of the reaction between both TIQ and THbetaC with some components of tobacco smoke as a neuroprotective mechanism for Parkinson's disease.

In vitro inhibition of catalase activity by cigarette smoke: relevance for oxidative stress.

The in vitro effects of cigarette smoke on catalase activity were investigated in biological preparations from rat liver and brain using a polarographic method. In both cases cigarette smoke solutions showed a potent ability to inhibit catalase activity with a slight time dependency. The reversibility of their inhibitory activity was demonstrated by in vitro dialysis tests. The catalase inhibitory compound(s) are formed in the smoking process, are not extracted with organic solvents and appear to have a relatively low molecular weight. We also examined the effects obtained by using two different commercial blends of tobacco, achieving a major inhibition with Burley tobacco in comparison to Bright tobacco. These data suggest that the cytotoxic and mutagenic effects of cigarette smoke may be mediated by its additional capacity to enhance the generation of free radicals by inhibiting catalase activity, thus contributing to cell damage particularly during oxidative stress.

Studies on the interaction between 1,2,3,4-tetrahydro-beta-carboline and cigarette smoke: a potential mechanism of neuroprotection for Parkinson's disease.

1,2,3,4-Tetrahydro-beta-carboline (TH beta C) is an endogenous or environmental neurotoxic factor putatively involved in the development of Parkinson's disease (PD). As part of our efforts to characterize the mechanism of the reported protection of smoking against PD, we have examined the interaction between TH beta C and cigarette smoke. We found that TH beta C reacts in vitro and under physiological conditions with some components of cigarette smoke to form N2-(cyanomethyl)-TH beta C (CM-TH beta C), N2-(gamma-cyanoethyl)-TH beta C (CE-TH beta C), N2-(1'-cyanopropyl)-TH beta C (CP-TH beta C), N2-(1'-cyanobutyl)-TH beta C (CB-TH beta C) and N2-formyl-TH beta C (F-TH beta C). Significant differences in the recovery of some of these TH beta C-derivatives were obtained for Burley and Bright tobacco. Several of the reported compounds showed reversible and competitive MAO-A inhibitory properties. The detection of some of these compounds in rat brain after chronic administration of TH beta C and a solution of cigarette smoke proved that the reported interactions also occur in vivo. These results are discussed as a potential mechanism of neuroprotection in the development of PD.

Inhibition of brain monoamine oxidase by adducts of 1,2,3,4-tetrahydroisoquinoline with components of cigarette smoke.

A series of adducts of 1,2,3,4-tetrahydroisoquinoline (TIQ) and some components of tobacco smoke were investigated for their ability to inhibit rat brain monoamine oxidase. 1-Cyano-TIQ (1CTIQ), N-(1'-cyanoethyl)-TIQ (CETIQ), N-(1'-cyanopropyl)-TIQ (CPTIQ), and N-(1'-cyanobutyl)-TIQ (CBTIQ) were found to act as competitive inhibitors for both MAO-A and MAO-B. Ki values ranged from 16.4 to 37.6 microM. N-(Cyanomethyl)-TIQ (CMTIQ) was not found to be an inhibitor (Ki > 100 microM). These findings may help to explain the in vivo inhibitory effects of tobacco smoke on MAO activity and the suggested protective effect of tobacco smoking against Parkinson's disease. They also appear to reinforce the usefulness of reversible MAO inhibitors in smoking cessation and abstinence. However, different results must be expected between Burley and Bright tobacco.

Interaction of 1,2,3,4-tetrahydroisoquinoline with some components of cigarette smoke: potential implications for Parkinson's Disease.

Tetrahydroisoquinoline (TIQ), a presumed proneutrotoxin linked with Parkinson's disease (PD), was found to interact with some components of cigarette smoke to give N-(cyanomethyl)-TIQ (CMTIQ), N-(1'-cyanoethyl)-TIQ (CETIQ), N-(1'-cyanopropyl)-TIQ (CPTIQ), N-(1'-cyanobutyl)-TIQ (CBTIQ), and 1-cyano-TIQ (1CTIQ). The in vitro formation of these compounds under physiological conditions occurs rapidly and with a high yield. Significant differences in the recovery of the different compounds were obtained when the data obtained from Burley tobacco were compared to those obtained from Bright tobacco. Following chronic administration of TIQ and a solution of cigarette smoke to rats, the presence of some of these compounds was also detected in the brain.