Risk factors associated with suicide attempt as predictors of suicide, Colombia, 2016-2017.

BACKGROUND: Suicidal behaviour is the cause of half of all violent deaths. It is considered to be a public health problem with one million victims a year. Suicide attempt is the most important risk factor. In Colombia, in 2017 the suicide attempt rate was 51.8/100,000 inhabitants, and the fatality rate reached 10.0/100,000. The objective is to identify suicide attempt factors associated with death and determine survival after the attempt for 2 years. MATERIAL AND METHODS: Retrospective cohort study and survival analysis. A total of 42,594 records of the suicide attempt surveillance system databases and 325 records of death by suicide in 2016 and 2017 were analysed. The risk factors were examined and a χ2-test and multivariate analysis and logistic regression were performed. Cumulative survival probability was calculated using the Kaplan-Meier method. A Cox regression model was applied to determine the proportional relationship of the suicide attempt variables that are related to suicide. RESULTS: Men die by suicide 4.5 times more often than women. One in four suicide victims had made at least one prior suicide attempt. The attempt factors related with death by suicide were: male gender (HR = 2.99; 95% CI, 2.27-3.92), adulthood (over 29 years, HR = 2.38; 95% CI, 1.90-2.99), living in a rural area (HR = 2.56; 95% CI, 2.04-3.20), chronic disease history (HR = 2.43; 95% CI, 1.66-3.57) and depression disorder (HR = 1.94; 95% CI, 1.55-2.41). Some 50% of suicide deaths occur up to 560 days after the suicide attempt. CONCLUSIONS: The risk of suicide is highest in male patients, with a history of depression, chronic illness and exposure to heavy workloads.

Factores De Riesgo Relacionados Con Intento de Suicidio Como Predictores De suicidio, Colombia 2016-2017✩

Introducción: La conducta suicida es la causa de la mitad de las muertes violentas. Se considera un problema de salud pública con un millón de víctimas al año. El intento de suicidio es el factor de riesgo más importante. En Colombia, en 2017 la tasa de intento de suicidio fue de 51,8/100.000 hab. y la letalidad alcanzó 10,0/100.000. El objetivo es identificar factores del intento suicida asociados con la muerte y determinar la supervivencia después del intento durante 2 años. Material y métodos: Estudio de cohorte retrospectiva y análisis de supervivencia. Se cruzaron 42.594 registros del sistema de vigilancia de intento de suicidio con 325 muertes por suicidio del registro único de defunciones de 2016 y 2017. Se examinaron factores de riesgo, y se realizó la prueba de la x2, análisis multivariado y regresión logística. Se calculó la probabilidad de supervivencia acumulada con el método de Kaplan-Meier. Se aplicó un modelo de regresión de Cox para determinar la relación proporcional de las variables del intento suicida que se relacionan con suicidio. Resultados: Por cada muerte de mujer por suicidio, mueren 4,5 varones por esta causa; 1 de cada 4 personas fallecidas reportó al menos un intento previo. Los factores del intento relacionados con la muerte por suicidio fueron: ser varón (HR = 2,99; IC95%, 2,27-3,92), la edad adulta (> 29 años, HR = 2,38; IC95%, 1,90-2,99), vivir en área rural (HR = 2,56; IC95%, 2,04-3,20) y padecer enfermedad crónica (HR = 2,43; IC95%, 1,66-3,57) o trastorno depresivo (HR = 1,94; IC95%, 1,55-2,41). El 50% de las muertes por suicidio ocurren hasta en los 560 días posteriores al intento. Conclusiones: Se evidencia mayor riesgo de suicidio en pacientes varones, con historia de expresión, antecedentes de enfermedades crónicas y exposición a carga laboral.

Background: Suicidal behaviour is the cause of half of all violent deaths. It is considered to be a public health problem with one million victims a year. Suicide attempt is the most important risk factor. In Colombia, in 2017 the suicide attempt rate was 51.8/100,000 inhabitants, and he fatality rate reached 10.0/100,000. The objective is to identify suicide attempt factors associated with death and determine survival after the attempt for 2 years. Material and methods: Retrospective cohort study and survival analysis. A total of 42,594 records of the suicide attempt surveillance system databases and 325 records of death by suicide in 2016 and 2017 were analysed. The risk factors were examined and a X2-test and multivariate analysis and logistic regression were performed. Cumulative survival probability was calculated using the Kaplan-Meier method. A Cox regression model was applied to determine the proportional relationship of the suicide attempt variables that are related to suicide. Results: Men die by suicide 4.5 times more often than women. One in four suicide victims had made at least one prior suicide attempt. The attempt factors related with death by suicide were: male gender (HR = 2.99; 95% CI, 2.27-3.92), adulthood (over 29 years, HR = 2.38; 95% CI, 1.90-2.99), living in a rural area (HR = 2.56; 95% CI, 2.04-3.20), chronic disease history (HR = 2.43; 95% CI, 1.66-3.57) and depression disorder (HR = 1.94; 95% CI, 1.55-2.41). Some 50% of suicide deaths occur up to 560 days after the suicide attempt. Conclusions: The risk of suicide is highest in male patients, with a history of depression, chronic illness and exposure to heavy workloads.

Evaluating accurate and efficient sampling strategies designed to measure social behavior and brush use in drylot housed cattle.

Efficient sampling strategies expedite behavioral data collection. While multiple studies have evaluated sampling strategies for core behaviors in cattle, few have focused on social interactions. To identify sampling strategies that accurately captured cattle social behaviors and brush use feedlot steers (n = 3 pens; 9 steers/pen) were observed from 8:00 to 17:00. Average bout duration (sec), total duration per day (sec), and bout frequency were recorded for allogrooming, bar licking, tongue rolling, and brush utilization. Frequency was recorded for headbutting and mounting. Data was extracted from continuous observation datasets using eight different sampling strategies and the results subsequently compared. Differences among sampling strategies were evaluated using a non-parametric One-Way ANOVA Kruskal-Wallis Test. Pearson correlation evaluated the strength of association between a specific sampling strategy and continuous observations. Bout duration for allogrooming (P > 0.65), bar licking (P > 0.60), tongue rolling (P > 0.99), brush use (P > 0.99), and mounting frequency (P > 0.70) did not differ from continuous observations. Tongue rolling (r2 > 0.95, P <0.0001) and brush use (r2 > 0.70, P < 0.0003) were best captured when cattle were observed from 08:00 to 14:00. When cattle were continuously observed from 08:00 to 14:00 or for 15 minutes every 30 minutes, allogrooming (P > 0.2) (frequency, duration), bar licking (P > 0.95) (frequency, duration), brush use (P > 0.1) (frequency, duration), heat butt (P > 0.30) (frequency), or tongue rolling (P > 0.30) (frequency, duration) did not differ from continuous observations. Observing cattle for 15 minutes every 30 minutes yielded the highest accuracy for all behavioral metrics and was considered the most effective strategy for comprehensively evaluating cattle social behavior (r2 > 75; P < 0.05). These results provide insight into accurate and efficient sampling strategies that expedite social behavior data collection in cattle and will facilitate efficient generation of new knowledge regarding cattle social behaviors.

Risk Factors Associated with Suicide Attempt as Predictors of Suicide, Colombia, 2016-2017. / Factores De Riesgo Relacionados Con Intento de Suicidio Como Predictores De suicidio, Colombia 2016-2017.

BACKGROUND: Suicidal behaviour is the cause of half of all violent deaths. It is considered to be a public health problem with one million victims a year. Suicide attempt is the most important risk factor. In Colombia, in 2017 the suicide attempt rate was 51.8/100,000 inhabitants, and the fatality rate reached 10.0/100,000. The objective is to identify suicide attempt factors associated with death and determine survival after the attempt for 2 years. MATERIAL AND METHODS: Retrospective cohort study and survival analysis. A total of 42,594 records of the suicide attempt surveillance system databases and 325 records of death by suicide in 2016 and 2017 were analysed. The risk factors were examined and a χ2-test and multivariate analysis and logistic regression were performed. Cumulative survival probability was calculated using the Kaplan-Meier method. A Cox regression model was applied to determine the proportional relationship of the suicide attempt variables that are related to suicide. RESULTS: Men die by suicide 4.5 times more often than women. One in four suicide victims had made at least one prior suicide attempt. The attempt factors related with death by suicide were: male gender (HR=2.99; 95% CI, 2.27-3.92), adulthood (over 29 years, HR=2.38; 95% CI, 1.90-2.99), living in a rural area (HR=2.56; 95% CI, 2.04-3.20), chronic disease history (HR=2.43; 95% CI, 1.66-3.57) and depression disorder (HR=1.94; 95% CI, 1.55-2.41). Some 50% of suicide deaths occur up to 560 days after the suicide attempt. CONCLUSIONS: The risk of suicide is highest in male patients, with a history of depression, chronic illness and exposure to heavy workloads.

Changes in Anxiety and Depression Traits Induced by Energy Restriction: Predictive Value of the Baseline Status.

Current evidence proposes diet quality as a modifiable risk factor for mental or emotional impairments. However, additional studies are required to investigate the effect of dietary patterns and weight loss on improving psychological symptoms. The aim of this investigation was to evaluate the effect of energy-restriction, prescribed to overweight and obese participants, on anxiety and depression symptoms, as well as the potential predictive value of some baseline psychological features on weight loss. Overweight and obese participants (n = 305) were randomly assigned for 16 weeks to two hypocaloric diets with different macronutrient distribution: a moderately high-protein (MHP) diet and a low-fat (LF) diet. Anthropometrical, clinical, psychological, and lifestyle characteristics were assessed at baseline and at the end of the intervention. The nutritional intervention evidenced that weight loss has a beneficial effect on trait anxiety score in women (ß = 0.24, p = 0.03), depression score in all population (ß = 0.15, p = 0.02), particularly in women (ß = 0.22, p = 0.03) and in subjects who followed the LF diet (ß = 0.22, p = 0.04). Moreover, weight loss could be predicted by anxiety status at baseline, mainly in women and in those who were prescribed a LF diet. This trial suggests that weight loss triggers an improvement in psychological traits, and that anxiety symptoms could predict those volunteers that benefit most from a balanced calorie-restricted intervention, which will contribute to individualized precision nutrition.

Successful medical treatment of infective endocarditis caused by Candida parapsilosis in an immunocompromised patient.

Candida spp is a common pathogen of nosocomial infections that has increased in recent decades, with mortality rates close to 40% in cases of systemic candidiasis. One type of presentation is infective endocarditis, which, by its prolonged need for treatment, represents a constant challenge for clinicians. We describe a 36-year-old woman, recently diagnosed with ovarian cancer, who developed aortic valve infective endocarditis caused by Candida parapsilosis and who was treated with oral antifungal medication, with no surgical intervention required.

Características de las tesis de pre-grado de medicina de una universidad pública del Perú / Characteristics of undergraduate medical thesis of a peruvian public university

Las tesis de pre-grado más que un requisito para titularse son una forma de hacer investigación. Estudios anteriores muestran una publicación de tesis entre 2,7% a 17,6%. Objetivo: Describir las características de las tesis de pregrado de una Facultad de Medicina Material y Métodos: Estudio bibliométrico. Se revisaron 221 tesis, recolectando: Año, número de autores, asesores y referencias bibliográficas, población estudiada y prioridades nacionales de investigación en salud. Se realizó una búsqueda en Google Académico, para evaluar publicación. Se utilizó estadística descriptiva. Resultados: Del total de tesis, el 91,6% tuvieron un solo asesor, 76% fueron descriptivas, 82,8% se realizó en población hospitalaria y el 62,4% fue en adultos. Se observó una menor producción en los años 2008-2010. De las tesis entre 2010-2014, 72,9% no correspondieron a ninguna prioridad nacional de investigación en salud.Sólo el 6,8% se basó en literatura de los últimos 5 años. Sólo 9 (4,1%) fueron publicadas en una revista científica indizada. Conclusión: Las tesis de pregrado se caracterizaron por ser descriptivas, hospitalarias, en adultos, basadas en literatura no actualizada y no acordes con las prioridades de investigación en salud. La publicación fué baja...

The undergraduate thesis rather than a requirement to graduate, are a way of doing research. Previous studies show a thesis published between 2.7% to 17.6% in indexed journals. Objective: To describe the characteristics of the undergraduate thesis of a medical school. Material and Methods: Bibliometric study. 221 theses were reviewed, collecting: year, number of authors, advisers, and references, study population, and national priorities for health research. A search was performed on Google Scholar to assess publication. Descriptive statistics were used. Results: Of the total, 91.6% of thesis had one advisor, 76% were descriptive, 82.8% were done in a hospital population, 62.4% in adults. A Iower production was found in the years 2008-2010. Of the theses between 2010-2014, 72.9% did not correspond to any national health research priority. Only 6.8% was based on literature of the last five years. Only 9 (4.1%) were published in anindexed scientific journal. Conclusion: The undergraduate thesis were characterized as descriptive, in hospitals, in adults, based on out dated literature and not in line with the national priorities for health research. The publication is Iow...

Evaluación de la calidad de estructura y contenido de los formatos de consentimiento médico informado de los hospitales de la Región Lambayeque: marzo-junio 2010 / An assessment of structure and contents quality of informed consent forms in Lambayeque Region: March-June 2010

Objetivo: Determinar la calidad de estructura y de contenido de los formatos de consentimiento médico informado utilizados en los diferentes hospitales de la región Lambayeque. Material y método: Estudio descriptivo, transversal y observacional. Obtenidos los formatos de CMI de los hospitales de la región de Lambayeque; se evaluó su calidad de estructura y de contenido constatándola con los Comités de Ética. Se establecieron dos categorías: Cumple (si figuraba de manera completa y detallada); o, No Cumple (por omisión o tergiversación). Para el análisis, los formatos fueron divididos por número de requisitos cumplidos: más del 75 (cumple 19-24 requisitos); entre el 50-75 (de 12 a18) y menos del 50 (de 0 a 11). Resultados: De los 8 formatos estudiados de los Hospitales de la Región de Lambayeque se encontró que en ningún (0) hospital cumplían con los requisitos del modelo al no lograr más del 75 (19-24 requisitos); 1 (12,5) hospitales se halló entre el 50 y 75 (12-18 requisitos) y en 7 hospitales (75) cumplían menos del 50 (0-11 requisitos). Conclusiones: La calidad de los formatos de CMI de los hospitales de la Región Lambayeque en cuanto a su estructura y contenido: Deficiente.

Objective: To determine the quality of informed medical consent forms (ICFs) used in different hospitals in Lambayeque region with respect to their structure and contents Material and method: This was a descriptive, cross-sectional and observational study. ICFs used in Lambayeque hospitals were assessed with respect to their quality of structure and contents with the participation of Ethics Committees. Two categories were established: complied (if the forms were complete and detailed); or non-compliant (because of omission or confounding). Forms were divided according to the number of requisites complied with: more than 75 (complying with 19-24 requisites); between 50 to 75 (12 to 18 requisites) and less than 50 (0 to 11 requisites). Results: Of the eight forms studied in the Hospitals of the Region Lambayeque found in no (0) were eligible hospital of failing to model more than 75 (19-24 requirements), 1 (12.5) hospitals was found between 50 and 75 (12-18 requirements) and in six hospitals (75) had less than 50 (0-11 requirements). Conclusions: The quality of ICFs in Lambayeque region in terms of their structure and contents is poor.