A Google-based approach for monitoring suicide risk.

People seeking information and news regarding suicide are likely to use the Internet. However, evidence of the relationship between suicide-related search volumes and national suicide-rates in different countries can be strikingly different. We aimed to investigate the relationship between suicide-rates and Google suicide-related search volumes in the Italian population (2008-2012) using the Italian mortality database that provided monthly national data concerning suicides (2008-2012). Moreover, this study aimed to identify future trends of national suicide rates on the basis of the results we obtained concerning the period 2013-14. Google Trends provided data of online monthly search-volumes of the term "suicide", "commit suicide" and "how to commit suicide" in Google Search and Google News (2008-2014). Google Search volumes for the term "suicide" lags suicide by three months (ρ=0.482, p-value<0.001), whereas no correlation was found between search volumes for "commit suicide" and "how to commit suicide" and national suicide rates. Google News search volumes for the three terms resulted in white noise. Apparently, online searches for suicide-related terms in Italy are more likely to be linked to factors other than suicidiality such as personal interest and suicide bereavement.

Fatal intrahepatic hemorrhage after nadroparin use for total hip arthroplasty.

Low-molecular-weight heparins have become the predominant choice for deep venous thrombosis prophylaxis and treatment. However, their use may cause bleeding complications. Intrahepatic bleeding is exceptional and only very few cases have been described. The authors present a unique case of fatal intrahepatic hematoma complicating nadroparin use in a 65-year-old woman with a hepatic cyst who was admitted to hospital for unilateral total hip arthroplasty. At autopsy, hemoperitoneum (2,000 ml of blood and clots) was evident. A ruptured sub-capsular hematoma involving the right lobe of the liver was observed. The hemorrhage within the cyst induced by the nadroparin use was likely responsible for the subsequent hepatic hematoma, liver rupture, and death. This case highlights the need for pathologists and surgeons to be aware of the possibility of intrahepatic hematoma in patients who have received low-molecular-weight heparins, undergone major surgery and present postoperative hemodynamic instability, especially in those with preoperative diagnosis of hepatic cyst.

Sudden death during medical thoracoscopy.

Medical thoracoscopy (or pleuroscopy) is a valuable diagnostic tool in patients with pleural pathology, being minimally invasive, inexpensive and relatively easy to learn. Complications may occur, depending on the complexity of the case, and mainly include broncho-pleural fistulas, chest infections, arrhythmia, severe hemorrhage due to blood vessel injury, and air or gas embolism. Death is very rare. The present report describes the peculiar case of a 72-year-old woman affected by a pleural empyema who suddenly and unexpectedly died during medical thoracoscopy. On autopsy, three small perforations of the right lung were found, without involvement of major vessels or bronchial ramifications. After a brief overview of medical thoracoscopy and its complications, the fatality and its possible pathophysiological mechanisms are analyzed through a review of the literature.

The need for an interdisciplinary approach in forensic sciences: perspectives from a peculiar case of mummification.

The finding of a mummified body raises many problems, also because of the limits of the medico-legal investigations in case of mummification. Psychological autopsy and behavioral analysis have demonstrated a significant impact in case of equivocal death. The mummified corpse of a woman was found sealed in a wardrobe during the death investigation of a 36-year-old man, later discovered to be the woman's son. The woman's corpse was well preserved and no external injuries were found. Autopsy could not ascertain the cause of death. The state of the premises and the writings on the walls offered an opportunity to investigate the man's psychological profile and to better understand how the events might have taken place. The role of an accurate investigative analysis of the crime scene is a cornerstone of forensic pathology and the case presented underlies the importance of an interdisciplinary approach in forensic sciences.

Employment status, inflation and suicidal behaviour: an analysis of a stratified sample in Italy.

BACKGROUND: There is abundant empirical evidence of a surplus risk of suicide among the unemployed, although few studies have investigated the influence of economic downturns on suicidal behaviours in an employment status-stratified sample. AIMS: We investigated how economic inflation affected suicidal behaviours according to employment status in Italy from 2001 to 2008. METHODS: Data concerning economically active people were provided by the Italian Institute for Statistical Analysis and by the International Monetary Fund. The association between inflation and completed versus attempted suicide with respect to employment status was investigated in every year and quarter-year of the study time frame. We considered three occupational categories: employed, unemployed who were previously employed and unemployed who had never worked. RESULTS: The unemployed are at higher suicide risk than the employed. Among the PE, a significant association between inflation and suicide attempt was found, whereas no association was reported concerning completed suicides. No association was found between completed and attempted suicides among the employed, the NE and inflation. Completed suicide in females is significantly associated with unemployment in every quarter-year. CONCLUSION: The reported vulnerability to suicidal behaviours among the PE as inflation rises underlines the need of effective support strategies for both genders in times of economic downturns.