Characterization of Suicide in the Department of Sucre: An Analysis of the News Published in El Meridiano de Sucre Newspaper, Colombia

Objectiv. To analyze the news published in the newspaper El Meridiano de Sucre from 2010 to 2016, related to consummated suicide. Method. 1) the search was limited to a specific period of time: 2010 - 2016; 2) the information provided by the newspaper articles was classified taking into account: the date of the event, the place, the age, the sex, the modality and the reason; 3) all information was introduced for analysis into the Statistical Package for Social Science (SPSS v.21). Results. An increase in suicide rate was found between 2015 and 2016. Among the most frequent reasons for committing suicide are: depression, family, health and economic problems. Conclusions. Both in Sincelejo and in rural area, the most frequent type of suicidal act in men and women is hanging, and the most frequent reason: “depression”.Objetivo. Analizar las noticias publicadas sobre suicidio consumado en el Periódico El Meridiano de Sucre del 2010 al 2016. Método. 1) la búsqueda se acotó a un tiempo específico (2010 – 2016); 2) se clasificó la información proporcionada por los artículos de periódico teniendo en cuenta: la fecha del acontecimiento, el lugar, la edad, el sexo, la modalidad y el motivo; 3) se introdujo toda la información al paquete estadístico Statistical Package for Social Science (SPSS v.21) para su análisis. Resultados. Se halló un aumento de las cifras del suicidio en los años 2015 y 2016. Entre los motivos más frecuentes para cometer el acto suicida se encuentran: depresión, problemas familiares, problemas de salud y problemas económicos. Conclusiones. Tanto en Sincelejo como en la zona rural sucreña, la modalidad de acto suicida más frecuente en hombres y mujeres es el ahorcamiento, y el motivo más frecuente: “la depresión”.Objetivo. Analisar as notícias publicadas sobre o suicídio consumado no jornal El Meridiano, de Sucre, de 2010 a 2016. Método. 1) a busca foi limitada a um horário específico (2010 - 2016); 2) as informações fornecidas pelos artigos de jornal foram classificadas levando-se em conta: a data do evento, o local, a idade, o sexo, a modalidade e a razão; 3) todas as informações foram introduzidas no pacote estatístico Statistical Package for Social Science (SPSS v.21) para análise. Resultados. Um aumento nos números de suicídio foi encontrado em 2015 e 2016. Entre os motivos mais frequentes para cometer o ato suicida estão: depressão, problemas familiares, problemas de saúde e problemas econômicos. Conclusões. Tanto em Sincelejo como em Sucreña rural, o tipo mais frequente do ato suicida em homens e mulheres está suspendendo, e a razão mais frequente: “a depressão”

Ideación suicida infanto-juvenil en Sucre: Una comparación entre niños y adolescentes con y sin vivencia de hechos victimizantes en su familia

Objective: 1) To determine the presence of suicidal ideation in children and adolescents in Sincelejo (Sucre, Colombia), considering age and sex and 2) To compare the presence of suicidal ideation in children and adolescents who have experienced a victimizing event with those who have not. Method: Quantitative approach, descriptive-comparative and cross-sectional. 1704 children and adolescents participated in the current study, most of the participants were female (n = 1016 girls; 59.6%). Results: A higher percentage of children and young people presented suicidal ideation between the ages of nine and fifteen, however, the cases decreased from 16 years of age onwards. Compared with children and adolescents who did not experience victimizing events in their family, a higher percentage of children and adolescents who experienced victimizing events in their family showed suicide ideation or planned to commit suicide almost all the time (p = .30). Children and young people with experiences of threat (p = .01), murder of loved ones (p =. 03) and kidnapping in the family (p =. 13) have generally thought or planned to commit suicide in a higher percentage than those without victimizing experiences. Conclusions: The current research contributes to the study of suicidal behaviour in Colombia, its definition and associated risk factors in the child and adolescent population who have lived and who have not experienced victimizing events in the framework of the armed conflict in Colombia.Objetivo: 1) Determinar la presencia de hechos victimizantes y de ideación suicida infanto-juvenil en Sincelejo (Sucre, Colombia), teniendo en cuenta la edad y el sexo y 2) Comparar la presencia de ideación suicida en niños y adolescentes que han vivido algún hecho victimizante con aquellos que no. Método: Enfoque cuantitativo, de tipo descriptivo-comparativo y de corte transversal. Participaron 1704 niños y adolescentes, la mayoría de los participantes fueron de sexo femenino (n= 1016 niñas; 59.6%). Resultados: Entre los nueve y los quince años un mayor porcentaje de niños y jóvenes presentaron ideación suicida, sin embargo, los casos disminuyeron de los 16 años en adelante. En comparación con los niños y adolescentes, que no vivieron hechos victimizantes, aquellos que sí los padecieron, en un más alto porcentaje, pensaron o planearon suicidarse casi todo el tiempo (p= 0.30). Los niños y jóvenes cuyas familias padecieron amenazas (p= 0.01), asesinato de seres queridos (p= 0.03) y secuestro de algún miembro de la familia (p= 0.13), generalmente, han pensado o planeado suicidarse en un mayor porcentaje que aquellos que no vivieron hechos victimizantes. Conclusiones: Esta investigación permite contribuir al estudio de la conducta suicida, su presencia en niños y adolescentes sucreños, y factores de riesgo de la población infantil y adolescente que ha vivido y no ha vivido hechos victimizantes en el marco del conflicto armado en Colombia. Palabras clave: Ideación suicida, niños, adolescentes, conflicto armado, hechos victimizantes

Ritos funerarios y experiencias de duelo en el pasado y durante la pandemia por COVID-19

Debido a las normas de bioseguridad, la pandemia del COVID-19 ha cambiado la manera en que los familiares y amigos asumen el duelo por la muerte de un ser querido, independientemente de la causa de la muerte. El objetivo del estudio fue describir la manifestación de ritos funerarios y experiencias de duelo en el pasado y durante la pandemia por COVID-19 en Sincelejo (Sucre, Colombia). La investigación es de enfoque cualitativo, de alcance descriptivo; se toma la teoría fundamentada como método cualitativo de análisis de datos, con la intención de interpretar los significados desde la realidad social de los individuos. El análisis de los datos se realizó con el programa ATLAS.Ti. Se concluye que los ritos funerarios han cambiado a lo largo del tiempo en el municipio de Sincelejo; sin embargo, debido a la pandemia, estos cambios se han acelerado aún más y han provocado nuevas formas de asumir el duelo: el duelo se vive sin el cuerpo y sin la mirada de los otros

Advances in the treatment of prolactinomas

Prolactinomas account for approximately 40% of all pituitary adenomas and are an important cause of hypogonadism and infertility. The ultimate goal of therapy for prolactinomas is restoration or achievement of eugonadism through the normalization of hyperprolactinemia and control of tumor mass. Medical therapy with dopamine agonists is highly effective in the majority of cases and represents the mainstay of therapy. Recent data indicating successful withdrawal of these agents in a subset of patients challenge the previously held concept that medical therapy is a lifelong requirement. Complicated situations, such as those encountered in resistance to dopamine agonists, pregnancy, and giant or malignant prolactinomas, may require multimodal therapy involving surgery, radiotherapy, or both. Progress in elucidating the mechanisms underlying the pathogenesis of prolactinomas may enable future development of novel molecular therapies for treatment-resistant cases. This review provides a critical analysis of the efficacy and safety of the various modes of therapy available for the treatment of patients with prolactinomas with an emphasis on challenging situations, a discussion of the data regarding withdrawal of medical therapy, and a foreshadowing of novel approaches to therapy that may become available in the future

Status Update and Interim Results from the Asymptomatic Carotid Surgery Trial-2 (ACST-2)

Objectives: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. Methods: Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both possible, but where there is substantial uncertainty as to which is most appropriate. Trial surgeons and interventionalists are expected to use their usual techniques and CE-approved devices. We report baseline characteristics and blinded combined interim results for 30-day mortality and major morbidity for 986 patients in the ongoing trial up to September 2012. Results: A total of 986 patients (687 men, 299 women), mean age 68.7 years (SD ± 8.1) were randomized equally to CEA or CAS. Most (96%) had ipsilateral stenosis of 70-99% (median 80%) with contralateral stenoses of 50-99% in 30% and contralateral occlusion in 8%. Patients were on appropriate medical treatment. For 691 patients undergoing intervention with at least 1-month follow-up and Rankin scoring at 6 months for any stroke, the overall serious cardiovascular event rate of periprocedural (within 30 days) disabling stroke, fatal myocardial infarction, and death at 30 days was 1.0%. Conclusions: Early ACST-2 results suggest contemporary carotid intervention for asymptomatic stenosis has a low risk of serious morbidity and mortality, on par with other recent trials. The trial continues to recruit, to monitor periprocedural events and all types of stroke, aiming to randomize up to 5,000 patients to determine any differential outcomes between interventions. Clinical trial: ISRCTN21144362. © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved

Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy

Background: Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods: ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings: Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86–1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91–1·32; p=0·21). Interpretation: Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable. Funding: UK Medical Research Council and Health Technology Assessment Programme