War and suicidal deaths by explosives in southwestern Croatia

A total of 853 suicides, from which 29 were committed by explosives, were recorded in the examined region during three distinctly specific intervals-peace time (1986-1990), wartime (1991-1995), and the postwar time (1996-2000). Suicides caused by explosives, without a terrorist background, from 1986-2000 were reviewed. Out of 29 suicides by explosives committed in the examined period, the age and sex of suicide victims and alcohol intoxication at the time of suicide were analyzed. In the prewar period no suicides by explosives were recorded, in distinction from wartime and the postwar period when 20 and 9 such suicides were recorded, respectively. Alcohol testing was performed in 76% of the cases, showing the highest alcohol concentration in suicides' blood in wartime with an average value of 1.58 g/kg of absolute alcohol. As to the suicides' sex, 93% of the victims were male and 7% female. The paper emphasizes the drastically increased number of suicides committed by explosives in wartime.     

Increased risk of suicide in persons with AIDS

The rate of suicide has been reported to be higher in persons with chronic and life-threatening illnesses (eg, cancer, Huntington's disease, and renal failure). We studied the rate of suicide in 1985 in New York City residents diagnosed with the acquired immunodeficiency syndrome (AIDS). There were 668 suicides in New York City residents in 1985, yielding a rate of 9.29 per 100,000 person-years. In men aged 20 to 59 years without a known diagnosis of AIDS, the rate was 18.75 per 100,000 person-years. There were 3828 individuals who lived with the diagnosis of AIDS for some part, or all, of 1985. There were 12 suicides in men aged 20 to 59 years from this group who lived 1763.25 person-years with a diagnosis of AIDS. This yields a suicide rate of 680.56 per 100,000 person-years. Thus, the relative risk of suicide in men with AIDS aged 20 to 59 years was 36.30 times (95% confidence limits, 20.45 to 64.42) that of men aged 20 to 59 years without this diagnosis, and 66.15 times (95% confidence limits, 37.38 to 117.06) that of the general population. We conclude that AIDS represents a significant risk factor for suicide.     

Suicide rate after the 1991-1995 War in Southwestern Croatia

BACKGROUND: The paper analyzed the impact of war, the most pernicious of social evils, taking into consideration intensity of change in rate of suicide in the southwestern region of Croatia during the war and including three distinctly specific intervals, two peacetime-one pre-war (1986-1990) and one post-war (1996-2000) as well as the period of the war itself (1991-1995). METHODS: From 853 cases of suicide committed during the period under review, age and gender of suicide victims, level of alcohol intoxication at suicide, means used in committing suicide, and suicide rate in years under review were analyzed. Quantitative characteristics of suicides were compared with other types of violent deaths, e.g., homicides and accidents. Frequencies of different features are shown graphically. Statistica 4.0 for Windows 98 was used in data processing. RESULTS: Of a total of 2,925 violent deaths in the period under review (1986-2000), 29.16% or 853 suicides (29.1%) were recorded. A total of 513 suicides were committed in the peace-time period--262 prior to the war (1986-1990) and 251 after the war (1996-2000)--while 340 suicides were recorded during the war (1991-1995). Means of committing suicide also changed drastically during the war, when 64 cases of firearm use were recorded compared with 18 cases during the pre-war interval and 36 cases in the post-war interval. CONCLUSIONS: Three parameters, namely, suicide rate, use of firearms, and intoxication, suffered the greatest changes in the war compared with the pre- and post-war period in the region under review.     

男性自杀率和男女自杀比与年龄变化的曲线拟合

目的探索男性自杀率和男女自杀比随年龄而变化的动态规律.方法用Manoel发表的WHO男和女各年龄组自杀率的资料,进行曲线拟合.结果男性自杀率随年龄而变化呈指数曲线规律,曲线方程为ln(43.35-Y)=4.2876-0.0552X,R2=0.9978,男女自杀率比值随年龄而变化呈抛物线规律,曲线方程为Y=1.376+0.1246X-0.00148X2,R2=0.9730.结论(1)社会科学象自然科学一样,可用数学方法精确测算;(2)从年龄方向上看,男女自杀比在中年时最高.     

男性自杀率和男女自杀比与年龄变化的曲线拟合

的探索男性自杀率和男女自杀比随年龄而变化的动态规律。方法用Manoel发表的WHO男和女各年龄组自杀率的资料 ,进行曲线拟合。结果男性自杀率随年龄而变化呈指数曲线规律 ,曲线方程为ln( 4 3 .3 5 -Y) =4.2 876-0 .0 5 5 2X ,R2 =0 .9978,男女自杀率比值随年龄而变化呈抛物线规律 ,曲线方程为Y =1.3 76 0 .12 46X -0 .0 0 14 8X2 ,R2 =0 .973 0。结论 ( 1)社会科学象自然科学一样 ,可用数学方法精确测算 ;( 2 )从年龄方向上看 ,男女自杀比在中年时最高。     

Tuberculosis mortality during a civil war in Guinea-Bissau

CONTEXT: Tuberculosis (TB) is an increasing global problem, despite effective drug therapies. Access to TB therapy during conflict situations has not been studied. OBJECTIVE: To determine the effect of irregular TB treatment due to an armed conflict in Guinea-Bissau, West Africa. DESIGN, SETTING, AND PATIENTS: Ongoing retrospective cohort study conducted in the capital city of Bissau among 101 patients with TB who received irregular or no treatment during the civil war (war cohort; June 7-December 6, 1998) and 108 patients with TB who received treatment 12 months earlier (peace cohort; June 7-December 6, 1997) and comparison of an additional 42 patients who had completed treatment before June 6, 1998, and 69 patients who had completed treatment before June 6, 1997. MAIN OUTCOME MEASURE: Mortality rates, compared by irregular (war cohort) vs regular (peace cohort) access to treatment, by intensive vs continuation phase of treatment, and by those who had previously completed treatment for TB. RESULTS: Irregular treatment was associated with an increased mortality rate among patients with TB. The mortality rate ratio (MR) was 3.12 (95% confidence interval [CI], 1.20-8.12) in the war cohort, adjusting for age, sex, human immunodeficiency virus (HIV) infection, residence, and length of treatment. Each additional week of treatment before the war started increased probability of survival by 5% (95% CI, 0%-10%). In the intensive phase of treatment, the adjusted MR was 3.30 (95% CI, 1.04-10.50) and in the continuation phase it was 2.26 (95% CI, 0.33-15.34). Increased mortality among the war cohort was most marked in HIV-positive patients, who had an adjusted MR of 8.19 (95% CI, 1.62-41.25). Mortality was not increased in HIV-positive or HIV-negative patients who had completed TB treatment when the war started. CONCLUSIONS: Interruption of treatment had a profound impact on mortality among patients with TB during the war in Guinea-Bissau. Regular treatment for TB was associated with significantly improved survival for HIV-infected individuals. In emergencies, it is crucial to ensure availability of TB drugs.     

二战时期英国紧急医院服务的问题初探

1939年英国实行了紧急医院服务计划,以优先救治战争中的军人和伤员,这项战时政策在为英国做出积极贡献的同时产生了一些问题?它剥夺了部分普通民众合法的求医权利,不平等地加重了部分医护人员的工作负担,并暴露出了医疗服务业内的歧视行为?它的成功运行体现出了战争时期公民权利在国家利益面前的牺牲与妥协,同时引发了民众对于医疗服务发展的理性思考,为战后医疗改革奠定了基础?     

心理健康教育对社区居民自杀影响的随访研究

目的探讨心理健康教育与心理卫生知识对社区居民自杀的影响.方法运用在杨浦区延吉街道的心理健康教育干预网络,对杨浦区2000～2002年的自杀率与前3年进行比较,再对区内的干预街道和对照街道进行比较,了解其中的差异.结果两组自杀人数所占意外死亡比例有显著性差异(χ2=45.86,P<0.01).2002年组的自杀率比1999年组的自杀率有所下降,尤其是65岁以上者下降近50%,但是在16岁以下组中的死亡数有所上升.结论预防自杀必须从心理健康做起,提高人的应激能力,主动进行健康心理的干预来防治抑郁和减少自杀的发生.     

心理健康教育对社区居民自杀影响的随访研究

目的　探讨心理健康教育与心理卫生知识对社区居民自杀的影响。方法　运用在杨浦区延吉街道的心理健康教育干预网络 ,对杨浦区 2 0 0 0～ 2 0 0 2年的自杀率与前 3年进行比较 ,再对区内的干预街道和对照街道进行比较 ,了解其中的差异。结果　两组自杀人数所占意外死亡比例有显著性差异 (χ2 =4 5 .86 ,P <0 .0 1)。 2 0 0 2年组的自杀率比 1999年组的自杀率有所下降 ,尤其是 6 5岁以上者下降近 5 0 % ,但是在 16岁以下组中的死亡数有所上升。结论　预防自杀必须从心理健康做起 ,提高人的应激能力 ,主动进行健康心理的干预来防治抑郁和减少自杀的发生。     

食管癌患者放射治疗前后外周血淋巴细胞染色体畸变率和微核率的检测及临床意义

目的：探讨食管癌放疗前后外周血淋巴细胞染色体畸变率和微核率的变化。方法：将符合入组条件的食管癌患者21例随机分成两组,Ⅰ组（n=10）采用普通放疗（照射野的形状为规则矩形野的放疗方法）;Ⅱ组（n=11）采用适形放疗（照射野的形状与靶区形状一致的放疗方法）,1.8～2.0 Gy/次,1次/日,5次/周,总剂量60～70 Gy。于放射治疗前后采外周静脉血,分析染色体畸变率和微核率。结果：普通放疗后与放疗前比较染色体畸变率和微核率均增高（P<0.05）,适形放疗后染色体畸变率和微核率比放疗前亦有提高,但差异无显著性（P>0.05）。结论：与普通放疗相比,适形放疗可减轻细胞遗传学的损伤;检测外周血淋巴细胞染色体畸变率和微核率可作为评价放疗引起食管癌患者细胞遗传学损伤的简单方法。     

经前经期杂症治验4则

在妇科临床中,月经病是发病率最高、就诊人数最多的一种病。而兼有杂症更是临床中常见。其主要原因是脏腑功能失常,血气不和,冲任二脉损伤以及肾一天癸一冲任一胞宫轴失调。笔者在长期的临床实践中体会到,对于经前或经期所出现的兼证,如果单纯的对症治疗,疗效欠佳;若能结合月经期的生理病理特点,遵循《内经》“谨察阴阳所在而调之,以平为期”的宗旨进行综合性治疗,则收效显著。兹介绍如下。