Does television induce suicidal contagion with adolescents?

In an attempt to assess what adolescents think they would do if they knew of previous adolescent suicides, 116 high school students viewed a videotaped vignette of a distressed high school student and were asked to imagine that they were she. They were then given an information sheet summarizing the vignette. One third of the information sheets contained an embedded sentence that two friends had recently committed suicide, another third a sentence that two friends had recently died in an airplane crash, and one third contained no embedded sentence. Subjects were then asked to rate the likelihood that they would engage in various behavioral alternatives (commit suicide, run away, abuse alcohol, drive recklessly, seek psychological help, try harder at school, adapt to the situation) and the degree to which they blamed the various situational factors described in the vignette (school, friends, alcohol, parents). Subjects also completed the Reasons fGr Living Inventory (RFL). The only significant difference across groups was the significantly higher score of the suicide group on the fear of social disapproval scale of the RFL. Adolescents may not be influenced by news about suicide or they may just deny such influence.     

Community attitudes toward childhood suicide and attempted suicide

To assess whether people's reactions to family members of child suicide attemptors were similar to reactions to family members of (a) actual suicides and (b) actual suicides that were preceded by a failed suicide attempt, 120 shoppers (60 men and 60 women) read and responded to one of five short newspaper articles about an incident of a 10-year-old child who either (a) attempted suicide, (b) committed suicide, (c) committed suicide after a previous suicide attempt, (d) died accidentally, or (e) died of a viral illness. Opinions about the psychological health of the victim and reactions to the surviving family varied depending on the nature of the incident. However, in many instances reactions to families of suicide attemptors could not be differentiated from reactions to families of actual suicides. Therefore, it is likely that the number of people affected by negative community reactions to suicidal behavior has been previously underestimated.     

Autologous breast reconstruction: the Vanderbilt experience (1998 to 2005) of independent predictors of displeasing outcomes

BACKGROUND: Optimal surgical outcomes are dependent on an appreciation of comorbid conditions that may handicap results. The purpose of this retrospective analysis was to delineate risk factors for complications after autologous breast reconstruction. STUDY DESIGN: An institutional database was constructed of patients who underwent autologous breast reconstruction from 1998 to 2005. Variables captured included age, diabetes and smoking status, prereconstruction radiation therapy, concomitant breast resection, preoperative albumin, flap type, and body mass index (BMI; based on World Health Organization classifications: BMI>25, overweight; >30, obese). The primary outcome was noninfectious wound complications (NIWC), a novel classification based on the extent of tissue derangement and need for operative intervention. Secondary outcomes were wound infection, hematoma, hernia, and fat necrosis. Statistical analysis was performed using chi-square tests and multiple logistic regression. RESULTS: The analysis included 200 flaps (transverse rectus abdominis myocutaneous [TRAM]=171; latissimus dorsi=29) in 180 patients. There were 19 infections (9.5%), 3 total flap losses (1.5%), 14 hematomas (7%), and 11 donor-site hernias (6%). The incidences of fat necrosis and any NIWC were 18% and 36%, respectively. Mean followup was 13.1 months (range 1.1 to 51.7 months). Multiple logistic regression demonstrated that obesity (BMI>30) is a statistically significant independent risk factor for any NIWC (hazards ratio=6.58; 95% CI, 2.85 to 15.18; p < 0.01) and for NIWC requiring operative treatment (NIWC>or=3; hazard ratio=6.23; 95% CI 2.15 to 18.05; p < 0.01). Increased BMI predicts NIWC, NIWC requiring operative intervention, and wound infection (p < 0.01). CONCLUSIONS: These data suggest that obesity is a strong predictor of simple and complex NIWC and of wound infection after autologous breast reconstruction. Obese patients should be counseled about their significantly increased risk of experiencing these unwanted outcomes.     

Public reactions to child suicide: Effects of child's age and method used

In two separate experiments, a total of 180 citizens at a suburban shopping mall responded to questionnaires about a fictitious newspaper article describing a male child's suicidal death. In Experiment I (90 subjects), the child's age was reported as either 10, 13½, or 17. In Experiment II, an additional 90 subjects responded to a fictitious newspaper article describing a 10-year-old boy's suicidal death by gunshot, hanging, or drug overdose. Seventeen-year-olds who committed suicide were rated more psychologically disturbed than 13½- or 10-year-olds. Parents of 17-year-old suicides were liked more than parents of younger children. In the case of the 17-year-olds, respondents were more likely to say that they felt that the cause of death should not be publicly reported. Across all ages, fathers were perceived as significantly more psychologically disturbed by female than by male respondents. Children who shot themselves were rated more psychologically disturbed than children who overdosed, but parents were rated about the same regardless of the child's method of suicide.     

Advances in Nucleotide Antiviral Development from Scientific Discovery to Clinical Applications: Tenofovir Disoproxil Fumarate for Hepatitis B

Exploration of naturally occurring chemical structures for medicinal uses has received significant interest in drug discovery and development research in the past few decades. None have had more success or products of greater clinical efficacy than synthetic analogs of nucleosides and nucleotides, especially as antiviral drugs. Nucleos(t)ide antivirals are synthetic analogs of the natural building blocks of DNA or RNA. This review focuses on the developmental path of tenofovir disoproxil fumarate (TDF), a prodrug of a nucleotide analog and its clinical applications as a first-line antiviral for chronic hepatitis B (CHB).Tenofovir is a potent antiviral compound, but has poor oral availability. The disoproxil fumarate (DF) prodrug moiety greatly enhances intestinal absorption allowing it to become an oral medication. Tenofovir is activated intracellularly, and the incorporation into HBV DNA prevents further elongation thus terminating replication. In patients with CHB, TDF has demonstrated broad, potent and sustained virologic response. Maintenance of viral suppression for up to 5 years resulted in regression of fibrosis and cirrhosis. No tenofovir-resistant HBV variants have been detected in patients after long-term use. The efficacy and safety profiles reported from cohort studies of clinical practices were consistent with those observed in registration trials.Continuous development includes a new oral prodrug, tenofovir alafenamide fumarate (TAF), which has enhanced delivery of tenofovir to target cells compared to TDF.     

Effects of oral dosage form and storage period on the antioxidant properties of four species used in traditional herbal medicine

Herbal infusions and decoctions in water are some of the most commonly consumed beverages in the world. Although water is not a good solvent for many of the active components in herbs, liquid preparations are rich in several bioactive compounds. Most of them have powerful antioxidant activity and have been related to medicinal herbs' properties. Herein, decoctions and infusions in water of lemon‐verbena (Aloysia citrodora) aerial parts and leaves, fennel (Foeniculum vulgare), pennyroyal (Mentha pulegium) and spearmint (Mentha spicata) aerial parts with different periods of storage (0, 30, 60 and 120 days), were prepared. The effects of the method of preparation and storage period on their antioxidant properties were analysed. For all the analysed species, infusions gave better results than the corresponding decoctions. Spearmint infusions showed the highest antioxidant properties, at all the storage periods, probably due to the highest levels and synergy between phenolics, flavonoids and ascorbic acid found in this sample. Linear discriminant analysis confirmed that the length of storage period has a significant influence on the antioxidant activity and antioxidant content. Flavonoids and reducing sugars proved to be the parameters that most highly contributed to cluster individual groups according to different periods of storage. Copyright © 2010 John Wiley & Sons, Ltd.