Plasma serotonin levels and suicidal behavior in adolescents.

To evaluate the relationship between plasma serotonin (p5-HT) levels and psychometric measures in suicidal adolescents vs. controls, 211 adolescents from three sites in Israel were divided into four groups: suicidal psychiatric inpatients (n=35); non-suicidal psychiatric inpatients (n=30); adolescents referred to the emergency room (ER) due to a suicide attempt (n=51); and a community-based control group from 4 high schools in the same catchment areas (n=95). All were interviewed and assessed for violence, aggression, depression, impulsivity, anger, anxiety, and p5-HT. p5-HT levels were significantly lower in the control group compared to all other groups. A significant negative correlation was found between p5-HT level and suicidal behavior severity among the suicidal inpatients. p5-HT did not discriminate between the psychiatric diagnostic categories and was significantly lower in ER violent compared to non-violent subjects. Gender, depression, and anger were associated with suicidal behavior in all four groups. Beck Depression Inventory (BDI) scores together with p5-HT levels discriminated between healthy controls and other groups. p5-HT level in combination with some of the psychometric scales may serve as a safe and inexpensive peripheral marker of psychopathology, and may help to differentiate between sub-populations of suicidal adolescents. The biological mechanism behind the serotonin dysregulation in suicidal adolescents requires further investigation.     

The impact of parental death versus separation from parents on the mental health of Israeli adolescents

Early research suggested that the loss of a parent during childhood can lead to depression and other psychopathology in children and adults. More recent research has differentiated between loss due to death and separation from parents and has questioned the link between early parental death and psychopathology. We examined the hypothesis that separation from parents has a more detrimental effect than the death of a parent on the mental health of adolescents in the community. Israeli adolescents (N = 844) with a mean age of 16.7 +/- 1.0 years (mean +/- SD) participated in this study. Seventy reported that a parent did not live at home during one of three 5-year periods until they reached the age of 15; 37 reported the death of a parent and 777 were from intact families. All participants completed the Brief Symptom Inventory (BSI), General Well Being Schedule (GWB), Parental Bonding Instrument (PBI), and Perceived Social Support Family/ Friends Scales (PSS-Fam and PSS-Fr). Adolescents who had experienced separation from parents had more psychiatric symptoms (BSI), expressed a lower sense of well-being (GWB), experienced less support from their family (PSS-Fam), and felt less cared for and more controlled by their parents (PBI) compared with those belonging to intact families. The death of a parent was not associated with significantly different scores on these variables. When we controlled for parental bonding (PBI) and perceived social support from family (PSS-Fam), the differences between the separation group and the intact family group were no longer significant. The psychological impact of separation from parents involves a greater risk for psychopathology than the death of a parent. The quality of the relationship with the parents moderates the negative impact of separation from them.     

An intervention program to reduce the number of hospitalizations of elderly patients in a primary care clinic

Background  

The elderly population consumes a large share of medical resources in the western world. A significant portion of the expense is related to hospitalizations.     

Laparoscopic management of suspicious ovarian cysts in elderly, postmenopausal women

OBJECTIVES: To present our experience with laparoscopic treatment of ovarian cysts in elderly, postmenopausal women. STUDY DESIGN: During the period January 1996 to August 1997, 21 elderly, postmenopausal women were admitted to the Rabin Medical Center for laparoscopy. The indications for the operation were an ovarian cyst that did not meet the criteria of a simple cyst, was larger than 4 cm, had pathological Doppler flow or elevated CA-125 level. RESULTS: The median age of the patients was 67.19 (range 60-74). Despite the fact that 15 (71.4%) of the patients suffered from chronic disease, all laparoscopies were successfully accomplished. No case of malignancy was found. CONCLUSIONS: Laparoscopic management of carefully selected ovarian cysts is an appropriate alternative for exploratory laparotomy even in elderly patients with or without underlying diseases.     

A study on the efficacy of digital enhancement of on-line portal images.

A novel method for evaluation of observer performance with portal images has been developed, in which the observer is required to identify and localize predefined anatomical landmarks in digital portal images. The method was employed to compare the spatial accuracy and decision time for landmark localization in unenhanced on-line portal images and images enhanced digitally by selective adaptive histogram modification. The results indicate that anatomical landmarks were more readily identified in the enhanced images, leading to significantly higher accuracy in landmark localization.     

On the mode of action of difenoxin (R 15 403). Part 2: Studies on the perfused isolated colonic loop of the rat (author's transl)]

The effect of 1-(3-cyano-3,3-diphenylpropyl)-4-phenyl-isonipecotinic acid hydrochloride (difenoxin, R 15 403), a new antidiarrhoic agent, was studied in vivo in rats with an isolated colonic loop. Difenoxin had no effect on transport or absorption of fluid during perfusion experiments. When given i.p. it inhibited the motility of the coecum but not that of the colon. Difenoxin has apparently no effect on normal rat colon, although an effect may have been masked by the wide variation of parameters measured under identical conditions.     

Use of color Doppler sonography during follicular aspiration in patients undergoing in vitro fertilization may reduce the risk of blood vessel injury

The use of color Doppler to identify small blood vessels (diameter: 0.68 +/- 0.17 mm to 2.28 +/- 0.81 mm; peak systolic velocity: 10.3 +/- 4.15 cm/s to 25.15 +/- 7.68 cm/s) during follicular aspiration may reduce patient's morbidity.