[Suicide and euthanasia : Discourse on physician-assisted suicide]

Suicidal thoughts and behavior have been a part of human nature since the beginning of mankind. In his autobiographical work From my Life: Poetry and Truth Goethe summarized two important aspects: "Suicide is an event of human nature which, whatever may be said and done with respect to it, demands the sympathy of every man, and in every epoch must be discussed anew". The authors of this article aim to motivate the readership to question and analyze this complex topic and the accompanying multifaceted positions with a summarized presentation of historical aspects and the more recent political developments.

In vivo assessment of an industrial waste product as a feed additive in dairy cows: Effects of larch (Larix decidua L.) sawdust on blood parameters and milk composition

When larch (Larix spp.) is processed in the wood industry, the sawdust is currently disposed of as waste or used as combustible material, even though it is rich in biologically active compounds. In this study the effect of larch sawdust supplementation on blood parameters as well as milk composition was examined in healthy mid-lactating dairy cows. Twenty-four multiparous Italian Friesian dairy cows were assigned to groups receiving either 300 g/day/cow of larch sawdust or a control diet, and treatments were continued for a 20 day period. Milk parameters were unaffected by treatment. A lower plasma total protein concentration was observed and can be attributed to a decrease in globulin concentration. A lower plasma urea concentration was also detected in the larch group. Moreover, biomarkers of liver function were influenced by the treatment. Total bilirubin was lower in larch-treated animals, and cholesterol tended to be lower. In addition, an interaction between day and treatment was observed for very low density lipoprotein. The concentration of other parameters, including reactive oxygen metabolites, superoxide dismutase, glutathione peroxidase and nitrotyrosine, did not differ between treatments. The observed benefits, together with the good palatability, make larch sawdust a promising candidate for the development of beneficial feed supplements for livestock. Further studies will be useful, particularly to evaluate its efficacy in different health conditions.

The suicide prevention effect of lithium: more than 20 years of evidence-a narrative review

The management and treatment of patients with suicidal behavior is one of the most challenging tasks for health-care professionals. Patients with affective disorders are at high risk for suicidal behavior, therefore, should be a target for prevention. Numerous international studies of lithium use have documented anti-suicidal effects since the 1970s. Despite the unambiguous evidence of lithium’s anti-suicidal effects and recommendations in national and international guidelines for its use in acute and maintenance therapy of affective disorders, the use of lithium is still underrepresented. The following article provides a comprehensive review of studies investigating the anti-suicidal effect of lithium in patients with affective disorders.

[Accidents and injuries in the EU. Results of the EuroSafe Reports]

BACKGROUND

Accidents and injuries are a relevant although largely preventable public health problem. Information on the causes of accidents is the basis for accident prevention and product safety. The current report "Injuries in the European Union", edited by EuroSafe, the European Association for Injury Prevention and Safety Promotion, is a summary of key statistics on accidents and injuries at the EU level. In addition to international data on cause of death, the data of the European Injury Data Base (IDB) in particular are presented.

METHODS

The IDB is a unique data source for the EU based on an internationally standardized dataset of external causes and circumstances of injuries, which is collected in the emergency department of hospitals. Thus, the IDB covers the entire spectrum of accidents and injuries in sufficient detail as is necessary for the derivation of preventive measures and the knowledge of involved products. The currently available IDB data are collected by the participating Member States (2012: Austria, Cyprus, Denmark, Germany, Italy, Latvia, Malta, The Netherlands, Norway, Portugal, Slovenia, and Sweden) in self-interest (i.e., without legal obligation) with the support of the EU health programs. The central database for the IDB is run by the European Commission and provides public access to the aggregated data of the participating countries. Currently, over 100 IDB hospitals in the EU upload around 300,000 cases per year into the EU database. The IDB contains information on all accident sectors (transport, workplace, school etc.) with a focus on leisure and sports accidents. Depending on the accident sector, up to 25 variables (activities, products involved, means of transport etc.) and often also short narratives are recorded for each case.

RESULTS

The report shows that 40 million people are treated in a hospital annually in the EU after accidents and violence, and that about 233,000 people die as a consequence of injury. There are large differences between countries in the rates of fatal and nonfatal injuries; these differences can be interpreted as a measure of the potential for prevention and as an indication of targeted measures in the countries with higher accident rates. The report also includes snapshots of the eight priority themes for injury prevention, as defined in the Recommendation of the European Council on Injury Prevention and Safety Promotion in 2007: children, adolescents and older people, vulnerable road users, sports, the use of products and services, violence, and self-injury.

DISCUSSION

The implementation of the IDB has proven to be feasible and useful for the participating countries, especially for data-based accident prevention in the important areas of home, leisure, and sports accidents. In the framework of the EU project JAMIE (2011-2014, Joint Action for Injury Monitoring in Europe), the IDB partners are currently working on further improving the IDB standards and quality criteria as well as the recruitment of further IDB countries. The medium-term goal is to integrate the EU IDB in the Eurostat Statistical System and to put the collection of IDB data on a statutory footing.

[Urogynecology II: urinary incontinence in men and women: surgical treatment of urinary incontinence and prolapse]

Numerous surgical procedures are available for the treatment of stress urinary incontinence in women and men. On a par with classical therapy options (e.g. colposuspension and artificial sphincter prosthesis) suburethral tape procedures have become established as the minimally invasive standard of care. Regarding comorbidities and recurrent urinary incontinence, therapeutic procedures should be modified on an individual basis. It is crucial to involve patients in therapeutic decision-making and counseling should be given with respect to all conservative and operative alternatives.

Small Scale Intramolecular Flexibility in 111mCd-Plastocyanin

The effect of mutations in the vicinity of the putative electron transfer path on the metal center of the electron transfer protein plastocyanin (spinacea) is investigated by monitoring the nuclear quadrupole interaction of 111mCd in Cd-derivatives of the protein via time differential perturbed angular correlation. The spectra for the wild type protein and the mutants were rather similar. All spectra exhibit a peculiar line profile which points towards a small scale intramolecular flexibility of the metal center.

Treatment of epileptic seizures in brain tumors: a critical review

Epileptic seizures represent a common signal of intracranial tumors, frequently the presenting symptom and the main factor influencing quality of life. Treatment of tumors concentrates on survival; antiepileptic drug (AED) treatment frequently is prescribed in a stereotyped way. A differentiated approach according to epileptic syndromes can improve seizure control and minimize unwarranted AED effects. Prophylactic use of AEDs is to be discouraged in patients without seizures. Acutely provoked seizures do not need long-term medication except for patients with high recurrence risk indicated by distinct EEG patterns, auras, and several other parameters. With chronically repeated seizures (epilepsies), long-term AED treatment is indicated. Non-enzyme-inducing AEDs might be preferred. Valproic acid exerts effects against progression of gliomatous tumors. In low-grade astrocytomas with epilepsy, a comprehensive presurgical epilepsy work-up including EEG-video monitoring is advisable; in static non-progressive tumors, it is mandatory. In these cases, the neurosurgical approach has to include the removal of the seizure-onset zone frequently located outside the lesion.