Demographic and Clinical Characteristics of Military Service Members Hospitalized Following a Suicide Attempt versus Suicide Ideation

Psychiatric hospitalization for a suicide attempt (SA), rather than suicide ideation (SI) alone, is a stronger risk indicator for eventual suicide death. Yet, little is known about demographic and clinical characteristics differentiating those admitted for SA versus SI. Understanding these differences has implications for assessment and treatment. A retrospective review of electronic medical records (EMRs) was performed on service members (n = 955) admitted for SA or SI at the Walter Reed Army Medical Center between 2001-2006. Service members hospitalized for SA were younger compared to those hospitalized for SI. The proportion of women admitted for SA was significantly higher than those admitted for SI whereas their male counterparts showed the opposite pattern. Patients admitted for SA, versus SI, had significantly higher prevalence of adjustment disorder with mixed disturbance of emotion and conduct (MDEC), personality disorder not otherwise specified (PDNOS), and borderline personality disorder (BPD). Patients admitted for SI had significantly higher prevalence of adjustment disorder with depressed mood and deferred Axis II diagnosis, compared to those admitted for SA. There were no significant between-group differences in the average or median number of documented prior suicide attempts. Findings highlight the need for more standardized assessment, diagnostic decision-making, and documentation practices for all patients.

Skeletal tissue growth, differentiation and mineralization in the NASA rotating wall vessel

The NASA Rotating Wall Vessel (RWV) is a device that creates a unique environment that supports three-dimensional tissue growth, a heightened level of cell differentiation and randomizes the position of the downward gravitational force on cells. Embryonic bone formation encompasses a cascade of chondrogenic and osteogenic events, which can be altered by changes in gravitational loading. These studies were conducted to determine if the chondrogenic cascade in bone formation would be enhanced or hindered in the unique culture environment of the RWV. Embryonic mouse pre-bone tissues were placed in the RWV at one of four different stages of chondrogenesis, ranging from undifferentiated mesenchyme cells to chondrocytes on the verge of undergoing terminal chondrocyte differentiation. After culture, tissues were analyzed for their size, the amount of alkaline phosphatase (ALP) activity and their ability to form a mineralized matrix. Tissue consisting of cells at the early phase of chondrogenesis grew very little and did not differentiate or mineralize when cultured in the RWV. Some tissues were cultured for short periods in the RWV then cultured in standard culture dishes (SCD). Following this culture regime, the cartilage grew only a small amount, but alkaline phosphatase activity increased, and some mineralized regions formed. The pattern of mineralization was abnormal, with two mineralized zones at each end of the cartilage instead of a single central zone. Tissues that were at the three more advanced stages of chondrogenesis when placed in the RWV showed substantial growth, differentiation and mineralization. Mineralization patterns in these older tissues was normal. Tissues at the oldest stage of chondrogenesis showed more growth and as much or more mineralization as tissue cultured only in SCD. These data suggest that exposure to the RWV at early stages of chondrogenesis severely limits the ability for cartilage growth and yields abnormal downstream morphogenesis. However, at later stages of chondrogenesis, the RWV environment may be beneficial and enhance growth and development. Future studies to characterize intercellular signaling molecules and gene expression activities of chondrocytes in the RWV will be valuable for understanding the mechanism of skeletogenesis.

The benefits of exercise in geriatric women

Women 65 years of age and older are the fastest growing segment of the population. As women age, physical inactivity is the leading cause of morbidity and mortality due to coronary heart disease, diabetes mellitus, and hypertension. There is also a loss of both physiologic and psychological capabilities that contributes to an overall reduction in function and independent living. Regular physical activity in geriatric women has been shown to reduce cardiovascular morbidity and all-cause mortality. Further research needs to be done to evaluate the role of regular physical activity in the management of diabetes and hyperlipidemia.

High frequency of the median artery of the forearm in South African newborns and infants

In a sample of 60 neonates and infants from black communities in the Johannesburg area, the median artery of the forearm was found in 50% of individuals (11.7% in one forearm only, 38.3% in both forearms). The frequency per forearm was 44.2%, much higher than that found in any previous study, even among adults from the same community (27.1% per forearm). The artery occurs bilaterally significantly more often than it does in one antimere only. There are no differences in its frequency between sexes or between antimeres. The artery provides an additional route of blood supply to the forearm that should be kept in mind by hand surgeons. It can also be harvested for vascular grafts.

Possible secular trend in the incidence of an anatomical variant: median artery of the forearm

Occurrence of a secular trend in the presence of a common anatomical variant-median artery of the forearm is studied. Data from the literature indicated the incidence of the median artery to be between 4.4 and 8.3% in adult cadavers studied before 1960 while our recent study found a frequency of 27.2%. In 224 adult and 60 infant cadavers of people born between 1900 and 1991 studied using a uniform method the incidence of the median artery in the birth cohort 1900-1910 was 15.0% of individuals, it rose to 29.7% in 1921-1930 and further to 38.1% in 1951-1960 to become 52.8% in 1980-1991. This trend is statistically significant. Since the median artery is deemed to dwindle away in most individuals around the 7th week of the intrauterine life, the increasing proportion of individuals who retain it into postnatal life may indicate a recent trend in human intrauterine development.

A further study of the high incidence of the median artery of the forearm in Southern Africa

Sixty-two forearms from 36 cadavers of South Africans of European extraction were dissected. The frequency of the median artery per forearm was 27.4%. There was neither bilateral difference nor sexual dimorphism in the incidence of the artery. These findings compare well with a previous study of black South Africans (Henneberg & George, 1992) where frequency per forearm was 27.1%. Our findings are much higher than those of earlier studies. This discrepancy may be explained either by differences in the thoroughness of the observations or regional variation, or by the occurrence of a secular trend in the development of vasculature.

High incidence of the median artery of the forearm in a sample of recent southern African cadavers

Observations of the presence of the median artery, providing substantial blood supply to the hand, were conducted on 96 dissected forearms of 15 adult African females and 49 adult males. The artery has a much higher incidence (27.1%) than previously reported by any author. There is no significant difference in its occurrence between sexes, nor between right and left limbs. The artery seems to occur more often bilaterally than unilaterally. The presence of the artery is not related to age. From a theoretical standpoint it is difficult to accept that a structure present in more than 1 in 4 of individuals should be considered an 'anomaly' or a 'variant'. A different approach to description of normal human anatomy is therefore necessary--that of presenting alternative anatomical patterns of equal standing rather than a single 'normal' pattern.