Suicide is the 10th leading cause of death and the 3rd among adolescents and young adults in the United States. During the last decade suicide surpassed motor vehicle accidents as the leading cause of death from injury.
The incidence of suicide spikes among young adults, falls rapidly, and then gradually rises again until peaking in the over-75 year-old group. In the youth group the incidence is higher among those pursuing Goth, Emo, and Punk lifestyles and occasionally occurs as a contagious phenomenon. In the senior group the incidence is higher among those with cancer or intractable disease and occasionally occurs as murder-suicide.
Women make 2-3 times the suicide attempts of men, but men have 4 times the completed suicides of women. Women tend to use means such as poison, while men tend to use firearms. Suicide among females correlates with victimization by bullying. In a Danish study, evidence of a prior infection with Toxoplasma gondii in women correlated with suicide incidence.
Not surprisingly, suicide risk correlates with mental illness, including disabling obsessive-compulsive and phobic disorders, bulimia, post-traumatic stress disorder, traumatic brain injury, substance abuse, manic-depressive disorder, and schizophrenia.
In substance abuse, increased risk is present in all three stages: intoxication, withdrawal, and chronic. Abusers using methamphetamine by intravenous injection are at special risk.
Manic-depressives are at increased suicide risk during both the manic and depressive phases. The most dangerous time for depressives is when they seem to be emerging from depression.
Schizophrenia sufferers are at heightened risk if they are relatively high-functioning or if they hear command hallucinations, ie, voices instructing them to harm themselves.
An especially risky time for psychiatric in-patients is when they are first released from the psychiatric institution.
Numerous social factors are also associated with increased suicide risk. These include living alone, having a recent loss such as job or love relationship, and poverty.
History of a relative or parent who has died from suicide is a risk intensifier, more so when the parent was the mother rather than the father. The risk is heightened on the anniversary of the death of the relative and when the person reaches the age of the deceased relative.
Suicide incidence is also higher among certain occupational groups such as police, firefighters, physicians, dentists, members of the military, and prisoners.
It is a myth that suicide incidence is highest during the winter holidays. Suicides are actually lowest during the months of November to January and are highest in May.
People who attempt suicide often share a number of personal characteristics: a preoccupation with death, isolation, emotional distance, a lack of humor, dwelling on past misfortunes, and a sense of hopelessness and helplessness.
Behavioral Red Flags
Red flags should spring up when someone at special risk of suicide exhibits certain activities. These include giving away prized possessions, making a will, organizing personal affairs, unexpectedly visiting friends or family, and acquiring items potentially useful in a suicide attempt.
It is a myth that persons who speak of suicide do not act on the thought. If a person speaks suicidally or is reasonably considered to be suicidal, intervention must be immediate and definitive. Here are some guidelines:
No one expects to need to use these strategies, but the suicide statistics show otherwise. Familiarity with the facts and knowledge of the strategies may well save someone’s life.
Thomas Falasca, DO
Enjoy the summer but don’t let a day at the beach or pool end in tragedy.
Consider these drowning statistics:
The Hollywood rendition of drowning is maximized for drama, not accuracy. Seldom is drowning accompanied by prolonged screaming and thrashing in the water. First, drowning can be swift. It requires only two minutes of submersion for a child to lose consciousness. Second, shouting requires a sufficient amount of air in the lungs, which the drowning person may not have. Third, sustaining flotation is more immediately important than waving for attention; the drowning person’s hands are more likely to be in the water attempting to keep the head above the surface. In contrast with Hollywood drama, drowning is more often swift and silent.
Drowning does not require deep water. Infants may drown in bathtubs or even in buckets of water. The lungs of most adult drowning victims contain less than 300 ml (10 ounces) of water.
Even nonfatal drowning has consequences. One third of drowning survivors sustain moderate to severe neurological sequelae. Recovery is often complicated by Acute Respiratory Distress Syndrome and by Ventilator-Associated Lung Injury as well as by infective pneumonia and chemical pneumonitis. Further complications are myocardial dysfunction as well as hepatic or renal insufficiency. Illness or injury occurs in 12-27% of drowning survivors who are 1-14 years of age.
But here are some precautions you can take to protect your safety and that of your loved ones.
The physicians of the Erie County Medical Society hope that this information helps you and your family to enjoy a pleasant and safe summer.
Thomas Falasca, DO
Binge Drinking Dangers
What Is Binge Drinking?
Binging means men drinking 5 or more alcoholic drinks or women drinking 4 or more alcoholic drinks within a 2-hour time period. A “drink” is considered to be 12 ounces of beer, 4 ounces of wine, or 1 ounce of 80-proof liquor.
Most peolple who binge drink are not alcohol dependent.
Prevalence of Binging
Binge drinking is more comon among young adults aged 18-34.
1 in 5 high school girls binge drink.
About 90% of the alcohol consumed by youth under the age of 21 in the United States is in the form of binge drinks.
Consequences of Binging
The most obvious consequences of binging are injuries resulting from impaired judgment or impaired reflexes and reaction time. Impact injuries result from car crashes and falls. Exposure injuries include burns, drowning, and cold exposure.
Binge drinking is especially dangerous in combination with cold exposure. First, it impairs judgment so that the dangers of hypothermia are not readily appreciated. Second, alcohol dilates the peripheral blood vessels so that heat is lost from the body at an accelerated rate. This unfortunate combination has resulted in three recent regional fatalities.
Additionally, incapacitation produced by alcohol renders bingers prone to victimization. Bingers may find themselves the targets of sexual assault, robbery, and other violent crime.
Further dangers to the binge drinker include alcohol poisoning, unintended pregnancy, and sexually transmitted disease.
A recent study by the Harvard School of Public Health compared frequent bingers with non-bingers and found the following behavior differences:
Missed Classes: 62% vs. 9%
Unplanned Sexual Activity: 42% vs. 8%
Unprotected Sex: 22% vs. 4%
Forgot Past Actions: 55% vs. 9%
Actions Later Regretted: 62% vs. 16%
Police Involvement: 13% vs. 2%
Injury: 26% vs. 3%
Drove after Drinking: 69% vs. 22%
Rode with Drunk Driver: 53% vs. 10%
Binge Drinking Precautions
Binge drinking does not have to be part of the socialization culture. The culture can change if individuals behave responsibly and follow a few suggestions:
Every life lost or irretrievably changed by binge drinking is a tragedy that no family has to endure. The Erie County Medical Society strongly supports individual and community efforts to change the behavior and culture of binge drinking on college campuses and elsewhere in our society.
Thomas Falasca, DO
The cold weather is here and so is the danger of frostbite.
What Is It?
Frostbite is tissue injury resulting from the freezing and crystallization of the body fluids within and between the cells. The ice crystals then damage the cell membranes. Further damage results from obstruction within the smallest blood vessels and inflammation when blood flow is reestablished.
How Will I Know It?
Frostbite can develop insidiously. It may begin with coldness that progresses to burning or throbbing. This can eventuate in numbness and then loss of sensation. The skin may subsequently become pale or bluish. Finally, frostbite causes finger clumsiness, difficulty walking, and severe joint pain.
The areas most often affected are fingers, toes, ears, and nose.
What Are the Consequences?
A case of frostbite can leave permanent reminders of the event. Some consequences are minor, such as cold sensitivity. Others are substantial, such as squamous cell carcinoma, arthritis, limb growth deformities in children, and gangrene. Frostbite can result in limb amputations or require nose and ear reconstruction surgery.
Who Is at Risk?
Both the very young and very old are at greater risk for frostbite. They have greater difficulty producing and regulating heat as well as a proportionately greater body surface area from which to lose heat.
Groups especially at risk for frostbite are those of African, Middle Eastern, and Pacific Island descent.
Women are usually more sensitive to frostbite than men.
People whose hands tend to become white in the cold are especially at risk for frostbite.
What to Avoid?
What To Do?
So be sure to protect yourself from frostbite and enjoy the many pleasant outdoor activities of winter.
Thomas Falasca, DO
Holiday Food Safety
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