Sandbox:Vindhya: Difference between revisions

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===Medical and Neurologic causes===
uicidal events
{| style="width:70%; height:100px" border="1"
Completed
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" | '''Neurologic disorders
suicide
| style="width:75%" bgcolor="Beige" ; border="1" | Cerebral neoplasms, cerebral trauma and post concussive syndromes ,Cerebrovascular disease, [[subarachnoid hemorrhage]], [[Migraine]], [[encephalitis]],[[ cerebral syphilis]], [[Multiple sclerosis]],[[Wilsons disease]],[[Huntington disease]],[[Epilepsy]]
A self-injurious behavior that resulted in fatality and
|-
was associated with at least some intent to die as a
|- bgcolor="LightSteelBlue"
result of the act.
| ''' Endocrine disorder'''
1) After a long argument with his girlfriend, which resulted in the
| bgcolor="Beige" | [[ Pituitary dysfunction]], [[Thyroid]] dysfunction, [[ parathyroid dysfunction]], [[Adrenal dysfunction]],[[ pheochromocytoma]]
end of their relationship, the patient collected a rope and rode his
|-
bike to an isolated area where he fatally hanged himself. A suicide
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" | '''Systemic conditions'''
note was later found. 2) After four documented attempts at suicide,
| style="width:75%" bgcolor="Beige" ; border="1" | Hypoxia, Cardiovascular disease, pulmonary insufficiency, [[anemia]]
the patient stole his uncle’s gun and shot himself and was fatally
|-
injured.
|- bgcolor="LightSteelBlue"
Suicide attempt A potentially self-injurious behavior, associated with
| '''Inflammatory disorders'''
at least some intent to die, as a result of the act.
| bgcolor="Beige" | [[ Lupus erythematosus]], [[rheumatoid arthritis]], [[ polyarteritis nodosa]], [[temporal arteritis]]
Evidence that the individual intended to kill him/
|-
herself, at least to some degree, can be explicit or
|- bgcolor="LightSteelBlue"
inferred from the behavior or circumstance. A suicide
| '''Deficiency states'''
attempt may or may not result in actual injury.
| bgcolor="Beige" | Vitamin B12 deficiency, [[ pellagra]]
1) After a fight with her friends at school, in which they discontinued
|- bgcolor="LightSteelBlue"
speaking with her, the patient ingested approximately 16 aspirin
| '''Miscellaneous '''
and eight other pills of different types on the school
| bgcolor="Beige" | [[ hypoglycemia]], [[carcinoid syndrome]], [[ uremia]], [[premenstrual syndrome]], [[porphyria]]
grounds. She said that she deserved to die, which was why she
|-
swallowed the pills. 2) The patient used a razor blade to lacerate
|- bgcolor="LightSteelBlue"
his wrists, his antecubital fossae, and his back bilaterally. He told
| '''Substances'''
his therapist that the “the main objective was to stop feeling like
| bgcolor="Beige" | [[Caffeine]],[[cannabis]],[[Hallucinogens]], [[theophylline]], [[amphetamines]],[[yohimbine]],[[sympathomimetics]], [[mercury]], [[Arsenic]],[[organophosphates]],[[benzene]]
that,” and he knew that he could die but didn’t care. According to
|-
the patient, he also ingested a bottle of rubbing alcohol because
|- bgcolor="LightSteelBlue"
in his health class he heard “that the medulla will get more suppressed
| '''Withdrawal'''
that way,” thereby increasing the chances that he would
| bgcolor="Beige" | [[alcohol]],[[caffeine]], [[opiods]],[[antihypertensives]]
be “successful” and die.
 
Preparatory acts
|}
toward
 
imminent
siadh classification
suicidal
==Classification==
behavior
 
The individual takes steps to injure him- or herself,
*Acute setting (<48 hours since onset) where moderate symptoms are noted, treatment options for hyponatremia include the following:
but is stopped by self or others from starting the
*3% hypertonic saline (513 mEq/L)
self-injurious act before the potential for harm has
*Loop diuretics with saline
begun.
*Vasopressin-2 receptor antagonists (aquaretics, such as conivaptan or tolvaptan)
1) The patient had run away from home overnight because his father
* Water restriction
had gone to school and retrieved a recent “bad” report card.
 
He was fearful of his father’s reaction. Upon his return home, a 5-
* In chronic asymptomatic setting, the treatment is as follows:
to 6-hour argument with his parents ensued, and he took a vegetable
*Fluid restriction
(broad, sharp) knife and went to his room. He reported putting
*Vasopressin-2 receptor antagonists
the knife to his wrist but never puncturing the skin. 2) The patient
*Other agents to be considered include loop diuretics with increased salt intake, urea, and demeclocycline
stated that he “couldn’t stand being depressed anymore”
 
and “wanted to die.” He decided to hang himself. He tied a telephone
*Raise serum sodium by 0.5-1 mEq/hr, and not more than 10-12 mEq in the first 24 hours,to avoid complications like Osmotic demyelination syndrome.
cord to the door knob and placed the cord loosely around
 
his neck. Then, he stopped himself and did not follow through
*In rare medical emergencies more commonly seen in cardiology in the context of hypervolemic severe hyponatremia rather than in SIADH : 
with the attempt.
* Continuous veno-venous hemofiltration (CVVH)  
Suicidal ideation Passive thoughts about wanting to be dead or active
*Slow, low-efficiency daily dialysis (SLEDD  have been used to improve hyponatremia. These methods are invasive so their use is very limited.<ref name="pmid19628685">{{cite journal |vauthors=Salahudeen AK, Kumar V, Madan N, Xiao L, Lahoti A, Samuels J, Nates J, Price K |title=Sustained low efficiency dialysis in the continuous mode (C-SLED): dialysis efficacy, clinical outcomes, and survival predictors in critically ill cancer patients |journal=Clin J Am Soc Nephrol |volume=4 |issue=8 |pages=1338–46 |year=2009 |pmid=19628685 |pmc=2723965 |doi=10.2215/CJN.02130309 |url=}}</ref>
thoughts about killing oneself, not accompanied
by preparatory behavior.a
1) Active: The patient reported to the doctor that he was thinking
about hanging himself in the closet. He was taken to the hospital
and admitted. 2) Passive: The patient reported ideas about wanting
to be dead but denied acting on these feelings.

Revision as of 16:00, 23 August 2017

uicidal events Completed suicide A self-injurious behavior that resulted in fatality and was associated with at least some intent to die as a result of the act. 1) After a long argument with his girlfriend, which resulted in the end of their relationship, the patient collected a rope and rode his bike to an isolated area where he fatally hanged himself. A suicide note was later found. 2) After four documented attempts at suicide, the patient stole his uncle’s gun and shot himself and was fatally injured. Suicide attempt A potentially self-injurious behavior, associated with at least some intent to die, as a result of the act. Evidence that the individual intended to kill him/ herself, at least to some degree, can be explicit or inferred from the behavior or circumstance. A suicide attempt may or may not result in actual injury. 1) After a fight with her friends at school, in which they discontinued speaking with her, the patient ingested approximately 16 aspirin and eight other pills of different types on the school grounds. She said that she deserved to die, which was why she swallowed the pills. 2) The patient used a razor blade to lacerate his wrists, his antecubital fossae, and his back bilaterally. He told his therapist that the “the main objective was to stop feeling like that,” and he knew that he could die but didn’t care. According to the patient, he also ingested a bottle of rubbing alcohol because in his health class he heard “that the medulla will get more suppressed that way,” thereby increasing the chances that he would be “successful” and die. Preparatory acts toward imminent suicidal behavior The individual takes steps to injure him- or herself, but is stopped by self or others from starting the self-injurious act before the potential for harm has begun. 1) The patient had run away from home overnight because his father had gone to school and retrieved a recent “bad” report card. He was fearful of his father’s reaction. Upon his return home, a 5- to 6-hour argument with his parents ensued, and he took a vegetable (broad, sharp) knife and went to his room. He reported putting the knife to his wrist but never puncturing the skin. 2) The patient stated that he “couldn’t stand being depressed anymore” and “wanted to die.” He decided to hang himself. He tied a telephone cord to the door knob and placed the cord loosely around his neck. Then, he stopped himself and did not follow through with the attempt. Suicidal ideation Passive thoughts about wanting to be dead or active thoughts about killing oneself, not accompanied by preparatory behavior.a 1) Active: The patient reported to the doctor that he was thinking about hanging himself in the closet. He was taken to the hospital and admitted. 2) Passive: The patient reported ideas about wanting to be dead but denied acting on these feelings.