Suicide is a major global public health concern and one of the leading causes of death worldwide. Previous suicide attempts are one of the strongest predictors of future suicide risk, underscoring the need for effective prevention strategies. Central to these strategies is the establishment of robust surveillance systems that deliver accurate and timely data at both national and local levels. This article describes the development, implementation, and progress of Uruguay’s national real-time surveillance system for suicide attempts, which comprehensively covers all emergency departments across the country. The Ministry of Public Health conducts continuous monitoring of suicide attempt cases using a real-time surveillance system. This article also explores the implications of this system for suicide prevention at various levels and discusses future challenges and opportunities for optimizing its use to enhance public health interventions.

Se discuten avances de una investigación en curso realizada desde el Departamento de Trabajo Social de la Facultad de Ciencias Sociales, Universidad de la República-Uruguay. Un equipo interdisciplinario pretende generar un aporte desde la investigación social en el campo de las políticas de Salud Mental a través del estudio del Plan de Implementación de Prestaciones en Salud Mental, decretado en 2011 en el marco del Sistema Nacional Integrado de Salud. El diseño metodológico de corte descriptivo tiene énfasis cualitativo por su carácter exploratorio e interpretativo relacional. Se releva la perspectiva de técnicos y usuarios sobre la implementación del Plan a nivel nacional. Se destaca como resultado preliminar la gran desinformación entre los indagados sobre el alcance de esta política innovadora que incluye un cambio de paradigma y que compromete a la sociedad que la sustenta.

Suicide is a major public health concern, and Uruguay has one of the highest suicide mortality rates in the Americas. In 2022, the Ministry of Public Health implemented a real-time digital surveillance system for suicide attempts as part of the National Suicide Prevention Strategy. This study presents findings from its first year, analysing 4723 emergency department presentations nationwide. The age-standardised suicide attempt rate was 140.44 per 100,000 inhabitants, with women accounting for 71.6% of cases. Self-poisoning was the most common method, followed by hanging and suffocation for men and self-cutting for women. Nearly half of all attempts involved individuals aged 15–29, highlighting the need for youth-focused and gender-sensitive interventions. This study demonstrates the value of real-time surveillance systems in identifying at-risk groups, informing prevention efforts, and supporting timely interventions. While some challenges in system implementation remain, future efforts should focus on strengthening data integration, leveraging artificial intelligence for risk assessment, and improving follow-up care to reduce repeated attempts and overall suicide mortality.

Hydrocephalus is a build-up of cerebrospinal fluid (CSF) in the brain and is characterized by abnormal dilatation of the cerebral ventricles. Patients can be either asymptomatic, have symptoms related to primary tumors, or have hydrocephalus-related symptoms. Generally, symptomatic patients are candidates for ventriculoperitoneal (VP) shunt placement to reduce acute symptoms. Little evidence exists regarding the resolution of symptomatic hydrocephalus secondary to brain tumors using stereotactic radiosurgery (SRS) alone as a primary treatment option. The present study is a retrospective series of eight patients (six men and two women) diagnosed with obstructive hydrocephalus due to brain tumors treated with radiosurgery between April 2013 and February 2021. The primary endpoint of the present study is to report our institutional experience regarding the control of symptomatic obstructive hydrocephalus due to brain tumors treated with upfront radiosurgery. The mean age was 52 years (range, 5-79). The most common presenting symptoms included headache (100%), vision-related symptoms (75%), and ataxia (37.5%). All patients showed symptom improvement after radiosurgery, five (62.5%) patients showed resolution in less than three days and the rest of the patients resolved hydrocephalus in a longer timeframe (more than three days). All patients lowered their Evans index compared to the index documented before radiosurgery, in a range from 0.02 to 0.17. Radiosurgery is a non-invasive alternative treatment for primary and secondary brain tumors that debut with obstructive hydrocephalus, tumors expected to have a high alpha/beta ratio might be suitable to attempt radiosurgery to avoid permanently implanted devices such as VP shunts or other invasive procedures such as a third ventriculostomy. The present study demonstrated that in selected cases SRS can lead to hydrocephalus symptom resolution along with a decrease in ventricular size in a relatively short time frame. Little evidence exists regarding the effect of SRS on symptomatic hydrocephalus resolution and further histology-specific studies are required. We acknowledge that this approach requires immediate access to radiosurgery and close clinical follow-up to ensure success.