RESUMO
OBJECTIVE: According to recent findings neuroendocrine response related to dissociative symptoms is related to dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis but HPA axis functioning as related to dissociation is only partially understood. METHOD: With the aim to test the relationship between basal serum cortisol and dissociative symptoms measured as somatoform and psychic dissociation we performed clinical testing and biochemical analysis in 30 inpatients with diagnosis of unipolar depression (mean age 41.46, SD=13.68). RESULTS: The results show that cortisol as an index of HPA axis functioning manifests significant relationship to somatoform dissociative symptoms (r=-0.40; p=0.014). CONCLUSIONS: The result indicates relationship between HPA-axis reactivity and somatoform dissociative symptoms in unipolar depressive patients and suggests that somatoform dissociation presents a defense mechanism related to a passive coping response.
Assuntos
Transtorno Depressivo/etiologia , Transtornos Dissociativos/etiologia , Hidrocortisona/sangue , Transtornos Somatoformes/etiologia , Adulto , Transtorno Depressivo/sangue , Transtorno Depressivo/fisiopatologia , Transtornos Dissociativos/sangue , Transtornos Dissociativos/diagnóstico , Transtornos Dissociativos/fisiopatologia , Feminino , Humanos , Sistema Hipotálamo-Hipofisário/fisiopatologia , Masculino , Pessoa de Meia-Idade , Sistema Hipófise-Suprarrenal/fisiopatologia , Transtornos Somatoformes/sangue , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/fisiopatologia , Estresse Fisiológico/complicações , Estresse Fisiológico/fisiopatologia , Inquéritos e QuestionáriosRESUMO
There is very little data and no prospective research possible in the field of catastrophic medicine (disaster medicine) including infectious diseases. This minireview tries to contribute to the pathogenesis and outcome of infectious diseases in areas after anthropogenic (war, genocide, terrorist attack, industrial disasters) and non anthropogenic (natural) catastrophes (earthquake, floods, tsunamis, hurricanes, volcano eruptions). Therefore ISC received a proposal to create a working group on infectious diseases in areas after catastrophes, better to understand epidemiology, prevention and therapy of infectious diseases occurring in conjunction to various anthropogenic and non anthropogenic (natural) disasters.
Assuntos
Controle de Doenças Transmissíveis/métodos , Doenças Transmissíveis/epidemiologia , Planejamento em Desastres/métodos , Desastres , Surtos de Doenças/prevenção & controle , Desastres/classificação , Humanos , Terrorismo , GuerraRESUMO
OBJECTIVES: Recent evidence indicates frequent EEG abnormalities in dissociated patients. This evidence is in agreement with findings that in certain psychiatric patients, psychosensory symptoms of epileptogenic nature, the so-called complex partial seizure-like symptoms occur. With respect to these findings, a hypothesis examined in this study states that increased level of experienced traumatic stress and dissociation in pathological conditions such as schizophrenia or depression relates to increased score of complex partial seizure-like symptoms. Also is suggested that the complex partial seizure-like symptoms might be related to unilateral hemispheric electrophysiological dysfunction, stress and dissociation. PARTICIPANTS AND METHODS: Psychometric assessment of dissociation, stress and measurement of right-left asymmetry of bilateral EDA in patients with schizophrenia (N=34) and depression (N=41) in comparison to healthy controls (N=36). RESULTS: Results indicate that increased traumatic stress and dissociation in both groups of patients significantly relate to increased level of complex partial seizure-like symptoms, and may cause the right-left EDA asymmetry. CONCLUSIONS: The data suggest relationship between left-hemispheric asymmetry and sympathetic over-activation in schizophrenia, and between right-hemispheric asymmetry with sympathetic under-activation in depression.
Assuntos
Transtorno Depressivo/fisiopatologia , Transtornos Dissociativos/fisiopatologia , Epilepsia Parcial Complexa/fisiopatologia , Esquizofrenia/fisiopatologia , Estresse Psicológico/fisiopatologia , Adulto , Estudos de Casos e Controles , Cérebro/fisiopatologia , Transtorno Depressivo/complicações , Transtornos Dissociativos/complicações , Eletroencefalografia , Epilepsia Parcial Complexa/complicações , Feminino , Lateralidade Funcional/fisiologia , Resposta Galvânica da Pele/fisiologia , Humanos , Masculino , Psicometria , Valores de Referência , Esquizofrenia/complicações , Estatísticas não Paramétricas , Estresse Psicológico/complicações , Sistema Nervoso Simpático/fisiopatologiaRESUMO
OBJECTIVES: Usual neuroendocrinological manifestation of traumatic stress and dissociation is dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis. The aim of the present study is to perform examination of HPA axis as indexed by basal serum prolactin and test its relationship to dissociative symptoms and symptoms of traumatic stress. PATIENTS AND METHODS: 25 inpatients treated at the university hospital with diagnosis of unipolar depression mean age 41.23 (SD=11.53) were assessed using psychometric measures of dissociation (DES) and traumatic symptoms (TSC-40), and using standard biochemical analytical methods basal serum prolactin levels were investigated. RESULTS: Data show that prolactin manifests significant relationship to dissociative symptoms (r=0.52, p=0.004). Significant correlation was not found between prolactin and traumatic symptoms measured by TSC-40 (r=0.31, p=0.07). CONCLUSIONS: The present data suggest that serum prolactin levels in unipolar depressive patients are related to dissociative symptoms that is likely caused by passive coping mechanisms leading to dissociation.
Assuntos
Adaptação Psicológica , Transtorno Depressivo/sangue , Transtornos Dissociativos/sangue , Prolactina/sangue , Estresse Psicológico/sangue , Adulto , Transtorno Depressivo/complicações , Transtornos Dissociativos/etiologia , Feminino , Humanos , Sistema Hipotálamo-Hipofisário/fisiopatologia , Masculino , Pessoa de Meia-Idade , Sistema Hipófise-Suprarrenal/fisiopatologia , Estatísticas não Paramétricas , Estresse Psicológico/complicaçõesRESUMO
In 1993-1998 and in 1999-2004 we have performed two surveys of pediatric bacterial meningitis in all 8 neurosurgery/pediatrics and infectious diseases departments in Slovakia. We have detected 101 and another 54 cases with attributable mortality of 15% and sequellae in 18%.
Assuntos
Infecção Hospitalar/epidemiologia , Infecções por Bactérias Gram-Negativas/epidemiologia , Meningites Bacterianas/epidemiologia , Infecções Estafilocócicas/epidemiologia , Criança , Pré-Escolar , Infecção Hospitalar/mortalidade , Infecção Hospitalar/terapia , Coleta de Dados , Infecções por Bactérias Gram-Negativas/terapia , Humanos , Lactente , Recém-Nascido , Meningites Bacterianas/microbiologia , Meningites Bacterianas/mortalidade , Meningites Bacterianas/terapia , Fatores de Risco , Eslováquia/epidemiologia , Infecções Estafilocócicas/terapia , Resultado do TratamentoRESUMO
Risk factors, therapy and outcome of 15 cases of nosocomial meningitis due to Pseudomonas aeruginosa is reviewed. No difference in risk factors was found, however mortality for Ps. aeruginosa was significantly higher (33.3 vs 15.1% p<0.04).
Assuntos
Antibacterianos/uso terapêutico , Infecção Hospitalar/microbiologia , Meningites Bacterianas/microbiologia , Infecções por Pseudomonas/mortalidade , Adolescente , Cefotaxima/uso terapêutico , Ceftazidima/uso terapêutico , Distribuição de Qui-Quadrado , Pré-Escolar , Cloranfenicol/uso terapêutico , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/mortalidade , Quimioterapia Combinada , Feminino , Gentamicinas/uso terapêutico , Humanos , Lactente , Recém-Nascido , Masculino , Meningites Bacterianas/tratamento farmacológico , Meningites Bacterianas/mortalidade , Meropeném , Infecções por Pseudomonas/tratamento farmacológico , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida , Tienamicinas/uso terapêuticoRESUMO
Meningitis after artificial implants in 60 children, mainly after foreign body infections (FBI) was caused more frequently by coagulase negative staphylococci and Ps. aeruginosa than other organisms and was significantly associated with perinatal trauma, hydrocephalus, haemorrhage or VLBW and had more neurologic sequels despite mortality was similar to other nosocomial meningitis.