RESUMO
In this study mean 4 p.m. cortisol levels were significantly higher in patients with major depression than in control subjects or in patients with bipolar depression or dysthymic-related disorders. Moreover, the distribution of values differed significantly among groups. Eighteen of 45 patients with major depression had cortisol levels of 10 micrograms/dl or more, compared with 2 of 20 bipolar depressed patients and 0 of 31 controls. Patients with very high cortisol levels (15 micrograms/dl or more) tended to fulfill criteria for major depression with mood-congruent psychosis. The distribution of values in the major depression group also suggested the existence of three major subgroups. The authors discuss the implications of these data.
Assuntos
Transtorno Depressivo/diagnóstico , Dexametasona , Hidrocortisona/sangue , Adolescente , Adulto , Idoso , Transtorno Bipolar/sangue , Transtorno Bipolar/diagnóstico , Transtorno Depressivo/sangue , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Twenty surgical staff members participated in a clinical trial to compare the microbiology and skin condition of hands when using a traditional surgical scrub (TSS) with a detergent-based antiseptic containing 4% chlorhexidine gluconate (CHG) and a short application without scrub of a waterless hand preparation (HP) containing 61% ethyl alcohol, 1% CHG, and emollients. The HP was associated with less skin damage (P = .002) and lower microbial counts postscrub at days five (P = .002) and 19 (P = .02). The HP protocol had shorter contact time (HP mean [M] = 80.7 seconds; TSS M = 144.9 seconds; P < .0001), and more subjects preferred the HP regimen (P = .001). The HP performed better than the TSS, was less costly, and should be evaluated in larger trials and considered for widespread implementation.
Assuntos
Anti-Infecciosos Locais , Antissepsia/métodos , Desinfecção das Mãos/métodos , Pele/efeitos dos fármacos , Adulto , Análise de Variância , Anti-Infecciosos Locais/economia , Anti-Infecciosos Locais/farmacologia , Clorexidina , Contagem de Colônia Microbiana , Análise Custo-Benefício , Eritema/induzido quimicamente , Etanol , Feminino , Dermatoses da Mão/induzido quimicamente , Humanos , Masculino , Pessoa de Meia-Idade , New York , Enfermagem de Centro Cirúrgico , Estudos Prospectivos , Fatores de TempoRESUMO
Plasma cortisol levels examined at 16.00 hours after dexamethasone in 31 controls and in 34 psychotic patients with various diagnoses, suggests that the ranges of such levels may help to discriminate among subtypes of psychotic patients. They were significantly higher in the unipolar depressed psychotic group than in control subjects or in psychotic patients with bipolar depression or schizophrenia. Moreover, the distribution of values differed between groups. Whereas 8 of 14 psychotic patients with unipolar depressive illness had post-dexamethasone cortisol values greater than or equal to 14 micrograms/dl, none of the remaining psychotic patients had similarly high values. Implications of these data are discussed.