RESUMEN
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.
Asunto(s)
Trastorno Depresivo/etiología , Trastornos Disociativos/etiología , Hidrocortisona/sangre , Trastornos Somatomorfos/etiología , Adulto , Trastorno Depresivo/sangre , Trastorno Depresivo/fisiopatología , Trastornos Disociativos/sangre , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/fisiopatología , Femenino , Humanos , Sistema Hipotálamo-Hipofisario/fisiopatología , Masculino , Persona de Mediana Edad , Sistema Hipófiso-Suprarrenal/fisiopatología , Trastornos Somatomorfos/sangre , Trastornos Somatomorfos/diagnóstico , Trastornos Somatomorfos/fisiopatología , Estrés Fisiológico/complicaciones , Estrés Fisiológico/fisiopatología , Encuestas y CuestionariosRESUMEN
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%.
Asunto(s)
Infección Hospitalaria/epidemiología , Infecciones por Bacterias Gramnegativas/epidemiología , Meningitis Bacterianas/epidemiología , Infecciones Estafilocócicas/epidemiología , Niño , Preescolar , Infección Hospitalaria/mortalidad , Infección Hospitalaria/terapia , Recolección de Datos , Infecciones por Bacterias Gramnegativas/terapia , Humanos , Lactante , Recién Nacido , Meningitis Bacterianas/microbiología , Meningitis Bacterianas/mortalidad , Meningitis Bacterianas/terapia , Factores de Riesgo , Eslovaquia/epidemiología , Infecciones Estafilocócicas/terapia , Resultado del TratamientoRESUMEN
Twenty five (25) cases of nosocomial postsurgical meningitis due to Acinetobacter baumannii meningitis were compared to other 146 cases of meningitis after surgery caused by other pathogens. Prior neurosurgical ventriculo-peritoneal shunt insertion and CNS abnormality as well as very low birth weight were significant risk factors for acquisition of Acinetobacter baumannii meningitis. Mortality - 40% among children with nosocomial meningitis was unacceptably high and significantly higher than among meningitis caused by microorganisms other than Acinetobacter baumannii.
Asunto(s)
Infecciones por Acinetobacter/mortalidad , Acinetobacter baumannii/aislamiento & purificación , Infección Hospitalaria/microbiología , Meningitis Bacterianas/microbiología , Infección de la Herida Quirúrgica/microbiología , Infecciones por Acinetobacter/tratamiento farmacológico , Acinetobacter baumannii/inmunología , Antibacterianos/uso terapéutico , Sistema Nervioso Central/anomalías , Sistema Nervioso Central/patología , Niño , Preescolar , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/mortalidad , Humanos , Recién Nacido , Recién Nacido de muy Bajo Peso/inmunología , Meningitis Bacterianas/tratamiento farmacológico , Meningitis Bacterianas/mortalidad , Factores de Riesgo , Infección de la Herida Quirúrgica/tratamiento farmacológico , Infección de la Herida Quirúrgica/mortalidad , Derivación Ventriculoperitoneal/efectos adversosRESUMEN
Within last 25 years we have observed 20 cases of fungal meningitis and/or cerebral abscesses. Commonest etiologic agens was Candida spp. (C. albicans 9 of 20). Molds were responsible for 4 cases of brain abscess. Mortality was 50% what seems to be very high. Extremely high mortality is caused by delayed onset of therapy, severe underlying disease and multiresistant fungal organisms such as Mucorales, Fusarium solani and Aureobasidium.