Biological tests may help clarify the relationships of schizoaffective disorder to both major depressive disorder and schizophrenia. Thyrotropin-releasing hormone (TRH), 500 micrograms i.v., was administered to 14 schizodepressed, 23 schizophrenics, 41 unipolar major depressives (all by RDC) and 45 healthy controls, all males 20-67 years old with no significant differences in age, body height or weight. Results showed no differences in maximal delta TSH (dTSH max) amongst schizoaffective depressed, schizophrenia and healthy control groups (10.1 +/- 1.3, 9.2 +/- 1.1, 9.7 +/- 0.8 microU/ml, means +/- SEM respectively). Mean major depressives' dTSH max was lower than in each of the other three groups (6.2 +/- 0.4 microU/ml, P less than 0.01 for all). Utilizing a less than or equal to 5.0 microU/ml cut-off criterion for blunting, the schizodepressed had 36%, schizophrenics 44%, healthy controls 22% and major depressed 59% blunters (P less than 0.05 from other three groups). Schizodepressed patients appeared significantly different from major depressed but closer to schizophrenics (and healthy controls) on the TRH test.

Adult↗

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Pulmonary valve endocarditis: improved diagnosis with biplane transesophageal echocardiography.

Pulmonary valve endocarditis is an uncommon disease. Improved visualization of the pulmonary valve on the longitudinal views provided by biplane transesophageal echocardiography (TEE) improves the diagnostic utility of TEE in pulmonary valve endocarditis. We report three cases of isolated pulmonary valve endocarditis diagnosed with biplanar TEE.

Adult↗

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The dexamethasone suppression test in a group of research diagnostic criteria schizoaffective depressed men.

A dexamethasone suppression test (DST) was performed on 8 schizoaffective depressed men. Cross-sectional comparisons were made with three groups: schizophrenics (n = 10), unipolar major depressives (n = 23) and healthy controls (n = 43). All were drug-free and similar in age and body weight. Evaluations utilized the Research Diagnostic Criteria (RDC) for diagnosis, and the Hamilton Rating Scale for Depression for depressive symptom rating. DST nonsuppression, defined as a blood cortisol level of greater than or equal to 5.0 micrograms/dl at 16.00 h postdexamethasone, was observed in 43.5% of the major depressive disorder patients. This was different from the other three groups: 12.5% in schizoaffective depressed, 10.0% in schizophrenics and 9.3% in healthy controls (p less than 0.01, p less than 0.01, and p less than 0.001 respectively). Although schizoaffective depressed patients were significantly different from major depressive disorder patients in their DST responses, both groups were similar in their total HRSD scores and different from the schizophrenics (p less than 0.01 for each). These results, together with others previously reported by us on the thyrotropin-releasing hormone challenge in the same diagnostic groups, may be taken to mean that schizoaffective disorder, depressed type, is biologically distinct from major depressive disorder but not schizophrenia. On the other hand, until further corroborated, they should probably be considered a reflection of the heterogeneity of the schizoaffective syndrome and the nonspecificity of the DST.

Adult↗

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Assistive algorithms for exposure management--Part II: Mycobacterium tuberculosis, meningococcemia, and measles.

Explore the source record for details and available documents.

Algorithms↗

PubMedDate not supplied

Epidemiology of bone fractures occurring during hospitalization.

OBJECTIVE: To investigate the incidence and epidemiology of nosocomial bone fractures. DESIGN: Observational, case series. SETTING: Tertiary care center. PATIENTS: All patients sustaining a fracture during hospitalization during the 18-month study period from July 1989 through December 1990. RESULTS: Twenty nosocomial fractures were identified. Twelve of these resulted from falls (3.5 fractures from falls/100,000 patient days). Fracture rates were higher on the neurology service than on other services. Patients who fell and sustained a fracture were significantly older than patients who fell but did not sustain a fracture (74 versus 58 years, respectively, p < .05). Falls occurring on weekends and holidays were approximately three times more likely to result in fracture than falls occurring on other days (p = .06). CONCLUSIONS: Nosocomial fractures were infrequent events but were more common in the elderly and in persons with significant neuropsychological impairment. Persons who sustained fractures during hospitalization were similar to those who fell and fractured bones in a community setting.

Accidental Falls↗

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A network for children's health.

This article explains how a new network of children's health services is evolving in Edmonton within existing hospital facilities. When plans for a free-standing children's hospital for northern Alberta did not prove economically feasible, an alternative was needed that would allow child health needs to be met more effectively within the existing system. The Children's Health Centre of Northern Alberta is the result. Its multidisciplinary, multisite, program-based nature has guided planning and operations from the beginning and has led to its unique strategic organization structure.

Alberta↗