Case report of congenital neutropenia type 4 with glucose-6-phosphatase catalytic subunit 3 (G6PC3) deficiency.

Congenital neutropenia syndromes encompass a group of genetic disorders characterized by persistent neutropenia and recurrent infections inherited in an autosomal recessive, dominant, or X-linked manner. These syndromes arise from mutations in various genes, and one of the significant genes involved is glucose-6-phosphatase catalytic subunit 3 (G6PC3), giving rise to a condition known as Dursun syndrome. As per existing knowledge, a total of 92 cases of Dursun syndrome have been reported globally, including eight cases from Saudi Arabia. Our study identified two additional cases exhibiting neutropenia since the early postnatal period and recurrent admissions due to infections. Additionally, these patients presented with oral ulcers, chronic diarrhea, and anomalies affecting the cardiac and genitourinary systems. The rising incidence of congenital neutropenia on a global scale necessitates heightened vigilance among clinicians to ensure thorough follow-up of patients with neutropenia. This proactive approach can lead to early detection and appropriate management of associated complications, ultimately improving patient outcomes.

Natural Occurrence of Maize Gibberella Ear Rot and Contamination of Grain with Mycotoxins in Association with Weather Variables.

Gibberella ear rot (GER) severity (percent area of the ear diseased) and associated grain contamination with mycotoxins were quantified in plots of 15 to 16 maize hybrids planted at 10 Ohio locations from 2015 to 2018. Deoxynivalenol (DON) was quantified in grain samples in all 4 years, whereas nivalenol, 3-acetyldeoxynivalenol, and 15-acetyldeoxynivalenol (15ADON) were quantified only in the last 2 years. Only DON and 15ADON were detected. The highest levels of GER and DON contamination were observed for 2018, followed by 2016 and 2017. No GER symptoms or DON were detected in 2015. Approximately 41% of the samples from asymptomatic ears had detectable levels of DON, and 7% of these samples from 2016 had DON > 5 ppm. Associations between DON contamination and 43 variables representing summaries of temperature (T), relative humidity (RH), rainfall (R), surface wetness, and T-RH combinations for different window lengths and positions relative to R1 growth stage were quantified with Spearman correlation coefficients (r). Fifteen-day window lengths tended to show the highest correlations. Most of the variables based on T, R, RH, and T-RH were significantly correlated with DON for the 15-day window, as well as other windows. For moisture-related variables, there generally was a negative correlation before R1, changing to a positive correlation after R1. Results showed that GER and DON can be frequently found in Ohio maize fields, with the risk of DON being associated with multiple weather variables, particularly those representing combinations of T between 15 and 30°C and RH > 80 summarized during the 3 weeks after R1.

Tar Spot: An Understudied Disease Threatening Corn Production in the Americas.

Tar spot of corn has been a major foliar disease in several Latin American countries since 1904. In 2015, tar spot was first documented in the United States and has led to significant yield losses of approximately 4.5 million t. Tar spot is caused by an obligate pathogen, Phyllachora maydis, and thus requires a living host to grow and reproduce. Due to its obligate nature, biological and epidemiological studies are limited and impact of disease in corn production has been understudied. Here we present the current literature and gaps in knowledge of tar spot of corn in the Americas, its etiology, distribution, impact and known management strategies as a resource for understanding the pathosystem. This will in tern guide current and future research and aid in the development of effective management strategies for this disease.

Stability of Hybrid Maize Reaction to Gibberella Ear Rot and Deoxynivalenol Contamination of Grain.

Trials were conducted to quantify the stability (or lack of G × E interaction) of 15 maize hybrids to Gibberella ear rot (GER; caused by Fusarium graminearum) and deoxynivalenol (DON) contamination of grain across 30 Ohio environments (3 years × 10 locations). In each environment, one plot of each hybrid was planted and 10 ears per plot were inoculated via the silk channel. GER severity (proportion of ear area diseased) and DON contamination of grain (ppm) were quantified. Multiple rank-based methods, including Kendall's concordance coefficient (W) and Piepho's U, were used to quantify hybrid stability. The results found insufficient evidence to suggest crossover G × E interaction of ranks, with W greater than zero for GER (W = 0.28) and DON (W = 0.26), and U not statistically significant for either variable (P > 0.20). Linear mixed models (LMMs) were also used to quantify hybrid stability, accounting for crossover or noncrossover G × E interaction of transformed observed data. Based on information criteria and likelihood ratio tests for GER and DON response variables, the models with more complex variance-covariance structures-heterogeneous compound symmetry and factor-analytic-provided a better fit than the model with the simpler compound symmetry structure, indicating that one or more hybrids differed in stability. Overall, hybrids were stable based on rank-based methods, which indicated a lack of crossover G × E interaction, but the LMMs identified a few hybrids that were sensitive to environment. Resistant hybrids were generally more stable than susceptible hybrids.

Is Lipoprotein (a) a Risk Factor for Coronary Artery Ectasia?

BACKGROUND: The pathophysiology of coronary artery ectasia (CAE) is under investigated and not well understood. Atherosclerosis is considered as the main etiologic factor for CAE in adults where more than 50% of CAE patients have atherosclerosis. Recently, lipoprotein (a) (Lp(a)) has emerged as a powerful risk factor for atherosclerosis and coronary artery disease (CAD). Serum levels of Lp(a) in patients with CAE have not been investigated. We assumed that Lp(a) may play a role in the pathogenesis of CAE. Principally, our study aims to identify whether Lp(a) is an independent risk factor for CAE. METHODS: Our study is a prospective pilot study. Study population was collected prospectively from pool of patients referred for elective cardiac catheterization at Jordan University Hospital (JUH) in the period extending from February 17, 2018 to June 31, 2018. Patients were referred for elective coronary angiography after being interviewed and physically examined by a cardiologist (HA). Patients with known history of CAD or who are already on anti-lipidemic drugs either documented in the medical records or by interviewing patients for history of revascularization were excluded from the study. RESULTS: Regarding the primary outcome, there was no significant difference in Lp(a) concentrations between normal and ectasia groups in the general sample (median: 17.5mg/dL vs. 20.4 mg/dL, P value = 0.38). CONCLUSIONS: Our study concludes that there is no detected relationship between elevated Lp(a) levels and developing CAE. CAE was more common in patients with low high-density lipoprotein (HDL) level (compared with patients with normal coronaries), higher total cholesterol level (compared with patients with non-obstructive stenosis) and higher hemoglobin A1c (HbA1c).

Expedited Removal of a Radial Hemostatic Compression Device Following Cardiac Catheterization Is Safe and Associated With Reduced Time to Discharge.

BACKGROUND: Radial access for cardiac catheterization has become increasingly adopted, owing much of its popularity to decreased bleeding complications compared with the femoral approach. Hemostatic compression devices (HCDs) for radial catheterization play a key role in this advantage, but the optimal duration of compression is unknown. A shorter duration of compression is encouraged by guidelines, but removing an HCD too quickly could result in serious bleeding. We aimed to evaluate the safety and effectiveness of expedited removal of a radial HCD after cardiac catheterization. METHODS: We conducted a prospective study of patients undergoing radial cardiac catheterization and/or percutaneous coronary intervention at a tertiary care academic medical center. Patients underwent HCD application using a TR Band® (Terumo Interventional Systems) which was removed after a prespecified amount of time in each of three sequential temporal cohorts: 2-h, 1-h, or 0.5-h. Each patient was monitored for development of bleeding or hematoma and for serious complications. RESULTS: A total of 354 patients participated in our study, with similar numbers in each group. There was a greater rate of minor bleeding in the 0.5-h (12%) and 1-h (19%) groups compared with the 2-h group (8%), but there were no serious complications (need for surgical consultation, transfusion, or unplanned admission) in any group. The average time to discharge was shorter in the 0.5-h and 1-h groups compared with the 2-h group. CONCLUSIONS: Deflating the radial HCD at 0.5 h is safe with no increase in the observed rate of major complications and is associated with reduced time to discharge after coronary angiography or percutaneous coronary intervention using the radial arterial approach.

Hinge Region in DNA Packaging Terminase pUL15 of Herpes Simplex Virus: A Potential Allosteric Target for Antiviral Drugs.

Approximately 80% of adults are infected with a member of the herpesviridae family. Herpesviruses establish life-long latent infections within neurons, which may reactivate into lytic infections due to stress or immune suppression. There are nine human herpesviruses (HHV) posing health concerns from benign conditions to life threatening encephalitis, including cancers associated with viral infections. The current treatment options for most HHV conditions mainly include several nucleoside and nucleotide analogs targeting viral DNA polymerase. Although these drugs help manage infections, their common mechanism of action may lead to the development of drug resistance, which is particularly devastating in immunocompromised patients. Therefore, new classes of drugs directed against novel targets in HHVs are necessary to alleviate this issue. We analyzed the conservation rates of all proteins in herpes simplex virus 1 (HHV-1), a representative of the HHV family and one of the most common viruses infecting the human population. Furthermore, we generated a full-length structure model of the most conserved HHV-1 protein, the DNA packaging terminase pUL15. A series of computational analyses were performed on the model to identify ATP and DNA binding sites and characterize the dynamics of the protein. Our study indicates that proteins involved in HHV-1 DNA packaging and cleavage are amongst the most conserved gene products of HHVs. Since the packaging protein pUL15 is the most conserved among all HHV-1 gene products, the virus will have a lower chance of developing resistance to small molecules targeting pUL15. A subsequent analysis of the structure of pUL15 revealed distinct ATP and DNA binding domains and the elastic network model identifies a functionally important hinge region between the two domains of pUL15. The atomic information on the active and allosteric sites in the ATP- and DNA-bound model of pUL15 presented in this study can inform the structure-based drug discovery of a new class of drugs to treat a wide range of HHVs.

Meta-Analysis of the Effects of QoI and DMI Fungicide Combinations on Fusarium Head Blight and Deoxynivalenol in Wheat.

Field trials were conducted in 17 U.S. states to evaluate the effects of quinone outside inhibitor (QoI) and demethylation inhibitor (DMI) fungicide programs on Fusarium head blight index (IND) and deoxynivalenol (DON) toxin in wheat. Four DMI-only treatments applied at Feekes 10.5.1, five QoI-only treatments applied between Feekes 9 or Feekes 10.5, three QoI+DMI mixtures applied at Feekes 10.5, and three treatments consisting of a QoI at Feekes 9 followed by a DMI at Feekes 10.5.1 were evaluated. Network meta-analytical models were fitted to log-transformed mean IND and DON data and estimated contrasts of log means were used to obtain estimates of mean percent controls relative to the nontreated check as measures of efficacy. Results from the meta-analyses were also used to assess the risk of DON increase in future trials. DMI at Feekes 10.5.1 were the most effective programs against IND and DON and the least likely to increase DON in future trials. QoI-only programs increased mean DON over the nontreated checks and were the most likely to do so in future trials, particularly when applied at Feekes 10.5. The effects of QoI+DMI combinations depended on the active ingredients and whether the two were applied as a mixture at heading or sequentially. Following a Feekes 9 QoI application with a Feekes 10.5.1 application of a DMI reduced the negative effect of the QoI on DON but was not sufficient to achieve the efficacy of the Feekes 10.5.1 DMI-only treatments. Our results suggest that one must be prudent when using QoI treatments under moderate to high risk of FHB, particularly where the QoI is used without an effective DMI applied in combination or in sequence.

Comunicación científica en Enfermería: importancia de las redes para la visibilidad y difusión del conocimiento / Scientific communication in Nursing: Importance of netwoks in the visibility and diffusion of knowledge / Comunicação científica em Enfermagem: importância das redes para a visibilidade e difusão do conheciment

La Biblioteca Virtual en Salud Enfermería (BVS Enfermería) se inserta en este escenario y tiene como misión la construcción del patrimonio informacional en Enfermería, con fácil acceso, sin limitaciones por el tiempo, espacio y fronteras, misma que impulsa los procesos de generación de conocimiento y contribuye para la formación y la práctica de la enfermería, para actuar con el compromiso ético-social en el área de educación, investigación y atención a la salud, así como para elevar la calidad de vida de la población en Brasil y en la región.

Estudio de los trastornos de personalidad y de la utilización de servicios en la población clínica atendida en la red de salud mental de un sector sanitario / Study of personality disorders and the use of services in the clinical population attended in the mental health network of a community area

Introducción. Los trastornos de personalidad (TP) constituyen un problema clínico y asistencial creciente. En España los estudios de los TP y de la utilización de servicios de salud mental (SM) en población clínica son escasos. Sin embargo, estos datos son necesarios para planificar la asistencia de los TP. Método. Se han estudiado todos los pacientes atendidos durante 1 año en el conjunto de los servicios psiquiátricos (n=2.701) y por separado en los servicios hospitalarios (n=193) y ambulatorios (n=2.649). Se han incluido todos los pacientes diagnosticados de TP mediante entrevista clínica (criterios DSM-IV-TR). Se han investigado variables demográficas, clínicas y uso de servicios de SM. Resultados. La proporción de TP en el conjunto de la población atendida fue del 11% (intervalo de confianza [IC] del 95%: 9,8-12,2) y en los servicios hospitalarios y ambulatorios del 17,6% (IC 95%: 12,9-23,6) y 10,3% (IC 95%: 9,2-11,5), respectivamente. Los TP más representados fueron el límite (25,7%), el histriónico (24%) y el obsesivo-compulsivo (6,4%), y el 19,6% fueron TP no especificado. Los TP hicieron una utilización importante de los recursos de salud mental (hospitalarios, ambulatorios y urgencias). Los trastornos del estado de ánimo, de ansiedad y por consumo de sustancias fueron los más comórbidos en el eje I. Conclusiones. El estudio de los TP atendidos en los servicios de SM de un distrito sanitario mediante evaluación clínica es un instrumento económico, sencillo y reproducible para planificar la asistencia de los TP (AU)

Introduction. Personality disorders (PD) are a growing clinical and health care problem. In Spain, the studies of PD and utilization of the Mental Health Services(MHS) in the clinical population are scant. However, these data are necessary in the planning of MHS for PD. Method. We studied all the patients attended throughout one year in all the psychiatric departments (n=2701), and separately in the inpatient (n=193) and outpatient (n=2649) psychiatric services. All the patients diagnosed with PD by clinical interview (DSM-IV-TR criteria) were included. Demographic and clinical variables as well as use of MHS were studied. Results. The proportion of PD in the population attended was 11% (95% CI: 9.8%-12.2%) and in the inpatient and outpatient psychiatric services 17.6% (95% CI: 12.9%-23.6%) and 10.3% (95% CI: 9.2%-11.5%), respectively. The most representative PD were borderline (25.7%), histrionic (24%) and obsessive-compulsive (6.4%) and 19.6% were not otherwise specified PD. PD accounted for an extensive use of mental health resources (inpatient, outpatient and emergency units). The most comorbid conditions in axis I were affective, anxiety and substance-related disorders. Conclusions. The study of PD attended in the MHS in a community area by means of clinical evaluation is an economical instrument, which is easily applied and replicated in planning of MHS for PD (AU)

Study of personality disorders and the use of services in the clinical population attended in the mental health network of a community area.

INTRODUCTION: Personality disorders (PD) are a growing clinical and health care problem. In Spain, the studies of PD and utilization of the Mental Health Services (MHS) in the clinical population are scant. However, these data are necessary in the planning of MHS for PD. METHOD: We studied all the patients attended throughout one year in all the psychiatric departments (n=2701), and separately in the inpatient (n=193) and outpatient (n=2649) psychiatric services. All the patients diagnosed with PD by clinical interview (DSM-IV-TR criteria) were included. Demographic and clinical variables as well as use of MHS were studied. RESULTS: The proportion of PD in the population attended was 11% (95% CI: 9.8%-12.2%) and in the inpatient and outpatient psychiatric services 17.6% (95% CI: 12.9%- 23.6%) and 10.3% (95% CI: 9.2%-11.5%), respectively. The most representative PD were borderline (25.7%), histrionic (24%) and obsessive-compulsive (6.4%) and 19.6% were not otherwise specified PD. PD accounted for an extensive use of mental health resources (inpatient, outpatient and emergency units). The most comorbid conditions in axis I were affective, anxiety and substance-related disorders. CONCLUSIONS: The study of PD attended in the MHS in a community area by means of clinical evaluation is an economical instrument, which is easily applied and replicated in planning of MHS for PD.

Health impact of water and sanitation infrastructure reconstruction programmes in eight Central American communities affected by Hurricane Mitch.

In response to Hurricane Mitch, which struck Central America in October-November 1998, the American Red Cross (ARC) and the Centers for Disease Control and Prevention (CDC) collaborated on a 3-year evaluation of the public health impact of ARC's water, sanitation and hygiene education activities in eight study areas in Honduras, Nicaragua, El Salvador and Guatemala. The evaluation compared: 1) access to and use of water and sanitation facilities, 2) the use of hygienic behaviours, and 3) diarrhoeal prevalence in children younger than 3 years of age before (February 2000) and after (February 2002) the interventions had been implemented. The evaluation included household and key informant interviews designed to measure these three components. Water quality of community water sources and household water was evaluated by measuring levels of indicator bacteria. During the final survey, an infrastructure evaluation provided a review of the design, construction, and current operation and maintenance of the water systems and latrines. The integrated water and sanitation infrastructure interventions and hygiene education programmes implemented following Hurricane Mitch effectively decreased diarrhoea prevalence in the target communities.

Association between intestinal parasitic infections and type of sanitation system in rural El Salvador.

OBJECTIVE: To identify demographic, behavioural and environmental determinants of intestinal parasitic infection, evaluate the impact of a variety of dry sanitation systems on intestinal parasitic infection, and evaluate the safety of using stored biosolids in agriculture in order to guide future sanitation interventions in rural areas of El Salvador. METHODS: Interviews were conducted with 109 households in eight communities where double-vaulted and solar urine-diverting desiccating latrines, pit latrines or no latrines were used. Faecal samples from 499 individuals were tested for enteric helminths and protozoa. RESULTS: Users of solar desiccating latrines had the lowest prevalence of enteric parasite infection. Double-vault, urine-diverting desiccating latrines effectively reduced the transmission of some pathogens, but may not achieve the conditions sufficient for the complete destruction of the more environmentally persistent pathogens, Ascaris lumbricoides and Trichuris trichiura. Contact with inadequately treated latrine biosolids was associated with an increased risk of Ascaris infection. CONCLUSIONS: Solar latrines were associated with the overall lowest prevalence of enteric parasitic infections. Members of households where latrine biosolids were used in agriculture had a higher prevalence of infection than those where biosolids were buried. We therefore recommend the promotion of solar latrines in rural areas of El Salvador over other dry sanitation systems, and recommend that stored biosolids not be used in agriculture.

[Variability in psychiatric medical practice evaluated by studying short-term psychiatric rehospitalization]. / Variabilidad en la práctica medicopsiquiátrica evaluada mediante el estudio de los reingresos psiquiátricos a corto plazo.

INTRODUCTION: Variability in medical practice can detect deficiencies in medical care quality. This study was designed to determine variations in psychiatric practice by studying short-term rehospitalization (SRH) that could result in differences in quality of psychiatric care. METHODS: Data on 894 consecutive admissions to an inpatient unit from March to December 2001 were collected. Readmissions over the next 90 days or less (SRH) were analyzed. The database was reviewed in order to extract information about several variables: age, gender, period from the first admission, number of previous admissions, interval between initial discharge and readmission, psychiatric diagnosis, aftercare provided by the mental health centers (MHC) and psychiatrist-associated variables. Differences between SRH and the other admissions were examined. RESULTS: There were significant variations in the aftercare provided by the MHC (p = 0.028). There were also variations in the psychiatrist responsible for the inpatient unit (p = 0.03), in the reference psychiatrist in a MHC (p = 0.007), but not in the emergency unit. CONCLUSIONS: This short-term rehospitalization study showed variations in quality of aftercare and in psychiatrist associated variables. Both these findings warrant further investigation that pays specific attention to staff attitudes, system barriers and facilitators of psychiatric care.

Variabilidad en la práctica medicopsiquiátrica evaluada mediante el estudio de los reingresos psiquiátricos a corto plazo / Variability in psychiatric medical practice evaluated by studying short-term psychiatric rehospitalization

Introducción. La variabilidad en la práctica médica puede detectar deficiencias en la calidad de la asistencia. Este estudio se diseñó para evaluar variaciones en la práctica psiquiátrica mediante el estudio de los reingresos a corto plazo (RAC) que pudieran determinar diferencias en la calidad de la asistencia psiquiátrica. Métodos. Se recogieron datos de 894 ingresos sucesivos en la unidad de agudos de marzo a diciembre de 2001. Se analizaron los reingresos ocurridos en un plazo inferior o igual a 90 días (RAC). Se revisó el registro de casos para obtener información sobre diversas variables: edad, sexo, período transcurrido desde el primer ingreso, número de ingresos previos, intervalo desde el alta al reingreso, diagnóstico psiquiátrico, seguimiento en los centros de salud mental (CSM) y variables relacionadas con los psiquiatras. Se examinaron las diferencias entre los RAC y el resto de los ingresos. Resultados. Se encontraron variaciones significativas en el seguimiento de los CSM después del alta (p=0,028).También se encontraron diferencias en el psiquiatra referente de la unidad de agudos (p=0,03) y en el psiquiatra de referencia de un CSM (p=0,007), pero no en urgencias. Conclusiones. El estudio de los reingresos psiquiátricos mostró variaciones en la calidad de la continuidad de cuidados y en factores relacionados con los psiquiatras. Son necesarios nuevos estudios que presten especial atención a las actitudes del equipo médico y a los factores que obstaculizan o facilitan la accesibilidad a la asistencia psiquiátrica (AU)

[Reflections on health planning and on health reform in Brazil]. / Reflexões sobre o planejamento em saúde e o processo da reforma sanitária Brasileira.

The authors considered carefully the brazilian social policies at the regimes of populism and militarism as well as at the democratic transition following the presupposition that the social planning in Latin America emerged as an instrument for social policies formulation. The authors also considered some tendencies of the Latin America Planning, emphasizing the Strategic Focus of the Health Program formulated by the Public Health School of Medellin; the Strategic Thought elaborated by Mario Testa; and the Strategic Situational Planning developed by Carlos Matus.

[ICD-9 versus DSM-III in the psychoses: anamnestic and catamnestic implications]. / ICD-9 versus DSM-III en las psicosis: implicaciones anamnésicas y catamnésicas.

We pretend with our study to compare the DSM-III diagnostic criteria with ICD-9 diagnostic criteria for psychotic episodes and to look for the diagnostic stability for both classifications. We studied 79 first psychotic episodes following ICD-9 and retrospectively we applied the DSM-III diagnostic criteria to the same patients. The mean follow up time was 46.6 +/- 6.7 months. In the ICD-9 the schizophrenic psychoses represented the main diagnostic group, not only the day they were discharged from the hospital 31.6% but also in the follow up 39.2%. On the other hand in the DSM-III, in the discharge day the schizophreniform disorder was the more frequent diagnostic 24%, while in the follow up the schizophrenic disorder came to the first position 32.9%. In the ICD-9 there was a 15.1% of diagnostic changes and in the DSM-III nearly the double 30.3%. In both classifications the unspecified and the atypical suffered a great diagnostic mobility; in both nosologies the schizophrenia was the most unchangeable diagnosis, no patient discharged with this diagnosis changed to another in the follow up. ICD-9 could be said that has a great sensitivity and an acceptable specificity for this entities, and DSM-III would have a moderate sensitivity but a very diagnostic specificity for these disorders.

[Impulsive suicidal behavior and serotonin]. / Conductas autolíticas impulsivas y serotonina.

In a group of 17 suicidal patients which either had previous suicidal attempts or presented other impulsive behaviors, response to Prl, cortisol and GH to the serotonergic dl-fenfluramine agonist were studied. Suicidal patients suffering from depressive disorders were previously excluded, as well as those with psychotic disorders. The results were compared with those of a control group (n = 17) matched for sex (76.5% females and 23.5% males in both groups) and age (25.1 years old, sd: 10 for the suicidal group and 25.3 years old, sd: 8.7 for controls; t = -0.07, df = 32, p. = .47). The most significant finding were the following: 1) Response to Prl in the suicidal group was significantly lower to that of controls, as much as in absolute terms (Prl = max-baseline): 7.4 ng/ml. (sd: 10.3) vs 15.5 ng/ml (sd: 14.1) (t = -1.9, df = 32, p less than .03) as percentage wise (Prl % = max-baseline): 106.6% (sd: 108.8) vs 214% (sd: 167.6) (t = -2.22, df = 32, p. less than .02). 2) The response of cortisol in the suicidal group was significantly lower to that of controls as much as in absolute terms (Cor = max-baseline): 1.7 ng/ml (sd: 2.8) vs 5 ng/ml (sd 5.4) (t = -2.25, df = 32, p less than .02) as percentage wise (Cor % max-baseline: 11.6% (sd: 19.8) vs 47.1% (sd: 56.7) (t = -2.44, df = 32, p less than 01). Baseline concentration of cortisol in suicidal patients was significantly higher to that of the controls (17.8 ng/ml (sd: 5.6) vs 13.3 ng/ml (sd: 5.3) (t = 2.41, df = 32, p less than .01). These results are in concordance with previous ones which suggest that a serotonergic dysfunction is present in patients which carry out impulsive suicidal attempts. Besides those patients have also higher indexes of stress and of an inefficiency of coping with acute stressful situations.