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The Charles Bonnet syndrome consists of visual hallucinations usually described in patients with bilateral eye pathology. The hallucinations are vivid and usually of a pleasant nature. Patients ordinarily maintain insight into the unreal nature of the visions. The syndrome appears to have an ophthalmologic and neurologic disease etiology. Treatment involves correction of the decreased visual acuity.
Consistent with new trends in medical training the First Medical Faculty, Charles University Prague included in its curriculum of general medicine a mandatory programme devoted to communication skills. The main objective is to teach students to establish valuable contact with the patient and elucidate the problem presented by the patient. Another objective is to show the therapeutic potential of a well conducted interview. All hitherto trained students who attended the classes on communication skills acquired within the repertoire of skills used in discussions with patients the skill of a non-directive interview focused on elucidation of the problem on which the patient saw his doctor. It proved possible to demonstrate that integration of theoretical knowledge into practical procedures used in diagnosis, treatment and supportive psychotherapy of somatic and psychosomatic diseases and reactive conditions is a relatively demanding and long-term process which can be mastered during training which uses acting (simulated doctor, simulated patient) and feedback by videorecording.
The research project CADISO (Cardiovascular Diseases and Stability of the Organism--Phytotherapeutical Possibilities) is an alliance board associating approximately 20 professional institutions, its centre and coordinating laboratory being the Department of Pharmaceutical Botany and Ecology, Faculty of Pharmacy, Charles University, Hradec Králové. It aims at the prevention (additives in food industry) and therapy of diseases of the circulatory apparatus using phytotherapeutic agents and substances isolated from higher plants and fungi. The project is divided into three systems of investigation: ADAPRETE, i.e. the substances increasing the nonspecific resistance of the organism (adaptogenes of plant origin, immunostimulants), DIACORD, dealing with the substances acting on the cardiovascular system in a mediated way, i.e. treating the diseases the eventual action of which alters the heart and vessels (antihypercholesterolemics, antihyperlipidemics, antidiabetics, anti-oxidants and quenchers of free radicals, hepatoprotectives, anti-aggregating agents), and CORCORAN studying the taxons and substances isolated from them which act directly on the circulatory system (cardiotonic, anti-arrhythmic and vasodilating agents). To achieve a real purpose of the project, the linking-up of the phytochemical, pharmacological-toxicological, pharmaceutical-technological fields, production of raw materials and legislation is ensured.
Charles Rob and the vascular surgeons at Strong Memorial Hospital have made significant contributions to the development of venology. Their impact on the surgical treatment of venous thromboembolism is emphasized. The technique for thrombectomy with temporary arteriovenous fistula is described. In a prospective randomized study from Sweden iliac vein patency was found in 76% of the operated group and 35% of the conservatively treated group after 6 months, and 77% versus 30%, respectively, after 5 years. A patent femoropopliteal vein with competent valves was found in 52% of the surgically treated patients compared with 26% of those treated conservatively after 6 months, and 36% versus 11%, respectively, after 5 years. Thrombectomy with temporary arteriovenous fistula is the author's method of choice to treat patients with acute iliofemoral venous thrombosis if the history of swelling of the thigh indicating iliac vein obstruction is less than 7 days' duration and the activity expectancy of the patient is more than 10 years.
Systolic heart murmurs caused by chronic mitral valve disease are particularly common in Cavalier King Charles Spaniels (CKCS) in Great Britain. To determine if American-bred CKCS have a similar high prevalence of chronic valve disease, results of stethoscopic examinations on 394 CKCS were analyzed. Left apical systolic heart murmurs were found in 22% of the dogs. The prevalence ranged from 9% in dogs < 1 year old to 100% in those > or = 10 years old; prevalence was 56% in dogs > or = 4 years old. Differences were not found in prevalence between sexes and among various coat colors. Reexamination of 79 dogs after 1 year revealed an incidence of new murmurs of 21%. Comparison of ages at initial examination in 128 referral hospital cases with chronic mitral valve disease revealed a mean age of 6.25 years in 17 CKCS, in contrast to a mean age of 12 years in other breeds. Echocardiographic and necropsy findings indicated that ruptured chordae tendineae and mitral valve prolapse are major components in the chronic valve disease process in CKCS.
The purpose of the present work was to investigate the susceptibility of S. pyogenes to antimicrobial agents. The strains have been taken from the bacteriological Service of Charles Nicolle's hospital at Tunis, and that during the period from January 1988- to December 1990. The antibiogram results as well as the minimal inhibitrice concentration determined by the agar diffusion technique, reveal that S. pyogenes continues to be very susceptible to the beta-lactamins (M.I.C. of penicillin G is "0.15 for 50% of strains tested. Resistance are noted for chloramphenicol; tetracycline and novobiocine (13%, 93%, 80%) not considered as good antibiotics anti-streptococcies. The macrolids are effective against S. pyogenes (100% of susceptibility) that's they are considered as the best alternating antimicrobiologents to the beta-lactamins (M.I.C. of erythromycin is 0.015.
Philippe-Charles Schmerling, often considered as the founder of paleontology, was undoubtedly a prominent personality in the province of Liège. The author evoques the beginning of paleontologic and prehistoric research in Wallonia through the biography and the analysis of Schmerling's works. Some of his contributions were completely disregarded, especially in the field of paleopathology where he can really be considered as a founder. Posterity will mainly retain his assertion about the contemporaneity of mankind with extinct animal species.
Clinical studies have shown that Cavalier King Charles Spaniels (CKCS) have a high prevalence of mitral valvular insufficiency (MVI). Echocardiography has the potential to disclose early valvular changes, and the present prospective study was designed to investigate the occurrence of mitral valve prolapse (MVP) in young CKCS without heart murmurs, and to correlate the degree of MVP with the clinical status of the dogs by including CKCS with MVI as well. The study was based on blinded evaluations of echocardiographic recordings of mitral valves from 34 CKCS and 30 control dogs. Thirteen (87%) of 15 three-year-old CKCS without heart murmurs had MVP (2 total and 11 partial), as compared with 1 (7%) of 15 three-year-old normal Beagle dogs (P < 0.0001), and none of 15 three-year-old normal Medium Size Poodles (P < 0.0001). Of 19 CKCS with MVI, MVP was found in 84% of the entire group and in 100% of dogs with pulmonary congestion or edema. The occurrence of total MVP tended to be higher in the group with MVI (47%, 9/19), when compared with the younger CKCS without heart murmurs (13%, 2/15, P = 0.06). MVP was positively associated with excessive heart rate variability (P = 0.003). The radius of curvature of the anterior mitral valve leaflet in systole was significantly reduced in dogs with MVP when compared with those without (P < 0.0001). In conclusion, this study shows that CKCS at an early age have a high occurrence of MVP. This suggests: 1) A genetic predisposition of CKCS to MVP; and 2) That MVP is a pathogenetic factor in the development of mitral valvular insufficiency. Follow up studies may add further support to these proposals, and clarify whether echocardiography may be an aid in selecting CKCS for future breeding.
This article presents rediscovered osteopathic manipulative techniques described by Charles Hazzard in 1905 and ascribed by him to Andrew Taylor Still, the founder of osteopathic medicine. Still refrained from writing about his manipulative techniques in any significant detail, apparently intentionally. The techniques published by Hazzard have both internal consistency and similarity to those less well described by Still, suggesting that the attribution is accurate. The techniques are analyzed and presented as a variant of a direct articulatory technique with axial compression. In honour of their originator, they are being termed the Still techniques.
Charles Darwin (1809-1882) suffered from a chronic illness that, throughout much of his adult life, impaired his functioning and severely limited his activities. The writings of this famous scientist as well as biographical materials indicate that he probably suffered from an anxiety disorder. His symptoms, when considered individually, suggest a variety of conditions, but taken together they point toward panic disorder with agoraphobia. This diagnosis brings coherence to Darwin's activities and explains his secluded lifestyle, including difficulty in speaking before groups and meeting with colleagues.
The Faculty of Medicine in Hradec Králové has some unique features that make it stand out from other similar faculties in this country: The school developed from regional traditions at the appropriate historic times, when due to closure of the universities during World War II. there was a serious death of physicians. The school was supported by the local governing organs, as well as by the generous financial assistance of citizens who identified with the idea of creating a university in Hradec Králové. An entirely new organizational form was utilized in the creation of the medical school: it was founded as a branch of the Faculty of Medicine at the Charles University in Prague. It was the first time that this form of organization in the history of our universities was used to prevent any legal delays during the postwar times when parliamentary legislation was not yet functional. It constitutes a synthesis of existing medical schools in Prague and Brno (Brünn): the first teachers were primarily equally recruited from both these universities. It had been connected almost from its beginning with the coexisting military medical school; at one time it represented this military medical training institution by itself. The school underwent so many transformations accompanied by the departure of a number of important professors that it was surprising that it was able to maintain its professional integrity. The answer to the question of why the first medical school in the postwar period was founded in Hradec Králové is not too difficult. The town was a metropolis of eastern Bohemia with an important cultural and political tradition; this eventually culminated in a targeted readiness of such institution.
In a dynamic sequence there has been presented longer than 50 years lasting history of the branch "Hygiene" (after the year 1989 joined with "Preventive Medicine") in the University Department of the same name of the Medical Faculty of Charles' University in Hradec Králové since the year 1945 till today. The modern primary preventive medical field "Hygiene and Preventive Medicine" today not only covers the medical studies but, at the same time, represents a complex integrating general ecological approach to solving most of problems of public health, environmental one included. Ensuring the global good conditions for man during his permanently sustainable healthy living and development being the ultimate goal.
Psychotherapy has become an independent interdisciplinary subject including prophylaxis, therapy and rehabilitation of health disorders by psychological methods, i.e. methods of communicative and relational nature. The effectiveness of psychotherapy has been scientifically proved. Since 1994, psychotherapy has been mandatory for undergraduate students at the 1st Faculty of Medicine of Charles University. Students even sit for a final state exam in psychotherapy. Postgraduate studies in psychotherapy have started in 1995 and take four years. The enrollment is 66 now. The curriculum is based on a differentially integrative concept and general model of psychotherapy.
The present tendency is to require publishing activity as one of the evaluation criteria for research performance, and to apply the ranking of journals according to their impact factors as published in the Science Citation Index (SCI). In the first two sections of this papers, ten top original papers and five top monographs from the faculty staff of the 1st Medical Faculty of the Charles University (1.MF) from the years 1991-1995 are quoted, to demonstrate their publishing results. The third section discusses the publishing output of the 1.MF and the Faculty Hospital, and covers 7,164 publications. From 1993, a detailed annual Faculty Bibliography has appeared. The publications are divided into 18 categories, and their absolute and relative quantities are presented in table form. The analysis of quantity and type of publishing category is compared with the analogous spectrum of document types appearing in Current Contents-Life Sciences. 87.9% of all publications appeared in journals. 11.3% were published in international journals indexed by SCI. The paper also discusses the impact of the evidence of such indexing of the growing publishing output of the 1.MF in all categories, including possibilities for increasing the number of papers published in core international journals, as defined by their SCI ranking.
Charles Cassidy Bass a native Mississippian introduced his method of toothbrushing and flossing to the dental community four decades ago. He chastised the academic, public health and military dentists for their lack of knowledge in area of preventive dentistry. Dr. Bass felt that his "Right Kind" method of oral hygiene was not well received by the dental profession. A questionnaire was sent to every United States dental school to determine what effects his teachings had on dental education. The study revealed that C. C. Bass' teachings were indeed accepted by the dental profession and are still in effect today.
An 80-year old previously healthy woman with recent onset of binocular macular degeneration presented for clinical psychiatric evaluation of elaborate complex visual hallucinations. In the absence of other organic or psychiatric findings the patient maintained insight into the unreal nature of her visions. As neuroleptic drugs showed no effect, low dose treatment with carbamazepin resulted in disappearance of hallucinations. The phenomenon of Charles-Bonnet-syndrome is discussed as an example of a neuro-psychiatric hallucinosis.
Schizophrenia disorders afflict approximately 1% of the population during their lifetime. Conventional antipsychotic agents show therapeutic limitations because of their side-effects and inefficacy among some patients. A novel antipsychotic class, named atypical neuroleptics, among Léponex is the leader, constitutes a hope in treatment-resistant schizophrenia. However, because the drug involves a 1% to 2% risk of agranulocytosis, an haematological oversees has been established. Moreover, the acquisition cost of clozapine is high in comparison with that of standard antipsychotics. The purpose of this study was to observe the management of 72 patients suffering from resistant schizophrenia, to assess the cost of this treatment in medical and social terms, and to realize cost-effectiveness study in Charles Perrens Hospital (Bordeaux). The survey based on three questionnaires (Clinical informations, Quality of Life, Epidemiological information) was sent to psychiatrists practising in this hospital. The results confirm efficacy (overall functioning measured by CGI which is significant, p < 0.0001) and tolerance of Léponex (no side effects in 33.3% patients, no agranulocytosis, only one neutropenia and only 4.2% neurologic side effects). We found a significant reduction of the annual mean number of days of full time hospitalization (214 days versus 135 after two years, p < 0.0005) associated with the significant reduction of direct cost mainly related to shorter length of hospitalization; and 45.8% versus 8.3% adjust to life in the community (p < 0.0004). Clozapine produced a marked improvement (p < 0.0001) in Quality of Life measured by two self-rating scales (SWN and TEAQV). The estimated total two-years cost decreased from 31,108 Francs/month/patient to 22,950 Francs/month/patient, a saving of 8,158 Francs/month/patient (a decrease of 26.2%). Although the acquisition cost of clozapine is high, cost effectiveness estimates in patients with treatment resistant schizophrenia suggest that the clinical benefits (improved psychopathology, social functioning and quality of life) of this drug may confer medium to long term economic benefits, primarily by reducing the need for psychiatric hospital service.
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