Veera Tepsumethanon, Boonlert Lumlertdacha and Channarong Mitmoonpitak
Background: Rabies is a fatal disease. However, dogs are the principal vehicle for rabies transmission of human. A little information about pre-morbid behavior in rabid dogs could be found in the literature. Objective: Assess the value of history taking in predicting rabies diagnosis in dogs, and identify the percentage of rabies positives by history taking in a prospective study. Materials and methods: Studies were conducted at the Rabies Diagnostic Unit, Queen Saovabha Memorial Institute, Thai Red Cross Society between 2002 and 2008. Historical data were collected prospectively from 153 live rabies suspected dogs on admission to the diagnostic facility. Results: Rabies was found in 14% to 80% of dogs with completed questionnaires except for dogs less than one month old, not sick or sick for more than 10 days. Conclusion: History taking does not help in decision-making for rabies post-exposure prophylaxis of humans.
Aleksandar J. Ignjatovski was born in the Smolensk Region, Russia, on 18.03.1875. He graduated from the Faculty of Medicine in St. Petersburg in 1899 where he started specialization in internal medicine and continued in Berlin, Heidelberg, Munich and Paris. In 1905 he was elected assistant professor in St. Petersburg, continued as an associate professor in Odessa in 1908 and a full-time professor in 1912 in Warsaw. During the October Revolution, he was the Head of the Internal Clinic in Rostov, and in 1920 he emigrated to Belgrade. In 1922 he was appointed full professor and Director of the First Internal Clinic at the Faculty of Medicine in Belgrade, which he established, developed and managed until his retirement in 1946. In 1948 he moved to Skopje as a full professor and first Director of the Internal Clinic at the Faculty of Medicine in Skopje. He studied the pathogenesis of arteriosclerosis and first proved it experimentally, and published a paper in 1908, indicating that it was associated with higher blood cholesterol level. He also dealt with immunobiology and infectious diseases, in particular tuberculosis and tetanus. Prof. A. Ignjatovski was an excellent clinician, teacher and scientist, who published over 80 papers. His most important textbooks are “Clinical Semiotics and Symptomatic Therapy”, in two editions, in Russian (1919) and in Serbian (1929-37), and “The Basics of Internal Propedeutics” in three volumes, published in Skopje in 1952, 1954 and 1963. The work of Prof. A. Ignjatovski, as a leading clinician and a great teacher and scientist, is embedded in the development of internal medicine, and medicine in general, in Russia, Serbia and Macedonia. The bright memorial of the founder and first director of the Internal Medicine Clinic and the first Head of the Department of Internal Medicine at the Faculty of Medicine in Skopje has been permanently incorporated in the history of medicine in R. Macedonia. Prof. A. Ignjatovski died on 18.08.1955.
B Zalar, A Blatnik, A Maver, Z Klemenc-Ketiš and B Peterlin
Depression is estimated to affect 350 million people worldwide. The World Mental Health Survey conducted in 17 countries found that, on average, about one in 20 people reported having an episode of depression in the previous year. Although depression has been shown to be moderately heritable by studies conducted in the past, the search for its so-called missing heritability has so far been unsuccessful. The difficulty in identifying common genetic variants predisposing to depression could be due to large sample sizes needed to detect small effects on genetic risk and the heterogeneous nature of major depressive disorder (MDD). The aim of our study was to determine whether there was a connection between a family history of depression in MDD patients and the presence of putative risk variants in the well-studied SLC6A4, COMT and PCLO genes. We analyzed 133 patients with MDD (30.0% with a positive family history for MDD and 70.0% sporadic cases) and compared them to 279 healthy controls. When comparing all the depressed patients to controls, no significant differences in genotype and allele distributions were detected. After stratifying patients according to their family history, the PCLO rs2522833 C allele was shown to be significantly less common in patients with a positive family history (p = 0.001), indicating a possible difference in the genetic structure of MDD between familial and sporadic cases and a less important role of the common genetic risk variants for the development of MDD in familial cases.
Primaljstvo i prve primalje u Bjelovaru 1756.-1856
Prve izučene (aprobirane) primalje dolaze u novoosnovani Bjelovar, jako vojno središte Vojne krajine početkom druge polovice XVIII. stoljeća zajedno s vojnim liječnicima, kirurzima i ljekarnicima, a većina njih je germanskoga podrijetla. U do sada neistraženom arhivskom materijalu za razdoblje 1756.-1856. pronadeni su podaci o 23 izučene primalje, od kojih je 14 bilo pukovnijskih i 9 gradskih primalja. Visok perinatalni pomor djece i majki i kriminalni pobačaji karakteristike su toga razdoblja. Uz model domicilnoga primaljstva: skrb za trudnice, rodilje, babinjače, novorodenčad i dojenčad, primalje u teškim porodima obavljaju krštenje iz nužde ugroženoj novorodenčadi ili su pak krsne kume zdravoj dojenčadi. Premda je u samom gradu Bjelovaru ustrojeno stručno primaljstvo, u okolici grada i dalje se porodi obavljaju bez stručne pomoći. Za razliku od većine tadašnjih gradova kontinentalne Hrvatske, pa i Dalmacije, u Bjelovaru postoji kontinuirano izučeno primaljstvo i zaštita materinstva od polovice XVIII. stoljeća.
Marija Sholjakova, Jordan Nojkov, Zorka Nikolova-Todorova, Mirjana Shosholcheva, Andrijan Kartalov and Biljana Kuzmanovska
Aim: To present a chronological overview of the most important events and actors that have marked the history of anaesthesiology and intensive treatment in R. Macedonia since its beginnings in the 1950s.
Method: Retrospective study based on archive materials, published literature and jubilee publications, as well as the memories of individuals who have worked in the field of anaesthesiology in the past period.
Results: Between the two World Wars the first anaesthesia procedures were handled by surgeons. After World War II, the development of anaesthesia in R. Macedonia could be divided into two periods: before 1965 and after 1965. Before 1965 anaesthesia was mainly given by technicians trained on courses, and after this year anaesthesiology was taken over by anaesthesiologists who had specialized at the Faculty of Medicine in Skopje. In 1985 the number of anaesthesiologists was 100, and today it exceeds 250. The most important figures in the history of Macedonian anaesthesiology are: Dr. Risto Ivanovski, who worked from 1954-78, and Prof. Dr. Vladimir Andonov, who worked as an anaesthesiologist from 1965-99. Both of them are doyens who contributed a lot to the development of the anaesthesiology service and education of anaesthesiologists in R. Macedonia. Intensive treatment had started in 1955, but in real terms it has been performed since 1966, when artificial ventilators were introduced. The modern Intensive Care Department was opened at the Surgical Clinic in 1995 and it was followed in other hospitals in the state. The Department of Anaesthesiology has existed since 1975, and it has made a huge contribution to the education of professionals who apply modern principles in emergency medicine and intensive care.
Conclusion: From modest beginnings in the 1950s, anaesthesiology today in R. Macedonia has developed well organized activity that successfully follow the trends of modern medicine in the field of anesthesiology, resuscitation, intensive care and pain treatment.
V. Galonsky, V. Chernov, R. Susloparova and A. Gradoboev
Currently in the modern pedagogical process at a higher medical institution, teachers often shift emphasis towards the new technologies and methods for treating diseases. In this case, classical techniques, their development, and scientists who influenced the formation of orthopaedic dentistry are undeservedly downplayed in the training process. In order to preserve the interest of dental students in the historical process, it is necessary to teach the material taking into account modern processes that occur in orthopaedic dentistry. We searched for materials on the history of prosthetic dentistry in the scientific and historical literature. A special attention was paid to those moments of history that had been reflected in the present through modern materials, schools or methods of treating patients. After the selection of the materials and their discussion, the teaching staff of the KrasSMU Department-Clinic for Prosthetic Dentistry made proposals regarding each of the nine training cycles. In each study cycle, we included some information about historical moments and personalities that are known to be important for students’ moral education and learning. Specifically, we used information taken from the scientific and historical literature, autobiographies, memoirs of contemporaries, and presentations containing material suitable for assimilation. Thus, we managed to naturally include the history of prosthetic dentistry into the educational process.
The applied approach to teaching the history of medicine had many positive aspects. Following up the development of views on various prosthetic dentistry issues allowed us to provide a more natural introduction to complex clinical disciplines. We emphasized the scientific experience continuity and the interdisciplinary approach to professional issues. A number of positive moral and ethical qualities were discussed that have allowed scientists to achieve significant results in their activities. Through the demonstration of domestic scientists’ achievements, we carried out promotion of patriotism among the students. Considering the above advantages, we emphasize the importance of teaching the history of prosthetic dentistry in educating future dentists.
This multicentre, cross-sectional observational study aimed to determine the prevalence of depression among the working population of Slovenia and identify factors correlating with higher prevalence of depression. It was conducted in three occupational medicine practices within major Slovenian primary health care centres. The study population consisted of 1,474 respondents [73.7 % of the invited participants, 889 (60.3 %) men and 585 (39.7 %) women with mean age of (40.5±9.8) years] who visited these practices for their regular check-ups from November 2010 to June 2012 and were asked to fill in a self-developed questionnaire and score depression on the Zung’s self-rating depression scale. According to the rating, 50 (3.4 %) respondents suffered from depression. In the multivariate analysis, depression correlated with the following independent variables: self-perceived exposure to chronic stress, positive family history of depression, and primary school education.
Background: Data regarding the natural history and outcome of treatment of chronic hepatitis B (CHB) patients in Thailand remain inconclusive.
Objective: We aimed to examine the natural history and outcome of therapy in Thai CHB patients treated with nucleoside analogues (NAs) monotherapy or interferon (IFN) monotherapy.
Method: CHB patients without clinical evidence of cirrhosis and alanine aminotransferase (ALT) levels >1.5 times of normal for at least 6 months were enrolled from 6 hospitals (2002 to 2005). Treatment included NAs and IFN. Treatment response was defined as ALT normalization and an HBV DNA level <10,000 copies/ml (or <2,000 IU/ml) and/or HBeAg seroconversion at the end of follow up. The study was approved by the institutional review board of each hospital.
Result: A total of 567 patients with mean age of 46.8 ± 11.9 y were included. The ratio of HBeAg positive to HBeAg negative patients was 1.3:1. Nineteen percent of patients had no HBeAg status. There were 262 HBeAg positive patients (46%) and 197 HBeAg negative patients 35%. Sixty-one percent received NAs while 20% received IFN as a first line treatment and the remaining 19% received no specific medication. For the HBeAg positive patients, HBeAg seroconversion and undetectable HBV-DNA were achieved in 32.8% and 50.5%, respectively in NAs group (on therapy), and HBeAg seroconversion and undetectable HBV-DNA were achieved in 24.3% and 21.4%, respectively in the IFN-treated group (off treatment). For the HBeAg negative patients, undetectable levels of HBV-DNA occurred in 68.8% in the NAs group while undetectable levels of HBV-DNA occurred in 37.5% of patients in the IFN-treated group. HBsAg loss was not found in the NAs group, but 2.8% of patients in IFN group had HBsAg loss. HBV DNA reappeared in the IFN group (off treatment) and NAs groups (on therapy) in 26.6% and 24.3% of patients, respectively. Minor adverse events of therapy were found in 9% of patients. Five percent of patients progressed to Child A cirrhosis and one patient in the NAs group (0.18%) died from causes unrelated to liver disease, during a 3-year follow-up.
Conclusion: The treatment response of Thai CHB patients from multicenter study showed the results similar to previous studies. However, higher durability of treatment with lower rate of reappearance of HBV DNA was observed in Thai CHB patients.
British scientist Sir Wilfrid Le Gros Clark was one of the most distinguished anatomists, neuroscientists and physical anthropologists of the twentieth century. He spent most of his career at the University of Oxford as the Chair of the Anatomy Department. This paper focuses on Le Gros Clark’s early career and provides a historical account of the three years he spent as a Principal Medical Officer in Sarawak, which was then a British controlled state on the island of Borneo. At Sarawak he carried out numerous medical, administrative, and educational duties, making significant improvements to the local health system. His success as the Principal Medical Officer came not only as a result of his medical knowledge and organizational skills, but also because of his extensive knowledge and understanding of the local cultures. Interested in the natural history of the country, Le Gros Clark also collected specimens of the local fauna. These would provide material for some of his most significant research carried out when he took an academic position in England. Years in Sarawak enriched Le Gros Clark not only as a scientist and medical practitioner, but also had a deep influence on his general outlook on life and personal development.