Possibilities of using vena cava filters in pregnant women with venous thromboembolism. Case reports.

Two cases of venous thromboembolism (VTE) (26th week and 35th week of pregnancy) are described. The standard anticoagulation therapy (Fraxiparine) with vena cava (IVC) filter insertion was applied with successful result and uneventful post partial period. The indications of IVC filters (permanent x retrievable x temporary) and timing of insertion and/or extraction are discussed. IVC filters are an effective and safe method in the prophylaxis and therapy of VTE in pregnancy. This method is justified to be used for a defined group of high-risk patients where benefit predominates potential complications.

[Correlation of neuropsychological tests and density of brain white matter in schizophrenia]. / Korelace neuropsychologických zkousek s denzitou bílé hmoty mozku u schizofrenie.

In a group of 10 subjects, nine schizophrenic patients and one healthy twin (seven men and three women, i.e. two monozygotic twin pairs: two patients and a healthy man and his sick twin brother, one dizygotic pair of two female patients, three male patients and one female patient without their appropriate twin siblings) Halstead-Reitan Neuropsychological Battery (HRNB) was used and partial neuropsychological tests (Wechsler Memory Scale, the Stroop Color-Word Test, Tonal Memory). The parameters of white matter density were evaluated by computed tomography. The fundamental findings include: In our small group numerous statistically significant correlations were found between neuropsychological tests and white matter density. 2. Higher density is associated with poorer neuropsychological efficiency. There are very similar correlations between neuropsychological variables and density parameters in different areas of the brain. 4. The majority of correlations of neuropsychological parameters is from the area of tactile and motor functions. 5. It is striking that there are statistically significant correlations of density with the simultaneous performance of both hands and the performance of the non-dominant hand but not with the performance of the dominant hand alone. 6. Some correlations pertain in addition to density also to the very controversial problem of the brain size of schizophrenic patients. In the investigated group an association between better neuropsychological performance and larger size of the brain was found. All findings will have to be tested in larger groups of patients and healthy subjects.

[Neuropsychological tests and smooth pursuit eye movements in schizophrenic twins]. / Neuropsychologické testy a plynulé sledovací ocní pohyby u schizofrenních dvojcat.

The authors compares results of neuropsychological tests/Halstead-Reitan Neuropsychological Battery, Stroop test, Wechsler Memory Scale, Seashore Tonal Memory Test/with results of smooth pursuit eye movements in nine pairs of twins/5 monozygotic and 4 dizygotic pairs/. In all instances at least one twin suffered from schizophrenia. The majority of neuropsychological tests differentiated clearly schizophrenic and healthy twins. Of seven parameters of smooth pursuit eye movements big saccades differentiated significantly. The authors found also correlations between neuropsychological tests and smooth pursuit eye movements. Significant correlations pertained to motor velocity (correlation of the Oscillation test with big saccades and with small saccades), complex psychomotor abilities (correlation of the Tactual Performance Test-Localization with big saccades), general indicators of cerebral activity or neuropsychological performance (correlation of the Tonal Memory test with big saccades and correlation of the Rhythm test with the amplitude of the curve), memory (correlation of the memory quotient MQ and the Logical Memory sub-test with small saccades) and work performance during a perception or psychic load (correlation of Stroop sub-test with big saccades). The method of smooth pursuit eye movements is not time consuming and does not involve major demands on the patient's cooperation. On the other hand, neuropsychological tests have the advantage that they reveal the impact of possible pathological conditions of the brain on behaviour. On the whole the results support the hypothesis that in schizophrenic patients a disease with structural or functional abnormalities of the brain is involved.

[The Halstead-Reitan Neuropsychological Battery. Initial experience with its use in Czechoslovakia]. / Neuropsychologická baterie Halstead-Reitan. První zkusenosti s ceským prevodem.

The authors present information on the basic, classical neuropsychological battery and its Czech application in adults (15 years and older). Its principles are adopted also by more recent partial methods. The validity of new methods is usually assessed by comparison with the former method. Its position in neuropsychology can be compared with that of Wechsler's intelligence scales in the area of assessment of intelligence. The author describes 11 original tests which form the battery. Although individual tests are used also separately, it is better not to deprive oneself of the comprehensive evaluation of cerebral functions and psychic consequences of neurological disease or damage. The authors assembled encouraging experience when examining the first 72 Czech patients--ambulatory psychiatric patients (n = 12), patients rated for invalidity (n = 20), epileptic patients (n = 33) and patients from the clinic for occupational diseases (n = 7).

[Humanitarian aid to persons with mental disorders]. / Humanitární pomoc psychicky alterovaným.

The role of psychiatrists in the Czechoslovak committee for human rights and humanitarian collaboration has its practical justification. Every year some three thousand applications of different character are addressed to the committee. Ten per cent are formed by mentally altered applicants. Lawyers are unable to evaluate these applications correctly. The task of the psychiatrist is to assess, as far as possible, the clinical diagnosis of the applicant. This is very difficult as the psychiatrist uses as a basis only a written document where he evaluates the contents and the formal aspect. A psychopathological analysis leads frequently to clear diagnostic conclusions. Statistical evaluation reveals that about one third of the applications are submitted by psychopathic personalities, one third is formed by applications of subjects suffering probably from mental disorders or diseases and the last third are paranoid patients. The ethical problem is how to react to the different types of applications. From the legal aspect the committee is not entitled to abuse the confidence of the applicant and even in case of serious mental disease to ask the community psychiatrist for intervention. At present the problem is solved by suggesting to the applicant to attend of his own free will the appropriate psychiatrist. Very frequently it is apparent from the reply that the applicant does not consider this suggestion suitable because he is not aware of his mental disease. In case of paranoid development the position is simplified by the fact that any treatment is without effect.

[Biological and experimental markers of sexual aggression]. / Nekteré biologické a experimentální markery sexuální agresivity.

Forty men who committed sexual offences with a varying extent of aggressiveness were examined by a series of psychological tests, phalloplethysmography and electroencephalography. The plasma testosterone level was assessed and in indicated cases the karyotype. Frequently in the delinquents an abnormal course of psychosexual development was revealed, disorders of sex life, the presence of sexual deviations and atypical EEG findings. The extent of aggression of the offence correlated significantly with younger age of the delinquent and the result of the phalloplethysomographic examination. Prediction of future aggressive behaviour of a subject is difficult even when modern examination methods are used.

[An EEG study in anorexia nervosa and an attempt to use it for prognostic prediction]. / EEG studie u mentálních anorexií a pokus o její prediktivní vyuzití.

Visual evaluation of EEG tracings was made in 77 patients with the clinical diagnosis of anorexia nervosa and in 76 neurotic patients. The following criteria were evaluated and correlated: age, height, body weight on admission and discharge, weight increment per day, presence of basic EEG activities [alpha, beta, gamma, delta], foci, paroxysms, reactions to hyperventilation and general evaluation of EEG (normal, atypical, abnormal). A significant correlation was found between the weight increment and the initial weight. A lower weight correlated with a higher weight increment. The relations between clinical variables and EEG criteria were statistically close to zero. A significant relationship was found between the presence of focal activity and weight increments. Thus only in anorectic patients with the presence of a focus prognostic possibilities of EEG may be presumed.

Factor analysis of EEG in healthy and diseased subjects.

Factor analysis was applied to EEG recordings of healthy and diseased subjects to be analyzed by an "on line" broad-band frequency analyser. Differences between the healthy and the diseased as to the number of given factors were established by means of the Lawly test. Up to 6 factors were determined for patients, up to 3 for the healthy. On medication, the number of factors rose in the delta and beta bands, remaining unchanged in the alpha band dropping the theta band. The patients manifested a sort of interindividual uniformity and intraindividual simplification. Except for different sites of pathological foci, the patients' EEG recordings were more like each other than those of healthy subjects. The latter might have undergone a similar process on medication. This enabled to establish more factors in the patients, moreover in such a way as to expose some general laws of cortical electric activity, such as unified cortical activity despite its various facets, hemispheral specificity, and finally also a relative autonomy of the frontal lobes.