[J. E. Purkinje and sports medicine]

Work which preceded contemporary sports medicine remains in the shadow of major discoveries made by J. E. Purkynĕ. The author draws therefore attention to some of Purkynĕ's original ideas and methods which quite rightly can be considered the basis of sports medicine. Purkynĕ was probably the first who followed up the response to exercise manifested in the circulation and other functions of the organism. He was also the author of some examination procedures which together with modern laboratory technique are the basis of functional diagnosis. In Purkynĕ's work we find also suggestions for the solution of problems of prevention, so frequently discussed nowadays. He considered advisable physical exercise an integral part of the perspective of good health of man. It is remarkable how much foresight he had more than 150 years ago not only in theory but also from the practical aspect as regards the lifestyle of modern man.

[Anxiolytics 1988-1991 (review)]

In the submitted paper the author reviews the literature on anxiolytics during the mentioned period, based on previous reviews. He discusses the extent to which anxiolytics are used. The majority of information pertains to benzodiazepine BD anxiolytics. He provides data on treatment of anxious conditions, on the administration of anxiolytics in impaired sleep, in gerontopsychiatry and alcohology. In broader indications anxiolytics are administered also in depressions, manias and other psychoses. Attention is paid also to the risk of development of dependence on anxiolytics, tolerance and withdrawal syndromes. In the conclusion the author present information on recent non-benzodiazepine anxiolytics.

[Adverse effects of antidepressive agents in hospitalized geriatric patients]

The frequency, intensity and profile of adverse effects of antidepressants was studied in elderly patients. The series consisted of 102 patients with depression admitted to hospitals in Bratislava and Moscow. The adverse effects of amitriptyline (Amitriptylin Spofa) and maprotiline (Ludiomil Ciba-Geigy) were compared. The assessment done on days 0, 7, and 28 of treatment showed that xerostomia had the highest occurrence rate with both preparations studied. In patients treated with amitriptyline adverse effects were more severe and were recorded more frequently, requiring treatment withdrawal in 3 patients. The overall intensity of adverse effects was significantly higher with amitriptyline (p < 0.05). In the group of patients treated with amitriptyline the adverse effects were more marked in those with severe somatic pathology. The risk of amitriptyline treatment in elderly patients is being emphasized along with the need for monitoring and correcting adverse effects of the treatment. Although maprotiline exhibited a lower occurrence rate of adverse effects, cardiac functions should be regularly checked in patients with preexisting cardiac pathology. (Tab. 2, Fig. 3, Ref. 6.).

[The importance and urgency of pneumothorax]

In a group of 110 subject with pneumothorax some factors are evaluated which may influence its impact and urgency. Attention is devoted to the length of the disease before surgical treatment, to the most frequent basic and accessory diseases, methods and complications of therapy, its effect and to economic aspects. Treatment on account of thoracotomy was indicated in 8.2% subjects. A total of six patients died. The authors recorded an increase of artificial pneumothorax. They draw attention to the disproportionately severe sequelae which may be due to apparently insignificant causes. Cure within one week was achieved in two-thirds of the group, the mortality increased steeply with the increasing number of relapses of the disease.

[Maintenance therapy in schizophrenia using clozapine]

Most of the experience with the atypical neuroleptic of Clozapine (Leponex, Sandoz) pertains to active treatment. In conjunction with possible risks, at present its administration in selected groups of patients is recommended. The authors describe the results of an intraindividual comparison of Clozapine in 11 patients with the diagnosis of schizophrenia (according to ICD-9), 7 men, mean age 30.5 years with previous neuroleptic treatment. The average period for comparison was 2.3 years (1.5-4 years), the mean daily dose of Clozapine was 200 mg (50-400 mg). During Clozapine treatment the hospitalization period was significantly shorter and the number of hospital admissions was lower. The frequency of undesirable effects was equal during both periods. During Clozapine treatment morning sleepiness and hypersalivation were more frequent and during treatment with neuroleptics extrapyramidal undesirable effects. In none of the patients they caused discontinuation of treatment. Transient leukopenia after Clozapine in one patient was improved after reduction of the dose. The paper is supplemented by the case-history of female patient treated by Clozapine monotherapy during 17 years.

[A case of male pseudopregnancy]

The authors give an account of views concerning pseudocyesis and phantom pregnancy resp. It is a condition which is extremely rare in males. The authors describe the case-history of a 60-year-old man hospitalized at the Psychiatric Clinic of the Faculty Hospital Bratislava on account of phantom pregnancy. They discuss the possible nosological classification of the presented case. In the conclusion they submit the view that phantom pregnancy can be included among monosymptomatic psychoses (e.g. as tactile hallucinosis).