Understanding Van Gogh's Night: bipolar disorder

Vincent Van Gogh (1853-1890) imparted in his art a deep essence of life, and in such a unique way that many would say it is possible to experience it vicariously by looking at his paintings even once. In 10 years, while exerting mental and physical efforts that may well have contributed to his premature death, he produced an impressive number of masterpieces. However, the specific neurological disorder Van Gogh suffered and how this may have influenced his art is still not clear. The combination of his eccentric personality, irascible temper, unstable moods and prolific creativity, makes the understanding of his illness a very complex endeavor and therefore poses a great challenge to those who investigate the relationships between the 'artistic mind', the brain and illness. In fact, most of the diagnoses (nearly 30) proposed for Van Gogh, during the last century, are not based on medical evidence but are ascertainable from analyses of his paintings and biographical data. Although no definitive diagnosis can be made based on such evidence, we conclude that according to DSM-IV criteria and findings extrapolated from his letters, Van Gogh is most likely to have suffered a bipolar disorder, affective or schizoaffective, which caused his death by suicide.

Mismatch of arterial and central venous blood gas analysis during haemorrhage.

BACKGROUND AND OBJECTIVE: Arterial base excess and lactate levels are key parameters in the assessment of critically ill patients. The use of venous blood gas analysis may be of clinical interest when no arterial blood is available initially. METHODS: Twenty-four pigs underwent progressive normovolaemic haemodilution and subsequent progressive haemorrhage until the death of the animal. Base excess and lactate levels were determined from arterial and central venous blood after each step. In addition, base excess was calculated by the Van Slyke equation modified by Zander (BE(z)). Continuous variables were summarized as mean +/- SD and represent all measurements (n = 195). RESULTS: Base excess according to National Committee for Clinical Laboratory Standards for arterial blood was 2.27 +/- 4.12 versus 2.48 +/- 4.33 mmol(-l) for central venous blood (P = 0.099) with a strong correlation (r(2) = 0.960, P < 0.001). Standard deviation of the differences between these parameters (SD-DIFBE) did not increase (P = 0.355) during haemorrhage as compared with haemodilution. Arterial lactate was 2.66 +/- 3.23 versus 2.71 +/- 2.80 mmol(-l) in central venous blood (P = 0.330) with a strong correlation (r(2) = 0.983, P < 0.001). SD-DIFLAC increased (P < 0.001) during haemorrhage. BE(z) for central venous blood was 2.22 +/- 4.62 mmol(-l) (P = 0.006 versus arterial base excess according to National Committee for Clinical Laboratory Standards) with strong correlation (r(2) = 0.942, P < 0.001). SD-DIFBE(z)/base excess increased (P < 0.024) during haemorrhage. CONCLUSION: Central venous blood gas analysis is a good predictor for base excess and lactate in arterial blood in steady-state conditions. However, the variation between arterial and central venous lactate increases during haemorrhage. The modification of the Van Slyke equation by Zander did not improve the agreement between central venous and arterial base excess.

[Illustrations de Oeuvres] / Chéron, dess. ; Vertue, dess. Van der Gucht, C. du Bosc et P. Fourdrinier, grav. ; Jean Racine, aut. du texte

Comprend : [Tome I. Bandeau à la Dédicace : lion et licorne entourant les armoiries et la devise du Duc de Glocester.] Honi soit qui mal y pense. [Cote : Yf 404-405/Microfilm R 122414] ; [Tome I. Pl. en reg. folio B : la Thébaïde ou les frères ennemis. Tragédie.] Thébaïde. [Cote : Yf 404-405/Microfilm R 122414] ; [Tome I. Pl. en reg. du titre de la tragédie Alexandre le grand :] Alexandre. [Cote : Yf 404-405/Microfilm R 122414] ; [Tome I. Pl. en reg. du titre de la tragédie Andromaque :] Andromaque. [Cote : Yf 404-405/Microfilm R 122414] ; [Tome I. Pl. en reg. du titre de la tragédie Britannicus :] Britannicus. [Cote : Yf 404-405/Microfilm R 122414] ; [Tome I. Pl. en reg. du titre de la tragédie Berenice :] Berenice. [Cote : Yf 404-405/Microfilm R 122414] ; [Tome I. Pl. en reg. du titre de la comédie Les Plaideurs :] Les Plaideurs. [Cote : Yf 404-405/Microfilm R 122414] ; [Tome II. Frontispice :] [Cote : Yf 404-405/Microfilm R 122414] ; [Tome II. Pl. en reg. du titre de la tragédie Bajazet :] Bajazet. [Cote : Yf 404-405/Microfilm R 122414] ; [Tome II. Pl. en reg. du titre de la tragédie Mithridate :] Mithridate. [Cote : Yf 404-405/Microfilm R 122414] ; [Tome II. Pl. en reg. du titre de la tragédie Iphigénie :] Iphigénie. [Cote : Yf 404-405/Microfilm R 122414] ; [Tome II. Pl. en reg. du titre de la tragédie Phèdre :] Phèdre. [Cote : Yf 404-405/Microfilm R 122414] ; [Tome II. Pl. en reg. du titre de la tragédie Esther :] Esther. [Cote : Yf 404-405/Microfilm R 122414] ; [Tome II. Pl. en reg. du titre de la tragédie Athalie :] Athalie. [Cote : Yf 404-405/Microfilm R 122414]

Complicated intra-abdominal infections in Europe: preliminary data from the first three months of the CIAO Study.

The CIAO Study is a multicenter observational study currently underway in 66 European medical institutions over the course of a six-month study period (January-June 2012).This preliminary report overviews the findings of the first half of the study, which includes all data from the first three months of the six-month study period.Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study.912 patients with a mean age of 54.4 years (range 4-98) were enrolled in the study during the first three-month period. 47.7% of the patients were women and 52.3% were men. Among these patients, 83.3% were affected by community-acquired IAIs while the remaining 16.7% presented with healthcare-associated infections. Intraperitoneal specimens were collected from 64.2% of the enrolled patients, and from these samples, 825 microorganisms were collectively identified.The overall mortality rate was 6.4% (58/912). According to univariate statistical analysis of the data, critical clinical condition of the patient upon hospital admission (defined by severe sepsis and septic shock) as well as healthcare-associated infections, non-appendicular origin, generalized peritonitis, and serious comorbidities such as malignancy and severe cardiovascular disease were all significant risk factors for patient mortality.White Blood Cell counts (WBCs) greater than 12,000 or less than 4,000 and core body temperatures exceeding 38°C or less than 36°C by the third post-operative day were statistically significant indicators of patient mortality.

Euroopan yhteisöjen tuomioistuimen tuomio 17.11.1998 asiassa C-391/95 (Van Uden) : Brysselin yleissopimus - välityslauseke - ennakkona maksettava maksu - väliaikaisten toimenpiteiden käsite

Ratkaisu koskee Brysselin yleissopimuksen 24 artiklaan perustuvaa tuomioistuimen toimivaltaa turvaamistoimiasiassa