Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Dec 2000
Biography Historical Article[Psychiatric case history of Vincent van Gogh].
Much has been written about Vincent van Gogh's pathological condition. Most authors base their various diagnoses on the symptoms he exhibited in the last years of his life. ⋯ He (also) developed an organic psychosyndrome with psychotic and epileptic elements. The stress (due to social isolation, by his being a psychiatric patient, and by poor prospects), the intoxication going on outside the hospitals and especially also the problems relating to his brother Theo caused a downward spiral culminating in suicide.
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Gastrointestinal luminal tonometry is a minimally invasive technique for measuring gastrointestinal ischaemia. Mucosal ischaemia leads to excessive production of tissue CO2 and thus to an increase of luminal PCO2. For this measurement, a nasogastric catheter is introduced with at its end a balloon permeable for CO2, this balloon is filled with air or liquid. ⋯ Tonometric parameters are reliable indicators of morbidity and mortality in critically ill patients. The effect of 'tonometry-guided' treatment on the morbidity and mortality is still a matter of debate. Other than using tonometry as a global ('hemodynamic') monitoring device, selective monitoring of the regional perfusion of the digestive tract--such as for diagnostic purpose in suspected chronic ischaemia due to splanchnic arterial disease--is a promising new application area.