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An observation of a treatment with digitalis antibodies (Fab-fragments) in a young child is presented. The elimination of this antidotum proved to be much slower than normally expected. In the patient's history, the disappearance of the Fab-fragments out of the blood lasted 142 days with a half-life of 15.6 days, whereas an elimination with a T½ of 28 hours is accepted. Probably there has been intracellular penetration of the antibodies into the liver, caused by concomitant diseases (Hepatitis A and B infections). An 'in vitro' experiment is reported. It demonstrates the equimolar binding of the Fab-fragments for digoxin and shows that the elimination of the Fab-fragments can be established by a routine radioimmunoassay of digoxin, in an indirect way. [ABSTRACT FROM AUTHOR]

Background: Curriculum reforms in medical schools require cultural and conceptual changes from the faculty. Aims and Methods: We assessed attitudes towards curriculum reforms in different academic, economic, and social environments among 776 teachers from 2 Western European medical schools (Belgium and Denmark) and 7 medical schools in 3 countries in post-communist transition (Croatia, Slovenia, Bosnia and Herzegovina). The survey included a 5-point Likert-type scale on attitudes towards reforms in general and towards reforms of medical curriculum (10 items each). Results: Teaching staff from medical schools in Bosnia and Herzegovina had a more positive attitude towards reforms of medical curriculum (mean score 36.8 out of maximum 50 [95% CI 36.1 to 37.3]) than those from medical schools in Croatia or Slovenia (30.7 [29.8 to 31.6]) or Western Europe (27.7 [27.1 to 28.3]) (P < 0.001, ANOVA). Significant predictors of positive attitudes towards medical curriculum reform in post-communist transition countries, but not in Western European schools, was younger age, as well as female gender in Bosnia and Herzegovina. Conclusions: Factors influencing faculty attitudes may not be easy to identify and may be specific for different settings. Their identification and management is necessary for producing sustainable curriculum reform. [ABSTRACT FROM AUTHOR]

We studied stroke volume during exercise in 12 male asymptomatic patients in sinus rhythm after intraatrial repair for d-transposition of the great arteries. Data indicate that during exercise, stroke volume did not increase in the patient group, while in control subjects stroke volume increased. [ABSTRACT FROM AUTHOR]

Apparently, in developing and in well-developed societies we are confronted with a crisis of academic medicine in all aspects: health care, teaching, and research. Health care providers in teaching hospitals are under pressure to generate revenues, academic research is pressed to keep pace with institutions devoted solely to research, and teaching is often understood not as privilege and honor but as burden and nuisance. The key problem and the principal cause of the crisis are low interest of the best young graduates to follow an academic career in a world where the benefits and values of the private sector are prevailing. Confronted with these circumstances and the continuous perils of permanent brain-drain, we developed an innovative concept of "shared employment' where two academic institutions (one in a developed and one in a developing country) will collaborate in development and support of fresh talents, building elite academic staff. Most academic exchange programs developed so far have proved to be ineffective and of poor vitality, in spite of loud exclamations, high expectations, and a huge amount of good will involved. In contrast, the suggested cooperation will be based exclusively on mutual interest and clearly defined benefits for all involved parties.