Self reported prevalence and treatment of sleep disorders in Austria.
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Biomedical subjects
Publications and source records attributed to G Kapfhammer.
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Sleep apnea and snoring are widely discussed as risk factors for internal and neurological diseases. The prevalence of snoring in an Austrian population survey is about 27.2% (males 36.5%, females 18.9%), and that of apnea (respectively irregularity and/or cessation of breathing) about 8.5% (31% of all snorers). Clinical symptoms like naps, daytime sleepiness, unquiet sleep, hypertonia, headache in the morning and psychological symptoms may be characteristics of sleep apnea. They should lead to further diagnosis and removal of this risk factor for ischemic heart disease and stroke.
UNLABELLED: Epidemiologic data on sleep disturbances in Austria were collected for the first time in March/April 1993 in a representative inquiry ( SAMPLE: n = 1000, 471 males, 529 females). 26% of the subjects reported sleep disturbances which were mostly chronic (21% had suffered from sleep disturbance for more than one year). The incidence of sleep disturbances increased with age, namely 13% in 14-30 year-old subjects, 22% in 31-50 year-old ones and 41% in subjects over 50. 7% suffered from disturbances in sleep initiation, i.e., they had a sleep latency of over 30 minutes. 19% of them had difficulties in getting to sleep at least once a week. Disturbances in maintaining sleep were reported by 28% of subjects, 56% of them needing longer than one hour to get back to sleep. 30% suffered from daytime sleepiness, 43% of the subjects were impaired by their sleep disturbances in some way, but only 34% had consulted their doctor.
A computer system has been designed for acquisition and evaluation of polysomnographic recordings. The aim is to create a system running on a microcomputer emulating all functions of a conventional chart recorder and offering the advantage of making computer assisted evaluations. We have done 87 investigations in the first year of operation and were fully satisfied by the performance of the system. The standard signals we recorded were SaO2, heart rate, respiratory effort, nasal and oral airflow and ECG, as well as EOG, EMG and EEG. Due to this new method, evaluation of the recording can be done in less time than with strip chart recordings and the use of hundreds of pages of paper per night can be avoided.
High costs involved in administering continuous long-term oxygen therapy to patients with chronic lung diseases and limited portability of oxygen sources stimulated research into and development of oxygen conserving devices. Oxytron (Weinmann, Hamburg) is a new electronic demand oxygen delivery system which limits oxygen flow to the early phase of inspiration. The reservoir cannula Oxymizer Pendant (Chad-Therapeutics Inc.) is a nasal prong system incorporating a pendant reservoir which stores oxygen during expiration and delivers it as a bolus at the onset of inspiration. Ten patients with significant hypoxaemia at rest received oxygen delivered at various breath interval settings with the Oxytron method and at flow rates of 2, 3 and 41/min with the reservoir cannula Oxymizer Pendant and with continuous flow. The results indicate that significantly less oxygen was required to provide equivalent oxygen saturation with Oxytron as compared with steady flow delivery: an oxygen flow reduction of greater than 75% was achieved at all Oxytron settings tested. With the reservoir cannula oxygen saving was most evident at low oxygen flows: 29.3, 19.4 and 4.7% less oxygen was required than with continuous flow at 2, 3 and 41/min. Individual patient acceptance of various drug delivery systems and response to therapy should be considered when prescribing home oxygen therapy. The use of oxygen saving techniques could result in a substantial cost saving and greater mobility may help to improve compliance in patients requiring continuous oxygen therapy.
The efficacy of, and tolerance to lactose-free sodium cromoglycate capsules was investigated in a multicentre trial. Data of 154 patients with asthma treated at 41 centres were evaluated over an observation period of 5 weeks. During treatment there was a significant reduction in the required dosage of concomitant medication, a marked improvement with regard to the severity of symptoms and a significant increase in peak flow rates. Assessment of treatment was "good" or "very good" in 86% of patients. Mild side effects such as cough or throat irritation were seen in only 2.6% of patients.
In a prospective study, 18 chimney sweeps aged between 21 and 57 years were examined with the aim of detecting the presence of heavy metals in the blood and urine, and identifying cardiopulmonary diseases. Elevated concentrations of cadmium were found in three cases, and of lead in two cases, the concentrations being such that damage to health could not be excluded. None of the chimney sweeps showed any signs of bronchial hyper-reactivity or coronary heart disease. With respect to risk factors for coronary heart disease, elevated cholesterol and/or triglyceride levels were observed in 7/16 patients. These figures are compatible with the average figures for the Austrian population at large.
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The case report is presented of a 35 year-old patient with fibrosing mediastinitis. Clinically, only non-specific features were present. Radiography, computed tomography and cavography were of great importance in establishing the diagnosis and in following up the patient. Diagnosis was confirmed histologically following thoracotomy. Fibrosing mediastinitis, although a rare condition, should be considered in the differential diagnosis of mediastinal processes.