Search PubMed⌕ Search

Biomedical subjects

H Hein

Publications and source records attributed to H Hein.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Extent of variations in minimal CPAP pressure requirements during a single night].

The frequency of apnoeic events during sleep depends on posture and sleep stage. This is due to a change of upper airway size and upper airway closing pressures during different postures and sleep stages. The extent of the change of the necessary "splinting" pressure during nasal CPAP therapy for obstructive sleep apnoea is unknown. We titrated during CPAP therapy the minimal effective pressure, depending on sleep stage and posture. The necessary pressure fluctuated, depending on the patient, between 3 and 10 mbar. The highest pressure was not solely achieved during supine position and REM; some patients needed higher pressures under other circumstances.

Adult↗
PubMed1996

[Oral testing for sulfite asthma].

AIM OF THE STUDY: Patients with asthma may develop bronchoconstriction after ingestion of sulfites. We studied the sensitivity and specificity of an oral provocation challenge with metabisulfite to detect a sulfite-sensitive asthma. METHODS: We performed an oral dose-response metabisulfite challenge in 44 patients with a history of sulfite-sensitive asthma, 27 patients with asthma but without a history of sulfite sensitivity, and 8 control subjects without asthma. Metabisulfite was administered in capsules in a single-blind manner. Airway response was assessed by FEV decline, measured 30' after each dose. RESULTS: Thirty-nine percent of patients with a history of sulfite-sensitive asthma demonstrated a significant bronchoconstriction after ingestion of metabisulfite, whereas patients without an appropriate history and control subjects did not respond to the challenge. CONCLUSIONS: The oral metabisulfite challenge exhibits a high specificity (100%) but low sensitivity of about 40%. Nonetheless, taking into account the uncertainties in the patients' history of sulfite-sensitive asthma, the oral metabisulfite challenge as performed by us is a useful method for the diagnosis of sulfite sensitive asthma.

Administration, Oral↗
PubMed1996

[Assessment of attention parameters in sleep apnea patients].

In the current study the modality-shift paradigm was applied to examine attention deficits in sleep-apnea patients. The reaction times of ipsi- and crossmodal light and sound stimuli were measured on 34 patients presenting symptoms of sleep-apnea. Some of the simple reaction times of ipsimodal (light-light; sound-sound) and crossmodal (light-sound; sound-light) stimuli correlated with mean or with minimal oxygen saturation, but did not correlate with the frequency or duration of obstructive apneas and hypopneas. However, results are different if the amount of modality-shift effect is taken into consideration. Significant correlations were found for the maximal duration of obstructive apneas and hypopneas as well as for mean oxygen saturation.

Attention↗
PubMed1995

Intractable cough associated with the supine body position. Effective therapy with nasal CPAP.

We describe five patients with severe nocturnal cough and daytime somnolence in whom the coughing attacks are triggered by assuming the supine body position. Quantity and quality of the nocturnal cough were evaluated in the sleep laboratory with and without nasal continuous positive airway pressure (N-CPAP). Air flow characteristics were assessed using flow volume and airway resistance loops. Airway anatomy was evaluated bronchoscopically. In all five patients, the cough had a barking quality. Flow-volume loops showed an expiratory collapse phenomenon in two of the patients. Endoscopically, all five patients had signs of airway collapse. All patients had difficulty falling asleep because of coughing and were awakened by it frequently. Sleep times ranged from 2.5 to 4.5 h per night. With N-CPAP pressures ranging from 5 to 13 cm H2O, all five patients had clinically significant improvement in their symptoms. Their sleep times increased to a range of 5 to 7.5 h per night and the daytime somnolence markedly improved or resolved. All five patients requested a N-CPAP unit for home use. We conclude that a cough that is predominantly associated with or exacerbated by the supine body position may be treated effectively with N-CPAP.

Adult↗
PubMed1995

[Nicotine as therapy of obstructive sleep apnea?].

In 8 smokers (age 57 +/- 6 years, BMI 26.4 +/- 3.8 kg/m2) with an apnea-hypopnea index of 22.2 +/- 19.5 and who wanted to give up smoking with the help of nicotine plaster, various characteristic values of respiratory disturbances (among others, average and longest duration of various apnea and hypopnea, average and minimum oxygen saturation) were investigated during nicotine and control nights. All characteristic values, with the exception of the average oxygen saturation (from 93.7 to 94.4%, p < 0.02), did not change significant. These results indicate that nicotine could be an effective drug. However, it cannot yet be recommended for the treatment of obstructive sleep apnea because of some still unanswered questions (efficacy for non-smokers, side-effects, risk of addiction).

Administration, Cutaneous↗
PubMed1993

[Theophylline in therapy of obstructive sleep apnea?].

We examined the effect of 375 mg theophylline at night in 95 patients (14 women, 81 men) with obstructive sleep apnoea. The apnoea-hypopnoea index decreased significantly from 20.9 +/- 17.2 to 13.5 +/- 15.8/hour, the nadir of oxygen saturation increased from 80.6 +/- 8.5 to 82.4 +/- 8%. A survey of the longterm effects of theophylline in 16 initially responding patients revealed after 31-922 (190 +/- 217) days therapy no statistically significant change of the apnoea-hypopnoea index; however, the nadir of oxygen saturation was lower compared to the beginning of the therapy (83.8 +/- > 79.3 +/- 7.6%). We believe that theophylline is useful in single cases of patients with obstructive sleep apnoea, but is necessary to reconfirm the positive effect.

Adult↗
PubMed1991

Iowa's infant mortality: looking worse, doing better.

Interstate comparisons of infant mortality data can be misleading unless causes of infant death are considered, says this author. In Iowa the percentage of preventable deaths dropped almost 35% in recent years.

Cause of Death↗
PubMed1990

[Changes in atrial natriuretic peptide in patients with lung embolism and obstructive respiratory tract disease].

Plasma levels of atrial natriuretic peptide (ANP) correlate closely with the pressure and mural tension of the right atrium and with pulmonary arterial pressure. We determined ANP levels in eight patients with scintigraphically confirmed pulmonary embolism, before and after reperfusion. Furthermore, ANP was measured in ten patients with acute obstruction of the airways, and during the course of clinical recovery. Peripheral venous blood was saved for determination of ANP plasma levels. The hormone concentrations were measured by radioimmunoassay. In ten patients with scintigraphically confirmed pulmonary embolism clearly higher ANP plasma levels were determined than after complete reperfusion (p less than 0.05). In patients with acutely exacerbated airways obstruction, hormone levels were measured which were significantly higher than those observed after clinical improvement (p less than 0.01). Since it is known, that ANP reduces pulmonary arterial smooth muscle tone and resistance, the hormone appears to be of physiological significance in pulmonary embolism and acute airways obstruction by lowering right ventricular afterload.

Adult↗
PubMed1989

[Diagnosis of the function of respiratory control in patients with obstructive sleep apnea syndrome].

UNLABELLED: Twenty-five patients with OSAS were investigated and compared with an age-matched control group of 20 healthy volunteers. The ventilatory responses to pure oxygen administration, active hyperventilation, progressive hyperoxic hypercapnia and progressive isocapnic hypoxia were studied in all subjects. RESULTS: Hypoxic ventilatory response in OSAS patients was significantly diminished as compared with the control group. Hypercapnic ventilatory response, decrease in ventilation due to chemoreceptor inactivation during oxygen respiration and after hyperventilation did not differ in the two groups. The diminished response to hypoxia in OSAS patients was correlated with the increased respiration-synchronous changes in nasal resistance. Our data seem to suggest that in OSAS patients the diminished responsiveness to hypoxia may increase the likelihood of nocturnal apnea. A decrease in hypoxic inspiratory drive appears to be one mechanism initiating upper airway occlusion.

Carbon Dioxide↗
PubMed1989

[Persulfate asthma in hairdressers].

At the a two-year apprenticeship, a young female hairdresser developed rhinoconjunctivitis and bronchial asthma, induced by a hair bleach containing the substance persulphate. On each occasion, her symptoms occurred in the form of an immediate reaction. The causative role of the bleach was demonstrated with the aid of an inhalation challenge test. In addition, the prick test produced a positive reaction vis-a-vis persulphate. The long latency period and the positive prick test might militate in favour of an allergic pathomechanism.

Adolescent↗
PubMed1986

Antenatal diagnosis and palliative treatment of nonimmune hydrops fetalis secondary to pulmonary extralobar sequestration.

The causes of nonimmune hydrops fetalis are multiple. Despite the fact that many of the affected fetuses are otherwise free of fatal abnormalities, many die in the neonatal period from pulmonary hypoplasia. The overall perinatal mortality is as high as 80%. Extralobar pulmonary sequestration is an abnormal and nonaerated mass of extra pulmonary-located lung tissue supplied by a systemic artery, and is a rare cause of nonimmune hydrops. In the only two published reports, the hydropic fetuses died at birth. Both the first antenatal diagnosis of this disorder and the first attempt at palliative in utero therapy are reported herein. Though the fetus ultimately delivered prematurely and succumbed, treatment was associated with both subjective improvements in fetal well-being and objective reversal of the hydrops.

Adult↗