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Biomedical subjects

I Fett

Publications and source records attributed to I Fett.

10 recordsLinked to original sources
PubMed1991

[Cardiopulmonary risk factors in patients with sleep apnea].

Since the interaction between disorders of the respiratory coordination and cardiovascular or cardiopulmonary regulation is still largely unknown the intention of the present investigation is to point out the coincidence of cardiac arrhythmias, such as premature ventricular capture (PVC) beats and conduction blocks, with obstructive sleep apnea (OSA). For the first time a group of more than 300 patients with suspected OSA is examined concerning risk factors and frequent diagnoses as obesity, hypertension, coronary heart disease (CHD), heart insufficiency, chronic obstructive pulmonary disease (COPD), and daytime hypoxaemia. Summarizing the results of lung function test, blood gas analysis, strain-ECG, Holter-ECG and inductive plethysmography with oxygen partial pressure measurement by ambulatory work-up the following statements can be made: PVC beats occurring markedly during sleep give hints for OSA being the underlying cause, especially if the patients are young and overweight. Hypoxaemia increasing during the apnea episodes should be considered as one possible pathogenetic mechanism. Second- and third degree conduction blocks and sinus arrest coincident very often with OSA. They suggest to be life-limiting factors the more so since they often go along with CHD or heart insufficiency. Systemic arterial hypertension and overweight have the highest prevalence in OSA, signs for heart insufficiency and daytime hypoxaemia are also significantly more frequent than in non-OSA patients. We could find no hints for direct pathogenetic coherence between CHD and OSA or between COPD and OSA, nevertheless pronounced nocturnal changes in blood gases and intrathoracic hemodynamics have important influence on the cardiopulmonary and cardiovascular system, as partly illuminated in other more pathogenetic oriented studies by the present time.

Arrhythmias, Cardiac↗
PubMed1991

[Treatment of primary and secondary therapy failure in patients with sleep apnea treated with nasal CPAP].

Two forms of treatment failure of nCPAP therapy should be distinguished: 1. Primary treatment failure: the reversal of apnoeas and hypopnoeas cannot be achieved due to central SA or a combination of MSA and central hypoventilation. In 10 patients who did not respond to nCPAP (7 patients with purely central SA and 3 patients with MSA who still demonstrated long phases of central hypoventilation during nCPAP) we performed a nasal intermittent positive pressure ventilation (nIPPV) during at least 3 treatment nights. In all patients a reversal of apnoeas and hypopnoeas could be achieved, despite a few phases of mask leakage. Due to possibly life threatening side effects continuous monitoring is required during the initial treatment phase. 8 patients who reported a reduction of symptoms have been successfully using the treatment at home for up to 22 months. 2. Secondary treatment failure: nCPAP leads to a normalisation of breathing pattern but patients refuse nCPAP or discontinue treatment. Besides patients who are poorly motivated there are four major side effects of nCPAP as a reason for non-compliance: a) drying out of the nasopharyngeal mucosa or rhinitis; b) pressure marks caused by the nose mask; c) intolerance to the high expiratory pressure; d) noise. Drying out of the mucosa and rhinitis are the most important side effects. If an increase of room temperature and humidity, nasal cream and small amounts of mint-oil as well as a heat-moisture exchanger (HME) prove inadequate, we use a heated humidifier (Dräger, Aquapor).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[Sleep apnea].

Explore the source record for details and available documents.

Humans↗
PubMed1989

[Long-term acceptance of nasal continuous positive airway pressure therapy in 70 patients with sleep apnea over a 6-month treatment period].

NCPAP therapy is considered to be an effective method of treatment in cases of obstructive and mixed sleep apnea (SA). We investigated its effectiveness during initiation of therapy, and the acceptance of the ambulatory long-term treatment. Here we present the first 70 patients (68 m, 2f) treated with nCPAP for at least six to a maximum of 20 months (on average: eleven months). Sixty-seven of the 70 patients were effectively treated with a nCPAP pressure of 5-15 mbar. The apnea index was reduced from 49 apnea episodes per hour (range 12-125) to 2 episodes per hour (range 0-8) on average. Therapy failed in one case (anatomical defect of the nasopharynx) and had to be abandoned in two cases (claustrophobia, acute rhinitis). Sixty-three patients, decided in favour of ambulatory long-term therapy. These patients were asked to complete a questionnaire about their experience with nCPAP. Four patients abandoned therapy (all within the first four weeks because of intolerance towards the apparatus), and one patient died 10 days after terminating treatment of an infection of the upper airway. Fifty-eight patients (82% of all) are still undergoing treatment. Eighty-eight per cent of these are using nCPAP for 5-7 nights a week throughout the entire sleep period, or at least for five hours. All patients report a marked reduction in or elimination of subjective symptoms. Mild local side effects occur quite frequently, but can be greatly reduced or eliminated in most cases. In individual cases they lead to a shortening of the nocturnal duration of application.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Results of left heart catheterization study in 64 patients with nocturnal disorders of respiratory control (sleep apnea)].

Sleep apnea (SA) is associated with increased morbidity of the cardiovascular system, the interaction between the disordering of respiratory coordination and cardiovascular regulation being largely unknown. In 64 patients (age: mean = 54.1; range: 35-67 years) with an increased apnea index (AI greater than 10), a cardiac catheterisation investigation was performed to exclude coronary heart disease (CHD) or cardiomyopathy. CHD was excluded in 39 patients, 6 patients had coronary single-vessel disease, 9 patients coronary two-vessel, and 10 three vessel disease. In 10 patients, cardiomyopathy was detected, while high-grade impairment of the left ventricular ejection fraction (greater than 30%) was observed in five patients. With the exception of a single patient, CHD was observed only in patients in the over-fifty age group. Arterial hypertension was seen in 84% of the patients with, and in 69% of the patients without, CHD. The patient groups with and without coronary heart disease did not differ with respect to apnea index, ten minute index, or the average duration of the 30 longest apneic episodes. Anginal complaints, observed in a total of 72% of the patients, were one of the major indications for coronary angiography. These results do not support the assumption that SA is primarily a consequence of underlying cardiac disease, but do indicate that SA must be considered a cardiac risk factor, especially in view of the fact that pronounced nocturnal changes in blood gases and haemodynamics, together with malignant arrhythmias, are found in conjunction with this disturbance of breathing.

Adult↗
PubMed1976

The future of women in Australian medicine.

Data are presented on the division of labour in doctor's households which show that, in addition to practising, medical women perform almost as much domestic work as do the wives of their male colleagues. In relation to The National Health Act 1970, and current postgraduate training procedures, this has implications for an increasingly polarized division of labour in medicine, as the numbers and proportions of women doctors increase. If the trend is not inhibited by amendment of postgraduate training procedures, and a more equitable distribution of domestic labour, a second-class status is likely for women in medicine, to the detriment of both the profession and the community.

Australia↗