Pneumologie
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Computed tomography (CT) is the method of choice for the morphological assessment of pulmonary structure. Airways. pulmonary parenchyma and their pathologies are shown with high spatial resolution. Airway diseases exhibit bronchial dilatation, wall thickening and an increased visibility in the lung periphery. ⋯ On the basis of CT-data lung volumes can be semented. Cine-CT allows to visualise motion of the central airways. e.g. in tracheomalacia, to assess regional ventilation to calculate pulmonary time constants. and to display the co-ordinated or dissociated motion of the thoracic wall and the diaphragm. Beyond the mere high-resolution visualisation of the structure of the lung the application of these CT-strategies makes a regional assessment of pulmonary function possible.
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An education program for patients with COPD is presented. This program was created for inpatient pulmonary rehabilitation at the Klinik Bad Reichenhall. ⋯ The patients should be motivated to manage the disease in an active and more independent way: They should control the natural course of their disease by learning preventive and restorative health care behaviours and self-help activities in case of acute exacerbations. The aim is to attain the acceptance of changing life-style.
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Mechanisms of allergen immunotherapy (AIT) are complex inducing numerous immunological effects. Successful AIT is most likely based on a functional switch of and tolerance induction in specific T cells downregulating allergic hypersensitivity and inflammation. Subcutaneous AIT for allergic rhinoconjunctivitis and allergic asthma has been successfully assessed in controlled studies with several clinically important allergens (i. e. birch-, grass- and mugwortpollen, dust mites, animal dander) and has shown convincing clinical efficacy. ⋯ Children tolerate AIT very well and benefit especially from its immunomodulatory effects. Risk factors for and results of unwanted systemic effects can effectively be minimized by training of the staff members involved, adhering to safety standards and immediate emergency treatment. Modified allergens, recombinant proteins and immunomodulatory adjuvants created by basic research are promises for an improved efficacy of AIT with reduced unwanted effects in the future.