Pneumologie
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The authors report on the course seen in 7 cases of pulmonary histiocytosis X. In Group I (3 patients) immunosuppressive therapy was initiated on account of severe general symptoms and reduced pulmonary function. Remission was induced in 2 cases, whereas relapses occurred intermittently in one patient. ⋯ Progression did not occur with any of the patients. Pulmonary histiocytosis X should be treated with corticosteroid monotherapy in case of progressive deterioration of pulmonary function and/or if there are severe general symptoms. Chance findings in patients who are otherwise free from complaints should merely result in a closely meshed control checkup before taking any action.
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We studied the effect of CPAP and BIPAP on cardiac output (CO) in 23 male obstructive sleep apnea (OSAS) patients with cardiac history but without congestive heart failure (CHF) during wakefulness using the thermodilution method. CPAP was applied at 10 cm H2O and 15 cm H2O, BIPAP at 10/0 cm H2O and 15/10 cm H2O. ⋯ CPAP and BIPAP did not differ in altering hemodynamics. So sleep apnea patients without CHF develop no severe decrease of CO during nasal positive pressure ventilation up to 15 cm 2O.
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The unexpected increase in the incidence of tuberculosis in many industrialized countries, which was recorded in Germany for the first time in 1992, provided the incentive for this retrospective analysis over the past 13 years of the epidemiology and resistance situation for Tbc in the Rhine/Main area. Basis for the evaluation were the data from our laboratory which is the only institution in the region performing type and resistance determinations on mycobacteria. During the period of the investigation, in which 3,738 tuberculoses were confirmed in cultures, the number of cases of the disease among German citizens decreased continuously. ⋯ An increase in resistance either against individual substances or in regard to combination resistance could not be observed. In spite of the relatively high number of HIV-positive persons in the Frankfurt region, HIV-associated tuberculosis is still too seldom to make a noticeable impression on the total incidence. In the light of the regional incidence and resistance rates determined by us, a special position or even pace-setting function of our conurbation within the epidemiological tuberculosis situation in Germany cannot be recognized at present.