Med Klin
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The favorable effect of hypothermia on brain damage resulting from cardiac arrest was first demonstrated in animal studies. Subsequent small-scale human studies have also shown positive effects. ⋯ The results convincingly showed a positive effect on survival and neurologic outcome. Based on the currently available data, the International Liaison Committee on Resuscitation (ILCOR) strongly recommends that unconscious adult patients who are resuscitated after ventricular fibrillation be cooled to temperatures between 32 and 34 degrees C for 12-24 h.
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Stroke is the most frequent neurologic disease, one of the most frequent reasons for disability and the third most frequent cause of death in Germany. Only the coordination of prevention, therapy in the acute setting and rehabilitation will improve the socioeconomic burden of stroke. ⋯ Since 2005, and the beginning of the third funding period, the Competence Net Stroke consists of nine sub-nets. The integrative, rather than dominating, structure eases flexible reactions to new developments and findings in research. The Competence Net Stroke can more straightforwardly adopt new, promising research areas and end funding of those which are unsuccessful. The future and continuity of the Competence Net Stroke are secured by the acquisition of alternative funding such as "Sonderforschungsbereiche", the sixth European framework program, industrial partners, and health insurance.
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In cancer pain management the application of opioids is established and follows the WHO guidelines. In the management of chronic non-cancer pain opioids are used increasingly but the effectiveness is less. ⋯ The psychomotor performance is not impaired in all patients but must be controlled in the individual patient. In chronic pain management opioids are a component of an interdisciplinary concept and can be used safely by considering therapy rules and supervision.
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Obstructive sleep apnea syndrome (OSAS) is regarded as a cardiovascular risk factor. Therefore, cardiopulmonary exercise capacity in patients with OSAS before and under treatment with continuous positive airway pressure (CPAP) was investigated. ⋯ Cardiopulmonary exercise capacity is markedly reduced in patients with OSAS. Long-term CPAP therapy leads to a significant improvement of reduced cardiopulmonary exercise capacity in these patients.
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Currently, endomyocardial biopsy is the most reliable method to detect an acute rejection after heart transplantation. However, as an invasive procedure it is associated with a definite risk for complications. Therefore, it was examined whether changes in QT time and QT dispersion on the surface ECG are able to predict an acute cellular rejection. ⋯ Provided that ECGs are performed regularly, measurements of QTc time and QTc dispersion can reliably be used to detect an acute rejection in the early phase after heart transplantation.