Med Klin
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Our investigation examined the influence of regular physical activity and sudden extrenious situations on the incidence of sudden cardiac death (scd) in two different Berlin districts with a total population of 219,251 in the examined age-groups. ⋯ The results show that the risk of scd for all persons regardless of their levels of regular physical activity and their preillness status is higher during strenuous activity than during inactivity. The increase of the risk for scd during activity is the highest for persons with sedentary lifestyles, whereas the risk increase for persons with active lifestyles is minimal. The protective effect of regular physical activity for scd by far exceeds the risk increase of the actual strenuous situation.
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Myoclonus is a possible side effect of opioid therapy, and have been described following systemic as well as spinal application. ⋯ For treatment of opioid-induced myoclonus a dose reduction or a change of the opioid should be considered as well as symptomatic treatment with benzodiazepines or baclofen.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Epidemiology and diagnosis of intermittent self-ventilation].
The purpose of the lung is intrapulmonary gas exchange. The circulatory system delivers the respiratory gases to the tissue. The ventilatory pump however is responsible for the circulation of air between the lungs and the ambient atmosphere. ⋯ Chronic ventilatory failure as a result of neuromuscular disease or scoliosis of the thoracic spine are the classical indications. COPD and myasthenia gravis are under discussion as indications for intermittent mechanical ventilation with an increasing tendency to ventilate. Epidemiological data however can only be roughly estimated due to the heterogeneity of indication and selection of the patients.
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Noninvasive ventilation as well established in treatment of chronic respiratory failure. Many announcements and our own experience give evidence that this method of treatment is useful for patients with acute respiratory failure too. Also the actual situation of our health system requires increasing attention to financial points of view. ⋯ So noninvasive ventilation is a cost reducing and gentle alternative compared to conventional invasive mechanical ventilation for many patients with acute respiratory failure. It is also practicable in regional hospitals. Further investigation is needed to specify those groups of patients who receive the most benefit from noninvasive ventilation.
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Patients who develop acute exacerbation of a chronic pulmonary disease (COPD), neuromuscular dysfunction and/or disorders of the ventilator control often require assistance of ventilation. transtracheal intubation presents risks of nosocomial pneumonia and injuries. There is general agreement that in patients with chronic alveolar hypoventilation noninvasive positive pressure ventilatory assistance improves ventilation, quality of life, and prolongs survival. Recently, some studies also demonstrate that noninvasive positive pressure ventilation may offer an alternative to intubation in some patients with COPD and lung edema. ⋯ These safeguards include extensive institutional experiences for noninvasive positive pressure ventilations, adequate physicians and respiratory care technicians to provide bedside skilled care and preparedness of emergent intubation, and the patient's mental alertness to tolerate noninvasive ventilatory techniques. The most pronounced benefits of noninvasive positive pressure ventilation was absence of side effects, shortening of time spent in ICU. The present clinical data support the hypothesis that noninvasive positive pressure ventilation may be an alternative for intubation in patient with acute respiratory failure and suggest further clinical investigative support.