MMW Fortschritte der Medizin
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Nocturnal breathing disorders are rather frequently observed in patients with left ventricular failure. When an obstructive sleep apnoea is present, nCPAP therapy is the preferred treatment method; the treatment probably also positively affects the left ventricular failure itself. Central sleep apnoea and in particular, the special form Cheyne-Stokes respiration have an unfavourable prognosis with increased mortality in patients with left ventricular failure. The indication for either nCPAP therapy or adaptive servoventilation cannot yet be regarded as verified and is the subject of ongoing clinical studies.
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Parasomnias are characterized by undesired behaviour (e.g. sleep-walk, teeth-grinding) or unpleasant experiential phenomenon (e.g. nightmares) during sleep. They are classified as arousal disorder, disturbances in the transitions between sleep states, REM-associated sleep disorders or as other parasomnias. In addition to general therapeutic measures to protect against self-inflicted and externally-inflicted injuries, different diagnostic and therapeutic options are available depending on the symptoms and the type of disorder present.
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Review Comparative Study
[Pharmacotherapy of chronic, non-tumour related pain. Efficacy, tolerability and patient benefit of an oral osmotic system with hydromorphone].
An overview of the results of a clinical study is presented in which efficacy, tolerability and patient benefit of a therapy with OROS (ORal OSmotic) hydromorphone (Jurnista) in patients with chronic pain was investigated. ⋯ The results emphasize the clinical effectiveness of oral osmotic hydromorphone in the treatment of chronic, intense pain.
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Review Comparative Study
[Trigeminal autonomic cephalgias: diagnostic and therapeutic implications].
Trigeminal autonomic cephalgias (TACs) are primary headache syndromes characterized by severe short-lasting headaches accompanied by ipsilateral facial autonomic symptoms. The group includes cluster headache (CH), paroxysmal hemicrania (PH), and short-lasting neuralgiform headache with conjunctival injection and tearing (SUNCT). ⋯ The therapeutic strategies, however, differ considerably. Although unusual, structural lesions in TACs have been described, affecting the therapeutic management.