Therapeutische Umschau. Revue thérapeutique
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Bone densitometry has replaced conventional X-ray imaging in the diagnosis of bone loss. Conventional X-ray techniques however, are still the source of choice in the diagnosis of fractures in patients with osteoporosis and in the differential diagnosis of atraumatic fractures. ⋯ The differential diagnosis of long bone fractures includes osteolytic metastases as well, and in the younger patients also bone cysts, bone tumours or hereditary skeletal diseases. Objective techniques have been developed, which allow the identification of beginning fractures but also the determination of the extent of vertebral deformation (SDI).
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Historical Article
[Home ventilatory support--retrospective view and perspectives].
Mechanical home ventilation is a child of this centuries polio epidemics. The tank respirator, or iron lung, signaled the beginning of the new era. ⋯ Hypoventilation syndromes of various origin are more and more encountered thanks to better detection methods. They benefit from a new, efficient and noninvasive technique, the positive pressure ventilation via nasal mask.
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Air pollution can also be considered a health risk for those living in Switzerland. During short episodes of high pollution (smog), protection from exposure can be recommended. ⋯ As the patient does not perceive a direct improvement in his personal health, it is difficult to promote ecologically acceptable behaviour. In view of the long term effects of continuous exposure to air pollution on the health of the population, such preventative activity is considered necessary.
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The most common disease of the pilosebaceous follicle is acne vulgaris. The primary detectable pathologic defect in acne is abnormal keratinization of the follicular epithelium, resulting in a retention hyperkeratosis. The primary lesion produced by this process, the comedo, ist the precursor of most other acne lesions. ⋯ Topical erythromycin and clindamycin appear to have equivalent efficacy. A major treatment advance has been heralded by the use of oral 13-cis retinoic acid (isotretinoin) in the management of patients with severe nodulocystic acne, acne conglobata and acne fulminans. Isotretinoin is teratogenic and should not be given to women of childbearing age.
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Administration of oxygen is an accepted component of the treatment of acute diseases leading to temporary arterial hypoxemia. In addition, long-term oxygen therapy of patients with chronic hypoxemia secondary to chronic obstructive lung disease (COPD) has become increasingly common, after beneficial effects on quality of life and survival have been reported. ⋯ Therefore, strict criteria have to be considered in the selection of hypoxemic patients with COPD. This article reviews the tests and criteria required for the prescription of long-term oxygen therapy as well as newer technical aspects in its application with special emphasis on transtracheal catheters.