Swiss medical weekly
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Usually, pain is caused by the excitation of nociceptors or of nociceptive afferent fibers. The responsiveness of the nociceptors can be modulated by endogenously released algesic substances or local hormones. Lesioned and regenerating nerve fibers show enhanced excitability and spontaneous activity. ⋯ Inhibition of spinal neurons, and analgesia, can be produced by stimulation of brain stem structures. Pharmacologically, pain inhibitory systems may involve serotonin and endogenous opioids as transmitter or modulator substances. For pain therapy, pain inhibitory systems may be activated e.g. by morphine and ther analgesic drugs, focal brain stimulation, various means of somatosensory afferent stimulation and by psychological influences such as stress.
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Swiss medical weekly · Nov 1981
[Oxygen consumption of the respiratory muscles in increased respiratory resistance].
The alveolar pressure was measured in 15 healthy men at different flow rates breathing without and with additional resistance from a stenosis (diameter 7 mm). Ventilation, breathing frequency, pulse rate, O2-uptake, and CO2-elimination were also measured during rest and during bicycle exercise. ⋯ During work, however, the stenosis, caused increased O2-uptake and CO2-elimination and decreased ventilation and breathing frequency. The mean O2-consumption by the respiratory musculature necessary to overcome the airway resistance is 0.00042 ml/gcm.
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Swiss medical weekly · Sep 1981
Case Reports[The pathogenesis of pulmonary edema after being buried by an avalanche].
A case of pulmonary edema in a rescued avalanche victim is described. The pathogenesis of this complication involves respiratory and hemodynamic factors which are responsible for the development of a hydrostatic pressure gradient between capillaries and alveoli. The resulting transsudation requires some time after the victim has been buried and probably the appearance of pulmonary edema directly precedes death. ⋯ However, such an event can, theoretically, be considered part of the pathophysiological processes in buried avalanche victims. In addition to the usual emergency treatment, therapy should, in the light of this theoretical consideration, also be directed towards normalization of the pressure relationship. This can be accomplished by decreasing the pressure in the lung capillaries and increasing the pressure in the alveoli.