[Amyotrophic lateral sclerosis and respiratory insufficiency].

Amyotrophic lateral sclerosis (ALS) is a disease causing degeneration of motor neurons, without any curative treatment. The most common cause of death is respiratory arrest due to atrophy of the respiratory musculature. ALS-associated respiratory insufficiency differs in mechanism from the more common causes of dyspnea, such as diseases of pulmonary or cardiac origin.

Is the effect of non-invasive ventilation on survival in amyotrophic lateral sclerosis age-dependent?

Background: Hypoventilation due to respiratory muscle atrophy is the most common cause of death as a result of amyotrophic lateral sclerosis (ALS). Patients aged over 65 years and presenting bulbar symptoms are likely to have a poorer prognosis. The aim of the study was to assess the possible impact of age and treatment with non-invasive ventilation (NIV) on survival in ALS.

Using respiratory rate and thoracic movement to assess respiratory insufficiency in amyotrophic lateral sclerosis: a preliminary study.

Background: Hypoventilation due to respiratory insufficiency is the most common cause of death in amyotrophic lateral sclerosis (ALS) and non-invasive ventilation (NIV) can be used as a palliative treatment. The current guidelines recommend performing spirometry, and recording nocturnal oxyhemoglobin saturation and arterial blood gas analysis to assess the severity of the hypoventilation. We examined whether the respiratory rate and thoracic movement were reliable preliminary clinical signs in the development of respiratory insufficiency in patients with ALS.

Validation of indirect calorimetry for measurement of energy expenditure in healthy volunteers undergoing pressure controlled non-invasive ventilation support.

The aim of this validation study was to assess the reliability of gas exchange measurement with indirect calorimetry among subjects who undergo non-invasive ventilation (NIV). Oxygen consumption (VO2) and carbon dioxide production (VCO2) were measured in twelve healthy volunteers. Respiratory quotient (RQ) and resting energy expenditure (REE) were then calculated from the measured VO2 and VCO2 values.

[The viper--Finland's only poisonous snake].

The viper (Vipera berus) is the most common poisonous snake in Europe, and the only one in Finland. In viper bites, highly varying amounts of venom end up into the victim, whereby prediction of the progression of symptoms of poisoning is very difficult. A severe clinical picture must always be anticipated.

Predictive equations over-estimate the resting energy expenditure in amyotrophic lateral sclerosis patients who are dependent on invasive ventilation support.

Background: Amyotrophic lateral sclerosis (ALS) is a form of degenerative motor neuron disease. At the end stage of the disease artificial feeding is often required. Nevertheless, very little is known about the energy demand of those ALS patients who are chronically dependent on tracheostomy intermittent positive pressure ventilation.

Pulseless electrical activity and unsuccessful out-of-hospital resuscitation: what is the cause of death?

Aims: To study the cause of deaths after witnessed cardiac arrest followed by pulseless electrical activity and unsuccessful of out-of-hospital resuscitation; and to detect any differences between causes of death determined at autopsy and those inferred from clinical history.

Methods: In this prospective observational study, data were collected from 91 individuals treated by the emergency medical services in three urban communities in southern Finland.

Results: Cause of death was determined at autopsy in 59 cases and without autopsy in 32 cases.

Time matters; what is the time in your defibrillator? An observational study in 30 emergency medical service systems.

Background: Measuring different intervals during cardiopulmonary resuscitation is a key element of resuscitation performance. For accurate time measurements, the internal clocks of automated external defibrillator (AEDs) need to be synchronized with the dispatch centre time.

Aim: To determine the present practice of using and synchronizing the AED clocks in five regions in Finland.