[COPD : a still neglected condition].

Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung disorder with a complex clinical picture. The diagnosis may be difficult at times, as COPD may develop insidiously and remain unnoticed for a long time. Therefore, general practitioners play a central role in early detection of disease.

[COPD - An Underestimated Disease].

COPD - An Underestimated Disease Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung condition with a complex clinical picture. The diagnosis is not easy to make because COPD can develop insidiously and remain unnoticed for a long time. Therefore, general practitioners play a central role in the early detection of the disease.

[Novelties in the Treatment of Asthma].

For general practitioners there have been important novelties in the treatment of asthma due to recent modifications of the international guidelines from Global Initiative for Asthma (GINA). In Step 1, use of short-acting beta2-agonists (SABA) without concomitant inhaled corticosteroids (ICS) as controller is no longer recommended for lack of efficacy and safety reasons. Instead, low dose ICS-formoterol as needed is recommended.

[Novelties in the Treatment of Asthma].

Novelties in the Treatment of Asthma For general practitioners there have been important novelties in the treatment of asthma due to recent modifications of the international guidelines from Global Initiative for Asthma (GINA). Step 1 no longer recommends the use of short-acting β2-agonists (SABA) without concomitant inhaled corticosteroids (ICS) as a controller because of the lack of efficacy and for safety reasons. Instead, low dose ICS-formoterol as needed is recommended.

Impact of high-altitude therapy on type-2 immune responses in asthma patients.

Background: Asthma patients present with distinct immunological profiles, with a predominance of type 2 endotype. The aim of this study was to investigate the impact of high-altitude treatment on the clinical and immunological response in asthma.

Methods: Twenty-six hospitalized asthma patients (nine eosinophilic allergic; EA, nine noneosinophilic allergic; NEA and eight noneosinophilic nonallergic; NN) and nine healthy controls in high altitude for 21 days were enrolled in the study.

Perception of climate change in patients with chronic lung disease.

Background: Climate change affects human health. The respective consequences are predicted to increase in the future. Patients with chronic lung disease are particularly vulnerable to the involved environmental alterations.

Unrecognized secondary causes of hypertension in patients with hypertensive urgency/emergency: prevalence and co-prevalence.

Background: Hypertensive urgency/emergency occurs frequently, yet no prospective data on common secondary causes, including sleep apnea (SA), renal artery stenosis (RAS), and hyperaldosteronism, are available.

Methods: Patients presenting to the emergency room for over 1 year with systolic blood pressure > or =180 mmHg and/or diastolic blood pressure > or =100 mmHg and typical symptoms were included. RAS was diagnosed by direct duplex/Doppler ultrasound of the renal artery, resistance index, and imaging.

A fatal case of spinal tuberculosis mistaken for metastatic lung cancer: recalling ancient Pott's disease.

Background: Tuberculous spondylitis (Pott's disease) is an ancient human disease. Because it is rare in high-income, tuberculosis (TB) low incidence countries, misdiagnoses occur as sufficient clinical experience is lacking.

Case Presentation: We describe a fatal case of a patient with spinal TB, who was mistakenly irradiated for suspected metastatic lung cancer of the spine in the presence of a solitary pulmonary nodule of the left upper lobe.

[Cheyne-Stokes respiration and cardiovascular risk].

Due to its high prevalence in patients with heart failure and its negative predictive value concerning morbidity and mortality, Cheyne-Stokes respiration (CSR) is a sleep disorders of major interest. CSR correlates with the degree of heart failure and is characterised by a typical crescendo/decrescendo breathing pattern combined with phases of central sleep apnoea, caused by pulmonary oedema and oscillation of ventilatory control. Thus, CSR is a marker of the severity of heart failure.

Sternal osteomyelitis: long-term results after pectoralis muscle flap reconstruction.

Background: Reports regarding long-term follow-up including quality-of-life assessment, pulmonary function, and donor-site morbidity after operative treatment for sternal osteomyelitis are rare.

Methods: Data for 69 consecutive patients were acquired from patients' charts and contact with patients and general practitioners, with special reference to treatment and clinical course. Twenty-four patients were interviewed and physically examined (mean follow-up, 4 years; range, 1 to 9 years).

Driving performance in patients with chronic obstructive pulmonary disease.

Patients with chronic obstructive pulmonary disease (COPD) present with impairments of their cognitive performance. It is still unknown whether cognitive deficits influence driving abilities in patients with COPD. The present study investigates driving performance in patients with COPD and healthy controls.

Reconstruction of the thoracic wall-long-term follow-up including pulmonary function tests.

Purpose: Thoracic wall reconstructions have become a standard procedure for the reconstructive plastic surgeon in the larger hospital setting, but detailed reports about long-term results including pulmonary function and physical examination are rare.

Materials And Methods: The data of 92 consecutive patients with full thickness chest wall resections were acquired from patient's charts and contact to patients, their relatives or general practitioners, with special reference to treatment and clinical course. At a mean follow-up of 5.

[Pathophysiology of the obesity hypoventilation syndrome].

The obesity hypoventilation syndrome (OHS) is defined by extreme overweight (BMI 30 kg/m2), daytime hypoventilation (PaCO2 > 45 mm Hg, the absence of other known causes of hypoventilation) and sleep-related breathing disorders. Obesity impairs breathing due to a restrictive ventilatory disorder, reduction of the capacity of respiratory muscles and diminishment of the ventilatory response. The restriction cannot serve as the only explanation of OHS because body weight or compliance on the one hand and hypoventilation on the other hand only correlate weakly.

[Acute effects of cardiac resynchronization therapy on breathing during sleep in patients with severe chronic heart failure--a pilot study].

Background: Sleep-related breathing disorders (SDB), especially Cheyne-Stokes respiration (CSR), have prognostic relevance in patients with chronic heart failure (CHF). Thus, we investigated acute effects of cardiac resynchronization therapy on breathing during sleep.

Methods: Beside a cardiopulmonary investigation, breathing during sleep was analysed polygraphically/polysomnographically on the night before and during the second night after implantation of a biventricular pacemaker for cardiac resynchronization.

[Influence of nocturnal oxygen therapy on quality of life in patients with COPD and isolated sleep-related hypoxemia: a prospective, placebo-controlled cross-over trial].

Background: In patients with COPD and isolated night time hypoxemia, oxygen administration has not shown any effects on life expectancy and the development of pulmonal arterial hypertension. The aim of the present pilot study was to investigate the influence of nocturnal oxygen therapy on the quality of life in daytime normoxemic COPD patients with nocturnal oxygen desaturations.

Patients And Methods: 19 patients with COPD, in a stable phase of the disease without need for oxygen supplementation under rest (PaO2 62.

[Sleep apnoea in women?--The forgotten gender].

The prevalence of clinically relevant, obstructive sleep apnoea syndrome (OSAS) in the general population is 2% in women and 4% in men. With increasing age and onset of postmenopausal status, the prevalence of OSAS in women becomes comparable to that of males. However, compared to prevalence data, women are under-represented in clinical sleep laboratories.

[Daytime ventilatory efficiency in obstructive sleep apnea syndrome--influence of CPAP-therapy].

Background: Obstructive sleep apnea syndrome (OSAS) is a nocturnal breathing disorder with possibly negative consequences on daytime control of ventilatory drive. We therefore investigated ventilatory efficiency, defined as the ventilatory equivalent for CO2 (VaE/VaCO2), in patients with OSAS during exercise before and under treatment with continuous positive airway pressure (CPAP).

Patients And Methods: In 21 patients with untreated OSAS, ventilatory efficiency, described as the slope (DeltaVaE vs.

[Locus of control belief is a predictor of CPAP-compliance in patients with obstructive sleep apnea syndrome].

Approximately 25 % of all patients suffering from obstructive sleep apnea syndrome (OSAS) discontinue CPAP-therapy in long-term follow-up. This study was conducted to investigate if there are any predictors signaling low compliance prior to initiation of CPAP-therapy. We used an open label longitudinal cohort study at an University hospital in-patient Sleep laboratory setting.

Sleep apnoea in heart failure.

Studies from the USA have reported that sleep apnoea is common in congestive heart failure (CHF), with Cheyne-Stokes respiration (CSR) being the most frequent type of sleep-disordered breathing (SDB) in these patients. Within the present study, the authors sought to assess the prevalence and type of SDB among CHF patients in Germany. A total of 203 CHF patients participated in this prospective multicentre study.