[Treatment of primary and secondary therapy failure in patients with sleep apnea treated with nasal CPAP].

Two forms of treatment failure of nCPAP therapy should be distinguished: 1. Primary treatment failure: the reversal of apnoeas and hypopnoeas cannot be achieved due to central SA or a combination of MSA and central hypoventilation. In 10 patients who did not respond to nCPAP (7 patients with purely central SA and 3 patients with MSA who still demonstrated long phases of central hypoventilation during nCPAP) we performed a nasal intermittent positive pressure ventilation (nIPPV) during at least 3 treatment nights.

[Cardiopulmonary risk factors in patients with sleep apnea].

Since the interaction between disorders of the respiratory coordination and cardiovascular or cardiopulmonary regulation is still largely unknown the intention of the present investigation is to point out the coincidence of cardiac arrhythmias, such as premature ventricular capture (PVC) beats and conduction blocks, with obstructive sleep apnea (OSA). For the first time a group of more than 300 patients with suspected OSA is examined concerning risk factors and frequent diagnoses as obesity, hypertension, coronary heart disease (CHD), heart insufficiency, chronic obstructive pulmonary disease (COPD), and daytime hypoxaemia. Summarizing the results of lung function test, blood gas analysis, strain-ECG, Holter-ECG and inductive plethysmography with oxygen partial pressure measurement by ambulatory work-up the following statements can be made: PVC beats occurring markedly during sleep give hints for OSA being the underlying cause, especially if the patients are young and overweight.

[Results of left heart catheterization study in 64 patients with nocturnal disorders of respiratory control (sleep apnea)].

Sleep apnea (SA) is associated with increased morbidity of the cardiovascular system, the interaction between the disordering of respiratory coordination and cardiovascular regulation being largely unknown. In 64 patients (age: mean = 54.1; range: 35-67 years) with an increased apnea index (AI greater than 10), a cardiac catheterisation investigation was performed to exclude coronary heart disease (CHD) or cardiomyopathy.

[Long-term acceptance of nasal continuous positive airway pressure therapy in 70 patients with sleep apnea over a 6-month treatment period].

NCPAP therapy is considered to be an effective method of treatment in cases of obstructive and mixed sleep apnea (SA). We investigated its effectiveness during initiation of therapy, and the acceptance of the ambulatory long-term treatment. Here we present the first 70 patients (68 m, 2f) treated with nCPAP for at least six to a maximum of 20 months (on average: eleven months).

The future of women in Australian medicine.

Data are presented on the division of labour in doctor's households which show that, in addition to practising, medical women perform almost as much domestic work as do the wives of their male colleagues. In relation to The National Health Act 1970, and current postgraduate training procedures, this has implications for an increasingly polarized division of labour in medicine, as the numbers and proportions of women doctors increase. If the trend is not inhibited by amendment of postgraduate training procedures, and a more equitable distribution of domestic labour, a second-class status is likely for women in medicine, to the detriment of both the profession and the community.