[Tachypnea--when breathing induces panic].
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Airway Resistance↗
Biomedical subjects
B Schwizer
Publications and source records attributed to B Schwizer.
[Snoring--when is etiological assessment necessary?].
Snoring is more than a social problem. Snoring is a sound produced by the vibrating structures of the upper airway. If clinical signs like sleepiness, fatigue, hypertension or vascular disease are present or if a surgical procedure for the treatment of snoring is considered, further investigations (respiratory polygraphy or full nocturnal polysomnography) should be performed. If sleep apnea is demonstrated, non-surgical approaches may be more promising.
Diagnosis, Differential↗
Outcome after unilateral lung volume reduction surgery in patients with severe emphysema.
OBJECTIVE: Bilateral lung volume reduction surgery (LVRS) has emerged as a palliative treatment option in patients with severe pulmonary emphysema. However, it is not known if a sustained functional improvement can be obtained using an unilateral approach. METHODS: We hypothesized that a palliative effect can also be obtained by unilateral LVRS and prospectively assessed lung function, walking distance, and dyspnea before and 3, 6, 12, 18, 24 and 36 months after unilateral LVRS. RESULTS: Twenty-eight patients were operated by the use of video-assisted thoracoscopic surgery (VATS) with a mean follow-up of 16.5 months (range 3-36 months). Forced expiratory volume in 1 s (FEV1) was significantly improved up to 3 months (1007+/-432 compared to 1184+/-499 ml, P<0.001), residual volume up to 24 months (4154+/-1126 compared to 3390+/-914 ml, P<0.01), dyspnea up to 12 months (modified Borg dyspnea scale 6.6+/-1.8 compared to 3.9+/-1.8, P=0.01) and walking distance up to 24 months (343+/-107 compared to 467+/-77 m, P<0.05) after unilateral LVRS compared to preoperative values. Overall, 25 of 28 patients reported a subjective benefit after unilateral LVRS. There was no 30-day mortality. Only two patients required surgery on the contralateral side after 4.5 and 6 months, respectively, both suffering from alpha-1-antitrypsin deficiency. CONCLUSIONS: Unilateral LVRS by the use of VATS results in a sustained beneficial effect, improving walking distance and dyspnea for up to 24 months in patients with severe emphysema. The preservation of the contralateral side for future intervention if required renders unilateral LVRS an attractive concept in this difficult palliative situation.
Aged↗
[Giant cell arteritis--a genetically-determined disease?].
We report on two siblings with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR). Temporal artery biopsies revealed GCA in three cases, and sclerosis of the wall of the temporal artery in one case. The HLA haplotype was identical in the first pair, and in the second pair HLA-A2, HLA-B39 and HLA-DR53 were identical. In three patients HLA-DR4 was demonstrated. Cases of familial aggregation of GCA have been reported in the literature. In several reports an increased prevalence of HLA-DR4 was described (about 40% of patients with GCA, compared with about 13% in the European population). HLA-DR4 was observed in three of our four patients and a haploidentity was found in one pair. Based on our observation and the results published in the literature, it seems probable that giant cell arteritis--a typical disease of advanced age--has at least partially a genetic basis.
Aged↗