[Results of a structural diagnosis of patients with chronic dyspnoea recruited from two cardiological practices]. / Ergebnisse einer strukturierten Diagnostik bei Patienten mit chronischer Dyspnoe in zwei kardiologischen Facharztpraxen.

While well validated algorithms exist for the diagnosis of patients with acute dyspnoea, such generally valid procedural instructions are lacking for patients with chronic dyspnoea. The diagnostic approach presented here is based on investigations of 246 patients with chronic dyspnoea recruited from two cardiological practices using a self-developed multi-level procedure. Besides anamnestic and clinical examinations, different diagnostic procedures, available in the ambulant range, are included. The results suggest that in over 50 % of the cases the cause of chronic dyspnoea can be determined from anamnestic and clinical examinations as well as from electrocardiogram and echocardiography. Additional inclusion of lung function and capillary blood gas analysis permitted a sufficient clarification in over 80 % of the cases. In a further step, cardiopulmonary exercise testing clarified the reasons for chronic dyspnoea in approximately 10 % of the remaining patients. Threshold values of lung function parameters as used for the differentiation of acute dyspnoea, do not seem suitable for the diagnosis of patients with chronic dyspnoea. By means of a simple step-wise diagnostic algorithm, applicable under ambulant conditions, the cause of chronic dyspnoea could sufficiently be clarified in more than 95 % of the cases.

[Number of patients with chronic dyspnea in three German specialist practices]. / Häufigkeit von Patienten mit chronischer Dyspnoe in drei deutschen Facharztpraxen.

In the second quarter 2011 the incidence of the symptoms "chronic dyspnea" among the patients in three specialist practices was determined by means of a self-developed questionnaire. 1286 anonymised questionnaires with full information could be evaluated. The proportion of the patients with a chronic dyspnea (inclusive "dyspnea and weakness feeling") in the practices amounted to between 15.3 and 57.7 %. An exclusive assessment of chronic dyspnea could be assigned to 10.4 to 31.4 % of the patients evaluated. From the view point of the treating physicians, the cause of the chronic dyspnea was sufficiently explained by the available information.

[An electroencephalographic comparison of fentanyl and sulfentanil (author's transl)]. / Fentanyl und Sulfentanil im elektroenzephalographischen Vergleich.

Equipotent analgesic doses of sulfentanil and fentanyl showed similar effects in 281 cases of clinical neuroleptanalgesia. In rabbits equimolecular doses of sulfentanil induced a deeper narcotic effect (burst suppression) than fentanyl. This supports the thesis of a coincidental increase of analgesic potency and narcotic effect in agonistic opioids. In equipotent doses the conventional EEG and the amplitude-frequency-spectra are equal. Quantificated analyses and statistical calculations show essentially similar changes in animal: - Fentanyl as well as sulfentanil changes only the dominant frequency in the theta-bands. - The percentage value increases only in the sigma-band, doesn't change in the alpha- and beta1-band and decreases in the theta-band, beta2--and beta3-band. - The power of sigma rises by a potency of ten in both substances; the change in the other frequencies shows similar sizes. Fentanyl and sulfentanil do not coure differences in the EEG.