Search

ZusammenfassungDie COVID-19-Pandemie stellt derzeit weltweit eine Herausforderung dar. In Österreich konnte eine Krise innerhalb des medizinischen Versorgungssystems bisher verhindert werden. Die Behandlung von Patienten mit ambulant erworbener Pneumonie („community acquired pneumonia“, CAP), inklusive durch SARS-CoV-2-Infektionen, sollte sich auch während der Pandemie weiterhin an evidenzbasierten CAP-Leitlinien orientieren. COVID-19-spezifische Anpassungen sind jedoch sinnvoll. Die Behandlung von Patienten mit chronischen Lungenerkrankungen muss während der Pandemie angepasst werden, ist aber weiterhin zu gewährleisten.

Die COVID-19-Pandemie stellt derzeit weltweit eine Herausforderung dar. In Österreich konnte eine Krise innerhalb des medizinischen Versorgungssystems bisher verhindert werden. Die Behandlung von Patienten mit ambulant erworbener Pneumonie („community acquired pneumonia“, CAP), inklusive durch SARS-CoV-2-Infektionen, sollte sich auch während der Pandemie weiterhin an evidenzbasierten CAP-Leitlinien orientieren. COVID-19-spezifische Anpassungen sind jedoch sinnvoll. Die Behandlung von Patienten mit chronischen Lungenerkrankungen muss während der Pandemie angepasst werden, ist aber weiterhin zu gewährleisten.

Zeitlhofer J, Seidel S, Klosch G, Moser D, Anderer P, Saletu B, Bolitschek J, Popovic R, Lehofer M, Mallin W, Fugger B, Holzinger B, Kerbl R, Saletu A, Machatschke IH, Pavelka R, Hogl B. Sleep habits and sleep complaints in Austria: current self-reported data on sleep behaviour, sleep disturbances and their treatment. Acta Neurol Scand: 2010: 122: 398–403. © 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard. Objectives – To acquire current information on sleep habits, disturbances and treatment options in the adult population of Austria and compare results with previously collected data. Materials and methods – A representative sample of the Austrian population (women: n = 522, men: n = 478). Results – Seventy-five percent reported daily sleep-duration between 6 and 8 h. In 76%, sleep latency was

Schlafstorungen und Schlafmangel sind in unserer modernen Gesellschaft weit verbreitet. Zwar hat das mediale Interesse an der Funktion und Bedeutung des Schlafs betrachtlich zugenommen, doch stellt sich die Frage, wie sehr der Stellenwert gesunden und ausreichenden Schlafs im Allgemeinen und das Schlafverhalten im Einzelnen dadurch beeinflusst bzw. verandert wird. In einer fur die osterreichische Bevolkerung reprasentativen Umfrage (n=1000, 478 Manner, 522 Frauen) wurden neben allgemeinen Schlafmerkmalen auch die subjektive Schlafqualitat, Schlafgewohnheiten und Hinweise auf Schlafstorungen in Zusammenhang mit demographischen und gesundheitlichen Aspekten untersucht. Rund 76% der Stichprobe gaben eine durchschnittliche Schlafdauer zwischen 6 und 8 h und eine normale Einschlaflatenz an. 90% waren mit ihrem Schlaf subjektiv zufrieden. 54% schlafen am Wochenende langer; Mittagsschlaf halten 23%, wobei hier der Anteil an Pensionisten relativ hoch ist. 87% schlafen immer im selben Bett, 31% schlafen standig allein, 46% immer mit Partner. Haufige Schlafstorungen gaben 18% an, wobei mehr als 70% keinerlei Masnahmen dagegen setzten. Von der Subpopulation, die aktiv ihre Schlafstorung behandelt, greifen immerhin 45% zu Schlafmitteln. Niedrigere Bildung und geringere berufliche Qualifikation sind mit einer verminderten Schlafqualitat assoziiert, ebenso Ubergewicht und Mangel an sportlicher/korperlicher Aktivitat. Trotz reichhaltigen Medienangebots nutzen die Osterreicher an erster Stelle Arzte und Apotheken als Informationsquelle uber Schlaf und Schlafstorungen. Diese deskriptive Darstellung der Schlafgewohnheiten und -storungen der Osterreicher bietet einen ersten Einblick in die Komplexitat von Schlaf und den Einfluss von potenziellen Storfaktoren.

Hintergrund Die Pravalenz von erhohter Tagesschlafrigkeit wurde in vielen Landern untersucht, wobei sich die Ergebnisse je nach gewahlter Definition und Methodik stark unterschieden. Die vorliegende Untersuchung wurde durchgefuhrt, um die Haufigkeit von erhohter Tagesschlafrigkeit in der osterreichischen Bevolkerung und den Zusammenhang mit verschiedenen schlaf- und gesundheitsbezogenen Faktoren zu erheben.

tudy objective The purpose of this study was to determine subjective health-related quality of life (HRQoL) in a sample of the Austrian population over 14 years of age in order to evaluate the effect of socio-demographic variables on HRQoL. Design/Setting HRQoL was determined by means of the quality of life index - German version (QLI-Ge). The influence of socio-demographic variables on HRQoL was assessed by statistical analysis using the Kruskal-Wallis test and an analysis of variance. Participants A random-quota procedure was used to get balanced representation from regions and demographic groups of the Austrian population. The sample consisted of 1049 participants, 493 men and 556 women. Main results Age was found to influence the QLI-Ge total score (index score) and most individual items, with increasing age resulting in a decrease in HRQoL. Differences between the sexes were observed in three dimensions: males scored higher in ‘physical well-being’, ‘psychological well-being’ and ‘occupational functioning’. Marital status impacted most items with married persons showing better values than divorced persons or singles. Profession had only a minor effect on HRQoL, the level of education showed no influence at all. Conclusions The socio-demographic variables age, sex and objective living conditions had a major influence on subjectively rated HRQoL, whereas profession and education were found to play a minor role in this context. It is recommended that in the interpretation of studies assessing HRQoL the above-mentioned objective factors be considered. This will be of particular importance when determining the effect of a pharmacotherapy on HRQoL in patients. Copyright © 2005 John Wiley & Sons, Ltd.

Objectives: To gain reliable data on sleeping habits and sleep disturbances of the Austrian population. Background: Exact data on sleeping habits are of interest in relation to assessment of sleep disturbance-related illnesses and general social processes. Methods: A prospective, cross-sectional study was performed with recruitment of a representative sample of 1049 Austrians (aged 15–82 years), according to the Federal Statistics population characteristics. Interviews were conducted in the households of the participants by specially trained interviewers of an institute for empirical research. Results: Men consider their quality of sleep to be significantly better than women (P=0.00234), and younger persons consider their quality of sleep to be significantly better than older persons (P=0.00001). In comparison, women and people over the age of 50 report worse subjective sleep quality, worse sleep efficiency, more difficulty in falling asleep and sleep maintenance, more apneic events, more pathologic limb movements, more daytime dysfunction, and more intake of sleeping medication. Other sociodemographic factors influence sleep reports to a lesser extent. Conclusions: Subjectively disturbed sleep (prevalence in the total population 24.9%), excessive hypnotic drug intake (prevalence 13.0%), and daytime dysfunction (prevalence 17.4%) are a widespread problem, especially in women and older people. With increasing life expectancy in Western societies, the prevalence of sleep disturbances will increase.

Purpose– To compare the self-reported estimation of sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI) and life quality assessed by the Quality of Life Index (QLI). Background– The PSQI comprised 19 questions and assessed a wide variety of factors relating to sleep quality. The QLI consisted of 10 items for self assessment of different dimensions of life quality. Subjects– A representative Austrian sample (n=1049) aged above 15 years. Procedure– Interviews in the homes of the participants. Results– 32.1% could be classified as poor sleepers (37% females, 26.5% males). Sleep quality decreased with increasing age, especially in women. Overall quality of life was highest in younger (15–29 years) and lowest in elderly subjects (over 50 years). Life quality decreased with increasing age. Between subjective sleep quality and quality of life a moderate, significant correlation was found (r2=0.6721). Conclusions– Complaints about a bad quality of sleep could be used as a screening method in the exploration of patients' quality of life (QoL).

Vorliegende Studie basiert auf einer reprasentativen Untersuchung an 1000 Osterreichern, die zu ihrem Schlafverhalten befragt wurden. Nachtliches Zahneknirschen gaben 4% an, es gab keine Geschlechtsunterschiede, jungere Personen waren haufiger betroffen als altere. Bruxismus zeigte keinen Zusammenhang mit psychopathologischen Symptomen, wie Angstlichkeit oder Depressivitat. Nur insgesamt 4 Personen berichteten, an Schlafwandeln zu leiden, dabei waren Manner haufiger betroffen. Sprechen im Schlaf wurde von 8% angegeben und 4% gaben an, unter Alptraumen zu leiden, bei beiden Schlafstorungen zeigten sich keine Geschlechts-oder Altersunterschiede. Beinunruhe beim Einschlafen wurde von 8% berichtet, altere Personen und unregelmasige Schnarcher zeigten sich haufiger betroffen

Quality-of-life (QoL) issues have become increasingly important in health care practice and research. Obstructive sleep apnoea syndrome (OSAS) results in an especially serious reduction in QoL. The purpose of this study was to measure the QoL (life satisfaction) of OSAS patients treated with nasal continuous positive airway pressure (nCPAP). We aimed to determine whether and to what extent the QoL of OSAS patients using nCPAP differs from that of randomly selected subjects without this disorder. The QoL of 67 patients treated for at least 3 months with nCPAP, 21 OSAS patients at the time of OSAS diagnosis, and 113 randomly selected persons visiting the hospital (controls) was investigated with the help of the Munich life-quality dimension list (MLDL), an instrument for cognitive assessment of elementary components (physical condition, psyche, social life, everyday life) of QoL. It was found that QoL of OSAS patients treated with nCPAP did not significantly differ from that of control subjects with regard to elementary components. The 21 untreated OSAS patients showed significantly lower scores in all four subcategories: physical condition (p

This study compared intravenous followed by oral clarithromycin (500mg twice daily; manufactured by Abbott Laboratories) with intravenous followed by oral erythromycin and cefuroxime (1g erythromycin three times daily, 1.5g cefuroxime three times daily intravenously, 500mg erythromycin, 500mg cefuroxime axetil orally) in the treatment of patients admitted to hospital with community-acquired pneumonia in 21 centres in Europe and Canada. 235 patients were enrolled for the study, of whom 169 (88 clarithromycin and 81 erythromycin/cefuroxime) were clinically evaluable and 47 (24 clarithromycin and 23 erythromycin/cefuroxime) were bacteriologically evaluable. All clinically evaluable patients received intravenous therapy for between 2 and 5 days. No significant differences between the treatment groups were seen regarding age, underlying disease, extent of chest x-ray shadowing and other indices of severity of pneumonia. A satisfactory clinical response was observed in 91 and 88% of clinically evaluable patients and 71 and 66% of all patients (intent-to-treat analysis) in the clarithromycin and erythromycin/cefuroxime groups, respectively, and similar bacterial cure rates were obtained (67 and 70%, respectively). There were no significant differences in the clinical and bacterial response rates between the two treatment groups. There was a significantly greater number of patients experiencing drug-related adverse events in the erythromycin/cefuroxime group (65%) than in the clarithromycin group (49%; p = 0.018), with significantly less nausea, vomiting, diarrhoea and abdominal pain occurring in the clarithromycin group. We concluded that clarithromycin is a suitable monotherapy for patients with community-acquired pneumonia who require intravenous treatment, and is associated with significantly fewer adverse effects than the combination of erythromycin and cefuroxime.

To acquire current information on sleep habits, disturbances and treatment options in the adult population of Austria and compare results with previously collected data.A representative sample of the Austrian population (women: n = 522, men: n = 478).Seventy-five percent reported daily sleep-duration between 6 and 8 h. In 76%, sleep latency was30 min, 15% described difficulties in sleep maintenance. Longer sleep on weekends was prevalent in 54%, 23% took a nap. Concerning sleep environment, 31% reported sleeping alone; the rest had a constant or occasional bed partner. Sleep disturbances such as sleep disruption or prolonged sleep latency were reported by 18%. Predominant symptoms included snoring/apneas (22%), nightmares (22%) and restless legs (21%). Daytime tiredness was reported by 17% and sleepiness by 20%. Twenty-four percent did not take treatment. Only 7% asked for medical help: 96% consulted their physician; 47% tried to change their way of living. Sleep promoting drugs were taken by 7%. Sleep improving measures were: sleep promoters (45%), general measures (20%), consultation of general practitioner (20%), psychotherapy (6%), and technical tools (3%). Comparison with a dataset of 1993 revealed only a slight increase in short sleepers and a slight decrease in long sleepers.Subjectively reported sleep disorders proved to be relatively stable between 1993 and 2007.

Introduction La qualite de vie (QDV) est un parametre important a considerer dans la BPCO. Cependant, la QDV est rarement un critere principal des etudes cliniques dans la BPCO. L’objectif de cette etude est d’etudier l’effet de la combinaison fixe du tiotropium (T) et de l’olodaterol (O) versus T seul et placebo, chez des patients BPCO. Methodes Les 2 etudes OTEMTO, randomisees, en double insu, en groupes paralleles ont evalue le VEMS et le score de Saint-Georges (SGRQ) apres 12 semaines de traitement avec l’association fixe T + O (2,5/5 μg ; 5/5 μg) par rapport au tiotropium 5 μg et au placebo chez des patients BPCO moderes a severes. Resultats Au total, 1621 patients traites ont ete analyses. Les caracteristiques des patients etaient similaires entre les etudes OTEMTO 1 et 2 avec respectivement un VEMS moyen post-BD de 1,52 L et 1,55 L (55,3 % et 54,8 % predit). Pour chaque etude, le critere principal de QDV etait significativement ameliore avec une difference cliniquement pertinente sur le score SGRQ superieure a 4 points vs placebo dans OTEMTO 1 (respectivement −4,12 et −3,67). La tolerance de l’association fixe T + O etait sans particularite. Conclusion L’association fixe tiotropium + olodaterol 5/5 μg ameliore cliniquement la QDV des patients BPCO moderes a severes dans les 2 etudes OTEMTO. L’efficacite sur la fonction pulmonaire de cette association fixe T + O est coherente avec les etudes precedentes ainsi que sa securite d’emploi.

A large number of studies have been focused on patients with severe obstructive sleep apnea syndrome (OSAS) being non-compliant with N-CPAP therapy, but data concerning patients who reject N-CPAP therapy from the very start, without a day of N-CPAP home therapy, do not exist. The purpose of the study was to determine differences, if any, in the quality of life (QoL) between patients rejecting N-CPAP therapy from the start, untreated patients with severe OSAS waiting for N-CPAP titration, and controls. Qol was measured in terms of life satisfaction on the basis of the Munich life quality dimension list (MLDL), an instrument for cognitive assessment of elementary components (physical condition, psyche, social life, everyday life) of QoL. Untreated patients (n = 16) with severe OSAS have a significantly worse QoL in the dimension of psyche (p = 0.00022), social life (p = 0.00582) and everyday life (p = 0.01633) than do rejecters of therapy (n = 19). In the dimension of physical condition, no significant difference was seen (p = 0.47138). Compared with controls (n = 113), rejecters of therapy have a significantly lower QoL score in regard of physical condition (p = 0.00014) but not in terms of psyche, social life and everyday life. We conclude that a good QoL and the absence of the stress of suffering is one reason why patients with severe OSAS reject N-CPAP therapy in spite of physical impairment.

To compare the self-reported estimation of sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI) and life quality assessed by the Quality of Life Index (QLI).The PSQI comprised 19 questions and assessed a wide variety of factors relating to sleep quality. The QLI consisted of 10 items for self assessment of different dimensions of life quality.A representative Austrian sample (n = 1049) aged above 15 years.Interviews in the homes of the participants.32.1% could be classified as poor sleepers (37% females, 26.5% males). Sleep quality decreased with increasing age, especially in women. Overall quality of life was highest in younger (15-29 years) and lowest in elderly subjects (over 50 years). Life quality decreased with increasing age. Between subjective sleep quality and quality of life a moderate, significant correlation was found (r2= 0.6721).Complaints about a bad quality of sleep could be used as a screening method in the exploration of patients' quality of life (QoL).

Sleep apnea and snoring are widely discussed as risk factors for internal and neurological diseases. The prevalence of snoring in an Austrian population survey is about 27.2% (males 36.5%, females 18.9%), and that of apnea (respectively irregularity and/or cessation of breathing) about 8.5% (31% of all snorers). Clinical symptoms like naps, daytime sleepiness, unquiet sleep, hypertonia, headache in the morning and psychological symptoms may be characteristics of sleep apnea. They should lead to further diagnosis and removal of this risk factor for ischemic heart disease and stroke.

Epidemiologic data on sleep disturbances in Austria were collected for the first time in March/April 1993 in a representative inquiry (n = 1000, 471 males, 529 females). 26% of the subjects reported sleep disturbances which were mostly chronic (21% had suffered from sleep disturbance for more than one year). The incidence of sleep disturbances increased with age, namely 13% in 14-30 year-old subjects, 22% in 31-50 year-old ones and 41% in subjects over 50. 7% suffered from disturbances in sleep initiation, i.e., they had a sleep latency of over 30 minutes. 19% of them had difficulties in getting to sleep at least once a week. Disturbances in maintaining sleep were reported by 28% of subjects, 56% of them needing longer than one hour to get back to sleep. 30% suffered from daytime sleepiness, 43% of the subjects were impaired by their sleep disturbances in some way, but only 34% had consulted their doctor.

Diagnosing of alveolitis is a puzzle of many pieces, based on clinical experience and keeping in mind the criteria of extrinsic allergic alveolitis. They are antigen-exposure, typical delayed postexpositional symptoms (cough, chills, fever, dyspnea, tiredness), and serological tests of precipitating antibodies. Helpful findings are X-ray of the chest, high resolution computer tomography, auscultation findings, lowered diffusing capacity, bronchoalveolar lavage with lymphocytes50% and low T4/T8-ratio, histology of periphere lung specimens, and occasional inhaled provocation. Differential diagnosis are toxic lung disorders, drug adverse effects, sarcoidosis, silicosis, autoimmune alveolitis, idiopathic fibrosing alveolitis. The most frequent failure in diagnosis are common viral cold, bronchopneumonia, sarcoidosis, chronic bronchitis, and miliar tuberculosis.

Nosocomial pneumonia is sometimes preventable. In manifestation it is a challenge to the interdisciplinary cooperation to pneumologists, internal medicine, intensive care medicine, clinical microbiologists, nursing staff and physiotherapists. Preventive measurements are of special value.

The sleep apnoea syndrome (SAS) is characterised by somatic, in particular cardiopulmonary and psychosocial, symptoms, the latter severely impairing the patient's social life. Excessive daytime somnolence and the resulting problems severely stress patients with SAS. Among 24 patients with SAS, 79.2% stated that they fell asleep during the day, frequently in 41.8% and occasionally in 37.4%. In addition, 70.8% of the patients with SA did not feel adequately rested on waking in the morning. Of the 24 patients, 17 had a job, and 11 of these experienced difficulty staying awake at the workplace. Suitable timely treatment (for example, with n-CPAP) improves not only the somatic, but also the neuropsychological symptoms.

116 males were examined. Of these, 52 belonged to a control group, whereas 40 had severe obstructive sleep apnoea (apnoea index20 + clinical symptoms) and 24 mild obstructive sleep apnoea (apnoea index 5-20 + clinical symptoms) (in the following, OSA signifies obstructive sleep apnoea). Cephalometry and planimetric examinations of the pharynx were performed in recumbent position with the head in neutral position and with shallow respiration. The narrowest passage of the pharynx was measured; other measured sites were the areas of the nasopharynx, oropharynx (at the level of the tip of the palatine uvula) and of the hypopharynx (at the level of the base of the tongue). The sum of all the measured cross-sections was obtained. The cephalogram was evaluated to obtain the length and thickness of the soft palate, the distance between the mandible and hyoid bone, the posterior airspace (PAS), the nuchal subcutaneous fatty tissue at the level of the spine of the second cervical vertebra (also known as axis), the thickness of the posterior pharyngeal wall at the level of the second cervical vertebra, or axis, and the angles between the sella, nasion and superior maxilla and between the sella, nasion and mandible (SNA and SNB, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)