356 research outputs found

    DIPOL - ein Reformcurriculum: problemorientiertes Lernen in der Dresdner Medizin

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    Im Reformcurriculum DIPOL (Dresdner Integratives Problem/Praxis/Patienten Orientiertes Lernen) werden zukünftige Ärzte früher und intensiver auf ihre spätere praktische Tätigkeit vorbereitet. DIPOL ist ein Hybridcurriculum, bestehend aus traditionellen Lehrformen (Vorlesungen, Seminare, Praktika) und neuen Elementen (problem- bzw. fallorientiertes Lernen, Kleingruppen, Tutorien, Unterricht an Simulatoren und im Skills Lab)

    Gesundheitsrisiken inhalierter Partikel

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    Although not all hazardous effects on human health have been clearly defined so far, the health risks of particulate matter can be considered evident. Pulmonary and cardiovascular diseases, in particular, are caused or aggravated by inhaled particulate matter. The aim of this article is to describe the incorporation and the effects on organ function of inhaled particles. Furthermore, the potential risks of de novo synthesised nanoparticles are discussed in the context of the public controversy regarding environmental particulate matter pollution.Obwohl die schädlichen Auswirkungen inhalierbarer Partikel auf unseren Organismus bisher noch nicht vollständig geklärt sind, kann eine Gesundheitsgefährdung durch Feinstäube als erwiesen angesehen werden. Insbesondere pulmonale und kardiovaskuläre Erkrankungen werden durch Feinstaubexposition ausgelöst oder verschlimmert. Dieser Artikel stellt Aufnahme und Auswirkungen inhalierter Partikel im menschlichen Organismus dar und erörtert potenzielle Gefahren de novo synthetisierter Nanopartikel im Kontext der auch in der breiten Öffentlichkeit kontrovers geführten Feinstaubdiskussion

    Estimating inert gas bubbling from simple SCUBA diving parameters

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    Inert gas bubbles frequently occur in SCUBA divers' vascular systems, eventually leading to decompression accidents. Only in professional settings, dive profiles can be adjusted on individual basis depending on bubble grades detected through ultrasonography. A total of 342 open-circuit air dives following sports diving profiles were assessed using echocardiography. Subsequently, (Eftedal-Brubakk) bubble grades were correlated with dive and individual parameters. Post-dive cardiac bubbles were observed in 47% of all dives and bubble grades were significantly correlated with depth (r=0.46), air consumption (r=0.41), age (r=0.25), dive time (r=0.23), decompression diving (r=0.19), surface time (r=- 0.12). Eftedal-Brubakk categorical bubble grades for sports diving with compressed air can be approximated by bubble grade = (age*50-1 - surface time*150-1+maximum depth*45-1+air consumption*4500-1)2 (units in years, hours, meter, and bar*liter; R2=0.31). Thus, simple dive and individual parameters allow reasonable estimation of especially relevant medium to higher bubble grades for information on relevant decompression stress after ascent. Echo bubble grade 0 is overestimated by the formula derived. However, echo might fail to detect minor bubbling only. The categorical prediction of individual decompression stress with simple bio and dive data should be evaluated further to be developed towards dive computer included automatic ex-post information for decision-making on individual safety measures.info:eu-repo/semantics/publishedVersio

    Regional lung aeration and ventilation during pressure support and biphasic positive airway pressure ventilation in experimental lung injury

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    INTRODUCTION: There is an increasing interest in biphasic positive airway pressure with spontaneous breathing (BIPAP+SBmean), which is a combination of time-cycled controlled breaths at two levels of continuous positive airway pressure (BIPAP+SBcontrolled) and non-assisted spontaneous breathing (BIPAP+SBspont), in the early phase of acute lung injury (ALI). However, pressure support ventilation (PSV) remains the most commonly used mode of assisted ventilation. To date, the effects of BIPAP+SBmean and PSV on regional lung aeration and ventilation during ALI are only poorly defined. METHODS: In 10 anesthetized juvenile pigs, ALI was induced by surfactant depletion. BIPAP+SBmean and PSV were performed in a random sequence (1 h each) at comparable mean airway pressures and minute volumes. Gas exchange, hemodynamics, and inspiratory effort were determined and dynamic computed tomography scans obtained. Aeration and ventilation were calculated in four zones along the ventral-dorsal axis at lung apex, hilum and base. RESULTS: Compared to PSV, BIPAP+SBmean resulted in: 1) lower mean tidal volume, comparable oxygenation and hemodynamics, and increased PaCO2 and inspiratory effort; 2) less nonaerated areas at end-expiration; 3) decreased tidal hyperaeration and re-aeration; 4) similar distributions of ventilation. During BIPAP+SBmean: i) BIPAP+SBspont had lower tidal volumes and higher rates than BIPAP+SBcontrolled; ii) BIPAP+SBspont and BIPAP+SBcontrolled had similar distributions of ventilation and aeration; iii) BIPAP+SBcontrolled resulted in increased tidal re-aeration and hyperareation, compared to PSV. BIPAP+SBspont showed an opposite pattern. CONCLUSIONS: In this model of ALI, the reduction of tidal re-aeration and hyperaeration during BIPAP+SBmean compared to PSV is not due to decreased nonaerated areas at end-expiration or different distribution of ventilation, but to lower tidal volumes during BIPAP+SBspont. The ratio between spontaneous to controlled breaths seems to play a pivotal role in reducing tidal re-aeration and hyperaeration during BIPAP+SBmean
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