Two hundred thirty-nine episodes of acute respiratory failure were studied prospectively in 146 patients with chronic respiratory insufficiency during 4 years. Survivors were followed from 6 to 48 months. Patients survived 68% of episodes. Sixty percent of patients survived the initial episodes of respiratory failure, and 55% were alive after 6 months. During the next 2 years the mortality of these patients was high so that only 20% survived 30 months, and the same percentage survived 48 months. The plateau of the survival of these patients after 30 months strongly suggested that the survivors had either stable or slowly progressive disease. In contrast, those patients who had insufficiency from progressive pulmonary disease died within 30 months. Obese patients and bronchitic patients without emphysema survived more frequently than patients with emphysema alone or those with chronic diffuse infiltrative disease. Surviving patients were younger, without recent losses of body mass, edema, or anemia. They had less reduction of expiratory flow rates and vital capacities, less hypercapnia, and mild acidosis and hypoxia. Patients with a poor prognosis were elderly, with decreased body mass, weight below 110 lb, with edema and anemia. They had lower midexpiratory flow rates and vital capacities, more severe hypoxia (PaO2 < 40 mm Hg), or severe hypercapnia (PaCO2 > 80 mm Hg) with acidosis (H ion > 60 nmoles/1, pH < 7.22).
To section or not to section. W H PearseCopyRight https://doi.org/10.2105/AJPH.73.8.843 Published Online: October 07, 2011
CURRENT LITERATURE: I. VEGETATIVE NEUROLOGY—METABOLIC INTEGRATION: 1. VEGETATIVE NERVOUS SYSTEM: PDF Only
Heart insufficiency, cardiomegaly and pathological changes of the ECG after exclusion of coronary heart disease, congenital or acquired vitia cordis and hypertension of the greater or lesser circulatory system result in the diagnosis cardiomyopathy with the liability of further differential-diagnostic demarcation. If causes of a secondary cardiomyopathy can be detected, a causal therapy is often possible, as to the remaining group of the idiopathic cardiomyopathies one must for the time being limit to an exclusively symptomatic treatment (protective therapy, limitation of the fluid supply, glycosides, diuretics, medicamentous and electric therapy of disturbances of the rhythm).
RlecenIt advances in intensive cardiac care and widespread use of continuous electrocardiographic monitoring have emphasized the fre*Iineny and natture of cardiac rhythm disturbanecs. Recognition, howvever, requires at least a lased on an tunderstanding of the "natural history" and hemnodvnamic consequence of a speconsideration of therapy. Proper therapy is cific arrhythmia. The net effect of a particular arrhythmia is (letermined by the circullatory state of the patient ais well as the nature of the rhvthm disturbance. Usuially "benign" rhythm disturbances such as ligenminv and atrial fibrillation, occurring in a patieit wtith limited cardiac reserve, mav' rapidly restult in severe cardiac decompensation \vith mn\ocardial ischemia, 1hvpoxia, and hypotension, shock, or death. Furthiermore, the arrhytlhmia mav compromise the blood supply to the end organs and thuis produce mvocardial infarction, renal failure. cerebrovascular accidents, hepatic necrosis, infaretion of the intestinal tract and the like. Since manv arrhvthmias are transient and cauise onlv minor alterations of the circullation, or ocetr in patients with less severelv compromised Circuilation, the sVrmptoms produced mav be
Economic needs and the ongoing liberalization of European electricity markets stimulate the interest of power utilities in developing models and optimization techniques for the generation and trading of electric power under uncertainty. Utilities participating in deregulated markets observe increasing uncertainty in load (i.e., demand for electric power) and prices for fuel and electricity on spot and contract markets. The mismatched power between actual and predicted demand may be supplied by the power system or by trading activities. The competitive environment forces the utilities to rate alternatives within a few minutes. In this chapter, we describe a mathematical model for optimal short term operation and trading of a hydro-thermal based electric utility, which is usually calledunit commitment problem because of the important role of the commitment or on/off decisions. Furthermore, we present a methodology for modelling the stochastic data process in form of a scenario tree and report on a Lagrangian-based decomposition strategy for solving the optimization model. We also provide some numerical experience obtained from test runs on realistic data from the German utility Vereinigte Energiewerke AG (VEAG). The optimization model has emerged from a collaboration with engineers of VEAG. For our tests we use a configuration of
