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Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Die Gastroenterologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Die Gastroenterologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A pre-purchase examination (PPE) serves to show the potential buyer the horses' health status and what effect this has on current and future use. At the same time, the PPE or its results are often the subject of disputes in court. This study is dedicated to the comparability of PPE results. Therefore, two trained observers examined 30 horses according to a standard PPE protocol. The data was compared at individual level and evaluated using SAS. Cohens kappa (κ), weighted kappa (κw), prevalence-adjusted, bias-adjusted kappa (PABAK) were used for calculation for data with a two- or three-point scale and intraclass correlation coefficient (ICC), limits of agreement (LoA) and Spearman rank correlation coefficient (RS) for all indicators based on continuous data. 23 of 46 indicators showed acceptable (κ, κw = 0.4; PABAK = 0.4) to good (κ, κw = 0.6; PABAK = 0.75) interobserver reliability at binary indicators. An acceptable (RS = 0.4; ICC = 0.4) to good (RS = 0.7; ICC = 0.7) interobserver reliability was found for all indicators based on continuous data. Nutritional status, scars or status of the hooves showed poor values for κ and PABAK. This study indicated acceptable to good interobserver reliability of a PPE protocol. Nevertheless, clearer instructions should partly be established to reduce the scope for interpretation and to improve comparability. [ABSTRACT FROM AUTHOR]

Copyright of Medizinische Klinik: Intensivmedizin & Notfallmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Praxis der Kinderpsychologie und Kinderpsychiatrie is the property of Vandenhoeck & Ruprecht GmbH & Co. KG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fast-track treatment pathways reduce the frequency of postoperative complications in elective colorectal resections by approximately 40% and due to the rapid recovery reduce the postoperative duration of hospitalization by approximately 50%. Specialized nursing personnel (enhanced recovery after surgery, ERAS, nurses) have already been appointed internationally to accompany and monitor the execution of multimodal perioperative treatment. In November 2018 a fast-track assistant was appointed in the Clinic for General and Visceral Surgery of the Municipal Clinic in Solingen for coordination of the fast-track treatment pathway. The results confirmed that a high adherence to perioperative fast-track treatment concepts can also be achieved in the German healthcare system by the assignment of specialized nursing personnel, with the known advantages for patients, nursing personnel, physicians and hospital sponsors. [ABSTRACT FROM AUTHOR]

Copyright of Der Gastroenterologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of ProCare is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Gastroenterologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Gastroenterologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Gastroenterologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Onkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Onkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The German population is aging in accordance with the worldwide trend; however, in comparison to most other industrial countries the number of disease-free years of life gained by patients is significantly lower in Germany. Subsequently, the number of hospitalizations and necessary surgical treatment for older and especially frail patients is significantly increasing. Several frailty scoring systems have been published with the aim of improving the assessment of the perioperative risk for these patients; however, these systems for risk assessment have not yet become clinical routine in surgery and therefore this group of frail patients remains underdiagnosed in the field of surgery. Frail patients in particular often need individualized treatment or the adaptation of standard of perioperative care. It has already been clearly shown that frail patients have a markedly higher incidence for certain risk factors (e.g. postoperative delirium, hypovolemia, pharmacological side effects and drug interactions). Additionally, malnutrition is common at the time of hospital admission in up to 70% of this patient group. If not recognized and treated accordingly all these risk factors lead to a compromised rehabilitation, higher complication rates, a prolonged length of hospital stay and a higher mortality. Special preoperative risk assessment scores, which highlight physical, psychological and social evaluation should be widely implemented in surgical departments. A standardized risk assessment embedded in evidence-based prerehabilitation programs and implemented in geriatric surgery centers can help to improve the outcome in this group of fragile patients. [ABSTRACT FROM AUTHOR]

Copyright of Zentralblatt fuer Arbeitsmedizin, Arbeitsschutz und Ergonomie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Frailty syndrome is usually related to the aging process and chronological age, but it is not an inevitable consequence of it - at least until the final phase of life. Primary care interventions that promote physical activity and nutrition can prevent the progression from pre-frailty to frailty. This article presents the current state of knowledge on primary and secondary prevention of frailty., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zeitschrift für Herz-, Thorax- und Gefaesschirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Best Practice Onkologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hintergrund: Postoperative Komplikationen können nach komplexen viszeralonkologischen Operationen zu erheblichen Beeinträchtigungen des Patienten und daraus resultierend zu einer prolongierten postoperativen stationären Verweildauer führen. Daher sollte die aktive Gestaltung der präoperativen Phase einen wichtigen Bestandteil der präoperativen/neoadjuvanten Therapie darstellen.Ziel der Arbeit: Ziel der vorliegenden Arbeit ist eine kritische Darstellung aktueller Prähabilitationskonzepte sowie deren Anwendbarkeit und Entwicklungspotenzial in der Viszeralchirurgie.Material und Methoden: Anhand einer selektiven Literaturübersicht werden aktuelle Studien und Konzepte vorgestellt und Therapiealgorithmen präsentiert.Ergebnisse: Die vorliegenden Studien unterscheiden sich in Zielgrößen, Gestaltung und zeitlichem Rahmen der Intervention. Insgesamt zeigen die Studienergebnisse positive Effekte einer aktiven Steigerung der körperlichen Fitness in der präoperativen Phase in Bezug auf die Lebensqualität, Rekonvaleszenz und postoperative pulmonale Komplikationsrate.Diskussion: Neben der Beurteilung des individuellen Komplikationsrisikos mittels Spiroergometrie kann durch ein gezieltes Ernährungs- und Aufbauprogramm die Leistungsfähigkeit vor viszeralchirurgischen Operationen gesteigert und somit Einfluss auf das postoperative Komplikationsrisiko genommen werden. Die Leistungsfähigkeit ist als modifizierbarer Risikofaktor zu verstehen, der auch in einem kurzen Zeitfenster präoperativ positiv beeinflusst werden kann. Die individuelle präoperative Versorgung optimiert die physische und psychische Verfassung der Patienten. Zur Sicherstellung der geforderten individuellen Versorgung müssen Ansätze geschaffen werden, die sich dezentral umsetzen lassen. [ABSTRACT FROM AUTHOR]

Postoperative delirium is common especially in the elderly and is associated with high rates of morbidity and mortality. Non-pharmacological multicomponent interventions are effective in reducing the incidence and to a degree the duration of postoperative delirium and are recommended in international guidelines on postoperative delirium as first line intervention for management of delirium. Non-pharmacological management of postoperative delirium consists of strategies for risk stratification, risk reduction by non-pharmacological bundle interventions, early recognition of delirium by screening protocols and immediate therapy of underlying causes of delirium and continuation of non-pharmacological bundles. Non-pharmacological bundle interventions address common perioperative risk factors. Bundles comprise strategies for oxygenation, mobilization, hydration and nutrition, sensory and cognitive stimulation, reorientation, modifications of environmental factors such as design aspects and noise reduction, adequate analgesia, management of agitation and anxiety, protecting circadian rhythms for example by adequate light exposure during daytime, family involvement and timely reduction of unnecessary catheters and anticholinergic drugs. The article aims at providing an overview of non-pharmacological management of postoperative delirium in the hospital., Competing Interests: Erklärung zu finanziellen Interessen Forschungsförderung erhalten: ja, von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.); Honorar/geldwerten Vorteil für Referententätigkeit erhalten: ja, von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.); Bezahlter Berater/interner Schulungsreferent/Gehaltsempfänger: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an im Bereich der Medizin aktiven Firma: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an zu Sponsoren dieser Fortbildung bzw. durch die Fortbildung in ihren Geschäftsinteressen berührten Firma: nein Erklärung zu nichtfinanziellen Interessen Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Development of an advanced practice nurse (APN) role for nutrition management: A needs assessment using a mixed methods approach Abstract. Background: Nurses are attributed to play a key role in nutrition management. This field has emerged to be a subject of advanced nursing practice. Aim: Conducting a needs assessment on the role profile of an advanced practice nurse (APN) in nutrition management according to the PEPPA framework. Methods: Mixed methods design. In a cross-sectional study on the current practice, the diagnostic accuracy of nurses' nutrition screening using Nutritional Risk Screening (NRS 2002) compared with independent assessment by a nutrition expert using NRS 2022 was examined. In case of a positive screening result, reasons were determined using an in-depth assessment. In addition, semi-structured, guideline-based interviews were conducted and content-analysed. Results: The identification of patients at risk by nurses' nutrition screening showed a need for improvement (sensitivity: 56%, specificity: 96%; n = 195). Commonly identified reasons for (risk of) malnutrition ( n = 51) were lack of desire to eat/lack of appetite or increased caloric needs due to illness. Development opportunities and expectations for an APN were specified based on the interviews ( n = 20). They refer to skill enhancement, support within the interprofessional team in complex treatment cases and a stronger nursing role in nutrition management. Conclusions: Based on the needs assessment, the APN's areas of responsibility were identified and assigned to the Hamric model, and implementation strategies could be derived.

The article provides information on the limitation of nutritional advise or nutritional counseling in academic education during business life and social counseling. Topics discussed include nutritionists in Austria, professional qualification of nutritionists, food service providers and dietary advice.

Nutrition is associated with pleasure and quality of life. The majority of oncological patients experience tumor-associated and treatment-associated nutrition-related symptoms and malnutrition. Consequently, the perception of nutrition during the course of the disease is increasingly more characterized by negative associations, which may persist for years after the end of treatment. This leads to a decreased quality of life, social isolation and a burden for relatives. In contrast, weight loss is initially positively perceived, especially by patients who previously perceived themselves as being overweight, until malnutrition becomes evident and leads to a decreased quality of life. Nutritional counseling can prevent weight loss, relieve adverse side effects, improve the quality of life and reduce mortality. Patients are not aware of this and the German healthcare system lacks structured and firmly established access pathways to nutritional counseling. Therefore, oncological patients need to be informed about the consequences of weight loss at an early stage and low-threshold access to nutritional counseling needs to be comprehensively implemented. Thus, malnutrition can be recognized and treated at an early stage and nutrition can contribute to a higher quality of life as a positively perceived daily activity., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Nutrition and Dementia - Dementia and Nutrition Abstract: Nutritional aspects play an important role both in the prevention of dementia and in its course. There is a mutual relationship between cognitive impairment and nutrition. In terms of prevention, nutrition is one of the potentially modifiable risk factors for the development of the disease, since it can influence both the structures and the functionality of the brain in a variety of ways. A food selection based on the traditional Mediterranean diet or on a generally healthy diet also seems to be advantageous for maintaining cognitive function. In the course of dementia, various symptoms of the disease sooner or later lead to nutritional problems, which make it difficult to achieve a varied, needs-based diet and are associated with an increased risk of a qualitatively and quantitatively inadequate nutrition. In order to maintain a good nutritional status in people with dementia for as long as possible, early detection of nutritional problems is fundamental. Strategies for the prevention and treatment include the elimination of potential causes of malnutrition and various supportive measures to promote adequate eating. The diet itself can be supported by an attractive, varied range of food, additional snacks, enrichment of the food with energy and nutrients and by oral nutritional supplements. Enteral or parenteral administration of nutrients, on the other hand, should be reserved for justified exceptional cases.

Screening and Assessment for an Early Identification of Malnutrition in Older People Abstract: Malnutrition is common among older people and leads to numerous negative clinical consequences due to changes in body composition and body function. A prerequisite for successful prevention and treatment is the early identification of older persons with (risk of) malnutrition. Therefore, in geriatric settings, routine malnutrition screening with a validated tool (e.g., Mini Nutritional Assessment or Nutritional Risk Screening) is recommended at regular intervals. In case of a positive screening result, a subsequent nutritional assessment is performed to confirm the diagnosis, to clarify the causes and to determine the energy and protein deficit, in order to initiate a targeted nutritional therapy and to improve the nutritional status of the older persons and thereby the overall prognosis.

Disease-related malnutrition has a strong influence on the further course of the disease and mortality, especially in chronically ill patients. In recent years it could be shown in large randomized studies that an individual nutrition therapy could significantly and relevantly improve the clinical outcome of patients in internal medicine with a risk of malnutrition, both in hospital and in aftercare. Therefore, due to the increasing proportion of multimorbid patients the significance of malnutrition and its treatment is becoming increasingly more important in the practice and in research. Nutritional medicine should nowadays be considered as an effective and integral component of a holistic treatment in internal medicine; however, further research is necessary in order to investigate new nutritional biomarkers and for a better integration of an evidence-based personalized nutritional medicine into routine clinical practice., (© 2023. The Author(s).)

Esophagectomy is considered to be a high risk procedure regarding postoperative morbidity and mortality. Therefore, in Germany, these operations are limited to hospitals fulfilling a minimum quantity. This systematic review focuses on risk and complication management regarding the impact of perioperative nutritional therapy, including the recent S3-guideline recommendations and comments of the German Working Group of Medical Societies (AWMF) which were established with contributions from the authors. [ABSTRACT FROM AUTHOR]

The article provides information on the risk of malnutrition in patients and residents in hospitals or nursing homes caused by nutritional status of food. Topics include impact on delay in wound healing after surgery, evidence based medicine for patients and screening tools for clinical nutrition and metabolism.

The assessment of the nutritional status of patients in the intensive care unit is recommended in current guidelines and should include the assessment of muscle status. A suitable method is the analysis of routine computed tomography (CT) scans, which are frequently performed in critically ill patients. With the help of special software, individual CT slices are processed and various parameters such as muscle area, muscle density or even the percentage of adipose tissue are displayed and quantified. It has been shown that cross-sectional acquisition of skeletal muscle in the lumbar spine correlates very well with total body muscle. There are defined, albeit population-based, cut-off values that can be used to establish diagnosis of sarcopenia. Monitoring of individualized nutritional therapy can be accomplished by assessment of repetitive CT examinations. The steadily growing body of data confirms that the method can make a valuable contribution to the assessment of body composition in intensive care medicine. Most of the currently available software requires time-consuming processing of the CT. Automated programs, which are now occasionally available and eliminate the need for most manual processing, may make the method even more attractive in the future. Ultimately, the risk of intensive transport to the CT or radiation exposure may be only justified for medical indications. Nevertheless, whenever CT is available for medical reasons, it should also be exploited for composition analysis., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

The treatment of chronic wounds often poses a therapeutic challenge. Assessment of the pathogenesis of the wound, causative and symptomatic interventions are key. Concerning treatment-concepts the evaluation of comorbidities, pain management, the nutrition status of as well as the mobility of the patient are recommended., Competing Interests: Erklärung zu finanziellen InteressenForschungsförderung erhalten: nein; Honorar/geldwerten Vorteil für Referententätigkeit erhalten: nein; Bezahlter Berater/interner Schulungsreferent/Gehaltsempfänger: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an Firma (Sponsor der Veranstaltung): nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an Firma (Nicht-Sponsor der Veranstaltung): nein.Erklärung zu nichtfinanziellen InteressenDie Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Nutritional problems occur very frequently in patients with cancer and different problems are associated with separate phases of the disease. Therefore, it is principally recommended to regularly screen all patients with cancer for nutritional disorders and in the case of conspicuous results meticulous diagnostics should be carried to clarify the underlying causes. The focus is on food intake and possible disturbing complaints, the physical performance index, nutritional status including weight change and body composition, the metabolic pattern and the presence of a systemic inflammatory reaction. As anti-cancer treatments frequently induce gastrointestinal derangements which endanger adequate food intake, individualized nutritional care should be offered routinely. After successful curative treatment patients are at risk of developing a metabolic syndrome; therefore, a balanced diet and regular physically activity are recommended. During palliative treatment special attention should be paid to the development of malnutrition. Patients are particularly endangered by cachexia with the combination of inadequate food intake, inactivity and prevailing catabolism. The treatment of cachexia requires a multiprofessional approach to ensure adequate food intake, guiding and supporting physical activity and interventions for normalization of the metabolic situation. In addition, the need for psychological and social support should be discussed. Dietary supplements are of minor relevance; however, deficits in micronutrients, such as vitamins and trace elements need to be balanced. At the end of life, care should primarily be focused on alleviating debilitating symptoms. To reliably support all patients affected by nutritional disorders, clear structures need to be established, responsibilities assigned and standardized procedures codified., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)