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Geriatric assessment is an integral part of geriatrics and leads to various improvements in the treatment of geriatric patients.Analysis of assessment data and patient characteristics in a large inpatient geriatric patient population. Evaluation of data from the Geriatrics in Bavaria Database (GiB-DAT) over 20 years as well as a cross-sectional study from 2020. Presentation of data for patients in inpatient acute geriatrics as well as continuing geriatric rehabilitation.The number of patient records and participating hospitals has steadily increased for both inpatient care types to 821,913 (status 31 March 2021). The Barthel index and other assessment results show differentiated values between acute geriatrics and continuing geriatric rehabilitation.The results demonstrate the differences in patient outcomes between the two types of care as well as changes in the setting over time. The constancy of the applied assessment instruments contributes to the comparability of the different hospitals; however, it is necessary to introduce new and alternative assessment instruments and to further develop inpatient geriatrics.HINTERGRUND: Geriatrisches Assessment ist integraler Bestandteil der Geriatrie und führt zu diversen Verbesserungen in der Behandlung geriatrischer Patienten.Analyse von Assessmentdaten und Patientenmerkmalen in einer großen stationären geriatrischen Patientenpopulation. Auswertung der Daten der Geriatrie in Bayern-Datenbank (GiB-DAT) über einen Zeitraum von 20 Jahren sowie einer Querschnittsuntersuchung aus dem Jahr 2020. Darstellung von Daten für Patienten der stationären Akutgeriatrie sowie der weiterführenden geriatrischen Rehabilitation.Die Zahl der Patientendatensätze und teilnehmende Kliniken ist für beide stationäre Versorgungsformen kontinuierlich angestiegen auf 821.913 (Stand 31. März 2021). Der Barthel-Index und andere Assessmentergebnisse zeigen differenzierte Werte zwischen der Akutgeriatrie und der weiterführenden geriatrischen Rehabilitation.Die Ergebnisse belegen die Unterschiede des Patientengutes beider Versorgungsformen sowie die Änderungen der Rahmenbedingungen im Verlauf. Die Konstanz der angewandten Assessmentinstrumente trägt zur Vergleichbarkeit der verschiedenen Kliniken bei. Andererseits ist es erforderlich, neue und alternative Assessmentinstrumente einzuführen und die stationäre Geriatrie weiterzuentwickeln.

The design of medical devices could be applied and developed for new microscopic surgical procedures instead of the traditional surgical procedures.

High salt concentrations in soil water impose osmotic and /or ionic stress and result in changed morphological and development patterns and modified physiological and biochemical processes in plants.

Triple-negative breast cancer (TNBC) represents a diverse group of breast cancers that are characterized by lack of expression of the estrogen receptor (ER), progesterone receptor (PR) and lack of amplification of the human epidermal growth factor (HER2) [1- 2].

The incidence of pituitary adenomas in the population is approximately 1: 1000 [1], which is 15% of all intracranial neoplasms [2].

It is necessary to detect diseases at an early stage since this may minimize harmful effects on the human body.

When looking at since-2016 articles published in the BJSTR, there seem relatively few studies from Western Europe, North America and Australia

Livestock performance and welfare may be adversely affected by weather conditions, heat stress being a sign of deterioration of animal welfare...

Vulvovaginal candidiasis is estimated to be the second most common cause of vaginitis after bacterial vaginosis [1].

Although pain management as core of healing (“Sedare dolorum divinum est”) has been declared by Hippocrates in old ages, the Pain medicine as a field of contemporary medicine exists slightly more than half century.

In the last decade, the rise of nanoparticles (NPs) in commercial products and in biomedical applications has urged the understanding of potential risks and harmful effects induced by their exposure at cellular level due to their biological interactions [1,2].

Frailty is an excess vulnerability to stressors, with a reduced ability to maintain or regain homeostasis after a destabilizing event, leading to poor outcomes: early death, disability, unplanned hospitalization and falls [1,2].

Malignant Glioma (MGs) variants, Glioblastoma (GBM) is the most common malignant tumor in the central nervous system.

Candidiasis is prevalent when the host defense is compromised. For example, individuals with diabetes mellitus, HIV infection, chronic systemic immune-suppressor drugs usage, or patients in intensive care units or having cancer are at high risk to develop persistent candida infection or recurrent episodes [1,2].

The casual association between abnormalities in the fetal development (eg., intrauterine growth restriction (IUGR) or prematurity) and the incidence of chronic conditions (eg., hypertension, coronary artery disease and stroke) in long-term was first proposed by Professor Barker [1,2].

Case reports describing disseminated Herpes simplex virus type 2 (HSV-2) disease are limited.

In Europe, musculoskeletal disorders (MSDs) are the most common occupation-related diseases, and in the United States, MSDs occupy 5th place in causes of visits to medical facilities.

Osteoporosis is a bone disease characterized by low Bone Mineral Density (BMD) leading to a reduction in bone quality.

The lung tumor is a leading cause of death worldwide. This type of disease in which there is uncontrolled progression of abnormal cells in the lung, when untreated, can extend through the process of metastasis in nearby tissues and in different parts of the body [1].

Modern evidence-based cardiology still utilizes historical gem drugs in routine everyday practice. The analgesic and antiinflammatory attributes of the salicylate-rich willow bark extracts are mentioned in the 16th century Ebers papyrus [1].

BACKGROUND: In clinical research as well as good clinical practice increasing importance is placed on standardized and evaluated procedures. They provide information which is important for the prognosis, determination of the need for interventions, determination of treatment goals and evaluation of treatment approaches and outcomes. Furthermore, they serve as justification of the reimbursement for presentation to official bodies. Until now no officially authorized German version of the performance-oriented mobility assessment (POMA) according to Tinetti was available. OBJECTIVES: This article presents a methodically translated German version of the POMA that also includes so far partially unpublished instructions for the examiner and the examined person. MATERIAL AND METHODS: The internationally recognized recommendations for the cross-cultural adaptation of health status measures served as the foundation of the translation process. By means of three translations from the original language into the target language a preliminary consensus version was developed, which was then translated back into the original language by two native speakers. RESULTS AND CONCLUSION: With this new and for the first time authorized German translation of the POMA a version of this assessment is available that achieves unification and standardization in German speaking countries and guarantees an improved comparability with international studies. Language: de

The heart rhythms accompanied by systole and diastole can change the blood volume in the vessels under the skin surface, and further alter the light absorption/reflection of vessels.

T1D consists of selective autoimmune killing of pancreatic islet β-cells that physiologically accomplish the task of secreting insulin on a regulated manner, in order to maintain blood glucose levels within normal range (70-140 mg/dl), under any circumstances.

To compare the ability of different frailty indexes based on a standardized comprehensive geriatric assessment (FI-CGAs) for predicting adverse outcomes.Prospective cohort study. Geriatric wards of a general hospital.307 hospitalized patients ≥ 65 years.The FI-CGA-10D (potential health deficits in ten functional domains), the FI-CGA-10D+CM (aforementioned potential health deficits and co-morbidity burden) and the FI-CGA-MIHD (multiple, individual potential health deficits, including functional deficits, co-morbid diseases, amongst others) were assessed at baseline during the patients` hospital stay. The FI-CGAs were analyzed as categorical (according to a FI-CGA scoreand ≥ 0.25) and continuous variables. Patients were followed up over 6 months.The FI-CGA-10D, FI-CGA-10+CM and the FI-CGA-MIHD predicted 6-month mortality when expressed as categorical (area under the receiver operating characteristic curve (AUC): AUC = 0.611, AUC = 0.637, AUC = 0.616, all p0.050, respectively) or continuous variables (AUC = 0.769, AUC = 0.837, AUC = 0.834, all p0.001, respectively). AUC comparisons showed that all three FI-CGAs exhibited a comparable ability to predict 6-month mortality when the FI-CGAs were expressed as categorical variables (all p0.200) and the FI-CGA-10D+CM and the FI-CGA-MIHD showed a better ability to predict 6-month mortality than the FI-CGA-10D, when the FI-CGAs were expressed as continuous variables (p0.001 and p = 0.007, respectively). None of the FI-CGAs predicted any of the other outcomes, i.e., unplanned re-admission to hospital and a fall during follow-up, irrespective of whether the FI-CGAs were expressed as categorical or continuous variables (all p ≥ 0.050).The more complex FI-CGAs, i.e., the FI-CGA-10D+CM and the FI-CGA-MIHD, revealed better ability to predict 6 month mortality than the more simple FI-CGA, i.e., the FI-CGA-10D.

In clinical research as well as good clinical practice increasing importance is placed on standardized and evaluated procedures. They provide information which is important for the prognosis, determination of the need for interventions, determination of treatment goals and evaluation of treatment approaches and outcomes. Furthermore, they serve as justification of the reimbursement for presentation to official bodies. Until now no officially authorized German version of the performance-oriented mobility assessment (POMA) according to Tinetti was available.This article presents a methodically translated German version of the POMA that also includes so far partially unpublished instructions for the examiner and the examined person.The internationally recognized recommendations for the cross-cultural adaptation of health status measures served as the foundation of the translation process. By means of three translations from the original language into the target language a preliminary consensus version was developed, which was then translated back into the original language by two native speakers.With this new and for the first time authorized German translation of the POMA a version of this assessment is available that achieves unification and standardization in German speaking countries and guarantees an improved comparability with international studies.

PURPOSE: This article investigates which medical and psychological variables predict long-term success of geriatric rehabilitation in patients who are discharged back to their home environment. MATERIALS AND METHODS: A prospective longitudinal cohort-study in the field with three data collection points was carried out. The matter concerns 68 patients of at least 65 years of age, a minimum MMSE of 18 points in an in-patient geriatric rehabilitation treatment followed-up at home 6 months after discharge. The medical and psychological predictors were assessed with valid instruments. RESULTS: After multi-collinearity diagnosis was carried out a multiple linear regression was calculated. A significant overall model (p=0.001) with a variance explanation of 53.0% resulted. Predictors for independence (Barthel-Index) after 6 months were the Barthel-Index at discharge, a positive development in cognitive function after discharge, rehabilitation concerned self-efficacy and goals concerning social contacts for the time after discharge. DISCUSSION: The interpretation of the results is limited by the sample size. However, since in spite of the small sample size a significant model resulted, the predictors seem to be relatively robust. While the functional status at discharge and the cognitive status were already mentioned as predictors for sustainability by other authors, the predictive power of self-efficacy as well as of goals concerning social contacts are in the area of geriatric rehabilitation a rather new finding. CONCLUSIONS: This should generate the implementation of measures which strengthen the conviction of the geriatric patients that they themselves can influence their course of recovery.

BACKGROUND : Little is known about the prevalence of falls and the related risk factors in the general population of community- living older people in Germany. OBJECTIVES : To assess the prevalence and related predictors of different types of falls in a sample of community-dwelling 65 years and older people in Germany living in a metropolitan area. Study design and setting prospective cohort study in 622 community dwelling people aged>/=65 years. RESULTS : A total of 107 persons (17.2%) reported falling at least once (occasional fallers), while 36 (5.7%) experienced two or more falls (recurrent fallers) in the last 6 months. Main predictors for all fallers were age (OR 1.8; 95% CI 1.1-3.0), being female (OR 1.7; 95% CI 1.1-2.2), living alone (OR 1.9; 95% CI 1.2-2.9), poor health status (OR 3.3; 95% CI 2.1-5.3), varifocals (OR 1.7; 95% CI 1.0-3.1), disturbance of memory (OR 1.7; 95% CI 1.0-3.0), depression (OR 4.8; 95% CI 2.5-9.2), sleep disturbances (OR 2.7; 95% CI 1.7-4.3), incontinence (OR 2.1; 95% CI 1.3-4.9), dizziness (OR 3.0; 95% CI 1.9-5.0), 3 medical conditions or more (OR 3.3; 95% CI 2.1-5.1), lower physical functioning and mobility. Two of the strongest predictors were reported falls (OR 4.9; 95% CI 3.1-7.7) and recurrent falls (OR 10.0; 95% CI 5.0-20.0) in the last 6 months. CONCLUSION : Older adults living at home should be screened for falls in history and problems in gait and mobility in any anamnesis to identify those who are at risk for falls. Language: en

There are few data regarding the accuracy of short frailty tools as predictors of mortality and other clinical outcomes of older patients admitted to a geriatric ward. We therefore analyzed the accuracy of Rockwood et al's Clinical Frailty Scale and an easy and quick to perform operationalization of Fried et al's frailty phenotype, as predictors of mortality and other clinical outcomes in our cohort of patients.Prospective analysis with a follow-up period of 6 months.307 patients who were 65 years of age or older were included in the study. The patients were assessed in terms of the two frailty measures during their stay in a geriatric ward.The Clinical Frailty Scale and the frailty phenotype were both suitable for differentiating between patients who died due to any cause from those who survived during follow-up (primary outcome) (area under the ROC curves (AUC) values 0.867 (95% CI 0.807-0.926), p0.001 and 0.754 (95% CI 0.688-0.821), p0.001, respectively). Regarding the secondary outcomes: 1. unplanned admission to hospital and 2. a fall during follow-up, the Clinical Frailty Scale discriminated or tended to discriminate between patients to whom these criteria applied and those to whom they did not (AUC=0.569 (95% CI 0.502-0.636), p=0.046 and AUC=0.574 (95% CI 0.501-0.647), p=0.071, respectively). The frailty phenotype did not show such a differentiation when applied to secondary outcomes (AUC=0.500 (95% CI 0.432-0.568), p=0.994 and AUC=0.518 (95% CI 0.439-0.598), p=0.658, respectively).Both short frailty instruments are suitable predictors of mortality in older patients who were admitted to a geriatric ward. The Clinical Frailty Scale, but not the frailty phenotype, predicted at least some of the secondary outcomes, i.e., the outcome unplanned admission to hospital during follow-up.

Zusammenfassung: In den letzten Jahren wurde vermehrt über eine neue Form der diffusen kortikalen Demenz berichtet: die Lewy-body-Krankheit (LBK). Ein wichtiges neuropathologisches Merkmal stellt das Auftreten von Lewy-bodies im Hirnstamm und Kortex dar, wobei verschiedene Subtypen existieren. Klinisch ist die LBK gekennzeichnet durch eine fortschreitende Demenz mit kognitivem Abbau, Parkinsonsymptomen, psychiatrischen Symptomen wie rezidivierenden Verwirrtheitszuständen, Fluktuationen der kognitiven Leistungen, psychotischen Symptomen oder Depression. Es ist schwierig, allgemein akzeptierte neuropathologische und klinische Kriterien für die LBK zu entwickeln, so daß Verwechslungen mit der (senilen Form der) Alzheimer-Demenz, aber auch dem idiopathischen Parkinsonsyndrom möglich sind. Es werden die Diagnosekriterien der Konsensus-Gruppe vorgestellt. Zur Validierung der Diagnose-Kriterien sind komplexe und langjährige prospektive Studien notwendig. Nur durch sie kann auch geklärt werden, ob es sich bei der LBK um eine eigene nosologische Entität handelt.

The aim of this project was to obtain information about drug therapy in geriatric units.Members of the geriatrics in Bavaria database (GiB-DAT) collected data on discharge medication and transferred them to the database. A total of 88,840 data sets of geriatric rehabilitation clinics and acute geriatric units were evaluated according to the anatomical therapeutic chemical (ATC) system.Patients (mean age: 81.1 years, female 67.7%) had an average of 10.4 diagnoses and took 8.0 drugs at discharge. A peak number of prescribed drugs was reached at the age of 60-70 years with a decrease in the following decades of life. Female patients received more drugs, significantly those in the decades from 71 to 80 and 81 to 90 years old. The bulk of the drugs were from the ATC groups "Cardiovascular system" (89.9%), "Nervous system" (82.3%) and "Alimentary tract and metabolism" (78%).

Static posturography is used to quantify body sway. It is used to assess the balance of elderly persons who are prone to falls. There is still no general opinion concerning the reliability of force platform measurements. The aim of this study was to test the reliability of force platform parameters when measuring elderly persons.The reliability of 11 force platform parameters was tested measuring 30 elderly persons. The following parameters were calculated: mean speed of center of pressure displacement in mm/s, length of sway in mm, sway area in mm(2), amplitudes of center of pressure movement, the axis of oscillation in degrees and the person's angles of inclination in degrees. Three measurements were taken on the same day, with a resting period of 2 min. Four different test conditions were used: normal standing and narrow stand with eyes open and eyes closed, respectively. Reliability was determined by using intraclass correlation coefficients.Six parameters had excellent reliability with a correlation coefficient of0.9: mean speed of center of pressure movement during narrow stand, area of sway during narrow stand, length of sway during normal and narrow stand, and the angle of inclination in the sagittal plane during normal stand and narrow stand. The condition "narrow stand eyes closed" proved to be the most reliable test position.Six parameters proved to have excellent reliability and are recommended to be used in further investigations. Narrow stand with eyes closed should be used as the test position. The tested protocol proved to be reliable. Whether these parameters can be used to predict falls in elderly persons remains to be investigated.

"Mobility and safety for the elderly (MoSi)") is a new intervention, especially designed for elderly people with gait disorders and for fallers.165 persons, 65 years or older, participated in this study.The participants were assessed prior to and after the 5-week intervention. The intervention included various elements of strength and balance training, stretching, reaction and coordination training, and information. The participants were instructed about how to prevent falls and what measures to take after a fall has occurred. Furthermore, they were taught home exercises. The intervention was set in an ambulatory physiotherapy department and consisted of 10 training sessions.Participants reported improved performance of gait (66 %), gait security (66 %), power (65 %), balance (62 %), sense of security (61 %) capacity (70 %) and well being (63 %).The Berg Balance Scale and the Balance test of the "Tinetti Balance Scale" showed significant improvements (p.001). The Timed Up and Go Test, the gait test of the Tinetti Balance Scale showed improvements in persons with very impaired gait (p.005). The Repeated Chair Stands Test showed no significant improvements. 137 (95 %) of the participants stated they would continue the exercises at home, 112 (79 %) stated they would continue the exercises under therapeutic supervision.The results show that the intervention is able to improve mobility and gait of elderly persons, subjectively and objectively, especially of persons with impaired gait. The motivation effect of the intervention was high which was marked by the large number of participants which wanted to continue their exercises at home. Furthermore, the intervention resulted in participants reporting improvements in other parameters such as capacity and well being.The intervention is able to improve important measures of balance in community dwelling older people. However, the effect on the number of falls still has to be investigated. The intervention is suitable for an ambulatory setting and shows significant effects after a short time. Due to the intervention's compactness it is appropriate for persons who normally would avoid training programs because of the duration.

Because of age-related modifications of the heart, lung, and circulation, several cardiopulmonary parameters present altered normal and reference values with increasing age. Other parameters, for example, arterial blood pressure, change only insignificantly with age. In older age groups it is more difficult to establish reference ranges and values because of the lack of "healthy" subjects. To establish cardiopulmonary parameters, appropriate investigations for the age group, for example, treadmill-ergometer, should be preferred. In judging if a value resulting out of the reference range is to be considered really pathologic, other factors are to be taken into account, such as circadian variations, motivation, associated pathologies as well as the actual physical and psychological conditions, when we are dealing with older subjects or patients.

Die steigende Zahl psychisch kranker alterer Menschen stellt zunehmende Anforderungen an betreuende Personen und versorgende Institutionen. Im bestehenden Versorgungssystem nehmen psychiatrische Landeskrankenhauser bei der Behandlung alterer chronisch psychisch Kranker und multimorbider Patienten eine wichtige Stellung ein.

In der Gerontopsychiatrie eines Landeskrankenhauses spielen bei vielen Patienten neben uberwiegend schweren und chronischen psychischen Erkrankungen korperliche Krankheiten und Beeintrachtigungen eine wichtige Rolle. Im Mittelpunkt dieser Studie, die retrospektiv alle im 1. Halbjahr 1989 in unserem Zentrum aufgenommenen Patienten uber 65 Jahre umfast (n = 271), steht die Untersuchung der Probleme, die sich aus dem gleichzeitigen Auftreten psychiatrischer und korperlicher Erkrankungen ergeben. Angaben, die das Gesamtprojekt und die Stichprobe betreffen, finden sich im vorangehenden Beitrag.