Augusta Krankenhaus

Introduction and objective: Periodontitis (PD) is caused by dysbiosis of the oral microbiome (OMB). The prevalence of PD is increased in RA patients. Both conditions have the ability to activate common inflammatory pathways. The OMB shift contributes to more severe course of PD and RA. This paper aims to summarize the impact of OMB on chronic inflammation in the pathogenesis of PD and RA. Description of the state of knowledge: The OMB can influence chronic inflammation and protein citrullination. The presence of antibodies against citrullinated peptides (ACPA) correlates with an increased incidence and severity of periodontitis. While numerous studies have reported a relationship between the OMB, PD and RA, the role of specific bacteria in RA remains unclear. Methodology: A literature review was conducted using two databases - PubMed and Google Scholar - with search terms such as "oral microbiome”, “rheumatoid arthritis", "periodontal health”, “oral microbiota”, “periodontal disease”. Articles published within the last eight years were prioritized. Conclusions: PD is more prevalent and severe particularly in ACPA-positive RA patients. Alterations in OMB are associated with systemic inflammation, contributing to RA progression. and worsening periodontal conditions. Periodontal treatment shows a potential to reduce RA activity, emphasizing the importance of dental care in RA. Anti-inflammatory treatments may restore oral homeostasis. Targeting the OMB offers a potential for managing RA and PD. Further research is needed to establish guidelines for personalized therapies and prophylaxis.

Introduction and Purpose: As the global population ages, ensuring a good quality of life for older adults becomes increasingly crucial. Tai Chi is a mind-body practice originating from ancient China that combines elements of martial arts, meditation, and focused visualization. In recent years, it has gained increasing popularity in the West, particularly due to its numerous health benefits. The purpose of this article is to review the health benefits of Tai Chi for the elderly population.Materials and Methods: A literature search was conducted using the medical databases PubMed and Google Scholar. Articles were retrieved in English, employing the keywords: „Tai Chi”, „elderly”, „ postural balance”, „ rehabilitation”, „cognition”.State of Knowledge: Tai Chi is a safe form of exercise for older adults. This practice involves slow, harmonious body movements synchronized with deep breathing and concentration. A growing body of research supports the benefits of Tai Chi as an integrative strategy in the treatment and rehabilitation of various age-related conditions. The therapeutic effects of Tai Chi for the health of seniors include improvements in balance, bone health, sleep quality, immunity, cognitive function, metabolic indicators, and cardiorespiratory fitness, as well as the alleviation of pain, symptoms of depression, stress, and anxiety.Summary: Tai Chi may support healthy aging by improving balance, fitness, and quality of life in older adults, but additional research is needed to fully understand its impact on health.

Nosocomial pneumonia is defined as pneumonia occurring ≥ 48 h after hospital admission in apatient without severe immunosuppression. It can occur in spontaneously breathing patients or with noninvasive ventilation (NIV) and mechanically ventilated patients. In patients with suspected ventilator-associated pneumonia (VAP) (semi)quantitative cultures of tracheobronchial aspirates or bronchoalveolar lavage fluid should be perfomed. The initial empirical antimicrobial treatment is determined by the risk for multidrug-resistant pathogens (MDRP). The advantage of combination treatment increases with the prevalence of MDRPs. The antibiotic treatment should be adapted when the microbiological results are available. After 72 h astandardized re-evaluation including the response to treatment and also checking of the suspected diagnosis of pneumonia in astructured form is mandatory. Treatment failure can occur as aprimary or secondary failure and in the case of primary progression necessitates another comprehensive diagnostic work-up before any further antibiotic treatment.

In recent years there has been a significant increase in the popularity of electronic cigarettes among adolescents and young adults worldwide. E-cigarettes have reached the market without the extensive preclinical toxicology testing or long-term safety studies required for conventional therapeutics and medical devices. Their effectiveness as a smoking cessation intervention, their impact at the population level and whether they are less harmful than combustible tobacco products are highly controversial. Studies show measurable adverse biological effects on organ and cell health in humans, animals and in vitro. E-cigarette use also increases the risk of respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma. There is a serious risk of complications associated with e-cigarette use, such as EVALI (E-cigarette or Vaping Product Use-Associated Lung Injury) - serious lung damage associated with, especially for adolescents. This paper reviews the effects of e-cigarettes on respiratory health.

Zusammenfassung Bis zu 10 % aller Notfallpatienten sind intensiv- oder überwachungspflichtig – Tendenz steigend. Im klinischen Alltag können jedoch nur wenige dieser Fälle unmittelbar auf eine Intensiv- oder Überwachungsstation verlegt werden. Aus diesem Grund besteht mitunter die Notwendigkeit einer verlängerten notfallmedizinischen Versorgung kritisch kranker Patient:innen in der Notaufnahme. Unter dem Motto „upstairs care, downstairs“ haben große Notaufnahmen im angloamerikanischen Raum hierfür die „emergency critical care units“ (ECCU) entwickelt. Dieses Konzept steht für eine frühe hochintensive Versorgung kritisch kranker Patient:innen innerhalb von Notaufnahmen mit dem Ziel einer bestmöglichen Stabilisierung und Allokation im Krankenhaus. Im Rahmen dieser Übersichtsarbeit sollen die bisherigen Daten zu ECCU genauer analysiert und auf die Situation in deutschen Notaufnahmen übertragen werden.

Studies comparing male and female patients with abdominal aortic aneurysms have shown that female patients are generally older and more often experience postoperative complications after endovascular and open repair. There are also indications that female patients have more extensive neck pathologies and that they more often have postoperative complications related to proximal neck pathology. This retrospective study describes all consecutive female patients who underwent EVAR between 1 January 2012 and 31 December 2021. Propensity-score matching was used to obtain a matched control male cohort. Propensity scores were generated with the following anatomic parameters: infrarenal and suprarenal angulation, proximal and distal neck diameter and neck length. 1 Female patient was matched with 3 male patients. A total of 160 patients were included, namely 120 male patients and 40 female patients. Due to matching, there were no significant differences regarding infrarenal and suprarenal angulation and proximal and distal neck diameter and length. All-cause and aneurysm-related mortality were comparable (p = 0.19 and p = 0.98). The necessity of neck-related secondary procedures was significantly higher in female patients (p = 0.02). In the multivariate analysis, the female sex was a significant predictor of endoleak type IA within 30 days. However, there was no significant association between intraoperative endoleak type IA and endoleak type IA at the end of follow-up. This study suggests that there was a higher initial incidence of endoleak type IA in female patients, despite thematched preoperative anatomic parameter. Due to the relatively low number of included female patients, conclusions should be drawn carefully.

ZusammenfassungDas ABCDE-Schema (Atemwege, Beatmung, Kreislauf, neurologische Defizite, Exposition/Umwelt) ist integraler Bestandteil der Schockraumversorgung nichttraumatologischer Patienten. Während respiratorische und zirkulatorische Probleme sowie Vigilanzminderung und neurologische Notfallbilder den Großteil des Erkrankungsspektrums bei kritisch kranken Patienten ausmachen, sind sog. E‑Probleme mit 0,4–0,9 % eher selten. In diesem Übersichtsartikel soll das E‑Problem genauer besprochen und auf typische Vertreter der E‑Probleme, wie Hypo‑/Hyperthermie, Intoxikationen, Liegetrauma, starke Schmerzen und Agitationszustände, vertiefend eingegangen werden.