We report a case of late onset primary lymphedema (lymphedema tarda) where edema is managed with high levels of B vitamins. This is the first successful treatment of lymphedema where a patient's function is fully restored without the limitation of compressive garments. This restored mobility is of significant benefit to the patient, as it allowed them to reengage in the activities of daily life. Similar to the edema seen in retinal veins in those with elevated endothelin levels, we speculate that the edema in primary lymphedema is related to diseased lymphatic vascular health. In our case, following 12 months of high dose B vitamins. similar results were seen as in retinal cases, with elimination of edema and restoration of an active quality of life for the patient, an outcome that was sustained a year later. Given the proven absence of toxicity or side effects, we suggest employment of such vitamin therapy as the standard tool in management of primary lymphedema. PEER REVIEWED ARTICLE Peer reviewers: Dr Alexandru Grigorean, Universitätsspital Zurich, Klinik für Angiologie One anonymous peer reviewer Received on July 28, 2024; accepted after peer review on September 19, 2024; published on October 30, 2024.

Headaches can have many causes. The causes can be very common but can also have a rare etiology. Therapy is the treatment of the respective etiology. Certain symptoms, so-called red flags, can prompt the general practitioner to act more quickly. The case report is about a 67-year-old patient who suffered from headaches, fatigue and nausea. The symptoms disappeared when lying down and only occurred when standing. An magnetic resonance imaging (MRI) of the skull was ordered. This showed hygromas of the cerebral hemispheres, which were caused by cerebrospinal fluid loss. A MR - myelography was performed, which showed cerebrospinal fluid loss at the level of thoracic vertebrae 11 and 12. The clinical symptoms and the imaging findings led to the diagnosis of spontaneous cerebrospinal fluid loss syndrome. Treatment was carried out by neurosurgical leak closure. The patient became symptom-free after the therapy. Intracranial hypotension is usually caused by loss of cerebrospinal fluid. Early detection is important for treatment and reduction of further complications. PEER REVIEWED ARTICLE Peer Reviewers: Prof. Dr Andreas Gantenbein, Rehaclinic Bad Zurzach One anonymous peer reviewer Received on August 19, 2024; accepted after peer review on September 19, 2024; published on October 30, 2024.

Die thorakale Sonographie ist von breitem Nutzen bei der Diagnostik und Therapie pleuraler, pulmonaler und anderweitiger thorakaler Erkrankungen. Da immer mehr Ultraschallgeräte in der Hausarztpraxis im Einsatz sind, sind Grundkenntnisse in der thorakalen Sonographie essentiell. Die thorakale Sonographie erlaubt in Echtzeit eine rasche Analyse thorakaler Pathologien. Neben der Diagnose von Pleuraergüssen können auch Zwerchfellfunktionsstörungen, pulmonale Konsolidationen, Tumore, Empyeme, Abszesse, Rippenfrakturen und thorakale Lymphadenopathien ohne Strahlenbelastung nachgewiesen und weiter spezifiziert werden. Zudem macht die Thoraxsonographie thorakale Interventionen sicherer (insb. Pleuraergusspunktionen) und kann postinterventionelle Röntgenuntersuchungen vermeiden. Thoracic sonography is widely beneficial in the diagnosis and treatment of pleural, pulmonary, and other thoracic diseases. With an increasing number of ultrasound devices being used in general practitioner offices, basic knowledge in thoracic sonography is essential. Thoracic sonography allows for a fast real-time analysis of thoracic pathologies. In addition to diagnosing pleural effusions, it can also identify diaphragmatic dysfunction, pulmonary consolidations, tumors, empyema, abscesses, rib fractures, and thoracic lymphadenopathies without radiation exposure and further specification. Moreover, thoracic sonography makes thoracic interventions safer (especially pleural effusion punctures) and can avoid post-interventional X-ray examinations. **Peer reviewers:** Prof. Dr. Robert Thurnheer, Kantonsspital Münsterlingen, Münsterlingen, Schweiz Dr. Rudolf Horn, Center da sandà Val Müstair, Sta. Maria, Schweiz Artikel erhalten am 8. Januar, 2024. Artikel veröffentlicht am 15. April, 2024.

Die Therapielandschaft für chronisch entzündliche Darmerkrankungen (CEDs) hat sich mittlerweile stark erweitert. So wurden in den letzten Jahren mehrere neue Biologika und niedermolekulare Substanzen zur Behandlung von CEDs zugelassen. Weitere Wirkstoffe befinden sich in der Entwicklung. Zur Vorbeugung und Behandlung der CEDs spielt auch die Ernährung eine wichtige Rolle. Mikrobiom-basierte Strategien sind ebenfalls ein Therapieansatz, der zunehmend in den Fokus rückt. Perianale Fisteln beim Morbus Crohn können medikamentös und/oder chirurgisch behandelt werden. Auch Stammzellen kommen hier mittlerweile erfolgreich zum Einsatz. Im Folgenden werden die aktuellen Therapiestrategien für Colitis ulcerosa und Morbus Crohn zusammengefasst. The therapy landscape for chronic Inflammatory Bowel Diseases (IBDs) has significantly expanded in recent years. Several new biologics and low-molecularweight substances have been approved for the treatment of chronic IBDs. Other agents are currently in development. Nutrition also plays a crucial role in the prevention and treatment of chronic IBDs. Microbiome-based strategies are emerging as a therapeutic approach gaining increasing attention. Perianal fistulas in Crohn's disease can be treated with medication and/or surgery. Stem cells are now successfully employed in this context. The following summarizes the current therapeutic strategies for ulcerative colitis and Crohn's disease. Die chronisch-entzündlichen Darmerkrankungen Colitis ulcerosa (CU) und Morbus Crohn (MC) gehören zu den häufigen Krankheiten. In der Schweiz sind rund 20.000 Menschen davon betroffen. 1 Bei der Pathogenese der CEDs spielen mehrere Faktoren eine Rolle, darunter genetische Prädisposition und epigenetische Einflüsse, Störungen des Immunsystems und des Mikrobioms sowie ungünstige externe Umwelteinflüsse, z. B. ungesunde Ernährung. 2

Glaucoma is a disease that affects the entire optic tract. The most significant risk factors are increased intraocular pressure and impaired regulation of ocular blood flow. Activation of the glial cells and oxidative stress in the axonal mitochondria play an important role. In the event of glaucoma damage, the risk factors are to be identified. Along with the reduction of intraocular pressure, other types of therapeutic approaches are now increasingly being discussed.

Coronavirus Disease 2019 (COVID-19) has been widely spreading all over the world since the beginning of 2020. World Health Organization, on January 30th, 2020, declared the spread of COVID-19 to be a “public health emergency of international concern” (PHEIC). As of January 8th, 2021, 89,107,341 COVID-19 cases and 1,916,087 deaths due had been reported. The disease is transmitted via inhalation or contact with infected droplets. The incubation period ranges from 2 to 14 days and can reach up to 21 days. Many people are asymptomatic. The estimated fatality rate ranges from 2%−3%. Special molecular tests are being used to detect the virus in respiratory secretions. Elevated levels of C-reactive protein have been detected in the blood sample, while the white blood cell counts were considered normal. The computerized tomographic chest scan is usually abnormal even in those with no symptoms or mild disease. Current treatment options are essentially supportive, as the role of antiviral agents is yet to be established. Preventative measures can be utilized to slow the spread of infection, such as isolation of suspected cases or those with mild symptoms and strict infection control measures at hospitals. Though the virus is far more infectious than its two ancestors, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), 2019-nCoV has a lower mortality rate. To date, the impact of this pandemic is uncertain, and the global research community is working diligently to find a satisfactory therapy. To date, there is no approved oral treatment.

Coronavirus Disease 2019 (COVID-19) has been widely spreading all over the world since the beginning of 2020. World Health Organization, on January 30^th^ 2020, declared the spread of COVID-19 to be a "public health emergency of international concern" (PHEIC). As of March 25^th^ 2020, 414,179 cases and 18,440 deaths due to COVID-19 had been reported worldwide. The disease is transmitted via inhalation or contact with infected droplets. The incubation period ranges from 2 to 14 days and can reach up to 21 days. Many people are asymptomatic. The estimated fatality rate ranges from 2%−3%. Special molecular tests are being used to detect the virus in respiratory secretions. Elevated levels of C-reactive protein have been detected in the blood sample, while the white blood cell counts were considered normal. The computerized tomographic chest scan is usually abnormal even in those with no symptoms or mild disease. Current treatment options are essentially supportive, as the role of antiviral agents is yet to be established. Preventative measures can be utilized to slow the spread of infection, such as isolation of suspected cases or those with mild symptoms and strict infection control measures at hospitals. Though the virus is far more infectious than its two ancestors, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), 2019-nCoV has a lower mortality rate. To date, the impact of this pandemic is uncertain, and the global research community is working diligently to find a satisfactory therapy. Several reports on *Nigella sativa* have been published, motivating us to review recent publications to summarize and investigate its possible therapeutic effect on the immune response and its potential to treat bacterial and viral infections, including COVID-19. For the advanced stage of the disease, we suggest using biological targeted magnetic hyperthermia. This can be used as adjuvant therapy, namely pseudo- adjuvant magnetic hyperthermia (PAMH).