Urologists will no longer provide bladder reflexes for patients for a short time: this action is intended to draw attention to excessive hygiene requirements in medical practices.
Stopped: As of mid-November, there may be no more bladder mirroring at resident urologists – at least for some time, except in emergencies.
BERLIN. Urologists sound the alarm: the requirements for reprocessing the instruments as well as requirements for proving the measures taken would become more and more comprehensive for established colleagues. In some federal states, the measures would also have to be paid for by external examiners, according to a statement by the Professional Association of German Urologists (BvDU).
Last weekend, the Board of Directors adopted a recommendation to its members that the urological examination for the diagnosis of bladder disease and the exclusion of bladder tumors (cytoscopy) and their follow-up should be temporarily suspended from mid-November. Emergencies would be treated further for the time being.
A stumbling block: At the end of last year, the Ludwigshafen health authority had banned the practice of cystoscopy by several urological practices in Rhineland-Palatinate because the treatment measures taken had not been validated by external examiners, writes the BvDU. The underlying legally binding hygiene guidelines, which are developed by the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the RKI, however, mainly considered the situation in hospitals, the professional association points out. They could not be transferred to outpatient care without considerable logistical and personnel expenditure.
The BvDU had already in the first quarter of 2019 to the Kassenärztlichen associations and health insurance companies turned to address this problem, so that would be created for the outpatient care suitable framework conditions so far unsuccessful, so the criticism. Therefore, the suspension action should increase the pressure on the KVen and the Federal Ministry of Health. (run)
Germany also wants to introduce the Nutri score for food labeling from next year. In Europe, the colorful nutrition label has been on the triumphal march for some time.
By Detlef Drewes
What is healthy? Tested in EU countries, the Nutri-Score label aims to help consumers eat more balanced.
BRUSSELS. There are examples like this, which are often told in Brussels: On the first morning of her holiday in France, Johanna goes into a supermarché and discovers her favorite muesli on the shelf. But immediately she notices the colored code – and she is surprised that her cereal only gets the orange rating "D".
After the holidays, Johanna studies the German version of the food labeling of her cereal. She reads nutritional value tables. But how to interpret the numbers exactly, she is not clear. What is healthy now? What is balanced?
The Verbraucherzentrale Bundesverband has written down this scene and advertises with it for the colored Nutri score. It is an invention of France, in which the National Agency for Public Health, Nutritionists, Food Industry Representatives and Consumer Protection Workers worked for almost 17 years before the 2018 logo was finally introduced. Surveys with our neighbors prove that this label performs best in terms of intelligibility.
Companies like
Just a few weeks after the official launch, Auchan, Intermarché, Leclerc and Fleury Michon have committed to introduce the system. "An easy-to-understand nutritional label is in line with Danone's strategy to help create healthier eating and drinking habits," said Richard Trechman, manager of yogurt giant Danone, explaining his company's commitment.
Many more companies have followed in the meantime. The Nutri score was an "important decision-making aid in the choice of food," emphasized Andreas Brosselmann, Quality Manager International at Bofrost.
In France in 2018, the first products entered the stores nationwide. Belgium followed in 2019. Spain and Portugal have decided to follow suit. Luxembourg and Switzerland are also determined to introduce the colorful labeling.
In Brussels, the project is sponsored by all means. Although there are weaknesses of the system, it says in the consumer protection department of the responsible European Commissioner Vera Jourova. But "the highest principle must be the intelligibility" is emphasized in the European Commission. There are obviously all agreed.
"The new labeling system must be understandable especially for the population groups affected by malnutrition and obesity," says Professor Berthold Koletzko, Chairman of the Nutrition Commission of the German Association for Paediatrics and Adolescent Medicine.
Germany is still considering, the other Europeans are impressed to enthusiastic. Up to 94 percent of polls – also in the Federal Republic – favored this new form of labeling.
A good, easy to understand picture
The Nutri score is calculated on the basis of the nutritional information for every 100 grams or per 100 milliliters. The calculation includes on the one hand nutrients that may have negative effects on health: energy content, sugars, saturated fatty acids and salt (sodium).
On the other hand, properties of the products are taken into account, which can have a positive effect. For the different ingredients, there are points that give an overall rating. From this, the classification into the colored classes "A" (green) to "E" (red) is derived.
Of course that means a simplification, according to the National Public Health Agency in Paris. Not all ingredients like vitamins, minerals or unsaturated fatty acids would be evaluated. But for that the system is easy to understand for everyone and results – together with the list of ingredients – a good picture.
That the regionality of food, organic farming or genetically modified ingredients would not be included, however, is considered justifiable. Finally, there are organic and quality seals.
Skepticism not only in Germany
The skepticism that exists in Germany is also present in other EU states. Although the independent French-Belgian test organization Test Achat / Test Santé is fundamentally in favor of the nutritional color theory of the Nuri scores, it complains about the lack of consideration of additives such as sweeteners and dyes or preservatives.
However, in Belgium, too, the colorful scale is considered to be the best variant available to ensure rapid consumer information. "People read in the business no nutritional reports, which were printed anyway so small that they are hard to decipher," it says at the consumer advocates in our neighboring country.
The conclusion of the European discussion is therefore: The Nutri Score can not be beaten in terms of comprehensibility, even if it has weaknesses in detail. But they are acceptable, because many citizens would not perceive the endless imprints anyway. Manufacturers, in turn, are pushing for the widest possible uniform labeling in the light of the common market.
Even if the screen is so captivating: Let your eyes wander off and on. Blink a lot. Every drop of your eyelid spreads tears and keeps you from getting too dry, they do not catch fire quickly.
. 4 March
Put on shoes, put on sunglasses, and off you go through the white winter landscape. By the way, each step is also a treat for your eyes. And that twice: movement stimulates blood circulation and melts hip gold. This keeps the blood vessels elastic, which also benefits the sensitive organ of vision. Another plus: exercise in the fresh air prevents dry eyes.
. 5 Switch off more often
Relax! Not only psychologists swear by it, eye specialists also rely on the power of inner balance. "During stress, the intraocular pressure can increase," explains Professor Horst Helbig of the University Hospital Regensburg. Hypnosis or autogenic training can slow the progression of the disease in green-star, studies suggest. But they do not replace a therapy.
. 6 Smoking cessation
"Smoking increases aging mechanisms on the eye," warns Professor Horst Helbig of the German Ophthalmological Society. Who smokes, risks the lens becoming clouded early (cataract) or the blood circulation worsens. The risk of age-related macular degeneration and glaucoma is also increasing. Good reasons to put the glow stick out of your hands for good.
. 7 To feed vitamins
The list of eye-healthy foods is long: spinach, fish, carrots, wholemeal bread. "A balanced, vitamin-rich diet is the best protection factor," says ophthalmologist Helbig. Especially vitamin A, C and E, but also the plant dyes lutein and zeaxanthin (abundant in green vegetables) prevent cell damage to the eye. The best way to get the nutrients fresh from the plate. Helbig: "Take supplements only in consultation with the doctor."
. 8 Keep a look
The letters on the street sign become more illegible? "Many people believe that stronger glasses fix the visual damage," says eye expert Eckert. But the eye test at the optician is not enough. "If someone looks worse in old age, it's up to the eyes, not the strength of the glasses," emphasizes Eckert. Therefore go to the ophthalmologist first. Only in the second step is it necessary to find a suitable visual aid.
Parents are more satisfied with established paediatricians than with clinics or with physicians of other disciplines, according to a study.
LEVERKUSEN. Established paediatricians perform significantly better in the eyes of parents than children's clinics and other specialists. 75 percent of parents rate the care of their children with the pediatrician as very good or good. 56 percent of clinics and 53 percent of other specialists such as orthopedists or ENT doctors.
This shows the study "Young Families 2019" on behalf of the company health insurance Pronova. In June and July of this year, 1000 adults in Germany were questioned online, in whose household at least one child under the age of ten lives.
61 percent of them had problems with pediatric care in the past two years. At the top was the overcrowding of the waiting rooms in the pediatric practice with waiting periods of an average of one hour, even for preventive appointments. The complained 33 percent of adults. 26 percent said they had to wait more than an hour despite the child's complaints. 17 percent reported having problems changing the pediatrician, 16 percent complained that they only get screening and vaccination appointments with a lead time of many weeks.
According to the survey, every third schoolchild between the ages of six and ten suffers from fatigue (37 percent) and difficulty concentrating (35 percent) several times a month. In 32 percent of this age group, listlessness and lack of drive cause problems. 29 percent of parents find restlessness in their child, 28 percent fatigue or slackness. Young parents up to the age of 29 report an above-average number of such complaints of their children.
The fear that her child might get sick drives 48 percent of adults. It is far more pronounced than the fear that the child will have to grow up in a polluted environment (38 percent), and concern for financial security. (iss)
What happens? The throat muscles relax during sleep, the upper respiratory tract narrows, the palate and suppository vibrate while breathing and produce the snoring sounds. The sleeping person usually does not notice, the partner often feels strongly burdened by the noise. At least 60 percent of men and 40 percent of women snore, high unreported cases of those affected.
What causes? With age, the muscle tension in the throat decreases. Anesthetic agents include runny nose, polyps, alcohol, smoking, obesity and synthetic sleeping pills and tranquilizers.
When to the doctor? Snoring is harmless in itself. Often the partner urges but on a therapy because he feels disturbed. For very loud snoring with respiratory failure and heavy daytime fatigue necessarily to the doctor. Then a thorough diagnosis in the sleep laboratory is advisable. A dentist-specific rail for the night pushes the lower jaw and tongue slightly forward and can brake out noise. Eventually, surgery helps to keep the airway clear. Discuss individually with the expert what makes sense.
What can I do? Changing Lifestyles, Limiting or Eliminating Alcohol Use and Smoking, Overweight Reduction Discard Sleep Aid. Better sleep on the side, as a support put a small pillow in the back. In the pharmacy there are special clamps that stretch the nostrils.
Tip for the Partner: It is often enough to talk to the snorer briefly or ask him to turn to the side. If that does not work, rest with ear plugs, try a light pill from the pharmacy or, if possible, move to another room.
. 3 Crunching teeth
What happens? Unconsciously the sleeping man grits his teeth or presses his jaw joints together. Crunching and pressing, however, can also take place during the day.
What causes? Mostly there is psychological or physical stress behind it. Alcohol, caffeine, smoking or medications can have a strengthening effect. Roughly estimated, five percent of over-65s are nocturnal crunchers.
When to the doctor? Nocturnal grinding noises are usually noticed by the partner. Crunching every now and then is not bad. But if you feel more often pain in the area of the cheek, the temple or in front of the ear, should let the dentist clarify possible causes. If the denture has already been damaged, for example by increased tooth abrasion, it is also the right contact person. An individually designed bite bar for the night protects the teeth and relieves the chewing muscles.
What can I do for myself? Get rid of crunchy enhancers like cigarettes or alcohol. Prosthesis wearers should remove their third party at night. It is important to reduce the stress level as much as possible. Talk about your worries and hardships that seem to keep you going to sleep. Have you ever tried yoga? It is good to learn a relaxation procedure. In some cases, psychotherapy counseling is the best way to solve problems.
Tip for the Partner: Listen, if your partner wants to talk about his charges. At the same time, take good care of your sleep.
Expert advice: Prof. Helmut Frohnhofen, German Society for Sleep Research and Sleep Medicine; Dr. Michael Bohndorf, ENT Center Düsseldorf; Dr. Bruno Imhoff, German Society for Functional Diagnostics and Therapy
Salmon: Based on the few data available to us on the problem, we can see that the perpetrators are mostly the adult children of the victims or the spouse. They are more likely to be male, have had or have had problems with drug abuse or drugs in the past, are suffering from mental or physical illness or have already come into conflict with the police. In addition, they are mostly socially isolated, unemployed or in financial difficulties and suffer from severe stress.
Again and again you can hear about violence among elderly people, for example in retirement homes. Why is that? And what can be done about it?
Salmon: We are increasingly seeing this kind of violence against older people, and we have to give it a lot of importance. According to our findings, it is probably much more likely to experience violence in a retirement home by other residents than by the nursing staff. There are many reasons for this, but a significant factor is that many patients in the facilities live with dementia or behavioral problems in a confined space. Our group is currently developing and testing an intervention strategy designed to prevent abuse between residents of facilities.
Zank: People with dementia often misunderstand roommate behaviors as aggressive behavior or threats. Here nurses can intervene de-escalating. Above all, it is important to have a precise analysis of what happened: What triggered the aggressive behavior? Is it possible to recognize a pattern of recurring situations? And: Can you avoid them in the future?
How can the victims be protected?
Salmon: An important strategy is first of all to detect abuse. We need to make sure that those who come into contact with older adults look for signs of abuse. Doctors are not yet particularly involved in this area, although sometimes they are the only people who have contact with the victim of abuse outside of the victim-victim relationship. Once a case is known, there are several ways to tackle abuse.
Although there are no randomized controlled trials to date, one promising strategy in the United States is to use multidisciplinary teams that bring together specialists from diverse fields such as medicine, law, social work, housing, and police to create a comprehensive plan to protect the victims , I believe that this strategy can also be applied very well in many other countries and societies. The intervention approaches should be the same.
Professor Zank, what political decisions are needed to prevent abuses?
Zank: For people in need of care, the same rights apply as for all other people. Nevertheless, there is a special responsibility of the state and society to be looked after with dignity and without danger to life and health. However, legally we often move in a gray area.
Therefore we need a Altenhilferecht in accordance with the child and youth welfare law! Any suspicion of endangerment of the child is checked – the main questions are whether there is a risk to the child and whether or which need for action exists. The possibility of enforcing such a review does not exist with the elderly. Only in case of danger to life and limb there is an immediate need for action, free nursing services of secrecy and allows police intervention. That should change.
What Can Relatives, Nurses, Doctors, and Elderly Patients Do To Protect Themselves?
Salmon: Stay alert when dealing with older people. Familiarize yourself with the signs and symptoms. Engage with non-governmental organizations and other institutions in your area with whom you can work together to educate and work together to prevent the abuse of the elderly.
Zank: In Institutions: Do not Just Take Violence! Instead, addressing the person who has misbehaved. Meeting with a trusted person such as the nurse, shifter or home director. Caregivers and physicians should gain safety through training in identifying maltreatment and neglect. At the same time they should become familiar with intervention measures.
Relatives and professional caregivers must be alert and accept help for signs of overwork, exhaustion, depressive symptoms . This can be advice, for example, leads to the use of relief options such as day care, vacation, volunteers or self-help groups. In institutions there should be supervision offers. Psychotherapy may be indicated for longer-term stress or overwork situations.
DRESDEN. In Dresden, the foundation stone was laid at the end of September at the University Hospital Carl Gustav Carus for the new Center for Metabolic-Immunological Diseases and Therapy Technologies Saxony (MITS).
According to Uniangaben, from 2023 physicians, biologists, engineers and materials scientists are to work together in the new building in order to further develop a bioreactor and make it available to patients. This innovative capsule aims to cure diabetes and metabolic-immunological diseases.
Based on the only transplant center for insulin-producing cells in Germany, Dresden is the best location for this demanding project.
Eight million diabetics in Germany
Experts in the fields of internal medicine, endocrinology, immunology, surgery, transplantation medicine, cell biology and materials science developed new medical approaches to the diagnosis, treatment and prevention of metabolic diseases such as diabetes, in order to further expand their expertise. The federal government and the Free State are supporting the new construction costs, which amount to around 35.5 million euros, at an unspecified level.
In view of the more than eight million diabetics in Germany today, it is no longer enough to counter these and other common diseases with the prevention and therapy strategies known to date.
"In order to reduce the epidemic spread and develop new low-impact treatment approaches for patients, we have to leave the beaten path. One key to this is the intensive study of the molecular dimension of the metabolism, "explains MITS spokesman Professor Stefan R. Bornstein.
Observing Biochemical Processes
"Innovative diagnostic procedures help us with this – above all mass spectrometry and molecular imaging. In the future, they will allow us to observe biochemical processes of metabolism directly in a living organism, "he adds.
The MITS will be one of the institutions in Germany that develops and tests the necessary procedures. "The results will also make an important contribution to the further development of the bioreactor," says Bornstein confidently.
Professor Michael Albrecht, Medical Director of the Dresden University Hospital, sees the MITS as "an excellent example of the classical translational function of the university medical center Dresden." (maw)
A poll among people with diabetes puts their finger on the wound: many feel left alone by politics.
BERLIN. According to many Germans, diabetology should be upgraded and more attention paid to the disease as a whole. This is suggested by a recent survey of diabetesDE – German Diabetes Assistance among more than 1500 people with type 2 diabetes mellitus.
86 percent of respondents feel that they are not adequately represented in politics. 89 percent think that the public is not well informed about diabetes. In addition, 44 percent of respondents reported that they did not receive training after their initial diagnosis.
To close this gap in the care, the position of the diabetes advisors should also be upgraded, says dr. Gottlobe Fabisch, Managing Director of the Association of Diabetes Counseling and Training Professions in Germany. The motto must be: "More attractiveness through better framework conditions."
Coalition wants to reform training paths
This also includes converting the further education program "Diabetes Consultant DDG" into a three-year dual training occupation, according to Fabisch. This has to be done on the basis of a federally regulated professional code. The chances for that would not be bad, according to the expert.
For example, the Union and the SPD had inscribed in their coalition agreement that they wanted to improve the health professions and reform training paths. This opportunity must also grab the profession of diabetes counselors at the head. There is a need for young diabetes professionals – just because of the rising number of patients.
The approximately 4,700 diabetes consultants who have successfully completed training in the past three decades may not be able to meet the demand for skilled workers in some regions today.
The president of the German Diabetes Association, Professor Monika Kellerer, agrees: "Diabetes treatment always takes place in a team." Without medical and professional careers, competent diabetological care in clinics and in the outpatient medical sector would be almost unthinkable. (hom)
It is known that physical activity protects the heart. A team has now investigated the role of anti-inflammatory metabolic changes.
BERLIN. Inflammatory processes in the body increase the risk of cardiovascular diseases. A new study presented at the Heart Days of the German Society of Cardiology in Berlin indicates that physically fit people have less inflammatory markers in their blood and are thus better protected against cardiovascular diseases.
In chronic systemic inflammation, the immune system is known to be permanently activated and releases inflammatory substances. The current study has shown that the inflammatory state, as measured by the biomarker hs-CRP (highly sensitive C-reactive protein), is prognostically important for cardiovascular disease. Already low inflammatory values below the values, as measured in clinically manifest inflammations, are therefore to be evaluated as a risk factor for cardiovascular diseases.
The team around Dr. Kirsten Lehnert from the University of Greifswald examined the relationship between physical performance and inflammatory markers in the blood of almost 1,500 people from Mecklenburg-Western Pomerania between the ages of 20 and 81 years. The physical fitness of the participants was assessed by the researchers using a load test with breathing gas measurement on the bicycle ergometer.
The higher the maximum oxygen uptake, the fitter was the subject. An increase in maximum oxygen uptake of 100 ml was significantly associated with 4.5% lower hs-CRP and 1% lower white blood cell count. Other inflammatory markers showed similar relationships. "We were able to show that higher physical performance is associated with less systemic inflammation," Lehnert concluded.
According to Lehnert, the results suggest that the widespread lack of physical activity in the population not only promotes poor physical fitness but also higher levels of inflammation, leading to cardiovascular diseases. "However, the influence of messenger substances and other factors in the context of an inflammatory reaction to the cardiovascular risk should be analyzed even more precisely," says Lehnert. (sj)
DRESDEN. Sporting activity should be part of human life. The WHO recommends at least 150 minutes of moderate or 75 minutes of intense physical activity per week for each.
This recommendation also applies explicitly to patients with chronic diseases, such as Philipp Sewerin, Heinrich Heine University, Düsseldorf, in the session "Pain and Activity in Rheumatology" at the DGRh Congress in Dresden highlighted.
Today, this goal is more vision or desire than reality, as a survey of a German health insurance company revealed in 3000 insured. These activity goals reached only 54 percent of those surveyed.
Worrying about harmful effects
The situation is similar in international cohorts of rheumatoid arthritis (RA) patients. The vast majority of respondents did not move regularly. With the exception of Finland, less than 20 percent met the goal of at least three times a week physical training.
Inactivity was more common among women, elderly RA patients and low levels of education. The inactivity correlated with health issues such as overweight, comorbidities, low functional status, higher disease activity, pain and fatigue – so the further analysis.
Worrying about the harmful effects of exercise is certainly a factor in the inactivity of RA patients. Others, according to Sewerin, are pain and uncontrolled disease activity, a long-standing RA and, ultimately, the fact that the topic has played a rather minor role in the doctor's discussion so far. And this despite the fact that there is now sufficient evidence for a positive effect of adequate physical activity on the disease activity.
As Severin has said, sport makes endorphins not only happy, but also self-confident and powerful through serotonin and dehydroepiandrosterone.
Myokines are released
See our Dossier Rheumatism in our issue of October 16, 2019 for more
Recent Reports on Investigation Methods, New Therapeutic Options and Study Insights, Backgrounds and
Much more important, however, is that it has a positive effect on the cytokines released by the muscles during physical activity, so-called myokines. These peptide hormones lead to the release of anti-inflammatory cytokines in macrophages, support bone metabolism, improve the glucose metabolism via effects on the pancreas, the liver and the intestine, stimulate fat metabolism in adipose tissue and increase the endothelial function in the blood vessels.
In addition, myokines also improve cognitive abilities, as demonstrated by the protagonists of myokin research, Fabiana Benatti from Sao Paulo and Bente Pedersen from Copenhagen (Nat Rev Rheumatol 2015; 11: 86-97).
In contrast, inactivity favors an inflammatory synovium and the accumulation of visceral fat, which in turn leads to macrophage infiltration and ultimately chronic-systemic inflammation.
Important pillar in RA management
Regular training and physical activity should therefore be regarded as a necessary and important pillar in the management of RA patients and more space in the doctor-patient interview.
At the same time, the image should no longer be defined by senior women in water aerobics, but rather by athletic role models for young rheumatism patients.
emergency paramedic expressly equip with the permission to medical science, or not? The initiative of the Bundesrat leads to a discussion within the medical profession.
By Anno Fricke and Thomas Hommel
Rescue mission: How far should the field of duties of emergency anarchists reach? Opinions differ.
BERLIN. The initiative of the Federal Council to allow emergency paramedics to inject, puncture or even take invasive measures in the event of an emergency has triggered a split echo in the medical profession. At its meeting on Friday, the Federal Council had introduced a proposal for amendment of the emergency paramedic law into the Bundestag. Emergency paramedics should therefore be "entitled to perform medical work" as long as there is no on-site medical assistance and a patient is in a life-threatening condition. Background of the Bundesrat advance are legal and action uncertainties on the part of the paramedics and the question of who would be liable in the event of damage.
The majority of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) is behind the Federal Council initiative. "The DIVI expressly does not share the concern of other professional associations, which oppose the independent implementation of invasive measures by emergency paramedics in acute emergency situations in the sense of transferring medical tasks," said the DIVI. Already on Friday, the associations of trauma surgeons, surgeons and orthopedic surgeons had voiced clear reservations against the proposal of the Federal Council.
DIVI: No erosion of the emergency medical system
"There is no danger that the emergency medical system could be eroded," DIVI President Professor Uwe Janssens told the "Ärzte Zeitung". The DIVI emphasizes the need for an ambulance-assisted rescue system. In international comparison, emergency-based systems are leading the way in patient survival.
However, it can not be conveyed that suitably trained and continuously trained paramedics should not take any life-saving measures when they arrive at the scene of the accident, as long as the ambulance has not yet arrived, according to DIVI's statement.
The President of the German Society for Anaesthesiology and Intensive Care Medicine (DGAI), Professor Rolf Rossaint, does not see any need for action.
Problem: Legal Uncertainties
It is questionable, it is said in a statement distributed by the DGAI and the professional association of German anaesthesiologists, whether the desired legal certainty is not already established by the applicable law. This also allows trained emergency attendants to "carry out medical measures independently in an emergency until the arrival of the emergency physician."
Current figures from Baden-Wurttemberg also showed that emergency paramedics would only have to perform activities that are extremely rare under the supervision of a physician. In addition, the emergency physicians with simultaneous alerts in the median rather before the rescue teams at the scene of the accident.
The anesthetist associations therefore warn against a "risk of lack of experience" among the emergency staff and a possible patient risk. If the change in law nevertheless comes, a clear definition of "emergency situations" would have to be made in an indication catalog.
Ulrich Schreiner, Managing Director of the private Björn Steiger Foundation, also fits into this score. Experience is the be-all and end-all in the rescue service – this applies equally to emergency physicians and paramedics alike, emphasized Schreiner. To be properly clarified, the question must be, "when may the paramedic do something?". Here, the current law has gaps and must be "reformed."
Björn Steiger Foundation for more competences of paramedics
In principle, Schreiner spoke in an interview with the "Ärzte Zeitung" for lending more powers to paramedics. "It is crucial that they see real emergencies and have routine". A fundamental problem of the rescue system in Germany is its fragmentation, emphasized Schreiner. "Federalism harms the rescue service, everyone does his bit." In some regions emergency care is alarmingly bad.
The "telenot doctor" developed at the University of Aachen represents a "huge opportunity" for better emergency care, says Schreiner. Emergency physicians receive video pictures of the paramedics' helmet camera live on site from the condition of the injured person. The paramedic can then act as instructed by the doctor. The telenot doctor is already being tested, for example in the district of Vorpommern-Greifswald.
ZURICH. The idea of measuring health-relevant values in the body via the skin has already arrived in medical diagnostics, such as sensor blood glucose measurement in diabetic patients. Researchers have now produced a new sensor that is flexible on the skin surface and particularly biocompatible because it consists of nanocellulose, reports the Empa – Swiss Federal Laboratories for Materials Testing and Research
.
Nanocellulose is a cheap, renewable raw material that is obtained in the form of crystals and fibers, for example from wood. The gelatinous substance may consist of nanocrystalline cellulose and cellulose nanofibers. Further sources for the material are bacteria, algae or production residues from food production.
0.5 millimeters thick is the "biochemistry laboratory" made of nanocellulose. researcher
could use this sensor on the skin metabolic parameters such as
Measure the concentration of calcium, potassium and nitrogen-containing ammonium ions.
This not only makes nanocellulose comparatively easy and sustainable to win. The "super pudding" also makes its mechanical properties interesting, which is why new composites with nanocellulose can be developed, which could be used as surface coatings, everyday objects such as beverage bottles or in the form of transparent packaging films.
Material from natural resources
The researchers of the Empa laboratory "Cellulose & Wood Materials" in Dübendorf (Switzerland) and Dr. med. Woo Soo Kim of Burnaby's Simon Fraser University in Canada also emphasized another feature of nanocellulose: its biocompatibility. Precisely because the material is extracted from natural resources, it is particularly suitable for biomedical research.
Researchers used nanocellulose as an "ink" in the 3D printing process ( Adv Electron Mater 2018, online December 19 ) to produce biocompatible sensors capable of measuring key metabolic levels. To make the sensors electrically conductive, the ink was added with silver nanowires. The researchers determined the exact ratio of nanocellulose and silver filaments to form a three-dimensional network, the Empa Communication notes.
It turned out that cellulose nanofibers are better suited than crystalline nanocellulose to make a crosslinked matrix with the tiny silver wires. "Cellulose nanofibers are as flexible as boiled spaghetti, but with a diameter of only about 20 nanometers and a few microns in length," says Empa researcher dr. Gilberto Siqueira.
Tiny Biochemistry Laboratory
Finally, the research team succeeded in developing sensors that measure metabolic parameters such as the concentration of calcium, potassium and nitrogen-containing ammonium ions. To further analyze the readings, the electrochemical skin sensor sends its results to a computer for further data processing. Overall, the tiny biochemistry lab on the skin is only half a millimeter thick.
While the current skin sensor specifically and reliably detects ion concentrations, the researchers are already working on a new version: "In the future, we would like to replace the silver particles with another conductive material, for example based on carbon compounds," explains Siqueira. Thus, the medical nanocellulose sensor would not only be biocompatible, but also completely biodegradable. (Eb)
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What is healthy? Tested in EU countries, the Nutri-Score label aims to help consumers eat more balanced.
During exercise, muscles release myokines, which have a positive effect on RA in RA.
Rescue mission: How far should the field of duties of emergency anarchists reach? Opinions differ.
With the 3D printer, the nanocellulose "ink" is applied to a carrier plate. Silver particles provide the electrical conductivity of the material.