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Gastrointestinal infections are among the most frequent imported diseases diagnosed in Germany in travelers or migrants from the tropics. Acute traveler's diarrhea is the most frequent illness in long-distance travelers and in high-risk areas (e.g. India, Mexico) around one third of all travelers suffer from diarrhea. Chronic diarrhea plays a role especially after longer stays abroad (> 4 weeks) and in migrants and is often caused by protozoa. Helminths are less frequently the causative agent of gastrointestinal complaints (diarrhea, nausea, abdominal pain). A worm infestation of the large and small intestines is often present but helminths can also affect the liver or lead to generalized symptoms of illness when larvae migrate. In principle, in the case of gastrointestinal complaints after exposure to the tropics, the possibility of an imported tropical endemic infectious disease must be considered and appropriate diagnostics initiated. For travelers returning from tropical countries other, sometimes life-threatening diseases, such as malaria, typhoid fever, rickettsiosis and viral hemorrhagic fever (VHF) can present with gastrointestinal symptoms and should never be overlooked., (© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Home blood pressure monitoring in combination with cointerventions can contribute to a better blood pressure control. More complex telemonitoring projects have shown promising initial results in studies in primary care and also in certain patient groups (e.g. pregnant women). The integration into the clinical routine is of crucial importance because "stand-alone" solutions have yet to show convincing effects on blood pressure. The new German Digital Care Act (Digitale-Versorgung-Gesetz, DVG) provides a framework to introduce, validate and prescribe digital applications in routine care financed by the Statutory Health Insurance, when positive effects on care have been confirmed and they are listed in the register of the digital healthcare applications (Verzeichnis der digitalen Gesundheitsanwendungen, DiGA).

Two decades after "To Err Is Human", the groundbreaking report published by the Institute of Medicine in the US, the German Patient Safety Alliance (Aktionsbündnis Patientensicherheit, APS) has published the "White Paper on Patient Safety". Based on the throughput model of health services research, the paper proposes a revised concept and definition of patient safety that focuses not only on the presence of adverse events (AE), but also on the ability of organizations and systems to adequately prioritize patient safety and implement this sustainably with improvement processes. Accordingly, a concept for measuring patient safety will be developed that no longer only quantitatively records AE, but also focuses on patient safety indicators that describe innovation competence. The epidemiological data will be updated; the rates of approximately 2-4% avoidable AE and 0.1% avoidable deaths among hospital patients appear to be highly conservative estimates. Data from non-representative sources, such as on legal procedures, underestimate frequencies by a factor of 30 ("litigation gap"). The most important obstacles to improving the situation are analyzed and give rise to the recommendation that, instead of one-point interventions (e.g., of a technical nature, such as IT-supported procedures), complex multicomponent interventions should increasingly be used in Germany, combining interventions with different approaches. Interventions at team level and with regard to management structures are focused on here.

The administration of drugs is often subject to error when performed by geriatric patients, resulting in reduced therapeutic effects. In particular, the correct administration technique for different dosage forms is a problem in elderly patients with limited audiovisual and ergonomic abilities. In addition to physician and carer intervention, community pharmacists can also contribute to solving outpatient problems of this kind at the time of issuing the drugs. This should preferably be done in collaboration with the respective medical practice. Some of the most common problems in drug administration, as well as the corresponding solutions offered by the pharmacist, are featured in the present paper. Inhalers, injection devices and ophthalmic solutions often cause difficulties for geriatric patients, as do even simple dosage forms such as drops. Pharmacy-based solutions to these problems include for instance: taking over the assembly of complex devices comprising multiple components, instructing patients in the proper use of additional dosing aids or adapting the administration technique to the patient's abilities.

This paper deals with health economic aspects of prevention. After giving a definition of the term prevention, published estimates of the burden of disease attributable to selected risk factors are presented. These estimates suggest that a considerable share of morbidity, mortality and health care costs may be avoided through prevention. Subsequently, the paper describes the methods that can be used to analyze the cost-effectiveness of preventive services. Typical problems arise from the necessity to estimate long-term costs and effects, which often requires modeling. A specific problem refers to whether so-called unrelated future health care costs caused by other diseases in life years gained through prevention should be included when calculating the costs of prevention. Economic evaluations of preventive services published in the literature often report very favorable cost-effectiveness ratios. In order to increase the efficiency of health care, more cost-effective preventive services should be developed and used.

Despite the success of childhood vaccinations in Europe, many infectious diseases pose a threat to adults, particularly because immunity induced by vaccination is not life long in some cases. This paper presents the rationale for adult boosters for diphtheria, hepatitis B, pertussis, poliomyelitis and tetanus. Moreover indication for adult-vaccinations against measles, mumps, German measles and varicella is discussed, as a significant part of the population in Germany is susceptible or without known immunity/vaccination history. Finally, immunisation of the elderly against infections with influenza-virus and S. pneumoniae will be described.