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Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The 70 recommendations summarize the current status of preoperative risk evaluation of adult patients prior to elective non-cardiothoracic surgery. Based on the joint publications of the German scientific societies for anesthesiology and intensive care medicine (DGAI), surgery (DGCH), and internal medicine (DGIM), which were first published in 2010 and updated in 2017, as well as the European guideline on preoperative cardiac risk evaluation published in 2022, a comprehensive re-evaluation of the recommendation takes place, taking into account new findings, the current literature, and current guidelines of international professional societies. The revised multidisciplinary recommendation is intended to facilitate a structured and common approach to the preoperative evaluation of patients. The aim is to ensure individualized preparation for the patient prior to surgery and thus to increase patient safety. Taking into account intervention- and patient-specific factors, which are indispensable in the preoperative risk evaluation, the perioperative risk for the patient should be minimized and safety increased. The recommendations for action are summarized under "General Principles (A)," "Advanced Diagnostics (B)," and the "Preoperative Management of Continuous Medication (C)." For the first time, a rating of the individual measures with regard to their clinical relevance has been given in the present recommendation. A joint and transparent agreement is intended to ensure a high level of patient orientation while avoiding unnecessary preliminary examinations, to shorten preoperative examination procedures, and ultimately to save costs. The joint recommendation of DGAI, DGCH and DGIM reflects the current state of knowledge as well as the opinion of experts. The recommendation does not replace the individualized decision between patient and physician about the best preoperative strategy and treatment. [ABSTRACT FROM AUTHOR]

Background: Many older patients are permanently prescribed one or more psychotropic drugs for treatment of symptoms, such as behavioral and psychological symptoms in dementia, depressive symptoms, anxiety, and insomnia. They therefore contribute to the risk of polypharmacy. Recently, deprescribing studies have been published in order to clarify if inadequate medications can be safely discontinued. This mini-review summarizes the study results and derives practical recommendations for routine use. Method: A literature search was carried out in PubMed for clinical studies on deprescribing in association with psychotropic substances. Results: After removal of duplications, 12 heterogeneous clinical studies were identified and reduction of psychotropic substances could be successfully achieved in 8 studies. In four of these studies psychological, behavioral and functional endpoints were reported. Criteria for successful deprescribing of sedatives were in particular motivation, information and sufficient cooperation of the patients and for antipsychotic drugs in people with dementia, the sustainable establishment of nonpharmaceutical treatment strategies. Deprescribing was not attempted in cases of a history of severe chronic mental illness and in cases of severe behavioral symptoms in dementia. Evidence for antidepressants was not sufficient to extract practical recommendations. Conclusion: Safe deprescribing of antipsychotic drugs in patients with dementia is justified if non-pharmacological treatment options are sustainably implemented, and for sedative drugs in well-informed, highly motivated and cooperative patients. [ABSTRACT FROM AUTHOR]

Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article focuses on regulations and advancements in blood products under Germany's Arzneimittelgesetz (AMG) and Transfusionsgesetz (TFG), emphasizing their classification as pharmaceuticals and the stringent oversight by institutions like the Paul-Ehrlich-Institut. It discusses the processing, immunohematology, molecular diagnostics, and traceability of blood products, highlighting technological advancements and challenges such as workforce shortages in laboratories.

Copyright of Anaesthesiologie & Intensivmedizin is the property of DGAI e.V. - Deutsche Gesellschaft fur Anasthesiologie und Intensivmedizin e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Paragraph 2 of the Driving License Ordinance (FeV) defines the relevant share of responsibility for every vehicle driver: Those who cannot move safely in traffic and pose a risk to themselves or others must refrain from driving a motor vehicle. The taking of medication should not be assessed differently from symptoms caused by a severe flu-like infection or gastrointestinal disorder. The assessment of drivers who have been treated with painkillers on a long-term basis with regard to their ability to safely participate in road traffic is complex and, including fundamental considerations, generally also requires a case-by-case approach and, if necessary, an assessment. The typical undesirable effects of most pain medication, especially WHO II and III, can potentially and usually only temporarily put this fitness to drive into question. On the other hand, taking painkillers can make driving possible in the first place. The ability to drive can be impaired in particular when dosing, changing substances, changing doses, supplementing co-medication and also discontinuing substances. A period of 2 weeks for not driving a motor vehicle can be considered useful here. The requirement for safety is to be set even higher for driving license group 2, professional drivers, bus drivers, passenger transport. In this context, road users are required to have a high level of character aptitude. There are trend-setting publications penned by the assessment criteria working group of the German Society for Traffic Psychology (DGVP). [ABSTRACT FROM AUTHOR]

Copyright of Nachrichten aus der Chemie is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article "Legal Innovations" deals with various legal changes in the field of healthcare. Changes in the training regulations for veterinary office assistance and dental specialist assistance are presented. Furthermore, the distribution of medical contract positions is reported according to the Healthcare Reform Financing Act. Other topics include an increase in the endowment of the nursing care fund and the repeal of certain provisions in the Physicians Act 1998, Dental Chamber Act, and Veterinary Chamber Act. In addition, adjustments to the pharmacopoeia are presented. There are changes in the Veterinary Medicines Act as well as in the Medicines Act, Health and Nutrition Safety Act, Food Safety and Consumer Protection Act, Veterinary Act, Medicinal Products Import Act 2005, Biocidal Products Act, Chemicals Act 1996, Patent Act 1970, Pharmacy Act, Animal Welfare Act, Veterinary Chamber Act, Prescription Drug Act, and Pharmacopoeia Act 2012. There is a separate law on veterinary medicines and adjustments in various laws are necessary. There are also changes in the Medicines Act, Medicinal Products Import Act, Prescription Drug Act, and Veterinary Medicines Act regarding compensation for drug dealers. There are financial measures to ensure the availability of medicines and changes in the Health and Nutrition Safety Act. There are also changes in the Narcotics Regulation and Psychotropic Substances Regulation regarding the handling of narcotics and psychotropic substances. [Extracted from the article]

The article deals with the medical obligation to verify the oral order of medication preparation in an emergency situation. It is stated that a registered nurse can independently prepare a medically ordered injection and generally does not need to be verified by a doctor. However, the doctor is obliged to check the prepared medications if the label on the ampoule deviates from the instruction. The article also describes a specific case in which a wrong administration of medication occurred due to misunderstandings in communication. The court ruled that the doctor had violated her duty to control, but the dismissal was not justified as it was a one-time mistake and the doctor had not received a warning before. However, the appellate court ruled differently and dismissed the lawsuit, as the error was classified as grossly negligent. The plaintiff filed an extraordinary appeal, which was deemed admissible and justified by the Supreme Court. It was determined that the doctor did not have a supervisory duty towards the nurse, as she acted independently as a registered nurse. The Higher Regional Court of Graz considered the dismissal justified, while the Supreme Court (OGH) granted the doctor's claims in its decision of August 31, 2022, 9 Ob A 75/22b. The OGH argued that the doctor's one-time mistake in an emergency situation was not so serious that the continuation of the employment relationship would be unreasonable. The doctor had not made similar mistakes before and had never been warned for misconduct. The OGH relied on the relevant legal bases, in particular § 15 GuKG and § 49 ÄrzteG, as well as on relevant case law and literature. The general dimension of the text deals with the importance of quality-assuring communication. It is emphasized that incidents like the disputed case mentioned in the text should lead to appropriate measures through functioning quality assurance systems. These measures could include regular clarifications about communication behavior and a verifying control according to the "check and re-check" system, for example. The goal is to avoid similar sources of errors and optimize patient safety. [Extracted from the article]

Copyright of Kriminologisches Journal is the property of Julius Beltz GmbH & Co. KG Beltz Juventa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Innere Medizin (2731-7080) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The year 2023 marks the 80th anniversary of the Swiss Tropical and Public Health Institute (Swiss TPH). Associated with the University of Basel, Swiss TPH combines research, education and services, working across a value chain from innovation and validation to application to improve people’s health and well-being. Around 700 staff and students work in Swiss TPH’s new headquarters in an emerging life-science cluster in Allschwil, Switzerland, focusing on infectious and non-communicable diseases, environment, society and health as well as health systems and interventions. In this special issue of Chimia, we highlight 30 years of research and development (R&D) at Swiss TPH, deeply grounded in partnership, towards new drugs for tropical diseases.

In discussion with Lukas Meier from the Swiss Tropical and Public Health Institute (Swiss TPH), Lutz Hegemann, Head of Novartis Global Health and Sustainability and Marcel Tanner, President of the Swiss Academies of Arts and Sciences, give their opinions on the changes that occurred in drug discovery and development for poverty-related diseases over the past 30 years. They emphasise the power of public–private partnerships and provide their points of views on what needs to be done in the future to ensure that the poorest of the poor also have access to important therapies

Abstract: Objective: Investigation of the impact of the Covid-19 pandemic on mainly low-threshold drug services and the reactions of clients to changes in services. Methodology : The main data source is an asynchronous qualitative online survey for outpatient drug service staff. In addition, we used figures from a quantitative online survey for the same target group. Results : While usual infection control measures were applied almost everywhere, the range of actual effects ranged from complete closures to rather minor restrictions. Emphasis was mostly placed on harm reduction and street social work. Counselling was often done by telephone, which was considered useful for many concerns, but made relationship building difficult. Especially clients in particularly precarious conditions continued to use drug services frequently. Conclusions : Different ways of dealing with pandemic-related measures arose in drug services. Often, creative solutions were developed for implementation, with a focus on essential harm reduction. Both staff and clients were exposed to numerous stresses due to the pandemic. [ABSTRACT FROM AUTHOR]

The article deals with the legal issues related to the repackaging of medicinal products. Since 2019, medicinal products must be equipped with a device to protect against tampering in order to prevent counterfeit medicines from entering the legal supply chain. The European Court of Justice has ruled that the repackaging of medicinal products is only allowed if the product cannot be marketed in the importing member state. Parallel imports of medicinal products are generally lawful. The ECJ has also ruled that the "debranding" of repackaged medicinal products is only permissible if the presentation of the new packaging damages the reputation of the brand or impairs the brand's indication of origin function. [Extracted from the article]

Copyright of Parodontologie: die Zeitschrift für die Praxis (Berlin, Germany) is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Delirium often occurs in elderly hospitalized patients. Multimorbidity and associated polypharmacy are known risk factors for developing delirium. Moreover, delirium itself often leads to the prescription of additional drugs. This article aims to enlighten the interrelation of delirium and polypharmacy in the context of recent evidence. It also tries to show possibilities of deprescribing. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Rheumatologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Objectives: This contribution points out necessary requirements for a controlled legalization of Cannabis for recreational use to adults to uphold health and minors protection. Without the proposed regulations the intended legalization would open an additional distribution channel for THC-products without achieving the intended politicial goals, i. e. better quality of Cannabis and reduction in crime rates. Methods: We outline necessary legislative changes for a controlled distribution of Cannabis for recreational purposes, which will reduce associated harm potentials. Results: Necessary elements of a controlled distribution of Cannabis are an excise tax on the products THC-content, the classification of THC-products under the German Medicines Act (Arzneimittelgesetz). THC-products shall only be manufactured by specialised limited companies, with superveillance by specialized authorities. A ban of any kind of marketing is necessary as well as an upper cap on THC-content of the products. A manipulation of the natural metabolizing of THC by the human body via additives and the addition of nicotine has to be ruled out by law. Consumers making purchases from illegal vendors and thus keeping them in the market need to sanctioned by criminal law even when buying only for own consumption. Conclusions: A controlled distribution of Cannabis has to be accompanied by an array of legal regulations, to mitigate the medical and economic costs of consumption that will result from a legalization of Cannabis. [ABSTRACT FROM AUTHOR]

The article discusses the planned controlled distribution of cannabis for recreational use in Germany. Various legislative changes are proposed, such as a THC tax, treating THC products as medicinal drugs, and distributing them exclusively through pharmacies. The authors advocate for an evidence-based legalization of cannabis, but emphasize that some proposals are not sufficiently justified and lack a coherent argumentation. They recommend that THC products be subject to the Medicines Act and should only be sold in pharmacies. Additionally, they argue for a limitation on THC content and a THC tax. [Extracted from the article]

The article examines the admissibility of patient support programs (PSPs) in healthcare. PSPs provide therapy-related support for patients and can promote treatment adherence and save costs. However, there are tensions between PSPs and the prohibition of lay advertising for prescription drugs. In Austria, there is no requirement for approval of PSPs, but they must comply with general regulations for the distribution and advertising of pharmaceuticals. The article discusses the legal requirements and provisions for PSPs and emphasizes that they should not be used for commercial purposes. [Extracted from the article]

With the entry into force of Regulation (EU) 536/2014 on clinical trials with medicinal products for human use on February 1, 2022, a comprehensive reorganization of clinical drug trials within the European Union was initiated. This article provides an overview of relevant key points of the EU regulation as well as the specific adjustments of Austrian pharmaceutical law through the AMG amendment BGBl I 2022/8. The approval process for clinical trials is initiated by the submission of the application dossier by the sponsor via the EU portal. There are three options for validation, depending on whether the clinical trial falls under the regulation and the application is complete or not. The responsibilities regarding Part I of the evaluation process are divided between BASG and the reviewing ethics committee. Austrian legislation has made changes related to clinical drug trials, including the use of the English language for multinational clinical trials and new provisions for sponsors. There are also new regulations for the protection of vulnerable groups in clinical trials. Regulation (EU) 536/2014 and the AMG (Medicinal Products Act) BGBl I 2022/8 bring comprehensive changes to clinical drug trials in order to make EU member states more attractive as research and development locations and to strengthen the role of the EU in the pharmaceutical industry. [Extracted from the article]

Osteoporosis is the most common systemic skeletal disease worldwide. Its consequences have a substantial impact on the quality of life of patients and increases the overall morbidity and mortality. Standardized diagnostic procedures and treatment recommendations have been available for years as German and international (S3) guidelines. Nevertheless, there is a considerable gap in the diagnosis and adequate treatment of osteoporosis, especially in Germany. The aim is to detect the disease at an early stage and to establish a specific and consistent treatment of osteoporosis. In this way the quality of life and independence of those affected can be maintained over a long period. In the acute and permanent treatment of manifest osteoporosis, surgeons, orthopedic and trauma surgeons play a key role. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Epileptologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medizinische Klinik: Intensivmedizin & Notfallmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The medical profession is calling for an EU strategy against drug supply shortages. At the 69th Consultative Meeting of German-speaking medical organizations, a communiqué was adopted, highlighting the increasing gaps in medication supply in Europe. The relocation of pharmaceutical production facilities to Asia further exacerbates the situation. Diversification of supply chains, strengthening the production of medicines and active ingredients in Europe, as well as effective measures for sufficient stockpiling, are demanded. The policy is urged to develop a strategy against dependence on Asian production facilities. [Extracted from the article]

Classical trigeminal neuralgia is typically characterized by a stimulus-evoked, recurrent and intense short-lasting stabbing pain in the innervation area of the trigeminal nerve. Its intensity is among the most severe pain imaginable in humans, and yet it is often misdiagnosed and undertreated. Triggers are common activities of daily life like talking or eating. The classical trigeminal neuralgia is due to a neurovascular compression at the nerve root entry zone. The secondary form is related to an underlying neurological disease (caused for example by multiple sclerosis or compression by a brain tumor); the etiology of the idiopathic trigeminal neuralgia is unknown. Treatment options include both medication (mostly antiepileptic drugs) and escalated interventional approaches (microvascular decompression, neurolesional percutaneous procedures, neuromodulative therapeutic options and radiosurgery). [ABSTRACT FROM AUTHOR]

Finger joint osteoarthritis (HOA) is a common joint disease that increases with age. The cause is polyethiological. The distal joints of the fingers are most frequently affected, followed by the carpometacarpal joint of the thumb, the proximal interphalangeal joints, and the metacarpophalangeal joints. The clinical symptoms of HOA are painful functional restrictions of the hand and fingers. In terms of therapy, lifestyle modifications and exercise are primarily recommended. Only when these measures are inadequate or not helpful drugs will be recommended be recommended. First-choice drugs are non-steroidal anti-inflammatory drugs applied topically or p.o. Pharmaceutically manufactured chondroitin preparations are also helpful. In severely painful or erosive forms of HOA, corticosteroids can be used intra-articularly. The status of laser therapy or fractionated radiation is (still) unclear. Classical disease-modifying drugs such as those used in inflammatory joint diseases have no therapeutic value. Surgical interventions should be considered if conservative treatments are not sufficiently helpful and hand function is significantly impaired. [ABSTRACT FROM AUTHOR]

We present data from 92404 clinical assessments from 619 Swiss nursing homes. The data were collected in 2019 and 2020 from over 65-year-old residents. Two-thirds of those studied had severe cognitive limitations, one quarter had significant behavioral disorders and just over half of the assessed patients showed signs of emotional instability or depression. 46% were treated with nine or more different drugs, 37% received a neuroleptic in 85% for more than 90 days. There is a positive correlation between the number of drugs taken, age, cognitive impairment and susceptibility to falls. Since neuroleptics are administered in 30% under uncertain indication and the susceptibility to falls is increased by 40% under neuroleptics, their use should be reduced in the course of structured interprofessional processes. [ABSTRACT FROM AUTHOR]

With the entry into force of Regulation (EU) 536/2014 and the AMG amendment BGBl I 2022/8, comprehensive changes were introduced in pharmaceutical law. The EU Regulation on clinical trials with human medicinal products replaced the existing system six months after its publication. The amendment to the Austrian Medicines Act came into effect retrospectively on February 1, 2022. This article provides an overview of the new regulations and the role of ethics committees in the approval process for clinical trials. The terms "clinical study" and "clinical trial" are also defined and their differences explained. According to Article 2(2)(4), a "non-interventional study" is a clinical study that is not a clinical trial. Therefore, all clinical studies are classified as either a subcategory of a clinical trial or a non-interventional study. The distinction between these two groups of clinical studies is of significant importance, as Regulation (EU) 536/2014 only covers clinical trials. Non-interventional studies are subject to their own national requirements under the Medicines Act. There are also various subcategories of clinical trials, including minimal-interventional clinical trials, commercial and non-commercial (academic) clinical trials, cluster trials, and post-authorization safety studies. The text describes the new approval process for clinical trials in pharmaceutical law. It explains that trial sites can be hospitals, medical practices, or scientific institutions. Actions outside of trial sites are assigned to the corresponding trial site. It also highlights the establishment of the "EU portal" and the "EU database" through which communication between sponsors and national authorities takes place. The new approval process includes a joint assessment procedure and a national assessment procedure. Ethics committees play a role in the approval process and review aspects of the application. The article describes the new regulations for ethics committees in pharmaceutical law. It emphasizes that consultations and voting can now also be done electronically if necessary to meet procedural deadlines. Ethics committees have the right to consult experts and request opinions. It is also mentioned that local ethics committees can be asked for opinions. The requirements for assessing ethics committees and their composition are also explained. It is emphasized that specialists in pharmacology and toxicology or individuals with equivalent pharmacological expertise must be involved. Another innovation is the establishment of a platform that serves as a central point of contact for the assessment of clinical trials by ethics committees. Finally, the obligations to provide information and the supervision of ethics committees are described. [Extracted from the article]

The study examines the risk of side effects in older people with complex health needs who start antihypertensive therapy. Within the first 30 days of starting the therapy, there is an increased risk of falls, fractures, and acute kidney failure. Particularly vulnerable age groups are affected by severe side effects. The study recommends careful consideration of the indication, cautious introduction of the medication, and regular monitoring of kidney values at the beginning of the therapy. The information is from the 10th edition of the Journal of General Medicine in 2024. [Extracted from the article]