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Osteoarthritis (OA) is a pro-infl ammatory, degenerative disease of the joints. Since the osteoarthritis risk pro le overlaps with that of other lifestyle-related diseases, such as obesity, type 2 diabetes mellitus (T2DM), or cardiovascular disease, a ected individuals are often multi-morbid. Physical activity has been demonstrated to be a valuable preventive and therapeutic tool in OA and also in almost all other lifestyle-related diseases. us, a ected individuals might bene t from an exercise program in multiple respects. To monitor e cacy of such training interventions, a set of reliable biomarkers, preferentially such that can be assessed from easily accessible biological uids, in particular urine or blood, would be desirable.In this short review, we give an overview of potential blood and urine biomarkers that might be used to monitor e cacy of exercise interventions in osteoarthritis patients, with a speci c focus on multi-morbidity. Currently, the most-extensively studied markers are in ammation-related factors, such as C-reactive protein (CRP) or interleukin-6 (IL-6), but also metabolic markers, for example the adipokines adiponectin, leptin, and resistin, and products of cartilage decay, such as C-telopeptide of type II collagen (CTX-II), or cartilage oligomeric protein (COMP). Finally, recent studies also point to circulating microRNAs (miRNAs) as potential biomarkers in OA, suggesting that they might also have the potential to be studied in the context of training interventions. KEY WORDS: Degenerative Joint Disease, Lifestyle-Related Diseases, Physical Activity, Blood and Urine Markers

Background: A central goal of medical school is acquisition of theoretical and practical competences. However, evidence on how capacity acquisition can be measured for special examination techniques is scarce. ToSkORL (Teaching of Skills in Otorhinolaryngology) is a project aimed at scientifically and didactically investigating students' self-evaluation skills in otorhinolaryngologic and head and neck examination techniques., Methods: During the examination techniques course, a standardized oral and practical exam for nine different techniques was conducted. Using Likert scales, self-evaluation was based on questionnaires before the clinical skills exam and objective evaluation was performed by the examiners during the examination using a checklist. Self- and objective evaluation were correlated. Nine different examination skills were assessed 42 times each by a total of 91 students., Results: Self-evaluation of competence in the different examination skills varied widely. Nevertheless, self- and objective evaluation correlated well overall, independent of age and gender. Students highly interested in otorhinolaryngology rated their own skills higher but tended toward overestimation. For examination items with intermediate difficulty, the highest divergences between self- and objective evaluation were found., Conclusion: Student self-evaluations are an appropriate instrument for measuring competences in otorhinolaryngologic examinations. Instructors should focus on items with allegedly intermediate difficulty, which are most often over- and underestimated., (© 2021. The Author(s).)

For centuries bath-houses and barber-surgeons formed such an integral part of public life that one is mystified by their vanishing from modern view with hardly any trace left. Previous authors have offered a variety of reasons for this disappearance: the bath-houses' notorious reputation, developing fuel-shortage, the "new" fashion of taking the waters and the outbreak of previously unknown contagious diseases are among those mentioned most frequently. While these factors may be valid reasons for a crisis afflicting the "hot-houses" they would hardly explain why fate overtook the barber-surgeons' entire trade. Judging from the sources available one cannot help but feel that the philosophers of the Enlightenment were largely responsible for such a dramatic change of society. Sceptical philosophy discarded the wisdom of the ancient medical authorities replacing traditional steam-bathing with "modern" cold-bathing. Society itself was subject to equally revolutionary changes: the local masters of the trade had to make room for surgeons educated at medical schools setting the stage for a new reality which has become "normal" to us.

We report a patient undergoing redo cardiac surgery for combined replacement of the aortic and mitral valves. During the course of the operation, a Swan-Ganz catheter - positioned preoperatively - was accidentally fixed to the wall of the pulmonary artery. As this did not interfere with cardiac output measurement or the pulmonary artery pressure wave form, the fixation was not noticed until an attempt was made to remove the catheter. Fluoroscopy revealed both the catheter's immobility and the location of the suture fixation. The patient required a sternotomy to remove the catheter. In order to avoid this complication, the indications for pulmonary artery catheters during cardiac surgery should be carefully considered. If catheters are inserted, their mobility should by all means be ensured before the chest is closed.