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Four isolated occurrences of Tertiary volcanic rocks in the northern Spessart at Beilstein, Hoher Berg, Madstein and Kasselgrund are relics of volcanic vents or dikes. They display alkaline basalts (s. l.) with mainly trachybasaltic composition, which, from normative mineral contents, may be designated as nepheline-bearing alkali-olivine basalts and basanites. In part, centimetre-sized xenoliths of spinel lherzolite occur. According to Ar-Ar dating, the alkaline basalts (s. l.) from Kasselgrund have erupted at 18.1 ± 0.3 or 19.3 ± 0.4 Ma, those of Hoher Berg between c. 18 and c. 21 Ma. These ages correspond to the Vogelsberg eruption stage I. A slightly younger Ar-Ar age of 16.8 ± 0.3 Ma was recorded for the Beilstein basalt, which is in chronological accordance to the turn of Vogelsberg eruption stages II and III. Samples of all four occurrences reveal major and trace element compositions, which are different from those of the Vogelsberg basalts. Compositions of basalts of the stage III from Vogelsberg coincide most with the Spessart basalts. This signals a special position of the northern Spessart volcanic rocks either as a discrete spatial part of the Vogelsberg volcanic suite or as smaller, independent eruption centres.

Robust data on the outcome of MET-aberrant NSCLC with nontargeted therapies are limited, especially in consideration of the heterogeneity of MET-amplified tumors (METamp).A total of 337 tumor specimens of patients with MET-altered Union for International Cancer Control stage IIIB/IV NSCLC were analyzed using next-generation sequencing, fluorescence in situ hybridization, and immunohistochemistry. The evaluation focused on the type of MET aberration, co-occurring mutations, programmed death-ligand 1 expression, and overall survival (OS).METamp tumors (n = 278) had a high frequency of co-occurring mutations (80% for all amplification levels), whereas 57.6% of the 59 patients with MET gene and exon 14 (METex14) tumors had no additional mutations. In the METamp tumors, with increasing gene copy number (GCN), the frequency of inactivating TP53 mutations increased (GCN4: 58.2%; GCN ≥ 10: 76.5%), whereas the frequency of KRAS mutations decreased (GCN4: 43.2%; GCN ≥ 10: 11.8%). A total of 10.1% of all the METamp tumors with a GCN ≥ 10 had a significant worse OS (4.0 mo; 95% CI: 1.9-6.0) compared with the tumors with GCN10 (12.0 mo; 95% confidence interval [CI]: 9.4-14.6). In the METamp NSCLC, OS with immune checkpoint inhibitor (ICI) therapy was significantly better compared with chemotherapy with 19.0 months (95% CI: 15.8-22.2) versus 8.0 months (95% CI: 5.8-10.2, p0.0001). No significant difference in median OS was found between ICI therapy and chemotherapy in the patients with METex14 (p = 0.147).METex14, METamp GCN ≥ 10, and METamp GCN10 represent the subgroups of MET-dysregulated NSCLC with distinct molecular and clinical features. The patients with METex14 do not seem to benefit from immunotherapy in contrast to the patients with METamp, which is of particular relevance for the prognostically poor METamp GCN ≥ 10 subgroup.

Imperial Porphyry, a famous dimension stone of spectacular purple color, was quarried in the Mons Porphyrites area north of Jabal Dokhan in the Eastern Desert of Egypt, from the beginning of the first until the middle of the fifth century AD. During this period, the valuable material was processed as decorative stone and was used for objects of art, reserved exclusively for the Imperial court of the Roman Empire. Later on, only antique spoils of smaller or bigger size have been re-used for these purposes. The Imperial Porphyry is a porphyritic rock of trachyandesitic to dacitic composition that occurs in the uppermost levels of shallow subvolcanic sill-like intrusions, forming a member of the Dokhan Volcanic Suite. Its purple color is mainly due to dispersed flakes of hematite, resulting from hydrothermal alteration of a dark green Common Porphyry of similar composition, underlying the Imperial Porphyry. Both, the Common Porphyry and the purple Imperial Porphyry’, are extensively exposed in the Roman quarries. Contacts between Common and Imperial Porphyry are irregular and gradational. In both rock types, intrusive breccias are frequent, indicating a complex intrusion history. U–Th–Pb zircon geochronology on two samples of Imperial Porphyry and one sample of the Common Porphyry yielded an age range of 609–600 Ma, thus confirming earlier results of radiometric dating. Geochemical evidence indicates that both the Imperial and the Common Porphyry are of medium- to high-K calc-alkaline affinity. The magmas have formed by partial melting of a subduction-modified upper mantle. The subsequent intrusion took place within a highly extended terrane (HET).

The new mineral riotintoite was discovered in the abandoned La Vendida mine, near Sierra Gorda, Antofagasta Region, Atacama desert, Chile. Associated minerals are vendidaite, eriochalcite, Mg-rich aubertite, magnesioaubertite, belloite, alunite, kaolinite, and halloysite. Riotintoite forms colorless platy crystals up to 0.1 × 0.4 × 0.4 mm in size and exhibits the forms {010} (the major form), {001}, {100}, {110}, {01![Graphic][1] }, {1![Graphic][2] 0}, {2![Graphic][3] 0}, {123}, {![Graphic][4] 23}, {![Graphic][5] 31}, and {1![Graphic][6] 1}. Riotintoite is brittle, with Mohs' hardness of 2½. There are three good cleavages: {010}, {001}, and {201}. D meas = 2.13(2) g/cm3, D calc = 2.129 g/cm3. The new mineral is optically biaxial (–), α 1.513(2), β 1.522(2), γ 1.526(2), 2 V (meas.) = 62(1)°, 2 V (calc.) = 67°. The infrared spectrum is given. The chemical composition (electron microprobe, H2O by gas chromatography) is (in wt.%): Al2O3 24.36, SO3 40.69, H2O 34(2), total 99.05. The empirical formula is: Al0.93(SO4)0.99(OH)0.81·3.25H2O. The crystal structure was solved using single-crystal X-ray diffraction data ( R 1 = 0.0398). Riotintoite is triclinic, space group P ![Graphic][7] , a 5.600(2) A, b 7.450(3) A, c 7.671(3) A, α 74.785(7)°, β 86.042(8)°, γ 75.810(7)°, V 299.4(2) A3, Z = 2. The structure is based on isolated clusters which are formed by pairs of edge-shared Al(H2O)3(OH)2O octahedra (AlO6 octahedra link via common OH–OH edge and O belongs to the SO42– anion) and SO4 tetrahedra. The clusters are linked by strong hydrogen bonds between water molecules and non-bridging oxygen atoms of SO4 tetrahedra. The strongest lines of the powder X-ray diffraction pattern [ d , A ( I , %) ( hkl )] are: 6.975 (100) (010), 4.459 (40) (111), 4.391 (72) (101), 3.766 (31) (![Graphic][8] ![Graphic][9] 1), 3.695 (29) (002, 012), 3.491 (24) (021, 020), 2.552 (26) (201, ![Graphic][10] 01, 013). [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif [4]: /embed/inline-graphic-4.gif [5]: /embed/inline-graphic-5.gif [6]: /embed/inline-graphic-6.gif [7]: /embed/inline-graphic-7.gif [8]: /embed/inline-graphic-8.gif [9]: /embed/inline-graphic-9.gif [10]: /embed/inline-graphic-10.gif

Community acquired pneumonia (CAP) is an infection with a limited spectrum of pathogens. Pneumonias acquired in a hospital or under immunoincompetence are being treated according to different algorithms. The concept of health care associated pneumonia (HCAP) is discarted. It is not capable to predict a high probability of multiresistant pathogens.

Magnesiovoltaite, a new voltaite-group mineral, was discovered in the Alcaparrosa mine, Cerro Alcaparrosa, El Loa province, Antofagasta region, Chile, in two associations, one of which includes coquimbite, tamarugite, alum-(Na), rhomboclase, yavapaiite, voltaite and opal, and the other one is botryogen, opal, tamarugite, alum-(K), pickeringite, magnesiocopiapite, and jarosite. Magnesiovoltaite forms yellow, brownish-yellow or pale yellowish-greenish isometric crystals up to 2 mm across. The main crystal forms are {111} and {100}; the subordinate forms are {110} and {211}. The new mineral is brittle, with subconchoidal fracture; cleavage is not observed. Mohs’ hardness is 2½. D meas = 2.51(2) g/cm 3 , D calc = 2.506 g/cm 3 . Magnesiovoltaite is optically anomalously anisotropic, uniaxial with e = 1.584(2) and ω = 1.588(2), or biaxial (−) with α = 1.584(2), β = 1.587(2), and γ = 1.588 (2). Possible causes of the optical anomalies are discussed. The infrared spectrum is given. The chemical composition is (EDS-mode electron microprobe, all iron is considered as Fe 3+ in accordance with Mossbauer data, H 2 O by gas chromatography of ignition products, wt. %): Na 2 O 0.13, K 2 O 4.64, MgO 9.13, MnO 1.73, ZnO 0.84, Al 2 O 3 2.47, Fe 2 O 3 13.36, SO 3 50.83, H 2 O 17.6, total 100.73. The empirical formula based on 66 O atoms per formula unit ( apfu ) is (K 1.85 Na 0.08 )(Mg 4.25 Mn 0.46 Zn 0.14 )Fe 3+ 3.14 Al 0.91 (SO 4 ) 11.91 (H 2 O) 18.325 O 0.035 . The simplified formula is K 2 Mg 5 Fe 3+ 3 Al(SO 4 ) 12 ·18H 2 O. The crystal structure has been refined to R = 3.2% using 1147 unique reflections with I > 2σ( I ). Magnesiovoltaite is cubic, Fd –3 c, a = 27.161(1) A, V = 20038(2) A 3 , and Z = 16. Magnesiovoltaite is isostructural with other cubic voltaite-group minerals. The strongest lines of the powder X-ray diffraction pattern [ d , A ( I , %) ( hkl )] are: 9.56 (29) (022), 6.77 (37) (004), 5.53 (61) (224), 3.532 (68) (137), 3.392 (100) (008), 3.034 (45) (048), 2.845 (30) (139). The type material is deposited in the collections of the Fersman Mineralogical Museum of the Russian Academy of Sciences, Moscow, Russia.

Introduction Although KRAS mutations in NSCLC have been considered mutually exclusive driver mutations for a long time, there is now growing evidence that KRAS-mutated NSCLC represents a genetically heterogeneous subgroup. We sought to determine genetic heterogeneity with respect to cancer-related co-mutations and their correlation with different KRAS mutation subtypes. Methods Diagnostic samples from 4507 patients with NSCLC were analyzed by next-generation sequencing by using a panel of 14 genes and, in a subset of patients, fluorescence in situ hybridization. Next-generation sequencing with an extended panel of 14 additional genes was performed in 101 patients. Molecular data were correlated with clinical data. Whole-exome sequencing was performed in two patients. Results We identified 1078 patients with KRAS mutations, of whom 53.5% had at least one additional mutation. Different KRAS mutation subtypes showed different patterns of co-occurring mutations. Besides mutations in tumor protein p53 gene (TP53) (39.4%), serine/threonine kinase 11 gene (STK11) (19.8%), kelch like ECH associated protein 1 gene (KEAP1) (12.9%), and ATM serine/threonine kinase gene (ATM) (11.9%), as well as MNNG HOS Transforming gene (MET) amplifications (15.4%) and erb-b2 receptor tyrosine kinase 2 gene (ERBB2) amplifications (13.8%, exclusively in G12C), we found rare co-occurrence of targetable mutations in EGFR (1.2%) and BRAF (1.2%). Whole-exome sequencing of two patients with co-occurring phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha gene (PIK3CA) mutation revealed clonality of mutated KRAS in one patient and subclonality in the second, suggesting different evolutionary backgrounds. Conclusion KRAS-mutated NSCLC represents a genetically heterogeneous subgroup with a high frequency of co-occurring mutations in cancer-associated pathways, partly associated with distinct KRAS mutation subtypes. This diversity might have implications for understanding the variability of treatment outcome in KRAS-mutated NSCLC and for future trial design.

In neutropenic patients with lung infiltrates, Aspergillus spp., P. jirovecii, multi-resistant gram-negative pathogens, mycobacteria, viruses and toxic effects from cytotoxic drugs, radiation, or pulmonary involvement by the underlying malignancy should be included into differential diagnosis. Pre-emptive treatment with mould-active systemic antifungal agents improves clinical outcome., Up to 25% of patients with profound neutropenia lasting for >10 days develop lung infiltrates, which frequently do not respond to broad-spectrum antibacterial therapy. While a causative pathogen remains undetected in the majority of cases, Aspergillus spp., Pneumocystis jirovecii, multi-resistant Gram-negative pathogens, mycobacteria or respiratory viruses may be involved. In at-risk patients who have received trimethoprim–sulfamethoxazole (TMP/SMX) prophylaxis, filamentous fungal pathogens appear to be predominant, yet commonly not proven at the time of treatment initiation. Pathogens isolated from blood cultures, bronchoalveolar lavage (BAL) or respiratory secretions are not always relevant for the etiology of pulmonary infiltrates and should therefore be interpreted critically. Laboratory tests for detecting Aspergillus galactomannan, β-d-glucan or DNA from blood, BAL or tissue samples may facilitate the diagnosis; however, most polymerase chain reaction assays are not yet standardized and validated. Apart from infectious agents, pulmonary side-effects from cytotoxic drugs, radiotherapy or pulmonary involvement by the underlying malignancy should be included into differential diagnosis and eventually be clarified by invasive diagnostic procedures. Pre-emptive treatment with mold-active systemic antifungal agents improves clinical outcome, while other microorganisms are preferably treated only when microbiologically documented. High-dose TMP/SMX is first choice for treatment of Pneumocystis pneumonia, while cytomegalovirus pneumonia is treated primarily with ganciclovir or foscarnet in most patients. In a considerable number of patients, clinical outcome may be favorable despite respiratory failure, so that intensive care should be unrestrictedly provided in patients whose prognosis is not desperate due to other reasons.

The new mineral okruschite (IMA No. 2013–047), the arsenate analogue of roscherite, was discovered in a hydrothermal vein cross-cutting rhyolite exposed in the Fuchs quarry, near Sailauf, Spessart Mountains, Bavaria, Germany. Associated minerals are braunite, Mn-bearing calcite and arseniosiderite. Okruschite forms tabular aggregates up to 0.15 × 0.3 × 0.3 mm in size of curved and somewhat misaligned laths. It is white, semitransparent; lustre is vitreous. D meas = 3.33(2), D calc = 3.340 g/cm 3 . Okruschite is optically biaxial (−), α = 1.671(3), β = 1.682(2), γ = 1.687(3), 2 V meas = 65(5)°. The infrared spectrum is given. The chemical composition is (electron microprobe, B and Li by ICP MS, H 2 O by gas chromatography of ignition products, wt. %): Li 2 O 0.04, BeO 7.70, MgO 1.68, CaO 8.28, MnO 16.27, FeO 4.89, Al 2 O 3 0.22, As 2 O 5 51.11, H 2 O 11.0, total 101.19. The empirical formula based on 34 O atoms is: Ca 1.99 (Mn 3.09 Fe 0.92 Mg 0.56 Al 0.06 Li 0.04 ) ∑4.67 Be 4.15 (AsO 4 ) 5.99 (OH) 3.64 · 6.40H 2 O. The simplified formula is Ca 2 Mn 2+ 5 Be 4 (AsO 4 ) 6 (OH) 4 · 6H 2 O. Okruschite is monoclinic, C 2/ c , a = 16.33(4), b = 12.03(3), c = 6.93(1) A, β = 94.84(5)°, V = 1357(4) A 3 , Z = 2. The strongest lines of the powder X-ray diffraction pattern [ d , A ( I , %) ( hkl )] are: 9.68 (39) (110), 4.95 (34) (310), 4.17 (34) (−311), 3.25 (100) (−202, 330), 3.11 (32) (−421), 2.841 (27) (240), 2.711 (26) (600), 1.726 (26) (461, −552, 004). Okruschite is named after Professor Martin Okrusch, from Germany. Type material is deposited in the collections of the Fersman Mineralogical Museum of the Russian Academy of Sciences, Moscow.

The hydrothermal Mn–Fe–As vein mineralization at Sailauf (Germany) hosts a complex sequence of oxide and carbonate minerals that record a protracted fluid history. The mineralization is related to a major unconformity that separates Permian (Zechstein) sedimentary rocks from underlying Variscan crystalline basement. The hydrothermal veins contain two principal mineralization stages, which are Mn oxides associated with calcite and hematite associated with Mn-calcite. The fluid evolution of the hydrothermal system has been reconstructed from fluid inclusion petrography, microthermometry, and LA-ICPMS microanalysis, coupled with stable isotope geochemistry of carbonate and oxide minerals. The fluid inclusions are high salinity sodic–calcic brines and the bulk fluid properties show no major differences between the Mn oxide and the hematite stage. LA-ICPMS analysis of major and trace elements demonstrates that the mineralization formed from chemically distinct fluid pulses characterized by variations in their K, Li, B, Pb and Zn concentrations. The fluid that precipitated the Mn oxide stage has anomalous Pb/Zn and Li/B ratios, which closely resemble fluids found in fracture fillings in red beds of the Permian Rotliegend basin. By contrast, the fluids associated with the hematite stage have Pb/Zn and Li/B ratios typical of crustal fluids that were derived from interaction with crystalline basement. Both fluids possess characteristic element ratios including Cl/Br, but variable absolute concentrations of most metals. This suggests that both fluids were modified by mixing with a common metal-depleted brine that had a similar Cl/Br ratio, most likely a formation water from the overlying Zechstein sedimentary rocks. The Sailauf mineralization provides insight into the protracted post-Variscan fluid evolution at the basement–cover interface. The compositionally anomalous fluid that precipitated the Mn oxides is comparable to brines derived from interaction with red beds and likely represents the ore fluid of Kupferschiefer-type sediment-hosted Cu deposits. Conversely, the fluid that deposited the hematite mineralization resembles fluids that typically form basement- and sediment-hosted Pb–Zn deposits.

Five electron-microprobe analyses were carried out using VEGA TS 5130MM SEM equipped with EDX analyzer (INCA Si(Li) detector), at an operating voltage of 20 kV and a beam current of 0.6 nA. The program INCA Energy 200 was used for the analytical data calculation. Attempts to use the WDS mode with higher beam currents were unsuccessful because of the instability of the mineral containing significant amounts of volatile components. H2O was determined by gas chromatography of products of ignition at 1200C with a Vario MICRO cube analyser (Elementar GmBH, Germany). CO2 was not analysed because of the absence of absorption bands corresponding to vibrations of C–O bonds in the IR spectrum. Analytical data are given in Table 1. Contents of F, Na, Mg, Si, P, K, Ca, Mn, Cu, Zn, As, Br, Sr, Pb are below detection limits. The empirical formula (based on 14 anions pfu and OH/H2O ratio calculated from charge balance) is Al1.96Fe3+0.06(SO4)0.98Cl0.98(OH)3.12·5.98H2O. The simplified formula is Al2(SO4)(OH)3Cl·6H2O, which requires Al2O3 29.59, SO3 23.23, Cl 10.29, H2O 39.21, O = Cl -2.32, total 100.00 wt%.

The Sailauf Mn Fe As vein mineralization located in the Spessart district (central Germany) is characterized by complex hydrothermal carbonate and oxide assemblages. The mineralization is hosted by a Permian rhyolite body and is structurally related to the Variscan unconformity that separates Permian sedimentary rocks from the underlying Variscan crystalline basement. The hydrothermal vein system has been studied by optical microscopy electron microprobe and LA ICPMS analysis of major and trace elements (including the REE). Four distinct mineralization stages that are characterized by diagnostic carbonate oxide assemblages are identified which are (I) pre ore stage (2) ore stage 1 (3) ore stage 2 and (4) the replacement stage. Hydrothermal carbonates show complex compositional trends in Ca Mn (Fe+Mg) space and comprise calcite Mn calcite Fe Mg calcite Ca rhodochrosite and Ca kutnahorite. Oxide assemblages are dominated by braunite and hematite with minor amounts of manganite and hausmannite. The mineralization is enriched in a distinct suite of trace elements including As W Pb Zn and Cu. Analysis of the paragenetic evolution in conjunction with the major and trace element data allows to reconstruct the fluid evolution of the hydrothermal system. The first order change in mineralogy between the two main ore stages (Mn oxides and calcite evolving into hematite and Mn rich calcite) records a pronounced shift in fluid pH and silica activity of the system. This interpretation is also supported by variations in the behavior of Ce in different carbonate generations. The late stage replacement carbonates relate to destabilization of the primary ore assemblages. The distinct geological setting immediately below the Permian unconformity in conjunction with the mineralogical and chemical data suggests that dynamic fluid mixing processes involving basement derived brines and more shallow groundwaters were important in the formation of the Sailauf Mn Fe As mineralization. The significant enrichment in the As W Pb Zn Cu element suite resembles that of other Mn Fe deposits and points to felsic lithologies as the main metal source of the mineralization. (C) 2012 Elsevier B.V. All rights reserved.

A method was developed for the determination of benzotriazoles (BTs) in dishwasher tabs. BTs consist of 1H-benzotriazole and/or tolyltriazole, i.e., a technical mixture of the two isomers 4-methylbenzotriazole and 5-methylbenzotriazole (5-MBT). The method consisted of weighing of an aliquot of the tab, addition of the internal standard 5-MBT, precipitation of the soaps with CaCl2 and KOH, derivatization of the filtrate with acetic acid anhydride in a two-phase system, and analysis of the organic toluene layer by gas chromatography with mass spectrometry in the selected ion monitoring mode. Eleven of 12 different dishwasher tabs from the German market were tested positive with BTs ranging from 2 to 66 mg/tab. Dishwashing experiments were performed to show that at least 99% of the BT amount used in the dishwasher did not remain on the dishes but was released into the wastewater treatment system. The annual release of BTs into the water system was estimated to be ~80 tons. Since 70% or less of the BTs can be degraded in wastewater treatment plants, at least 24 tons are annually released into rivers in Germany.

Community acquired pneumonia (CAP) is an infection with a limited spectrum of pathogens. Pneumonias acquired in a hospital or under immunoincompetence are being treated according to different algorithms. The concept of health care associated pneumonia (HCAP) is discarted. It is not capable to predict a high probability of multiresistant pathogens.

Nach den neuesten Richtlinien sollen Patienten, bei denen eine typische Anamnese und in einer nicht uberwachten ambulanten Polygraphie ein typischer RDI-Befund (Respiratory Disturbance Index; erhohte Anzahl von Apnoen und Hypopnoen/Std. Messzeit) festgestellt worden ist, ohne weitere Polysomnographie einer CPAP („continuous positive airway pressure”)-Therapie zugefuhrt werden. Diese Vorgehensweise ist im Hinblick auf ihre Brauchbarkeit und Konsequenzen unter Praxisbedingungen bis heute nicht uberpruft worden. Es sollten deshalb in dieser Pilot-Untersuchung die Ergebnisse einer ambulanten Vordiagnose mittels 4–6-Kanal-Polygraphie mit denjenigen einer Polysomnographie in einem Schlafzentrum verglichen werden. Insbesondere interessierte die Anzahl der Patienten, die eventuell falschlicherweise ins Schlaflabor uberwiesen wurden oder bei genauer Einhaltung der Auswahlkriterien nicht behandelt worden waren. Insgesamt wurden 243 Patienten in die 9 Schlafzentren eingewiesen, 191 Manner und 52 Frauen. Der durchschnittliche Epworth-Schlafrigkeits-Skala (ESS)-Score lag bei 9,4±5,1. Bei 152 Patienten war der RDI mitgeteilt worden. Als erhohte Apnoe/Hypopnoe-Aktivitat wurde in dieser Studie exemplarisch ein Befund mit einem RDI oder AHI (Apnoe-Hypopnoe-Index) >10/h festgelegt. 16 von 153 Patienten (10,5%) wurden falsch negativ eingestuft, da der RDI in der ambulanten Polygraphie unter 10/h, in der Polysomnographie dagegen uber 10/h gemessen wurde. Bei 10 Patienten, die in der ambulanten Polygraphie einen RDI>10/h aufwiesen, wurde polysomnographisch ein AHI 10/h besitzt eine zu geringe Sensitivitat und Spezifitat. Die polygraphische ambulante Untersuchung reicht generell nicht aus, um ohne weitere Absicherung des Befundes durch eine Polysomnographie nicht behandlungsbedurftige Patienten zu identifizieren oder eine CPAP-Therapie einzuleiten.

Die nosokomiale Pneumonie gehort zu den haufigsten nosokomialen Infektionen und ist die haufigste auf der Intensivstation. Die nosokomiale Pneumonie ist mit einer signifikanten Mortalitat und Morbiditat assoziiert, und ihr Auftreten verschlechtert die Prognose des Patienten deutlich. Nach der Definition der DRGs auch im deutschen Krankenhaussystem ist die nosokomiale Pneumonie uberwiegend Sache des Krankenhauses und kann somit nicht nur das Ergebnis der Patientenbehandlung, sondern auch das finanzielle Ergebnis des Krankenhauses beeintrachtigen. In diesem Sinne kommt vor allem der Pravention, aber auch der Diagnostik und der schweregradadaptierten Therapie eine ganz entscheidende Bedeutung zu. Die hier vorgelegte aktualisierte Kurzfassung der Leitlinien zur Pravention, Diagnostik und Therapie der nosokomial erworbenen Pneumonie soll helfen, das Problem noch bewusster zu machen und gleichzeitig durch ein praxisnahes Arbeitsblatt die Dokumentation auf der Intensivstation zu erleichtern.