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Abstract Background In patients with very severe dementia self-rating of quality of life usually is not possible and appropriate instruments for proxy-ratings are not available. The aim of this project is to develop an instrument of clinical proxy-ratings for this population. Methods Using electronic instruments, physicians and nurses recorded patient behaviour and changes of behaviour over a period of one year. Based on these data a list of 65 items was generated and subsequently allocated to 14 categories. This list was tested in 217 patients (61–105 yrs) with dementia diagnosed according to ICD-10 by both physicians and nurses. The severity of dementia was assessed by means of the Global Deterioration Scale (GDS) and the Brief Cognitive Rating Scale (BCRS). The Spitzer-Index (proxy-rating) was used as a global quality of life measure. Activity of daily living was rated using the Barthel Index. Results A factor analysis of the original 65 items revealed 5 factors (communication, negative affect, bodily contact, aggression, and mobility). By stepwise removing items we obtained satisfactory internal consistencies of the factors both for nurses' and physicians' ratings. The factors were generally unrelated. The validity of the instrument was proven by correlations of the factors communication and mobility with the Brief Cognitive Rating Scale (BCRS) and the Barthel-Index. Conclusion The results demonstrate the reliability and validity of the Vienna List as a proxy rating measurement of quality of life in patients with severe dementia. The psychometric properties of the scale have to be proved in further studies.

Persons well advanced in years suffer from constantly increasing polypathia, loss of performance and loss of functions. At the same time the demands of an ever more quickly changing society grow. Society hardly cares for the elderly, the handicapped and disabled. Often, these people are regarded as a burden, a fact that they are very well aware of. When the usual patterns of communication fail, physicians may become impatient and are, as a consequence, perceived as intimidating and indifferent by the patient. In this way the physician initiates a vicious circle, which often leads to a complete failure in communication. This is by no means surprising, as the art of communication and its fundamental significance for the physicians and their work have still not found entry into medical curricula. As long as physicians define their very old patients exclusively in terms of their increasing physical weaknesses, their task can only be restricted to improving patients' weakened condition to a very limited extent. The patient well advanced in years is thus not recognized as an individual person with feelings, worries and desire desire to find a meaning in life.

Acetylation of insulin with 3H-acetic anhydride resulted in the predominant 3H-labeling at the aminoterminal position of the B-chain (B1). The labeled insulin was unchanged in its immunologic reactivity as compared to native insulin. It was used in a second antibody radioimmunoassay for the detection of antiinsulin-antibodies in insulin-dependent patients with Diabetes mellitus.

Levamisole treatment was started in 8 patients with inactive SLE. Four patients, who have now been followed up for over 12 months, have not shown clinical deterioration. Three of these patients received concomitant maintenance corticosteroid therapy, the dosage of which could be reduced in each case. A decrease in anti-DNA antibodies was observed in all 4 patients. Levamisole had to be withdrawn in the other 4 patients. One patient developed an exacerbation of her LE skin manifestations after two months, whilst in another patient fever and skin rash (probably drug-induced) were observed after one month. The cooperation of the 2 other patients was not satisfactory and the drug had, thus, to be withdrawn. In conclusion, 4 out of 8 patients with SLE showed a beneficial response to levamisole therapy.

Human rheumatoid arthritis (RA) collagenase and bacterial collagenase were shown to agglutinate collagen-coated erythrocytes. Native collagens of type I and type II reacted equally well, while denatured collagens showed less distinct agglutination activity. The sensitivity of the method for the detection of purified bacterial collagenase from Clostridium histolyticum is very high (100 pg). It is, however, low for human RA collagenase. The agglutination reaction is not inhibited by concentrations of native collagen causing distinct inhibition of anticollagen sera (2mg%). EDTA inhibits the agglutination completely.