[Endobronchial Foreign Bodies Telling Readable Stories]. / Endobronchiale Fremdkörper, die lesbare Geschichten erzählen.

We present two case reports in which, in a surprising way, readable writing or numbers on the aspirated material provided useful information about the more detailed circumstances of the aspiration.In the first case, the patient complained of foreign body sensation after using a metered dose inhaler. A few hours later, the initially unknown aspirated material was recovered by flexible bronchoscopy. With the help of the text fragment on the material, it could be concluded that it was the packaging foil of a candy, which had entered the mouthpiece of the metered dose inhaler while stored in the patient's jacket pocket.In the second case, the patient experienced recurrent pneumonia over a period of years. With the help of the serial number on the bronchoscopically recovered plastic material, the exact time and place of aspiration could be determined. The patient had aspirated the plastic label of a spare part during his occupational activity in a car repair shop.

[Lung contusion after jumping from a 10 meter tower in a swimming pool]. / Lungenkontusion nach Sprung ins Wasser.

BACKGROUND: Lung contusions often occur in the context of polytrauma, but much less frequently in sports injuries. CASE DESCRIPTION: We report on a 22-year-old patient who presented to our emergency room. On the same day he jumped from a 10 meter tower in a swimming pool and hit the surface of the water with his thorax and abdomen. He complained of pain in the right chest and hemoptysis immediately after the jump.The examination findings remained without further abnormalities.In the chest x-ray no abnormalities were found.The CT thorax with contrast medium revealed homogeneous ground-glass opacities in the middle lobe and less in the ventrobasal upper lobe on the right, consistent with the pulmonary contusion with parenchymal bleeding. In addition, there was a minimal pneumothorax border on the paracardial right side.Bronchoscopy performed on the same day showed evidence of blood in the middle lobe bronchus.The hemoptysis stopped spontaneously. On the 3rd day of the hospital stay, the patient was discharged with stable vital parameters and asymptomatic. CONCLUSION: Hemoptysis immediately after a sports chest injury may occur as a result of pulmonary contusion. In contrast to conventional chest x-rays, computed tomography is of great importance in the diagnosis of pulmonary contusion.

[Pneumology in the Model Degree Program of the Medical Faculty Ostwestfalen Lippe, Germany]. / Das Fach Pneumologie im Modellstudiengang der Medizinischen Fakultät Ostwestfalen-Lippe (OWL).

The specialist field of "pneumology" is still underrepresented in university clinics in Germany, but this is not the case at the newly founded medical faculty Ostwestfalen-Lippe (OWL) in Bielefeld. This is linked to representing pneumology and internal intensive care medicine in patient care, teaching and research across the board and the opportunity to actively help shape the development of the human medicine faculty in an exciting environment.The early anchoring of the subject "Pneumology" in the model degree program of medical school in OWL (begin winter semester 2021/22) contributes to further visibility and a university medical orientation. In this overview various issues of Pneumology in the Model Degree Program are explored by basic scientists, clinical teachers, members of the medical faculty and a student.In today's Evangelisches Klinikum Bethel (EvKB), pulmonary medicine has a long tradition. The hospital's first lung and infection center was opened in 1927. The EvKB's department for internal medicine, pneumology and intensive care medicine, which has been independent since 2009, is becoming a university clinic for pneumology within the medical faculty OWL. Relevant translational and interdisciplinary research can be intensified.There are 30 "Pneumology" teaching units in the model degree program, which are divided into two study sections using different formats, such as lectures, seminars, hands on courses and skills lab. It is represented in particular in the module complex "Circulation and Respiration". The content of the first phase of teaching was carried out by a module commission, with members representing the subjects involved in the module.Knowledge of the basics from, for example, physiology, pathophysiology, anatomy and pathology are taught to the students in the run-up to the pneumology course. Using the example of physiology, the presentation of the learning content of a basic subject is elaborated in this article.Half of all teaching units on pneumology of the entire course took place in the 2nd semester (in March and April 2022), so that students experienced the clinical relevance of the content at an early stage. There was a particular focus on obstructive airway and restrictive lung diseases. After imparting the basic knowledge of the physical examination of the lungs in the Skills Lab, the most important pathological findings in the above-mentioned diseases on inspection, palpation, auscultation and percussion are demonstrated and practised in patients as part of bedside teaching under supervision.Communication training is also longitudinally integrated into the modular teaching, with a total of more than 200 teaching hours and is performed interdisciplinary. In the "Circulation and Breathing" module eight hours are devoted to this with simulated patients, the anamnesis and therapy advice on classic cardiopulmonary diseases. For the students, integrating the teaching of basic theory and its clinical application for each organ systems represents a challenge in the model degree program, the advantages outweigh from today's perspective.

Successful management of a bleeding complication during transaxillary transcatheter aortic-valve implantation: a case report.

Background: The axillary artery is an alternative access route for transcatheter aortic-valve implantation (TAVI) in patients who have unfavourable femoral arteries as well as comorbidities which preclude surgery. Transaxillary TAVI (TAx-TAVI), with a complete non-transfemoral approach, is a feasible and safe alternative even if complications like vascular closure device failure with bleeding occurs. Case summary: We describe here a simplified non-transfemoral TAx-TAVI approach in a 71-year-old patient with pulmonary oedema due to severe symptomatic aortic stenosis with a prohibitively high surgical risk (Society of Thoracic Surgeons Mortality 11.9%) and extensive peripheral artery disease that rendered the femoral arteries unsuitable for access. Importantly, this strategy also allows for successful management of bleeding events, particularly those associated with vascular closure device failure, by the use of a new covered stent device. The patient was discharged on Day 6 after admission in stable conditions. In short-term follow-up (30 days), he is asymptomatic with normal left-ventricular function. Discussion: The TAx-TAVI is a promising alternative to transfemoral TAVI approach. Patient safety, even during bleeding complications, can be guaranteed with appropriate preparation.