[Group Training of Patients with Chronic Lung Diseases under Outpatient Conditions - Recommendations of the Working Group Lung Sports in Germany and the German Airways League]. / Ambulanter Lungensport und körperliches Training bei Patienten mit Atemwegs- und Lungenkrankheiten.

To improve acceptance and use of physical training by patients with chronic lung diseases, recommendations for performing lung exercises on an outpatient basis in a group setting are given by experts in physical training, sports therapists and pulmonologists. The evidence-based positive effects of physical training were analyzed for asthma , COPD, interstitial lung diseases, cystic fibrosis, lung carcinoma, and pulmonary hypertension. The requirements for lung exercises in outpatient groups as well as compensation by care providers were given on the basis of legal regulations. Furthermore, the main items of the training units as well as supervision by specially trained group leaders in relation to the severity of the underlying lung disease are described. Finally, aspects of safety of the participating patients are discussed, including the prevention of infection with corona-2-virus.

[Guideline for the Diagnosis and Treatment of Asthma - Guideline of the German Respiratory Society and the German Atemwegsliga in Cooperation with the Paediatric Respiratory Society and the Austrian Society of Pneumology]. / S2k-Leitlinie zur Diagnostik und Therapie von Patienten mit Asthma.

The present guideline is a new version and an update of the guideline for the diagnosis and treatment of asthma, which replaces the previous version for german speaking countries from the year 2006. The wealth of new data on the pathophysiology and the phenotypes of asthma, and the expanded spectrum of diagnostic and therapeutic options necessitated a new version and an update. This guideline presents the current, evidence-based recommendations for the diagnosis and treatment of asthma, for children and adolescents as well as for adults with asthma.

A new potassium-based intermediate and its role in the desorption properties of the K-Mg-N-H system.

New insights into the reaction pathways of different potassium/magnesium amide-hydride based systems are discussed. In situ SR-PXD experiments were for the first time performed in order to reveal the evolution of the phases connected with the hydrogen releasing processes. Evidence of a new K-N-H intermediate is shown and discussed with particular focus on structural modification. Based on these results, a new reaction mechanism of amide-hydride anionic exchange is proposed.

[Relevance of Outpatient, Equipment-based Exercise Training in Patients with Chronic Respiratory Diseases]. / Stellenwert ambulanter, gerätegestützter Trainingstherapie bei Atemwegs- und Lungenkrankheiten.

Exercise training is one of the most important components in disease management for patients with chronic respiratory diseases. The clinically relevant benefits of endurance and strength training on dyspnea, exercise capacity and quality of life have been evaluated very well. However, there are some legal limitations by the German Working Group for Rehabilitation (BAR) concerning outpatient exercise training programs (beyond pulmonary rehabilitation): only group-based callisthenic training programs receive funding from health care insurances while professional equipment-based training programs are excluded despite their outstanding effectiveness.This review provides an overview on the methodology and the benefits of outpatient exercise training programs for patients with chronic respiratory diseases, and it critically discusses the organizational structures of these programs in Germany.

[Psycho-oncology in dermatology]. / Psychoonkologie in der Dermatologie.

Psycho-oncology is a young discipline-in dermatology as well as in the medicine. The topic is heterogeneous and not clearly defined. The proportion of indications for emotional care in oncology is up to 50%, depending on the method of diagnosis. In daily dermatological practice, careful distribution of information and helping with coping are essential in order to not overwhelm the patient. The doctor should ask questions about the patient's expectations, fears, and any unclear items.

[Pulmonary rehabilitation in COPD]. / Rehabilitation bei COPD.

COPD as a widespread disease will need much more attention of all health care providers in future. Otherwise COPD could lead to increasing costs, especially caused by the systemic nature of this disease and the large number of comorbidities as well as an increase of morbidity with reduced personal fitness and quality of life. As a result, the occupational and social participation subsequently decrease. Specific diagnostic in rehabilitation shows these consequences and a multimodal, multi-professional therapeutic management can be started. This means an optimized pharmacotherapy, different steps of intensity of indoor or outdoor rehabilitation with a training for patients, withdrawal therapy, psycho-social support and in severe cases non invasive artificial respiration. The indication for rehabilitation and the legal requirements are shown, as well as the ways to get rehabilitation and the possibilities of a rehabilitation chain including rehabilitation follow up and physical training. It has been proved that rehabilitation improves the symptoms of the disease, the personal fitness and the quality of life. Futhermore, rehabilitation reduces the days and the time spent in hospital and eventually reduces fear and depression. Therefore if consequently followed, rehabilitation in COPD is a valid therapeutic measure that can diminish the epidemiologic burden of this widespread disease.

Proteasomes generate spliced epitopes by two different mechanisms and as efficiently as non-spliced epitopes.

Proteasome-catalyzed peptide splicing represents an additional catalytic activity of proteasomes contributing to the pool of MHC-class I-presented epitopes. We here biochemically and functionally characterized a new melanoma gp100 derived spliced epitope. We demonstrate that the gp100(mel)47-52/40-42 antigenic peptide is generated in vitro and in cellulo by a not yet described proteasomal condensation reaction. gp100(mel)47-52/40-42 generation is enhanced in the presence of the ß5i/LMP7 proteasome-subunit and elicits a peptide-specific CD8(+) T cell response. Importantly, we demonstrate that different gp100(mel)-derived spliced epitopes are generated and presented to CD8(+) T cells with efficacies comparable to non-spliced canonical tumor epitopes and that gp100(mel)-derived spliced epitopes trigger activation of CD8(+) T cells found in peripheral blood of half of the melanoma patients tested. Our data suggest that both transpeptidation and condensation reactions contribute to the frequent generation of spliced epitopes also in vivo and that their immune relevance may be comparable to non-spliced epitopes.

The incorporation of empirical item difficulty data into the Angoff standard-setting procedure.

This study represents an attempt at incorporating empirical item difficulty data into the Angoff standard-setting procedure without affecting the subjective judgment of the raters. The Rasch-model ability level corresponding to minimal competence was estimated for each of 536 items on the American Association of State Social Work Boards (AASSWB) social work licensure examinations from their empirical calibrations and Angoff ratings. The mean of these estimates for all items on a given examination was taken as the level of minimal competence of the entire examination. This procedure yielded raw passing scores that were 4 to 6 items lower (out of 150) and pass rates that were 7% to 15% higher than those obtained using the "standard" Angoff procedure.

[Experimental results of the optimization of external prednisolone therapy]. / Experimentelle Ergebnisse zur Optimierung der externen Prednisolontherapie.

The initial steps of any topical therapy are characterized by the degree of liberation of the agent from the ointment base and their penetration into different skin layers. A high percentage of the topically applied prednisolone does not penetrate into the skin and may be removed from the skin surface even after some time. By altering the functional structure of the horny layer and considerably increase of prednisolone liberation from ointment bases urea is a effective penetration promotor also for prednisolone. The increased prednisolone penetration into human skin from urea containing ointment correspond with the degree of blanching results by vasoconstriction test under in vivo conditions. The resulting penetration optimation of prednisolone has two possible applications in topical therapy: an increased therapeutic effect for a given prednisolone concentration and a given therapeutic effect could be obtained with a reduced prednisolone concentration.

[Skin permeation of liposomal incorporated hydrocortisone]. / Hautpermeation von liposomal inkorporiertem Hydrocortison.

With the liposomal incorporated hydrocortisone a very much improved concentration-time profile was obtained in the different layers of human skin after topical application when compared with conventional hydrocortisone in the ointment. The increased hydrocortisone penetration into human skin correspond with the degree of blanching results by vasoconstriction test. Under in vivo conditions the influence of liposomal hydrocortisone on percutaneous resorption was investigated. In guinea pigs a decreased serum concentration and urinary excretion of hydrocortisone could be demonstrated. Thus, hydrocortisone-loaded liposomes, when applied topically, act as a selective drug delivery system, it can be provide increased therapeutic efficacy and, simultaneously, decreased unwanted systemic effects. The significance of liposomal incorporated attenuative and higher potent glucocorticoids in external therapy is discussed.

Relationship of nursing program predictors and success on the NCLEX-RN examination for licensure in a selected associate degree program.

This ex post facto correlational study sought to determine the relationship of selected admission criteria and performance in the integrated nursing major didactic courses of an associate science in nursing degree program as predictors for performance on the licensing examination for registered nurses. A significant positive relationship at .01 with NCLEX was individually demonstrated with all of the seven ASN nursing courses and with SAT verbal scores. Not significant were age at graduation from the program, high school class rank percentile, and SAT math scores. Multivariate regression weights derived from an equation using course grades of 104 graduates were used to predict NCLEX scores. The predicted scores correlated strongly (n = .78551, p less than .001) with the actual scores. Ten predicted and actual scores were provided for demonstration.