[Quality in acute inpatient rheumatology 2021 : Current aspects of the KOBRA quality label of the Association of Rheumatological Acute Care Clinics]. / Qualität in der akutstationären Rheumatologie 2021 : Aktuelle Aspekte zum KOBRA-Qualitätslabel des Verbandes Rheumatologischer Akutkliniken (VRA e.V.).

A comprehensive health policy quality campaign launched in 2021 aims to improve the quality and transparency of hospital care for people with diseases in Germany. Legal requirements for minimum volumes and the expansion of quality contracts between cost units and hospitals as well as the use of quality indicators relevant to planning for demand-oriented and quality-oriented further development of inpatient care will increase competition in the quality of care between hospitals. The topic of development and definition of quality in medicine was also comprehensively addressed by the Association of Rheumatological Acute Care Clinics (VRA) shortly after its foundation in 1998. At the center of acute inpatient quality management are binding structural criteria linked to the continuous outcome benchmarking in acute rheumatology care (KOBRA) project launched in 2003 in rheumatology (and continuously implemented to date) measuring process and outcome quality. Based on this framework (fulfillment of the structural quality and participation in the KOBRA project) successfully participating rheumatology units can acquire the KOBRA seal of approval for 2 years at a time, which is awarded by the project management, the aQua Institute. The outstanding position of the project is exemplified by data evaluation on treatment change in active rheumatoid arthritis, diagnosis confirmation of connective tissue diseases and vasculitis during the inpatient stay as well as on participatory decision-making processes concerning rheumatoid arthritis (referring to the results of the data collection period 2018). By anchoring projects for structural, process and outcome quality acute inpatient rheumatology is well prepared for the paradigm shift demanded by health policies. Additionally, the KOBRA project is a good prerequisite to meet the requirements concerning quality management fixed in the Federal Joint Committee (G-BA) guidelines for recognition as a rheumatology center.

Treatment of adolescents and young adults (AYA) with cancer in a multidisciplinary setting: on the way to a highly specialized AYA unit.

Further survival improvements of adolescents and young adults (AYA) with cancer are clearly affected by biological characteristics of the malignancies and age-specific needs. Multidisciplinary teams drawing expertice from both pediatric and adult cancer teams as well as clinical trials are required to meet the age specific needs of AYA patients with cancer. In 2011, the first AYA unit was established at the University Hospital Halle (Saale), where patients with newly-diagnosed cancer aged 15-25 are treated interdisciplinary by pediatric and adult oncologists. The enrollment into pediatric or adult clinical trials is controlled by age 18. Over the last 2 years, 19 AYA with cancer have been treated at the unit; and, in turn patients and their relatives reflected a high satisfaction with the offered novel health care approach. In the scope of the future Comprehensive Cancer Center at the University Hospital Halle (Saale), a complete ward is planned for all admitted AYA up to 25 years with cancer. The patients will be treated by a tumor-specialized multidisciplinary team of adult or pediatric oncologists and oncological surgeons. Therefore, we intend to establish a special teaching curriculum for physicians, nurses and psychosocial health care staff. Rather than age, cancer biology of a malignancy, surveillance data of late side effects as well as the age-specific needs of AYA patients will be crucial for best treatment options.

Beta-carotene-loaded nanostructured lipid carriers.

Nanostructured lipid carriers (NLC) technology was used to disperse hydrophobic beta-carotene in an aqueous phase. NLC are lipid nanoparticles with a particle matrix consisting of a blend of a liquid and solid lipid. They were produced by melting the lipid blend at 80 degrees C and dispersing it into a hot emulsifier solution. The aim of this study was to extend the limited knowledge of melt-emulsified lipidic colloids in food systems and to evaluate the feasibility for further applications as functional ingredient in beverages. Physical stability of the NLC suspension was examined at 2 different storage temperatures by measuring the particle size with photon correlation spectroscopy (PCS) and laser diffractometry (LD). All particles containing sufficient amounts of emulsifier were smaller than 1 microm (LD diameter 100%) at a mean particle size of around 0.3 microm (LD) for 9 wk at 20 degrees C and at least 30 wk at 4 to 8 degrees C. Differential scanning calorimetry (DSC) was used to study the solid state of the lipids both in the beta-carotene loaded PGMS and in the NLC particles. Propylene glycol monostearate (PGMS) when dispersed as NLC recrystallized up to 98% during storage time. Within the regarded period of 7 mo no polymorph transitions were observed. Furthermore, stability of the beta-carotene in water dependent on NLC concentration and tocopherol content was measured photospectrometrically to get an estimation of the behavior of NLC in beverages.