[Relevance of MRSA on a Visceral Surgical Intensive Care Unit]. / Relevanz von MRSA auf einer viszeralchirurgischen Intensivstation.

Background: Resistance to antibiotics is a worldwide increasing problem. A well-known example is methicillin resistant Staphylococcus aureus, MRSA. What is the relevance of MRSA on a surgical ICU? Patients/Material and Methods: On a 20 bed academic SICU/intermediate care ward 14,976 patients were treated in a seven-year period. We identified only 98 MRSA-positive patients. 56 (57 %) of them were merely colonised, 42 (43 %) suffered from an MRSA infection. A control group comprised 56 similar patients without MRSA detection. Results: Patients with MRSA infection had a higher mortality rate (OR 4.18; p = 0.002), but only 4 out of 20 patients died due to the MRSA infection. APACHE 2 score of more than 20 was predictive for being colonised with MRSA (OR 3.08; p = 0.04), but it was not a risk factor for developing an MRSA infection (OR 1.03; p = 0.95). Patients with MRSA colonisation did not have a higher mortality rate than patients without. Conclusion: Outcome depended on severity of the disease, but not on the MRSA colonisation status. Patients with MRSA infection were more likely to die, but the reason of death rarely was MRSA.

Meeting the nutritional requirements of hospitalized patients: an interdisciplinary approach to hospital catering.

AIM OF STUDY: The study served to assure the quality of our catering, to locate problems, and to define further optimization measures at the Bern University Hospital. The main objective was to investigate whether the macronutrient and energy content of the hospital food complies with the nutritional value calculated from recipes as well as with the recommendations issued by the German Nutrition Society (DGE). MATERIAL AND METHODS: Prospective, randomized, single-center quality study. Complete standard meals were analyzed over seven consecutive days for each seasonal menu plan in one year. The quantitative and qualitative chemical content of a randomly chosen menu was determined by an external laboratory. RESULTS: Sixty meals were analyzed. The amount of food served and the ratio of macronutrients contained in the food satisfactorily reflected all recipes. Not surprisingly, the energy and carbohydrate content of our meals was lower than in the German recommendations, because the report of the DGE is based on the sum of meals, snacks and beverages consumed over the whole day and not only on the main meals, as we analyzed. CONCLUSIONS: Periodic quality control is essential in order to meet recommendations and patients' expectations in hospital catering. Members of the catering service should undergo regularly repeated skills training, and continuous efforts should be made to ensure portion size for all delivered meals. Food provision in the hospital setting needs to be tailored to meet the demands of the different patient groups, to optimize nutritional support, and to minimize food waste.

[Der Regenbogen in Wissenschaft und Kunst]. / Der Regenbogen in Wissenschaft und Kunst.

New ideas and calculations about angles are presented, particularly about the degree of polarization of the first twenty rainbows, and it is proved why never more than two rainbows can be seen in the sky. The general sky brightness of the rainbow neighborhood is calculated with the Fresnel reflection formulas. It is shown that for certain refraction indices the first one or each of the higher rainbows can be polarized completely and that with a rising n there is an upper limit of existence for each one of them. This is clearly shown by diagrams. The standard of the exact color finding on rainbows is described with special emphasis on the fact that the loss of saturation, due to light reflected by waterdrops, must be considered. Some special features of rainbows mentioned in literature are pointed out and the importance of this phenomenon in constructive art, folklore, and religion is discussed.