[Special care units for the treatment of acutely ill, cognitively impaired geriatric patients in Germany]

During recent years, specialized wards have been established in geriatric hospital departments as a consequence of the growing need of special care for acutely ill older patients, who are also cognitively impaired. However, there are neither established standards nor any commonly agreed concept of care. A written survey among 12 specialized wards in Germany revealed some characteristics of these wards: extended geriatric assessment, special education of staff including validation and gerontopsychiatric issues, and particular equipment/architecture, such as hidden doors and group rooms, and in some cases loop tracks for walking, therapeutic facilities, and 'living rooms' on the wards. There is a wide variability with respect to the designation of these wards, the number of beds, length of stay, and admission criteria. It appears from this survey that there should be an exchange of empirical experience made on these wards, and there is a need of collaborative research on its usefulness.

DNA strand break induction, mutagenicity, and cytotoxicity of the mycotoxins 11-β-hydroxy-7-deoxy-rosenonolactone, rosenonolactone, and trichothecin

11-β-hydroxy-7-deoxy-rosenonolactone (TSS1), a mycotoxin of the rosenane class, was tested on cytotoxicity, induction of DNA single strand breaks and muta-genicity. Its effects were compared to those of rosenonolactone and trichothecin. TSS1 had stronger antibiotic activity againstEscherichia coli (EC 50: 10μg/mL) than rosenonolactone (EC 50: >200μg/mL) but weaker activity than trichothecin (EC 50: 3μg/mL). The same order of activity was found for the inhibition of yeast fermentation (EC 50 of TSS1: 45μg/mL; EC 50 of rosenonolactone: > 120μg/mL; EC 50 of trichothecin: 3.4μg/mL).In the trypan blue exclusion test using V79 Chinese hamster cells, TSS1 proved to be cytotoxic (EC50: 30μg/mL) at even lower doses than trichothecin (EC50: 200μg/mL). Rosenonolactone had no significant toxicity up to the highest soluble concentration (500μg/mL).DNA single strand breaks caused by TSS1 occurred at the same concentrations at which damage of the cell membrane became apparent. For trichothecin single strand breaks were detected only at concentrations at which the membrane was already highly damaged. No single strand breaks were observed in V79 cells after incubation with rosenonolactone up to the limit of solubility (500μg/mL).In the reversion assay withhis Salmonella typhimurium strains TA 98 and TA 100, no mutagenicity was observed for any of the examined mycotoxins up to 800μg/plate with and without the addition of a rat liver preparation for metabolism of the test compound.