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Zusammenfassung Die inhalative Anwendung von Medikamenten hat f?r die Dauertherapie bei Mukoviszidose von jeher einen gro?en Stellenwert. Dabei war die Feuchtinhalation die klassische Applikationsform. Das z?he Bronchialsekret soll durch gel?ste lungeng?ngige Partikel gelockert werden, sodass die Atemwege mit Husten oder mit Physiotherapie leichter gereinigt werden k?nnen. Die erforderlichen hohen Dosierungen der pseudomonaswirksamen inhalativen Antibiotika konnten fr?her nur mittels Feuchtverneblung von L?sungen erreicht werden. Seit wenigen Jahren sind inhalative Pr?parate in Pulverform speziell f?r Mukoviszidose verf?gbar. Die neu entwickelten Arzneimittel und Inhalatoren unterscheiden sich deutlich von den herk?mmlichen Pulverpr?paraten zur Therapie chronisch obstruktiver Atemwegserkrankungen. Zwei inhalative Antibiotika in Pulverform, Tobramycin und Colistin, sowie das osmotisch wirksame und schleiml?sende Mannitol werden in diesem Artikel vorgestellt. Pr?sentiert werden technologische Aspekte, Studiendaten zu Wirksamkeit und Vertr?glichkeit sowie die praktische Anwendung dieser neuen Arzneimittel.

The inquiry of the association between social class and illness/life expectancy lacks as well on theory orientated conceptualization of the complex causal chain from social inequality to individual consequences as on differentiation of each of its links. In order to eliminate these deficits a hierarchical multidimensional process model will be introduced, in which the position in the system of social inequality (macro dimension) is connected with the dimension of social action (meso dimension, esp. family and professional context) and this again with the dimension of the individual (micro dimension: personality/organism) in different stages of the life course.

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This study was designed to provide information to which extend home-based nursing care services for the elderly take part in the care for older people with mental disorders. Also of interest was the involvement of clinical facilities and services of the geropsychiatric treatment system in the health care for the clients. A one day data collection in 29 nursing care services in two North Rhine-Westphalian regions could raise informations about 1,246 clients aged 60 years and over 1,522 persons (41.8%) had a mental disorder, diagnosed by a nursing and/or medical professional. 68% of the mental disordered clients had dementia or a demential disorder, 6% a functional psychosis, and 31% a neurotic, psychogenic disorder or substance abuse (small number of clients with two and more diagnoses). 82% of clients with mental disorders had one or more additional somatic disease(s). These diseases were mostly the cause for the involvement of home-based nursing care service. Barely 8% of clients with mental disorders were placed from clinical facilities and services of the geropsychiatric treatment system into the nursing care services. Beside the home-based care, only a 12% of mental disordered received clients outpatient psychiatric treatment. Systematic cooperation between the nursing care services and the system of (gero-) psychiatric treatment was a rare exception.