Habitual snoring without episodes of apnea or hypoventilation and without respiratory related arousals is considered to be annoying and without any need for treatment. However, studies seem to suggest an enormous psychosocial impact of annoyance for the bed partner. Apart from subjective questionnaires there still exists no generally accepted mode of measurement that can describe snoring objectively. We therefore adapted methods developed for environmental medicine and established a new snore score using psycho-acoustic parameters. For quantification of snoring noise we conducted nocturnal measurements in 19 habitual snorers. Free-field snore sounds were acquired with two low-cost non-contact microphones and transferred to a PC (sampling frequency 11 kHz). The data were recorded, analysed and stored automatically using a MATLAB script. Following the analysis of sound characteristics and levels, the score was computed from relevant parameters containing the rating level (L(R)), maximum level, two percentile levels for frequent maxima (L(5)S; L(1)) and snoring time. The determined values substantially exceeded the prescribed limits defined by WHO noise guidelines, and mainly affected the equivalent continuous sound exposure level, rating level and the immission standard values of brief noise peaks, whose maximum was exceeded by up to 32 dB(A). The Berlin snore score illustrated the objective acoustic annoyance on a scale from 0 to 100. It allows inter-individual comparison and objectifies the need for therapy. The clinical applicability of evaluating the reduction of snoring after surgical therapy is discussed exemplarily. The presented measuring method was found to be suitable for quantifying snoring noise and can be easily integrated into existing polysomnographic applications. In the case of habitual snoring with objective evidence of psychosocially disturbing acoustic annoyance, health fund providers should assume the costs of mandatory medical therapy.

Results show a 97% rate of satisfaction of the SAM program and a high self-reported pain improvement in a cohort of 314 women using our SAM program. The results suggest that the SAM program should remain a standard practice in our institution. Some recommendations will be drawn to better tailor the SAM program to the needs expressed by the users.

Objective: The objective of the study was to establish the compatibility of injectable meropenem with 101 other drugs during Y-site administration. Methods: Meropenem (50 mg/mL, 10 mL) was combined with 101 undiluted injectable drugs (10 mL each) at room temperature. Each preparation was performed twice. The first sample underwent a visual evaluation and a particle count test by light obstruction immediately after mixing. These tests were repeated 4 hours after mixing using the second preparation. Incompatibility was defined as precipitation or other visual change (turbidity, crystal formation, gas formation, color change) or failure to meet United States Pharmacopeia (USP) <788> 1.B specifications at any time point. Results: A total of 83 of the 101 injectable drugs tested with meropenem were found to be compatible both visually and using the USP <788> particle counter. The gross incompatibility of the other 17 drugs was determined by visual observation. One mixture complied with the specifications, but showed an increase of temperature upon mixing and was removed from the study. Conclusion: Of the 101 drugs tested, 83 were found to be compatible while the remaining 17 were incompatible. One drug was removed from the study as its compatibility was unclear.

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