there was no evidence of a difference between collagenase and fibrinolysin/deoxyribonuclease in the debridement of pressure ulcers.

No abstract

All in all, DemTect and MMSE are not interchangeable. The MMSE estimates the average cognitive impairment of patients as considerably less pronounced than the DemTect. MMSE is, thus, not an instrument that would be recommended for the identification of mild cognitive impairment. In this case, tests with higher reliability and validity should be used.

For the treatment of geriatric inpatients, the efficacy of a multimodal geriatric intervention based on findings of a comprehensive geriatric assessment has well been established. Therefore, the focus of elderly inpatient care switched to the identification of geriatric patients who have unintended or unscheduled contact to an accident and emergency department. In Germany, a uniform standard on how to correctly identify geriatric patients in such settings has yet to be established.Three medical societies, the Federal Association of Geriatrics ("Bundesverband Geriatrie", BVG), the German Society for Gerontology and Geriatrics ("Deutsche Gesellschaft für Gerontologie und Geriatrie", DGGG) and the German Geriatrics Society ("Deutsche Gesellschaft für Geriatrie", DGG) have reached a consensus on tools and instruments for the identification of geriatric patients in the emergency care setting. Basis of the consensus were the existing scientific evidence and further considerations, especially the applicability of international findings in Germany and feasibility.Three recommendations are made: (1) The use of prognostic indices is not recommended, as prognostic indices appear to be inappropriate to disclose the complex needs of geriatric patients. (2) Comprehensive geriatric assessment is established and effective, but too complex for use in the emergency setting. It is recommended for cases in which information from screening instruments or other sources does not allow a clear decision. (3) Among screening instruments, the Identification of Seniors At Risk (ISAR) screening tool seems to be well established and suitable for screening purposes in Germany. A German adaption is recommended as well as the implementation in settings where no other tools or geriatric expertise are available.

Gait disorders are one of the most common gerontoneurological symptoms. Falls that occasionally cause severe injuries are highly relevant consequences. A clinical neurological examination and inspectoral gait analysis are the core investigations of the diagnostic process, which yields hypotheses with respect to the impaired structures as well as to specific diagnostic measures. The supplemental motor assessment quantifies the resulting impairment of mobility and risk of falling with the help of well-established instruments. Characteristic of gait disorders in the elderly are the multifactorial causes which make the complete identification, correct prioritization and adequate treatment the biggest challenges. The therapeutic concept is multiprofessional and includes the causal treatment of underlying diseases, physiotherapeutic training programs, prescription of medical aids and nutritional interventions. Identification and modification of risk factors (including those that are iatrogenic) are of superior importance.