Oropharyngeal dysphagia (OD) is a highly prevalent and growing condition in the older population. Although OD may cause very severe complications, it is often not detected, explored, and treated. Older patients are frequently unaware of their swallowing dysfunction which is one of the reasons why the consequences of OD, ie, aspiration, dehydration, and malnutrition, are regularly not attributed to dysphagia. Older patients are particularly vulnerable to dysphagia because multiple age-related changes increase the risk of dysphagia. Physicians in charge of older patients should be aware that malnutrition, dehydration, and pneumonia are frequently caused by (unrecognized) dysphagia. The diagnosis is particularly difficult in the case of silent aspiration. In addition to numerous screening tools, videofluoroscopy was the traditional gold standard of diagnosing OD. Recently, the fiberoptic endoscopic evaluation of swallowing is increasingly utilized because it has several advantages. Besides making a diagnosis, fiberoptic endoscopic evaluation of swallowing is applied to evaluate the effectiveness of therapeutic maneuvers and texture modification of food and liquids. In addition to swallowing training and nutritional interventions, newer rehabilitation approaches of stimulation techniques are showing promise and may significantly impact future treatment strategies.

Aims Considerable differences in the long‐term trends of heart failure (HF) exist between different countries. To extend the existing knowledge on HF epidemiology in Germany, we analysed trends of HF‐related hospitalizations, hospital days and in‐hospital deaths during a 14‐year period (2000–2013). Methods and results Data were derived from the official German Federal Health Monitoring System, which includes an annual and complete enumeration of inpatients at the time of discharge from the hospital. HF cases were identified by the primary diagnosis code for HF (I50). From 2000 to 2013, the absolute number of HF‐related hospitalizations increased by 65.4% (239 694–396 380 cases) and by 28.4% after age‐standardization (261–335 per 100 000 population). Accordingly, the absolute number of HF‐related hospital days increased by 22.1% (3.4–4.2 million hospital days), despite a marked decrease by 25.9% in average length of stay (14.3–10.6 days). With approximately 35 000 in‐hospital deaths (∼45 per 100 000 population), the annual number of HF‐related in‐hospital deaths remained consistently high, and in‐hospital mortality rate in HF patients constituted 9.3% in 2013. Patients aged >65 years were disproportionately affected. In 2013, HF was the leading cause of disease‐related hospitalizations and in‐hospital deaths, representing 2.1% and 8.8% of all cases, respectively. Conclusion In Germany, the burden of HF is growing further, and the risk of death in HF remains high. These trends can only be partly attributed to demographic developments suggesting an exigent need for increased awareness and enhanced efforts in the prevention and management of HF.

diagnostic accuracy for the identification of infection was comparable among tympanal and rectal thermometry and lower for temporal artery thermometry. Different cut-off points should be used to identify infection using tympanal (37.3°C) or rectal (37.9°C) thermometry. In general, temperature measurement is an insensitive method to identify geriatric patients with infection. Registration number clinicaltrials.com: KSMC-tempger-1.

The use of standardized order sets for the management of sepsis in elderly patients should be strongly recommended for better performance in treatment. Compliance with the protocol was associated with reduced length of stay, reduced mortality, and improved initial appropriate therapy.