[Development of quality standards for patients with rheumatoid arthritis for use in Germany]

Despite a qualitatively and structurally good care of patients with rheumatoid arthritis (RA) in Germany, there are still potentially amendable deficits in the quality of care. For this reason, the German Society for Rheumatology (DGRh) has therefore decided to ask a group of experts including various stakeholders to develop quality standards (QS) for the care of patients with RA in order to improve the quality of care. The QS are used to determine and quantitatively measure the quality of care, subject to relevance and feasibility. The recently published NICE and ASAS standards and a systematic literature search were used as the basis for development. A total of 8 QS, now published for the first time, were approved with the intention to measure and further optimize the quality of care for patients with RA in Germany.

Fatal impalement injury of the head due to a curtain rail

During a dispute, a boy was injured by a curtain rail which penetrated the skull in the left frontal region and led to severe brain injury. Despite intensive medical care, death occurred 10 days later due to malignant cerebral edema. With regard to the question whether the trauma resulted from throwing or pushing, some biomechanical aspects are discussed including individual morphologic findings as well as the kinetic energy required for penetrating the skull. According to the calculated data, we conclude that the velocity necessary for penetrating could be reached by throwing the curtain rail.