Primärer Deckzellentumor des Bauchfells bei Asbestose

Zusammenfassung Es wird über einen primären, teils zottig-papillär, teils knotig-plattenartig wachsenden Deckzellentumor des Bauchfells bei einem Asbestarbeiter mit etwa 26jähriger Staubexposition und mittelschwerer Asbestosis der Lungen berichtet, der an tuberkulöser Leptomeningitis bei Caries tuberculosa der Lendenwirbelsäule und weitgehend vernarbter Lungentuberkulose starb. Auf Grund der histologischen Struktur des Tumors mit seinen Eisenstaubablagerungen und dem röntgenographisch erfolgten Asbeststaubnachweis im Geschwulstgewebe wird ein ursächlicher Zusammenhang zwischen beiden Erkrankungen angenommen. Die Tumorentstehung wird auf überschießende Regenerationserscheinungen der unter chronischem Fremdkörperreiz stehenden Serosa im Sinne der Theorien von Ribbert und Fischer-Wasels zurückgeführt.Mit 10 Textabbildungen.     

Eine Reisestudie über schweren Manganismus bei ägyptischen Mangangrubenarbeitern

Ohne Zusammenfassung     

Genetik primärer Kopfschmerzen

Migraine has an important genetic component. The prototypic monogenic form of migraine is hemiplegic migraine, a rare subtype of migraine with aura, for which three causative genes have been identified. Studies of transgenic animal models have substantially improved our understanding of the molecular pathophysiology of this monogenic model disease as well as of migraine in general. Beyond this, there are other (rarer) monogenic forms of migraine, e.g., in the context of hereditary mostly vascular syndromes such as CADASIL. By contrast, the common types of migraine with and without aura are genetically complex. With the identification of the first robust genetic risk variants in large genome-wide association studies, our knowledge in this still dynamically expanding field has substantially increased. This review summarizes the current status of migraine genetics, with a special focus on hemiplegic migraine as well as the most recent findings in complex migraine genetics. In addition, the first preliminary findings on the genetics of other types of primary headache disorders (cluster headache, tension-type headache) are briefly reviewed.     

Die Rolle der Medien bei Entstehung,Verlauf und Bewältigung von Essstörungen

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Essstörungen gehören in westlichen Gesellschaften zu den häufigsten psychosomatischen Erkrankungen. Die Medien...     

COVID-19-Sterbefälle bei Bewohnern vollstationärer Pflegeeinrichtungen in München – Todesursachen und Sterbeorte

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Die neue Infektionskrankheit COVID-19 trat erstmalig im Dezember 2019 in China auf. Eine systematische Auswertung von...     

Prävention und Aufklärung über Virusinfektionen bei Schwangeren und Neugeborenen: Mission possible

Ohne Zusammenfassung     

Interdisziplinärer Forschungsverbund Epidemiologie—EpiBerlin

The Interdisciplinary Network for Epidemiological Research in Berlin (EpiBerlin) has the goal of bringing together epidemiologists and experts in epidemiology and public health in Germany's capital city of Berlin and to offer them opportunities for knowledge transfer and networking. In that way, existing resources may be strengthened and additional potential in Berlin as a science center may be developed. EpiBerlin was founded by an initiative of the Berlin Center of Public Health (BZPH) and is closely affiliated with the three universities in Berlin (Free University, Technical University, and Humboldt University) as well as the Robert Koch Institute, Germany's national center for health research. EpiBerlin is evenly funded by the state of Berlin, through the Senatsverwaltung für Wissenschaft, Forschung und Kultur (Senate Administration for Science, Research, and Culture), and the Bund-L?nder-Kommission (Commission of the Federation and States). The development of a databank of the epidemiological databases in the region of Berlin (EpiDB) aims to show the variety of epidemiological work in the area. The aim of EpiDB is to provide transparency and an overview of existing and current research in Berlin, which may also benefit external users. Cooperation, networking, and division of labor for joint venture research may be promoted, also beyond the region of Berlin.     

Vergleich zwischen wärmeabgabe und wärmezufuhr über die lunge und körperoberfläche bei der hypothermie bzw. bei deren behandlung

Zusammenfassung Seit 6 Jahren wird in Kanada, England und Amerika die Behandlung hypothermer Patienten mittels der sogenannten Central-Body-Rewarming-Methode (CBRW), d. h. mittels der Inhalation erwärmter und befeuchteter Luft oder Sauerstoff, durchgefiihrt. Da these neue Methode derherkömmlichen Wannenbehandlung in manchen Aspekten überlegen zu sein scheint, wurden beide in der vorliegenden Arbeit miteinander verglichen. Die Wärmeaufnahme über die Lunge wird größer, wenn die eingeatmete Luft (max. 45°C) wasserdampfgesättigt ist. Diese Wärme geht vollständig an das thorakale Blut über und weiter zum Herz and zum Gehirn. Dort werden Atem- und Kreislaufzentrum rasch stimuliert. Bei der Wannentherapie steigt die Rektaltemperatur schneller, jedoch die Ösophagus- und die Trommelfelltemperatur und somit die Gehirntemperatur langsamer als bei der CBRW. Der gefährliche after-drop tritt bei der CBRW nicht auf (Lloyd 1973), und die Gefahr eines Wiedererwärmungskollapses ist nicht gegeben. Assistierte Beatmung bei der CBRW führt zu einem schnelleren Anstieg der kritischen Kerntemperatur.     

Infertilität bei Männern

Although male reproductive functions are impaired in about half of the infertile couples seeking offspring, even today the examination and treatment of the male partner continues to be neglected. Despite the lack of evidence for a “sperm crisis”, so highly touted in the press, the public remains worried, while the fact that male fertility declines beyond the age of 40 years and is accompanied by increasing genetic risks for the offspring goes largely unnoticed. In addition to a thorough physical examination supplemented by imaging techniques such as ultrasonography of the scrotal organs, semen analysis according to WHO guidelines, hormone determinations, and cyto- and molecular genetic analyses form part of the routine investigation of the infertile male. Few disorders have become subjects of rational treatment, such as hypogonadotropic hypogonadism with gonadotropins or GnRH, treatment of sexually transmitted diseases by antibiotics, and microsurgical reconstruction of blocked seminal ducts. Early treatment of maldescended testes in boys or changing lifestyle (e.g., discontinuation of smoking) are important preventive measures. In the age of evidence-based medicine, most empirical treatments have been demonstrated to be ineffective. Thus, pregnancy rates from patients with varicocele who underwent long-practiced surgical or radiologic interventional therapy were not different from those of patients receiving counseling. At present, in cases of non-obstructive azoospermia or severe oligoasthenoteratozoospermia, intracytoplasmic sperm injection (ICSI) using single sperm derived from semen or extracted from testicular biopsy tissue (TESE) represents the most successful treatment modality, although it remains symptomatic and not curative.     

Aufwachsen unter familiärer Belastung in Deutschland

Family adversity comprises many risk factors for parents and children. The German early intervention approach Frühe Hilfen aims at providing enduring, effective, and scientifically validated prevention and intervention for effective child protection against those risks. The study on risk and protective mechanisms in the development of families with diverse psychosocial risks aims at identifying those mechanisms that cause and stabilize or moderate and diminish maltreatment and neglect, as well as cognitive, social, and emotional developmental deviations in risk families, specifically in the current German social and child protection system. The study examines the development of competence and early behavior problems in a sample of infants and toddlers and the interaction quality with their caregivers by applying a longitudinal sequential-cohort design. The assessments include developmental tests, systematic observations, and questionnaire data. First results suggest stable risk group membership and moderate stability of single risk factors.     

Präsentismus bei Medizinstudierenden

Background

Presenteeism is defined as the behaviour of attending work while being sick, a behaviour that appears to be especially common amongst doctors. Medical socialisation is already apparent during medical school. However, whether medical students also show above-average presenteeism has not been specifically investigated.

Objective

We aimed to provide a more detailed of presenteeism in medical school: Is presenteeism more common amongst medical students when compared to students of other subjects? Does the prevalence of presenteeism change over the course of medical studies? Is presenteeism associated with health-related outcomes and behaviour?

Materials and methods

We collected data on the prevalence of presenteeism in students, as well as on their general physical and mental health and study-related behaviour and experiences, at three different time points at one German university. We compared the prevalence of presenteeism between medical students and students of other subjects and investigated factors associated with presenteeism in medical students using logistic regression analysis.

Results

We found no differences in the prevalence of presenteeism between medical students and students of other subjects at the different survey time points. However, we did find that presenteeism was more prevalent amongst female students when compared to their male counterparts. A tendency to overcommit was consistently proven to be a predictor of presenteeism.

Conclusions

Medical students do not seem to attend classes while sick more frequently than the average student. However, the share of female students, who, as a group, show presenteeism more often, continues to increase. The reasons for presenteeism might change over the course of study and should be pursued in future studies.

     

Inanspruchnahme famili?rer Ressourcen bei sp?terem Pflegebedarf

The family is an important resource in elderly care. It is of great interest if persons who might be in need of care in the future would use this resource. Our study assessed wishes and expectations regarding family care in a representative sample of the general population (≥?45 years, N?=?1,445) using questionnaires. Logistic regressions were performed to analyze the potential impact on the willingness to use or provide family care. One quarter of the participants reported experience in family care. In case of own need 62.9% of participants would prefer care provided by relatives and 56.7% would prefer professional care. Participants are more likely to use family care if they report having relatives, are experienced in care of relatives or do not associate old age with being a burden, e.g. report low values in the image of age "being a burden/demanding". Perceived willingness of the relatives to provide care is more likely if there is little regional distance to the relatives, in male participants and if participants talked about future care with their relatives. Besides structural factors, negative images of old age might have a negative influence on the willingness to use family care. Talking about care in old age seems to have a positive impact.     

Epidemiologische Entwicklung bei ausgewählten sexuell übertragbaren Infektionen (STI) in Deutschland

The number of people living with HIV infection has been increasing since the mid 1990s and is expected to rise further in the coming years. The HIV epidemic in Germany is still most affected by developments in the group of men who have sex with men (MSM). In this group, the number of newly diagnosed HIV infections has increased in recent years especially in large cities. Despite increased efforts to motivate HIV-infected people, who were not previously diagnosed, to be tested as early as possible and to seek medical treatment, the number of undiagnosed HIV-infected persons has increased. There are more people infected with HIV than those who have been tested positive for HIV and subsequently receive antiretroviral treatment. However, early testing and treatment alone are not sufficient to effectively contain the infection. Increased efforts are required to more effectively prevent new HIV infections by combining all the available options. In Germany as in all other developed countries, a stronger increase in the number of syphilis infections among MSM is reported, which is primarily due to a higher willingness to risk unprotected contacts, whereby the risk of HIV infection is also increased. The public prevention messages available for HIV are only partially effective against syphilis. More frequent examinations and optimized therapy management are necessary in addition to the use of condoms to prevent the spread of syphilis, gonorrhea, and Chlamydia trachomatis. Sustainable containment of new HIV infections must, therefore, be accompanied by both containment of sexually transmitted infections (STI) and use of public prevention messages for HIV/STI.     

Ernährungstherapie bei Nahrungsmittelallergien

A therapeutic diet is only indicated if the diagnosis of food allergy is certain. In the case of an unproven suspicion everything should be done to confirm or disprove the diagnosis by diagnostic measures (patient history, diet history, food and symptom protocol etc.). In the case of proven food allergy there are different aims of nutritional therapy. Most importantly the patient should learn how to identify his eliciting agent in pre-packed and non-prepacked food and how to avoid it. The elimination diet should take into account the individual condition of the patient. In particular, if basic foods have to be eliminated from the diet, safe alternatives have to be determined to maintain a nutritionally balanced diet and to maintain a high quality of life. To ensure the nutritional adequacy of the diet, micro- and macronutrient intake should be analysed and improved, if necessary. For pollen-associated food allergy and certain chronic conditions it might be necessary to be aware of possible triggering factors as well as potential cross-reactions. Moreover, individual tolerance should be maintained during elimination diets and not jeopardized by voluntary and unnecessary self-denial of certain foods.     

HIV-Prävention bei Drogenkonsumenten

Efficient prevention of HIV in drug users has had to overcome major political opposition in the last decade. Even today many evidence-based measures for the prevention of infections in drug users are still not being applied. Only a few preventive approaches are broadly carried out in the GFR: methadone maintenance performed by general practitioners, antiretroviral therapy and information about safer use given by AIDS- and drug-consultants and syringeexchange by pharmacies and at special institutions. In contrast, injection room facilities, street workers council, vaccination programs and low threshold medical treatment are only implemented in isolated cases. Nevertheless, HIV prevalence among drug users has been reduced successfully and the rate of new infections has decreased from 13.2% in 1994 to 9% in 2006. These strategies, however, do not seem to have any effect on the spread of hepatitis C among drug users. Here we still face a prevalence of 45-70%. Therefore, future research should focus on preventive measures against HCV infection of drug users.     

Infertilität bei Frauen

Background

The incidence of female infertility has not changed since the early 1990s. Based on new data from basic research on infertility, novel options in the diagnostics and treatment of infertility have emerged, besides in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).

Aim

This review summarizes the current knowledge on female infertility and on modern concepts in diagnostics and treatment.

Methods

A literature research on the causes of infertility and on treatment options was performed, including demographic factors, infectiology, anatomy, endocrinology and metabolism, endometriosis, lifestyle and environmental factors, and psychological factors.

Results

Chlamydial infection is still the major cause of tubal infertility. Improvement of the patient’s fertility by correction of endocrine and metabolic disorders, in particular thyroid dysfunction and glucose metabolism, as well as fertility surgery are of main interest.

Conclusions

Besides assisted reproductive techniques, concepts to optimize individual fertility have gained increasing importance.