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PubMed1994

[Asylum and immigration in Germany].

"Germany, which used to be one of the most tolerant countries in matters concerning asylum, has, since the eighties, been confronted by very large migratory flows. Immigration to [West Germany] consisted every year of hundreds of thousands of asylum-seekers, a similar number of...Germans from Russia, Kazakhstan, Romania and Poland, as well as a large number of East Germans. On May 26th 1993, the Bundestag adopted a new law making asylum and immigration to Germany increasingly difficult. The problem of immigration has not been resolved, however, as is shown by the situation in the East European countries, Germany's neighbours, who are suffering the consequences of the new asylum policy...." (SUMMARY IN ENG)

Demography↗

PubMed2003

Isoniazid resistance among tuberculosis patients by birth cohort in Germany.

SETTING: Germany, 1997-2000. OBJECTIVE: To determine the prevalence of isoniazid resistance by year of birth among previously treated and untreated tuberculosis patients by country of birth. DESIGN: Univariate and multivariate analyses of data on 8658 cases from a nationally representative sample. RESULTS: The crude prevalence of isoniazid resistance was 2.4% and 9.9% among Germany-born patients respectively without and with a prior treatment history. Among those without a history, there was virtually no difference between quartiles of birth cohorts, while among those with, a large decrease from the oldest to the youngest was observed. Among foreign-born patients, the prevalence of isoniazid resistance increased from 3.8% to 11.8% from the oldest to the youngest among those without, and more than doubled from less than 20% to more than 40% among those with prior treatment. CONCLUSION: This analysis suggests a remarkably constant and low prevalence of isoniazid resistance among never treated Germany-born patients. In contrast, among the diverse group of foreign-born patients, the prevalence increases appreciably from the oldest to the youngest birth cohorts. This indicates that tuberculosis treatment policies in Germany have been sound and that great care is needed to prevent acquisition of additional resistance among foreign-born patients.

Adolescent↗

PubMed2004

Behçet's disease in patients of German and Turkish origin living in Germany: a comparative analysis.

OBJECTIVE: To evaluate the relationship between ethnic origin and manifestations of Behçet's disease (BD) in patients of German and Turkish origin living in Germany. METHODS: Between 1995 and 2000, 32 patients of German and 33 patients of Turkish origin living in Germany were evaluated for the entire spectrum of disease manifestations, disease severity, HLA associations, sex, age at disease manifestation, and time to diagnosis. RESULTS: There were no statistically significant differences between German and Turkish patients. There was no association of sex or HLA-B51 with any manifestation of BD. The only significant difference between the 2 groups was the median time from the first manifestation of the disease to diagnosis, which was 0 years for the Turkish, but 3.5 years for the German patients (p = 0.0005). Additionally, 4 patients of German origin had been misdiagnosed as having spondyloarthropathy (SpA) before the final diagnosis of BD was made (12%). In comparison to Turkish patients living in Turkey (data from the literature), only 2 differences were found: one concerned the frequency of ocular involvement (lower in the patients in Turkey), and the other the male to female ratio, which was reported as 1.03:1 in Turkey, but 3.7:1 in Germany. CONCLUSION: Our results do not favor an ethnic influence on the expression of BD. Environmental influences may be responsible for the higher frequency of ocular manifestations and the higher male to female ratio in patients living in Germany compared to those living in Turkey.

Adolescent↗

PubMed1992

[A drug evaluation and classification program in the USA--also a model for Germany].

The question of recognition and possibilities of proof regarding impairment by narcotics and drugs is gaining significance also in Germany. Therefore, it is necessary to deal more closely with the United States "Drug Evaluation and Classification Program" and consider its application in Germany as well. The American program is based on standardized education of drug recognition expert trainees and well-tested methods of examination. The results are convincing. The expert reports prepared by the examiners and the chemical-toxicological results correlate in 80 to 97% of the cases. As long as no definite findings regarding dose/concentration effect relationships exist, the classification of behavior, appearance and medical examination plays a significant role. To a great extent, the program makes allowance for the existing possibilities in Germany as well. The authors of this article would consider it to be wrong if, in Germany extensive, time-consuming field studies were undertaken to obtain further knowledge prior to introduction of such a program. On the other hand, despite the existing difficulties, it should be endeavored to find dose/concentration effects.

Alcoholic Intoxication↗

PubMed2004

The Beijing genotype is emerging among multidrug-resistant Mycobacterium tuberculosis strains from Germany.

SETTING: Germany, 1995 to 2001. OBJECTIVE: To determine the genetic relationship of 451 multidrug-resistant (MDR) Mycobacterium tuberculosis strains from Germany and to identify strains of the Beijing genotype. DESIGN: All strains were analysed using IS6110 fingerprinting and a cluster analysis was performed. Clustering of isolates was used as a measure for recent transmission. RESULTS: Two hundred and fourteen of 433 strains (49.4%) with more than four IS6110 copies formed 46 fingerprint clusters comprising two to 32 patients. Transmission links based on classical epidemiological data could be established for 39 cases (18.2%) and in 14 clusters (30.4%), and included three cases of exogenous reinfection with MDR strains. One hundred and seventy-five strains (38.8%) were of the Beijing genotype with an increasing annual proportion from 19.2% in 1995 to 58.3% in 2001. About 70% of these patients had an indication of foreign birth, mainly the former Soviet Union. CONCLUSION: Transmission of MDR strains seems to be contributing to the spread of MDR-TB in Germany, and exogenous reinfection with MDR strains must be considered as a possible cause of treatment failure. A high proportion of these MDR strains is probably carried over from the former Soviet Union, and strains of the Beijing genotype represent an increasing cause of MDR-TB in Germany.

Adolescent↗

PubMed2003

Caries prevalence in an adult population: results of the Study of Health in Pomerania, Germany (SHIP).

PURPOSE: The aim of this study was to assess the caries prevalence in the adult population of Pomerania, Germany in comparison to national and international data. MATERIALS AND METHODS: The study sample comprised 4,022 randomly selected subjects who were examined from October 1997 to May 2001 within the "Study of Health in Pomerania" (medical and dental, population-based cross-sectional study in Pomerania, Northeast Germany. Response rate: 69%. Age range of subjects: 25-79 yrs). Carious defects, fillings and missing teeth were diagnosed and the DMFT/S scores were calculated according to WHO guidelines (1997). These figures were compared to other German, Swedish and US data. RESULTS: Women exhibited higher mean DMFT and DMFS values in all age groups than men. The mean DMFT/S scores were slightly higher than the values for the only two available nationally representative age groups in Germany. The prevalence of primary carious lesions or secondary caries was very low, resulting in minor treatment needs (decayed surfaces: mean 0.95 +/- 3.3) and high care indices (FS/DFS) for all age groups (90-95%). In contrast to this, the mean numbers of fillings in adults and especially of missing teeth in seniors were much higher in Pomerania for all age groups than in the Swedish and US adult population, where a caries decline was demonstrated. CONCLUSION: In spite of a very low prevalence of primary carious lesions and secondary caries, the mean number DMFT/S and especially MT/S scores in the Pomeranian adult population are high in comparison with Swedish and US data, but differed only slightly from the limited available national data for Germany.

Adult↗

PubMed2005

Greywater recycling systems in Germany--results, experiences and guidelines.

Although Germany is not considered a water-poor country, there exist regional differences in water supply and consumption. During the past 15 years, the greywater aspect has been dealt with in Germany with a greater interest and variable success. In addition to an increased environmental awareness, water costs also play an important role in increasing the demand for advanced greywater treatment plants nstalled in buildings. Under favourable conditions, the amortisation costs usually lie between 5 and 7 years. Systems that have been extensively tried and tested and have been shown to be most reliable are those employing an advanced biological treatment followed by an UV disinfection. Systems based on membrane technology are being developed and researched intensively in Germany for municipal wastewater treatment. However, so far they play no role in greywater recycling. Greywater systems operating under low energy and maintenance requirements without the use of chemicals are mostly favoured. In Germany, greywater recycling systems should be registered at the Health Office in order to guarantee that no cross-connections exist with the drinking water network and that pipes are labelled according to regulations. The hygienic requirements for recycled greywater, which is primarily used for toilet flushing, are oriented towards the EU-Guidelines for Bathing Waters. The use of recycled greywater for irrigation purposes is minor. As to the use of recycled water for laundry, the first promising investigation results are now available.

Conservation of Natural Resources↗

PubMed2005

A population survey of sexual activity, sexual dysfunction and associated help-seeking behavior in middle-aged and older adults in Germany.

The Global Study of Sexual Attitudes and Behaviors was a survey of 27,500 men and women aged 40 to 80 years in 29 countries. Here we report the sexual activity, the prevalence of sexual problems and related help-seeking behaviour among subjects in Germany. A telephone survey was conducted in 2001 and 2002, using a standardised questionnaire covering demographics, general health, relationships, and sexual behaviours, attitudes and beliefs. A total of 1,500 individuals in Germany (750 men and 750 women) completed the survey. Eighty-six percent of men and 66% of women had engaged in sexual intercourse during the year preceding the interview. The most common male sexual problems were early ejaculation (15%), a lack of sexual interest, erectile dysfunction and non-pleasurable sex (each 8%). The most common female sexual problems were a lack of sexual interest (18%), non-pleasurable sex (14%) and lubrication difficulties (13%). Most sexual problems were less common among men and women in Germany than in other European regions. Increasing age was a significant predictor of a lack of sexual interest and erectile difficulties in men. Only 18% of men and 15% of women had talked to a doctor about their sexual problem(s). In conclusion, many middle-aged and older German adults reported continued sexual interest and activity. Overall, sexual problems were less prevalent in Germany compared with other European regions. Of those who experienced sexual problems, however, few had sought medical help. This was often due to a lack of perception of a problem.

Adult↗

PubMed2005

[Acupuncture and moxibustion in Germany].

Although Germany is an important cradle of Western medicine, traditional Chinese acupuncture and moxibustion are widely accepted and have been developed hardly in Germany for several centuries. This paper reviews the development courses of acupuncture and moxibustion in Germany, and gives an introduction to the level of acupuncture and moxibustion science, acupuncture in medical insurance, acupuncture research, acupuncture clinics, acupuncture organizations, acupuncture journals and trend of acupuncture development in Germany.

Acupuncture↗

PubMedDate not supplied

[Investigation of the prevalence of summer eczema in Icelandic horses in northern Germany].

An epidemiological study on summer eczema (SE) was performed in 490 Icelandic horses from 24 stud farms located in Lower Saxony and Westphalia. The study revealed a prevalence of summer eczema of 29.8 %. Horses imported from Iceland were affected with a frequency of 71.9 %, whereas horses born in Germany and other countries had a prevalence of 15.6 % and 27.3 %. Mares (33.1 %) and geldings (29.1 %) were more often affected by summer eczema than stallions with 15.5 %. The most common sites of summer eczema were mane and tail. Five to eight years old horses were more severely affected by SE than younger or older horses. Piebald horses showed higher degrees of SE than grey horses. The high prevalence of SE in Icelandic horses kept in Germany was due to imported horses from Iceland particularly horses imported at an age of seven to 15 years were at an extremely high risk to SE (96.4 %). The prevalence of SE significantly increased with higher age. Chestnut and grey horses born in Germany were prone to a lower risk to SE than bay, black or piebald horses. In horses imported from Iceland, a higher inbreeding coefficient was significantly related to a lower prevalence of SE. The most efficient measure recommended for reduction of SE in Germany would be to abandon imports of Icelandic horse from Iceland.

Age Factors↗

PubMed2005

[Jewish veterinarians in Germany, 1918-1945].

In 1998 there were only twelve Jewish veterinarians known who practised in Germany between 1918 and 1945. 133 of them have now been found. Most of the Jewish veterinarians had their roots in merchant families and were general practitioners in the countryside. To be "Jewish" did not concern until 1933. Compared with the other medical professionals like human medical professionals (10,9 %), in 1933 the number of Jewish veterinarians was low (1,6 %, whole German Jewish population 0,77 %). Right with the beginning of the National Socialistic rule Jewish veterinarians were exposed to different forms of harassment. Soon after, on April 7th 1933, with the so-called Gesetz zur Wiederherstellung des Berufsbeamtentums (BBG; law for the restoration of civil service), the prosecution took on an official quality. The Reichstierärztekammer (Chamber of veterinary service) was very eager to Aryanize the German veterinary service. The BBG made the Jewish veterinarians who worked in public positions lose their jobs with the single exception of those who had the status of a so-called "Frontkämpfer" (a soldier who fought at the frontline during World War I). Many of the Jewish veterinarians who were still in Germany in November 1938 were arrested after the pogrom of November 9/10th and kept in concentration camps and prisons for about one month. The few students of veterinary medicine who already had started their studies in 1933 still could make their exams in Germany, but they did not get a licence. On January 31st 1939 all Jewish veterinarians in Germany lost their licence. 55 Jewish vets managed to emigrate in time. Nineteen German Jewish Veterinarians died in concentration camps and ghettos. Two are known to have committed suicide. Until 1997, there was no act of appreciation or rehabilitation of German Jewish veterinarians. In 2003 the degrees of two Jewish veterinarians, Hermann Cussel and Paul Stern, were renewed posthumously by the Hanover School of Veterinary Medicine, while the President of the school also apologized for any injustice which was done by the school during the time of National Socialism.

Animals↗

PubMedDate not supplied

[Dermacentor reticulatus (Fabricius, 1794)--distribution, biology and vector for Babesia canis in Germany].

This work deals with occurrence, distribution as well as biology and vectorial capacity of the ornate dog tick (Dermacentor (D.) reticulatus). Until 30 years ago this tick has only been described in a few natural foci in southern Germany. Its distribution has however expanded in the course of the last years. With the exception of northern Germany it is now covering large areas of Germany. This is particularly the case in the Upper Rhine Valley, Saarland and the Mark Brandenburg. However, it is endemic in many other areas of Germany as well. The transformation of agricultural land into fallow land, an increase in host reservoirs and climatic changes are discussed as main contributors to this change. Little is known about the role of this species as a vector for virus, rickettsia, bacteria and protozoa as well as its medical and veterinary importance. D. reticulatus is a vector for Babesia canis canis. It is reported here about a case of autochthonous babesiosis in a dog from Berlin/Brandenburg.

Animals↗

PubMed2006

Lymphogranuloma venereum emerging in men who have sex with men in Germany.

A resurgence of lymphogranuloma venereum (LGV) has been observed in several European countries. LGV is not a mandatorily notifiable disease in Germany. Reports of LGV cases have actively been collected by the Robert Koch-Institut since 2004 to describe the outbreak and estimate the extent of the LGV problem in Germany. Updates on the LGV outbreak were published in the German national epidemiological bulletin. Physicians were asked to send their samples to a laboratory for genotyping. A possible case was defined as a person with symptoms of proctitis and/or inguinal lymph node swelling and a positive chlamydia serology. A probable case had in addition a positive chlamydia rectal or urinary PCR test. A case was confirmed if the genotype L1-L3 was identified based on sequence analysis of omp1 gene sequences. Since 2003, LGV has been reported in 78 male patients in Germany. Of these, 61 patients were confirmed as genotype L2. Fifty eight out of 78 patients (74%) are known to be men who have sex with men (MSM). Fifty five patients (71%) had rectal symptoms and 49 (63%) knew they were HIV positive. Sixty two (79%) of the patients were residents of Berlin or Hamburg. LGV has emerged in MSM in Germany at the same time as in other European countries. It is thought that LGV may become endemic in the MSM community in German metropolitan areas, because the number of reported patients with LGV continues to increase. The increase in the number of LGV cases and the high HIV prevalence in LGV patients are of great public health concern. Clinicians and MSM may not be sufficiently aware of the disease, and existing efforts to promote awareness and prevention of sexually transmitted infections and HIV need to be strengthened.

Disease Outbreaks↗

PubMed2006

[Awards to Hajime Hoshi dedicated from Germany].

In the Hajime Hoshi Memorial Exhibit Hall of Hoshi University, many awards dedicated to H. Hoshi from Germany are displayed. Hoshi made a donation amounting to about 20 millions dollars to the distressed chemistry science community of Germany just after the 1st World War. The Hoshi fund gave the scientific society hope to recover, and deeply impressed and delighted the German people. The awards to Hoshi dedicated from Germany strongly reflect the hot spirit of Japan-Germany cultural exchange. The present study investigates the details of the awards.

Awards and Prizes↗

PubMed1981

[Microsurgery: organization and indication in the Federal Republic of Germany].

Since 1960's the new technique of microsurgery of the nerves was introduced in Germany at Departments of Plastic Surgery, Handsurgery and Neurosurgery. Since 1974 the technique of microvascular surgery was used in different places. In March 1975 the first free flap transfer was performed at our clinic in Munich. In the same year 24 h reimplantation services were established in Hamburg and Munich. In connection with training of other colleagues and information of the population we could perform up to 31 march 1980 703 replantations at the hand with a survival rate of 78.5%. Through education by annual instructional courses and fellowships at our clinic further replantation services were established in Germany. A general request showed that up to the middle of 1979 2742 micro- and 381 macro-replantations were performed in Germany. The places where replantations are done should be classified in 1. replantation centres (at present 9 in FRG), 2. replantation services (at present 4 in FRG), 3. places with microvascular experiences (at further 4 places in FRG). The training program for a member of a replantation team should include: 1. general surgery, traumatology, 2. plastic surgery, 3. hand surgery, 4. microsurgery. Beside the replantation also the clinical application of free tissue transplantation is increasingly used at our clinic and other places in Germany.

Adult↗

PubMedDate not supplied

[Return to Germany--personal motive and markers of the subjective life space of Jewish emigrants].

120 Jewish people who were forced to emigrate from Germany to Israel or Argentinia during the "Third Reich" were interviewed. Interviews dealt with the psychic situation; additionally, scales were applied for measurement of morale, attitudes towards the present situation and the future, and perceived changeability of the situation. The group of emigrants was divided into two subgroups: Emigrants who stayed in foreign countries, and emigrants who returned to Germany in old age. The emigrants were compared with a control-group of german people who were not discriminated against and persecuted, and who were not forced to emigrate. Significant differences between the two groups were found: The emigrants showed a higher degree of perceived changeability and a more positive life-review. Perceived stress and activity in different intra- and extrafamilial roles were higher. Emigrants who had gone back to Germany showed a higher degree of perceived changeability and a lower degree of sorrow concerning personal future than emigrants who stayed in Israel or Argentinia. Perceived stress in extrafamilial roles was higher. Additionally, motives for going back to Germany and for staying in Israel or Argentinia were analyzed.

Acculturation↗

PubMed1996

[Psychiatric diseases and their treatment in general practice in Germany. Results of a World Health Organization (WHO) study].

As part of an international study initiated by the World Health Organization (WHO) about psychological disorders in primary health care, patients in the Federal Republic of Germany were compared with patients in other European centres. Patients from Germany do not differ from other European patients in respect to sociodemographic variables or psychiatric disorders. The most frequent CIDI-based diagnoses recorded in patients attending general practices are current depressive episodes (8.6%), generalized anxiety disorders (8.5%), neurasthenia (7.5%), and alcohol dependence (6.3%). In 20.9% of the patients at least one psychiatric diagnosis based on ICD-10 was recorded. In Germany significantly lower global ratings of health status are given than in other European centres although there is no difference in diagnostic prevalence rates. The recognition rate, i.e. the agreement between the CIDI-based ICD-10 diagnoses and the recognition as a case by the physician, is 56.2%-60.2%. On the other hand, the CIDI detects 90% of the patients described as psychologically ill by the physicians if subthreshold cases are also counted, or 46.4% if only defined diagnoses are taken into account. There is a significant correlation between severity of the psychiatric disorder and disability in social functioning. In Mainz and in the other European countries the disability rate of patients with a well-defined disorder is between 67.0% and 72.7%, whereas in Berlin this relation is not as clear, because especially in East Berlin there is a higher rate of unemployment in view of the political situation. Drug treatment is prescribed for 16.1% of the patients in primary care for psychiatric disorders. Half the patients recognized by physicians as cases receive medication. In the rest of Europe patients receive significantly more tranquillizers than in Germany, where the use of herbal drugs is more wide spread.

Adult↗

PubMed1997

[Nutritional iodine supply in Germany. Results of preventive measures].

Germany is an iodine deficiency area with endemic goitre. The prophylactic procedures which have been initiated gradually since 1983, were different between the eastern and western part of Germany. In East Germany iodine supply could be improved by "mandatory prophylaxis" until 1989. However, after the reunification of Germany and the adaption of the "voluntary principle", the iodine intake decreased again. In December 1993, new regulations concerning iodized salt became effective (so called "2nd decree") combined with a relaxation of the declaration of duty. This relaxation considerably contributed to the significant increase in iodized salt utilisation in food production. The rise of iodine content of food and breast milk, the higher iodine intake with food, the decrease of fetal thyroid volume and the increase in renal iodine excretion are clear indicators of a better iodine supply. However, the desired target figures have not been obtained yet.

Germany↗