Prevalences of mental distress and its associated factors in unaccompanied refugee minors in Germany.

Prevalences for mental disorders within minor refugees are comparatively high and heterogeneous. To reduce heterogeneity and identify high-risk subgroups, we compared unaccompanied refugee minors (URM) to accompanied refugee minors (ARM) regarding depressive symptoms and mental distress. Furthermore, we examined associative factors of mental distress in URM on a broad scale. We conducted a survey with a cross-sectional design in four German University hospitals. The sample consisted of n = 172 URM and n = 52 ARM aged 14-21. Depressive symptoms were assessed via the Patient Health Questionnaire (PHQ-9). Mental distress was assessed by the Refugee Health Screener (RHS-15). Mann-Whitney test was used to examine differences between URM and ARM. Associated factors of mental distress were evaluated via a stepwise multiple regression analysis. URM showed significantly higher mean scores for PHQ-9 (p < .001) and RHS-15 (p < .001) compared to ARM indicating medium effect sizes. Furthermore, URM were significantly more likely to surpass the cut-off for depression (61.6% vs. 30.8%) and overall mental distress (81.4% vs. 53.8%) compared to ARM. The factors Number of stressful life events (SLE), Female gender, and Fear of deportation were found to be associated with an increased mental distress in URM, whereas Weekly contact to a family member, School attendance, and German language skills were accompanied with lower distress scores. All six factors accounted for 32% of the variance of mental distress in URM (p < .001). Within minor refugees, URM are a highly vulnerable subgroup, which should receive particular attention and more targeted measures by health authorities. Our results indicate that these measures should comprise a rapid promotion of family contact, school attendance, language acquisition, and the fast processing of asylum applications. However, the cross-sectional design limits the interpretability of the results.

Increasing sample diversity in psychiatric genetics - Introducing a new cohort of patients with schizophrenia and controls from Vietnam - Results from a pilot study.

OBJECTIVES: Genome-Wide Association Studies (GWAS) of Schizophrenia (SCZ) have provided new biological insights; however, most cohorts are of European ancestry. As a result, derived polygenic risk scores (PRS) show decreased predictive power when applied to populations of different ancestries. We aimed to assess the feasibility of a large-scale data collection in Hanoi, Vietnam, contribute to international efforts to diversify ancestry in SCZ genetic research and examine the transferability of SCZ-PRS to individuals of Vietnamese Kinh ancestry. METHODS: In a pilot study, 368 individuals (including 190 SCZ cases) were recruited at the Hanoi Medical University's associated psychiatric hospitals and outpatient facilities. Data collection included sociodemographic data, baseline clinical data, clinical interviews assessing symptom severity and genome-wide SNP genotyping. SCZ-PRS were generated using different training data sets: (i) European, (ii) East-Asian and (iii) trans-ancestry GWAS summary statistics from the latest SCZ GWAS meta-analysis. RESULTS: SCZ-PRS significantly predicted case status in Vietnamese individuals using mixed-ancestry (R2 liability = 4.9%, p = 6.83 × 10-8), East-Asian (R2 liability = 4.5%, p = 2.73 × 10-7) and European (R2 liability = 3.8%, p = 1.79 × 10-6) discovery samples. DISCUSSION: Our results corroborate previous findings of reduced PRS predictive power across populations, highlighting the importance of ancestral diversity in GWA studies.

Activities of an Environmental Analysis Van in the German Federal State Schleswig-Holstein.

A cooperation was started between the Union of Physicians of Schleswig-Holstein (Bad Segeberg, Germany) and an environmental engineer in 1992. A mobile unit for environmental analysis was set up, the Environmental analysis Van (EAV) or mobile umweltambulanz. Inspection of sites and collection of air and dust/material samples for analysis of xenobiotics were performed on request. The results of this cooperation were evaluated to show which sources of indoor pollutants could be particularly relevant to human health impairment. During a 30-month period form July 1993 to December 1995, 1793 site inspections wer conducted. Xenobiotic analysis and subsequent advising was performed in 1318 cases; enhanced concentrations of one or more toxic substances (mainly biocides such a pentachlorophenol, permethrin, and/or hexachlorocyclohexane) were found in 71% of the sites analyzed. Formaldehyde, volatile organic compounds, and contamination by molds were also documented. A follow-up was done on 80 clients of the Environmental Analysis Van, which had detected elevated concentrations of permethrin because of pyrethroid-treated carpeting. The effect of removing all contaminated carpeting on health improvement in comparison with nonremoval was statistically significant (p<0.0001). Pyrethroid-treated carpeting, which was already 5, 7 and 10 years old, revealed permethrin concentrations of 115, 100, and 150 mg/kg dust. This result indicates that indoor contamination of permethrin is highly persistent and may be the cause of adverse health effects.

Amoxicillin/clavulanic acid vs cefetamet pivoxil in the treatment of acute exacerbation of chronic bronchitis (AECB) in adults.

In this open comparative and prospective study 180 adults of either sex were randomised to treatment with either amoxicillin/clavulanic acid (AMC) 500/125mg tid or cefetamet pivoxil (CAT) 500mg bid for 7 days. Demographic data and assessable findings were similar in both groups. Clinical outcomes of 169 assessable patients showed high efficacy of both drugs: 92% with AMC and 96% with CAT. Bacteriological response rates were equivalent in 141 evaluable cases: 84% vs. 89%, respectively. Baseline susceptibility testing (DIN) revealed a notable number of Haemophilus species either intermediately susceptible or resistant to AMC. Gastrointestinal disorders predominated among the adverse events with diarrhea occurring nearly twice as often in the AMC group. CAT is an effective and safe alternative option in the treatment of AECB in adults. The advantage of CAT is its enhanced activity against gram-negative bacteria. It is well tolerated.

[The value of tumor markers CA 15-3 and CEA in breast cancer]. / Zur Wertigkeit der Tumormarker CA 15-3 und CEA beim Mammakarzinom.

Tumor marker serum levels of 580 patients in different stages of breast cancer were examined in a retrospective analysis. Patients with nonmetastatic breast cancer showed a preoperatively elevated CA 15-3 in 16% and an elevation of CEA in 12%. In case of local recurrence in 24% CA 15-3- and in 9% CEA-levels were positive. The sensitivity of both markers increased in stage of distant metastasis (58%/48%). CA 15-3 was significantly more sensitive than CEA in case of visceral metastatic spread (56%/34%).

[Effects of renovation measures on the health status of persons, exposed to pyrethroids through carpets and flooring]. / Auswirkungen von Sanierungs-massnahmen auf den Gesundheitszustand von Personen, die über Teppiche bzw. Auslegeware gegenüber Pyrethroiden exponiert waren.

80 clients of a mobile unit for environmental quality testing were contacted after monitoring for potential toxic substances in their homes or places of work. Elevated concentrations of pyrethroids (in all cases at least permethrin) were found in these 80 cases in dust or materials, mainly because of pyrethroid treated carpetings. The clients were questioned whether they removed one or all of the contaminated carpets. Furthermore, they were questioned as to their state of health and the period of time which had passed since the carpets were removed. 75 of the 80 contacted clients had initially called the mobile unit for environmental quality testing because of health impairments, whereas 5 clients had done this only for preventive reasons. 47 (59%) of the contacted clients had removed all carpetings which were contaminated with permethrin. 8 (10%) clients had got rid of a part of the contaminated carpets and 25 (31%) clients did not remove any carpet. 39 (83%) of the clients who had removed all contaminated carpetings, described a complete or at least partial improvement of their complaints. The complaints of 6 (13%) clients did not improve despite removal of their carpets. The lowest concentration of permethrin that was assessed at the homes of clients, who, after removing all contaminated carpet floorings, described complete recovery, were 10-15 mg/kg dust and 15 mg/kg carpet, respectively. The effect of removing all contaminated carpetings on health improvement in comparison with the results of not removing any carpet was statistically significant (test: chi 2, p < 0.0001). The corrected contingency coefficient amounted to 0.71. In 3 cases, where the contaminated carpets had already existed for 5, 7 and 10 years in the homes of clients, there were still permethrin-concentrations of 115, 100 and 150 mg per kg dust. This result indicates that indoor contamination of permethrin is highly persistent.