Writing autohistoria-teoría: agency and illness in German life narratives by Evelyne Leandro and Mely Kiyak.

Health concerns by migrants have been neglected in the German healthcare system, and they are impacted by discriminating discourses of othering. By analysing two autobiographical illness narratives by immigrants in contemporary Germany, this article exposes limitations in existing discourses of migration health and argues for more relational and affirmative theories of illness and care. Evelyn Leandro's diary The Living Death: The Struggle with a Long-Forgotten Illness (2017) describes her own drawn-out therapy against leprosy as a Brazilian in Berlin. In Mr Kiyak Thought That the Best Part of His Life Will Start Now (2013), the Turkish-German journalist Mely Kiyak narrates her father's experience with advanced lung cancer in a German hospital. Drawing on medical anthropology, postcolonial theory and material (eco)feminism, I argue that these narratives establish migrant health and agency in transnational assemblages that include chemotherapy, lungs and skin, family networks, healthcare providers, food cultures and health policies. These assemblages of illness are connected with the narratives' hybrid and relational aesthetics and politics: similar to Gloria Anzaldúa's practice of autohistoria-teoría, I show how Kiyak's and Leandro's life writing combines personal and communal storytelling with critical theorising to include diverse voices, languages, histories and identities. By transgressing identities of self and other, German and foreign, patient and physician, human and non-human, the narratives inspire a greater sense of the extent to which (all) bodies, histories, cultures, technology and medicine are entangled in a dense network of relations. This article envisions a relational and hybrid ontology and aesthetics of migration health and thereby intervenes into the growing field of transcultural medicine and medical humanities.

[First description of canine leproid granuloma in Germany: 2 case reports]. / Erstbeschreibung des kaninen leproiden Granuloms in Deutschland: 2 Fallberichte.

Using cytology, histopathology, and DNA sequencing the diagnosis of canine leproid granuloma (CLG) was made in 2 dogs. The dogs were presented with nodular skin lesions on the head and pinnae. CLG is caused by nontuberculous mycobacteria that have not yet been finally classified. To date, this disease has been reported in Australia, New Zealand as well as North and South America, however no case reports have been published in Germany until now. In both cases, a combination of surgery and long-term drug administration (rifampicin, clarithromycin, doxycyclin and local application of clofazimin) was chosen and successfully eliminated the granulomas.

Report on an unusual case of leprosy from Germany: just an exception of the rule?

CASE PRESENTATION: We report on a German leprosy patient originating from Pakistan who had a relapse more than 5 years after completion of multi-drug therapy (MDT) of his first episode of multibacillary (MB) leprosy. State-of-the-art laboratory techniques (histopathology, PGL-I serology, microscopy and DNA/RNA qPCR) were applied for laboratory confirmation and monitoring of treatment outcome. Serology indicated the relapse long before the presence of unambiguous clinical signs. At the time of diagnosis of the relapse the patient had a remarkably high bacterial load suggesting increased risk for a second relapse. Furthermore, unexpectedly prolonged excretion of viable bacilli through the upper respiratory tract for more than 3 months after onset of MDT was shown. Therefore, MDT was administered for 2 years. DISCUSSION AND CONCLUSIONS: The clinical course of the patient, as well as the prolonged excretion of viable bacilli, underlines the usefulness of laboratory assessment. Laboratory tools including up-to-date molecular assays facilitate rapid diagnosis, timely MDT, identification of individuals excreting viable bacilli and patients at risk for relapses, monitoring of treatment outcome and respective adaptation of treatment where appropriate.

[Feline leprosy in a 5-month-old male cat in Germany]. / Feline Lepra bei einem 5 Monate alten Kater in Deutschland.

A 5-month-old, male, 4 kg European shorthair cat presented with ulcera ted cutaneous nodules in many areas over its entire body. The serological results for feline immunodeficiency virus and the feline leukaemia virus were negative. Following detection of acid-proof bacilli in histological examination of three skin biopsies, the diagnosis of mycobacteriosis of the skin was made. Polymerase chain reaction revealed the presence of Mycobacteriumlepraemurium. After surgical excision of all cutaneous nodules and a 14.5-week antibiotic therapy with Rifampicin and Clarithromycin, the cat was classified as being cured. During the observation period of 1 year after the end of the therapy, no relapse occurred.

Leaching of rare earth elements from fluorescent powder using the tea fungus Kombucha.

In most modern technologies such as flat screens, highly effective magnets and lasers, as well as luminescence phosphors, Rare Earth Elements (REE) are used. Unfortunately no environmentally friendly recycling process exists so far. In comparison to other elements the interaction of microorganisms with REE has been studied to a less extent. However, as REE are ubiquitously present in nature it can be assumed that microorganisms play an important role in the biogeochemistry of REE. This study investigates the potential of organic acid-producing microbes for extracting REE from industrial waste. In Germany, 175 tons of fluorescent phosphor (FP) are collected per year as a distinct fraction from the recycling of compact fluorescent lamps. Because the FP contains about 10% of REE-oxides bound in the so-called triband dyes it is a readily accessible secondary resource of REE. Using the symbiotic mixed culture Kombucha, consisting of yeasts and acetic acid bacteria, REE were leached at a significant rate. The highest leaching-rates were observed in shake cultures using the entire Kombucha-consortium or its supernatant as leaching agent compared to experiments using the isolates Zygosaccharomyces lentus and Komagataeibacter hansenii as leaching organisms. During the cultivation, the pH decreased as a result of organic acid production (mainly acetic and gluconic acid). Thus, the underlying mechanism of the triband dye solubilisation is probably linked to the carboxyl-functionality or a proton excess. In accordance with the higher solubility of REE-oxides compared to REE-phosphates and -aluminates, the red dye Y2O3:Eu2+ containing relatively expensive REE was shown to be preferentially solubilized. These results show that it is possible to dissolve the REE-compounds of FP with the help of microbial processes. Moreover, they provide the basis for the development of an eco-friendly alternative to the currently applied methods that use strong inorganic acids or toxic chemicals.

Recommendations of the German Central Committee against Tuberculosis (DZK) and the German Respiratory Society (DGP) for the Diagnosis and Treatment of Non-tuberculous Mycobacterioses.

Non-tuberculous mycobacterioses comprise a group of diseases caused by mycobacteria which do not belong to the Mycobacterium (M.) tuberculosis-complex and are not ascribed to M. leprae. These mycobacteria are characterized by a broad variety as to environmental distribution and adaptation. Some of the species may cause specific diseases, especially in patients with underlying immunosuppressive diseases, chronic pulmonary diseases or genetic predisposition, respectively. Worldwide, a rising prevalence and significance of non-tuberculous mycobacterioses is recognized. The present recommendations summarise current aspects of epidemiology, pathogenesis, clinical aspects, diagnostics - especially microbiological methods including susceptibility testing -, and specific treatment for the most relevant species. Diagnosis and treatment of non-tuberculous mycobacterioses during childhood and in HIV-infected individuals are described in separate chapters.

Yeast diversity on grapes in two German wine growing regions.

The yeast diversity on wine grapes in Germany, one of the most northern wine growing regions of the world, was investigated by means of a culture dependent approach. All yeast isolates were identified by sequence analysis of the D1/D2 domain of the 26S rDNA and the ITS region. Besides Hanseniaspora uvarum and Metschnikowia pulcherrima, which are well known to be abundant on grapes, Metschnikowia viticola, Rhodosporidium babjevae, and Curvibasidium pallidicorallinum, as well as two potentially new species related to Sporidiobolus pararoseus and Filobasidium floriforme, turned out to be typical members of the grape yeast community. We found M. viticola in about half of the grape samples in high abundance. Our data strongly suggest that M. viticola is one of the most important fermenting yeast species on grapes in the temperate climate of Germany. The frequent occurrence of Cu. pallidicorallinum and strains related to F. floriforme is a new finding. The current investigation provides information on the distribution of recently described yeast species, some of which are known from a very few strains up to now. Interestingly yeasts known for their role in the wine making process, such as Saccharomyces cerevisiae, Saccharomyces bayanus ssp. uvarum, Torulaspora delbrueckii, and Zygosaccharomyces bailii, were not found in the grape samples.

Medieval orthopaedic history in Germany: Hieronymus Brunschwig and Hans von Gersdorff.

Hans von Gerssdorff and Hieronymus Brunschwig, who flourished in Germany in the latter half of the fifteenth century, have both left early printed treatises on Surgery which give excellent woodcuts showing pictures of instruments, operations, and costumes, at the end of the medieval period. Hieronymus Brunschwig or Hieronymus Brunschwygk (ca. 1450 - ca. 1512), was a German surgeon (wundartzot), alchemist and botanist. He was notable for his methods of treatment of gunshot wounds. His most influential book was the Buch der Cirurgia. Gersdorff(1455-1529) was a military surgeon who gained wide experience during 40 years of campaigning and was an expert in the treatment of battlefield injuries. His work covers anatomy, surgery, leprosy, and glossaries of anatomical terms, diseases, and medications.

Effect of Lactobacillus paracasei subsp. paracasei, L. casei 431 on immune response to influenza vaccination and upper respiratory tract infections in healthy adult volunteers: a randomized, double-blind, placebo-controlled, parallel-group study.

BACKGROUND: Probiotics can modulate the immune system in healthy individuals and may help reduce symptoms related to respiratory infections. OBJECTIVE: The objective of the study was to investigate the effect of the probiotic strain Lactobacillus paracasei subsp. paracasei, L. casei 431 (Chr. Hansen A/S) (hereafter, L. casei 431) on immune response to influenza vaccination and respiratory symptoms in healthy adults. DESIGN: A randomized double-blind, placebo-controlled trial was conducted in 1104 healthy subjects aged 18-60 y at 2 centers in Germany and Denmark. Subjects were randomly assigned to receive an acidified milk drink containing ≥10(9) colony-forming units of L. casei 431 (n = 553) or placebo (n = 551) for 42 d. After 21 d, subjects received the seasonal influenza vaccination. The primary outcome was seroprotection rate (anti-influenza antibody titers by hemagglutination inhibition) 21 d after vaccination. Other outcomes were seroconversion rate and mean titers, influenza A-specific antibodies and incidence, and duration and severity of upper respiratory symptoms. Antibiotic use and use of health care resources were recorded. RESULTS: There was no effect of L. casei 431 on immune responses to influenza vaccination. Generalized linear mixed modeling showed a shorter duration of upper respiratory symptoms in the probiotic group than in the placebo group (mean ± SD: 6.4 ± 6.1 vs. 7.3 ± 9.7 d, P = 0.0059) in the last 3 wk of the intervention period. No statistically significant differences were found for incidence or severity. CONCLUSIONS: Daily consumption of L. casei 431 resulted in no observable effect on the components of the immune response to influenza vaccination but reduced the duration of upper respiratory symptoms. The trial was registered at www.isrctn.com as ISRCTN08280229.

[Tropical dermatology training in the Bundeswehr: Deployment in Manaus, Brazil]. / Tropendermatologische Ausbildung in der Bundeswehr: Einsatz in Manaus/Brasilien.

Training in tropical dermatology at the Fundação de Medicina tropical (FMT-AM) in Manaus, Brazil, offers an ideal opportunity to become familiar with the broad spectrum of tropical skin-diseases which are endemic in the tropical rainforest of the Amazon region. Besides frequently observed cases of cutaneous leishmaniasis of the new world, mucocutaneous forms of leishmaniasis and all entities of the different deep mycoses of South America are also regularly diagnosed. Of special importance in the dermatological care of the population is the early diagnosis of all clinical forms of leprosy and the long-term care of HIV patients. Modern diagnostics, including histopathology and molecular biology analytical methods, enable patients at the FMT-AM to be diagnosed without having to solely rely on clinical presentation and epidemiological data.

[Surgical Indications for Diverticulitis in Germany: Are All Operations Justified?]. / Operationsindikation der Sigmadivertikulitis in Deutschland: Sind alle Operationen gerechtfertigt?

INTRODUCTION: Pathological changes of preexisting sigma diverticulosis into a state of sigma diverticulitis are possible. Treatment of sigma diverticulitis accounts for a significant proportion of emergency treatments in clinics. The number of patients treated for sigma diverticulitis has risen steadily in recent years. Although it can be observed that operated cases making 7 % compared with 14 % to all stationary admissions, there is a less marked increase. Nevertheless, the question should be clarified as to how high the proportion of complicated surgical cases is in relation to non-complicated cases. It is important to clarify, in this context, if each operation is justified or whether in some cases there is over-treatment. MATERIAL AND METHODS: All data relating to Germany, were prospectively collected by the treating hospitals using the DRG and evaluated by the Federal Statistical Office. The treatment numbers from Erlangen were prospectively collected from the encrypted DRG and analysed retrospectively by the coding officer. The investigated period lasted from 2005 to 2010. To demonstrate some treatment options, the following possible forms of therapy were examined with reference to the Hansen/Stock classification. RESULTS: In Germany, about 40 % of stationary patients with sigma diverticulitis are treated surgically. It is striking that in about two thirds of all operated patients uncomplicated forms of diverticulitis were present. The remainder consisted of covered or free perforations. For these complicated forms, various treatment approaches have been established. Ultimately, in dependence of timing these are always surgically treated. In the milder forms the general indication for surgery has come into discussion as the recommendation for a surgical approach after the second relapse in the symptom-free interval is being questioned by several groups based on the age of the studies on which the recommendations are based. CONCLUSION: A significant increase in hospital admissions and surgically treated patients is demonstrated. Striking was that a closer analysis of data revealed that mainly non-complicated cases were surgically treated. This should be seen as a clear indication for an over-treatment. Therefore, possibly not all surgeries performed are justified. In the case of complicated forms, in consideration of various treatment paths, surgery is inevitable in most cases.

[The etiology of leprosy and Gerhard Henrik Armauer Hansen: what does "Armauer" mean?]. / Ätiologie der Lepra und Gerhard Henrik Armauer Hansen: Was bedeutet "Armauer"?

Hansen discovered the bacteria in 1873 in unstained material and is therefore recognized as the discoverer of the leprosy pathogen. Hansen is a very common surname but in contrast Armauer is a very rare surname. Gerhard Henrik Hansen added the maiden name of his grandmother on his mother's side to his name early on. This happened not only out of family attachments but also as a physician and aspiring scientist to set himself apart from other Hansens.

Malaria and quinine resistance: a medical and scientific issue between Brazil and Germany (1907-19).

This article addresses the discussion about quinine-resistant malaria plasmodium in the early decades of the twentieth century. Observed by Arthur Neiva in Rio de Janeiro in 1907, the biological and social resistance of malaria sufferers to preventive and curative treatment with quinine was corroborated three years later by Oswaldo Cruz during the construction of the Madeira-Mamoré Railway in the Brazilian Amazon. Likewise in 1910, ailing German workers were transferred from Brazil to Hamburg's Institute for Maritime and Tropical Diseases, where quinine resistance was confirmed by Bernard Nocht and Heinrich Werner. When the First World War saw failures in treating and preventing malaria with quinine along with violent outbreaks of the disease on the Turkish and Balkan fronts, resistance to this alkaloid became the topic of the day within the field of experimental medicine in Germany. New attempts were made to account for the resistance, especially by the physician Ernst Rodenwaldt, who explored the topic by applying modern theories on heredity. The present article offers a preliminary survey and analysis of pronouncements about quinine resistance, shedding new light on the circulation of knowledge in the field of tropical medicine.

Malaria and quinine resistance: a medical and scientific issue between Brazil and Germany (1907–19)

This article addresses the discussion about quinine-resistant malaria plasmodium in the early decades of the twentieth century. Observed by Arthur Neiva in Rio de Janeiro in 1907, the biological and social resistance of malaria sufferers to preventive and curative treatment with quinine was corroborated three years later by Oswaldo Cruz during the construction of the Madeira-Mamoŕe Railwayin the Brazilian Amazon. Likewise in 1910, ailing German workers were transferred from Brazil to Hamburg’s Institute for Maritime and Tropical Diseases, where quinine resistance was confirmed by Bernard Nocht and Heinrich Werner. When the First World War saw failures in treating and preventing malaria with quinine along with violent outbreaks of the disease on the Turkish and Balkan fronts, resistance to this alkaloid be came the topic of the day within the field of experimental medicinein Germany. New attempts were made to account for the resistance, especially by the physician Ernst Rodenwaldt, who explored the topicby applying modern theories on heredity. The present article offers a preliminary survey and analysis of pronouncements about quinine resistance, shedding new light on the circulation of knowledge in the field of tropical medicine. (AU)

[Recommendations for diagnosis and treatment of nontuberculous mycobacterioses of the German Central Committee against tuberculosis and the German Respiratory Society]. / Empfehlungen zur Diagnostik und Therapie nichttuberkulöser Mykobakteriosen des Deutschen Zentralkomitees zur Bekämpfung der Tuberkulose (DZK) und der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin (DGP).

Nontuberculous mycobacterioses comprise a group of diseases caused by mycobacteria which do not belong to the Mycobacterium (M.) tuberculosis complex and are not ascribed to M. leprae. These mycobacteria are characterized by a broad variety as to environmental distribution and adaptation. Some of the species may cause specific diseases, especially in patients with underlying immunosuppressive diseases, chronic pulmonary diseases or genetic predisposition, respectively. Worldwide a rising prevalence and significance of nontuberculous mycobacterioses can be recognized. The present recommendations summarise actual aspects of epidemiology, pathogenesis, clinical aspects, diagnostics - especially microbiological methods including susceptibility testing -, and specific treatment for the most relevant species. Diagnosis and treatment of nontuberculous mycobacterioses during childhood and in HIV-infected individuals are described in separate chapters.

[Neisser and the clap]. / Neisser en de druiper.

In 1879, during his specialization in dermatology, Albert Ludwig Sigesmund Neisser (1855-1916) discovered the bacterial cause of gonorrhoea. The gonococcus - Neisseria gonorrhoea - would, however, not bear his name until 1933. Neisser's early research focused primarily on venereal diseases, syphilis in particular, and on leprosy. Later, as a hygienist, he became a passionate advocate of public clinics for venereal diseases, regulated prostitution, and health education. In 1916, Neisser died of sepsis after lithotripsy for nephrolithiasis. His scientific inheritance includes many publications on a variety of venereal and skin diseases and public health-related topics, and textbooks such as Ikonographia dermatologica and Stereoskopischer Medizinischer Atlas.