[Increase of scabies and therapy resistance among German military personnel : An 8-year follow-up study in the Department of Dermatology of the Armed Forces Hospital Berlin, Germany (2012-2019)]. / Anstieg von Skabies und Therapierefraktärität bei Bundeswehrangehörigen : Acht-Jahre-Follow-up-Studie aus der Hautklinik des Bundeswehrkrankenhauses Berlin (2012­2019).

BACKGROUND: The diagnosis of scabies has become surprisingly frequent in Germany in recent years and the use of scabicides has risen significantly. OBJECTIVE: The aim of our survey was to determine whether this trend can also be detected among military personnel of the German Armed Forces (Bundeswehr). METHODS: The study was conducted as a retrospective single-center study over a period of 8 years from 2012 to 2019 in the Department of Dermatology of the Armed Forces Hospital Berlin, Germany. Data were generated from the hospital information system (KIS), which was searched for all scabies-coded diagnoses according to ICD10 code B86 both as outpatients and inpatients. Only first presentations with scabies diagnosis confirmed by dermoscopy or microscopy by a dermatologist were included. Inpatient treatment was required if a patient was not cured after at least three antiscabies treatment cycles in the outpatient setting. RESULTS: The data show that there has been a steady increase in the diagnosis of scabies in Bundeswehr personnel. Moreover, our data show that the number of unsuccessfully treated outpatients increased and required in-hospital treatment. CONCLUSION: We observed an increase of scabies among German military personnel who represent a typical at-risk group. These results support the observations of an increased incidence of scabies in Germany in general and especially in an at-risk population. With the general increase in scabies cases, there are also increasing numbers of German military personnel who are refractory to treatment, which was largely attributed to inadequate treatment of contact persons and individual treatment errors. Nevertheless, the data also emphasize the low overall prevalence of scabies; therefore, all diagnoses should be confirmed by dermoscopy or microscopy after 14 days whenever possible to rule out the bias of overreporting due to false-positive cases diagnosed only by clinical examination.

[Dermatology in the military medical forces]. / Dermatologie im Sanitätsdienst der Bundeswehr.

Dermatological and venereological expertise is indispensable for the medical care of our soldiers at home and during military missions and represents a major competence in military medicine. Therefore, in the new structure of the combined German Forces medical services, dermatological clinics have been set up at all Bundeswehr hospitals, which, as academic teaching hospitals, are regionally involved in the medical care of the civilian population. In addition to general dermatological and dermatosurgical care, wound treatment and tropical dermatology represent military medicine-related priorities. Dermatological clinics are maintained in an interdisciplinary network at the Bundeswehr hospitals in Berlin, Hamburg, Koblenz, Ulm, and Westerstede. Outpatient dermatological treatment facilities complete the medical care at numerous locations where troops are based.

The urokinase plasminogen activator system in angiosarcoma, Kaposi's sarcoma, granuloma pyogenicum, and angioma: an immunohistochemical study.

UNLABELLED: Background Extracellular matrix proteolysis is one of the most important steps in angiogenesis. The urokinase-type plasminogen activator system (uPAS), consisting of the urokinase plasminogen activator (uPA), the uPA receptor (uPA-R), and their corresponding inhibitors, PAI-1 and PAI-2, is thought to play a role in this process. METHODS: We investigated the expression of the components of uPAS in angiosarcoma (AS, n = 4), Kaposi's sarcoma (KS, n = 31), granuloma pyogenicum (GP, n = 25), angioma (AN, n = 15), and healthy controls (CO, n = 15) with immunohistochemical methods. RESULTS: We found positive immunostaining for uPA-R and uPA in all cases of AS. Only two of four cases were positive for PAI-1, whereas all cases were negative for PAI-2. In KS, we observed positive immunostaining in 16 of 31 (51.6%) cases for uPA-R, in 11 of 31 (35.5%) cases for uPA, in 3 of 31 (9.6%) cases for PAI-1, and in 2 of 31 (6.4%) cases for PAI-2. The GP cases showed the following positive results: 4 of 25 (16%) for uPA-R, 6 of 25 (24%) for uPA, 10 of 25 (40%) for PAI-1, and 11 of 25 (44%) for PAI-2. Four cases (26.6%) of AN were positive for PAI-1 and five cases (25%) for PAI-2. In AN (n = 15), there was staining for neither uPA nor uPA-R. In none of the controls (n = 15) was immunostaining for the components of uPAS found in blood vessels. CONCLUSIONS: uPAS is involved in malignant, benign, and reactive proliferative angiomatous lesions, but is absent in normal blood vessels. The upregulation of uPA and its corresponding receptor, uPA-R, in AS and KS supports the hypothesis of the proliferative nature of these lesions; however, the upregulation of the inhibitors (PAI-1 and PAI-2) in benign and reactive proliferative angiomatous lesions (GP and AN) shows how this process may be limited.

[Antibiotic resistance of enterococci in Germany]. / Antibiotikaresistenz der Enterokokken in Deutschland.

BACKGROUND: The resistance of enterococci against various antimicrobial substances including vancomycin has increased markedly. Since 1989 in the USA in particular high resistance rates against vancomycin have been observed but very few surveillance have been published in Europe. Therefore, we conducted a multicenter study in Germany to obtain information about the incidence and distribution of vancomycin and/or high-level aminoglycoside-resistant enterococci. METHODS: A total of 2046 enterococcal isolates were identified and susceptibility-testing was performed according to international guidelines. RESULTS: A total number of 90.5% of the enterococcal isolates were identified as Enterococcus faecalis and 7.8% was Enterococcus faecium. Resistance against ampicillin was detected in 56.6% of the Enterococcus faecium isolates, however, in only one Enterococcus faecalis isolate. High-level resistance against gentamycin or streptomycin was observed in 7.3% and 24.8% of the isolates, respectively. Twelve isolates showed resistance against vancomycin, however, cross resistance with teicoplanin was found in only two isolates. CONCLUSION: The rate of resistance of enterococci in Germany is still considerably lower than in the United States. Previous vancomycin therapy has been implemented as a risk factor for colonization or infection with vancomycin-resistant enterococci. Continued vigilance, decreased use of vancomycin and strict enforcement of infection control measures are appropriate measures to control the growing problem of resistant enterococci.

[Computer tomographic diagnosis of acute cerebral ischemmia]. / Computertomographische Diagnostik bei akuter Hirnischämie.

Computed tomography (CT) is the first step in the radiological diagnostics of brain emergencies. We intend to study which pathophysiological changes are detected by CT and how CT contributes to prognosis and patient management in acute cerebral ischemia. We review recent publications about the role of CT in acute cerebral ischemia. Ischemic brain edema is associated with a decreased X-ray attenuation. Computed tomography is thus highly sensitive in detecting irreversibly damaged ischemic brain tissue. Patients showing large volumes of ischemic edema, exceeding one third of the middle cerebral artery territory, do not benefit from thrombolysis and have an increased risk of brain hemorrhage. The brain territory at risk from ischemia can be detected by CT angiography. To combine CT with CT angiography is a pragmatic approach which enables carefully directed treatment in acute cerebral ischemia.

Novel method for coupling of poly(ethyleneglycol) to carboxylic acid moieties of proteins.

Lack of toxicity, excellent solubility and superb biocompatibility make polyethylene glycol (PEG) one of the most popular modifiers of biologicals. The most common method for attachment of PEG is based on modification of amino groups of proteins with methoxy- or succinimide-derivatives of PEG. In the case of proteins with amino groups important for biological activity, this modification can lead to inactivation of proteins. A new strategy for covalent attachment of PEG to carboxylic groups of proteins using O,O-bis-(2-aminopropyl)polyethylene glycol and carbodiimide/N-hydroxysuccinimide-mediated reaction was developed. The reaction is carried out under mild aqueous conditions. The attached PEG serves as a hydrophilic spacer for further bioconjungation with biomolecules and haptens. Lipase from Candida rugosa was used as a model protein. Characteristic data of the modified protein such as activity, isoelectric points and stability were compared with that of the unmodified protein.

[Suicide in Berlin]. / Selbstmord in Berlin

PIP: Trends in suicide in Berlin from the mid-nineteenth century to the present are analyzed, and comparisons are made with data for other cities, the Federal Republic of Germany and the German Democratic Republic, and selected other countries. Consideration is given to variations in suicide by month, district of residence, social status, sex, marital status, motivation for suicide, religion, nationality, age group, and method of suicide.^ieng