[125 Years German Central Committee for the Fight against Tuberculosis (DZK)]. / 125 Jahre Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK).

The German Central Committee for the Fight against Tuberculosis (DZK) celebrates this year its 125th birthday. On this occasion, the DZK as one of the oldest TB organizations worldwide is looking back on the development during its history and records the results in a comprehensive book, summarized in this article. In the book, the various political changes with their impact on the DZK are mirrored, starting with the German Empire, the Weimar Republic, the so-called "Third Reich", the two German states separated after the Second World War and the current FRG. Tuberculosis (TB) was the dominant widespread disease in the 19th century, today it is the leading infectious disease worldwide. As a consequence of migration, this affects also Germany. After meanwhile - in particular in 2015/16 - risen numbers of new cases (especially of those not born in Germany, which in 2019 accounted for 72 % of all cases), the impact of drug-resistant tuberculosis (in 2019, 11.4 % of all new cases had some resistance (384 cases), including 87 cases of MDR-TB, and of these 8 cases of XDR-TB and 27 cases of pre-XDR-TB), as well as the high proportion (81,5 %) - in 2019 - of open and thus very infectious pulmonary TB among new TB cases in Germany, impressively show that TB continues to be a health problem that should not be underestimated and that is increasingly concentrated in risk groups (socially disadvantaged persons, people from high-prevalence countries, homeless people, drug addicts, alcoholics, HIV-infected persons). The DZK therefore continues to play an important role in TB control as a link between the national and international organizations responsible for combating TB.

[Pulmonary Medicine and its Institutions During National Socialism]. / Die Lungenheilkunde und ihre Institutionen im Nationalsozialismus.

When the National Socialists came to power in 1933, a complete paradigm shift took place in the health policy under the principle "Public interest ahead of self-interest". In the early years there was an intense discussion about whether tuberculosis (TB) is more caused by heredity or by infection. Finally, the arguments of leading TB specialists were accepted that TB is predominantly an infectious disease. In 1939, the year Germany started World War II, TB mortality was at its lowest, with only a few countries having lower rates. TB mortality increased in all areas during the war, both in the civilian population and in the Wehrmacht, as well as in prisoners of war, foreign forced laborers and concentration camps. Incapable TB patients were considered biological and social "ballast". They were worthless for the "national community" and had to be socially excluded. Thus one could refuse them the "marriage loan" introduced in the summer 1933, forbid starting from 1935 also the marriage. From 1938 on, TB-patients with open TB, who showed themselves unreasonable, could be compulsorily isolated as "asocial" by public health physicians - mostly pulmonary specialists. There, under prison conditions and with limited food, most patients fell victim to TB in a short time. Especially inhuman was the handling of prisoners in the concentration camps, where the disease was very common. Thousands of people were killed prematurely through deliberate neglect, starvation, abuse for medical experiments, or simply murdered. TB mortality increased by 160 - 240 % compared to pre-war levels. With the support of the victorious Allied powers, the TB control system was restructured and the institutions such as DGP and DZK were re-established. In the following years, the TB situation improved slowly, in the FRG initially slightly faster than in the GDR.

[100 years DGP -100 years of pneumology in Germany]. / 100 Jahre DGP - 100 Jahre deutsche Pneumologie.

During the first half of its 100-year history, tuberculosis was predominant in the German Society of Pneumology (DGP). This led largely to the separation of pneumology from internal medicine, particularly in the universities. Since the 1960s, the spectrum of respiratory diseases has changed considerably. Asthma, COPD, lung cancer, and pneumonia today rank among the most widespread diseases. Numerous new diagnostic and therapeutic methods have induced dramatic changes in the field of pneumology. Today, pneumology, together with cardiology and gastroenterology, belongs to the major specialties of internal medicine. One of the most urgent tasks of the DGP is to improve the insufficient representation at German universities, and thus promote teaching and research in respiratory medicine.

Screening for alpha1-Pi deficiency in patients with lung diseases.

In patients with pulmonary emphysema, studies have reported 2-3% of individuals with severe alpha1-Pi deficiency. The aims of this study were to evaluate the accuracy of a new method for quantifying alpha1-Pi through phenotyping from dried blood spots (DBS) and to test the hypothesis that the screening of a population at risk increases the detection rate for severe alpha1-Pi deficiency. The accuracy of phenotyping results from DBS was compared to conventional methods in a total of 555 individuals. In a prospective study 1,060 patients with chronic lung disease were screened for alpha1-Pi deficiency using DBS. The validation of the phenotyping method from DBS showed an accuracy of 100%. Out of 1,060 tested patients, none had a severe PiZ deficiency and only 3 had PiSZ, whilst 36 (3.34%) individuals were identified as heterozygous for PiMS and 39 (3.68%) for PiMZ. No patients with severe alpha1-Pi deficiency could be detected in this population and the frequency of PiMS or PiMZ detected was similar to that of the normal population. Thus, the screening of an unselected population of chronic obstructive pulmonary disease and asthma patients may not detect a large number of individuals with severe alpha1-Pi deficiency.