[Two severe cases of disseminated cutaneous nontuberculous mycobacteriosis due to Mycobacterium haemophilum]. / Zwei schwere Fälle von disseminiert-kutanen, nichttuberkulösen Mykobakteriosen durch Mycobacterium haemophilum.

Mycobacterium haemophilum is a rare pathogen belonging to the group of slowly growing nontuberculous mycobacteria (NTM) that can cause infections, especially in immunocompromised patients. Detection by culturing is difficult because M. haemophilum only grows under special cultivation conditions. Therefore, it is believed that the pathogen is too rarely identified as a cause of disease overall. In addition to patients with severe immunodeficiency, e.g. due to acquired immunodeficiency syndrome (AIDS), chemotherapy or immunosuppression after transplantation, patients with underlying rheumatic diseases are increasingly described in the literature, who are at risk due to the immunosuppressive treatment regimen. Clinically, ulcerative skin alterations, lymphadenopathy and arthropathy are in the foreground. In immunosuppressed patients with unclear skin lesions, infections due to M. haemophilum should be considered and specific microbiological diagnostics should be initiated.

Mobile Air Quality Studies (MAQS)-an international project.

Due to an increasing awareness of the potential hazardousness of air pollutants, new laws, rules and guidelines have recently been implemented globally. In this respect, numerous studies have addressed traffic-related exposure to particulate matter using stationary technology so far. By contrast, only few studies used the advanced technology of mobile exposure analysis. The Mobile Air Quality Study (MAQS) addresses the issue of air pollutant exposure by combining advanced high-granularity spatial-temporal analysis with vehicle-mounted, person-mounted and roadside sensors. The MAQS-platform will be used by international collaborators in order 1) to assess air pollutant exposure in relation to road structure, 2) to assess air pollutant exposure in relation to traffic density, 3) to assess air pollutant exposure in relation to weather conditions, 4) to compare exposure within vehicles between front and back seat (children) positions, and 5) to evaluate "traffic zone"-exposure in relation to non-"traffic zone"-exposure.Primarily, the MAQS-platform will focus on particulate matter. With the establishment of advanced mobile analysis tools, it is planed to extend the analysis to other pollutants including NO2, SO2, nanoparticles and ozone.

Analysis of research output parameters: density equalizing mapping and citation trend analysis.

BACKGROUND: Burden of disease studies indicate major socio-economic burdens since many years. They should be used for the allocation of funding. However, imbalances are present in funding policies and therefore benchmarking becomes increasingly important in health services research. METHODS: The present study assessed benchmarking approaches. Using large data base analyses, research was analyzed for different health research output parameters. The fields of cardiovascular and respiratory medicine served as models to assess irregular patterns of health research. For visualization, density equalizing mapping procedures were used. RESULTS: Specific areas of major research activity were identified for European countries and large differences were found. Spatial distribution of published items for cardiac and cardiovascular systems differed in comparison to the distribution for the respiratory system. In general, large countries dominated the overall number of published items. When qualitative measures such as citation analysis were assessed, differing results were achieved. In this category, mostly Scandinavian countries dominated. CONCLUSION: The present approach of comparative output benchmarking can be used to assess institutional operating figures at the national and international level and to analyze imbalances in health and research funding.

Interfield dysbalances in research input and output benchmarking: visualisation by density equalizing procedures.

BACKGROUND: Historical, social and economic reasons can lead to major differences in the allocation of health system resources and research funding. These differences might endanger the progress in diagnostic and therapeutic approaches of socio-economic important diseases. The present study aimed to assess different benchmarking approaches that might be used to analyse these disproportions. Research in two categories was analysed for various output parameters and compared to input parameters. Germany was used as a high income model country. For the areas of cardiovascular and respiratory medicine density equalizing mapping procedures visualized major geographical differences in both input and output markers. RESULTS: An imbalance in the state financial input was present with 36 cardiovascular versus 8 respiratory medicine state-financed full clinical university departments at the C4/W3 salary level. The imbalance in financial input is paralleled by an imbalance in overall quantitative output figures: The 36 cardiology chairs published 2708 articles in comparison to 453 articles published by the 8 respiratory medicine chairs in the period between 2002 and 2006. This is a ratio of 75.2 articles per cardiology chair and 56.63 articles per respiratory medicine chair. A similar trend is also present in the qualitative measures. Here, the 2708 cardiology publications were cited 48337 times (7290 times for respiratory medicine) which is an average citation of 17.85 per publication vs. 16.09 for respiratory medicine. The average number of citations per cardiology chair was 1342.69 in contrast to 911.25 citations per respiratory medicine chair. Further comparison of the contribution of the 16 different German states revealed major geographical differences concerning numbers of chairs, published items, total number of citations and average citations. CONCLUSION: Despite similar significances of cardiovascular and respiratory diseases for the global burden of disease, large input and output imbalances have been revealed in the present study which point to a need for changes in funding policies. The present study supplies data that could be used for decision making in the field of health systems funding.

Institutional operating figures in basic and applied sciences: scientometric analysis of quantitative output benchmarking.

BACKGROUND: Institutional operating figures and benchmarking systems are important features for the implementation of efficacy in basic and applied sciences. They are needed for research evaluation and funding policy. However, the current policy settings for research evaluation urgently need review since there may be imbalances present in many areas. METHODS: The present study assessed benchmarking of research output. By the use of large data bases research output was categorized and analyzed. Specific areas of major research activity were identified by comparing publication density on different organ systems and inter- and intrafield comparison was performed for selected countries. RESULTS: Novel density-equalizing mappings were constructed that illustrate trends of publication activity and identify subsets of major interest in a total of 5,527,558 published items. A dichotomy was present between Western countries such as the US, UK or Germany and Asian countries such as Japan, China or South Korea concerning research focuses. CONCLUSION: The present study is the first large scale analysis of global research activity and output over the last 50 years. The presently described assessment of operating figures at the national and international level can be used to identify single areas of research that are heavily focused. Further research on qualitative output benchmarking is needed to improve current policy settings for research evaluation.

Models of asthma: density-equalizing mapping and output benchmarking.

Despite the large amount of experimental studies already conducted on bronchial asthma, further insights into the molecular basics of the disease are required to establish new therapeutic approaches. As a basis for this research different animal models of asthma have been developed in the past years. However, precise bibliometric data on the use of different models do not exist so far. Therefore the present study was conducted to establish a data base of the existing experimental approaches. Density-equalizing algorithms were used and data was retrieved from a Thomson Institute for Scientific Information database. During the period from 1900 to 2006 a number of 3489 filed items were connected to animal models of asthma, the first being published in the year 1968. The studies were published by 52 countries with the US, Japan and the UK being the most productive suppliers, participating in 55.8% of all published items. Analyzing the average citation per item as an indicator for research quality Switzerland ranked first (30.54/item) and New Zealand ranked second for countries with more than 10 published studies. The 10 most productive journals included 4 with a main focus allergy and immunology and 4 with a main focus on the respiratory system. Two journals focussed on pharmacology or pharmacy. In all assigned subject categories examined for a relation to animal models of asthma, immunology ranked first. Assessing numbers of published items in relation to animal species it was found that mice were the preferred species followed by guinea pigs. In summary it can be concluded from density-equalizing calculations that the use of animal models of asthma is restricted to a relatively small number of countries. There are also differences in the use of species. These differences are based on variations in the research focus as assessed by subject category analysis.

[The impact of avian influenza on health care system]. / Die Bedeutung der aviären Influenza für das Gesundheitssystem.

Avian influenza is a viral transmitted disease that mainly occurs in birds. First described in 1878 in Italy the disease can be found worldwide. The causing agent belongs to the family of orthomyxoviridae. Since its enormous spread among poultry in 2003, the influenza virus H5N1 is heralded as a possible agent of a new pandemic. H5N1 is pathogen to humans with a mortality rate of over 60%. The main reason that this virus has not caused a pandemic yet is its lack to propagate freely between humans. The current review explores the impact of avian influenza on the health system.