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1.
BMC Public Health ; 21(1): 1296, 2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215224

RESUMO

BACKGROUND: The outbreak and global spread of COVID-19 was accompanied by an increase in reports of stigmatization of Chinese and Asian-looking people. The behavioral immune system provides a framework for stigmatization in response to infectious disease threats. Specifically, stigmatization might increase with rising levels of infectious disease threat. The present study aimed to examine this hypothesis during the early phase of the COVID-19 pandemic. METHODS: As part of the "EUCLID" project ( https://euclid.dbvis.de ), a total of 5011 persons from Germany were surveyed via an online-questionnaire between February 2nd and April 3rd, 2020, covering the progression of the COVID-19 pandemic over three time periods which were defined by critical events. RESULTS: There was no evidence for an increase in the stigmatization of Chinese and Asian-looking people across three topics, that is personal proximity, air travel, and medical measures upon arrival from China. CONCLUSIONS: The present findings provide good news in that participants showed an adaptive response to the infectious disease threat rather than displaying increased stigmatization. Further research is necessary to specify the conditions that increase the risk of stigmatization in response to infectious disease threats.


Assuntos
COVID-19 , Pandemias , China/epidemiologia , Alemanha/epidemiologia , Humanos , SARS-CoV-2 , Estereotipagem
2.
Antimicrob Resist Infect Control ; 10(1): 102, 2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215330

RESUMO

INTRODUCTION: In late 2019, a novel coronavirus was detected in China. Supported by its respiratory transmissibility, even by people infected without symptomatic disease, this coronavirus soon began to rapidly spread worldwide. BACKGROUND: Many countries have implemented different infection control and containment strategies due to ongoing community transmission. In this context, contact tracing as well as adequate testing and consequent quarantining of high-risk contacts play leading roles in containing the virus by interrupting infection chains. This approach is especially important in the hospital setting where contacts often cannot be avoided and physical distance is usually not possible. Furthermore, health care workers (HCWs) usually have contact with a variety of vulnerable people, making it essential to identify infections among hospital employees as soon as possible to interrupt the rapid spread of SARS-CoV-2 in the facility. Several electronic tools for contact tracing, such as specific software or mobile phone apps, are available for the public health sector. In contrast, contact tracing in hospitals often has to be carried out without helpful electronic tools, and an enormous amount of human resources is typically required. AIM: For rapid contact tracing and effective infection control and management measures for HCWs in hospitals, adapted technical solutions are needed. METHODS: In this study, we report the development of our containment strategy to a web-based contact tracing and rapid point-of-care-testing workflow. RESULTS/CONCLUSION: Our workflow yielded efficient control of the rapidly evolving situation during the SARS-CoV-2 pandemic from May 2020 until January 2021 at a German University Hospital.


Assuntos
Teste de Ácido Nucleico para COVID-19/métodos , COVID-19/transmissão , Redes de Comunicação de Computadores , Busca de Comunicante/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Pandemias , Testes Imediatos , SARS-CoV-2 , COVID-19/epidemiologia , Alemanha/epidemiologia , Hospitais Universitários , Humanos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Aplicativos Móveis , Recursos Humanos em Hospital , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Estações do Ano , Software , Fluxo de Trabalho
3.
Artigo em Alemão | MEDLINE | ID: mdl-34212206

RESUMO

BACKGROUND: Lip, oral cavity, and pharynx cancers (ICD-10: C00-C14) describe a heterogeneous group of tumors with strong variations in incidence, mortality, and survival by entity. OBJECTIVES: This work provides a detailed overview of epidemiologic measures for these tumor entities, taking into account heterogeneity in age, sex, location, and stage. MATERIAL AND METHODS: Incidence and mortality data for Germany for the years 1999-2016 were extracted from the interactive database of the Center for Cancer Registry Data (ZfKD). Age and stage distributions and five-year relative survival were calculated on the pooled ZfKD data set (diagnosis years 1999-2017). RESULTS: In 2016, overall incidence and mortality for all entities were 17.6 and 7.0 per 100,000 men and 6.5 and 1.8 per 100,000 women, respectively. The five-year relative survival in 2015-2017 was 53 and 63%, respectively. There were marked differences in survival as well as age and stage distributions between entities. Trend analyses showed an increase in age at diagnosis, particularly in male patients, and no change in stage distributions. However, five-year relative survival increased from 45% (men) and 59% (women) in 1999-2002 to 52% and 63% in 2013-2017. CONCLUSION: The marked heterogeneity of the studied tumors highlights the need to differentiate the analysis by sex and entity for meaningful interpretation of epidemiologic metrics. With the expansion of clinical cancer registration in Germany, additional analyses including other important clinical factors will be possible in the future.


Assuntos
Neoplasias Bucais , Neoplasias Faríngeas , Feminino , Alemanha/epidemiologia , Humanos , Incidência , Masculino , Neoplasias Bucais/epidemiologia , Neoplasias Faríngeas/epidemiologia , Sistema de Registros
4.
Artigo em Alemão | MEDLINE | ID: mdl-34213569

RESUMO

After caries, molar incisor hypomineralisation (MIH)-also known as chalky teeth-is one the most common dental diseases in children and adolescents. In addition to aesthetic limitations, especially on the anterior teeth, hypersensitivities and enamel breakdowns on permanent molars are of functional importance. While the MIH prevalence rates range from ~ 10% to ~ 30% and is well described, the situation regarding aetiology is unsatisfactory. Although efforts have been made in the past to clarify the aetiology, no plausible reason is available so far. Aetiology research has to be judged as methodologically challenging, since it should ideally be embedded in prospectively planned birth cohort studies. The aim of this article is to summarize typical clinical characteristics of MIH, epidemiological findings and potential causes with special reference to the earlier published results from the two Munich birth cohort studies GINIplus and LISA.


Assuntos
Hipoplasia do Esmalte Dentário , Incisivo , Adolescente , Criança , Hipoplasia do Esmalte Dentário/diagnóstico , Hipoplasia do Esmalte Dentário/epidemiologia , Hipoplasia do Esmalte Dentário/etiologia , Alemanha/epidemiologia , Humanos , Dente Molar , Prevalência
5.
BMC Infect Dis ; 21(1): 634, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215215

RESUMO

BACKGROUND: The introduction of human papillomavirus (HPV) vaccination has resulted in a remarkable decline of genital warts in women and men, but in Germany historical rates of vaccination are relatively low. We report long-term surveillance data on changes in HPV 6 and HPV 11 infection and the prevalence of genital warts in young women in the Wolfsburg HPV epidemiological study (WOLVES). METHODS: Women born in 1983/84, 1988/89, and 1993/94 participated in four cohorts between 2009/10 and 2014/15. Quadrivalent vaccination coverage and prevalence of HPV 6/11 infection and genital warts are reported for participants aged 19-22 years and 24-27 years at the time of sample collection. Statistical analyses were done to compare similarly aged participants using 2 × 2 contingency tables (Röhmel-Mansmann unconditional exact test; two-side alpha of 0.05). RESULTS: A total of 2456 women were recruited. Between 2010 and 2015, there was a statistically significant decrease in the prevalence of HPV 6 infection among women aged 24-27 years (2.1% versus 0.0%; P < 0.0001) and women aged 19-22 years (2.0% versus 0.0%; P = 0.0056). There was no significant decline in HPV 11 infection. In total, 52 of 2341 participants were diagnosed with genital warts. There was a statistically significant drop in the risk of developing genital warts in women aged 24-27 years between 2010 and 2015 (4.7% versus 1.7%, respectively; P = 0.0018). The overall risk of developing genital warts in women aged 19-27 years decreased from 3.1% in 2010 to 1.2% in 2015 (P = 0.0022). CONCLUSIONS: An increase in vaccination coverage was associated with a decreased prevalence of genital warts in young women. A protective effect greater than herd immunity alone was seen despite low vaccination rates. Quadrivalent vaccine had a protective effect on genital HPV 6 infection and an almost fully protective effect on the development of genital warts in the youngest population.


Assuntos
Condiloma Acuminado/epidemiologia , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Cobertura Vacinal/economia , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Papillomaviridae/imunologia , Infecções por Papillomavirus/economia , Infecções por Papillomavirus/virologia , Prevalência , Estudos Prospectivos , Adulto Jovem
6.
Proc Natl Acad Sci U S A ; 118(31)2021 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-34261775

RESUMO

Over the last months, cases of SARS-CoV-2 surged repeatedly in many countries but could often be controlled with nonpharmaceutical interventions including social distancing. We analyzed deidentified Global Positioning System (GPS) tracking data from 1.15 to 1.4 million cell phones in Germany per day between March and November 2020 to identify encounters between individuals and statistically evaluate contact behavior. Using graph sampling theory, we estimated the contact index (CX), a metric for number and heterogeneity of contacts. We found that CX, and not the total number of contacts, is an accurate predictor for the effective reproduction number R derived from case numbers. A high correlation between CX and R recorded more than 2 wk later allows assessment of social behavior well before changes in case numbers become detectable. By construction, the CX quantifies the role of superspreading and permits assigning risks to specific contact behavior. We provide a critical CX value beyond which R is expected to rise above 1 and propose to use that value to leverage the social-distancing interventions for the coming months.


Assuntos
COVID-19/transmissão , COVID-19/virologia , Telefone Celular , Busca de Comunicante , SARS-CoV-2/fisiologia , COVID-19/epidemiologia , Alemanha/epidemiologia , Humanos
7.
Artigo em Inglês | MEDLINE | ID: mdl-34208085

RESUMO

The validity of the Montreal Cognitive Assessment (MoCA) in migrants is questionable, as sociodemographic factors and the migration process may influence performance. Our aim was to evaluate possible predictors (age, education, sex, depression, and migration) of MoCA results in Turkish migrants and Germans living in Germany. Linear regression models were conducted with a German (n = 419), a Turkish (n = 133), and an overall sample. All predictor analyses reached statistical significance. For the German sample, age, sex, education, and depression were significant predictors, whereas education was the only predictor for Turkish migrants. For the overall sample, having no migration background and higher education were significant predictors. Migration background and education had an impact on MoCA performance in a sample of German and Turkish individuals living in Germany. Thus, culture-specific normative data for the MoCA are needed, and the development of culture-sensitive cognitive screening tools is encouraged.


Assuntos
Depressão , Depressão/epidemiologia , Escolaridade , Alemanha/epidemiologia , Humanos , Modelos Lineares , Testes de Estado Mental e Demência
8.
Front Cell Infect Microbiol ; 11: 659753, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34268132

RESUMO

Antibiotic resistance represents a major global concern. The rapid spread of opportunistically pathogenic carbapenemase-encoding bacteria (CEB) requires clinicians, researchers, and policy-makers to swiftly find solutions to reduce transmission rates and the associated health burden. Epidemiological data is key to planning control measures. Our study aims to contribute by providing an analysis of 397 unique CEB isolates detected in a tertiary hospital in Germany. We propose new findings on demographic variables to support preventive sanitary precautions in routine clinical practice. Data on detected CEB was combined with patient's demographic and clinical information for each isolate. Multiple regression techniques were applied to estimate the predictive quality of observed differences. Our findings confirm the role of age and gender in CEB colonization patterns and indicate a role for ethnicity and domicile. Also, carbapenemase-encoding A. baumannii was most frequently introduced to the hospital, while the risk of colonization with VIM-encoding P. aeruginosa rose with the length of hospital stay. P. aeruginosa remains an important complication of prolonged hospital stays. The strong link to hospital-wastewater may have implications for hospital-built environments. A. baumannii can be efficiently controlled from spreading at hospital admission. OXA-encoding CEB being harder to detect in routine screening, targeted preventive measures, such as culture media selective for carbapenem-resistant bacteria, would be opportune for patients from selected regions. The CEB differences linked to ethnicity found in our study may further be supporting the tailoring of diagnostic approaches, as well as health policies upon confirmation by other studies and a better understanding of their global distribution.


Assuntos
Acinetobacter baumannii , Grupos Étnicos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Proteínas de Bactérias/genética , Alemanha/epidemiologia , Humanos , Testes de Sensibilidade Microbiana , Pseudomonas aeruginosa , beta-Lactamases/genética
9.
Artigo em Inglês | MEDLINE | ID: mdl-34281045

RESUMO

BACKGROUND: Worldwide, the number of treatments in the field of sports medicine is increasing. However, the COVID-19 pandemic has changed everyday life. Many consultations had to be cancelled, postponed, or converted to a virtual format. Telemedicine in sports medicine could support physicians. This study analyzes the use and perception of telemedicine applications among physicians and patients in the field of sports medicine in Germany. METHODS: This prospective cross-sectional study was based on a survey of sports medicine physicians and patients in Germany during the COVID-19 pandemic. Descriptive statistics were calculated. RESULTS: We analyzed the responses of 729 patients and 702 sports medicine physicians. Most believed that telemedicine is useful. Both physicians and patients rated their knowledge of telemedicine as unsatisfactory. The majority of respondents said they do not currently use telemedicine but would like to do so. Patients and physicians reported that their attitude had changed positively towards telemedicine and that their usage had increased due to COVID-19. The majority in both groups agreed on implementing virtual visits in stable disease conditions. Telemedicine was considered helpful for follow-up monitoring and prevention by both groups. CONCLUSION: Telemedicine in sports medicine has seen limited use but is highly accepted among physicians and patients alike. The absence of a structured framework is an obstacle to effective implementation. Training courses should be introduced to improve the limited knowledge regarding the use of telemedicine. More research in telemedicine in sports medicine is needed. This includes large-scale randomized controlled trials, economic analyses and explorations of user preferences.


Assuntos
COVID-19 , Médicos , Medicina Esportiva , Telemedicina , Estudos Transversais , Alemanha/epidemiologia , Humanos , Pandemias , Estudos Prospectivos , SARS-CoV-2
10.
Transl Psychiatry ; 11(1): 392, 2021 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-34282129

RESUMO

The COVID-19 pandemic and resulting measures can be regarded as a global stressor. Cross-sectional studies showed rather negative impacts on people's mental health, while longitudinal studies considering pre-lockdown data are still scarce. The present study investigated the impact of COVID-19 related lockdown measures in a longitudinal German sample, assessed since 2017. During lockdown, 523 participants completed additional weekly online questionnaires on e.g., mental health, COVID-19-related and general stressor exposure. Predictors for and distinct trajectories of mental health outcomes were determined, using multilevel models and latent growth mixture models, respectively. Positive pandemic appraisal, social support, and adaptive cognitive emotion regulation were positively, whereas perceived stress, daily hassles, and feeling lonely negatively related to mental health outcomes in the entire sample. Three subgroups ("recovered," 9.0%; "resilient," 82.6%; "delayed dysfunction," 8.4%) with different mental health responses to initial lockdown measures were identified. Subgroups differed in perceived stress and COVID-19-specific positive appraisal. Although most participants remained mentally healthy, as observed in the resilient group, we also observed inter-individual differences. Participants' psychological state deteriorated over time in the delayed dysfunction group, putting them at risk for mental disorder development. Consequently, health services should especially identify and allocate resources to vulnerable individuals.


Assuntos
COVID-19 , Saúde Mental , Controle de Doenças Transmissíveis , Estudos Transversais , Alemanha/epidemiologia , Humanos , Pandemias , Fatores de Proteção , SARS-CoV-2
11.
BMC Gastroenterol ; 21(1): 296, 2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34284732

RESUMO

BACKGROUND AND AIMS: Bacterial infections are common in patients with decompensated liver cirrhosis and a leading cause of death. Reliable data on antibiotic resistance are required to initiate effective empiric therapy. We here aim to assess the antimicrobial resistance profile of bacteria among patients with liver cirrhosis and infection. METHODS: Overall, 666 cirrhotic patients admitted to Hannover Medical School between January 2012 and April 2018 with ascites were assessed for bacterial infection. In case of infection, bacteria cultured from microbiological specimens of ascites, blood or urine were identified and analyzed for resistances against common antibiotic agents. Furthermore, analyses compared two periods of time and community-acquired vs. nosocomial infections. RESULTS: In 281 patients with infection, microbiological sampling was performed and culture-positive results were obtained in 56.9%. Multidrug-resistant (MDR)-bacteria were found in 54 patients (19.2%). Gram-positive organisms were more common (n = 141/261, 54.0%) and detected in 116/192 culture-positive infections (60.4%). Comparing infections before and after 2015, a numerical decline for MDR-bacteria (23.8% vs. 15.6%, p = 0.08) was observed with a significant decline in meropenem resistance (34.9% vs. 19.5%, p = 0.03). MDR-bacteria were more frequent in the case of nosocomial infections. Of note, in ascites the majority of the tested bacteria were resistant against ceftriaxone (73.8%) whereas significantly less were resistant against meropenem (27.0%) and vancomycin (25.9%). CONCLUSIONS: In our tertiary center, distinct ratios of gram-positive infection with overall low ratios of MDR-bacteria were found. Adequate gram-positive coverage in the empiric therapy should be considered. Carbapenem treatment may be omitted even in nosocomial infection. In contrast, 3rd generation cephalosporins cannot be recommended even in community-acquired infection in our cirrhotic population.


Assuntos
Antibacterianos , Infecções Bacterianas , Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/epidemiologia , Farmacorresistência Bacteriana , Alemanha/epidemiologia , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/tratamento farmacológico
12.
Artigo em Inglês | MEDLINE | ID: mdl-34205383

RESUMO

The COVID-19 pandemic has been a challenging period of upheaval for higher education students. This study aims to assess the factors associated with psychological stress during the COVID-19 pandemic among a sample of students in health-related fields at Munich universities in Germany. Students (n = 623) from KSH Munich and LMU Munich completed an online cross-sectional survey. Information on demographics and academic and everyday difficulties due to the COVID-19 pandemic as well as data on physical and mental health were collected. Multivariable logistic regression analyses were performed to identify factors associated with the outcome. The prevalence for higher psychological stress was 44% among the study population. Factors associated with higher psychological stress were: lower overall life satisfaction (p < 0.0001), worsened health situation (p < 0.0001), lack of social support (p = 0.0301) and social interaction (p = 0.0115), worries about financial difficulties due to loss of income (p = 0.0134), stressful thoughts about a second wave (p < 0.0001), feeling unable to positively influence the situation (p = 0.0262) and study-related effects, such as perceived study burden (p = 0.0003) and likely delay in studies (p = 0.0178)). The COVID-19 pandemic is having a significant negative impact on the mental health of students in health-related fields. Proactive efforts to support the mental health and well-being of students are needed.


Assuntos
COVID-19 , Pandemias , Estudos Transversais , Depressão , Alemanha/epidemiologia , Humanos , SARS-CoV-2 , Estresse Psicológico/epidemiologia , Estudantes , Universidades
14.
BMC Health Serv Res ; 21(1): 673, 2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-34238295

RESUMO

BACKGROUND: Hemodialysis (HD) and peritoneal dialysis (PD) are equivalent treatment alternatives for patients with end stage renal disease. In Germany, there is a legal obligation to inform every patient about all treatment alternatives and their possible harms and benefits. However, there is a low utilization of PD. Therefore, the question arises, whether HD patients perceive that they were informed about different dialysis options. We further investigate, if personal characteristics of informed and non-informed patients vary, and if both groups experienced the decision for their dialysis treatment as shared decision making (SDM). METHODS: The database was a nationwide postal survey of 590 HD patients from two statutory health insurers in Germany. Participants were asked whether they have been informed about both dialysis options. A logistic regression model examines impact factors on this information. We investigate differences in the German version of the 9-item SDM Questionnaire (SDM-Q-9) between informed and non-informed patients with a multivariate linear regression model. RESULTS: 56 % of the respondents reported they had been informed about different dialysis treatment options. Patients older than 65 had a 61 % lower chance than patients ≤ 65 for this information (p < 0.001). High educated patients had a 47 % higher chance for this information than patients with low education level (p = 0.030). Informed patients rated a higher SDM-Q-9 scores than non-informed patients (76.9 vs. 44.2; p < 0.001). Non-informed patients showed high values in those SDM-Q-9 items which had no regard to different treatment options. CONCLUSIONS: A great proportion of HD patients - mostly elderly patients and patients with a low education level - did not perceive that they were informed about different dialysis options before dialysis was initiated. The current obligation to provide information about all treatment alternatives in Germany is a first step to assure the unselected access to different treatment options. But it has not reached routine application in health care yet. Information about different treatment options can pave the way for SDM. While SDM is considered to be a valuable tool in clinical medicine, there is still room for improvement for its successful implementation when it comes to decision making on different dialysis treatment options. TRIAL REGISTRATION: The MAU-PD study (Multidimensional analysis of causes for the low prevalence of ambulatory peritoneal dialysis in Germany) is registered at the German Clinical Trials Register. DRKS-ID: DRKS00012555 Link: https://www.drks.de/drks_web/setLocale_EN.do . Date of Registration in DRKS: 2018/01/04.


Assuntos
Diálise Peritoneal , Diálise Renal , Idoso , Tomada de Decisões , Tomada de Decisão Compartilhada , Alemanha/epidemiologia , Humanos , Participação do Paciente , Estudos Retrospectivos , Inquéritos e Questionários
15.
BMC Neurol ; 21(1): 283, 2021 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-34281522

RESUMO

BACKGROUND: Most spontaneous subarachnoid hemorrhages (SAH) occur unexpectedly and independently of classical risk factors. In the light of increasing climate variability and change, we investigated weather and rapid weather changes as possible short-term risk factors for SAH. METHODS: Seven hundred ninety one patients admitted to three major hospitals in Germany for non-traumatic SAH with a determinable onset of SAH symptoms were included in this hospital-based, case-crossover study. The effects of atmospheric pressure, relative air humidity, and ambient temperature and their 24 h changes on the onset of SAH under temperate climate conditions were estimated. RESULTS: There was no association between the risk of SAH and 24 h weather changes, mean daily temperature or mean relative air humidity in the overall population. For every 11.5 hPa higher mean daily atmospheric pressure, the risk of SAH increased by 15% (OR 1.15, 95% confidence interval (CI) 1.01-1.30) in the entire study population with a lag time of three days. CONCLUSION: Our results suggest no relevant association between 24 h-weather changes or absolute values of ambient temperature and relative humidity and the risk of SAH. The medical significance of the statistically weak increase in SAH risk three days after exposure to high atmospheric pressure is unclear. However, as the occurrence of stable high-pressure systems will increase with global warming and potentially affect SAH risk, we call for confirming studies in different geographical regions to verify our observations.


Assuntos
Pressão Atmosférica , Umidade , Hemorragia Subaracnóidea/epidemiologia , Temperatura , Adulto , Idoso , Estudos Cross-Over , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
16.
Emerg Infect Dis ; 27(8): 2097-2106, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34286687

RESUMO

Toxoplasmosis is a zoonotic infection contracted through Toxoplasma gondii-contaminated food, soil, or water. Seroprevalence in Germany is high, but estimates of disease incidence are scarce. We investigated incidences for various toxoplasmosis manifestations using anonymized healthcare claims data from Germany for 2011-2016. Patients with a toxoplasmosis diagnosis during the annual observational period were considered incident. The estimated incidence was adjusted to the general population age/sex distribution. We estimated an annual average of 8,047 toxoplasmosis patients in Germany. The average incidence of non-pregnancy-associated toxoplasmosis patients was 9.6/100,000 population. The incidence was highest in 2011, at 10.6 (95% CI 9.4-12.6)/100,000 population, and lowest in 2016, at 8.0 (95% CI 7.0-9.4)/100,000 population. The average incidence of toxoplasmosis during pregnancy was 40.3/100,000 pregnancies. We demonstrate a substantial toxoplasmosis disease burden in Germany. Public health and food safety authorities should implement toxoplasmosis-specific prevention programs.


Assuntos
Toxoplasma , Toxoplasmose , Anticorpos Antiprotozoários , Atenção à Saúde , Feminino , Alemanha/epidemiologia , Humanos , Incidência , Gravidez , Fatores de Risco , Estudos Soroepidemiológicos , Toxoplasmose/epidemiologia
17.
Emerg Infect Dis ; 27(8): 2025-2032, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34286688

RESUMO

Infections with Mycobacterium microti, a member of the M. tuberculosis complex, have been increasingly reported in humans and in domestic and free-ranging wild animals. At postmortem examination, infected animals may display histopathologic lesions indistinguishable from those caused by M. bovis or M. caprae, potentially leading to misidentification of bovine tuberculosis. We report 3 cases of M. microti infections in free-ranging red deer (Cervus elaphus) from western Austria and southern Germany. One diseased animal displayed severe pyogranulomatous pleuropneumonia and multifocal granulomas on the surface of the pericardium. Two other animals showed alterations of the lungs and associated lymph nodes compatible with parasitic infestation. Results of the phylogenetic analysis including multiple animal strains from the study area showed independent infection events, but no host-adapted genotype. Personnel involved in bovine tuberculosis-monitoring programs should be aware of the fastidious nature of M. microti, its pathogenicity in wildlife, and zoonotic potential.


Assuntos
Cervos , Mycobacterium bovis , Tuberculose Bovina , Animais , Animais Selvagens , Áustria , Bovinos , Alemanha/epidemiologia , Mycobacterium bovis/genética , Filogenia
18.
Medicine (Baltimore) ; 100(27): e26526, 2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34232186

RESUMO

ABSTRACT: Smartphone alerting systems (SAS) for first responders potentially shorten the resuscitation-free interval of patients with acute cardiac arrest. During the corona virus disease-19 (COVID-19) pandemic, many systems are suspended due to potential risks for the responders.Objective of the study was to establish a concept for SAS during the COVID-19 pandemic and to evaluate whether a SAS can safely be operated in pandemic conditions.A SAS had been implemented in Freiburg (Germany) in 2018 alerting nearby registered first responders in case of emergencies with suspected cardiac arrest. Due to the pandemic, SAS was stopped in March 2020. A concept for a safe restart was elaborated with provision of a set with ventilation bag/mask, airway filter, and personal protective equipment (PPE) for every volunteer. A standard operating procedure was elaborated following the COVID-19 guidelines of the European Resuscitation Council.Willingness of the participants to respond alarms during the pandemic was investigated using an online survey. The response rates of first responders were monitored before and after deactivation, and during the second wave of the pandemic.The system was restarted in May 2020. The willingness to respond to alarms was lower during the pandemic without PPE. It remained lower than before the pandemic when the volunteers had been equipped with PPE, but the alarm response rate remained at approximately 50% during the second wave of the pandemic.When volunteers are equipped with PPE, the operation of a SAS does not need to be paused, and the willingness to respond remains high among first responders.


Assuntos
COVID-19/epidemiologia , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias , Equipamento de Proteção Individual , Smartphone , Socorristas , Alemanha/epidemiologia , Humanos , Estudos Retrospectivos , SARS-CoV-2
19.
Artigo em Alemão | MEDLINE | ID: mdl-34232335

RESUMO

BACKGROUND AND AIM OF THE WORK: Information on the oral health of the population is important for the assessment of (preventable) disease burden, for the estimation and planning of health resources and costs, and for the evaluation of health inequalities. The aim of this work is to investigate for the first time self-perceived oral health, including associated factors, based on data from a nationally representative sample for the adult population in Germany. MATERIAL AND METHODS: The data basis is the nationwide German Health Update study (GEDA 2019/2020-EHIS, n = 22,708 aged 18 years and older). In the telephone interview, the participants were asked how they would describe the state of their teeth and gums - "very good," "good," "fair," "bad," or "very bad." Sociodemographic, behavioral, and dental characteristics are examined as associated factors. Prevalences and results of multivariate binary logistic regressions (odds ratios, OR) are reported. RESULTS AND DISCUSSION: Of the participants, 71.4% perceived their oral health as very good or good, 28.6% as fair to very bad. Difficulty in chewing and biting on hard foods (OR 4.0), unmet dental care needs (OR 2.3), male gender (OR 1.5), and not consuming fruits and vegetables daily (OR 1.2) were the most important associated factors for fair to very bad self-perceived oral health; for men, low education (OR 2,1), daily smoking (OR 1.6) and not receiving dental care annually (OR 1.4) were also important. From the results, starting points for promoting oral health can be derived.


Assuntos
Saúde Bucal , Adulto , Estudos Transversais , Escolaridade , Alemanha/epidemiologia , Humanos , Masculino , Prevalência , Fatores Socioeconômicos
20.
PLoS One ; 16(7): e0254648, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34260657

RESUMO

In the fight against the COVID-19 pandemic, personal hygiene behaviours such as proper handwashing have gained significantly more attention and interpersonal contact is performed with great care. Disgust, as a disease-avoidance mechanism, can play an important role in the promotion of hygiene behaviour. We know from previous research that pathogen disgust can be a predictor of an individual's behaviour in the pandemic. Given that the pandemic greatly affects our food and eating behaviour, the current study aims to add to the existing evidence and to complement it by investigating the role of food-specific disgust in the pandemic. For that, we conducted an online survey in Germany in April 2020, while the pandemic was spreading in Europe. A total of 519 participants completed the survey and provided information about their COVID-19-related attitudes and behaviours and about their food disgust sensitivity. The results show that food disgust sensitivity is an important predictor for an individual's feelings, shopping behaviour, and disease-preventive behaviour related to the COVID-19 pandemic. Given that the success of political measures to fight the pandemic critically depends on the population to support and follow the proposed measures, a better understanding of the factors driving individual behaviour is key. Implications for pandemic management are discussed.


Assuntos
Ansiedade/virologia , COVID-19/epidemiologia , Asco , Comportamento Alimentar/psicologia , Pandemias/prevenção & controle , Adulto , Idoso , COVID-19/psicologia , Feminino , Alemanha/epidemiologia , Humanos , Higiene , Internet , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
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