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Background Stroke is the second most common cause of death worldwide. Even after surviving, long-term rehabilitation often becomes necessary and does not always lead to complete recovery. Guidelines focus on prevention of risk factors and present concepts for rehabilitation after a stroke. Additional to these recommendations, complementary medicine (CM) utilization is common among patients with neurological conditions. CM also offers a wide range of therapies for both prevention and rehabilitation in stroke. There is limited information available on CM utilization among stroke survivors and differences to patients without former stroke diagnosis. Methods and results This analysis was based on data of the 2017 National Health Interview survey (NHIS, n = 26,742; response rate 80,7%). We analyzed the prevalence of consultations among stroke patients with CM practitioners within the last 12 months and reasons for utilization. 3.1% of participants reported a stroke, individuals without a prior stroke diagnosis were more likely to have used CM in the past 12 months (31.3% without versus 28.9% with stroke). Consultations with a chiropractor and of using mind-body-medicine was higher in individuals without stroke diagnosis, while more stroke survivors had consulted a naturopath. Equal proportions had consulted a homeopath. Most common therapy approaches among stroke survivors were spiritual meditation (13.7%), progressive relaxation (5.4%), yoga (5.2%), mindfulness meditation (4.3%), mantra meditation (3.1%), guided imagery (2.6%) and tai chi (1.7%). CM use in stroke survivors was associated with female sex (adjusted odds ratio [AOR] = 2.12, 95% confidence interval [CI] = 1.56–2.88) and higher education (AOR = 1.94, CI = 1.42–2.65). Conclusion Stroke patients were less likely to take advantage of complementary medicine than the general population. Since there are many safe and beneficial options, stroke survivors might profit from better information about the existing possibilities regarding prevention and rehabilitation.

In recent years Jupyter notebooks have conquered class rooms and some scientists also enjoy their convenience to quickly evaluate ideas and check whether a more detailed study is justified. To lower the threshold for getting started with Jupyter notebooks and to ease sharing and collaborative use, offering a JupyterHub service is tempting. However, offering such a service for a larger science class also requires a compute backend with sufficient resources such that hundreds of notebooks can be run simultaneously. Since resource usage for teaching activities typically fluctuates significantly over the year, dedicated compute resources seem inefficient. In this paper we present an alternative by exploiting an existing high throughput computing cluster (BAF2) at the University of Bonn, which comes with the additional advantage that scientific users may use the very same software and data environment they also select for their batch jobs. To implement this, we used a novel approach which allowed us to integrate BAF2 execute nodes although they do not have inbound network connectivity. Therefore, it does not touch the security concept of the cluster. The very same technique can be used to integrate any compute resources without inbound network connectivity and thus allows one to overcome usual firewall restrictions. This design also simplifies exploiting remote resources e.g. offered by resource federations or cloud providers.

Herpes zoster (HZ) wird durch die Reaktivierung des Varicella-zoster-Virus (VZV) ausgelost. Die Inzidenz von HZ und assoziierten Problemen nimmt mit steigendem Lebensalter zu. Mit einer lebenslangen Pravalenz von 30 % erkrankt jeder zweite 85-Jahrige sozusagen 1‑mal an einem HZ. Die 3 Therapiesaulen umfassen antivirale, topische und analgetische Therapien. Eine extreme Belastung kann der akute und persistierende Schmerz, der dann in eine postherpetische Neuralgie (PHN) ubergeht, darstellen. Therapeutisch herausfordernd kann akut und im Verlauf der neuropathische Schmerz sein. Eine wesentliche Besserung im Sinne der Pravention eines HZ und zudem der Reduktion des Kollektivs erkrankter Patienten, die eine PHN entwickeln, stellt die Impfung mit HZ-Impfstoffen dar. Von der standigen Impfkommission des Robert Koch-Instituts (STIKO) wird ein Totimpfstoff bei allen Personen ab dem 60. Lebensjahr empfohlen. Risikogruppen wie Patienten mit Immunschwache wird die Impfung bereits ab einem Alter von 50 Jahren nahegelegt.

$\gamma p \rightarrow K^+ \Lambda$ differential cross sections and recoil polarisation data from threshold for extremely forward angles are presented. The measurements were performed at the BGOOD experiment at ELSA, utilising the high angular and momentum resolution forward spectrometer for charged particle identification. The data discriminates between conflicting results in the world data set and enable extraction of the cross section as the minimum momentum transfer to the recoiling hyperon is approached., Comment: 12 pages (including a 2 page appendix), 14 figures

Background Emerging antimicrobial resistance (AMR) challenges gonorrhoea treatment and requires surveillance. Aim This observational study describes the genetic diversity of Neisseria gonorrhoeae isolates in Germany from 2014 to 2017 and identifies N. gonorrhoeae multi-antigen sequence typing (NG-MAST) genogroups associated with AMR or some patient demographics. Methods 1,220 gonococcal isolates underwent AMR testing and NG-MAST. Associations between genogroups and AMR or sex/age of patients were statistically assessed. Results Patients’ median age was 32 years (interquartile range: 25–44); 1,078 isolates (88.4%) originated from men. In total, 432 NG-MAST sequence types including 156 novel ones were identified, resulting in 17 major genogroups covering 59.1% (721/1,220) of all isolates. Genogroups G1407 and G10557 (G7072) were significantly associated with decreased susceptibility to cefixime (Kruskal–Wallis chi-squared: 549.3442, df: 16, p

The BGO-OD experiment at the ELSA accelerator facility uses an energy tagged bremsstrahlung photon beam to investigate the excitation structure of the nucleon via meson photoproduction. The setup with a BGO calorimeter surrounding the target and an open dipole spectrometer covering the for ward region is ideally suited for investigating low momentum transfer processes, in particular in strangeness photoproduction. The associated photoproduction of K0S and hyperons is essential to understand the role of K* exchange mech anisms. A cusp-like structure observed in the yp → K0SΣ+ reaction at the K* threshold is described by models including dynamically generated resonances from vector meson-baryon interactions. Such interactions are pre dicted to give a peak like structure in K0SΣ0 photoproduction off the neutron. A very preliminary cross section is determined and compared to the prediction, the results appear to support the model

In February 2019, the fourth expert meeting on rapid diagnostic tests (RDTs) for sexually transmitted infections (STI) was held at the Robert Koch Institute (RKI) in Berlin. Novel technical developments and new aspects of RDT applications were discussed by representatives from the German STI Society (DSTIG); RKI; the Paul Ehrlich Institute; national reference centers for HIV, HBV, and HCV; and reference laboratories for Chlamydia, gonococci, and Treponema pallidum.As a result of this meeting, we present a revision of the joint statement on STI diagnostics with RDTs from 2017. The Regulation (EU) 2017/746 of the European Parliament and of the Council on in vitro diagnostic medical devices became effective in May 2017 and includes more stringent regulatory requirements for RDTs, mainly concerning conformity of manufacturing processes and performance characteristics of class D in vitro diagnostics (detection of HIV, HBV, HCV, and T. pallidum). Some RDTs for HIV, HCV, and T. pallidum have been evaluated in clinical studies and/or were WHO prequalified and may be used in low-threshold services. Among them are some HIV RDTs available and approved for self-testing. In addition, some HBV RDTs based on detection of HBs antigen (HBsAg) received WHO prequalification. However, false negative results may occur in samples with low HBsAg levels, as for instance in HIV-coinfected patients receiving antiretroviral therapy. For Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), antigen-based RDTs still do not allow reliable detection of infection. Only PCR-based CT/NG RDTs possess sufficient diagnostic accuracy to be used as point-of-care tests. Rapid PCR tests for NG, however, do not provide any information about antimicrobial resistance.

The BGO-OD experiment at the ELSA accelerator facility uses an energy tagged bremsstrahlung photon beam to investigate the excitation structure of the nucleon. The setup consists of a highly segmented BGO calorimeter surrounding the target, with a particle tracking magnetic spectrometer at forward angles. BGO-OD is ideal for investigating low momentum transfer processes due to the acceptance and high momentum resolution at forward angles. In particular, this enables the investigation of strangeness photoproduction where t-channel exchange mechanisms play an important role. This also allows access to low momentum exchange kinematics where extended, molecular structure may manifest in reaction mechanisms. First key results at low $t$ indicate a cusp-like structure in $K^+\Sigma^0$ photoproduction at $W = 1900$\,MeV, line shapes and differential cross sections for $K^+\Lambda$(1405)$\rightarrow K^+\Sigma^0\pi^0$, and a peak structure in $K^0_S\Sigma^0$ photoproduction. The peak in the $K^0_S\Sigma^0$ channel appears consistent with meson-baryon generated states, where equivalent models have been used to describe the $P_C$ pentaquark candidates in the heavy charmed quark sector., Comment: Proceedings of The 12th International Workshop on the Physics of Excited Nucleons (NSTAR 2019)

The unexpected nodal structure of the beam asymmetry recently reported by the GRAAL collaboration in η′ photoproduction very close to threshold could be explained by a previously unobserved narrow resonance. The BGO-OD experiment is ideally suited to verify this measurement via the detection of forward going charged particles which in the threshold region of interest allows the identification of the reaction γp → η′ p solely based on the proton going in the forward direction. This yields unprecedented statistics if, in the missing mass analysis of the η′ meson, the background can be sufficiently well controlled. Preliminary results using a linearly polarised photon beam are shown. The reaction γp → η′ p was identified in the BGO forward spectrometer, with simulated data used to seperate signal and background.

The γ p → K + Σ 0 differential cross section at extremely forward angles was measured at the BGOOD experiment. A three-quarter drop in strength over a narrow range in energy and a strong dependence on the polar angle of the K + in the centre-of-mass of the reaction is observed at a centre-of-mass energy of 1900 MeV. Residing close to multiple open and hidden strangeness thresholds, the structure appears consistent with meson-baryon threshold effects which may contribute to the reaction mechanism.

Herpes zoster (HZ) is caused by the reactivation of varicella zoster virus. The incidence of herpes zoster and associated problems increases with age. With a life-long prevalence of 30%, every second 85-year-old person experiences HZ once in his lifetime. Three therapeutic columns are based on antiviral, topical and analgetic therapies. An extreme handicap is acute and persistent pain which can develop into postherpetic neuralgia (PHN). Those pain symptoms are predominantly neuropathic. The management of acute and chronic manifestation of pain may be challenging. HZ vaccination represents a substantial improvement in terms of prevention of herpes zoster and reduction of long-term complications, such as PHN. The permanent vaccination commission of the Robert Koch Institute recommends vaccination with dead virus for all persons over the age of 60 years. Risk groups like immunosuppressed patients are advised to be vaccinated starting at the age of 50 years.

Background German national guidelines recommend ceftriaxone combined with azithromycin for Neisseria gonorrhoeae (NG) treatment since 2014. The Gonococcal-Resistance-Network (GORENET) monitors gonococcal antimicrobial resistance (AMR) in Germany. The aim is to assess whether national guidelines are still effective in Germany and which factors affect higher minimum inhibitory concentrations (MICs). Methods GORENET laboratories sent NG isolates to the conciliar laboratory for centralized retesting of AMR using E-test. We included infection year, sex, age, infection site and clinical service type in the analysis. Geometric means were calculated for MICs for infection year. The effects of infection year, sex, age, infection site and clinical service type on MICs for ceftriaxone, cefixime, and azithromycin were investigated by multiple linear regression. Results Overall, 278 (2014), 303 (2015), 438 (2016) and 409 (2017) isolates were analysed. Of these, 90% of isolates came from men. Median age was 33 years (IQR: 25–44). Cumulative geometric means of MICs 2014–2017 were 0.006 µg/ml for ceftriaxone, 0.022 µg/ml for cefixime, and 0.185 µg/ml for azithromycin. In adjusted analysis, MICs decreased for ceftriaxone, cefixime and azithromycin by 0.74 (CI-95% 0.70–0.79), 0.89 (CI-95% 0.87–0.92) and 0.79 (CI-95% 0.75–0.83) per year, respectively. For ceftriaxone, isolates from urology (1.40; 95%-CI 1.15–1.69) and other service types (1.39; 95%-CI 1.10–1.77) compared to internal medicine, and from women (1.58; 95%-CI 1.14–2.18) were associated with increased MICs. Regarding cefixime isolates collected from urology (1.14; 95%-CI 1.02–1.28) compared to internal medicine, and from women (1.41; 95%-CI 1.18–1.69) were associated with increased MICs. For azithromycin, isolates from urology (0.82; 95%-CI 0.70–0.97) compared to internal medicine, and from women (0.77; 95%-CI 0.59–1.00) were associated with decreased MICs. Conclusion Treatment options as recommended by German national guidelines are still applicable. The lower MICs after 2014 may be due to the change of national treatment guidelines in 2014. Differences in MICs regarding service types and sex need to be further investigated. Disclosure No significant relationships.

Background The widespread antimicrobial resistance (AMR) of Neisseria gonorrhoeae (NG) is a serious problem for the treatment of gonorrhoea. Because NG infections are not reportable in Germany, only limited data on disease epidemiology and antimicrobial susceptibility patterns are available. The Gonococcal Resistance Network (GORENET) monitors trends of NG AMR in Germany and links this to epidemiological data and NG multiantigen sequence typing (NG-MAST) data to guide treatment algorithms and target future prevention strategies. Methods Between April 2014 and December 2018, NG isolates and data on patient-related information were collected from laboratories nationwide and centralized susceptibility testing using E-test was performed. Susceptibility results for cefixime, ceftriaxone, azithromycin, ciprofloxacin and penicillin were defined according to EUCAST 4.0 standards. Results Of 2115 isolates, 91.6% of isolates were from men. The most frequently tested materials among men were urethral (92.4%) and rectal swabs (3.8%), and among women mainly endocervical swabs (80.9%). Resistance to ceftriaxone (MIC ≥0.125 mg/L) occurred only sporadically (0–0.3%) during the entire observation period (2015 and 2018), while 1.0–2.1% of isolates were resistant to cefixime (MIC ≥0.125 mg/L). Proportion of isolates resistant to azithromycin (MIC ≥ 0.5 mg/L) was 11.4% (2014), 11.3% (2015), 4.3% (2016), 3.7% (2017), 9.4% (2018). 53.4–71.7% were resistant to ciprofloxacin, and 14.2–24.3.1% were resistant to penicillin. Conclusion Resistance to ceftriaxone and to cefixime was low, whereas azithromycin resistance showed a discontinuous presentation with partly high levels during the observation period. Rates of ciprofloxacin and penicillin resistance were very high. According to the current national guidelines, ceftriaxone 1-2g IV and azithromycin 1,5g orally are usually used in dual therapy. Shortly revised national guidelines will state that use of azithromycin should be avoided if possible if a test of cure can be guaranteed and a susceptibility test is available. Continued surveillance of NG AMR remains relevant to ensure efficient disease management. Disclosure No significant relationships.

Background Neisseria gonorrhoeae (NG) infections are not reportable in Germany. The Gonococcal Resistance Network (GORENET) is a laboratory network to monitor antimicrobial resistance (AMR) in Germany, linking data from sequence typing to epidemiological data. We described prevalence of gonococcal sequence types in Germany and associations to AMR to improve future treatment and prevention strategies. Methods NG isolates collected between April 2014 and December 2017 were tested by E-test and sequence typed by NG multiantigen sequence typing (NG-MAST). For sequence typing, DNA was extracted and internal fragments of porB and tbpB were amplified by polymerase chain reaction. Fragments were sequenced by Sanger sequencing and evaluated using a global database (www.ng-mast.net). Genogroups were assigned to sequence types which shared one allele and exhibited ≥99% homogeneity in the other allele. Results 1220 isolates were sequence typed (106 in 2014, 96 in 2015, 525 in 2016, and 495 in 2017). In total, we detected 422 different sequence types that grouped into 17 genogroups. Among the most prevalent genogroups were G2400 (6.8%), G1407 (6.8%), G5441 (6.2%), G25 (5.6%), G2992 (5.5%) and G10557 (5.3%). The multi-resistant G1407 and G2400 were most prevalent in 2014 (12.4% and 10.5%, respectively) and declined to 6.1% and 7.3% in 2017. Two new genogroups, G11461 (3.6%) and G17420 (2.1%), emerged showing high prevalence in 2017 and no association to extended-spectrum cephalosporin resistance. Furthermore, a novel genogroup-association with cefixime resistance and reduced cephalosporin susceptibility was identified. Conclusion From 2014 to 2017 prevalence of G1407 declined and two novel extended-spectrum cephalosporin sensitive clones G11461 and G17420 seem to have replaced the multi-drug resistance clone G1407. To verify these results, continuous testing with an increased number of isolates should be performed. Disclosure No significant relationships.

The BGO-OD experiment at the ELSA accelerator facility uses an energy tagged bremstrahlung photon beam to investigate the excitation structure of the nucleon. The setup consists of a highly segmented BGO calorimeter surrounding the target, with a particle tracking magnetic spectrometer at forward angles. BGO-OD is ideal for investigating low momentum transfer processes due to the acceptance and high momentum resolution at forward angles. In particular, this enables the investigation of strangeness photoproduction where t-channel exchange mechanisms play an important role. This also allows access to a kinematic region where extended, molecular structure may manifest in reaction mechanisms. The extensive strangeness photoproduction programme includes the photoproduction of neutral and charged kaons using both hydrogen and deuterium targets.

Since the discovery of the Λ(1405), it remains poorly described by conventional constituent quark models, and it is a candidate for having an “exotic” meson-baryon or “penta-quark” structure, similar to states recently reported in the hidden charm sector.The Λ(1405) can be produced in the reactionγpK+Λ(1405). The pure I=0 decay mode into Σ0π0is prohibited for the mass-overlapping Σ(1385). Combining a large aperture forward magnetic spectrometer and a central BGO crystal calorimeter, the BGO-OD experiment is ideally suited to measure this decay with theK+in the forward direction. Preliminary results are presented.*Supported by DFG (PN 388979758, 405882627)

Bakterielle sexuell ubertragbare Infektionen (STI) zeigen seit Jahren weltweit eine deutliche Zunahme. In Deutschland wird diese Tatsache durch steigende Meldezahlen fur Syphilis bestatigt. Auch fur die nicht meldepflichtigen STI Gonorrhoe, Chlamydia-trachomatis- und Mycoplasma-genitalium-Infektionen wird eine zunehmende Inzidenz beobachtet. Entscheidend fur die Weiterverbreitung ist, dass das breite klinische Spektrum, welches neben Urogenitalsitus auch Pharynx und Rektum einbezieht, durch eine hohe Zahl asymptomatischer Verlaufe erganzt wird. Neue Real-Time-Multiplex-Diagnostikverfahren ermoglichen einen schnellen und gezielten Nachweis von STI-Erregern. Die haufigste bakterielle STI ist die urogenitale Chlamydieninfektion mit den Serovaren D-K, die besonders bei jungen Erwachsenen auftritt. Einer Chlamydien-Proktitis kann eine Infektion mit L-Serovaren und damit eine Lymphogranuloma-venereum (LGV)-Infektion zugrunde liegen. Neisseria (N.) gonorrhoeae zeigte in den letzten Jahren eine starke Resistenzentwicklung mit Ausbildung von Einzel- und Multiresistenzen gegenuber bisher gangigen Antibiotika. Daher ist fur N. gonorrhoeae zusatzlich zum nucleic acid amplification test (NAAT) eine kulturelle Empfindlichkeitstestung durchzufuhren. Auch fur Mycoplasma genitalium sind Resistenzentwicklungen bekannt, die eine Therapie erschweren konnen.

Worldwide, the incidence of bacterial sexually transmitted infections (STIs) has shown a significant increase in recent years. In Germany, this circumstance is reflected by a rise in the number of reported syphilis cases. There has also been an uptick in the incidence of non-notifiable STIs such as gonorrhea and infections caused by Chlamydia trachomatis and Mycoplasma genitalium. A key factor in the spread of these infections is their varied clinical presentation, which includes urogenital, pharyngeal and rectal involvement as well as a large number of asymptomatic cases. New real-time multiplex PCR methods allow for rapid and targeted detection of STI pathogens. The most common bacterial STI is urogenital chlamydial infection caused by serovars D-K, which affects young adults in particular. Lymphogranuloma venereum (LGV) caused by L serovars often presents as chlamydial proctitis. In recent years, Neisseria (N.) gonorrhoeae has shown a significant development of resistance, with high-level monoresistance and multiresistance to antibiotics commonly used for treatment. It is therefore imperative that sensitivity testing of N. gonorrhoeae be performed in addition to nucleic acid amplification tests (NAATs). Increased drug resistance has also been observed for Mycoplasma genitalium, a fact that complicates treatment.

The BGO-OD experiment at the ELSA accelerator facility uses an energy tagged bremstrahlung photon beam to investigate the excitation spectrum of the nucleon. The setup consists of a highly segmented BGO calorimeter surrounding the target, with a particle tracking magnetic spectrometer at forward angles. BGO-OD is ideal for investigating the photoproduction of hadrons of non-zero strangeness. The high momentum resolution at forward angles covers a kinematic region where t-channel exchange mechanisms play a dominant role. Access to this low momentum transfer region also allows the investigation of degrees of freedom not derived from constituent quark models, for example, the role of (vector) meson - baryon interactions and dynamically generated states in photoproduction reactions. Data taking for the first part of an extensive physics programme is complete and preliminary results and ongoing analysis are presented. (Less)

Die Urethritis, mit typischen Symptomen wie Dysurie und Fluor, wird durch Bakterien, Pilze, Protozoen und Viren verursacht, die oft sexuell ubertragen werden. Aufsteigende Entzundungen konnen zu Sterilitat und schweren Krankheitsbildern fuhren. Erregereigenschaften und patientenspezifische Faktoren bestimmen den Verlauf. Bei Nachweis einer sexuell ubertragbaren Infektion (STI) ist immer die Untersuchung auf weitere STIs zu fordern. Die Gonorrhoe manifestiert sich an Schleimhauten des Urogenital- und Analtrakts, des Rachens und der Konjunktiven. Besorgniserregend ist die Entwicklung von Einzel- und Multiresistenzen. Derzeit wird die duale Therapie mit Ceftriaxon und Azithromycin empfohlen. Die urogenitale Chlamydien-Infektion (Serovare D–K) gehort zu den haufigsten STIs. Bei einer Proktitis sollte auch an eine LGV-Infektion gedacht werden. Zur Behandlung eignen sich Doxycyclin oder Azithromycin. Genitale Mykoplasmeninfektionen bestehen oft bei persistierender oder rezidivierender Urethritis. Zunehmend treten Resistenzen auf. Zur Behandlung wird Azithromycin empfohlen. Die Trichomoniasis gilt als STI mit der hochsten Pravalenz. Mittel der Wahl ist Metronidazol.

Weltweit sind zunehmende Antibiotikaresistenzen (AMR) bei Infektionen mit Neisseria gonorrhoeae (NG) zu beobachten. Aufgrund der fehlenden Meldepflicht in Deutschland stehen kaum epidemiologische und bevolkerungsbezogene Daten zur Verbreitung von NG-Infektionen und deren AMR zur Verfugung. Ziel der hier vorgestellten Erhebung war die Erfassung der NG-Diagnostikmethoden und AMR-Testungen von Laboren in Deutschland. Zwischen Juni und August 2013 wurde eine Querschnittserhebung in Deutschland uber einen Online-Fragebogen durchgefuhrt. Labore mit NG-Diagnostik wurden identifiziert, um sie hinsichtlich der Diagnostikmethoden, des Probenumfangs, der getesteten Antibiotika, der beobachteten AMR sowie mit Blick auf allgemeine Laborangaben zu charakterisieren. Insgesamt fuhrten 188 von 521 teilnehmenden Laboren eine NG-Diagnostik durch. Ihre Angaben waren somit Grundlage fur die weiteren statistischen Auswertungen. 92,6 % der Labore fuhrten einen Kulturnachweis durch. Im Median wurden 60 Proben pro Quartal (PpQ) (IQR 15–270) getestet. Der Positivenanteil unter Mannern lag bei 4,1 % sowie 6,9 %. Die Mehrzahl (82,1 %) der 151 Labore mit Kulturnachweis fuhrte eine AMR-Testung durch. Die hier am haufigsten getesteten Antibiotika waren Ciprofloxacin (94,8 %), Penicillin (93,1 %), Doxycyclin (70,0 %) und Ceftriaxon (67,2 %). Die Antibiotika gegen die am haufigsten jemals Resistenzen beobachtet wurden waren Ciprofloxacin (87,1 %), Penicillin (78,3 %), Doxycyclin (56,6 %) und Azithromycin (35,1 %; alle Angaben als Protzentsatz der Labore). Es wurden unterschiedliche AMR-Ablesestandards verwendet. Die weltweite Resistenzentwicklung weist darauf hin, dass eine regelmasige Uberwachung von AMR bei NG-Infektionen erforderlich ist. Die im Rahmen der Studie erhobenen Daten zur deutschen Laborlandschaft bei der NG-Diagnostik bieten hierfur eine wichtige Voraussetzung.

Diese venerischen Erkrankungen (STI) sind in Europa selten. Das Lymphogranuloma venereum (LGV), verursacht durch L-Serovare von Chlamydia trachomatis, verlauft in Stadien mit genitoanalen Ulzerationen und wird zunehmend bei MSM (men who have sex with men) mit HIV-Infektion angetroffen. Therapie der Wahl ist Doxycyclin. Im Spatstadium sind chirurgische Masnahmen erforderlich. Ulcus molle, hervorgerufen durch Haemophilus ducreyi, ist in den Tropen verbreitet. Klinisch findet sich ein dolentes Ulkus mit Lymphangitis. Therapeutisch wird Azithromycin eingesetzt. Bei HIV-Infektion kann es zu Therapieversagen kommen. Die Donovanosis, durch Klebsiella granulomatis verursacht, ist durch Ulzerationen und destruierende Granulome im Genitoanalbereich gekennzeichnet. Mittel der Wahl ist Azithromycin. Die Verbreitung des Zika-Virus erfolgt uber die Aedes-Mucke. Auch eine sexuelle Ubertragung ist moglich. Die Infektion kann beim Fotus zur Mikrozephalie fuhren. Eine Therapie gibt es nicht. Praventiv werden Muckenschutz und Gebrauch von Kondomen empfohlen.

Nazi anti-Semitism had a considerable impact on dermatology during the period 1933 to 1945. Before World War II, dermatology in German-speaking lands was at the forefront of medicine, and about 25% of the dermatologists were Jewish. Many perished during the Holocaust; others emigrated from Germany and played a major role in advancing dermatology in their new homes, especially in the United States. Erich Langer (1891–1957) was almost unique, because he survived the entire period in Berlin. Langer had been chief of dermatology at Berlin-Britz, a large city hospital, before 1933 but was discharged almost immediately after the Nazi takeover because of his Jewish roots. In June 1945 he returned to his old department and resumed charge. He became one of the key figures in rebuilding German dermatology in the immediate postwar years. He served as first chair of dermatology at the new Free University in Berlin, started two journals, and wrote several books. Until recently, very little was known about Erich Langer's mysterious tale of survival and how he evaded Nazi roundups. Fortunately, we have discovered considerable archival material that has allowed us to piece together, for the first time, a detailed account of Langer's courageous and remarkable story as the last Jewish dermatologist in Nazi Berlin.

Erratum zu: Hautarzt (2019) https://doi.org/10.1007/s00105-019-4446-0 Im CME-Fragebogen dieses Beitrages ist ein Dosierungsfehler bei der Anwendung von Tilidin aufgetreten. Bitte beachten Sie die korrekte Frage. Ein 82-jahriger Patient mit einem akuten Herpes zoster thorakal und einer bekannten …

Sexuell ubertragbare Infektionen (STI) sind ubiquitar verbreitet. Durch die zunehmende Globalisierung breiten sich Erreger mit den jeweiligen Resistenzen rasch kontinentubergreifend aus. Derzeit lassen sich dramatische Resistenzentwicklungen bei Gonokokken beobachten. Es besteht die Gefahr der Entwicklung multiresistenter Neisseria-gonorrhoeae-Stamme. Aus diesem Grund mussten die Therapieempfehlungen weltweit uberarbeitet werden. Bei der Syphilis ist ein deutlicher Anstieg der Erkrankungsfalle in Deutschland zu beobachten. Die Behandlung mit Penicillin ist unverandert wirksam, jedoch werden Resistenzen gegen Makrolide zunehmend problematisch. Fur Chlamydieninfektionen bestehen gut etablierte diagnostische und therapeutische Richtlinien. Besondere Beachtung findet ein Ausbruch von Lymphogranuloma venereum (LGV) in Europa unter MSM (men who have sex with men) mit gleichzeitiger HIV-Infektion.

BGO-OD is a new meson photoproduction experiment at the ELSA facility of Bonn University. It aims at the investigation of non strange and strange baryon excitations, and is especially designed to be able to detect weekly bound meson-baryon type structures. The setup for the BGO-OD experiment is presented, the characteristics of the photon beam and the detector performances are shown and the initial experimental program is discussed.

Summary Background Benign mucinous metaplasia of the genitalia (BMM) is a rare condition typified by cells with foamy mucinous cytoplasm. Differential diagnoses include extramammary Paget disease (PD) and human papillomavirus (HPV)-induced vulval intraepithelial neoplasia (VIN) with mucinous differentiation. Objectives To characterize histopathological and immunohistochemical features of BMM and to forge criteria for differentiation from PD and VIN with mucinous differentiation. Methods Eight biopsy specimens of BMM were stained with haematoxylin and eosin, periodic acid–Schiff and alcian blue, and for cytokeratin (CK) 7, CK10, CK14, CK20, carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), S100, gross cystic disease fluid protein-15 (GCDFP-15), lysozyme and Ki67 and compared with PD. Polymerase chain reaction was performed in order to identify HPV-specific DNA. Results BMM showed mucin deposition in superficial epithelial layers ranging from numerous large goblet cells to subtle deposits. The epithelium often showed polygonal (squamoid) or cuboidal differentiation while columnar differentiation was an inconsistent feature. A band-like inflammatory infiltrate was consistently present. Metaplastic epithelium consistently expressed CK7, CEA and EMA either in the entire epithelium or in a superficial band, while CK14, CK10, GCDFP-15 and lysozyme were largely not expressed, and staining for CK20 and S100 was negative. Comparison with PD demonstrated similar staining characteristics, but in a scattered pattern of mucinous cells within preserved squamous epithelium and not in a band-like pattern as in BMM. Nuclear pleomorphism and Ki67-positive mucinous cells in superficial epithelial layers were seen only in PD; GCDFP-15 and/or lysozyme were expressed in the majority of cases of PD. No evidence of HPV-specific DNA was found in BMM. Conclusions The spectrum of changes in BMM is distinctive, and BMM can be differentiated with surety from both PD and VIN with mucinous differentiation.

Nachdem die Gonorrho mikrobiologisch nachgewiesen ist, lasst sie sich mit einer gezielten antibiotischen Therapie in der Regel gut heilen. Die Zunahme der Resistenz gegenuber mehreren verschiedenen Substanzklassen in den letzten Jahren erschwert jedoch die Behandlung

Limited data exist in regard to productivity and staffing in the anatomic pathology laboratory. In 2004, the National Society for Histotechnology (NSH) conducted a pilot study to examine productivity and staffing in the histology laboratory. After review of the data, The College of American Pathologists (CAP)/NSH Histotechnology Committee concluded that a larger survey was required to further address and expand on the pilot study findings. In 2007, a total of 2674 surveys were sent out to North American laboratories. From the responses, comparisons of laboratory demographics and productivity were examined by institution type and workload volume. Productivity was measured as the number of paraffin-embedded tissue blocks processed per full-time equivalent per year. This manuscript presents and discusses the data collected from the CAP/NSH Workload Study.

Malignant changes in persistent venous leg ulcers are a grave complication of chronic impaired wound healing. In our case, a venous leg ulcer had persisted on the right calf for 30 years. Exophytic tumors in the ulcer with frequent bleeding prompted biopsies. A squamous cell carcinoma was found, but only in the second biopsy. The surgical procedure was planned so that in a single session both the tumor and the underlying causes of the chronic venous insufficiency in the leg could be treated appropriately. Extirpation of the enlarged lymph nodes in the groin was combined with crossectomy and removal of the long saphenous vein, followed by circular radial excision of the ulcer scar fascia (fasciotomy). The excised tissue was examined histologically. Muscle biopsies were taken from the site of suspicious adhesions of the fascia to the calf muscle. The large, circular defects on the lower leg were covered with the appropriate dressing to condition the wound bed. After three weeks the well-granulated area was covered with meshed split skin grafts. During the operation and in the post-operative phase, machine-assisted and manual decongestion was performed, an established therapy for lymphedema, chronic venous insufficiency and chronic venous ulcers.

Malakoplakia is an acquired granulomatous disorder first described by Michaelis and Gutmann in 1902. The pathogenesis of malakoplakia is poorly understood, but it is thought to be secondary to an acquired bacteriocidal defect in macrophages occurring mostly in immunosuppressed patients or in the setting of autoimmune disease. Malakoplakia has been described in numerous anatomic locations, most commonly in the genitourinary tract. Microscopically, malakoplakia consists predominantly of sheets of macrophages known as von Hansemann cells with scattered targetoid intracytoplasmic inclusions known as Michaelis-Gutmann bodies. Cutaneous malakoplakia is a rare entity with less than 50 cases reported in the literature. In this article, we review cutaneous malakoplakia including the clinical, gross, and microscopic features as well as the treatment and prognosis of 40 cases of cutaneous malakoplakia identified in the literature.

Recent years have seen a world-wide increase in antimicrobial resistance (AMR) in cases of infection with Neisseria gonorrhoeae (NG). NG infection is not notifiable in Germany and there is a lack of information available about the spread and AMR of NG infections. The objective of the study was to provide information on diagnostic methods and AMR testing in cases of NG infections in German laboratories. A cross-sectional survey was undertaken in Germany between June and August 2013 using an online questionnaire. Laboratories performing NG diagnostics were identified and described with regard to the diagnostic methods used, the number of tests performed, the antibiotics tested and the AMR observed, in addition to general laboratory information. In total, 188 of the 521 participating laboratories performed NG diagnostics; these were included in the further statistical analysis. 92.6 % of the 188 laboratories performed culture. A median of 60 (IQR 15-270) samples per quarter (SPQ) were tested, with an overall positivity rate of 4.1 and 6.9 % among men. Most (82.1 %) of the 151 laboratories performing NG culture tested for AMR as well. The most frequently tested antibiotics were ciprofloxacin (94.8 %), penicillin (93.1 %), doxycycline (70.0 %) and ceftriaxone (67.2 %). The most frequently observed AMR ever were those against ciprofloxacin (87.1 %), penicillin (78.3 %), doxycycline (56.6 %) and azithromycin (35.1 %; all percentages refer to laboratories). The laboratories used different standards regarding susceptibility criteria. The emergence and spread of AMR shows that it is crucial to assess and monitor the scope and trends of multidrug-resistant gonorrhea. The data collected on diagnostic methods and AMR testing in cases of NG infections in German laboratories constitute an important basis for future monitoring.

Background In most gonococcal populations, penicillin-resistant strains have increased dramatically and penicillin can no longer be recommended for the treatment of gonorrhoea. Cefixime is the first oral third generation cephalosporin and represents an alternative therapeutical approach. Objective To evaluate the in vitro activity of cefixime against a gonococcal population in Germany. Material 203 Neisseria gonorrhoeae strains, isolated in the area of Heidelberg between 1986 and 1990, including 14 penicillinase-producing Neisseria gonorrhoeae (PPNG) strains and five strains with chromosomally mediated penicillin resistance (CMPR). Methods Determination of minimal inhibitory concentration (MIC) of cefixime was performed by standard agar dilution technique. Auxotype/serovar (A/S) classification was performed by using Neisseria defined agar and 12 gonococcal outer membrane porin specific monoclonal antibodies in a coagglutination assay. Results The MIC range reached from ≤ 0.00025 μg/ml to 0.125 μg/ml cefixime. For both penicillin sensitive- and penicillin-resistant strains, the geometric mean MIC was 0.0048 μg/ml, MIC 50 0.002 μg/ml and MIC 90 0.008 μg/ml. Among gonococcal strains with an MIC of ≤ 0.001 μg/ml cefixime strains belonging to A/S class (P)AH(U)/IA-1/2 were significantly more frequent ( p 0.001 μg/ml. Conclusion Cefixime showed very high antimicrobial activity against Neisseria gonorrhoeae . All tested gonococcal strains were susceptible to cefixime. The A/S class composition of a tested gonococcal population influences very strongly the range of MICs.