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  • 1
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    Online Resource
    Prescription of antibiotics in the medical care of newly arrived refugees and migrants
    Wiley ; 2021
    In:  Pharmacoepidemiology and Drug Safety Vol. 30, No. 8 ( 2021-08), p. 1074-1083
    Details
    In: Pharmacoepidemiology and Drug Safety, Wiley, Vol. 30, No. 8 ( 2021-08), p. 1074-1083
    Abstract: Unnecessary and inappropriate use of antibiotics is a widespread problem in primary care. However, current data on the care of refugees and migrants in initial reception centers is pending. This article provides data on prescription frequencies of various antibiotics and associated diagnoses. Methods In this retrospective observational study, patient data of 3255 patients with 6376 medical contacts in two initial reception centers in Germany were analyzed. Patient data, collected by chart review, included sociodemographic characteristics, diagnoses, and prescriptions. Antibiotic prescription behavior and corresponding physician‐coded diagnoses were analyzed. Results Nineteen percent of all patients in our study received systemic antibiotics during the observation period, with children below the age of 10 years receiving antibiotics most frequently (24%). The most commonly prescribed antibiotics were penicillins (65%), macrolides (12%), and cephalosporins (7%). The most frequent diagnoses associated with antibiotic prescription were acute tonsillitis (26%), bronchitis (21%), infections of the upper respiratory tract (14%), and urinary tract infections (10%). In case of acute bronchitis 74% of the antibiotic prescriptions were probably not indicated. In addition, we found a significant number of inappropriate prescriptions such as amoxicillin for tonsillitis (67%), and ciprofloxacin and cotrimoxazol for urinary tract infections (49%). Conclusion Regarding inappropriate prescription of antibiotics in refugee healthcare, this study shows a rate ranging from 8% for upper respiratory tract infections to 75% for acute bronchitis. Unnecessary use of antibiotics is a global problem contributing to gratuitous costs, side effects, and antimicrobial resistance. This research contributes to the development of stringent antibiotic stewardship regiments in the particularly vulnerable population of migrants and refugees.
    Type of Medium: Online Resource
    ISSN: 1053-8569 , 1099-1557
    URL: Issue
    URL: Article
    DOI: 10.1002/pds.v30.8
    DOI: 10.1002/pds.5254
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 1491218-1
    SSG: 15,3
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  • 2
    Online Resource
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    Status of HIV and comorbidities in refugees with HIV from Ukraine
    Wiley ; 2024
    In:  HIV Medicine Vol. 25, No. 4 ( 2024-04), p. 479-483
    Details
    In: HIV Medicine, Wiley, Vol. 25, No. 4 ( 2024-04), p. 479-483
    Abstract: To describe the clinical characteristics of refugees with HIV from Ukraine that seek continuation of medical care in Germany. Methods Fourty‐six refugees with HIV that had left Ukraine between 24 February and 30 December 2022 were examined. Information on patients' history was obtained using a standardized questionnaire for clinical care. Interviews were conducted in Russian during their first clinical presentation. Results Fourty‐six persons (41 females and 5 males) were included and their mean age was 39.6 (±8.4) years. The mean time since HIV diagnosis was 8.0 (median, IQR 7.15) years and 70.3% of participants currently received tenfofovir‐DF, lamividine and dolutegravir. Most refugees had an undetectable HIV viral load and their current mean CD4 T cell count was 702 (SD ± 289) per μL. Serology revealed previous hepatitis B infection in 50.4% without evidence for replication, with undetectable anti‐hepatitis B surface antigen in the remaining refugees. Antibodies against hepatitis C were present in 23 refugees (50%), but only 10 patients had been diagnosed with hepatitis C previously. Five refugees had undergone successful antiviral treatment for hepatitis C. Detectable HCV‐RNA was evident in nine patients (19.6%). Sixteen (38.6%) refugees had a positive tuberculosis (TB) interferon gamma release assay, and four were on TB treatment for previously diagnosed infection. One had been diagnosed with multidrug‐resistant (MDR) TB, two with pre‐extensively drug‐resistant (pre‐XDR) TB and two with XDR TB and were treated with combinations of second‐line and novel agents according to WHO guidelines. Conclusions Based on this preliminary analysis of a not fully representative cohort, refugees with HIV from Ukraine were young, mostly healthy females highly adherent to antiretroviral therapy. The rate of transmittable co‐infections urges early diagnostic evaluation and treatment.
    Type of Medium: Online Resource
    ISSN: 1464-2662 , 1468-1293
    URL: Issue
    URL: Article
    DOI: 10.1111/hiv.v25.4
    DOI: 10.1111/hiv.13597
    Language: English
    Publisher: Wiley
    Publication Date: 2024
    detail.hit.zdb_id: 2020341-X
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  • 3
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    Online Resource
    Clinical relevance of terminal Schwann cells: An overlooked component of the neuromuscular junction
    Wiley ; 2018
    In:  Journal of Neuroscience Research Vol. 96, No. 7 ( 2018-07), p. 1125-1135
    Details
    In: Journal of Neuroscience Research, Wiley, Vol. 96, No. 7 ( 2018-07), p. 1125-1135
    Abstract: The terminal Schwann cell (tSC), a type of nonmyelinating Schwann cell, is a significant yet relatively understudied component of the neuromuscular junction. In addition to reviewing the role tSCs play on formation, maintenance, and remodeling of the synapse, we review studies that implicate tSCs in neuromuscular diseases including spinal muscular atrophy, Miller–Fisher syndrome, and amyotrophic lateral sclerosis, among others. We also discuss the importance of these cells on degeneration and regeneration after nerve injury. Knowledge of tSC biology may improve our understanding of disease pathogenesis and help us identify new and innovative therapeutic strategies for the many patients who suffer from neuromuscular disorders and nerve injuries.
    Type of Medium: Online Resource
    ISSN: 0360-4012 , 1097-4547
    URL: Issue
    URL: Article
    DOI: 10.1002/jnr.v96.7
    DOI: 10.1002/jnr.24231
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 1474904-X
    SSG: 12
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  • 4
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    Online Resource
    What is Normal? Neuromuscular junction reinnervation after nerve injury
    Wiley ; 2019
    In:  Muscle & Nerve Vol. 60, No. 5 ( 2019-11), p. 604-612
    Details
    In: Muscle & Nerve, Wiley, Vol. 60, No. 5 ( 2019-11), p. 604-612
    Abstract: In this study we present a reproducible technique to assess motor recovery after nerve injury via neuromuscular junction (NMJ) immunostaining and electrodiagnostic testing. Methods Wild‐type mice underwent sciatic nerve transection with repair. Hindlimb muscles were collected for microscopy up to 30 weeks after injury. Immunostaining was used to assess axons (NF200), Schwann cells (S100), and motor endplates (α‐bungarotoxin). Compound motor action potential (CMAP) amplitude was used to assess tibialis anterior (TA) function. Results One week after injury, nearly all (98.0%) endplates were denervated. At 8 weeks, endplates were either partially (28.3%) or fully (71.7%) reinnervated. At 16 weeks, NMJ reinnervation reached 87.3%. CMAP amplitude was 83% of naive mice at 16 weeks and correlated with percentage of fully reinnervated NMJs. Morphological differences were noted between injured and noninjured NMJs. Discussion We present a reproducible method for evaluating NMJ reinnervation. Electrodiagnostic data summarize NMJ recovery. Characterization of wild‐type reinnervation provides important data for consideration in experimental design and interpretation.
    Type of Medium: Online Resource
    ISSN: 0148-639X , 1097-4598
    URL: Issue
    URL: Article
    DOI: 10.1002/mus.v60.5
    DOI: 10.1002/mus.26654
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 1476641-3
    SSG: 12
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  • 5
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    Online Resource
    Humoral immune response following prime and boost BNT162b2 vaccination in people living with HIV on antiretroviral therapy
    Wiley ; 2022
    In:  HIV Medicine Vol. 23, No. 5 ( 2022-05), p. 558-563
    Details
    In: HIV Medicine, Wiley, Vol. 23, No. 5 ( 2022-05), p. 558-563
    Abstract: People living with HIV (PLWH) with low CD4 T‐cell counts may be at a higher risk for severe coronavirus disease 2019 (COVID‐19) outcomes and in need of efficient vaccination. The World Health Organization (WHO) now recommends prioritizing PLHIV for COVID‐19 vaccination. Data on immune responses after messenger RNA (mRNA) vaccination in PLHIV in relation to CD4 counts are scarce. We aimed at assessing the humoral immune response in PLHIV after mRNA vaccination against COVID‐19. Methods We examined a cohort of PLHIV after prime ( n  = 88) and boost ( n  = 52) vaccination with BNT162b2. We assessed levels of anti‐severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) spike (S) protein‐specific immunoglobulin G (IgG)/IgA and circulating neutralizing antibodies in plasma and correlated results to the cellular immune status. BNT162b2‐vaccinated health care workers served as controls. Results All PLWH had a viral load of ≤ 200 HIV‐1 RNA copies/mL and 96.5% had a viral load of 〈  50 copies/mL. Anti‐S IgG and neutralizing antibody responses after BNT162b2 priming were significantly lower in PLHIV having a CD4:CD8 T‐cell ratio of 〈  0.5. However, we observed robust humoral immunity in the majority of PLWH receiving antiretroviral therapy (ART) irrespective of CD4 T‐cell nadir, current CD4 count or CD4:CD8 ratio after full BNT162b2 vaccination. Nevertheless, HIV‐negative controls produced significantly higher mean anti‐S IgG concentrations with less variability. Conclusions The majority of PLWH mounted robust responses after complete BNT162b2 vaccination but overall amounts of antibodies directed against the SARS‐CoV‐2 receptor‐binding domain were variable. The impact on clinical efficacy remains unclear.
    Type of Medium: Online Resource
    ISSN: 1464-2662 , 1468-1293
    URL: Issue
    URL: Article
    DOI: 10.1111/hiv.v23.5
    DOI: 10.1111/hiv.13202
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2020341-X
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  • 6
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    Support for global health and pandemic preparedness in medical education in Germany: Students as change agents
    Wiley ; 2021
    In:  The International Journal of Health Planning and Management Vol. 36, No. S1 ( 2021-05), p. 112-123
    Details
    In: The International Journal of Health Planning and Management, Wiley, Vol. 36, No. S1 ( 2021-05), p. 112-123
    Abstract: The COVID‐19 pandemic has reinforced Germany's role as global health player, but the education system is lagging behind and does not adequately prepare health professionals for the new challenges. This study aims to strengthen global health in undergraduate medical education in Germany. Major objectives include: to review the current situation, explore changing demand for global health and introduce innovative teaching models and the drivers for change. Mixed methods and an explorative approach were applied, comprising a scoping review, online surveys carried out at Hanover Medical School, March/April 2020. Target groups were undergraduate medical students ( n  = 384) and additionally lecturers ( n  = 172), and finally new multiprofessional teaching courses initiated by students and developed collaboratively. The results reveal only slow pace of change on the level of the education system, while demand for global health education has increased markedly in all actor groups, but strongest in the group of students in the preclinical phase. Implementation of global health programmes illustrates how students can become change agents and enhance institutional innovation bottom‐up. However, in order to achieve wider transformative potential, these efforts must be flanked by macro‐level policy changes and integrated in future pandemic preparedness strategies.
    Type of Medium: Online Resource
    ISSN: 0749-6753 , 1099-1751
    URL: Issue
    URL: Article
    DOI: 10.1002/hpm.v36.S1
    DOI: 10.1002/hpm.3143
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 1491188-7
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