ABSTRACT
Background: By early June 2022, around 300,000 children and adolescents from Ukraine were registered in the German central registry for foreigners.The updated recommendations for action should provide the foundations for an evidence-based and targeted care for the diagnosis and prevention of infectious diseases in underage refugees and asylum seekers, exemplified by Ukraine. Objective: The recommendations for action are intended to support medical personnel in the care of minor refugees in order to1) ensure early recognition and completion of an incomplete vaccination status,2) diagnose and treat common infectious diseases,3) ensure early recognition and treatment of infectious diseases that are rare in the German healthcare system. Material and methods: The recommendations for action were drafted as level 1 (S1) guidelines coordinated by the Association of the Scientific Medical Societies in Germany (AWMF) and were adapted to the situation of refugees from Ukraine.The recommendations were compiled by a representative expert panel appointed by the participating professional societies in an informal consensus and finally officially adopted by the board of directors of all societies concerned. Results: Recommendations are given for the extent of the medical evaluation of minor refugees, including the medical history and physical examination, adapted to the situation of refugees from Ukraine. A blood count and screening for tuberculosis, hepatitis B and C as well as human immunodeficiency virus (HIV) infections are recommended for all minor refugees.For a rapid completion of the vaccination status, an age-related and indications-related prioritization of individual vaccinations will be undertaken. Conclusion: In view of the continuing high numbers of refugees not only from Ukraine, a further professionalization of medical health care is necessary. For this purpose, the necessary structural and personnel framework conditions need to be accomplished.
ABSTRACT
BACKGROUND: Increased serum IgE levels are characteristic but not specific for allergic diseases. Particularly, severe atopic dermatitis (AD) overlaps with hyper-IgE syndromes (HIES) regarding eczema, eosinophilia, and increased serum IgE levels. HIES are primary immunodeficiencies due to monogenetic defects such as in the genes DOCK8 and STAT3. As it is not known to date why allergic manifestations are not present in all HIES entities, we assessed the specificity of serum IgE of AD and HIES patients in the context of clinical and immunological findings. METHODS: Clinical data, skin prick tests, specific IgE to aero- and food allergens, and T helper (Th) subpopulations were compared in AD and molecularly defined HIES patients. RESULTS: Total serum IgE levels were similarly increased in STAT3-HIES, DOCK8-HIES, and AD patients. The ratio of aeroallergen-specific IgE to total IgE was highest in AD, whereas DOCK8-HIES patients showed the highest specific serum IgE against food allergens. Overall, clinical allergy and skin prick test results complied with the specific IgE results. Th2-cell numbers were significantly increased in DOCK8-HIES and AD patients compared to STAT3-HIES patients and controls. AD patients showed significantly higher nTreg-cell counts compared to STAT3-HIES and control individuals. High Th17-cell counts were associated with asthma. Specific IgE values, skin prick test, and T-cell subsets of STAT3-HIES patients were comparable with those of healthy individuals except decreased Th17-cell counts. CONCLUSION: Hyper-IgE syndromes and atopic dermatitis patients showed different sensitization pattern of serum IgE corresponding to the allergic disease manifestations and Th-cell subset data, suggesting a key role of DOCK8 in the development of food allergy.
Subject(s)
Dermatitis, Atopic/immunology , Guanine Nucleotide Exchange Factors/immunology , Immunoglobulin E/immunology , Job Syndrome/immunology , STAT3 Transcription Factor/immunology , Adult , DNA Mutational Analysis , Dermatitis, Atopic/blood , Female , Flow Cytometry , Guanine Nucleotide Exchange Factors/genetics , Humans , Immunoglobulin E/blood , Job Syndrome/blood , Job Syndrome/genetics , Male , Middle Aged , STAT3 Transcription Factor/genetics , Skin Tests , T-Lymphocytes, Helper-Inducer/immunology , Young AdultABSTRACT
A three-dimensional dose verification with photographic emulsions (x-ray films) was realized within the tumour therapy project at GSI Darmstadt, using carbon ions. We present Bragg-peak measurements for 88, 100 and 200 MeV/u carbon ion beams as the simplest case of dose verification. An actual patient treatment plan, composed by the superposition of Bragg-peaks having different energies and intensities, was used to perform a three-dimensional dose verification of an irregularly formed target volume. The shape of the measured dose distribution from film closely matches the intended irradiation volume. Furthermore, the calculated and measured optical density distribution is in good agreement with a maximum deviation of less than 10%.
Subject(s)
Film Dosimetry/methods , Imaging, Three-Dimensional/methods , Radiotherapy Planning, Computer-Assisted/methods , Radiotherapy, Conformal/methods , Carbon Radioisotopes , Film Dosimetry/instrumentation , Ions , Neoplasms/radiotherapy , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted/instrumentation , Sensitivity and SpecificityABSTRACT
A model was developed to calculate the response of films to heavy ion irradiation as a function of particle type and energy. It is based on the local effect model and was extended to be applied to the non-homogeneous target of photographic emulsions. The calculation was performed for protons and carbon ions in the energy range from 2 to 430 MeV u(-1). The calculated film responses are in very good agreement with experimental data. Based on this model calculation a data base of film responses was set up. This enables a three-dimensional dose verification with films in the heavy ion tumour therapy project at GSI, Darmstadt.
Subject(s)
Computer Simulation , Dose-Response Relationship, Radiation , Film Dosimetry/methods , Models, Theoretical , Protons , Radiotherapy Planning, Computer-Assisted/instrumentation , Carbon , Film Dosimetry/instrumentation , Ions , Radiotherapy Planning, Computer-Assisted/methods , Sensitivity and SpecificityABSTRACT
The response of films to heavy-ion irradiation was investigated systematically by recording dose-response curves for protons and carbon ions in an energy range of 8-430 MeV u(-1). In order to allow for an objective comparison of different experimental results, a practicable method was developed to decouple the value of the net optical density from the film's processing conditions and a precise definition of the film response was deduced. A qualitative explanation of the strong variation of the film response depending on particle type and energy is given, based on the particle's track structure. The data presented here form the basis for using films for dosimetry in mixed particle radiation fields and their application in the heavy-ion therapy project at GSI, Darmstadt.
