Suicide among immigrants in Germany.

AIMS: The identification of high-risk groups is crucial in public health suicide prevention approaches. This study aims to compare suicide risks of Germans with nine of the largest immigrant populations living in Germany. METHODS: Based on a German national database of mortality statistics, the number of suicides in Germans and immigrants was available for the study period (2000 - 2017), stratified for gender and age groups. Standard mortality ratios (SMR) for suicide were computed since age distributions differed between populations. Moreover, SMR of immigrant populations were correlated with potential risk and resilience factors. RESULTS: The analysed dataset covers a period of 18 years, which translates to over 1.47 billion life years (LY) and 206,056 recorded suicides. 134,971,779 LY (10.1%) and 8,936 (4.3%) suicides were assigned to non-German citizens. SMR, calculated for nine of the largest immigrant populations, were lower compared with the German reference population ranging from 0.24 (Greek nationality) to 0.86 (Russian nationality). SMR in immigrants was highest in adolescents and declined with age. SMR was associated with country of origin (CO) suicide rates as well as with socio-economic factors of immigrant groups in Germany. With the global financial crisis, suicide risk of immigrants from the most affected countries decreased more strongly compared to immigrants from other CO. CONCLUSIONS: The suicide risk strongly differs between the individual immigrant groups and is associated with risk factors of the respective CO. Therefore, future suicide prevention approaches in immigrants should take CO-specific vulnerabilities into account as well as age-related risk factors.

Minor changes in gene expression in the mouse preoptic hypothalamic region by inflammation-induced prostaglandin E2.

We investigated to what extent inflammation-induced prostaglandin E2 (PGE2 ) regulates gene expression in the central nervous system. Wild-type mice and mice with deletion of the gene encoding microsomal prostaglandin E synthase-1 (mPGES-1), which cannot produce inflammation-induced PGE2 , were subjected to peripheral injection of bacterial wall lipopolysaccharide (LPS) and killed after 5 h. The median and medial preoptic nuclei, which are rich in prostaglandin E receptors, were isolated by laser capture microdissection (LCM), and subjected to whole genome microarray analysis. Although the immune stimulus induced robust transcriptional changes in the brain, as seen by a quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) on selected genes, only small PGE2 -dependent gene expression changes were observed in the gene array analysis and, for only two genes, a pronounced differential expression between LPS-treated wild-type and mPGES-1 knockout mice could be verified by qRT-PCR. These were Hspa1a and Hspa1b, encoding heat shock proteins, which showed a two- to three-fold higher expression in wild-type mice than in knockout mice after immune challenge. However, the induced expression of these genes was found to be secondary to increased body temperature because they were induced also by cage exchange stress, which did not elicit PGE2 synthesis, and thus were not induced per se by PGE2 -elicited transcriptional events. Our findings suggest that inflammation-induced PGE2 has little effect on gene expression in the preoptic region, and that centrally elicited disease symptoms, although PGE2 -dependent, occur as a result of regulation of neuronal excitability that is a consequence of intracellular, transcriptional-independent signalling cascades. Our findings also imply that the profound changes in gene expression in the brain that are elicited by peripheral inflammation occur independently of PGE2 via a yet unidentified mechanism.

Hepatitis B and C virus infection in Romanian non-Hodgkin's lymphoma patients.

We determined the hepatitis C virus (HCV) antibodies (anti-HCV) and the hepatitis B virus (HBV) surface antigen (HBsAg) in a cohort of 68 consecutive non-Hodgkin's lymphoma (NHL) patients diagnosed and treated in our institution between December 1997 and March 1999. 27 cases were diagnosed as low-grade, 33 as intermediate-grade, and eight as high-grade NHL. In 35 cases (51.4%) we found evidence of either HCV or HBV infection. Anti-HCV antibodies were found in 20 patients (29.5%) and HBsAg was found in 21 patients (30.8%). In six patients both anti-HCV and HBsAg were present. Anti-HCV were present in 12/27 low-grade NHL cases (44.4%) and in 8/41 intermediate/high-grade (aggressive) NHL cases (19.5%, P < 0.03). HBsAg was found in 10/27 low-grade NHL cases (37%) and in 11/41 aggressive NHL cases (26.8%). Evidence of liver disease, as reflected by elevated aminotransferases or typical alterations at liver biopsy, was present in eight patients. Cryoglobulins were present in six patients, all anti-HCV positive and with low-grade NHL. The prevalence of both HCV antibodies and HBsAg was significantly higher (P < 0.0001) in our NHL cases than in a sample of the general Romanian population, where the prevalence of anti-HCV was 4.9% and that of HBsAg was 6.3%. It is difficult to say whether either HCV or HBV had actually been involved in lymphomagenesis or if alpha-interferon treatment would be effective in this subset of patients.

Granulocyte-macrophage colony stimulating factor treatment of febrile neutropenia following remission induction chemotherapy for acute leukemia.

Recombinant human granulocyte macrophage colony stimulating factor (GM-CSF) was given for 2-6 days in 10 patients with febrile neutropenias following remission induction chemotherapy for acute leukemia (6 acute lymphoblastic and 4 acute myeloid leukemias) in which, broad spectrum and targeted antibiotherapy was ineffective. In 7 patients, the addition of GM-CSF helped overcome the serious infectious complications, leading to an accelerated neutrophil recovery averaging 18.4 days, significantly faster than in a historic group of 9 similar patients in whom GM-CSF was not given Side-effects of GM-CSF treatment were minor and reversible. GM-CSF treatment did not have any significant effect on the achievement of complete remission status.