Univ., Diss.--Karlsruhe, 2002.

Background Over one million asylum seekers were registered in Germany in 2016, most from Syria and Afghanistan. The Refugee Convention guarantees access to healthcare, however delivery mechanisms remain heterogeneous. There is an urgent need for more data describing the health conditions of asylum seekers to guide best practices for healthcare delivery. In this study, we describe the state of health of asylum seekers presenting to a multi-specialty primary care refugee clinic. Methods Demographic and medical diagnosis data were extracted from the electronic medical records of patients seen at the ambulatory refugee clinic in Dresden, Germany between 15 September 2015 and 31 December 2016. Data were de-identified and analyzed using Stata version 14.0. Results Two-thousand-seven-hundred and fifty-three individual patients were seen in the clinic. Of these, 2232 (81.1%) were insured by the state indicating arrival within the last 3 months. The median age was 25, interquartile range 16–34. Only 786 (28.6%) were female, while 1967 (71.5%) were male. The most frequent diagnoses were respiratory (17.4%), followed by miscellaneous symptoms and otherwise not classified ailments (R series, 14.1%), infection (10.8%), musculoskeletal or connective tissue (9.3%), gastrointestinal (6.8%), injury (5.9%), and mental or behavioral (5.1%) categories. Conclusions This study illustrates the diverse medical conditions that affect the asylum seeker population. Asylum seekers in our study group did not have a high burden of communicable diseases, however several warranted additional screening and treatment, including for tuberculosis and scabies. Respiratory illnesses were more common amongst newly arrived refugees. Trauma-related mental health disorders comprised half of mental health diagnoses.

Background Over one million asylum seekers were registered in Germany in 2016, most from Syria and Afghanistan. The Refugee Convention guarantees access to healthcare, however delivery mechanisms remain heterogeneous. There is an urgent need for more data describing the health conditions of asylum seekers to guide best practices for healthcare delivery. In this study, we describe the state of health of asylum seekers presenting to a multi-specialty primary care refugee clinic. Methods Demographic and medical diagnosis data were extracted from the electronic medical records of patients seen at the ambulatory refugee clinic in Dresden, Germany between 15 September 2015 and 31 December 2016. Data were de-identified and analyzed using Stata version 14.0. Results Two-thousand-seven-hundred and fifty-three individual patients were seen in the clinic. Of these, 2232 (81.1%) were insured by the state indicating arrival within the last 3 months. The median age was 25, interquartile range 16–34. Only 786 (28.6%) were female, while 1967 (71.5%) were male. The most frequent diagnoses were respiratory (17.4%), followed by miscellaneous symptoms and otherwise not classified ailments (R series, 14.1%), infection (10.8%), musculoskeletal or connective tissue (9.3%), gastrointestinal (6.8%), injury (5.9%), and mental or behavioral (5.1%) categories. Conclusions This study illustrates the diverse medical conditions that affect the asylum seeker population. Asylum seekers in our study group did not have a high burden of communicable diseases, however several warranted additional screening and treatment, including for tuberculosis and scabies. Respiratory illnesses were more common amongst newly arrived refugees. Trauma-related mental health disorders comprised half of mental health diagnoses.

Der physiologische Stratum corneum (SC) pH-Wert ist von zentraler Bedeutung für die epidermale Permeabilitätsbarriere (EPB) und die Hautflora. Physiologisch liegt der SC-pH bei ≤ 5, wohingegen er im Alter bis auf 6 ansteigt. Als Folge sind Regeneration und Integrität der EPB signifikant gestört. Zudem verändert sich die Hautflora im Alter quantitativ und qualitativ. Ob Hautpflegeprodukte mit einem pH-Wert von 4,0 Klinik, Hautphysiologie und Mikrobiologie der Altershaut beeinflussen, war Gegenstand dieser Arbeit. Bereits durch einmalige Applikation einer O/W-Emulsion (pH 4,0) normalisierte sich der erhöhte Altershaut-pH über 7 Stunden. Um Langzeiteffekte durch Externa mit pH 4,0 auf die EPB und die Hautflora zu untersuchen, wurde eine randomisierte, kontrollierte und doppelblinde Studie durchgeführt. In einem Seniorenheim verwendeten zwei Gruppen von Hochbetagten (≥ 80 Jahre) eine Hautpflegeserie (Lotion, Creme, Waschsyndet) mit jeweils unterschiedlichem pH Wert (Gruppe A: pH 4,0; Gruppe B: pH 6,0). Nach 7-wöchiger Anwendung reduzierte sich die Hauttrockenheit in beiden Gruppen. Im Vergleich zum Basiswert verbesserte sich die epidermale Barriereintegrität in Gruppe A signifikant (p=0,007), blieb jedoch in Gruppe B nahezu unverändert. In Gruppe B nahm die epidermale Barrierekohäsion ab (p=0,025), wohingegen die Kohäsion der epidermalen Barriere in Gruppe A unverändert blieb (p=0,814). Verglichen mit dem Basiswert kam es in Gruppe A (p=0,004) im Gegensatz zu Gruppe B (p=0,327) zu einer signifikanten Verkürzung der epidermalen Barriereregenerationszeit nach experimenteller Schädigung. Die Bestimmung der Hautflora zeigte in beiden Gruppen eine signifikante Zunahme (p=0,016, p=0,017) der Gesamtkeimzahl (KbE/qcm Haut). Außerdem wurde nach der Anwendung in Gruppe A (100%) bei mehr Probanden eine residente Mischflora konstatiert als in Gruppe B (88%). Die langfristige Anwendung von Externa mit einem pH von 4,0 verbesserte die Funktion der EPB signifikant im Vergleich zu Produkten mit pH 6,0. Darüber hinaus stabilisierte sich die residente Hautflora und verminderte sich die Hauttrockenheit in beiden Gruppen. Zusammenfassend ist festzuhalten, dass Hautpflegeprodukte mit einem pH von 4,0 die Funktion der EPB verbessern und sich positiv auf die Hautflora bei Hochbetagten auswirken.