Prevalence of antibodies against influenza A and B viruses in children in Germany, 2008 to 2010.

The prevalence of influenza A and B virus-specific IgG was determined in sera taken between 2008 and 2010 from 1,665 children aged 0-17 years and 400 blood donors in Germany. ELISA on the basis of whole virus antigens was applied. Nearly all children aged nine years and older had antibodies against influenza A. In contrast, 40% of children aged 0-4 years did not have any influenza A virus-specific IgG antibodies. Eightysix percent of 0-6 year-olds, 47% of 7-12 year-olds and 20% of 13-17 year-olds were serologically naïve to influenza B viruses. By the age of 18 years, influenza B seroprevalence reached approximately 90%. There were obvious regional differences in the seroprevalence of influenza B in Germany. In conclusion, seroprevalences of influenza A and influenza B increase gradually during childhood. The majority of children older than eight years have basal immunity to influenza A, while comparable immunity against influenza B is only acquired at the age of 18 years. Children aged 0-6 years, showing an overall seroprevalence of 67% for influenza A and of 14% for influenza B, are especially at risk for primary infections during influenza B seasons.

Seroprevalence of herpes simplex virus type 1 and type 2 in Thuringia, Germany, 1999 to 2006.

The prevalence of herpes simplex virus (HSV) type-specific IgG was determined in sera taken in 1999 to 2006 from 1,100 children aged 0­18 years, 800 blood donors and 200 pregnant women in Thuringia, Germany, using tests based on the HSV glycoproteins (g) gG. By the age of 10­12 years, HSV-1 IgG prevalence reached 57.3%, rising to 69.3% by the age of 16­18 years and to 78.0% by the age of 28­30 years. Between 2.7% and 4.7% of the children aged up to 15 years had HSV-2 antibodies, increasing to 7.3% at the age of 16­18 years and to 13.6% among adults. The prevalence of HSV-1 antibodies among girls was significantly lower than among boys and a significantly higher prevalence of HSV-2 IgG in women than in men was detected. The reduced incidence of HSV-1 infections during childhood, especially in girls, has to be followed up since a higher number of primary HSV-2 infections may result. Between 2.7% and 4.7% of all children tested seemed to acquire HSV-2 by intrauterine or neonatal infection. We also compared the use of gG-1 with gC-1: the agreement of 97.2% between the two ELISAs suggests that gG-1 and gC-1 can be considered equivalent antigenic targets.

An in vitro study of the reliability of DIAGNOdent measurements.

Aim of this in vitro study was to assess the reliability of measurements by a laser fluorescence technique for occlusal caries detection. Four dentists using four DIAGNOdent devices (Dds) according to manufacturer's instructions examined 80 carefully cleaned extracted molars with non-cavitated occlusal lesions. Inter- and intra-examiner reproducibility were calculated using Lin's intra-class correlation coefficient (ICCLin) and the limits of agreement by Bland and Altman (Comp Biol Med 1990;20:337). An excellent intra-examiner reproducibility was found for all dentists (ICCLin 0.93-0.98). The inter-examiner reliability was proved to be good and excellent (ICCLin 0.74-0.98). By reason of the registered lower mean fluorescence values of dentist 3 compared with his/her colleagues all these measurements were excluded from further calculations. Differences between Dd instruments were not evident. When the values of the Dd were categorized according to the treatment related cut-off limits a substantial reproducibility was found in the range of 0-14 (ICCLin 0.66; DIFF 4.0/-3.5) and >30 (ICC(Lin) 0.6% of all Dd measurements were reproduced in the range 15-30 (ICC(Lin) 0.16; DIFF 8.1/-7.3). The results suggest that dentists should be trained before using Dd. The low reliability in the interval of 15-30 could indicate a limited use for a longitudinal caries monitoring on pits and fissures; further research should be focused on this clinically important interval.

Sensitivity of human adenoviruses to different groups of chemical biocides.

As it is no longer readily permissible to propagate polioviruses, adenoviruses will probably become more frequently used for virucidal testing of broad-spectrum disinfectants. We tested prototype strains of different adenovirus serotypes belonging to the subgenera C and D for sensitivity to liposomal povidone-iodine (PVP-I), peracetic acid (PAA) and formaldehyde. Virucidal assays were performed as suspension tests in accordance with the German guidelines for testing the effectiveness of chemical disinfectants against viruses. The sensitivity of the adenovirus serotypes to test disinfectants varied greatly. Prototype strains of adenovirus 5 and 44 statistically selected as 'little sensitive' to PVP-I, PAA and formaldehyde were found to be the most resistant. These might be suitable as model viruses for testing the broad-spectrum virucidal activity of disinfectants and might even replace the resistant poliovirus type 1. The main reason for the different chemical sensitivity of adenovirus serotypes may be the composition of the viral capsid proteins. Alternatively a different chemical inactivation of the viral genome could be involved.

Immunofluorescence test for sensitive detection of varicella-zoster virus-specific IgG: an alternative to fluorescent antibody to membrane antigen test.

A highly sensitive indirect fluorescence antibody test (IFAT) has been developed on the basis of varicella-zoster virus (VZV)-infected human lung carcinoma (A549) cells and evaluated for the determination of immunity to VZV. Different serum panels with negative, low, moderate or high anti-VZV IgG levels detected by the fluorescent antibody to membrane antigen (FAMA) assay were investigated. As a result, the sensitivity and the specificity of IFAT were 100% compared to FAMA test. In anti-VZV IgG-positive sera, a significant correlation between the results of FAMA procedure and IFAT could be shown. However, there were considerably higher antibody titers by the IFAT than by FAMA. Whereas the FAMA test had a detection limit of 250 mIU/ml anti-VZV IgG, the limit of detection of IFAT was 50 mIU/ml. In conclusion, the IFAT using VZV-infected A549 cells as antigen allows a highly sensitive, specific, and rapid detection of anti-VZV IgG class antibodies. This simple technique can replace the labor-intensive FAMA procedure for laboratory determination of immunity to VZV.

Seroprevalence of herpes simplex virus type 1 and type 2 in selected German populations-relevance for the incidence of genital herpes.

This study was carried out to determine the prevalence of antibodies to herpes simplex virus types 1 (HSV-1) and 2 (HSV-2) in selected German populations, such as blood donors, hospital patients, and human immunodeficiency virus (HIV)-seropositive individuals. Serum samples collected between 1996 and 1998 were tested by enzyme immunoassays using monoclonal antibody-selected native gG1 and gG2 as antigens and an immunoblot using type-specific recombinant glycoproteins. Equivocal results were resolved by an "in-house" Western blot assay. The prevalence of HSV-1 antibodies increased steadily with age and reached high levels of >/=88% among subjects 40 years of age or older. In the sample of patients and blood donors, the HSV-2 seroprevalence was 12.8% (95% CI = 11.9-13.8%). About 81% of the HSV-2 seropositive subjects were coinfected with HSV-1. When adjusted for age, there was no difference in the HSV-2 seroprevalence between hospital patients and blood donors. The HSV-2 seroprevalence was significantly higher among women (15%) than among men (10.5%), yielding a female : male odds ratio of 1.5 for hospital patients and of 1.67 for blood donors. Among the HIV-infected population, 91.1% were seropositive for HSV-1 and 47.9% for HSV-2. HIV-infected women have a significantly higher risk of HSV-2 infection than men (odds ratio [OR] = 3.22; 95% confidence ratio [CI] 1.99-5.20). In conclusion, although the rate of infections with HSV-2 is relatively low in the German population, attention should be given to the further development in adolescents, especially in view of a possible decrease of HSV-1 seroprevalence in childhood.

Correlations between subjective compliance, objective compliance, and factors determining compliance in geriatric hypertensive patients treated with triamterene and hydrochlorothiazide.

There are correlations between objective and subjective compliances on the one hand and factors determining compliance (3 times drug intake per day, no support by the family to get over the disease and no nicotine abuse). In agreement with the literature, mainly subjective criteria (due to disease, therapy, doctor, and environment) influence compliance strongly. To realize their personal psychological task to help the patients even better it is of importance for the doctors to analyze the variability of these parameters. Measures to improve compliance, such as better psychological guidance for the patient taking these factors and the patient's personality into consideration, can be helpful to improve the relatively poor compliance reported in the literature to be as little as 20-50%.

Pharmacokinetics of ethinylestradiol and levonorgestrel after administration of two oral contraceptive preparations.

Serum concentration profiles and pharmacokinetic parameters (cmax, tmax, AUC24, AUC0-00, MRT) of ethinylestradiol (EE2) and levonorgestrel (LNG) were obtained following administration of two combined oral contraceptives. The constituents of the preparations were as follows: Gravistat (0.05 mg EE2, 0.125 mg LNG); Minisiston (0.03 mg EE2, 0.125 mg LNG). In 20 of the volunteers blood samples were taken before and up to 36 hours following the intake of a single table. In 11 women the investigation was carried out at day 21 of a treatment cycle (steady-state condition). In spite of pronounced interindividual variations of the pharmacokinetic data, a clear dependency of EE2 concentration curves on the estrogen dose of the respective preparation could be demonstrated. Under the condition of steady-state (21st day of administration) there was a slight but significant rise of the EE2 peak serum concentrations and a pronounced increase of the LNG levels, closely reflected by elevation of the AUC values. SHBG serum concentration was significantly increased by the 10th day of treatment in all subjects receiving Gravistat, whereas the mean value in the Minisiston-group did not remarkably change. Although LNG is known to be bound to SHBG with high affinity, the missing parallelism between LNG- and SHBG-concentrations suggests other (additional?) mechanisms for the elevated LNG-binding capacity in women taking combined EE2-LNG preparations.

PIP: Serum concentration profiles and pharmacokinetic parameters of ethinyl estradiol (EE2) and levonorgestrel (LNG) were obtained after administration of 2 combined oral contraceptives (OCs). The constituents of the preparations were as follows: Gravistat (0.05 mg EE2, 0.125 mg LNG); Minisiston (0.03 mg EE2, 0.125 mg LNG). Blood samples were taken before and up to 36 hours after intake of a single tablet by 20 volunteers. In 11 women, the investigation was conducted on day 21 of a treatment cycle (steady-state condition). In spite of pronounced interindividual variations of the pharmacokinetic data, a clear dependency of EE2 concentration curves on estrogen dose of the respective preparation could be demonstrated. With the condition of steady-state (21st day of administration), there was a slight but significant rise of EE2 peak serum concentrations and a pronounced increase in LNG levels, closely reflected by the elevation of the area under curve values. Sex hormone binding globulin (SHBG) serum concentration was significantly increased by day 10 of treatment in all those receiving Gravistat, whereas the mean value in the Minisiston group did not change remarkably. Although LNG is known to be bound to SHBG with high affinity, the missing parallelism between LNG and SHBG concentrations suggests other, possibly additional, mechanisms for the elevated LNG-binding capacity in those women taking combined EE2-LNG preparations.

[The pharmacokinetics of azlocillin after single and multiple intravenous injections during the third trimester]. / Zur Pharmakokinetik von Azlocillin nach einfacher und wiederholter intravenöser Applikation in der Spätschwangerschaft.

Examining serum level values and urinary concentrations taken from non-pregnant control persons and pregnant women suffering from urinary tract infections (UTI) during the III. trimenon, the pharmacokinetic dates after single and repeated applications of 4 g azlocillin have been evaluated. We used a computer program based on the two-compartment model. It is shown that during pregnancy complicated by UTI the elimination half-life time will be prolonged and returns after therapy nearly to normal values. The results, discussed with the dates given by literature, allow us to state that it is not necessary to change dosage and application interval of azlocillin during pregnancy.

[Comparative studies of calcium resorption modified by vitamin D2 and D3 in patients with chronic renal failure and dialysis patients]. / Vergleichende Untersuchungen zur Calciumresorption unter dem Einfluss von Vitamin D2 and D3 bei Patienten mit chronischer Niereninsuffizienz und bei Dialysepatienten.

In 16 patients with a chronic renal insufficiency at the stage of the compensated retention and 13 test persons of the chronic haemodialysis programme determinations of the total calcium and of the ionized calcium fraction as well as investigation of the intestinal calcium absorption by means of the isotope 47Ca were performed. In these cases the influence of vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol) on these parameters of the calcium metabolism was compared. Under the treatment with vitamin D a normalization of the serum calcium levels concerning the total calcium concentration as well as with regard to the ionized calcium fraction was achieved; this effect took place parallel to the improvement of the intestinal calcium absorption. Vitamin D3, had a more favourable effect than vitamin D2. The necessary doses are below 40,000 U a day.

[Pharmacokinetic studies of azlocillin in pregnancy]. / Pharmakokinetische Untersuchungen mit Azlocillin während der Schwangerschaft.

Examining blood level values and urinary concentrations taken from pregnant and nonpregnant women, the pharmacokinetic dates of azlocillin have been evaluated. We used a computer program based on the two-compartment model. The evaluation of azlocillin concentrations in serum and urine has been realized with the two following methods: polarography and agar diffusion test. We found nearly equal values of serum concentrations when using both methods. There are no statistical differences between pharmacokinetic dates of pregnant and nonpregnant women. Therefore we state: It is not necessary to change the dosage and the application interval of azlocillin during pregnancy.