[Chronic chikungunya arthritis]. / Chronische Chikungunya-Arthritis.

This article describes the case of a 48-year-old female traveller returning from Bangladesh who presented with persisting pain and joint swelling due to chikungunya virus infection, which had persisted for months. Typical symptoms are a high fever and musculoskeletal disorders, which can last for months up to years. The chronic inflammatory form is treated similarly to those recommended for other chronic inflammatory joint diseases. Due to the increasing prevalence of the virus and its vectors as well as the unbroken travel activity, an increase in imported cases in Europe and establishment of the pathogen in southern Europe are to be expected.

Insufficient vaccination rates in patients with systemic lupus erythematosus in a German outpatient clinic.

BACKGROUND: Patients with systemic lupus erythematosus (SLE) are at an increased risk of acquiring infections due to the disease itself and the immunosuppressive therapy. Furthermore, infections largely contribute to overall SLE mortality. Vaccinations against preventable diseases are therefore of particular importance for these patients. AIMS: To estimate vaccination frequencies among patients with SLE, we studied patients in a survey and calculated vaccination rates based on their vaccination documents. Patients were recruited from our outpatient clinic during one of their routine visits. For the statistical analysis, they have been stratified by age (≥60 vs. <60 years) for further subgroup analysis due to age-related recommendations for some vaccines. RESULTS: Among the patients studied (n = 68) we found rather low vaccination rates in particular for the strongly recommended vaccines against pneumococcus and influenza (21% and 49%, respectively). Furthermore, protection rates for important basic vaccinations were found to be low, e. g. pertussis protection for 31% of patients. Beside these findings, we saw age-dependant differences for a variety of vaccines: while the pneumococcus vaccination was more often given to patients ≥60 years, measles, pertussis, diphtheria and hepatitis B vaccinations were found significantly more often in younger patients. CONCLUSIONS: Vaccination rates have to be improved among SLE patients, in particular for vaccines protecting from respiratory tract infections such as pneumococcus and influenza.

[S3 guidelines on long-term opioid treatment in non-cancer pain. Recommendations for opioid use in clinical rheumatology]. / S3-Leitlinie "Langzeitanwendung von Opioiden bei nicht tumorbedingten Schmerzen". Empfehlungen zum Einsatz von Opioiden für den klinisch tätigen Rheumatologen.

The long-term use of opioids for chronic pain can be problematic in many respects. Besides potentially harmful and considerable undesired side effects and possible drug abuse, the indications for prescription, efficacy and safety in the long run have to be considered. The recently updated S3 guidelines on long-term opioid treatment in non-cancer pain (LONTS) provide recommendations with the highest currently available evidence. This article summarizes the most relevant contents for the clinical rheumatologist.

The control of lymphoid leukosis in a flock White Plymouth Rock chickens.

Lymphoid leukosis (LL) was successfully controlled in a commercial basic breeding line of White Plymouth Rock chickens. The control method has been developed for breeder flocks and consists of three elements: --In the flock under study, homogenates of embryos from all eggs collected during a number of 14-day periods are tested for the presence of LL viruses. --Only eggs from hens that have been shown not to shed virus in their eggs are used for the production of progeny. The offspring are reared in isolation during the first two months of life, at which time the age-related resistance against tumour formation by LL viruses appears to be sufficiently developed. --The chickens are subsequently inoculated intramuscularly with LL viruses of subgroups A and B transferred to a conventional chicken house. The vaccination raises a solid immunity to horizontal LL virus exposure and, due to the age-related resistance, tumour formation does not follow. No excretion of LL viruses could be detected in three generations of White Plymouth Rock chickens to which the three elements of the control procedure were applied. Clinical disease was not observed in any of the chickens under notice.

The control of lymphoid leukosis in a flock White Plymouth Rock chickens.

Summary Lymphoid leukosis (LL) was successfully controlled in a commercial basic breeding line of White Plymouth Rock chickens. The control method has been developed for breeder flocks and consists of three elements: - In the flock under study, homogenates of embryos from all eggs collected during a number of I4-day periods are tested for the presence of LL viruses. - Only eggs from hens that have been shown not to shed virus in their eggs are used for the production of progeny. The offspring are reared in isolation during the first two months of life, at which time the age-related resistance against tumour formation by LL viruses appears to be sufficiently developed. - The chickens are subsequently inoculated intramuscularly with LL viruses of subgroups A and B transferred to a conventional chicken house. The vaccination raises a solid immunity to horizontal LL virus exposure and, due to the age-related resistance, tumour formation does not follow. No excretion of LL viruses could be detected in three generations of White Plymouth Rock chickens to which the three elements of the control procedure were applied. Clinical disease was not observed in any of the chickens under notice.