[Studies on Factors Influencing Influenza Vaccination Rates in Patients with Chronic Obstructive Pulmonary Disease]. / Untersuchungen zu Einflussfaktoren auf die Influenza-Impfraten bei Patienten mit chronisch obstruktiver Lungenerkrankung.

BACKGROUND : With low influenza vaccination rates among the chronically ill, approaches to increase these rates among risk patients with chronic obstructive pulmonary disease (COPD) are to be uncovered. METHODS : 120 COPD patients from Magdeburg filled out a questionnaire and were analyzed regarding the influenza vaccination status 2015/2016 or 2016/2017. Vaccinated and unvaccinated were compared in socio-epidemiological factors, the health belief model (HBM), self-efficacy (GESIS-ASKU), anxiety/depression (HADS-D) and disease processing (FKV-LIS). RESULTS : 62.5 % (n = 75) were vaccinated, 31.7 % (n = 38) unvaccinated, 5.8 % (n = 7) made no statement. In over or equal to 60-year-olds 76 % were vaccinated, in under 60-year-olds 42 % were vaccinated. 60 % (n = 72) knew to belong to a risk group. Unvaccinated indicated greater concern about side effects of the vaccination (p = .004) and drew a worse benefit-expense balance (p = .001). Unvaccinated were more often uncertain about the vaccination protection and the severity of influenza (p ≤ .001). Vaccinated were highly motivated to think about vaccination themselves and more often had a positive vaccination history (p = .001). COPD patients showed a lower self-efficacy than the reference group of the German general population (p = .000), vaccinated and unvaccinated did not differ (p = .418). No difference between vaccinated and unvaccinated was found in the processing of the disease and in depression and anxiety, but unvaccinated tended to give higher anxiety values. CONCLUSION : Measures should particularly target COPD patients under 60 years of age with a negative vaccination history and sensitize them as risk patients. Widespread uncertainties about the severity of influenza and vaccination protection should be addressed. It should be communicated that influenza vaccination does not lead to exacerbation. The vaccination recommendation should increasingly be made by pulmonologists.

Sub-acute occupational hypersensitivity pneumonitis due to low-level exposure to diisocyanates in a secretary.

There is virtually no information in the literature about the exposure levels needed to induce hypersensitivity pneumonitis (HP) by diisocyanates. The present study reports a case of occupational HP due to diisocyanates after low-level exposure. A 53-yr-old female never-smoker developed progressive shortness of breath on exertion, cough, fatigue and flu-like symptoms shortly after she began work as a secretary of a car body repair shop. A diagnosis of HP was made 2 yrs later, based on a restrictive ventilatory defect, a reticulonodular and discrete ground-glass pattern on high-resolution computed tomography, lymphocytosis in bronchoalveolar lavage and specific immunoglobulin G antibodies to diisocyanate human serum albumin conjugates in the patient's serum. The diagnosis was confirmed by recovery after exposure cessation and deterioration after re-exposure. Ambient monitoring revealed air concentrations of different diisocyanate monomers below the detection limit in both the patient's work station and in front of the paint spray booths, with the exception of one measurement that showed 4,4-methylenediphenyl diisocyanate concentrations of 3 microg x m(-3) in front of one booth (corresponding to a total reactive isocyanate group concentration of 1 microg x m(-3)). The present authors conclude that concentrations of diisocyanates far below current exposure limits may induce hypersensitivity pneumonitis in susceptible subjects.

[Coincidence of lung diseases caused by Mycobacterium fortuitum and esophageal achalasia--case report and review of the literature]. / Koinzidenz von Lungenerkrankungen durch Mycobacterium fortuitum und Osophagusachalasie--Kasuistik und Literaturübersicht.

We report on a case of lung infection due to mycobacterium fortuitum in conjunction with esophageal achalasia. A review of literature and a discussion on pathophysiological, clinical and therapeutical aspects are included. We conclude that bacterial poly-resistance in case of infections resembling tuberculosis should prompt a search for atypical mycobacteria. Patients suffering from nontuberculous mycobacteriosis of the lung should be subject to oesophageal examination.

[Possible significance of the lipoxygenase pathway of arachidonic acid metabolism for the pathogenesis of constrictive reactions of lung blood vessels]. / Mögliche Bedeutung des Lipoxygenaseweges des Arachidonsäuremetabolismus für die Pathogenese konstriktorischer Reaktionen an Lungengefässen.

Recent studies suggest a key role of lipoxygenase (LOX) pathway of arachidonic acid (AA) metabolism in the regulation of pulmonary artery tone. We investigated the influence of specific inhibition of leucotriene biosynthesis on constrictory reactions of isolated rabbit pulmonary arteries in the organ bath. The substance FLM 5,011 selectively inhibiting the LOX pathway leads at a bath concentration of 5 X 10(-5) M to an inhibition in the order of 75% of AA- and phospholipase (PLP) A2-induced contraction (cumulative measurement, 37 degrees C, pH 7.4, isotonic contraction). The inhibitory effect on calciumionophore A 53,712-induced contraction was only 31.4%. We compared these findings with actions of nordihydroguiaretic acid and PAMBA. Our findings suggest that in rabbit lung arteries receptors for AA-products must exist and that the activation of AA depends on calcium. The present investigations underline the relevance of LOX products to genesis of pulmonary hypertension in man.