Seroepidemiology of parvovirus B19 in the Frankfurt am Main area, Germany: evaluation of risk factors.

BACKGROUND: Parvovirus B 19 is a virus that is distributed by respiratory droplets. It is known to be an initiator of erythema infectiosum (children's fifth disease), with erythroblasts being the target cells of infection. In case of vertically transmission, hydrops fetalis has been documented. OBJECTIVE: Parvovirus B19 seroprevalence was investigated in serum samples routinely collected from patients who had been admitted to the University Hospital in Frankfurt a. M., Germany. Patients were classified in different groups in order to analyze parovirus B19 seroprevalences in terms of risk factors. MATERIALS AND METHODS: Between June 2007 and March 2010, a total of 2,197 serum samples were analyzed for parvovirus B19-immunoglobulin G using an enzyme-linked immunosorbent assay. The study population included six groups of patients, namely, patients suffering from haemophilia, malignant disease, immunodeficiency diseases, common gynecological ailments, pregnant women and children with malignant diseases. RESULTS: Of the 2,197 serum samples, 1,383 contained antibodies to parvovirus B19 (62.9%). The overall seroprevalence in adults (20 to ≥60 years of age) was 71%. Gradually rising prevalences were recorded in children/adolescents with increasing age. We found a positive serostatus in 54.9% of adult patients with malignant disease, in 64.2% of patients with haemophilia (1 to ≥60 years), in 66.7% of patients under immunosuppression with various drugs (1 to ≥60 years) and in 41.7% of oncological patients aged 1-19 years. Of the pregnant women (aged 15-49 years), 71.1% were seropositive. CONCLUSION: The seroprevalence of parvovirus B19 in patients admitted to the University Hospital in Frankfurt a.M. was, on average, lower than that among the general population in Germany. Infection among patients in specific risk groups did not spread more than that in age-matched non-selected patients, with the exception of the group of immunocompromised patients.

Social context rather than behavioral output or winning modulates post-conflict testosterone responses in Japanese quail (Coturnix japonica).

Testosterone regulates the expression of sexual and aggressive behavior in male vertebrates and treatments with testosterone may promote territorial aggression and winning in dyadic contests. Conversely, individual testosterone levels respond to sexual or aggressive interactions and the social environment. Post-conflict testosterone in winner males though appears to be more complex than simply reflecting conflict outcome. Expression and degree of post-conflict testosterone responses may adapt to additional modulators such as repeated winning experience, audience presence, opponent's fighting ability, and self-assessment. We present simulated intrusion experiments with male Japanese quail using mirror-elicited aggression and fights with real opponents ('direct challenge'). We recorded agonistic behavior and measured immunoreactive testosterone metabolites (TM) non-invasively from individual droppings. Frequencies of initiated agonistic behavior were similar whether towards the mirror or in direct challenge tests, although some of the males were behaviorally non-responsive to the mirror ('mirror submissives'). However, there was no TM response to the mirror test in both, mirror fighters and mirror submissives, thus independently of behavioral output. After direct challenges TM levels were elevated in all males (focal males winning or conflict unresolved after 30 min), hence independently of conflict outcome. Thus, in male quail a combination of physical stimuli and the individual perception of own and opponent's fighting ability explained the expression of post-conflict TM responses rather than behavioral performance, conflict outcome, or any of these factors alone. In sum, our results emphasize that the degree of androgen responsiveness to agonistic behavior is fine-tuned by components related with social context and environment.

Timely confirmation of gastro-esophageal reflux disease via pH monitoring: estimating budget impact on managed care organizations.

BACKGROUND: Current guidelines recommend the use of pH monitoring to confirm the diagnosis of acid reflux in patients with a normal endoscopy. This analysis evaluated the financial impact of pH monitoring with the wireless pH capsule on a managed care organization (MCO) in the United States. METHODS: A decision model was constructed to project total 1-year costs to manage GERD symptoms with and without the adoption of wireless pH capsules in a hypothetical MCO with 10 000 eligible adult enrollees, of whom 600 presented with GERD-like symptoms. Costs of GERD diagnosis, treatment, and symptom management for those in whom a GERD diagnosis was ruled out by pH monitoring were assessed. The incremental per-member-per-month (PMPM) and per-treated-member-per-month (PTMPM) costs were the primary outcomes. Data sources included literature, expert input, and standardized fee schedules. RESULTS: An increase of 10 percentage points in the use of pH monitoring with wireless pH capsules yielded incremental PMPM and PTMPM costs of $0.029 and $0.481, respectively. The costs of proton pump inhibitor (PPI) therapy to the plan dropped to $236,363 from $238,086, while increases were observed in pH monitoring (from $16 739 to $21 973) and non-GERD therapy costs (from $1392 to $1740). The results were sensitive to the percentage of patients requiring repeat endoscopy before wireless pH monitoring and the cost of PPIs. CONCLUSIONS: Timely and increased use of pH monitoring as recommended in published guidelines leads to less unnecessary use of PPIs with a modest budgetary impact on health plans.

2D electrochemical time of flight and its application in the measurements of the kinetics of lateral electron hopping in monolayer films at the air/water interface.

A 2D electrochemical time-of-flight (ETOF) method was developed to measure diffusion constants of lateral mobility of amphiphiles and lateral electron hopping in Langmuir monolayers at the air/water interface. Photolithographically fabricated generator-collector ETOF devices featured two parallel gold microelectrodes (7 mm in length, 40 microm wide, spaced by a 10-microm gap). In 2D ETOF measurements, such a device is touching the water surface where the generator and collector electrodes function as a collinear pair of line microelectrodes. Bulk measurements, with a generator-collector device submerged in an electrolyte solution, were carried out to calibrate the devices by relating the transit times to the known D values of Ru(NH3)6(2+) in a series of solutions of different viscosity adjusted with sucrose. A new method to define and to measure transit times in the step mode ETOF experiments was developed that requires only the pseudo-steady-state values of the collector current. Reliability of the 2D ETOF technique was established by investigating lateral diffusion of an amphiphilic tetradecane TEMPO derivative for which the D values were also measured by 2D voltammetry. Combination of 2D ETOF and 2D voltammetry allows one to independently measure diffusion coefficients and concentrations of redox species. This advantageous feature was then used to reevaluate kinetics of lateral electron hopping in Os(DPP)3(ClO4)2 (DPP, 4,7-diphenyl-1,10-phenanthroline) solid monolayers on the water surface. The true rate constant of electron self-exchange, kex = 1.0 x 10(9) M(-1) s(-1), was obtained. The fact that the latter is more than 1 order of magnitude larger than its value obtained in a homogeneous acetonitrile solution suggests that the structure and locale of the Os(DPP)3(III+/II+) monolayer system result in a larger electronic coupling and/or smaller reorganization energy.

Effects of recombinant human erythropoietin on T lymphocyte subsets in hemodialysis patients.

Lymphocyte subpopulations were studied by immunofluorescence staining with monoclonal antibodies and laser flow cytometry in the blood of 23 hemodialysis patients before and after 3 months of treatment with recombinant human erythropoietin (rhEPO). Correction of anemia was accompanied by an increase in natural killer cells and a decrease in B lymphocytes. In the 11 patients (Group 1) with a baseline helper/suppressor (T4/T8) ratio greater than or equal to 2, the latter significantly decreased from 3.0 +/- 0.3 to 2.1 +/- 0.3 through both an increase in T8 cells and a decrease in T4 cells (p less than 0.005). Among the 12 patients with a pre-EPO T4/T8 ratio less than 2 (Group 2), no difference in T cell subsets was observed. The decrease in ferritin levels observed over the study period was not significant. In addition, the mean increase in hemoglobin levels during the first month of rhEPO therapy was greater in Group 2 than in Group 1 (1.1 +/- 0.3 vs. 0.6 +/- 0.3 g/dl, p less than 0.025). No change in any parameter was observed in eight control patients not receiving rhEPO. These results suggest that rhEPO can induce changes in lymphocyte subpopulations of hemodialysis patients through mechanism(s) yet to be clarified; conversely, the T4/T8 ratio might be a predictive factor for the erythropoietic response to rhEPO.

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[Unusual aneurysm of the pancreas arcade in occlusion of the celiac trunk]. / Ungewöhnliches Aneurysma der Pankreasarkade bei Verschluss des Truncus coeliacus.

This is a report about a rare aneurysm of the pancreas arcade--the angiography showing an occlusion of the celiac axis. Using a diagram of the arterial phase of the angiography, the morphology of the collateral circulation between the celiac axis and the superior mesenteric artery is described. The reason the occlusion of the celiac axis formed collateral circulation and the origin of the aneurysm and the therapeutic steps to be taken are discussed.

Compared effects of irradiation and cyclophosphamide induced erythroid aplasia on the catabolism of exogenous erythropoietin.

The effect of erythroid aplasia on the clearance rate of exogenous erythropoietin from the circulation has been studied in irradiated (200, 400 and 800 r) and cyclophosphamide (50 mg/kg) treated rats. After irradiation, the T1/2 was increased from 1.5 h in controls to 2.3 h. In spite of similar aplasia, the T1/2 observed after cyclophosphamide administration was identical to the T1/2 in controls. These results suggest that the action of X-rays on the catabolism of erythropoietin is independent of erythroid aplasia and could be related to an extramedullary effect of irradiation.

Polycythaemia and erythropoietin producing uterine fibromyoma.

A case of polycythaemia secondary to uterine fibromyoma is reported. Polycythaemia disappeared after hysterectomy. Erythropoietic activity was detected in the cyst fluid of the tumour. Plasma and urine contained no erythropoietic factor. Polycythaemia was related to erythropoietinlike material produced by the tumour.

Cytogenetic evidence of clonal evolution in 5q- anemia.

The clinical homogeneity of myeloproliferative syndromes associated with a 5 q- marker can be contested, but nevertheless finds support in the 2 case reports we have cited. One of these observations of refractory anemia with partial myeloblastosis and 5 q- marker has shown a transformation into an acute myelomonocytic leukemia with clonal chromosomal evolution.

Specificity of the 5q-chromosome in a distinct type of refractory anemia.

A further instance of the 5q-chromosome associated with a distinct type of aregenerative anemia strengthened the hypothesis of specificity and consistency of this karyotypic abnormality in a new hematologic entity. The Giemsa banding technique revealed that the deletion of the long arms of chromosome number 5 was interstitial: del (5) (pter leads to q12 : : q31 leads to qter).