[Guidelines for the Management of Community Acquired Pneumonia in Children and Adolescents (Pediatric Community Acquired Pneumonia, pCAP) - Issued under the Responsibility of the German Society for Pediatric Infectious Diseases (DGPI) and the German Society for Pediatric Pulmonology (GPP)]. / S2k-Leitlinie Management der ambulant erworbenen Pneumonie bei Kindern und Jugendlichen (pädiatrische ambulant erworbene Pneumonie, pCAP).

The present guideline aims to improve the evidence-based management of children and adolescents with pediatric community-acquired pneumonia (pCAP). Despite a prevalence of approx. 300 cases per 100 000 children per year in Central Europe, mortality is very low. Prevention includes infection control measures and comprehensive immunization. The diagnosis can and should be established clinically by history, physical examination and pulse oximetry, with fever and tachypnea as cardinal features. Additional signs or symptoms such as severely compromised general condition, poor feeding, dehydration, altered consciousness or seizures discriminate subjects with severe pCAP from those with non-severe pCAP. Within an age-dependent spectrum of infectious agents, bacterial etiology cannot be reliably differentiated from viral or mixed infections by currently available biomarkers. Most children and adolescents with non-severe pCAP and oxygen saturation > 92 % can be managed as outpatients without laboratory/microbiology workup or imaging. Anti-infective agents are not generally indicated and can be safely withheld especially in children of young age, with wheeze or other indices suggesting a viral origin. For calculated antibiotic therapy, aminopenicillins are the preferred drug class with comparable efficacy of oral (amoxicillin) and intravenous administration (ampicillin). Follow-up evaluation after 48 - 72 hours is mandatory for the assessment of clinical course, treatment success and potential complications such as parapneumonic pleural effusion or empyema, which may necessitate alternative or add-on therapy.

Food-induced anaphylaxis and cofactors - data from the anaphylaxis registry.

Food allergens are frequent causes of anaphylaxis. In particular in children and adolescents they are the most frequent elicitors of severe allergic reactions, and in adults food allergens rank third behind insect venom and drugs. Since July 2006 severe allergic reactions from Germany, Austria, and Switzerland are collected in the anaphylaxis registry. Currently 78 hospitals and private practises are connected. From July 2006 until February 2009 1,156 severe allergic reactions were registered. Among children and adolescents (n = 187, age range from 3 months to 17 years) food allergens were the most frequent triggers, comprising 58% of cases. In the adult group (n = 968, 18 - 85 years) food allergens were in the third position (16.3%) behind insect venom and drugs. In children legumes (31%) and in particular peanuts were frequently responsible food allergens, followed by tree nuts (25%) with hazelnut being the most frequent elicitor. In adults fruits (13.4%) most often induced severe food-dependent anaphylaxis, but also animal products (12.2%); among these most frequently crustaceans and molluscs. Cofactors were often suspected in food-dependent anaphylaxis, namely in 39% of the adult group and in 14% of the pediatric group. In adults drugs (22%) and physical activity (10%) were reported to be the most frequent cofactors, in children physical activity was suspected in 8.7% and drugs in 2.6%. Concomitant diseases like atopic dermatitis, allergic asthma, or allergic rhinoconjunctivitis were reported in 78% of children and adolescents and in 67% of the adults. In conclusion, food-induced anaphylaxis, its cofactors and concomitant diseases are age-dependent. The data offers to identify risk factors of anaphylaxis.

Prevalence of self reported food allergy in US adults: 2001, 2006, and 2010.

BACKGROUND: Epidemiologic evidence indicates that food allergies are increasing in the population. Information on a change in self-reported food allergy (srFA) in adults over time is lacking. OBJECTIVE: To report the prevalence of srFA and compare differences at three time points over a decade. METHODS: We analyzed srFA and reported physician-diagnosed food allergy in 4000 U.S. adults who participated in the 2010 U.S. Food and Drug Administration Food Safety Survey. Information on causative food(s), reaction severity characteristics, and various diagnostic factors was also analyzed. We compared 2010 Food Safety Survey data with 2006 and 2001 data, and highlighted relevant differences. RESULTS: SrFA prevalence increased significantly, to 13% in 2010 and 14.9% in 2006 compared with 9.1% in 2001 (p less than 0.001). Physician diagnosed food allergy was 6.5% in 2010, which was not significantly different compared with 7.6% in 2006 and 5.3% in 2001. SrFA increased in both men and women, non-Hispanic white and black adults, 50-59 year olds, and in adults with a high school or lower education. In 2010, milk, shellfish, and fruits were the most commonly reported food allergens, similar to 2001. Also, in 2010, 15% of reactions reportedly required a hospital visit and 8.4% were treated with epinephrine. Minor differences in reaction severity characteristics were noted among the surveys. CONCLUSIONS: Analysis of survey results indicates that the prevalence of srFA increased among U.S. adults from 2001 to 2010 and that adults are increasingly self-reporting FAs without obtaining medical diagnosis. Improved education about food allergies is needed for this risk group.

Febrile ulceronecrotic Mucha-Habermann disease following suspected hemorrhagic chickenpox infection in a 20-month-old boy.

We present the youngest pediatric patient so far with febrile ulcerative Mucha-Haberman disease (FUMHD) after an admitting clinical picture of hemorrhagic varicella infection. With a time to diagnosis of 25 days, the 20-month-old boy responded to low dose cyclosporine and prednisolone given for 3 months and is free of disease after 4 years of follow up. We describe a polyclonal CD8+ T cell response with elevated pro-inflammatory cytokines and a fivefold upregulation of the high-affinity Fc receptor type I (CD64) on granulocytes. Early consideration of FUMHD in the differential diagnosis of a systemic inflammatory disease combined with a generalized necrotizing rash is important for early and adequate management of children with this rare and challenging disease.

Abituzumab combined with cetuximab plus irinotecan versus cetuximab plus irinotecan alone for patients with KRAS wild-type metastatic colorectal cancer: the randomised phase I/II POSEIDON trial.

BACKGROUND: Integrins are involved in tumour progression and metastasis, and differentially expressed on colorectal cancer (CRC) cells. Abituzumab (EMD 525797), a humanised monoclonal antibody targeting integrin αν heterodimers, has demonstrated preclinical activity. This trial was designed to assess the tolerability of different doses of abituzumab in combination with cetuximab and irinotecan (phase I) and explore the efficacy and tolerability of the combination versus that of cetuximab and irinotecan in patients with metastatic CRC (mCRC) (phase II part). METHODS: Eligible patients had KRAS (exon 2) wild-type mCRC and had received prior oxaliplatin-containing therapy. The trial comprised an initial safety run-in using abituzumab doses up to 1000 mg combined with a standard of care (SoC: cetuximab plus irinotecan) and a phase II part in which patients were randomised 1 : 1 : 1 to receive abituzumab 500 mg (arm A) or 1000 mg (arm B) every 2 weeks combined with SoC, or SoC alone (arm C). The primary end point was investigator-assessed progression-free survival (PFS). Secondary end points included overall survival (OS), response rate (RR) and tolerability. Associations between tumour integrin expression and outcomes were also assessed. RESULTS: Phase I showed that abituzumab doses up to 1000 mg were well tolerated in combination with SoC. Seventy-three (arm A), 71 (arm B) and 72 (arm C) patients were randomised to the phase II part. Baseline characteristics were balanced. PFS was similar in the three arms: arm A versus SoC, hazard ratio (HR) 1.13 [95% confidence interval (CI) 0.78-1.64]; arm B versus SoC, HR 1.11 (95% CI 0.77-1.61). RRs were also similar. A trend toward improved OS was observed: arm A versus SoC, HR 0.83 (95% CI 0.54-1.28); arm B versus SoC, HR 0.80 (95% CI 0.52-1.25). Grade ≥3 treatment-emergent adverse events were observed in 72%, 78% and 67% of patients. High tumour integrin αvß6 expression was associated with longer OS in arms A [HR 0.55 (0.30-1.00)] and B [HR 0.41 (0.21-0.81)] than in arm C. CONCLUSION: The primary PFS end point was not met, although predefined exploratory biomarker analyses identified subgroups of patients in whom abituzumab may have benefit. The tolerability of abituzumab combined with cetuximab and irinotecan was acceptable. Further study is warranted. CLINICALTRIALS.GOV IDENTIFIER: NCT01008475.

Statistical mixture design development of digestion methods for Oyster tissue using inductively coupled plasma optical emission spectrometry for the determination of metallic ions.

The quantitative determination of chemical elements in organic or biological samples is an important analytical problem. Normally the elements to be determined in the organic matrix must be transformed into a simple inorganic form. A digestion method by heating on a block digestor has been developed for the determination of Al, As, Ba, Ca, Cd, Co, Cu, Fe, Mg, Mn, V and Zn in Oyster tissue by ICP OES. A simplex centroid statistical mixture design has been used to study the effects of changing HNO(3), HCl and H(2)O(2) reagent proportions on the digestion of these samples. Response surface and principal component analyses show that the species Ca, Cd, Cu, Fe, Mg, Mn and Zn have very similar analytical tendencies under this experiment. By means of mixture modeling maximum recoveries for these ions were predicted using 19%, 18% and 63% of the HCl, HNO(3) and H(2)O(2) pseudocomponent mixtures, respectively. This corresponds to 21.4%, 30.8% and 47.8% of the HCl, HNO(3) and H(2)O(2) commercial solutions. Furthermore the As, Co and V ions present large recoveries for these mixtures as well. The Al and Ba ion recoveries are seen to be independent of the mixture proportions. The analysis of Oyster tissue reference material (SRM 1566b - NIST) under optimized conditions at the selected wavelengths resulted in ion recoveries between 90% and 100%.

Box-Behnken design: an alternative for the optimization of analytical methods.

The present paper describes fundamentals, advantages and limitations of the Box-Behnken design (BBD) for the optimization of analytical methods. It establishes also a comparison between this design and composite central, three-level full factorial and Doehlert designs. A detailed study on factors and responses involved during the optimization of analytical systems is also presented. Functions developed for calculation of multiple responses are discussed, including the desirability function, which was proposed by Derringer and Suich in 1980. Concept and evaluation of robustness of analytical methods are also discussed. Finally, descriptions of applications of this technique for optimization of analytical methods are presented.

Chlamydophila pneumoniae respiratory tract infection aggravates therapy refractory bronchitis or pneumonia in childhood.

BACKGROUND: Chlamydophila pneumoniae was frequently found in bronchial secretions of children with therapy-refractory bronchitis or pneumonia. It was studied, how the agent modifies the course of disease and what findings are associated with the infection. PATIENTS AND METHODS: Bronchial secretions obtained at bronchoscopy of 428 children were studied for C. pneumoniae infection using polymerase chain reaction with enzyme immunoassay detection. Children tested negative and positive were compared for their clinical findings. RESULTS: C. pneumoniae was found in 143 children (33 %). A C. pneumoniae infection has been found to be associated with a purulent bronchial inflammation (90/143 vs. 144/285, p = 0.02), a Streptococcus pneumoniae co-infection (13/143 vs. 6/285, p = 0.002) and a restrictive disturbance (11/51 vs. 8/93, p = 0.04). Purulent inflammation (Odds ratio 7.9; 95 % confidence interval [CI] 1.6-39.3), 2 co-infections (Odds ratio 14.3; 95 % CI 1.4-144.4) and co-infection with M. pneumoniae (4/4 versus 9/26, p = 0.03; Mantel Haentzel 3.0; 95 % CI 1.1-8.0) were identified as factors more often associated with a restrictive disturbance in children with bronchial C. pneumoniae infection. An adequate antibiotic therapy improved pulmonary function. No association was found for wheezing, eosinophil inflammation of the nasal mucosa, alpha-1 antitrypsin or immunoglobulin deficiency in serum, level of secretory IgA in bronchial mucus, pathological lung scintigram, gastro-esophageal reflux disease, sweat test and other co-infections. CONCLUSIONS: In children with therapy-refractory bronchitis or pneumonia bronchial C. pneumoniae infection was associated with a more severe disease in case of several, mostly bacterial co-infections. Adequate antibiotic therapy for C. pneumoniae infection has been demonstrated to improve pulmonary function.

Molecular and clinical characteristics of respiratory syncytial virus infections in hospitalized children.

The objective of this study was to determine the importance of respiratory syncytial virus (RSV) for hospitalization in the north east of Germany and to obtain molecular epidemiological data of the circulating strains. Using a rapid and sensitive reverse transcriptase-PCR, it was found that a quarter of pediatric respiratory disease admissions were due to RSV. Infections caused by RSV in hospitalized patients were determined over the whole year. Both RSV groups A and B were identified with a predominance of RSV A (86%) over the entire period. The analysis of the deduced amino acid sequences by direct sequencing showed that very similar RSV strains are circulating in the community.

The infrared vibrational intensities and polar tensors of HFCO and DFCO.

The infrared vibrational intensities of HFCO and DFCO have been calculated at the B3LYP/cc-pVTZ, MP2(FC)/6-311++G(3d,3p) and QCISD(FU)/aug-cc-pVTZ levels. All calculations predict the isotopomers to have identical intensity sums, within about 1 km mol(-1). This is in contrast with experimental intensity sum results reported in the literature. Dipole moment derivative directions calculated by the three methods are in excellent agreement for all in-plane normal coordinates. All the theoretical polar tensor elements are also in good agreement with each other having standard deviations varying between 0.003 and 0.043 e. The oxygen and fluorine atoms have negative mean derivatives (approximately -0.6 e), whereas the carbon mean derivative is very positive (approximately +1.1e) and the hydrogen one is almost zero (approximately +0.03 e). The HFCO theoretical intensity sums calculated by all three methods as well as their carbon and oxygen mean dipole moment derivatives are in good agreement with those estimated from the experimental intensities and atomic mean derivatives of H2CO and F2CO.

Comparison of human herpesvirus 8 and Epstein-Barr virus seropositivity among children in areas endemic and non-endemic for Kaposi's sarcoma.

Human herpesvirus 8 (HHV-8) is the etiologic agent of Kaposi's sarcoma (KS). Several studies indicate horizontal HHV-8 transmission among children in areas where KS is endemic, but few studies have assessed acquisition of HHV-8 by children in low seroprevalence areas. Antibody screening was carried out for HHV-8 and Epstein-Barr virus (EBV) on 787 serum specimens from children living in two areas where HHV-8 is not endemic, the United States (US) and Germany, and on 184 specimens from children living in a KS-endemic area (Nigeria). For children in the US and Germany, the results showed low HHV-8 seroprevalence rates (3-4%). However, US children aged 6 months to 5 years had higher HHV-8 antibody titers than did 6-17-year-old children (P < 0.01), a finding consistent with more recent infections being detected in the younger children. Compared with seroprevalence rates and antibody titers in US and German children, those in Nigerian children were significantly higher, and seroprevalence increased with age. There was no evidence of cross-reactivity between assays for HHV-8 and EBV, despite the genetic similarity of these two herpesviruses. The data indicate that HHV-8 transmission among children where HHV-8 is not endemic occurs, but is uncommon. The findings also suggest that HHV-8 antibodies, as measured by current tests, may not persist for long periods in populations at low risk for KS and that vertical transmission is rare, although longitudinal studies are necessary to address directly these issues.

Real-time PCR to improve the diagnosis of respiratory syncytial virus infection.

Respiratory syncytial virus (RSV) is one of the most important virus respiratory pathogens in infants and young children. A rapid and sensitive diagnosis is essential to focus any outbreak due to this virus. A real-time RT-PCR method was designed using a primer/probe pair from the F gene. Simultaneously with nested RT-PCR and antigen ELISA, 71 consecutive specimens from hospitalized children with clinical symptoms of acute respiratory distress were evaluated to confirm the incidence of RSV infection. RSV was detected in 25 (35.2 %) specimens by real-time RT-PCR and in 19 (26.7 %) by nested RT-PCR. The assay was specific for RSV. The procedure offers a rapid and sensitive alternative to conventional RT-PCR. Closed-tube detection eliminates the risk of contamination.

The infrared fundamental intensities and polar tensor of CH3NC.

The molecular force field and polar tensor of methyl isocyanide have been determined from its gas phase vibrational frequencies and infrared intensities. Quantum chemical results from MP2(FC), B3LYP and quadratic configuration interaction calculation including single and double substitutions procedures using a 6-311 + +G(3d,3p) basis set have been used to determine the signs of the dipole moment derivatives with respect to the normal coordinates as well as estimate individual fundamental intensities of the overlapped v1-v5 and v3-v6 band systems. Principal component graphical representations of the A1 and E symmetry polar tensor elements were useful in determining preferred sets of tensor elements. The mean dipole moment derivative (GAPT charge) of the methyl carbon in CH3NC, 0.347 e, is between the corresponding values in CH3CN, 0.110 e, and CH3F, 0.541 e. The mean dipole moment derivatives obtained here indicate the correct 1s methyl carbon ionization energy as 293.35 eV which is 0.98 eV higher than the corresponding ionization energy of the terminal atom.

Bronchial Chlamydia pneumoniae infection, markers of allergic inflammation and lung function in children.

A relationship between respiratory Chlamydia pneumoniae infection (RCPI) and bronchial asthma is under discussion. Our objective was to study the frequency of RCPI and whether it is associated with markers of asthma in children with recurrent or chronic bronchitis as well as pneumonia. One-hundred and forty-eight children who underwent bronchoscopy were enrolled; 42 children with additional respiratory infections were excluded. Therefore, 106 children were examined, regarding a RCPI, by polymerase chain reaction (PCR) of tracheobronchial aspirate, eosinophilic inflammation of respiratory mucosa (cytology, eosinophilic cationic protein [ECP]), total serum immunoglobulin E (IgE) and specific IgE for six important allergens, as well as lung function tests if possible. There was a RCPI in 55 of 106 children (51.9%); 25.4% of PCR positives (14/55) were weakly positive (double cut-off), which was more prevalent in the 2-5-year age-group and teenagers. Children with RCPI, inclusive of weak positives, showed a milder eosinophilia of nasal mucosa than children without RCPI (5.58% vs. 9.35%, p=0.039). Eosinophilia of > or =13% in nasal- and/or bronchial swab, as a marker for respiratory allergy, was less frequent in patients with RCPI too (7.3% vs. 21.6%, p=0.035). There were no differences in ECP. Total IgE was lower in PCR-positive children (101 vs. 179 IU/ml, p=0.032). Specific IgE with a radioallergosorbent test (RAST) of at least class 3 (as a marker for a relevant allergy), as well as any RAST above zero (to characterize early forms of allergy), were both less frequent in the RCPI group. In contrast, weak positives showed the highest rates of sensitization, surpassing RCPI negatives. In lung-function tests, vital capacity was lower in RCPI patients (87.5% vs. 95.3%, p=0.045); all parameters characterizing obstructive disturbance tended to be higher. Weak positives had both the greatest reduction of vital capacity (75.3%) and the most impaired obstructive parameters. All differences were accentuated in children of 11-18 years of age. Hence, our results indicate that in the children selected, a RCPI is common and not associated with allergic respiratory inflammation. Weak positives, however, differ, having the highest rate of allergic sensitization, reduction of lung volume, and obstructive disturbance. This group might be important in clinically observed asthma after pneumonia caused by C. pneumoniae. In these children, early diagnosis and treatment of a RCPI is recommended.

Tuning pacemaker frequency of individual dopaminergic neurons by Kv4.3L and KChip3.1 transcription.

The activity of dopaminergic (DA) substantia nigra (SN) neurons is essential for voluntary movement control. An intrinsic pacemaker in DA SN neurons generates their tonic spontaneous activity, which triggers dopamine release. We show here, by combining multiplex and quantitative real-time single-cell RT- PCR with slice patch-clamp electrophysiology, that an A-type potassium channel mediated by Kv4.3 and KChip3 subunits has a key role in pacemaker control. The number of active A-type potassium channels is not only tightly associated with the pacemaker frequency of individual DA SN neurons, but is also highly correlated with their number of Kv4.3L (long splice variant) and KChip3.1 (long splice variant) mRNA molecules. Consequently, the variation of Kv4alpha and Kv4beta subunit transcript numbers is sufficient to explain the full spectrum of spontaneous pacemaker frequencies in identified DA SN neurons. This linear coupling between Kv4alpha as well as Kv4beta mRNA abundance, A-type channel density and pacemaker frequency suggests a surprisingly simple molecular mechanism for how DA SN neurons tune their variable firing rates by transcriptional control of ion channel genes.

Factorial design of electrolyte systems for the separation of fatty acids by capillary electrophoresis.

In this work, a capillary zone electrophoretic methodology using UV indirect detection (224 nm) for the analysis of fatty acids (FAs) in saponified oils is proposed. The electrolyte consisted of a 5 mmol l(-1) phosphate buffer, pH 7. containing 4 mmol l(-1) sodium dodecylbenzenesulfonate (SDBS) as chromophore, 4 mmol l(-1) dimethyl-beta-cyclodextrin and 45% acetonitrile (ACN). The composition of the electrolyte was optimized by a 2(3) factorial design with triplicate at the central point. The design established practical concentration boundaries for SDBS and ACN. In a defined concentration range of 2-4 l(-1), SDBS can certainly be used as a chromophore for indirect detection without imparting excessive baseline noise. For ACN, a suitable interval of 45-55% was found to enhance FAs solubilization without overflowing the system with bubble formation and current interruption. Additionally, the design revealed the importance of dimethyl-beta-cyclodextrin in the resolution of difficult pairs and its function as a solubilizing agent for long chain FAs. At the optimized conditions, nine FAs from C10 to C20, including mono- di- and tri-unsaturated C18 fatty acids were baseline separated in less than 10 min. The proposed method was applied to the separation of FAs in edible oils and polyunsaturated fatty acid enriched margarine. Additionally, spectral monitoring at 206 nm was used to confirm peak identity in the samples.

The infrared fundamental intensities and polar tensor of allene.

The polar tensor of allene was calculated from the infrared fundamental band intensities of C3H4 and C3D4. The ambiguities in the signs of the dipole moment derivatives with respect to their normal coordinates were resolved by comparison of tensor elements with ab initio calculations at the B3LYP, MP2(FC) and CCD(FC) levels with a 6/311 + + G(3d,3p) basis set. The results are similar to those previously obtained by Koga and co-workers except for the choice of an average of two sign combinations for the E symmetry elements. The values of the mean dipole moment derivatives for the sp and sp2 carbon atoms obtained in this work, 0.032 and -0.133 e, respectively, are in good agreement with the CCD(FC)/6-311 + + G(3d,3p), 0.061 and -0.128 e, and MP2(FC)/6-311 + + G(3d,3p), 0.072 and -0.153 e, theoretical results. The mean dipole moment derivatives are shown to be consistent with potential models relating 1s electron ionization energies and atomic charges.

The infrared intensities and polar tensors of the fluorochloromethanes.

The polar tensors of CF3Cl, CF2Cl2 and CFCl3 have been calculated using recent measurements of their gas phase infrared fundamental intensities. The polar tensors obtained for CF2Cl2 and CFCl3 are in very good agreement with those obtained previously since the more recent experimental intensity results are in good agreement with those reported earlier. For CF2Cl2 rhoC = +1.626, rhoF = -0.577 and rhoCl = -0.26e whereas rhoC = +1.369, 0.478 and rhoCl = 0.297e for CFCl3. However, two sets of significantly different mean dipole moment derivatives are obtained from the experimentally measured intensities of CF3Cl reported by two different laboratories. On the other hand, the differences in the mean derivatives of these two sets are not large enough so that results from electronegativity models, potential models for core ionization energies and quantum chemical calculations at the Moller-Plesset 2 and B3LYP density functional levels are sufficient to indicate which set is the correct one. As such average values of rhoC = +1.907+/-0.178e, rhoF = -0.590+/-0.056e and rhoCl = -0.139+/-0.013e obtained from both sets of polar tensor elements are recommended for the CF33Cl mean dipole moment derivatives.

General non-specific morbidity is reduced after vaccination within the third month of life--the Greifswald study.

OBJECTIVES: The incidence of many serious infectious diseases fundamentally decline as a success of consequent vaccination regimens. However, it is a matter of discussion if vaccination might cause unspecific negative side effects on the immune system. To answer this, we performed a clinical study on children with the question as to whether there is an enhanced frequency of infection diseases after vaccination or not. METHODS: The study population (n=496) was randomized to a group of vaccinated children (first vaccination on the 60th day of life, n=201) and a group of unvaccinated children (first vaccination on the 90th day of life, n=295). Frequencies of unspecific, morbidity-related signs were recorded by the mothers with a diary card. These data were taken for further statistical analysis to determine if the factor "vaccination" does have a significant effect on the variable "morbidity". RESULTS: Various infectious disease-associated symptoms (vomiting, coughing, signs of rhinitis, restlessness, rash and pain) were significantly less often seen in vaccinated than in non-vaccinated children. CONCLUSIONS: Our study revealed that children who received vaccination against diphtheria, pertussis, tetanus, HiB and poliomyelitis simultaneously within the third month of life do not exhibit enhanced frequencies of infectious disease-associated symptoms. In contrary, the frequencies of infection-associated symptoms were found to be significantly reduced. This might be caused by a vaccination-associated unspecific enhancement of immunological activity (e.g. mediated by interleukin 2) or by other presently still unknown factors.

The infrared fundamental intensities and polar tensor of CF4.

Atomic polar tensors of carbon tetrafluoride are calculated from experimental fundamental infrared intensities measured by several research groups. Quantum chemical calculations using a 6-311 + + G(3d, 3p) basis set at the Hartree-Fock, Möller-Plesset 2 and Density Functional Theory (B3LYP) levels are used to resolve the sign ambiguities of the dipole moment derivatives. The resulting carbon mean dipole moment derivative, pC = 2.051 e, is in excellent agreement with values estimated by a MP2/6-311 + + G(3d, 3p) theoretical calculation, 2.040 e, and by an empirical electronegativity model, 2.016 e. The pC value determined here is also in excellent agreement with the one obtained from the CF4 1s carbon ionization energy using a simple potential model, 2.059 e. Crawford's G intensity sum rule applied to the fundamental intensities of CH4, CH3F, CH2F2 and CHF3 results in a prediction of a 1249 km mol(-1) intensity sum for CF4 in good agreement with the experimental values of 1328 +/- 37.9, 1208.0 +/- 54.4 and 1194.8 +/- 7.4 km mol(-1) reported in the literature.