Relapsing fever and its serological discrimination from lyme borreliosis

Summary Patients withBorrelia-caused relapsing fever produce cross-reacting antibodies toBorrelia burgdorferi, the anti-genetically related causative agent of Lyme borreliosis. The antibody response of the serum of a patient (acute and convalescent) with relapsing fever was analysed by the immunoblot technique usingBorrelia hermsii andB. burgdorferi as antigens. The diagnosis was established by microscopic detection of spirochetes in the patient's blood. The patient's serum showed significantly elevated titers of IgG and IgM in aB. burgdorferi indirect immuno-fluorescence assay. Immunoblot analysis indicated the presence of cross-reacting antibodies directed toB. burgdorferi antigens with apparent molecular weights of 60, 41, 40, 36, 30 and 20 kDa.

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Rückfallfieber — serologische Abgrenzung von Lyme Borreliose. Fallbericht

Zusammenfassung Patienten mit borrelieninduziertem Rückfallfieber produzieren kreuzreagierende Antikörper gegen den nah verwandten Erreger der Lyme-Borreliose,Borrelia burgdorferi. Wir beschreiben die Antikörperantwort einer Patientin mit klinisch diagnostiziertem Rückfallfieber gegenBorrelia hermsii, einem Erreger des zeckenübertragenen Rückfallfiebers in den USA, undB. burgdorferi. Die Diagnose eines Rückfallfiebers konnte durch den mikroskopischen Nachweis von Spirochäten im Blut der Patientin gesichert werden. Die Patientin zeigte signifikant erhöhte IgG- und IgM-Titer imB. burgdorferi-IFT. Die Immunoblot-untersuchungen zeigen, daß kreuzreagierende Antikörper gegenB. burgdorferi-Antigene mit einem apparenten Molekulargewicht von etwa 60, 41, 40, 36, 30, und 20 kDa gerichtet sind.

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This study was presented in part at the spring meeting of the Deutsche Gesellschaft für Hygiene und Mikrobiologie (DGHM), March 14–15, 1991 (Berlin, Germany).     

Technische Möglichkeiten und Perspektiven des Einsatzes telemedizinischer Geräte in der Augenheilkunde

Home monitoring will soon be established as an innovative way to provide telemedical care in ophthalmology. At present there are no fundamental technical restrictions for telemedical enhancements in ophthalmology, however a wider application range and depth could lead to harmonized and simplified device and interface development. This may help to initiate new concepts in ophthalmological home monitoring.     

Schulische Tabakprävention

Aim

The aim of this paper is to give an overview of international research on the effects of structural prevention measures at schools on the smoking behaviour of pupils.

Methods

A systematic literature search was conducted using four social sciences databases. In total, 11 international publications from different countries were included.

Results

The formal adoption of written smoking bans alone does not affect the smoking behaviour of pupils. The implementation of additional activities, particularly regular controls of smoking bans and consequent sanctioning of transgressions, is related to students smoking prevalence.

Discussion

Most studies on the effect of structural prevention activities at schools are crosssectional with some methodological problems. On the basis of the results preliminary recommendations are presented.     

Evaluation of two commercial amplification assays for detection ofMycobacterium tuberculosis complex in respiratory specimens

Summary To evaluate the usefulness of two standardized commercially available amplification assays for the detection ofMycobacterium tuberculosis: Amplicor® test (Roche) and MTD-Amplified direct test (Gen-Probe) a total of 281 respiratory specimens from 198 patients with symptoms of pulmonary diseases were examined and compared with conventional methods. Fifty-seven specimens were positive and 218 negative by both amplification assays. Three specimens were reactive by Amplicor® only, and three by MTD only. In comparison with culture, the sensitivity, specificity, positive predictive value and negative predictive value were 96.0, 94.8, 80.0, and 99.1%, respectively, for the Amplicor® test; the corresponding values were 94.0, 94.4, 78.3, and 98.6%, respectively, for the MTD. However, when 28 specimens from 14 patients on antituberculous therapy were excluded the improvement in PPV and specificity of both assays was obtained. In conclusion, both commercially available amplification tests are almost equally sensitive and specific and are suitable for the implementation in daily routine work in the specialized clinical laboratories.

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Bewertung zweier kommerzieller Amplifikationsassays für den Nachweis vonMycobacterium tuberculosis complex in Proben aus den Atemwegen

Zusammenfassung Um die Brauchbarkeit zweier standardisierter, kommerziell erhältlicher Amplifikationsassays für den Nachweis vonMycobacterium tuberculosis (Amplicor® Test (Roche und MTD Amplified Direct Test (Gen-Probe) zu beurteilen, wurden insgesamt 281 Proben aus den Atemwegen von 198 Patienten mit Symptomen einer Lungenerkrankung vergleichend mit konventionellen Methoden untersucht. 57 Proben waren positiv und 218 in beiden Amplifikationsassays negativ. Drei Proben waren nur mit Amplicor® positiv, drei nur mit MTD. Im Vergleich zur Kultur ergab sich eine Sensitivtät von 96,0%, Spezifität von 94,8%, ein positiver prädiktiver Wert von 80,0% und ein negativer prädikativer Wert von 99,1% für den Amplicor® Test. Die entsprechenden Werte für den MTD-Test sind 94,0, 94,4, 78,3 und 98,6%. Wenn man jedoch 28 Proben von 14 Patienten, die unter tuberkulostatischer Therapie standen, ausschließt, erhöhen sich der positive prädiktive Wert und die Spezifität bei beiden Testsystemen. Es folgt, daß beide kommerziell erhältlichen Amplifikationstests an Sensitivität und Spezifität nahezu gleich sind und sich für die Anwendung in der täglichen Routinearbeit in klinischen Speziallabors eignen.

     

?Adherence“ bei Kompressionstherapie

Pressure garment therapy shows dropout rates between 30% and 59%. It is not the patient's health-related beliefs which lead to abandonment of therapy but the amount of negative side effects accompanying pressure garment therapy. Moreover, patients report a lack of information dealing with the garments, anxiety of damaging the skin and feelings of shame in contact with other people. The disabilities and restraints cannot be dispersed but only moderated. The two basic variables of an adherence promoting model are psychoeducation and strengthening of resources within a participative relationship between therapist and patient.     

Evaluation der Neuen Rückenschule

Background

According to the biopsychosocial approach of the German new back school the core objectives are sustainable improvement of physical and psychosocial health resources. Subjects with non-specific low back pain were investigated to evaluate the desired physical effects.

Methods

Coordinative and postural motor exercises were evaluated by means of surface electromyography (EMG). Applying a modified waiting group design 56 participants were examined 3 months before the start, at the beginning and at the end of the new back school program as well as 3 and 12 months after completion and the results were compared to a healthy control group (n=56) matched for age and body mass index (BMI).

Results

Initially significant group differences were found in 18?% of all statistical calculations of the static and 6?% of the dynamic test situations. Considering the trunk muscles the most frequent significant alterations from normative data were found in the lumbar multifidus muscle (static tests 29?% and dynamic tests 7?%). No relevant changes in the number of statistical results could be detected directly after completion of the new back school program. Nevertheless, at 12 months follow-up the number of significant differences to the normative data of the control group dropped by one third to 12?% of all calculations with static loads.

Conclusion

The adjustment effects at 12 months follow-up indicate a delayed positive influence of the new back school program on muscular physiological parameters. Individuals with chronic non-specific back pain showed a long-term profit from participation in the new back school program due to the initiated orientation to a modified more active lifestyle.