Post-exposure prophylaxis for measles with immunoglobulins revised recommendations of the standing committee on vaccination in Germany

Passive immunisation with immunoglobulins as post-exposure prophylaxis after contact with measles is recommended by the German Standing Committee on Vaccination (STIKO) particularly for unprotected individuals at high risk of complications for whom active immunization is contraindicated, such as infants <6 months of age, immunocompromised patients and pregnant women. The efficacy of passive immunisation in preventing measles depends on how soon after exposure it is administered, the concentration of measles antibodies in the immunoglobulin products and dosage. Since the global introduction of standard active immunisation against measles and the concomitant reduction in virus circulation, the levels of measles virus (MV)-specific IgG antibodies in the population have dropped. Thus, the concentration of MV-specific antibodies in immunoglobulin products derived from human plasma donors has declined as the proportion of vaccinated donors has increased. The MV-neutralizing capacity of immunoglobulin products is not routinely tested in Germany. No official data exist on the concentrations of MV-specific IgG antibodies in individual batches of immunoglobulins available in Germany and the required minimum level for MV-specific IgG is not stipulated.The STIKO re-evaluated available data and measurements of MV-neutralizing capacities of available immunoglobulin (IgG) products in Germany at the National Reference Centre Measles, Mumps, Rubella at the Robert Koch Institute. Based on the findings, STIKO modified its previous recommendations on the post-exposure use of immunoglobulins (2001), especially with respect to risk groups, application and dosage. STIKO now recommends a single intravenous administration of immunoglobulins (400 mg/kg body weight) as soon as possible, preferably within six days, after exposure to measles, specifically for infants aged <6 months, susceptible pregnant women and immunocompromised patients.     

Lipoedema is not lymphoedema: A review of current literature

Lipoedema is a rare painful disorder of the adipose tissue. It essentially affects females and is often misdiagnosed as lymphoedema or obesity. It is globally misdiagnosed or underdiagnosed, and the literature is lacking appropriate guidance to assist clinicians towards this diagnosis. However, the need to recognise this disorder as a unique entity has important implications to establish proper treatment and, therefore, its tremendous effect on patients. Early diagnosis and treatment can turn these patients’ lives upside down. The aim of this review is to focus on the clinical guidance, differential diagnosis, and management strategies. In addition, other aspects of lipoedema, including epidemiology and pathogenesis, are also being discussed here. Lipoedema is distinct from obesity and distinct from lymphoedema, although it might progress to involve the venous and lymphatic system (venolipedema or lympholipedema or both). Late diagnosis can leave the patient debilitated. Management of lipoedema includes weight loss, control of oedema, complex decongestive physiotherapy, liposuction, and laser‐assisted lipolysis. However; there are increasing reports on tumescent liposuction as the preferred surgical option with long‐lasting results. The role of more randomised controlled studies to further explore the management of this clinical entity remains promising.     

Determinants of participation in further training among workers with disabilities

Abstract

Purpose: To analyse the determinants of the participation in further training for workers without and with disabilities in Germany. In particular, we are interested in testing the hypothesis that people with disabilities are less likely to receive further training. Method: Using longitudinal data from the German Socio-Economic Panel which covers the period 1989 to 2008, we estimate panel data regression models that allow us to identify the factors affecting the likelihood to participate in further training for people without and with disabilities. Results: The results confirm that workers with disabilities are less likely to participate in further training as compared to workers without disabilities (especially among males). In addition, variables such as age, years of education, occupation and firm size have a significant effect on the likelihood to get involved in further training for the disabled sample. We also found that people with disabilities have experienced more intensely the changes and variations in the participation rates over the period analysed compared to people without disabilities. Conclusions: From a public policy perspective, these findings show the importance of designing and implementing specific training programs for people with disabilities, which can contribute to maintaining and increasing their integration in the German labour market.

• Implications for Rehabilitation

• Training and vocational rehabilitation can in many cases be critical to achieve or secure employment.

• A person becoming disabled may, even after completion of the medical rehabilitation process, not be able to continue to work in the previous occupation.

• Rehabilitation specialists must be more involved within the design, provision and implementation of further training. They can also help to identify adaptive equipment and specific training tools that contribute to increasing the participation in further training among the disabled population.

• However, the odds of participating in further training among workers with disabilities is around 17% lower than that registered for their non-disabled counterparts.

     

Food cravings discriminate differentially between successful and unsuccessful dieters and non-dieters. Validation of the Food Cravings Questionnaires in German

Food cravings have been strongly associated with triggering food consumption. However, definitions and measurements of food cravings are heterogeneous. Therefore, [Cepeda-Benito et al., 2000] and [Cepeda-Benito et al., 2000] have suggested the Food Cravings Questionnaires (FCQs) to measure food cravings as a multidimensional construct at trait- and state-level. In the current study, we validated a German version of the FCQs in an online study (N = 616). The factor structure of the state and trait versions could partially be replicated, but yielded fewer than the originally proposed factors. Internal consistencies of both versions were very good (Cronbach’s α > .90), whereas retest reliability of the state version was expectedly lower than that of the trait version. Construct validity of the trait version (FCQ-T) was demonstrated by high correlations with related eating behavior questionnaires and low correlations with questionnaires unrelated to eating. Most importantly, FCQ-T-subscales were able to discriminate between successful and unsuccessful dieters and non-dieters. Validity of the state version was supported by positive relations with food deprivation and current negative affect. Taken together, the German version of the FCQs has good psychometric properties. Moreover, this study provided first evidence that distinct dimensions of food cravings are differentially related to success and failure in dieting.     

An overview of values for the threshold of toxicological concern

An overview of values for the threshold of toxicological concern (TTC) is presented. This comprises the more established TTC values, including those that have been endorsed by regulatory bodies, and those that have more recently been proposed and may still need further development. The overview is structured by use/exposure scenario and provides, in particular, key information on the underlying databases. It is aimed to support the application of the TTC approach in the risk assessment of chemicals whereby it is important to be aware under which circumstances a certain TTC value can be applied. Some recommendations for potential future developments to further improve the TTC approach are also being made.     

Effects of 5-fluorouracil and gemcitabine on a breast cancer cell line (MCF-7) via the JAK/STAT pathway

Aberrant activation of the JAK/STAT pathway may predispose to malignancy as a consequence of the deregulation of cell proliferation, differentiation or apoptosis such as in cancer of the blood, head and neck, and breast. In our study we aimed to investigate the effects of 5-fluorouracil (5-FU) and gemcitabine on a breast cancer cell line (MCF-7 cells) via the JAK/STAT pathway. Distribution of JAK1, JAK2, JAK3 and STAT2, STAT3, STAT4, STAT5 were evaluated on MCF-7 cells following gemcitabine and 5-FU treatment and in the absence of drug treatment by an indirect immunohistochemical method. It was observed that JAK1, JAK3, STAT5 and particularly STAT2 activation were more effective than the other JAK/STATs in breast cancer progression. Following treatment with 5-FU, JAK1 and STAT5 immunoreactivities were decreased in MCF-7 cells in comparison with both gemcitabine-treated and non-treated groups. These results suggest that the JAK/STAT pathway plays an important role in breast cancer pathogenesis and may be more affected after 5-FU treatment rather than gemcitabine. Drugs which block STAT5 may provide a novel therapeutic approach for the treatment of breast cancer.     

Risk factors in childhood arterial ischaemic stroke: Findings from a population-based study in Germany

Objective

Acute treatment of childhood arterial ischaemic stroke and prevention strategies for recurrent stroke episodes depend strongly on each child's individual risk profile. The aim of this study is to characterize risk factors for childhood stroke, their occurrence in isolation or combination, and to identify possible common risk factor patterns.