[Morbidity differences according to nursing stage and nursing setting in long-term care patients: Results of a claims data based study]. / Morbiditätsunterschiede bei Pflegebedürftigen in Abhängigkeit von Pflegesektor und Pflegestufe: Eine Untersuchung auf der Basis von Abrechnungsdaten der Gesetzlichen Krankenversicherung.

BACKGROUND: We analyzed the differences in morbidity patterns of chronic diseases between long-term care dependent persons in nursing homes compared to those dwelling in the community. We also investigated morbidity differences between long-term care need stages in Germany. MATERIALS AND METHODS: The study included claims data of one nationwide operating statutory health insurance in 2006. Inclusion criteria were age ≥ 65 years, minimum 1 out of 46 diagnoses in at least 3 quarters of the year (n = 8,670). A comparison population was formed with n = 114,962. Prevalences, relative risks, and odds ratios for the risk of nursing home care were calculated. RESULTS: In the bivariate analysis, only three chronic diseases - dementia, urinary incontinence, and chronic heart failure - showed a higher risk for nursing home care. Regression analysis revealed that only dementia showed higher odds related to the stage of nursing needs. CONCLUSION: Among the chronic diseases, only dementia shows a substantially elevated risk for nursing home care. Risk studies on other chronic diseases associated with higher risks of long-term care dependency and specific intervention strategies aiming at delaying or preventing nursing home admission should be developed.

Five-year follow-up on the PAT study: specific immunotherapy and long-term prevention of asthma in children.

BACKGROUND: A 3-year course of specific immunotherapy (SIT) in children with hay fever to grass and/or birch pollen significantly reduced the risk of developing asthma. To investigate the long-term preventive effect, we performed a follow up--2 years after termination of immunotherapy. METHODS: A total of 183 children, aged 6-14 years with grass and/or birch pollen allergy could be investigated 2 years after discontinuation of SIT or no treatment. Conjunctival provocation tests (CPTs) and methacholine bronchial provocation tests were carried out during the season and winter after 5 years. The development of asthma was assessed by clinical evaluation. RESULTS: The significant improvement in hay fever and CPT results observed after 3 years of SIT persisted at the 5-year follow-up. No difference in bronchial responsiveness to methacholine was found after 5 years because of spontaneous improvement during the follow-up period in the control patients. The immunotherapy-treated children had significantly less asthma after 5 years as evaluated by clinical symptoms [odds ratio 2.68 (1.3-5.7)] in favor of SIT for prevention of development of asthma and significantly less patients reported an increase in asthma scores (P < 0.01). CONCLUSION: Immunotherapy for 3 years with standardized allergen extracts of grass and/or birch shows long-term clinical effect and preventive effect on development of asthma in children with seasonal rhinoconjunctivitis.

Decreased tumor incidence and increased survival by one year oral low dose arginine supplementation in the mouse.

The effects of arginine on tumor growth, antitumor mechanisms and a potential therapeutic role have been reviewed recently. In these studies, however controversial they were, high dose protocols for arginine treatment have been applied. Based upon own recent findings that low dose arginine stimulates the immune system and blocks lipid peroxidation, we performed preventive treatment with low dose (50 mg/kg body weight per day, orally administered) L-arginine in 150 mice for a period of one year. We compared survival and total number of tumors at the end of the feeding period to that found in 150 mice given taurine in the same dosage and in 150 mice without treatment. Survival of the arginine treated group was statistically significant as compared to that of the control group without treatment (p < 0.05): 116 mice were alive in the control group, 122 in the group administered taurine and 132 in the arginine treated group. The total number of tumors was significantly lower in the arginine treated group vs. the control group (p < 0.01). The total number of malign and benign tumors was significantly lower in the arginine treated group, whereas taurine significantly reduced the number of benign tumors only (p < 0.05). Arginine and taurine stimulate the immune system at the lymphocyte level. Arginine also acts at the macrophage level, inducing nitric oxide mediated cytotoxicity against tumor cells. Both compounds are known to block the formation of lipid peroxidation products. We therefore suggest that these two mechanisms are responsible for the decreased total number of tumors and the concomitant increase in survival.

Cross-reactivity with Tagetes in Arnica contact eczema.

A 69-year-old patient, with known mercury and adhesive plaster allergy, developed facial dermatitis within 24 h of contact with arnica (Arnica). Skin testing showed positive reactions to arnica and, among various other plants of the Compositae, also to Tagetes sp. hybr. (marigold). Cross-reactivity between Tagetes and arnica has not previously been described.