Human seroprevalence against Borrelia burgdorferi sensu lato in two comparable regions of the eastern Alps is not correlated to vector infection rates.

Seroprevalences were determined by testing sera of 1607 blood donors from North, East, and South Tyrol. In the Tyrols, the continental divide delimitates areas with high seroprevalences of IgG antibodies against Borrelia burgdorferi sensu lato in the North (7.2%) from areas with low seroprevalences in the South (1.5%). To determine Borrelia prevalences in unfed Ixodes ricinus ticks, 755 questing ticks were tested by PCR. Prevalences in nymphal and adult ticks were found to be 19.7% (n=132) and 21.5% (n=205) in North Tyrol and 23% (n=43) and 23.7% (n=376) in South Tyrol, respectively. Sequencing of 46 Borrelia-positive ticks yielded 74% Borrelia (B.) afzelii, 11% B. garinii, 7% B. lusitaniae, 7% B. burgdorferi sensu stricto, and 2% B. valaisiana infections. Distinct genetic clusters could not be delimitated on either side of the continental divide. This study describes occurrence and geographic dispersion of Borrelia spp. in the Tyrols, discusses possible reasons for significant differences in human seroprevalence, and indicates that prevalence of Borrelia in vector ticks is not a direct predictive factor for the local seroprevalence in humans.

Spotted fever group--Rickettsiae in the Tyrols: evidence by seroepidemiology and PCR.

The aim of our study was to assess the occurrence of Rickettsia in the inner-alpine valleys of the Eastern Alps and to determine the amount of seroreaction among the local human population. Ticks were investigated by PCR and the percentage of seropositives was determined among local blood donors by an in-house immunofluorescence assay. The local cut-off titre for screening of IgG was set at 1 : 128 with a well-characterised low-risk collective according to WHO-guidelines. Positive sera were confirmed by independent re-testing. Rickettsia is present in ticks north and south of the continental divide. Of 259 ticks investigated, 12.4% are positive for Rickettsia. Of over 1200 blood donors tested so far, 7.7% bear IgG at a titre of 1 : 128 or higher against R. helvetica. R. helvetica is present in the study area, causes immunoreaction among local residents and is associated with anamnestic erythema. Furthermore, screening with a second Spotted Fever Group Rickettsia indicates that significant parts of the Tyrolean population are exposed to a Rickettsia other than R. helvetica.

Absence of indigenous specific West Nile virus antibodies in Tyrolean blood donors.

In the last several years, West Nile virus (WNV) was proven to be present especially in the neighboring countries of Austria, such as Italy, Hungary, and the Czech Republic, as well as in eastern parts of Austria, where it was detected in migratory and domestic birds. In summer 2010, infections with WNV were reported from Romania and northern Greece with about 150 diseased and increasingly fatal cases. We tested the sera of 1,607 blood donors from North Tyrol (Austria) and South Tyrol (Italy) for antibodies against WNV by using IgG enzyme-linked immunosorbent assay (ELISA). Initial results of the ELISA tests showed seroprevalence rates of 46.2% in North Tyrol and 0.5% in South Tyrol, which turned out to be false-positive cross-reactions with antibodies against tick-borne encephalitis virus (TBEV) by adjacent neutralization assays. These results indicate that seropositivity against WNV requires confirmation by neutralization assays, as cross-reactivity with TBEV is frequent and because, currently, WNV is not endemic in the study area.

Lyme neuroborreliosis: aetiology and diagnosis of facial palsy in children from Tyrol.

BACKGROUND: Lyme neuroborreliosis (LNB) is the second most common manifestation of Borrelia burgdorferi sensu lato (s. l.) infection in Europe. LNB is difficult to differentiate from other aetiologies of aseptic meningitis. Diagnostic criteria for LNB in children are not established. Therfore, based on the epidemiology of LNB in children from Tyrol, the aim of our study was to point out the necessity of a clear definition of pediatric LNB to avoid underdiagnosis and overtreatment. PATIENTS AND METHODS: All medical charts of patients presented with acute peripheral facial palsy from January 2002 to December 2005 were reviewed. The patients were rediagnosed according to the criteria of the German Society of Neurology (DGN). RESULTS: We identified 66 patients with peripheral facial palsy. 30 children were handled as B. burgdorferi s. l. infection. 5 patients were overtreated with antibiotic therapy. After reevaluation according to the DGN criteria 7 cases were reclassified as possible, 16 cases as probable and 7 cases as confirmed LNB. CONCLUSIONS: Utilization of the established DGN criteria for pediatric LNB might help to elucidate the propability of LNB. Prospective studies are required to establish a classification system. A diagnostic tool, based on laboratory and clinical data, should avoid overtreatment of pediatric LNB.

Lack of microbial DNA in tissue specimens of patients with abdominal aortic aneurysms and positive Chlamydiales serology.

In a case-control study that included a total of 98 patients and 83 controls, the possible link between various pathogens and abdominal aortic aneurysms was investigated. For 68 patients with abdominal aortic aneurysm and age-matched controls, no differences were detected in the levels of immunoglobulin (Ig)A and IgG Chlamydiaceae and Chlamydophila pneumoniae antibodies. Patients with IgA titers positive for Chlamydophila pneumoniae showed progressive disease (defined as an annual increase of the aneurysm diameter of > or = 0.5 cm) more frequently than patients with negative IgA titers (p = 0.046). Polymerase chain reactions performed to detect DNA for Chlamydophila pneumoniae, Chlamydia trachomatis, Chlamydophila psittaci, human cytomegalovirus, Borrelia burgdorferi and Helicobacter pylori in tissue specimens of 30 patients and 15 controls were negative. In summary, Chlamydophila pneumoniae may contribute to aortic aneurysm disease progression, but DNA of this and other pathogens was not found in patients' specimens.

Characterization of methicillin-resistant Staphylococcus aureus from Ulaanbaatar, Mongolia.

In order to expand current knowledge of the types of methicillin-resistant Staphylococcus aureus (MRSA) strains circulating in central Asia, six MRSA strains collected from hospitals in Ulaanbaatar, Mongolia during 2000-2002 were examined. Three strains possessed a staphylococcal cassette chromosome mec (SCCmec) element of type IV c, were sequence type (ST) 154 according to multilocus sequence typing (MLST), and contained lukS-lukF (Panton-Valentine leukocidin). Another three strains contained a SCCmec element of type III and were MLST type ST 239. Using automated ribotyping, the six MRSA strains were divided into four different EcoRI ribotypes, and two groups of isolates were distinguished by means of SmaI-macrorestriction patterns. In comparison to other countries, the incidence of MRSA in Mongolia is low.

Preparation of immunoblot test stripes from a Rubella virus-like particles dye crystal complex as antigen.

Stably transfected Chinese hamster ovary (CHO24S) cells were the source for Rubella virus-like particles (RVLP) containing all structural proteins (E1, E2, C and their dimers). RVLP are secreted from the CHO24S cells into the medium and the time-point for collecting the medium with the highest yield of >100 kDa proteins (with 17 mg protein from 10 ml cell culture supernatant) was after 2 days of incubation. Different methods for RVLP isolation from the cell culture supernatants were assessed by SDS-PAGE and Western blotting (using sera positive or negative for Rubella virus (RV)-specific antibodies or an anti-E1 monoclonal antibody). A combination of membrane filtration with a rapid, novel gradient ultracentrifugation step (using Coomassie brilliant blue G crystals as adsorbens for RVLP that facilitated virus isolation) was the most suitable technique. 132 RV-positive human sera (RV IgG > 20 IU/ml by commercial ELISA) were tested by our "self made" immunoblot test stripes (using RVLP adsorbed to dye crystals as antigen) for the presence or absence of antibodies specific for RV structural proteins. 57.6% of these sera had antibodies against E1, E2 and C, 31% against E1 and C, and 1.5% against E1 only, whereas 3.8% had no RV specific antibodies and only 6.0% were equivocal which demonstrated that these "self made" test stripes can reliably differentiate RV antibody specificities.

Clinical, radiographic and functional predictors of pulmonary gas exchange impairment at moderate exercise in patients with sarcoidosis.

BACKGROUND: Pulmonary gas exchange impairment (GEI) is a common consequence of intrathoracic sarcoidosis presenting with important therapeutic and prognostic implications. OBJECTIVE: To determine the role of clinical, radiographic and functional variables in predicting GEI during moderate exercise at the estimated lactate threshold (theta(L)) in patients with sarcoidosis. METHODS: Fifty-four outpatients (29 females) with biopsy-proven sarcoidosis had clinical evaluation (baseline dyspnea index), lung function tests and an incremental cardiopulmonary exercise test with theta(L) estimation. On a separate day, patients underwent a constant work rate test at theta(L) with assessment of arterial blood gas tensions. RESULTS: There was no evidence of GEI [DeltaP (A - a) O(2)/VO(2) >20 mm Hg.l. min(-1)] in patients with radiographic stages 0-I (n = 13). In the remaining 41 patients, GEI was associated with more extensive radiographic involvement and reduced diffusing capacity of the lung for carbon monoxide (DL(CO)), forced expiratory volume in 1 s, total lung capacity and forced vital capacity (% predicted;p < 0.05); baseline dyspnea index and resting arterial blood gas tensions, in contrast, were not significantly related to GEI. DL(CO) correlated best with GEI. The negative predictive value of DL(CO) >70% predicted (absent-to-mild impairment) was 91.3% (sensitivity = 81.8%) and the positive predictive value of DL(CO)

Epidemiology of rubella infections in Austria: important lessons to be learned.

In order to ascertain the epidemiology of rubella infections in Austria, a seroepidemiological study was performed. Data collected from 115 cases diagnosed at the Institute of Hygiene and Social Medicine of the University of Innsbruck during 2001 were evaluated. The results indicate this infection can no longer be categorised as a paediatric disease (mean age, 18.5 years), and several other findings were particularly striking: (i) 47% of the patients had elevated C-reactive protein levels and 50% had increased anti-streptolysin O titres; (ii) only a few patients complained of fever, while symptoms such as rash and lymphadenopathy, which are also associated with several other viral infections, including HIV, were found frequently; and (iii) the 115 rubella cases detected in the 1-year study period represented an incidence of >13 per 100,000 population. This high incidence of infection underlines the need for further improvement of diagnostic tests and more successful vaccine strategies.

Serological evidence for human granulocytic ehrlichiosis in Western Austria.

In order to evaluate the seroprevalence of human granulocytic ehrlichiosis in western Austria, sera from 357 Tyrolean blood donors were tested by an immunofluorescence assay. To assess the concomitant seroreactivity against Borrelia burgdorferi sensu lato, sera were further investigated by enzyme-linked immunoassay and Western blot. Thirty-two sera (9.0%) showed antibodies to Anaplasma phagocytophilum at a titre of 1:128 or higher, and 30 (8.4%) were seroreactive against Borrelia burgdorferi sensu lato. Infection with these two pathogens seems to occur in all Tyrolean districts except Landeck, the most upstream district of the Inn River Valley.

First documented case of infection with the tick-borne encephalitis virus in Vorarlberg, Austria.

The present study provides evidence and documentation of the first case of infection with the tick-borne encephalitis (TBE) virus acquired in the federal state of Vorarlberg (Austria). The area in which the viral infection was discovered lies in the vicinity of Ludesch in the Illvalley (Bludenz district). In order to investigate the current state of immunity to TBE in the Vorarlberg community, a total of 218 representative sera samples taken from donors resident in the districts of this state were investigated for antibody titers (IgG) of TBE. 38% of the samples had antibody titers representative of sufficient patient immunity, with the highest immunity (63%) in persons aged 20-40 years. Donors living in urban areas had a higher percentage of immunity (43%) than those living in rural areas (33%). Further, men were more immune to infection (43%) than women (33%). The lowest level of immunity (18%) to TBE was found in the Bregenzerwald communities. Based on this report, wider criteria for administering TBE vaccines to patients from the Illvalley should be applied, in particular among the elderly and those living in rural areas.

Regressäo de aneurisma pulmonar na doença de Behçet / Pulmonary aneurysm regression in Behçets disease

Os autores apresentam um caso de paciente com doença de Behçet que se queixava de início súbito de dispnéia aos pequenos esforços, tosse seca, astenia e cefaléia frontal. Relatava também emagrecimento importante no último mês, quando foi feito tratamento presuntivo para tuberculose e, após apresentar hemoptise volumosa, foi encaminhado para esclarecimento diagnóstico. Com história clínica e exame físicodetalhados, foi feito o diagnóstico de doença de Behçet, sendo iniciado tratamento com droga imunossupressora associada a corticosteróide e conseqüentemente regressäo dos aneurismas. Neste artigo säo discutidos também os aspectos clínicos, radiológicos, histopatológicos e terapêuticos dessa síndrome

Production of metallo-carbohedrenes in the solid state.

Macroscopic quantities of the metallo-carbohedrenes TI(8)C(12) and V(8)C(12) have been synthesized with an arc discharge technique. Mass spectroscopy of raw soot samples generated in both an alternating and direct current arc between two metal-graphite powder composite electrodes establishes that the titanium and vanadium analogs of the metallo-carbohedrenes have been produced. An estimated yield of approximately 1 percent is obtained, and significantly, the products are stable in air.

Physiological alterations consequent to 20-week conditioning programs of bicycling, tennis, and jogging.

This study investigated the efficacy of free-wheel bicycling and tennis as endurance conditioning activities. The subjects were 38 sedentary, middle-aged male volunteers, who were randomly assigned to one of four groups: bicyling (N=9); tennis (N=10); jogging (N=9); and control (N=10). Each subject was tested twice at the beginning and once at the conclusion of the 20-week study. Each training group exercised 3 days/week for 30 min/day, following 15 minutes of formal warm-up. The bicycling, tennis and jogging groups had an average attendance of 3.0, 2.7, and 2.8 days/week, and maintained theri exercise intensity at 83, 65, and 85% of HR max respectively. Using analysis of covariance, only the bicycle and jogging groups significantly increased treadmill Vo2max (14.8 and 13.3% respectively) even though there was a 5.7% improvement for the tennis group. The control group did not change. Vo2max was also assessed on a cycle ergometer for the bicycle and jogging groups, and increased significantly by 17.4 and 14.0% respectively, thus, specificity of the training response was not identified. VEmax increased significantly in the bicycling and jogging groups, while resting blood pressure did not change for any of the four groups. Relative to body composition, only the bicycle group increased lean body weight. The bicycle and jogging groups had substantial decreases in relative and absolute body fat, but these changes were not statistically significant due to changes in the control group. In conclusion, bicycling and jogging appear to provide comparable physiological benefits. Tennis produced only modest increases in endurance capacity but, since the duration of each training session was only 30 to 50% of a typical time period for playing tennis, the results of the present study may, in fact, be underestimating changes in Vo2max due to the interaction of intensity and duration in facilitating change.