[Implementing secondary poliomyelitis vaccination]. / Durchführung der Poliomyelitis-Wiederimpfung.

Revaccination is necessary also in poliomyelitis immunisation. Recommendations concerning type and frequency of vaccination vary. According to the results of an investigation in vaccinating patients 10-20 years after the last oral vaccination life vaccine can be administered for revaccination. After more than 20 years patients are seronegative. Therefore, a new basal immunisation is necessary after prevaccination with inactivated vaccine.

Lyme arthritis in a 12-year-old patient after a latency period of 5 years.

Lyme arthritis (LA) may be confused with other rheumatic diseases, particularly in the absence of a history of erythema migrans (EM). We report the case of a 12-year-old patient who developed a large effusion of the right knee joint. The titer for antinuclear antibodies was 1:80 and the test for rheumatoid factor was negative. Investigations for antibody response to Borrelia burgdorferi demonstrated remarkable elevation of IgG antibody and no specific IgM response. These results were confirmed by immunoblotting reactivity with the bands p83/100, p58, p43, p41, p39, OspA, p30, OspC, p21, and p17. We subsequently learned that the child had suffered a tick bite followed by an EM 5 years earlier and had been treated with trimethoprim/sulfamethoxazole at that time. The patient now was given intravenous ceftriaxone, 2 g daily for 14 days. In the absence of clinical improvement 3 weeks later a knee joint aspiration was performed which resulted in a positive polymerase chain reaction (PCR) test for B. burgdorferi DNA (OspA) in the synovial fluid. The patient fully recovered 2 months later without further treatment. The case indicates that the latency period between EM and onset of LA may last up to 5 years. In addition to serologic test methods, analysis of synovial fluid using PCR may be decisive for making the final diagnosis of LA.

[Clinical laboratory diagnosis and aging. 1: Results of data evaluation of clinico-chemical laboratory values in a study of aging]. / Klinische Labordiagnostik und Altern. Teil 1: Ergebnisse einer Datenauswertung klinisch-chemischer Laborwerte in einer Alternsstudie.

The results of the determination of 24 basic blood chemistry variables from 262 men and 239 women, half of each group 44.4 +/- 0.9 and 63.0 +/- 0.9 (men) and 44.4 +/- 0.9 and 62.8 +/- 0.8 years old (women), resp., are compared. In men, only 6 analytes show significant differences between the age groups: Alanine aminotransferase decreases, aspartate aminotransferase decreases, iron decreases with p < 0.05; sodium increases, calcium decreases, protein (serum) decreases with p < 0.001. In women, 16 analytes, compared between both groups, are significantly different: Urea, uric acid, creatinine, triglycerides, total cholesterol, LDL cholesterol, LDL-C/HDL-C ratio, alanine aminotransferase, alkaline phosphatase, gamma-glutamyltransferase, sodium and ferritin are increased in the older group, whereas HDL cholesterol, iron, transferrin, and total protein are decreased. The sex differences are more distinct in the group of 44 years old persons than in the 63 years old one. These results will be completed by the comparison with the evaluation of the stored laboratory values of 9923 patients between 20 and 89 years old.

[Clinical laboratory diagnosis and aging. 2: Suitability of clinico-chemical basic parameters as markers ob biological aging]. / Klinische Labordiagnostik und Altern. Teil 2: Zur Eignung klinisch-chemischer Basisparameter als Marker des biologischen Alters.

In 262 men (about half of them 44.4 +/- 0.9 and 63.0 +/- 0.9 years old, resp.) and 239 women (about half of them 44.4 +/- 0.9 and 62.8 +/- 0.8 years old, resp.) the results of 12 clinical chemical analytes were used to calculate laboratory indices which were compared with the biological age in accordance with Ries. The indices were calculated by using concentrations of alkaline phosphatase, iron, total protein, total cholesterol, glucose, uric acid, urea, HDL cholesterol, creatinine, LDL cholesterol, transferrin, and triglycerides. Only in the younger group of women are the correlations between laboratory indices and biological age significant. In the same group, several single parameters also significantly correlate with pre-aging. Among them are alkaline phosphatase, the LDL-C/HDL-C ratio, bilirubin, triglycerides, and glucose.