Search

Studies have reported sex and age differences in self-rated health. On average, women rate their health as being poorer compared to men, and older individuals report poorer health than younger individuals. The current study evaluated sex and age differences for self-reported immune fitness, i.e. the capacity of the body to respond to health challenges (such as infections) by activating an appropriate immune response in order to promote health and prevent and resolve disease. Data from different survey studies (N = 8586) were combined for the current analyses. N = 8064 participants (93.3%) completed the single-item scale to assess momentary immune fitness (mean (Standard deviation, SD) age of 32.4 (16.7) years old, range: 18 to 103, 68.0% women) and N = 4263 participants (49.7%) completed the Immune Status Questionnaire (ISQ) to assess past year's immune fitness (mean (SD) age of 40.9 (17.1) years old, range: 18 to 103, 61.1% women). The analyses revealed that women rated their momentary and past year's immune fitness significantly lower than men ( p < 0.001). A small but significant decline in momentary immune fitness when aging was found (r = -0.073, p < 0.001). In contrast, past year's immune fitness steadily improved with progressing age (r = 0.295, p < 0.001), and for each age group the difference from the 18-24 years old group was statistically significant ( p < 0.001). When using age as covariate, the sex differences in immune fitness remained significant for both momentary immune fitness ( p < 0.001) and past year's immune fitness ( p < 0.001). In conclusion, women report a poorer momentary and past year's immune fitness than men. The sex effects in immune fitness are robust and seen across all age groups except the elderly. A relative stable momentary immune fitness was found across the age groups. However, past year's immune fitness (assessments with the ISQ) improved with age. This observation may be related to the fact that the studie

The purpose of the current study was to assess the effects of substituting corn with ground brown rice on growth performance, immune status, and gut microbiota in weanling pigs. Seventy-two weanling pigs (28 d old with 6.78 ± 0.94 kg body weight [BW]) were randomly allotted to two dietary treatments with six pens and six pigs (three barrows and gilts) per pen within a randomized complete block design. The control pigs were fed a typical diet for weanling pigs based on corn and soybean meal diet (control diet: CON), and the other pigs were fed a formulated diet with 100% replacement of corn with ground brown rice for 35d (treatment diet: GBR). Growth performance, immune status, and gut microbiota of weanling pigs were measured. The substitution of corn with GBR did not affect growth performance or diarrhea frequency. Additionally, there were no differences in white blood cell number, hematocrit, cortisol, C-reactive protein, and serum tumor necrosis factor-alpha levels between pigs fed CON or GBR for the first 2 wk after weaning. However, weanling pigs fed GBR had lower (P < 0.05) serum transforming growth factor-beta 1 level than those fed CON. Furthermore, weanling pigs fed GBR had increased (P < 0.05) relative abundance of phylum Firmicutes and genus Lactobacillus and Streptococcus and decreased (P < 0.05) relative abundance of phylum Bacteroidetes and genus Clostridium and Prevotella in the gut microbiota compared with those fed CON. In conclusion, there was no significant difference in growth performance when corn was replaced with ground brown rice in diets for weanling pigs. Furthermore, the substitution of corn with ground brown rice in weaning diet modulated immune status and gut microbiota of pigs by increasing beneficial microbial communities and reducing harmful microbial communities. Overall, ground brown rice-based diet is a potential alternative to corn-based diet without negative effects on growth performance, immune status, and gut microbiot

The purpose of the current study was to assess the effects of substituting corn with ground brown rice on growth performance, immune status, and gut microbiota in weanling pigs. Seventy-two weanling pigs (28 d old with 6.78 ± 0.94 kg body weight [BW]) were randomly allotted to two dietary treatments with six pens and six pigs (three barrows and gilts) per pen within a randomized complete block design. The control pigs were fed a typical diet for weanling pigs based on corn and soybean meal diet (control diet: CON), and the other pigs were fed a formulated diet with 100% replacement of corn with ground brown rice for 35d (treatment diet: GBR). Growth performance, immune status, and gut microbiota of weanling pigs were measured. The substitution of corn with GBR did not affect growth performance or diarrhea frequency. Additionally, there were no differences in white blood cell number, hematocrit, cortisol, C-reactive protein, and serum tumor necrosis factor-alpha levels between pigs fed CON or GBR for the first 2 wk after weaning. However, weanling pigs fed GBR had lower (P < 0.05) serum transforming growth factor-beta 1 level than those fed CON. Furthermore, weanling pigs fed GBR had increased (P < 0.05) relative abundance of phylum Firmicutes and genus Lactobacillus and Streptococcus and decreased (P < 0.05) relative abundance of phylum Bacteroidetes and genus Clostridium and Prevotella in the gut microbiota compared with those fed CON. In conclusion, there was no significant difference in growth performance when corn was replaced with ground brown rice in diets for weanling pigs. Furthermore, the substitution of corn with ground brown rice in weaning diet modulated immune status and gut microbiota of pigs by increasing beneficial microbial communities and reducing harmful microbial communities. Overall, ground brown rice-based diet is a potential alternative to corn-based diet without negative effects on growth performance, immune status, and gut microbiot

PurposeColon cancer (CC) is a serious disease burden. The prognosis of patients with CC is different, so looking for effective biomarkers to predict prognosis is vitally important. Ferroptosis is a promising therapeutic and diagnosis strategy in CC. However, the role of ferroptosis in prognosis of CC has not been studied. The aim of the study is to build a prognosis model related ferroptosis, and provide clues for further therapy of CC.MethodsThe RNA-seq data were from TCGA (training group) and GEO (testing group). The R language and Perl language were used to process and analyze data. LASSO regression analysis was used to build the prognosis model. ssGSEA was used to compare the immune status between two groups. Immunohistochemistry was used to detect expression of AKR1C1 and CARS1 in colon cancer tissues and adjacent tissues.ResultsThe prognosis model consisted of five ferroptosis related genes (AKR1C1, ALOX12, FDFT1, ATP5MC3, and CARS1). The area under curve (AUC) at 1-, 2-, and 3-year were 0.668, 0.678, and 0.686, respectively. The high- and low-risk patients had significant survival probability and could be clearly distinguished by the PCA and t-SNE analysis. The multivariate cox regression analysis also showed the riskscore is an independent prognosis factor. Importantly, we found that the immune status between high- and low-risk patients were different obviously, such as CD8+T cells. And STING, a new promising immune target, was also correlated to our signature genes statistically significantly.ConclusionOur ferroptosis prognosis signature could predict survival of CC patients to a certain degree. And the crosstalk between ferroptosis and immune, especially STING need further studies.

Chronic bronchitis in children is manifested by a number of specific and nonspecific immune responses. In children, there are changes in the system of both cellular and humoral immunity, which are characterized by T-cell immunodeficiency. The aim of the study was to assess the state of the immune status in chronic bronchitis in children. To achieve this goal, 60 children aged 7 to 18 years with chronic bronchitis were examined, who were hospitalized in the pulmonology department of the Republican Specialized Scientific and Practical Medical Center of Pediatrics during 2020-2021. During the period of exacerbation of the disease, a significant decrease in the number of leukocytes, the relative and absolute number of lymphocytes was established. Serum immunoglobulins are one of the main indicators of humoral immunity. In children with chronic bronchitis, on the part of humoral immunity, pronounced hypoimmunoglobulinemia, a sharp increase in the level of IgM, IgA and IgG were noted.

Chronic bronchitis in children is manifested by a number of specific and nonspecific immune responses. In children, there are changes in the system of both cellular and humoral immunity, which are characterized by T-cell immunodeficiency. The aim of the study was to assess the state of the immune status in chronic bronchitis in children. To achieve this goal, 60 children aged 7 to 18 years with chronic bronchitis were examined, who were hospitalized in the pulmonology department of the Republican Specialized Scientific and Practical Medical Center of Pediatrics during 2020-2021. During the period of exacerbation of the disease, a significant decrease in the number of leukocytes, the relative and absolute number of lymphocytes was established. Serum immunoglobulins are one of the main indicators of humoral immunity. In children with chronic bronchitis, on the part of humoral immunity, pronounced hypoimmunoglobulinemia, a sharp increase in the level of IgM, IgA and IgG were noted.

Background: The main target of human immunodeficiency virus (HIV) is cluster of differentiation 4 (CD4) T lymphocytes and several other immune cells that have CD4 receptors. They are also present in skin and mucosa, such as Langerhans cells (LC). Mucocutaneous lesions are one of the first clinical presentations of immunosuppression in HIV seropositive patients that manifest at different stages of the infection and require early diagnosis and prompt treatment. Purpose: To determine the clinical characteristics and the pattern of various mucocutaneous manifestations in Human immunodeficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) patients at Intermediate Care and Infectious Diseases Dr. Soetomo General Academic Hospital Surabaya. Methods: This is a descriptive retrospective study with a cross-sectional design. The study subject was classified as all HIV-AIDS patients with mucocutaneous manifestations treated in Intermediate Care and Infectious Diseases Dr. Soetomo General Academic Hospital Surabaya in 2019. Result: Out of the 614 patients who participated in the study, 72.1% were males. The majority of patients were in the age group 25–49 years (75.4%). The most common risk factor was heterosexuality (41.7%). Based on the distribution of mucocutaneous manifestations, the most common mucocutaneous manifestation was candidiasis mucocutan 387 patients (49.4%) followed by the pruritic papular eruption (PPE) 118 patients (15.1%) and human papillomavirus infection 57 patients (7.3%). Conclusion: Mucocutaneous manifestations occur throughout the course of HIV infection, and they can be considered as good clinical indicators for the progression of the disease and underlying immune status in resource-poor settings.

Background: The main target of human immunodeficiency virus (HIV) is cluster of differentiation 4 (CD4) T lymphocytes and several other immune cells that have CD4 receptors. They are also present in skin and mucosa, such as Langerhans cells (LC). Mucocutaneous lesions are one of the first clinical presentations of immunosuppression in HIV seropositive patients that manifest at different stages of the infection and require early diagnosis and prompt treatment. Purpose: To determine the clinical characteristics and the pattern of various mucocutaneous manifestations in Human immunodeficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) patients at Intermediate Care and Infectious Diseases Dr. Soetomo General Academic Hospital Surabaya. Methods: This is a descriptive retrospective study with a cross-sectional design. The study subject was classified as all HIV-AIDS patients with mucocutaneous manifestations treated in Intermediate Care and Infectious Diseases Dr. Soetomo General Academic Hospital Surabaya in 2019. Result: Out of the 614 patients who participated in the study, 72.1% were males. The majority of patients were in the age group 25–49 years (75.4%). The most common risk factor was heterosexuality (41.7%). Based on the distribution of mucocutaneous manifestations, the most common mucocutaneous manifestation was candidiasis mucocutan 387 patients (49.4%) followed by the pruritic papular eruption (PPE) 118 patients (15.1%) and human papillomavirus infection 57 patients (7.3%). Conclusion: Mucocutaneous manifestations occur throughout the course of HIV infection, and they can be considered as good clinical indicators for the progression of the disease and underlying immune status in resource-poor settings.

Purpose: While extreme physical exertion is known to induce changes in the status of inflammation comparisons of the responses for various mediators of inflammation after acute bouts of high-intensity exercise have been limited. Subjects and Methods: We examined the responses in serum levels of novel inflammatory proteins, calprotectin, suPAR, CD163, and pro- and anti-inflammatory cytokines in 12 physically active volunteers (10 men, 2 women, mean age 37± 14 years) before and after completing various types of extreme physical exertion (marathon run, half-marathon run or 24-h cross-country skiing). For comparisons, the levels of the biomarkers were also measured at rest in 30 healthy controls (25 men, 5 women, mean age 42 ± 12 years) with low or sedentary activity. Results: Extreme physical exertion induced significant increases in serum calprotectin (p < 0.0005), suPAR (p < 0.01), CD163 (p < 0.05), IL-6 (p < 0.0005), IL-8 (p < 0.01) and IL-10 (p < 0.0005) (pre- vs 3h-post-exercise). These responses were found to normalize within 48 hours. While the increases in blood leukocytes were of similar magnitude following the different types of exercise, markedly more pronounced responses occurred in serum TNF-α (p < 0.01), IL-8 (p < 0.01) and CD163 (p < 0.05) in those with more intense activity. In 3-h post-exercise samples significant correlations were observed between serum calprotectin and IL-6 (rs = 0.720, p < 0.01), IL-10 (rs = 0.615, p < 0.05), TNF-α (rs = 0.594, p < 0.05), suPAR (rs = 0.587, p < 0.05) and blood leukocytes (rs = 0.762, p < 0.01). Conclusion: The present results suggest distinct exercise-intensity dependent changes in mediators of inflammation (including calprotectin, suPAR and CD163) following extreme physical exertion. Our findings indicate that there is a major reversible impact of high-intensity physical exertion on the status of inflammation.

[EN] The main purpose of this study was to find several early factors affecting stayability in rabbit females. To reach this goal, 203 females were used from their first artificial insemination to their sixth parturition. Throughout that period, 48 traits were recorded, considered to be performance, metabolic and immunological indicators. These traits were initially recorded in females' first reproductive cycle. Later, removed females due to death or culling and those that were non-removed were identified. A first analysis was used to explore whether it was possible to classify females between those reaching and those not reaching up to the mean lifespan of a rabbit female (the fifth reproductive) cycle using information from the first reproductive cycle. The analysis results showed that 97% of the non-removed females were classified correctly, whereas only 60% of the removed females were classified as animals to be removed. The reason for this difference lies in the model's characteristics, which was designed using early traits and was able to classify only the cases in which females would be removed due to performance, metabolic or immunologic imbalances in their early lives. Our results suggest that the model defines the necessary conditions, but not the sufficient ones, for females to remain alive in the herd. The aim of a second analysis was to find out the main early differences between the non-removed and removed females. The live weights records taken in the first cycle indicated that the females removed in their first cycle were lighter, while those removed in their second cycle were heavier with longer stayability (-203 and +202 g on average, respectively; P < 0.05). Non-removed females showed higher glucose and lower beta-hydroxybutyrate concentrations in the first cycle than the removed females (+4.8 and -10.7%, respectively; P < 0.05). The average lymphocytes B counts in the first cycle were 22.7% higher in the non-removed females group (P < 0.05). The

[EN] The main purpose of this study was to find several early factors affecting stayability in rabbit females. To reach this goal, 203 females were used from their first artificial insemination to their sixth parturition. Throughout that period, 48 traits were recorded, considered to be performance, metabolic and immunological indicators. These traits were initially recorded in females' first reproductive cycle. Later, removed females due to death or culling and those that were non-removed were identified. A first analysis was used to explore whether it was possible to classify females between those reaching and those not reaching up to the mean lifespan of a rabbit female (the fifth reproductive) cycle using information from the first reproductive cycle. The analysis results showed that 97% of the non-removed females were classified correctly, whereas only 60% of the removed females were classified as animals to be removed. The reason for this difference lies in the model's characteristics, which was designed using early traits and was able to classify only the cases in which females would be removed due to performance, metabolic or immunologic imbalances in their early lives. Our results suggest that the model defines the necessary conditions, but not the sufficient ones, for females to remain alive in the herd. The aim of a second analysis was to find out the main early differences between the non-removed and removed females. The live weights records taken in the first cycle indicated that the females removed in their first cycle were lighter, while those removed in their second cycle were heavier with longer stayability (-203 and +202 g on average, respectively; P < 0.05). Non-removed females showed higher glucose and lower beta-hydroxybutyrate concentrations in the first cycle than the removed females (+4.8 and -10.7%, respectively; P < 0.05). The average lymphocytes B counts in the first cycle were 22.7% higher in the non-removed females group (P < 0.05). The

Background. The article analyzes the nature of the change in the phenotypic composition of blood lymphocytes, the content of IgA, IgG, IgM, and the fractional composition of immune complexes in patients with ischemic stroke and chronic brain ischemia. The purpose of this study was to investigate the nature of disorders of cellular and humoral parts of the immune system in the acute period of ischemic stroke. Materials and methods. A comparative clinical and immunological examination was performed in 85 patients in the acute period of ischemic stroke (basic group) and 66 patients with chronic cerebral ischemia (control group). To assess cellular immunity, we used the indicators of immunophenotyping of blood cells — the absolute and percentage content of the population of T- and B-lymphocytes, their main subpopulations: T-helper cells, cytotoxic T-cells, subpopulations of natural killers. To evaluate humoral immunity, the contents of the main classes of immunoglobulins (IgA, IgG, IgM) and circulating immune complexes were studied. Results. In the acute period of stroke, an increase in the number of leukocytes (p = 0.028) and a decrease in lymphocytes (p = 0.031), T-lymphocytes (p = 0.002), T-helpers (p = 0.027) and cytotoxic T-lymphocytes (p = 0.045) were observed. There was also a tendency to a decrease in the number of natural killers (p = 0.45). In the humoral immunity an increase in the B-lymphocytes (p = 0.048), dysgammaglobulinaemia due to an increase in IgG level (p = 0.048) and the tendency to hyperfunction of IgA and IgМ (p = 0.05) were observed. Changes in immune status indicators are more pronounced with increasing severity of stroke. Conclusions. These studies demonstrate the involvement of the immune system in a complex set of reactions involved in the development of cerebral accidents., Актуальность. В статье проанализирован характер изменения фенотипического состава лимфоцитов крови, содержания IgA, IgG, IgM и фракционного состава иммунных комплексов у пациентов с ишемическим инсультом и хронической ишемией мозга. Цель исследования: изучить характер нарушений клеточного и гуморального звеньев иммунитета в остром периоде ишемического инсульта. Материалы и методы. Провели сравнительное клинико-иммунологическое обследование 85 пациентов в остром периоде ишемического инсульта (основная группа) и 66 пациентов с хронической ишемией мозга (контрольная группа). Для оценки клеточного иммунитета использовали показатели иммунофенотипирования клеток крови — абсолютное и процентное содержание популяции Т- и В-лимфоцитов, их основных субпопуляций: Т-хелперов, цитотоксических Т-клеток, субпопуляции натуральных киллеров. Для оценки гуморального иммунитета исследовали содержание основных классов иммуноглобулинов (IgA, IgG, IgM) и циркулирующих иммунных комплексов. Результаты. В остром периоде инсульта наблюдали повышение количества лейкоцитов (р = 0,028) и снижение уровня лимфоцитов (р = 0,031), зрелых Т-лимфоцитов (р = 0,002), Т-хелперов (р = 0,027) и цитотоксических Т-лимфоцитов (р = 0,045). Отмечена тенденция к снижению количества натуральных киллеров (р = 0,45). В гуморальном звене иммунитета наблюдалось увеличение В-лимфоцитов (р = 0,048), дисгаммаглобулинемия за счет повышения уровня IgG (р = 0,048) и тенденции к гиперфункции IgА и IgМ (р = 0,5). Изменения показателей иммунного статуса более выражены при увеличении тяжести инсульта. Выводы. Данное исследование доказывает вовлечение иммунной системы в сложный комплекс реакций, участвующих в развитии инфарктов мозга., Актуальність. У статті проаналізований характер змін фенотипового складу лімфоцитів крові, вмісту IgA, IgG, IgM і фракційного складу імунних комплексів у пацієнтів з ішемічним інсультом і хронічною ішемією мозку. Мета дослідження: вивчити характер порушень клітинної і гуморальної ланок імунітету в гострому періоді ішемічного інсульту. Матеріали та методи. Провели порівняльне клініко-імунологічне обстеження 85 пацієнтів у гострому періоді ішемічного інсульту (основна група) та 66 пацієнтів із хронічною ішемією мозку (контрольна група). Для оцінки клітинного імунітету використовували показники імунофенотипування клітин крові — абсолютний і відсотковий вміст популяції Т- і В-лімфоцитів, їх основних субпопуляцій: Т-хелперів, цитотоксичних Т-клітин, субпопуляції натуральних кілерів. Для оцінки гуморального імунітету досліджували вміст основних класів імуноглобулінів (IgA, IgG, IgM) і циркулюючих імунних комплексів. Результати. У гострому періоді ішемічного інсульту спостерігали підвищення кількості лейкоцитів (р = 0,028) і зниження рівня лімфоцитів (р = 0,031), зрілих Т-лімфоцитів (р = 0,002), Т-хелперів (р = 0,027) і цитотоксичних Т-лімфоцитів (р = 0,045). Відзначена тенденція до зниження кількості натуральних кілерів (р = 0,45). У гуморальній ланці імунітету спостерігали підвищення В-лімфоцитів (CD20+) (р = 0,048), дисгаммаглобулінемію за рахунок підвищення рівня IgG (р = 0,048) і тенденції до гіперфункції IgА і IgМ (р = 0,05). Зміни показників імунного статусу більш виражені при зростанні тяжкості інсульту. Висновки. Це дослідження доводить залучення імунної системи до складного комплексу реакцій, які беруть участь у розвитку інфарктів мозку.

Introduction: Immune therapy plays a larger role in cancer treatment these days, but in order to find new therapies and improve already existing ones, more knowledge about the immune system is needed. The peripheral blood contains many different cell types, some extensively studied, some less well-known. By using multicolor flow cytometry, the immune status of an individual can be displayed in relatively short time. Aim: The aim of this study was to develop a multicolor flow cytometry method in order to examine the distribution of 31 cell types, with a focus on immune regulatory cells, in peripheral blood in healthy donors, as well as examine the impact of cryopreservation on the different subsets. Methods: After isolating the mononuclear cells from peripheral blood using Ficoll separation, each sample (n = 19) were analyzed with three flow cytometry panels. The remaining cells were cryopreserved in -190°C and later thawed and analyzed the same way as the fresh samples were. Results: The cell distribution in fresh samples were mostly consistent with other studies. While the percentage of many cell types remained unchanged after thawing, the total percentage of T helper cells and some subsets were decreased in frozen samples, leading to a decrease in total T cells. Furthermore, the percentage of total monocytes were increased and the distribution of monocyte subsets were altered in frozen samples, among others. Conclusion: This study confirms the results of other studies of the human immune system and provides valuable knowledge about the impact of cryopreservation.

Introduction: Immune therapy plays a larger role in cancer treatment these days, but in order to find new therapies and improve already existing ones, more knowledge about the immune system is needed. The peripheral blood contains many different cell types, some extensively studied, some less well-known. By using multicolor flow cytometry, the immune status of an individual can be displayed in relatively short time. Aim: The aim of this study was to develop a multicolor flow cytometry method in order to examine the distribution of 31 cell types, with a focus on immune regulatory cells, in peripheral blood in healthy donors, as well as examine the impact of cryopreservation on the different subsets. Methods: After isolating the mononuclear cells from peripheral blood using Ficoll separation, each sample (n = 19) were analyzed with three flow cytometry panels. The remaining cells were cryopreserved in -190°C and later thawed and analyzed the same way as the fresh samples were. Results: The cell distribution in fresh samples were mostly consistent with other studies. While the percentage of many cell types remained unchanged after thawing, the total percentage of T helper cells and some subsets were decreased in frozen samples, leading to a decrease in total T cells. Furthermore, the percentage of total monocytes were increased and the distribution of monocyte subsets were altered in frozen samples, among others. Conclusion: This study confirms the results of other studies of the human immune system and provides valuable knowledge about the impact of cryopreservation.

Merkel cell carcinoma (MCC) usually arises in sun-exposed areas of older patients and might be more aggressive in the immunocompromised. We performed a retrospective chart review of 40 consecutive MCC patients treated at our institution between the years 2006-2017. Clinical and epidemiologic data were utilized and therapy and survival were analyzed. Compared to Surveillance, Epidemiology, and End Results (SEER) data, our population was entirely Caucasian (100% versus 95%; P=0.11) and male predominant (75% versus 63%; P=0.11). The median age was 76. The patients more often had Tumor-Node-Metastasis (TNM) stage I disease (50% versus 39%; P=0.00003) and a primary tumor size<2cm (57.5% versus 34%; P<0.01). They received more frequently lymph node dissection (70% versus 63%, P=0.002) compared with the SEER findings. We identified a subset of immunocompromised patients (n=10) who presented with more stage III disease (40% versus 33%; P=0.021). Time to death averaged 290.1 days in this subset versus 618.2 days (P<0.001) in immunocompetent patients and their likelihood of death was 5 times higher. As clinical outcomes in MCC patients vary by immunological status, a multidisciplinary tumor-board approach may better optimize individual patient management.

Merkel cell carcinoma (MCC) usually arises in sun-exposed areas of older patients and might be more aggressive in the immunocompromised. We performed a retrospective chart review of 40 consecutive MCC patients treated at our institution between the years 2006-2017. Clinical and epidemiologic data were utilized and therapy and survival were analyzed. Compared to Surveillance, Epidemiology, and End Results (SEER) data, our population was entirely Caucasian (100% versus 95%; P=0.11) and male predominant (75% versus 63%; P=0.11). The median age was 76. The patients more often had Tumor-Node-Metastasis (TNM) stage I disease (50% versus 39%; P=0.00003) and a primary tumor size<2cm (57.5% versus 34%; P<0.01). They received more frequently lymph node dissection (70% versus 63%, P=0.002) compared with the SEER findings. We identified a subset of immunocompromised patients (n=10) who presented with more stage III disease (40% versus 33%; P=0.021). Time to death averaged 290.1 days in this subset versus 618.2 days (P<0.001) in immunocompetent patients and their likelihood of death was 5 times higher. As clinical outcomes in MCC patients vary by immunological status, a multidisciplinary tumor-board approach may better optimize individual patient management.

Objective — to determine the role of correction of immune status disorders in treatment of adolescents with unfavorable course of diffuse nontoxic goiter (DNG).Materials and methods. We have assessed somatic health status, thyroid and immune status of 202 boys and 198 girls with DNG, aged 10—17 years. The comparison group consisted of 100 virtually healthy people of the same age and 30 adolescents with ENT pathology and thyroid gland (TG) of normal size. During treatment of patients with unfavorable course of DNG and with ENT pathology we had applied basic therapy with potassium iodide medications and/or L­thyroxine in conjunction with immunomodulators.Results and discussion. As distinct from patients with pathology of ENT organs and TG of normal size, in patients with DNG and ENT pathology there is an imbalance of immunocompetent cells due to decreased percentage of СD3+ lymphocytes against the background of preservation of CD4/CD8+ lymphocyte ratio and disorder in oxygen­-dependent processes of phagocytosis (decreased absorbing capacity of phagocytic cells, lower results of an induced NBT test with a decrease of metabolic reserve of neutrophils). It has been proved that differentiated therapy in patients with DNG and ENT pathology enables not only improvement of status of thyroid and immune systems, but a more positive prognosis for the course of goiter in adolescence as well.Conclusions. In patients with DNG and ENT pathology we have observed changes in cellular and phagocytic components of immunity. Imbalance of immunocompetent cells emerges against the background of disorders in oxygen­-dependent processes of phagocytosis. Comprehensive application of basic therapy and immunomodulating drugs improves prognosis for the course of DNG in adolescence as a result of normalization of status of thyroid and immune systems., Цель работы — определить роль коррекции нарушений иммунного статуса в лечении подростков с неблагоприятным течением диффузного нетоксического зоба (ДНЗ).Материалы и методы. У 202 мальчиков и 198 девушек 10—17 лет с ДНЗ оценено состояние соматического здоровья, тиреоидного и иммунного статуса. Группу сравнения составили 100 практически здоровых сверстников и 30 подростков с ЛОР-­патологией и нормальным объемом щитовидной железы (ЩЖ). При лечении больных с неблагоприятным течением ДНЗ и ЛОР­-патологией применяли базовую терапию препаратами калия йодида и/или L-тироксина в комплексе с иммуномодулирующими средствами.Результаты и обсуждение. У больных с ДНЗ и ЛОР-­патологией, в отличие от больных с патологией ЛОР­-органов и нормальным объемом ЩЖ, наблюдается дисбаланс иммунокомпетентных клеток за счет снижения относительного количества СD3+-­лимфоцитов при сохранении соотношения CD4/CD8+­-лимфоциты и нарушения кислородозависимых процессов фагоцитоза (снижение поглощающей способности фагоцитирующих клеток, показателей индуцированного НСТ­-теста с уменьшением метаболического резерва нейтрофилов). Доказано, что у больных с ДНЗ и ЛОР-­патологией дифференцированная терапия способствует улучшению состояния тиреоидной и иммунной систем и прогноза течения зоба в подростковом возрасте.Выводы. У больных с ДНЗ и ЛОР­-патологией наблюдаются изменения в клеточном и фагоцитарном звеньях иммунитета. Дисбаланс иммунокомпетентных клеток происходит на фоне нарушения кислородозависимых процессов фагоцитоза. Комплексное применение базовой терапии и иммуномодулирующих препаратов улучшает прогноз течения ДНЗ в подростковом возрасте благодаря нормализации состояния тиреоидной и иммунной системы., Мета роботи — визначити роль корекції порушень імунного статусу в лікуванні підлітків із несприятливим перебігом дифузного нетоксичного зоба (ДНЗ).Матеріали та методи. У 202 хлопців і 198 дівчат 10—17 років із ДНЗ оцінено стан соматичного здоров’я, тиреоїдного та імунного статусу. Групу порівняння утворили 100 практично здорових однолітків і 30 підлітків із ЛОР-­патологією та нормальним об’ємом щитоподібної залози (ЩЗ). Під час лікування хворих із несприятливим перебігом ДНЗ та ЛОР­-патологією застосовували базову терапію препаратами калію йодиду та/або L-­тироксину в комплексі з імуномодуляційними засобами.Результати та обговорення. У хворих із ДНЗ із ЛОР-­патологією, на відміну від хворих із патологією ЛОР­-органів та нормальним об’ємом ЩЗ, спостерігається дисбаланс імунокомпетентних клітин завдяки зниженню відносної кількості СD3+­-лімфоцитів на тлі збереження співвідношення CD4/CD8+­-лімфоцити та порушення киснезалежних процесів фагоцитозу (зниження поглинальної здатності фагоцитарних клітин, показників індукованого НСТ-­тесту зі зменшенням метаболічного резерву нейтрофілів). Доведено, що у хворих із ДНЗ та ЛОР-­патологією диференційована терапія дає змогу не лише покращити стан тиреоїдної та імунної систем, а й поліпшити прогноз перебігу зоба в підлітковому віці.Висновки. У хворих із ДНЗ та ЛОР-­патологією спостерігаються зміни у клітинній і фагоцитарній ланках імунітету. Дисбаланс імунокомпетентних клітин настає на тлі порушень киснезалежних процесів фагоцитозу. Комплексне застосування базової терапії та імуномодуляційних препаратів покращує прогноз перебігу ДНЗ у підлітковому віці завдяки нормалізації стану тиреоїдної та імунної систем.

Мета дослідження: вивчення вмісту есенціальних макро- та мікроелементів (цинку, міді, магнію, заліза) у крові та еякуляті, аналіз особливостей антиоксидантного та імунного захисту у хворих на хронічний абактеріальний простатит (ХАП) та обґрунтування доцільності застосування поліелементних і імуномодулювальних препаратів.Матеріали та методи. Під спостереженням перебувало 120 хворих на ХАП, зокрема 60 пацієнтів із синдромом запального хронічного тазового болю (категорія IIIА) і 60 хворих із синдромом незапального хронічного тазового болю (категорія IIIВ). Мікроелементи у крові та еякуляті визначали методом атомно абсорбційної спектрофотометрії на апараті С 115 ПК. Стан антиоксидантного захисту розглядали на підставі кількісного визначення каталазиза А. Бахом і С. Зубковою та супероксиддисмутази. Імунний статус аналізували за результатами визначення концентрації інтерлейкінів-6, -8 (ІЛ-6, ІЛ-8) та кількісного визначення альфа-фактора некрозу пухлин (α-ФНП) у сироватці крові за допомогою набору фірми «ВЕКТОР-БЕСТ» шляхом імуноферментного аналізу. Корекцію порушень у біоелементному статусі та імунному захисті проводили шляхом призначення хворим додатково до стандартної терапії поліелементного комплексу та інтерферону альфа-2b.Результати. Достовірне зниження мікроелементів Zn, Мg та Fe і підвищення Cu констатували в обох групах хворих на ХАП. Також зазначено, що при тривалому перебігу ХАП відбувається зниження рівнів антиоксидантних ферментів. Спостерігають достовірне підвищення концентрації у крові прозапальних цитокінів в обох групах хворих на ХАП. Особливо значне підвищення спостерігалося у сироватці крові ІЛ-8. Під впливом лікування фіксували вірогідну позитивну динаміку покращення біоелементного складу крові та еякуляту, підвищення рівня антиоксидантних ферментів та зниження концентрації прозапальних цитокінів у крові хворих на ХАП.Заключення. При хронічному абактеріальному простатиті (ХАП) відзначають зниження рівня Zn, Мg і Fe та підвищення рівня міді як у крові, т, Цель исследования: изучение состава эссенциальных микроелементов (цинка, меди, магния, железа) в крови и эякуляте, анализ особенностей антиоксидантной и иммунной защиты у больных хроническим абактериальным простатитом (ХАП) и обоснование целесообразности использования полимикроэлементных и иммуномодулирующих препаратов.Материалы и методы. Были обследованы 120 больных ХАП, в частности 60 пациентов с синдромом воспалительной хронической тазовой боли (СВХТБ – категория IIIА) и 60 больных с синдромом невоспалительной хронической тазовой боли (СНХТБ – категория IIIВ). Микроэлементы в крови и эякуляте определяли методом атомно абсорбционной спектрофотометрии на аппарате С 115 ПК. Состояние антиоксидантной защиты рассматривали на основании количественного опреде ления каталазы за А. Бахом и С. Зубковой и супероксиддисмутазы. Иммунный статус анализировали по результатам определения концентрации интерлейкинов-6, -8 (ИЛ-6, ИЛ-8) и количественного определения альфа-фактора некроза опухолей (α-ФНО) в сыворотке крови с помощью набора фирмы «ВЕКТОР-БЕСТ» путем иммуноферментного анализа. Коррекцию нарушений в биоэлементном статусе и иммунной защите проводили путем назначения больным вместе со стандартной терапией полиэлементного комплекса и интерферона альфа-2b.Результаты. Достоверное снижение микроэлементов Zn, Fe, Мg и повышение Cu отмечали в обеих группах пациентов с ХАП. Также от мечено, что при длительном течении ХАП происходит снижение уровней антиоксидантных ферментов. Отмечено достоверное повышение концентрации в крови провоспалительных цитокинов в обеих группах больных ХАП. Особенно значительное повышение отмечалось в сыворотке крови ИЛ-8. Под влиянием лечения фиксировали позитивную динамику улучшения биоэлементного состава крови и эякулята, повышение уровня антиоксидантных ферментов и снижение концентрации провоспалительных цитокинов в крови больных ХАП.Заключение. При хроническом абактериальном простатите (ХАП) отмечено снижение уровня цинка, железа, магния и повышение, The objective: Studying of level of essential microelements (Zinc, Copper, Magnesium, Iron) in blood and ejaculate, specialty of antioxidant and immune defense of the patients with chronic nonbacterial prostatitis and reasoning of polymicroelemental and immunomodulat ing medication use.Materials and methods. Under supervision were 120 patients with chronic nonbacterial prostatitis, among them 60 patients with inflammatory chronic pelvic pain syndrome (ICPPS – category IIIA) and 60 patients with noninflammatory chronic pelvic pain syndrome (NCPPS – IIIB). Microelements in whole blood and ejaculate were determined using atomic absorption spectrophotometry on C 115 PC. State of antioxidant defense was judged considering quantification of Catalase after A. Bach and S.Zubkova and Superoxide Dismutase. Immune status was analyzed in accordance to the results of determination of the interleukins-6, -8 (IL-6, IL-8) concentration and quantification of tumor necrosis factor-alpha (α-TNF) in blood serum, using the set of company “VECTOR-BEST”, by immunoassay analysis. Correction of violations of bioelemental status and immune defense was conducted by prescription except the standard therapy the polyelemental complex and interferon alpha-2b.Results. A certain decrease of microelements Zn, Fe, Mg and Cu increase were observed in both groups of patients with chronic nonbacterial prostatitis. Also it was noted that with long duration of chronic nonbacterial prostatitis takes place the antioxidant enzymes level decrease. It was noted a visible concentrations increase of proinflammatory cytokines in blood of both groups of patients with chronic nonbacterial prostatitis. Especially significant increase in serum was IL-8. Under influence of treatment was noted positive dynamics of improve ment of bioelemental consist of blood and ejaculate, increase of antioxidant enzymes level and decrease of proinflammatory cytokines concentration in blood of patients with chronic nonbacterial prost

In patients with minor dental defects activated factors and mechanisms of innate immunity cellular link advantage immune defense, which is dominated macrophage system cells (monocytes / macrophages). Formation of immune response is accompanied by the development of delayed-type hypersensitivity., У пациентов с малыми дефектами зубных рядов активируются факторы и механизмы врожденного иммунитета с преимуществом клеточного звена противоинфекционной защиты, в котором преобладают клетки макрофагальной системы (моноциты / макрофаги). Формирование иммунного ответа сопровождается развитием гиперчувствительности замедленного типа., У пацієнтів з малими дефектами зубних рядів активуються фактори і механізми вродженого імунітету із перевагою клітинної ланки протиінфекційного захисту, в якому переважають клітини макрофагальної системи (моноцити/макрофаги). Формування імунної відповіді супроводжується розвитком гіперчутливості сповільненого типу.

The analysis of cellular and humoral immunity indicators in the blood of patients with purulent peritonitis (PP) with the determination of their diagnostic value while determining the stage of peritonitis was performed. The levels of CD3, CD4, CD8, CD4 / CD8, CD19, CD16, CD95, CD25, IgA, IgM, IgG during hospitalization of 126 patients with PP was investigated. Monitoring of immune responsiveness stated regular changes in cellular and humoral immunity caused by the influence of cytokine profile, describing immunosuppression, the extent of which depends on the length and stage of PP. The progressive deepening of PP stages (in reactive and toxic stage) led to an increase in white blood cell count, CD95, due to the influence of dose-dependent increase in IL-6, CD19, IgM, G, and NK-cells (CD16) and CD25, the dynamics of which is closely related and dependent of IL-2.This was accompanied by a progressive lymphocytopenia, a decrease in CD3, CD4, which at constant or slightly increasing concentration led to decrease in CD8 IRI (CD4 / CD8) caused by the impact of immunosuppressive IL-6, stepwise reduction of IgA. Severe secondary immunodeficiency was observed in patients with end-stage PP and lymphocytopenia progressed along with the growth of white blood cell and marker CD95 with disruption of T-lymphocytes subsets (CD4 decrease at a constant or insignificant growth of CD8) with critical IRI indicators. The decrease in CD25, CD16 and CD19 dysfunction with sharp inhibition of the antibodies synthesis – decrease in IgM and G, A concentrations was also determined.

The current study examined the independent and combined effects of HIV and marijuana (MJ) use (no use, light use, and moderate-to-heavy use) on neurocognitive functioning among a convenience sample of HIV-positive (HIV+) and HIV-negative (HIV-) individuals recruited from HIV community care clinics and advertisements in the Greater Los Angeles area. MJ users consisted of individuals who reported regular use of MJ for at least 12 months, with last reported use within the past month. Participants included 89 HIV+ (n = 55) and HIV- (n = 34) individuals who were grouped into non-users, light users, and moderate-to-heavy users based on self-reported MJ use. Participants were administered a brief cognitive test battery and underwent laboratory testing for CD4 count and viral load. HIV+ individuals demonstrated lower performance on neurocognitive testing than controls, and moderate-to-heavy MJ users performed more poorly on neurocognitive testing than light users or non-users. Moderate-to-heavy HIV+ users performed significantly lower on learning/memory than HIV- moderate-to-heavy users (MD = -8.34; 95% CI: -16.11 to -0.56) as well as all other comparison groups. In the domain of verbal fluency, HIV+ light users outperformed HIV- light users (MD = 7.28; 95% CI: 1.62-12.39), but no HIV group differences were observed at other MJ use levels. HIV+ MJ users demonstrated lower viral load (MD = -0.58; 95% CI: -1.30 to 0.14) and higher CD4 count than non-users (MD = 137.67; 95% CI: 9.48-265.85). The current study findings extend the literature by demonstrating the complex relationship between HIV status and MJ use on neurocognitive and clinical outcomes.

The current study examined the independent and combined effects of HIV and marijuana (MJ) use (no use, light use, and moderate-to-heavy use) on neurocognitive functioning among a convenience sample of HIV-positive (HIV+) and HIV-negative (HIV-) individuals recruited from HIV community care clinics and advertisements in the Greater Los Angeles area. MJ users consisted of individuals who reported regular use of MJ for at least 12 months, with last reported use within the past month. Participants included 89 HIV+ (n = 55) and HIV- (n = 34) individuals who were grouped into non-users, light users, and moderate-to-heavy users based on self-reported MJ use. Participants were administered a brief cognitive test battery and underwent laboratory testing for CD4 count and viral load. HIV+ individuals demonstrated lower performance on neurocognitive testing than controls, and moderate-to-heavy MJ users performed more poorly on neurocognitive testing than light users or non-users. Moderate-to-heavy HIV+ users performed significantly lower on learning/memory than HIV- moderate-to-heavy users (MD = -8.34; 95% CI: -16.11 to -0.56) as well as all other comparison groups. In the domain of verbal fluency, HIV+ light users outperformed HIV- light users (MD = 7.28; 95% CI: 1.62-12.39), but no HIV group differences were observed at other MJ use levels. HIV+ MJ users demonstrated lower viral load (MD = -0.58; 95% CI: -1.30 to 0.14) and higher CD4 count than non-users (MD = 137.67; 95% CI: 9.48-265.85). The current study findings extend the literature by demonstrating the complex relationship between HIV status and MJ use on neurocognitive and clinical outcomes.

In aquatic systems, mercury (Hg) is an environmental contaminant that causes acute and chronic damage to multiple organs. In fish, practically all of the organic Hg found is in the form of methylmercury (MeHg), which has been associated with animal and human health problems. This study evaluates the impact of waterborne- exposure to sublethal concentrations of MeHg (10 lgL-1) in gilthead seabream (Sparus aurata). Hg was seen to accumulate in liver and muscle, and histopathological damage to skin and liver was detected. Fish exposed to MeHg showed a decreased biological antioxidant potential and increased levels of the reactive oxygen molecules compared with the values found in control fish (non-exposed). Increased liver antioxidant enzyme activities (superoxide dismutase and catalase) were detected in 2 day- exposed fish with respect to the values of control fish. However, fish exposed to MeHg for 10 days showed liver antioxidant enzyme levels similar to those of the control fish but had increased hepato-somatic index and histopathological alterations in liver and skin. Serum complement levels were higher in fish exposed to MeHg for 30 days than in control fish. Moreover, head–kidney leukocyte activities increased, although only phagocytosis and peroxidase activities showed a significant increase after 10 and 30 days, respectively. The data show that 30 days of exposure to waterborne MeHg provokes more significant changes in fish than a short-term exposure of 2 or 10 days.

Introduction: Impaired sleep can have a significant impact on perceived health status. The aim of the current study was to examine the relationship between perceived health status and sleep quality, total sleep time, and insomnia. Materials and methods: A survey was conducted among Dutch university students. General health and perceived immune status were scored on a scale ranging from 0 (very poor) to 10 (excellent). Sleep parameters were collected with the insomnia subscale of the SLEEP-50 questionnaire. Total sleep time (TST) was recorded, and sleep quality was scored on a scale ranging from 0 (very poor) to 10 (excellent). Non-parametric correlations (Spearman)were used to examine the association between perceived heath and immune status and the sleep parameters. Results: N = 509 subjects completed the survey (N = 143 men, and N = 366 women). They were on average 20.8 (2.6) years old and reported a TST of 7.7 (0.9) hours. Mean (SD) scores were 14.6 (4.3) for insomnia, 7.3 (1.2) for sleep quality, 7.7 (1.0) for general health, and 7.8 (1.3) for perceived immune status. Perceived general health correlated significantly with scores for insomnia (r = -0.228, p = 0.0001) and sleep quality (r = 0.235, p = 0.0001), but not with TST (r = 0.058, p = 0.196). Similarly, perceived immune status correlated significantly with scores for insomnia (r = -0.193, p = 0.0001) and sleep quality (r = 0.234, p = 0.0001), but not with TST (r = 0.051, p = 0.254). A significant correlation was found between perceived health status and immune functioning (r = 0.704, p = 0.0001). Insomnia scores were highly correlated to sleep quality (r =-0.697, p = 0.0001) and to a lesser extent with TST (r = -0.218, p = 0.0001). Overall, the observed associations were stronger in men when compared with women. Conclusion: Whereas insomnia and sleep quality were significantly related to perceived general health and immune status, this relationship was not found for total sleep time.

We analyzed the formal consultations seen by the infectious diseases service over a 14-year period at one of the largest pediatric hospitals in Australia. We highlight the increasing demand for pediatric infectious diseases expertise and the reasons for which consultations are sought. Our findings will help in planning and resource allocation in an era of increasingly complex patients. © 2013 by Lippincott Williams & Wilkins.

We analyzed the formal consultations seen by the infectious diseases service over a 14-year period at one of the largest pediatric hospitals in Australia. We highlight the increasing demand for pediatric infectious diseases expertise and the reasons for which consultations are sought. Our findings will help in planning and resource allocation in an era of increasingly complex patients. © 2013 by Lippincott Williams & Wilkins.

Physical inactivity and sedentary lifestyles are believed to be independent risk factors for the occurrence of numerous diseases, including, obesity, Type 2 diabetes, metabolic syndrome, cardiovascular disease, cancer and mental health, all leading to substantial morbidity and/or premature death. It has been found that regular exercise, is associated with better quality of life and health outcomes, and reduces the risk of cardiovascular disease and cancer. Here, we review the effects regular exercise has on mental health and well-being, on the immune system and in cancer, cardiovascular disease, autoimmunity and metabolic syndrome. Is exercise the new immunotherapy to treat diseases? © 2014 © Future Medicine Ltd.

Background As the European population is getting older, there is growing need in scientific data on how to achieve healthy and successful aging. A decline in immune function with age is unanimously supported by many epidemiological and clinical observations, with a decrease in T-cell mediated function encompassing a large part of this alteration. In the EU-funded VITAGE project, the effects of aging on biomarkers of immune status are being studied in three European countries. According to strict inclusion/exclusion criteria, a cohort of 300 healthy male non-smoking 20¿75 years old volunteers were enrolled in France (n = 99), Spain (n = 100) and Austria (n = 101). In each country, the volunteers were classified as a function of age (one age group per decade). Biomarkers of immune status were determined including delayed-type hypersensitivity tests, measurement of lymphocyte surface markers, and serum determinations of interleukin-2, complement fractions and immunoglobulins. Results There were moderate differences in the biomarkers of immune status of the VITAGE study volunteers among the three European centres. The percentage of Natural Killer (NK) cells was 156% and 142% higher in Spain as compared to France and Austria, respectively (p < 0.0001), and this increase was observed at any age group above 30 years. Comparison between age-groups showed that in Spain, but not in France or Austria, older individuals had significantly a lower B lymphocyte distribution and conversely, a higher NK cell distribution. Moreover, the CD4/CD8 ratio was positively correlated with age in Austrian subjects (p < 0.0001). Conclusion Our results provide evidence of an increased NK cell distribution in the elderly, especially in the Spanish population. NK cell status may predict morbidity and

Introduction. Activated Protein C [APC] improves outcome in immunocompetent patients with severe sepsis particularly in those who are perceived to have high mortality risk. Before embarking on a trial of APC administration in immunocompromised septic patients, a preliminary study on plasma levels of protein C in this cohort is essential. Objective. To assess serum Protein C concentrations in immunocompromised patients as compared to immunocompetent patients during sepsis, severe sepsis, septic shock and recovery. Methods. Prospective cohort study in a tertiary hospital. Patients satisfying inclusion criteria were enrolled after informed consent. Clinical variables were noted with sample collection when patients met criteria for sepsis, severe sepsis, septic shock and recovery. Protein C levels were measured using monoclonal antibody based fluorescence immunoassay. Results. Thirty one patients participated in this study (22 immunocompromised, 9 immunocompetent). Protein C levels were found to be significantly lower in the immunocompromised group compared to the immunocompetent group, particularly observed in severe sepsis [2.27 (95% CI: 1.63-2.9) vs 4.19 (95% CI: 2.87-5.52) mcg/ml] (p = 0.01) and sepsis [2.59 (95% CI: 1.98-3.21) vs 3.64 (95% CI: 2.83-4.45) mcg/ml] (p = 0.03). SOFA scores were similar in both the groups across sepsis, severe sepsis and septic shock categories. Protein C levels improved significantly in recovery (p = 0.001) irrespective of immune status. Conclusion. Protein C levels were significantly lower in immunocompromised patients when compared to immunocompetent patients in severe sepsis and sepsis categories. Our study suggests a plausible role for APC in severely septic immunocompromised patients which need further elucidation. © 2009 Panwar et al; licensee BioMed Central Ltd.

Introduction. Activated Protein C [APC] improves outcome in immunocompetent patients with severe sepsis particularly in those who are perceived to have high mortality risk. Before embarking on a trial of APC administration in immunocompromised septic patients, a preliminary study on plasma levels of protein C in this cohort is essential. Objective. To assess serum Protein C concentrations in immunocompromised patients as compared to immunocompetent patients during sepsis, severe sepsis, septic shock and recovery. Methods. Prospective cohort study in a tertiary hospital. Patients satisfying inclusion criteria were enrolled after informed consent. Clinical variables were noted with sample collection when patients met criteria for sepsis, severe sepsis, septic shock and recovery. Protein C levels were measured using monoclonal antibody based fluorescence immunoassay. Results. Thirty one patients participated in this study (22 immunocompromised, 9 immunocompetent). Protein C levels were found to be significantly lower in the immunocompromised group compared to the immunocompetent group, particularly observed in severe sepsis [2.27 (95% CI: 1.63-2.9) vs 4.19 (95% CI: 2.87-5.52) mcg/ml] (p = 0.01) and sepsis [2.59 (95% CI: 1.98-3.21) vs 3.64 (95% CI: 2.83-4.45) mcg/ml] (p = 0.03). SOFA scores were similar in both the groups across sepsis, severe sepsis and septic shock categories. Protein C levels improved significantly in recovery (p = 0.001) irrespective of immune status. Conclusion. Protein C levels were significantly lower in immunocompromised patients when compared to immunocompetent patients in severe sepsis and sepsis categories. Our study suggests a plausible role for APC in severely septic immunocompromised patients which need further elucidation. © 2009 Panwar et al; licensee BioMed Central Ltd.

Effects of air pollution on morbidity and mortality may be mediated by alterations in immune competence. In this study we examined short-term associations of air pollution exposures with lymphocyte immunophenotypes in cord blood among 1,397 deliveries in two districts of the Czech Republic. We measured fine particulate matter < 2.5 microm in diameter (PM2.5) and 12 polycyclic aromatic hydrocarbons (PAHs) in 24-hr samples collected by versatile air pollution samplers. Cord blood samples were analyzed using a FACSort flow cytometer to determine phenotypes of CD3+ T-lymphocytes and their subsets CD4+ and CD8+, CD19+ B-lymphocytes, and natural killer cells. The mothers were interviewed regarding sociodemographic and lifestyle factors, and medical records were abstracted for obstetric, labor and delivery characteristics. During the period 1994 to 1998, the mean daily ambient concentration of PM2.5 was 24.8 microg/m3 and that of PAHs was 63.5 ng/m3. In multiple linear regression models adjusted for temperature, season, and other covariates, average PAH or PM2.5 levels during the 14 days before birth were associated with decreases in T-lymphocyte phenotype fractions (i.e., CD3+ CD4+, and CD8+), and a clear increase in the B-lymphocyte (CD19+) fraction. For a 100-ng/m3 increase in PAHs, which represented approximately two standard deviations, the percentage decrease was -3.3% [95% confidence interval (CI), -5.6 to -1.0%] for CD3+, -3.1% (95% CI, -4.9 to -1.3%) for CD4+, and -1.0% (95% CI, -1.8 to -0.2%) for CD8+ cells. The corresponding increase in the CD19+ cell proportion was 1.7% (95% CI, 0.4 to 3.0%). Associations were similar but slightly weaker for PM2.5. Ambient air pollution may influence the relative distribution of lymphocyte immunophenotypes of the fetus.

Effects of air pollution on morbidity and mortality may be mediated by alterations in immune competence. In this study we examined short-term associations of air pollution exposures with lymphocyte immunophenotypes in cord blood among 1,397 deliveries in two districts of the Czech Republic. We measured fine particulate matter < 2.5 microm in diameter (PM2.5) and 12 polycyclic aromatic hydrocarbons (PAHs) in 24-hr samples collected by versatile air pollution samplers. Cord blood samples were analyzed using a FACSort flow cytometer to determine phenotypes of CD3+ T-lymphocytes and their subsets CD4+ and CD8+, CD19+ B-lymphocytes, and natural killer cells. The mothers were interviewed regarding sociodemographic and lifestyle factors, and medical records were abstracted for obstetric, labor and delivery characteristics. During the period 1994 to 1998, the mean daily ambient concentration of PM2.5 was 24.8 microg/m3 and that of PAHs was 63.5 ng/m3. In multiple linear regression models adjusted for temperature, season, and other covariates, average PAH or PM2.5 levels during the 14 days before birth were associated with decreases in T-lymphocyte phenotype fractions (i.e., CD3+ CD4+, and CD8+), and a clear increase in the B-lymphocyte (CD19+) fraction. For a 100-ng/m3 increase in PAHs, which represented approximately two standard deviations, the percentage decrease was -3.3% [95% confidence interval (CI), -5.6 to -1.0%] for CD3+, -3.1% (95% CI, -4.9 to -1.3%) for CD4+, and -1.0% (95% CI, -1.8 to -0.2%) for CD8+ cells. The corresponding increase in the CD19+ cell proportion was 1.7% (95% CI, 0.4 to 3.0%). Associations were similar but slightly weaker for PM2.5. Ambient air pollution may influence the relative distribution of lymphocyte immunophenotypes of the fetus.

Excessive consumption of energy and fat increases the risk for obesity. Snacks containing sucrose polyesters (SPE) as a dietary fat replacer are on the market in the United States. SPE products have been shown to lower concentrations of serum carotenoids in short-term studies. Experimental studies on the longer-term effects on health of decreased carotenoid concentrations are lacking. A 1-y randomized, double-blind, placebo-controlled parallel trial was performed. Subjects (n = 380) with a habitual low or high fruit and vegetable intake were assigned to the treatments (0, 7, 10 or 17 g/d SPE). SPE was given in the form of spreads, chips or both. The groups were compared for serum carotenoids, vitamins and markers of oxidative damage, eye health, cardiovascular health and immune status. After 1 y, serum lipid-adjusted carotenoids showed the largest decrease in the SPE chips and spread group (17 g/d) compared with the control group [α-carotene 33%; β-carotene 31%, lycopene 24%, β-cryptoxanthin 18%, lutein 18% (all P < 0.001) and zeaxanthin 13% (P < 0.05)]. Consumption of SPE spread (10 g/d SPE) decreased carotenoid concentrations by 11-29% (all P < 0.05). SPE chips (7 g/d SPE) decreased zeaxanthin (11%), β-carotene (12%) and α-carotene (21%; all P < 0.05). Serum lipid adjusted α-tocopherol decreased significantly by 6-8% (all P < 0.001) in all SPE groups. No negative effects were observed on markers of oxidation, eye health, cardiovascular health or immune status. This study shows that decreases in serum carotenoid concentrations do not affect possible markers of disease risk.

RIVM rapport:De stand van zaken betreffende de ontwikkeling van immuunfunctie testen voor de bot, Platichthys flesus is beschreven. Epidemiologische veldstudies hebben aangetoond dat deze platvis species een hoge prevalentie aan infectieuze ziekten heeft, hetgeen gecorreleerd kan worden met de aanwezigheid van contaminanten in het aquatische milieu. Om een mogelijk causaal verband vast te kunnen stellen en om de bot als indicator species te kunnen gebruiken, zijn immuunfunctie-testen ontwikkeld. Het rapport beschrijft de ontwikkeling en toepassing van assays voor het bepalen van niet-specifieke cytotoxie, lymfocytenstimulatie en de immunohistochemische identificatie van leukocyt populaties in de bot. Deze assays, tezamen met andere testen die momenteel in ontwikkeling zijn, zullen gebruikt worden om de immuunstatus van de bot te 'peilen' in immunotoxicologische experimenten., The state of the art concerning the development of immune function tests in flounder, Platichthys flesus has been described. It is known from epidemiological field surveys that this flatfish species has a high prevalence of infectious diseases which is correlated with aquatic pollution. In order to provide more evidence for a possible causal link and to use flounder as an indicator species, immune function tests were developed. This report describes the development and application of assays to measure non-specific cytotoxicity, lymphocyte stimulation and immunohistochemical identification of leukocyte populations of flounder. These assays, as well as others which are developed at the moment, will be applied to monitor the immune status of flounder in immunotoxicological experiments.

De stand van zaken betreffende de ontwikkeling van immuunfunctie testen voor de bot, Platichthys flesus is beschreven. Epidemiologische veldstudies hebben aangetoond dat deze platvis species een hoge prevalentie aan infectieuze ziekten heeft, hetgeen gecorreleerd kan worden met de aanwezigheid van contaminanten in het aquatische milieu. Om een mogelijk causaal verband vast te kunnen stellen en om de bot als indicator species te kunnen gebruiken, zijn immuunfunctie-testen ontwikkeld. Het rapport beschrijft de ontwikkeling en toepassing van assays voor het bepalen van niet-specifieke cytotoxie, lymfocytenstimulatie en de immunohistochemische identificatie van leukocyt populaties in de bot. Deze assays, tezamen met andere testen die momenteel in ontwikkeling zijn, zullen gebruikt worden om de immuunstatus van de bot te 'peilen' in immunotoxicologische experimenten., The state of the art concerning the development of immune function tests in flounder, Platichthys flesus has been described. It is known from epidemiological field surveys that this flatfish species has a high prevalence of infectious diseases which is correlated with aquatic pollution. In order to provide more evidence for a possible causal link and to use flounder as an indicator species, immune function tests were developed. This report describes the development and application of assays to measure non-specific cytotoxicity, lymphocyte stimulation and immunohistochemical identification of leukocyte populations of flounder. These assays, as well as others which are developed at the moment, will be applied to monitor the immune status of flounder in immunotoxicological experiments.

RIVM rapport:De stand van zaken betreffende de ontwikkeling van immuunfunctie testen voor de bot, Platichthys flesus is beschreven. Epidemiologische veldstudies hebben aangetoond dat deze platvis species een hoge prevalentie aan infectieuze ziekten heeft, hetgeen gecorreleerd kan worden met de aanwezigheid van contaminanten in het aquatische milieu. Om een mogelijk causaal verband vast te kunnen stellen en om de bot als indicator species te kunnen gebruiken, zijn immuunfunctie-testen ontwikkeld. Het rapport beschrijft de ontwikkeling en toepassing van assays voor het bepalen van niet-specifieke cytotoxie, lymfocytenstimulatie en de immunohistochemische identificatie van leukocyt populaties in de bot. Deze assays, tezamen met andere testen die momenteel in ontwikkeling zijn, zullen gebruikt worden om de immuunstatus van de bot te 'peilen' in immunotoxicologische experimenten., The state of the art concerning the development of immune function tests in flounder, Platichthys flesus has been described. It is known from epidemiological field surveys that this flatfish species has a high prevalence of infectious diseases which is correlated with aquatic pollution. In order to provide more evidence for a possible causal link and to use flounder as an indicator species, immune function tests were developed. This report describes the development and application of assays to measure non-specific cytotoxicity, lymphocyte stimulation and immunohistochemical identification of leukocyte populations of flounder. These assays, as well as others which are developed at the moment, will be applied to monitor the immune status of flounder in immunotoxicological experiments.

RIVM rapport:De stand van zaken betreffende de ontwikkeling van immuunfunctie testen voor de bot, Platichthys flesus is beschreven. Epidemiologische veldstudies hebben aangetoond dat deze platvis species een hoge prevalentie aan infectieuze ziekten heeft, hetgeen gecorreleerd kan worden met de aanwezigheid van contaminanten in het aquatische milieu. Om een mogelijk causaal verband vast te kunnen stellen en om de bot als indicator species te kunnen gebruiken, zijn immuunfunctie-testen ontwikkeld. Het rapport beschrijft de ontwikkeling en toepassing van assays voor het bepalen van niet-specifieke cytotoxie, lymfocytenstimulatie en de immunohistochemische identificatie van leukocyt populaties in de bot. Deze assays, tezamen met andere testen die momenteel in ontwikkeling zijn, zullen gebruikt worden om de immuunstatus van de bot te 'peilen' in immunotoxicologische experimenten., The state of the art concerning the development of immune function tests in flounder, Platichthys flesus has been described. It is known from epidemiological field surveys that this flatfish species has a high prevalence of infectious diseases which is correlated with aquatic pollution. In order to provide more evidence for a possible causal link and to use flounder as an indicator species, immune function tests were developed. This report describes the development and application of assays to measure non-specific cytotoxicity, lymphocyte stimulation and immunohistochemical identification of leukocyte populations of flounder. These assays, as well as others which are developed at the moment, will be applied to monitor the immune status of flounder in immunotoxicological experiments.

RIVM rapport:INLEIDING In 1994 is als voorloper op een landelijk onderzoek een pilot-onderzoek voor het PIENTER-project (Peiling Immunisatie Effect Nederland ter Evaluatie van het Rijksvaccinatieprogramma) uitgevoerd. In het kader van dit project wordt een serumbank opgericht die sera moet bevatten van een representatitieve steekproef van de Nederlandse bevolking. Met behulp van deze gedefinieerde serumbank kan populatie-onderzoek worden verricht naar de immuniteit van ziekten uit het Rijksvaccinatieprogramma, naar het voorkomen van infectieziekten en naar serumderterminanten voor andere aandoeningen. Onderdeel van het pilot-onderzoek is de evaluatie van de vragenlijst zodat een vragenlijst kan worden ontwikkeld voor het landelijke onderzoek. DOEL Evaluatie van vragenlijst als onderdeel van een pilot van een cross-sectioneel populatie-onderzoek in de provincie Utrecht. METHODE Uit de provincie Utrecht is een naar inwonertal gewogen steekproef van gemeenten getrokken. Uit bevolkingsregisters van vier gemeenten (Utrecht, Zeist, Amerongen en Woudenberg) is een leeftijd gestratificeerde steekproef (leeftijdklassen 0, 1-4, 5-9 t/m 75-79 jaar) getrokken van 510 personen. Deelnemers werden gevraagd een vragenlijst in te vullen en deze tezamen met Rijksvaccinatieboekje, tropenvaccinatieboekje en militairpaspoort mee te nemen naar een spreekuur voor bloedafname. Inentingsgegevens uit deze boekjes werden op het spreekuur geregistreerd. De mening van de deelnemers over de lengte en duidelijkheid van vragen en frequenties van ontbrekende waarden zijn beschreven. Tevens zijn de naar leeftijd gewogen percentages voor de zelf-gerapporteerde vaccinatiestatus en de relatie met geloofs- of levensbeschouwelijke groepering beschreven. De zelf-gerapporteerde vaccinatiestatus voor DKTP en BMR zijn vergeleken met de vaccinatiestatus uit het Rijksvaccinatieboekje. De naar leeftijd gewogen percentages voor ervaren gezondheidstoestand, nationaliteit en hoogst voltooide opleiding zijn vergeleken met cijfe, INTRODUCTION In 1994 a pilot-study of the so-called PIENTER-project was carried out. The aim of this project is to establish a serum bank of a representative sample of the Dutch population. The serum bank will be used to estimate age-specific immunity of the general population against childhood diseases of the Netherlands Immunisation Programme, the incidence of infectious diseases with a frequent subclinical course and the prevalence of serum-derterminants of other illnesses. The questionnaire used in the pilot-study was evaluated in order to develop a questionnaire for the nation-wide data collection. AIM Evaluation of the questionnaire used for data collection in a pilot of a cross-sectional population-based study in the province of Utrecht. METHODS A sample of four municipalities weighted by the number of inhabitants was taken out of the municipalities in the Province of Utrecht. 510 persons in the age strata 0, 1-4, 5-9 to 75-79 years were randomly selected from the populations registers of these four municipalities. The participants have been asked to give some blood and to fill in a questionnaire. They have been requested to bring their vaccination certificates of the Dutch immunisation programme, of vaccination on the occasion travelling to the tropics and of military service. These vaccination data were registered on a study form. The opinion of the participants on the length and clarity of the questionnaire and the frequency of missing values for all questions were described. The population proportions weighted by age for self-reported vaccination history and the relation with religion were given. Self-reported vaccination history for diphteria, pertussis, tetanus, poliomyelitis and mumps, measles and rubella was compared with information on the vaccination history derived from the vaccination certificate of the Dutch immunisation programme. The proportions weighted by age for self-perception of health status, nationality and level of education were compar

RIVM rapport:Inleiding: De immuunstatus van de algemene Nederlandse bevolking is wat betreft bof, mazelen, rubella, difterie, tetanus en poliomyelitis redelijk in kaart gebracht. Veel minder is bekend over de immuunstatus bij bepaalde subgroepen van de bevolking. Een onderzoek uitgevoerd in Amsterdam in 1987 toonde een verminderde immuunstatus tegen rubella aan bij Amsterdamse allochtone vrouwen. Dit bericht was aanleiding voor de GGD van het stadsgewest 's-Hertogenbosch een serologisch onderzoek en vaccinatie met BMR bij allochtonen uit te voeren. Materiaal en methoden: Gedurende de periode maart 1990 tot maart 1992 werden personen die een verblijfsvergunning in Nederland aanvroegen (immigranten) en waarbij een onderzoek op tuberculose werd uitgevoerd, verzocht deel te nemen aan het onderzoek. In totaal werden door medewerkers van de GGD van het stadsgewest 's-Hertogenbosch 315 immigranten benaderd voor bloedafname. De seroprevalentie t.a.v. bof en mazelen werd bepaald met een Enzyme Linked Immunosorbent Assay (ELISA), t.a.v rubella met een Haemagglutinatie Remmingstest (HAR), t.a.v. poliomyelitis met een neutralisatietest en t.a.v. difterie en tetanus met een Toxin Binding Inhibition (ToBI) test. De serologische bepalingen werden uitgevoerd in het Rijksinstituut voor Volksgezondheid en Milieuhygiene (RIVM). Resultaten: Bij 251 personen (80% van 315 benaderde personen) werd bloed afgenomen. Hiervan waren 57% man en 43% vrouw. Ruim 44% van de respondenten kwam uit Marokko, ruim 24% uit Turkije en ruim 31% uit 31 overige landen. Voor berekeningen werden de deelnemers uit de 31 overige landen gecombineerd (restgroep). De mediane leeftijd in Marokko, Turkije en de overige landen varieerde tussen 22 en 28 jaar. De mediane verblijfsduur in Nederland tot aan het moment van bloedafname was 0,5 tot 1 maand. In totaal werd bij 1,6% van de respondenten geen meetbare antistoffen gevonden tegen bof. Bij alle respondenten werden voldoende meetbare antistoffen tegen mazelen gevonden. Bij ruim, In the city of 's-Hertogenbosch people applying for a residence permit were tested for antibodies against mumps, measles, rubella, diphtheria, tetanus and poliomyelitis. For the residence permit a certificate of check on tuberculosis from the local municipal health service is also needed. When applying for this permit participants were asked to enroll in the study. This study was initiated to investigate the observation that some women of etnic origin at child-bearing age in Amsterdam had a significant lower percentage of antibodies against rubella than the percentage found in Dutch women, and henceforth rubella vaccination was recommended in women from foreign origin. The antibody tests included an Enzyme Linked Immunosorbent Assay (ELISA) for detecting mumps and measles antibodies, a Haemagglutination Inhibitiontest (HAI) for detecting rubella antibodies, a neutralization test for detecting poliomyelitis antibodies and a Toxin Binding Inhibition (ToBI) test for detecting diphtheria and tetanus. The antibody titres for mumps, measles, rubella and poliomyelitis proved almost similar to those in the Dutch population as assessed in other studies. Compared with the Dutch population of the same age (25-29 year) the immunity against diptheria and tetanus was lower ; however, compared with the Dutch population of age 35-39, who have not been vaccinated according to the national immunisation programme, the immunity of immigrants was higher. Low percentage of antibodies against rubella were not found.

INLEIDING In 1994 is als voorloper op een landelijk onderzoek een pilot-onderzoek voor het PIENTER-project (Peiling Immunisatie Effect Nederland ter Evaluatie van het Rijksvaccinatieprogramma) uitgevoerd. In het kader van dit project wordt een serumbank opgericht die sera moet bevatten van een representatitieve steekproef van de Nederlandse bevolking. Met behulp van deze gedefinieerde serumbank kan populatie-onderzoek worden verricht naar de immuniteit van ziekten uit het Rijksvaccinatieprogramma, naar het voorkomen van infectieziekten en naar serumderterminanten voor andere aandoeningen. Onderdeel van het pilot-onderzoek is de evaluatie van de vragenlijst zodat een vragenlijst kan worden ontwikkeld voor het landelijke onderzoek. DOEL Evaluatie van vragenlijst als onderdeel van een pilot van een cross-sectioneel populatie-onderzoek in de provincie Utrecht. METHODE Uit de provincie Utrecht is een naar inwonertal gewogen steekproef van gemeenten getrokken. Uit bevolkingsregisters van vier gemeenten (Utrecht, Zeist, Amerongen en Woudenberg) is een leeftijd gestratificeerde steekproef (leeftijdklassen 0, 1-4, 5-9 t/m 75-79 jaar) getrokken van 510 personen. Deelnemers werden gevraagd een vragenlijst in te vullen en deze tezamen met Rijksvaccinatieboekje, tropenvaccinatieboekje en militairpaspoort mee te nemen naar een spreekuur voor bloedafname. Inentingsgegevens uit deze boekjes werden op het spreekuur geregistreerd. De mening van de deelnemers over de lengte en duidelijkheid van vragen en frequenties van ontbrekende waarden zijn beschreven. Tevens zijn de naar leeftijd gewogen percentages voor de zelf-gerapporteerde vaccinatiestatus en de relatie met geloofs- of levensbeschouwelijke groepering beschreven. De zelf-gerapporteerde vaccinatiestatus voor DKTP en BMR zijn vergeleken met de vaccinatiestatus uit het Rijksvaccinatieboekje. De naar leeftijd gewogen percentages voor ervaren gezondheidstoestand, nationaliteit en hoogst voltooide opleiding zijn vergeleken met cijfe, INTRODUCTION In 1994 a pilot-study of the so-called PIENTER-project was carried out. The aim of this project is to establish a serum bank of a representative sample of the Dutch population. The serum bank will be used to estimate age-specific immunity of the general population against childhood diseases of the Netherlands Immunisation Programme, the incidence of infectious diseases with a frequent subclinical course and the prevalence of serum-derterminants of other illnesses. The questionnaire used in the pilot-study was evaluated in order to develop a questionnaire for the nation-wide data collection. AIM Evaluation of the questionnaire used for data collection in a pilot of a cross-sectional population-based study in the province of Utrecht. METHODS A sample of four municipalities weighted by the number of inhabitants was taken out of the municipalities in the Province of Utrecht. 510 persons in the age strata 0, 1-4, 5-9 to 75-79 years were randomly selected from the populations registers of these four municipalities. The participants have been asked to give some blood and to fill in a questionnaire. They have been requested to bring their vaccination certificates of the Dutch immunisation programme, of vaccination on the occasion travelling to the tropics and of military service. These vaccination data were registered on a study form. The opinion of the participants on the length and clarity of the questionnaire and the frequency of missing values for all questions were described. The population proportions weighted by age for self-reported vaccination history and the relation with religion were given. Self-reported vaccination history for diphteria, pertussis, tetanus, poliomyelitis and mumps, measles and rubella was compared with information on the vaccination history derived from the vaccination certificate of the Dutch immunisation programme. The proportions weighted by age for self-perception of health status, nationality and level of education were compar

Inleiding: De immuunstatus van de algemene Nederlandse bevolking is wat betreft bof, mazelen, rubella, difterie, tetanus en poliomyelitis redelijk in kaart gebracht. Veel minder is bekend over de immuunstatus bij bepaalde subgroepen van de bevolking. Een onderzoek uitgevoerd in Amsterdam in 1987 toonde een verminderde immuunstatus tegen rubella aan bij Amsterdamse allochtone vrouwen. Dit bericht was aanleiding voor de GGD van het stadsgewest 's-Hertogenbosch een serologisch onderzoek en vaccinatie met BMR bij allochtonen uit te voeren. Materiaal en methoden: Gedurende de periode maart 1990 tot maart 1992 werden personen die een verblijfsvergunning in Nederland aanvroegen (immigranten) en waarbij een onderzoek op tuberculose werd uitgevoerd, verzocht deel te nemen aan het onderzoek. In totaal werden door medewerkers van de GGD van het stadsgewest 's-Hertogenbosch 315 immigranten benaderd voor bloedafname. De seroprevalentie t.a.v. bof en mazelen werd bepaald met een Enzyme Linked Immunosorbent Assay (ELISA), t.a.v rubella met een Haemagglutinatie Remmingstest (HAR), t.a.v. poliomyelitis met een neutralisatietest en t.a.v. difterie en tetanus met een Toxin Binding Inhibition (ToBI) test. De serologische bepalingen werden uitgevoerd in het Rijksinstituut voor Volksgezondheid en Milieuhygiene (RIVM). Resultaten: Bij 251 personen (80% van 315 benaderde personen) werd bloed afgenomen. Hiervan waren 57% man en 43% vrouw. Ruim 44% van de respondenten kwam uit Marokko, ruim 24% uit Turkije en ruim 31% uit 31 overige landen. Voor berekeningen werden de deelnemers uit de 31 overige landen gecombineerd (restgroep). De mediane leeftijd in Marokko, Turkije en de overige landen varieerde tussen 22 en 28 jaar. De mediane verblijfsduur in Nederland tot aan het moment van bloedafname was 0,5 tot 1 maand. In totaal werd bij 1,6% van de respondenten geen meetbare antistoffen gevonden tegen bof. Bij alle respondenten werden voldoende meetbare antistoffen tegen mazelen gevonden. Bij ruim, In the city of 's-Hertogenbosch people applying for a residence permit were tested for antibodies against mumps, measles, rubella, diphtheria, tetanus and poliomyelitis. For the residence permit a certificate of check on tuberculosis from the local municipal health service is also needed. When applying for this permit participants were asked to enroll in the study. This study was initiated to investigate the observation that some women of etnic origin at child-bearing age in Amsterdam had a significant lower percentage of antibodies against rubella than the percentage found in Dutch women, and henceforth rubella vaccination was recommended in women from foreign origin. The antibody tests included an Enzyme Linked Immunosorbent Assay (ELISA) for detecting mumps and measles antibodies, a Haemagglutination Inhibitiontest (HAI) for detecting rubella antibodies, a neutralization test for detecting poliomyelitis antibodies and a Toxin Binding Inhibition (ToBI) test for detecting diphtheria and tetanus. The antibody titres for mumps, measles, rubella and poliomyelitis proved almost similar to those in the Dutch population as assessed in other studies. Compared with the Dutch population of the same age (25-29 year) the immunity against diptheria and tetanus was lower ; however, compared with the Dutch population of age 35-39, who have not been vaccinated according to the national immunisation programme, the immunity of immigrants was higher. Low percentage of antibodies against rubella were not found.

RIVM rapport:Inleiding. Een belangrijke bijdrage aan het inzicht in het voorkomen van infectieziekten op basis van surveillance van gegevens uit morbiditeits- en mortaliteitsregistraties en van gegevens uit laboratoria, kan worden geleverd door serosurveillance: onderzoek naar de aanwezigheid van specifieke antistoffen in de populatie. Met name ter bewaking van de immuniteit van de bevolking voor de ziekten waartegen in het kader van het Rijksvaccinatieprogramma wordt gevaccineerd is sero- oftewel immunosurveillance noodzakelijk. Daarom zijn door het RIVM initiatieven ontwikkeld om een serumbank van een aselecte steekproef van de Nederlandse bevolking op te richten en is het zogenaamde PIENTER-project (Peiling Immunisatie Effect Nederland ter Evaluatie van het Rijksvaccinatieprogramma) van start gegaan. In 1994 werd een pilot-onderzoek uitgevoerd. Doel. Het pilotonderzoek had een tweeledig doel: ten eerste de beoordeling van de haalbaarheid van de opzet en het ontwerp van een in de praktijk getoetst protocol voor de uiteindelijke landelijke gegevensverzameling, ten tweede de toetsing van de mogelijkheid om met de gekozen opzet een representatieve dataset te verkrijgen (met behulp van uitgebreid non-respons-onderzoek waarvan in deel II van deze onderzoeksrapportage verslag wordt gedaan). Opzet. Een cross-sectioneel populatie-onderzoek werd uitgevoerd in de provincie Utrecht. Methode. In vier gemeenten werd een leeftijdsgestratificeerde steekproef van 510 inwoners (0-80 jaar) getrokken uit het bevolkingsregister. Van de beoogde deelnemers die schriftelijk werden benaderd werd verwacht dat zij een vragenlijst zouden invullen en een speciaal spreekuur bezoeken voor afname van een bloedmonster. De logistieke evaluatie vond plaats op grond van de ervaringen gedurende de pilot, deels vastgelegd in registraties en logboeken van de betrokken onderzoeksmedewerkers, deels ontleend aan de gegevens van een schriftelijke evaluatie met behulp van een vragenlijst voor alle externe participanten, Introduction. The occurrence of infectious diseases is monitored on the basis of surveillance data from morbidity and mortality registers and data from laboratories. Important additional information can be derived from serosurveillance: the study of the prevalence of specific antibodies in the population. Particularly for the control of the immunity for diseases against which people are vaccinated following the National Immunization Programme serosurveillance or immunosurveillance is necessary. Therefore, the RIVM has taken the initiative to establish a serum bank of a random sample of the Dutch population and the so-called PIENTER-project has been started. In 1994 a pilot study was carried out. Aim. The pilot study had a twofold aim: firstly, the assessment of the feasibility of the design and the development of an ascertained protocol for the final nation-wide data collection, secondly the judgement of the possibility to obtain a representative data set (by means of an comprehensive non-response investigation, which is described in part II of this report series). Design. A cross-sectional population-based study was done in the province of Utrecht. Methods. An age-stratified random sample of 510 inhabitants (0-80 years of age) was taken from the population registers of four municipalities. The intended participants who were approached by mail, were expected to fill in a questionnaire and to visit a clinic to allow blood to be taken. The evaluation of the logistics was based on the experience during the pilot, partly written down in registrations and personal logbooks of the study team, partly derived from a written questionnaire filled in by the concerned collaborators. Furthermore, the non-response study has offered leads for optimalization of the acquisition of participants. Findings and recommendations Data collection in the general population can be done in cooperation with Public Health Services with a central coordination. The cooperation between the many par

RIVM rapport:Inleiding Om de huidige immuunstatus van de Nederlandse bevolking te bepalen is het PIENTER-project (Peiling Immunisatie Effect Nederland ter Evaluatie van het Rijksvaccinatieprogramma) opgezet. In het kader van dit project wordt een serumbank opgericht, die sera moet bevatten van een representatieve steekproef van de Nederlandse bevolking. De serumbank wordt benut voor: 1. immunosurveillance onderzoek naar leeftijdspecifieke immuniteit tegen ziekten waartegen in het RVP wordt gevaccineerd ; 2. schatting van voorkomen van infectieziekten die vaak subklinisch verlopen ; 3. onderzoek naar prevalentie van serum-determinanten van andere ziekten. Om de haalbaarheid van een dergelijk project te toetsen is een pilot onderzoek uitgevoerd in de provincie Utrecht. Doel van dit pilot-onderzoek is, naast het toetsen van de logistiek en haalbaarheid van de onderzoeksopzet (zie deel 1 van de rapportage), inzicht te verkrijgen in redenen van weigering opdat responsverhogende maatregelen genomen kunnen worden in het hoofdonderzoek en het toetsen van representativiteit. Opzet. Non-responsonderzoek als onderdeel van een cross-sectioneel populatie onderzoek. Methode. Uit de provincie Utrecht is een naar inwonertal gewogen steekproef van gemeenten uitgevoerd. Uit bevolkingsregisters van vier gemeenten (Utrecht, Zeist, Amerongen en Woudenberg) is een naar leeftijd gestratificeerde steekproef getrokken van 510 personen. De beoogde respondenten werden gevraagd een vragenlijst in te vullen en een spreekuur voor bloedafname te bezoeken. Alle personen die niet hebben geparticipeerd aan de bloedafname zijn in de week na de bloedafname telefonisch of -indien dit onmogelijk was- schriftelijk benaderd voor het non-respons onderzoek. Van de non-respondenten zijn gegevens verzameld over reden van nonrespons, bereidheid tot deelname aan extra bloedafname spreekuur, vragenlijstgegevens over geloofs- of levensovertuiging, vaccinatiestatus, land van herkomst, sociaal-economische status en ervaren gezo, Introduction. A pilot study on the feasibility of the establishment of a serumbank of a representative sample of the Dutch general population was carried out. The aims of this so-called 'PIENTER-project' were to estimate: 1. age-specific immunity of the general population against childhood diseases of the Netherlands Immunization Programme, 2. the incidence of infectious diseases with a frequent subclinical course 3, the prevalence of serum-determinants of other illnesses. This report describes the results of the non-response study which was performed to obtain insight in the reasons for nonparticipation and to test the representativity. Design. Nonresponse study as part of a cross-sectional population survey. Methods. 510 persons in the age-strata (0, 1-4, 5-9 to 75-79 years) were randomly selected out of four municipalities in het Province of Utrecht. The participants have been asked to fill in a questionnaire and to visit a local health service to give some blood. The nonparticipants were contacted by telephone (or mail). In this nonresponsestudy data were obtained on the reasons for nonparticipation, willingness to visit additional hours to give blood. Information on religion, vaccination history, self-perception on health status, country of nationality and level of education were collected with a short questionnaire. Data obtained from the registries of the municipalities were age, sex, nationality and marital status. Part of the eligible persons received a written reminder. Differences between participants and nonparticipants were tested in logistic regression analyses. To get information on the immunity of nonparticipants and participants, the immunity against hepatitis A and measles was weighted by the variables in the logistic regression model. Results. Four groups of (non)participants were distinguished: 1. initial participants (n=714, 34%) ; 2. additional participants who visited the additional hours of the local health service to give blood (n=113, 6%)

RIVM rapport:Inleiding: Serosurveillance - onderzoek naar de aanwezigheid van specifieke antistoffen in de populatie - kan een belangrijke bijdrage leveren aan het inzicht in het voorkomen van infectieziekten. Met name ter bewaking van de immuniteit van de bevolking voor ziekten waartegen in het kader van het Rijksvaccinatieprogramma wordt gevaccineerd is sero- oftewel immunosurveillance van belang. In 1994 is als voorloper op een landelijk onderzoek een pilot-onderzoek voor het PIENTER-project (Peiling Immunisatie Effect Nederland ter Evaluatie van het Rijksvaccinatieprogramma) uitgevoerd. In het kader van dit project wordt een serumbank opgericht van een aselecte steekproef van de Nederlandse bevolking. Methode: Uit de provincie Utrecht is een naar inwonertal gewogen steekproef van gemeenten getrokken. Uit bevolkingsregisters van Utrecht, Zeist, Amerongen en Woudenberg is een naar leeftijd gestratificeerde steekproef (0, 1-4, 5-9 t/m 75-79 jaar) getrokken van 510 personen (N=2040). Van 827 personen kon een bloedmonster worden afgenomen. Daarin zijn antistofbepalingen verricht voor bof, mazelen, rubella, kinkhoest, Toxoplasma, Toxocara, T. spiralis en hepatitis A. De specifieke seroprevalentie werd berekend voor leeftijd, geslacht, ervaren gezondheid, sociaal economische status, geboorteland en religie. Resultaten: Voor bof, mazelen en rubella bedroeg het percentage seronegatieven resp. 2,4%, 1,8% en 2,4%. Ruim de helft van het aantal personen zonder aantoonbare antistoffen was jonger dan een jaar. Voor mannen was het percentage seronegatieven zowel voor bof, mazelen als rubella iets hoger (bof 3,7% vs. 2,2% ; mazelen 3,4% vs. 1,5% ; rubella 3,7% vs. 2,0%). Voor personen met een geloof waarbij vaccinaties principieel worden afgewezen, antroposofen en personen die niet tot een dergelijk geloof behoorden, bedroegen het percentage seronegatieven voor bof resp. 3,1%, 15,0% en 2,5%, voor mazelen resp. 0.9%, 6,1% en 1,9% en voor rubella 7,0%, 2,4% en 0,0%. In Woudenberg was het perce, Important information on the occurrence of infectious diseases can be derived from serosurveillance. In 1994 a pilot study for the PIENTER-project was carried out to investigate the feasibility of the establishment of a serum bank representatitive for the Dutch general population. As part of this pilot-study the seroprevalence was measured for mumps, measles, rubella, pertussis, Toxoplasmosis, Toxocara, T. spiralis and Hepatitis A in the 827 participants. The seroprevalences for mumps, measles and rubella was 97,6%, 98,2% and 97,6%, respectively. IgA-antibodies and/or IgG-antibodies against pertussis of at least 5 Units/ml were present for 61,3% and 35,6% of the participants. The seroprevalence for toxoplasma, toxocara and hepatitis A were 43%, 19% and 27,1%, respectively and increased with age. Only two participants had antibodies for T. spiralis. However, due to the small and non-representatitive sample in the pilot, it is impossible to make reliable conclusions. After the large scale nation-wide data collection that will be realised in 1995/1996 reliable seroprevalence estimates for the Dutch general population will become available.

RIVM rapport:INLEIDING In 1994 is als voorloper op een landelijk onderzoek een pilot-onderzoek voor het PIENTER-project (Peiling Immunisatie Effect Nederland ter Evaluatie van het Rijksvaccinatieprogramma) uitgevoerd. In het kader van dit project wordt een serumbank opgericht die sera moet bevatten van een representatitieve steekproef van de Nederlandse bevolking. Met behulp van deze gedefinieerde serumbank kan populatie-onderzoek worden verricht naar de immuniteit van ziekten uit het Rijksvaccinatieprogramma, naar het voorkomen van infectieziekten en naar serumderterminanten voor andere aandoeningen. Onderdeel van het pilot-onderzoek is de evaluatie van de vragenlijst zodat een vragenlijst kan worden ontwikkeld voor het landelijke onderzoek. DOEL Evaluatie van vragenlijst als onderdeel van een pilot van een cross-sectioneel populatie-onderzoek in de provincie Utrecht. METHODE Uit de provincie Utrecht is een naar inwonertal gewogen steekproef van gemeenten getrokken. Uit bevolkingsregisters van vier gemeenten (Utrecht, Zeist, Amerongen en Woudenberg) is een leeftijd gestratificeerde steekproef (leeftijdklassen 0, 1-4, 5-9 t/m 75-79 jaar) getrokken van 510 personen. Deelnemers werden gevraagd een vragenlijst in te vullen en deze tezamen met Rijksvaccinatieboekje, tropenvaccinatieboekje en militairpaspoort mee te nemen naar een spreekuur voor bloedafname. Inentingsgegevens uit deze boekjes werden op het spreekuur geregistreerd. De mening van de deelnemers over de lengte en duidelijkheid van vragen en frequenties van ontbrekende waarden zijn beschreven. Tevens zijn de naar leeftijd gewogen percentages voor de zelf-gerapporteerde vaccinatiestatus en de relatie met geloofs- of levensbeschouwelijke groepering beschreven. De zelf-gerapporteerde vaccinatiestatus voor DKTP en BMR zijn vergeleken met de vaccinatiestatus uit het Rijksvaccinatieboekje. De naar leeftijd gewogen percentages voor ervaren gezondheidstoestand, nationaliteit en hoogst voltooide opleiding zijn vergeleken met cijfe, INTRODUCTION In 1994 a pilot-study of the so-called PIENTER-project was carried out. The aim of this project is to establish a serum bank of a representative sample of the Dutch population. The serum bank will be used to estimate age-specific immunity of the general population against childhood diseases of the Netherlands Immunisation Programme, the incidence of infectious diseases with a frequent subclinical course and the prevalence of serum-derterminants of other illnesses. The questionnaire used in the pilot-study was evaluated in order to develop a questionnaire for the nation-wide data collection. AIM Evaluation of the questionnaire used for data collection in a pilot of a cross-sectional population-based study in the province of Utrecht. METHODS A sample of four municipalities weighted by the number of inhabitants was taken out of the municipalities in the Province of Utrecht. 510 persons in the age strata 0, 1-4, 5-9 to 75-79 years were randomly selected from the populations registers of these four municipalities. The participants have been asked to give some blood and to fill in a questionnaire. They have been requested to bring their vaccination certificates of the Dutch immunisation programme, of vaccination on the occasion travelling to the tropics and of military service. These vaccination data were registered on a study form. The opinion of the participants on the length and clarity of the questionnaire and the frequency of missing values for all questions were described. The population proportions weighted by age for self-reported vaccination history and the relation with religion were given. Self-reported vaccination history for diphteria, pertussis, tetanus, poliomyelitis and mumps, measles and rubella was compared with information on the vaccination history derived from the vaccination certificate of the Dutch immunisation programme. The proportions weighted by age for self-perception of health status, nationality and level of education were compar

RIVM rapport:Inleiding: De immuunstatus van de algemene Nederlandse bevolking is wat betreft bof, mazelen, rubella, difterie, tetanus en poliomyelitis redelijk in kaart gebracht. Veel minder is bekend over de immuunstatus bij bepaalde subgroepen van de bevolking. Een onderzoek uitgevoerd in Amsterdam in 1987 toonde een verminderde immuunstatus tegen rubella aan bij Amsterdamse allochtone vrouwen. Dit bericht was aanleiding voor de GGD van het stadsgewest 's-Hertogenbosch een serologisch onderzoek en vaccinatie met BMR bij allochtonen uit te voeren. Materiaal en methoden: Gedurende de periode maart 1990 tot maart 1992 werden personen die een verblijfsvergunning in Nederland aanvroegen (immigranten) en waarbij een onderzoek op tuberculose werd uitgevoerd, verzocht deel te nemen aan het onderzoek. In totaal werden door medewerkers van de GGD van het stadsgewest 's-Hertogenbosch 315 immigranten benaderd voor bloedafname. De seroprevalentie t.a.v. bof en mazelen werd bepaald met een Enzyme Linked Immunosorbent Assay (ELISA), t.a.v rubella met een Haemagglutinatie Remmingstest (HAR), t.a.v. poliomyelitis met een neutralisatietest en t.a.v. difterie en tetanus met een Toxin Binding Inhibition (ToBI) test. De serologische bepalingen werden uitgevoerd in het Rijksinstituut voor Volksgezondheid en Milieuhygiene (RIVM). Resultaten: Bij 251 personen (80% van 315 benaderde personen) werd bloed afgenomen. Hiervan waren 57% man en 43% vrouw. Ruim 44% van de respondenten kwam uit Marokko, ruim 24% uit Turkije en ruim 31% uit 31 overige landen. Voor berekeningen werden de deelnemers uit de 31 overige landen gecombineerd (restgroep). De mediane leeftijd in Marokko, Turkije en de overige landen varieerde tussen 22 en 28 jaar. De mediane verblijfsduur in Nederland tot aan het moment van bloedafname was 0,5 tot 1 maand. In totaal werd bij 1,6% van de respondenten geen meetbare antistoffen gevonden tegen bof. Bij alle respondenten werden voldoende meetbare antistoffen tegen mazelen gevonden. Bij ruim, In the city of 's-Hertogenbosch people applying for a residence permit were tested for antibodies against mumps, measles, rubella, diphtheria, tetanus and poliomyelitis. For the residence permit a certificate of check on tuberculosis from the local municipal health service is also needed. When applying for this permit participants were asked to enroll in the study. This study was initiated to investigate the observation that some women of etnic origin at child-bearing age in Amsterdam had a significant lower percentage of antibodies against rubella than the percentage found in Dutch women, and henceforth rubella vaccination was recommended in women from foreign origin. The antibody tests included an Enzyme Linked Immunosorbent Assay (ELISA) for detecting mumps and measles antibodies, a Haemagglutination Inhibitiontest (HAI) for detecting rubella antibodies, a neutralization test for detecting poliomyelitis antibodies and a Toxin Binding Inhibition (ToBI) test for detecting diphtheria and tetanus. The antibody titres for mumps, measles, rubella and poliomyelitis proved almost similar to those in the Dutch population as assessed in other studies. Compared with the Dutch population of the same age (25-29 year) the immunity against diptheria and tetanus was lower ; however, compared with the Dutch population of age 35-39, who have not been vaccinated according to the national immunisation programme, the immunity of immigrants was higher. Low percentage of antibodies against rubella were not found.

RIVM rapport:Inleiding. Een belangrijke bijdrage aan het inzicht in het voorkomen van infectieziekten op basis van surveillance van gegevens uit morbiditeits- en mortaliteitsregistraties en van gegevens uit laboratoria, kan worden geleverd door serosurveillance: onderzoek naar de aanwezigheid van specifieke antistoffen in de populatie. Met name ter bewaking van de immuniteit van de bevolking voor de ziekten waartegen in het kader van het Rijksvaccinatieprogramma wordt gevaccineerd is sero- oftewel immunosurveillance noodzakelijk. Daarom zijn door het RIVM initiatieven ontwikkeld om een serumbank van een aselecte steekproef van de Nederlandse bevolking op te richten en is het zogenaamde PIENTER-project (Peiling Immunisatie Effect Nederland ter Evaluatie van het Rijksvaccinatieprogramma) van start gegaan. In 1994 werd een pilot-onderzoek uitgevoerd. Doel. Het pilotonderzoek had een tweeledig doel: ten eerste de beoordeling van de haalbaarheid van de opzet en het ontwerp van een in de praktijk getoetst protocol voor de uiteindelijke landelijke gegevensverzameling, ten tweede de toetsing van de mogelijkheid om met de gekozen opzet een representatieve dataset te verkrijgen (met behulp van uitgebreid non-respons-onderzoek waarvan in deel II van deze onderzoeksrapportage verslag wordt gedaan). Opzet. Een cross-sectioneel populatie-onderzoek werd uitgevoerd in de provincie Utrecht. Methode. In vier gemeenten werd een leeftijdsgestratificeerde steekproef van 510 inwoners (0-80 jaar) getrokken uit het bevolkingsregister. Van de beoogde deelnemers die schriftelijk werden benaderd werd verwacht dat zij een vragenlijst zouden invullen en een speciaal spreekuur bezoeken voor afname van een bloedmonster. De logistieke evaluatie vond plaats op grond van de ervaringen gedurende de pilot, deels vastgelegd in registraties en logboeken van de betrokken onderzoeksmedewerkers, deels ontleend aan de gegevens van een schriftelijke evaluatie met behulp van een vragenlijst voor alle externe participanten, Introduction. The occurrence of infectious diseases is monitored on the basis of surveillance data from morbidity and mortality registers and data from laboratories. Important additional information can be derived from serosurveillance: the study of the prevalence of specific antibodies in the population. Particularly for the control of the immunity for diseases against which people are vaccinated following the National Immunization Programme serosurveillance or immunosurveillance is necessary. Therefore, the RIVM has taken the initiative to establish a serum bank of a random sample of the Dutch population and the so-called PIENTER-project has been started. In 1994 a pilot study was carried out. Aim. The pilot study had a twofold aim: firstly, the assessment of the feasibility of the design and the development of an ascertained protocol for the final nation-wide data collection, secondly the judgement of the possibility to obtain a representative data set (by means of an comprehensive non-response investigation, which is described in part II of this report series). Design. A cross-sectional population-based study was done in the province of Utrecht. Methods. An age-stratified random sample of 510 inhabitants (0-80 years of age) was taken from the population registers of four municipalities. The intended participants who were approached by mail, were expected to fill in a questionnaire and to visit a clinic to allow blood to be taken. The evaluation of the logistics was based on the experience during the pilot, partly written down in registrations and personal logbooks of the study team, partly derived from a written questionnaire filled in by the concerned collaborators. Furthermore, the non-response study has offered leads for optimalization of the acquisition of participants. Findings and recommendations Data collection in the general population can be done in cooperation with Public Health Services with a central coordination. The cooperation between the many par

RIVM rapport:Inleiding Om de huidige immuunstatus van de Nederlandse bevolking te bepalen is het PIENTER-project (Peiling Immunisatie Effect Nederland ter Evaluatie van het Rijksvaccinatieprogramma) opgezet. In het kader van dit project wordt een serumbank opgericht, die sera moet bevatten van een representatieve steekproef van de Nederlandse bevolking. De serumbank wordt benut voor: 1. immunosurveillance onderzoek naar leeftijdspecifieke immuniteit tegen ziekten waartegen in het RVP wordt gevaccineerd ; 2. schatting van voorkomen van infectieziekten die vaak subklinisch verlopen ; 3. onderzoek naar prevalentie van serum-determinanten van andere ziekten. Om de haalbaarheid van een dergelijk project te toetsen is een pilot onderzoek uitgevoerd in de provincie Utrecht. Doel van dit pilot-onderzoek is, naast het toetsen van de logistiek en haalbaarheid van de onderzoeksopzet (zie deel 1 van de rapportage), inzicht te verkrijgen in redenen van weigering opdat responsverhogende maatregelen genomen kunnen worden in het hoofdonderzoek en het toetsen van representativiteit. Opzet. Non-responsonderzoek als onderdeel van een cross-sectioneel populatie onderzoek. Methode. Uit de provincie Utrecht is een naar inwonertal gewogen steekproef van gemeenten uitgevoerd. Uit bevolkingsregisters van vier gemeenten (Utrecht, Zeist, Amerongen en Woudenberg) is een naar leeftijd gestratificeerde steekproef getrokken van 510 personen. De beoogde respondenten werden gevraagd een vragenlijst in te vullen en een spreekuur voor bloedafname te bezoeken. Alle personen die niet hebben geparticipeerd aan de bloedafname zijn in de week na de bloedafname telefonisch of -indien dit onmogelijk was- schriftelijk benaderd voor het non-respons onderzoek. Van de non-respondenten zijn gegevens verzameld over reden van nonrespons, bereidheid tot deelname aan extra bloedafname spreekuur, vragenlijstgegevens over geloofs- of levensovertuiging, vaccinatiestatus, land van herkomst, sociaal-economische status en ervaren gezo, Introduction. A pilot study on the feasibility of the establishment of a serumbank of a representative sample of the Dutch general population was carried out. The aims of this so-called 'PIENTER-project' were to estimate: 1. age-specific immunity of the general population against childhood diseases of the Netherlands Immunization Programme, 2. the incidence of infectious diseases with a frequent subclinical course 3, the prevalence of serum-determinants of other illnesses. This report describes the results of the non-response study which was performed to obtain insight in the reasons for nonparticipation and to test the representativity. Design. Nonresponse study as part of a cross-sectional population survey. Methods. 510 persons in the age-strata (0, 1-4, 5-9 to 75-79 years) were randomly selected out of four municipalities in het Province of Utrecht. The participants have been asked to fill in a questionnaire and to visit a local health service to give some blood. The nonparticipants were contacted by telephone (or mail). In this nonresponsestudy data were obtained on the reasons for nonparticipation, willingness to visit additional hours to give blood. Information on religion, vaccination history, self-perception on health status, country of nationality and level of education were collected with a short questionnaire. Data obtained from the registries of the municipalities were age, sex, nationality and marital status. Part of the eligible persons received a written reminder. Differences between participants and nonparticipants were tested in logistic regression analyses. To get information on the immunity of nonparticipants and participants, the immunity against hepatitis A and measles was weighted by the variables in the logistic regression model. Results. Four groups of (non)participants were distinguished: 1. initial participants (n=714, 34%) ; 2. additional participants who visited the additional hours of the local health service to give blood (n=113, 6%)

RIVM rapport:Inleiding: Serosurveillance - onderzoek naar de aanwezigheid van specifieke antistoffen in de populatie - kan een belangrijke bijdrage leveren aan het inzicht in het voorkomen van infectieziekten. Met name ter bewaking van de immuniteit van de bevolking voor ziekten waartegen in het kader van het Rijksvaccinatieprogramma wordt gevaccineerd is sero- oftewel immunosurveillance van belang. In 1994 is als voorloper op een landelijk onderzoek een pilot-onderzoek voor het PIENTER-project (Peiling Immunisatie Effect Nederland ter Evaluatie van het Rijksvaccinatieprogramma) uitgevoerd. In het kader van dit project wordt een serumbank opgericht van een aselecte steekproef van de Nederlandse bevolking. Methode: Uit de provincie Utrecht is een naar inwonertal gewogen steekproef van gemeenten getrokken. Uit bevolkingsregisters van Utrecht, Zeist, Amerongen en Woudenberg is een naar leeftijd gestratificeerde steekproef (0, 1-4, 5-9 t/m 75-79 jaar) getrokken van 510 personen (N=2040). Van 827 personen kon een bloedmonster worden afgenomen. Daarin zijn antistofbepalingen verricht voor bof, mazelen, rubella, kinkhoest, Toxoplasma, Toxocara, T. spiralis en hepatitis A. De specifieke seroprevalentie werd berekend voor leeftijd, geslacht, ervaren gezondheid, sociaal economische status, geboorteland en religie. Resultaten: Voor bof, mazelen en rubella bedroeg het percentage seronegatieven resp. 2,4%, 1,8% en 2,4%. Ruim de helft van het aantal personen zonder aantoonbare antistoffen was jonger dan een jaar. Voor mannen was het percentage seronegatieven zowel voor bof, mazelen als rubella iets hoger (bof 3,7% vs. 2,2% ; mazelen 3,4% vs. 1,5% ; rubella 3,7% vs. 2,0%). Voor personen met een geloof waarbij vaccinaties principieel worden afgewezen, antroposofen en personen die niet tot een dergelijk geloof behoorden, bedroegen het percentage seronegatieven voor bof resp. 3,1%, 15,0% en 2,5%, voor mazelen resp. 0.9%, 6,1% en 1,9% en voor rubella 7,0%, 2,4% en 0,0%. In Woudenberg was het perce, Important information on the occurrence of infectious diseases can be derived from serosurveillance. In 1994 a pilot study for the PIENTER-project was carried out to investigate the feasibility of the establishment of a serum bank representatitive for the Dutch general population. As part of this pilot-study the seroprevalence was measured for mumps, measles, rubella, pertussis, Toxoplasmosis, Toxocara, T. spiralis and Hepatitis A in the 827 participants. The seroprevalences for mumps, measles and rubella was 97,6%, 98,2% and 97,6%, respectively. IgA-antibodies and/or IgG-antibodies against pertussis of at least 5 Units/ml were present for 61,3% and 35,6% of the participants. The seroprevalence for toxoplasma, toxocara and hepatitis A were 43%, 19% and 27,1%, respectively and increased with age. Only two participants had antibodies for T. spiralis. However, due to the small and non-representatitive sample in the pilot, it is impossible to make reliable conclusions. After the large scale nation-wide data collection that will be realised in 1995/1996 reliable seroprevalence estimates for the Dutch general population will become available.

RIVM rapport:INLEIDING In 1994 is als voorloper op een landelijk onderzoek een pilot-onderzoek voor het PIENTER-project (Peiling Immunisatie Effect Nederland ter Evaluatie van het Rijksvaccinatieprogramma) uitgevoerd. In het kader van dit project wordt een serumbank opgericht die sera moet bevatten van een representatitieve steekproef van de Nederlandse bevolking. Met behulp van deze gedefinieerde serumbank kan populatie-onderzoek worden verricht naar de immuniteit van ziekten uit het Rijksvaccinatieprogramma, naar het voorkomen van infectieziekten en naar serumderterminanten voor andere aandoeningen. Onderdeel van het pilot-onderzoek is de evaluatie van de vragenlijst zodat een vragenlijst kan worden ontwikkeld voor het landelijke onderzoek. DOEL Evaluatie van vragenlijst als onderdeel van een pilot van een cross-sectioneel populatie-onderzoek in de provincie Utrecht. METHODE Uit de provincie Utrecht is een naar inwonertal gewogen steekproef van gemeenten getrokken. Uit bevolkingsregisters van vier gemeenten (Utrecht, Zeist, Amerongen en Woudenberg) is een leeftijd gestratificeerde steekproef (leeftijdklassen 0, 1-4, 5-9 t/m 75-79 jaar) getrokken van 510 personen. Deelnemers werden gevraagd een vragenlijst in te vullen en deze tezamen met Rijksvaccinatieboekje, tropenvaccinatieboekje en militairpaspoort mee te nemen naar een spreekuur voor bloedafname. Inentingsgegevens uit deze boekjes werden op het spreekuur geregistreerd. De mening van de deelnemers over de lengte en duidelijkheid van vragen en frequenties van ontbrekende waarden zijn beschreven. Tevens zijn de naar leeftijd gewogen percentages voor de zelf-gerapporteerde vaccinatiestatus en de relatie met geloofs- of levensbeschouwelijke groepering beschreven. De zelf-gerapporteerde vaccinatiestatus voor DKTP en BMR zijn vergeleken met de vaccinatiestatus uit het Rijksvaccinatieboekje. De naar leeftijd gewogen percentages voor ervaren gezondheidstoestand, nationaliteit en hoogst voltooide opleiding zijn vergeleken met cijfe, INTRODUCTION In 1994 a pilot-study of the so-called PIENTER-project was carried out. The aim of this project is to establish a serum bank of a representative sample of the Dutch population. The serum bank will be used to estimate age-specific immunity of the general population against childhood diseases of the Netherlands Immunisation Programme, the incidence of infectious diseases with a frequent subclinical course and the prevalence of serum-derterminants of other illnesses. The questionnaire used in the pilot-study was evaluated in order to develop a questionnaire for the nation-wide data collection. AIM Evaluation of the questionnaire used for data collection in a pilot of a cross-sectional population-based study in the province of Utrecht. METHODS A sample of four municipalities weighted by the number of inhabitants was taken out of the municipalities in the Province of Utrecht. 510 persons in the age strata 0, 1-4, 5-9 to 75-79 years were randomly selected from the populations registers of these four municipalities. The participants have been asked to give some blood and to fill in a questionnaire. They have been requested to bring their vaccination certificates of the Dutch immunisation programme, of vaccination on the occasion travelling to the tropics and of military service. These vaccination data were registered on a study form. The opinion of the participants on the length and clarity of the questionnaire and the frequency of missing values for all questions were described. The population proportions weighted by age for self-reported vaccination history and the relation with religion were given. Self-reported vaccination history for diphteria, pertussis, tetanus, poliomyelitis and mumps, measles and rubella was compared with information on the vaccination history derived from the vaccination certificate of the Dutch immunisation programme. The proportions weighted by age for self-perception of health status, nationality and level of education were compar