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Objectives: Psychosomatic rehabilitation clinics represent an important branch of care with good treatment results in Germany. So far, however, it is largely unclear which processes underlie the treatment successes. In the partial evaluations of the Hersfeld catamnesis study presented here, recourse is made to the construct of mentalizing ability, which has become very important in recent psychotherapy research. Methods: The mentalization ability of a large sample (N = 559) was assessed with the help of the Mentalization Questionnaire (MZQ), and psychological and somatic complaints were assessed with HEALTH-PSB scale from HEALTH-49 at three points in time, namely at admission, at discharge and in a 6-month catamnesis. Results: Both the total score of the MZQ and all subscores show significant reductions in mentalization deficits in the small effect size range, the HEALTH-PSB in the high effect size range and the catamnesis in the medium effect size range. A regression analysis shows that the reduction in mentalization deficits has a high predictive power for symptom improvement. Conclusions: The results indicate that the construct of mentalization ability is a central target variable in psychosomatic rehabilitation.

Aim of the Study: Existing evaluation studies show the effectiveness of treatments in psychosomatic rehabilitation clinics. However, the clinics are facing new challenges, which can be attributed to the changes in the world of work, for example. At the same time, new patient groups such as older patients are coming more into focus, for whom the clinics are not yet sufficiently prepared. Against this background, an evaluation study was conducted in the Klinik am Hainberg, a psychosomatic rehabilitation clinic, to examine the changes in central dimensions of the outcome in psychosomatic medicine., Method: For the comparison of admission vs. discharge, data are available from a sample of 761 patients, of whom 559 still responded to the 6-month Follow-up) (73% response rate). Five modules of the HEALTH-49 were evaluated., Results: In all modules, improvements were found with medium to large effect sizes at discharge, and with medium effect sizes at 6-month Follow-up. Neither age, nor gender, nor time off work had an influence on the rehabilitation outcome. Only lower education was associated with less improvement., Conclusions: The results show the effectiveness of the treatments studied. The practiced rehabilitation concept seems to be effective even for patient groups that are particularly in focus, such as those with longer work incapacity or also older patients., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Human epidermal growth factor receptor 2 (HER2) is a central predictive biomarker in breast cancer. Inaccurate HER2 results in different laboratories could be as high as 20%. However, this statement is based on data generated more than 13 years ago and may not reflect the standards of modern diagnostic pathology. We compared central and local HER2 testing in a total of 1581 HER2-positive tumors from five clinical trials. We evaluated the clinical relevance for pathological complete response (pCR) and disease-free survival in a subgroup of 677 tumors, which received an anti-HER2 therapy. Over the period of 12 years, the discordance rate for HER2 decreased from 52.4 (GeparTrio) to 8.4% (GeparSepto). Discordance rates were significantly higher in hormone receptor (HR)-positive tumors (26.6%), compared to HR-negative tumors (16.3%, P<0.0001), which could be explained by a different distribution of HER2 mRNA levels in HR-positive and HR-negative tumors. pCR rates were significantly lower in discordant tumors (13.7%) compared to concordant tumors (32.2%, GeparQuattro and GeparQuinto, P<0.001). In survival analysis, tumors with discordant HER2 testing had a reduced overall survival (OS) in the HR-negative group (P=0.019) and a trend for improved OS in the HR-positive group (P=0.125). The performance of local HER2 testing was considerably improved over time and has reached a 92% concordance, which shows that quality initiatives in diagnostic pathology are working. Tumors with discordant HER2 testing had a reduced therapy response and different survival rates.

In higher age, various diseases are more frequently present and occur in combination, with diabetes mellitus representing the comorbidity seen most frequently. Within the framework of a retrospective study, it has been evaluated whether the degree of metabolic compensation has an influence on the activities of daily life in geriatric patients after an acute event and following rehabilitation treatment. For this purpose over a period of 27 months (01/02/2000 - 03/31/2002), diabetic patients of a Saxonian geriatric center (n = 644, mean age 77.86 years/SD 7.115, 30.3% males) were examined before, directly after, and 2 - 3 years after rehabilitation. Independent of age, rehabilitation resulted in a significant increase in activities of daily living (ADL, Barthel index); however, after 2 - 3 years these values decreased again, not depending on age, but they remained significantly above the baseline values (multiple comparison of mean values). The values at the time of dismissal did not depend on metabolic parameters. The result of the rehabilitation treatment checked by means of a questionnaire 2 - 3 years after dismissal showed clear advantages for those patients having a near-normal compensation of metabolism. When HbA1c was below 7% at the time-point of the geriatric rehabilitation the Barthel index score in the questionnaire was found to be significantly higher (multiple comparisons of mean values) than in patients with a HbA1c of 7% or higher. With increasing age, the danger of hypoglycemia was seen to be significantly elevated (Fisher's exact test).

Human bocavirus (HBoV) was recently detected in samples from children and infants with infections of the respiratory tract. Here we analyze the prevalence of IgG and IgM antibodies against HBoV virus-like VP2 particles in healthy adult blood donors and children using a newly established standardized enzyme-linked immunosorbent assay. Virus-specific IgG antibodies were frequently detected in infants with active viremia and respiratory illness (10/24, 42%) and in young children without detectable HBoV genomes in their blood (27/52, 52%). In sera obtained from healthy adults, ubiquitous VP2-specific antibodies were found in 280/299 (94%) cases. HBoV-specific IgM antibodies were detected in 10/24 (42%) of sera samples obtained from HBoV DNA-positive children, and in 6/24 (25%) the sera displayed equivocal responses. In contrast, VP2-specific IgM was not detectable in samples obtained from 52 children without detectable amounts of HBoV genomes in their blood. Only 2/299 sera samples from healthy adult blood donors were found to be IgM-positive (1%), and equivocal IgM responses were observed in 9/299 (3%) individuals. In conclusion, a high IgG seroprevalence of HBoV in the adult population was observed, whereas the presence of virus-specific IgM was associated with viremia. These data show that ELISA test systems for the detection of HBoV-specific antibodies are a valuable tool for serological diagnosis of this new emerging pathogen.

The study objective was to get more information on characteristics of ozone risk groups. We performed repeated (on average 16 times) lung function tests and interviews with 171 persons belonging to four different population subgroups (44 healthy children, 43 juvenile asthmatics, 43 athletes, and 41 elderly). The environmental half hour mean ozone concentrations ranged from 8 to 99 ppb. For two groups there was significant NO2 co-pollution. The asthmatics showed statistically significant ozone related increased ORs for eye irritations, the elderly for nose irritations. Significant lung function decrements (increase in ozone by 50 ppb) were found for asthmatics (FVC -4.3% afternoon one day lag, -4.9% afternoon two day lag, -3.6% morning one day lag) and children (FVC -3.2% same morning, PEF -11.9% same morning, PEF -4.6% morning one day lag). In the group of elderly, however, there were also some significant FVC and PEF increments. Ozone responders were found more often in the groups of asthmatics and children (21% resp. 18%) compared with elderly and athletes (both 5%). The results suggest that children and asthmatics have a higher risk of being ozone sensitive showing more ozone related acute lung function decrements than other population groups.

Measurements with a body plethysmograph of lung function parameters and reports of unusual complaints or irritations were taken from 41 senior citizens in the situations where they usually spend their daytime hours. The subjects belonged to a group commonly assumed to be at risk from ozone. Each subject was examined on 8 days both in the morning and in the afternoon. The object was to obtain for every subject an equal distribution of measuring days between those with elevated ozone concentrations (maximum 0.5 h mean values between 1.00 and 4.00 p.m. of at least 0.050 ppm) and those with low ozone concentrations (maximum 0.5 h mean values between 1.00 and 4.00 p.m. of at most 0.040 ppm). The results showed no relevant ozone related effects on the lung function parameters or the subjective reports of irritations. Thus there was no indication that senior citizens represent a group at particular risk with respect to moderately elevated concentrations of environmental ozone, as occur in central Europe.