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Background: Current guidelines of the "Centers for Disease Control and Prevention [CDC]" recommend routine screening for Hepatitis B before cytotoxic or immunosuppressive therapies are initiated. The national German guideline "Prophylaxis, diagnosis and therapy of hepatitis B virus infection" is in line with the CDC recommendations and underscores general HBV screening before immunosuppression is induced. However, screening adherence and acceptance of these guidelines vary in different oncological specialities. To assess the HBV screening adherence a retrospective study was performed., Patients and Methods: Data of 140 patients were analyzed retrospectively. 37 case-records did not meet inclusion criteria. Patients diagnosed with breast-cancer (n = 43) and Hodgkin's disease (n = 14) requiring chemotherapy were included, as well as patients receiving allogenic stem cell transplantation (SCTx) therapy (n = 22) or transarterial chemoembolization (TACE) therapy of the liver (n = 24). All included case-records were reviewed regarding HBV and HCV serology., Results: In the TACE group three patients were screened for HBsAg. Four patients with breast cancer and five patients in the Hodgkin disease group were screened for HBsAg. In contrast, screening adherence was 100 % in the group of patients receiving allogenic stem cell transplantation therapy (n = 22)., Conclusion: Apart from patients with allogenic stem cell transplantation, only some patients receiving immunosuppressive therapies had been screened for HBV infection. Our data indicate that standardized checklists may improve HBV screening previous to immunosuppressive therapies. These clinical structures have led to an almost optimal screening adherence in the high-risk group of allogenic SCTx patients., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background and Objective: Infections with pneumococcus have a high morbidity and mortality rate. The elderly and patients with an immunodeficiency are at particular risk. The increasing resistance of Streptococcus pneumoniae to antibiotics impairs effective treatment. Prophylactic vaccination is possible since 1977. The currently available 23-valent polysaccharide vaccine is effective against more than 90% of the most common pneumococcal serotypes. Although the STIKO (Ständige Impfkommission am Robert-Koch-Institut, Berlin) has been recommending vaccination for the elderly and at risk patients since 1995, only 6% of the elderly are vaccinated., Patients and Methods: In 1999 in a prospective observational study involving 4347 vaccinations, in addition to demographic and anamnestic data, the tolerability of Pneumovax 23 was documented by the physician on the basis of a score (very good/good/moderate/ poor). Adverse events (AE) were recorded on the questionnaire of the Paul Ehrlich Institute. 83.5% of the patients were older than 60 years and 44% had at least one additional chronic disease. Influenza vaccinationwas given simultaneously in 23%., Results: In 95.9% of the 4271 evaluable patients local, and in 97.3% systemic tolerability was assessed to be very good/good. Only in 1.4% (n = 60) of the patients were local and/or systemic adverse events seen., Conclusion: Pneumococcal vaccination--also in combination with influenza vaccine, is safe and cost-effective.

A new sandwich antigen enzyme-linked immunosorbent assay (ELISA) for the detection of Aspergillus galactomannan in blood plasma was compared with the latex-agglutination test by investigation of six patients with histologically proven invasive aspergillosis. The ELISA gave positive results in all six patients while the latex test recognized 5/6 as positive. On an average the antigen ELISA gave positive results 19 days earlier than the latex test.