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Hematologic and oncologic patients with chemo- or immunotherapy-related immunosuppression are at substantial risk for bacterial infections and Pneumocystis jirovecii pneumonia (PcP). As bacterial resistances are increasing worldwide and new research reshapes our understanding of the interactions between the human host and bacterial commensals, administration of antibacterial prophylaxis has become a matter of discussion. This guideline constitutes an update of the 2013 published guideline of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO). It gives an overview about current strategies for antibacterial prophylaxis in cancer patients while taking into account the impact of antibacterial prophylaxis on the human microbiome and resistance development. Current literature published from January 2012 to August 2020 was searched and evidence-based recommendations were developed by an expert panel. All recommendations were discussed and approved in a consensus conference of the AGIHO prior to publication. As a result, we present a comprehensive update and extension of our guideline for antibacterial and PcP prophylaxis in cancer patients.

[EN] Background: As people become older, the biological process of aging leads to a decline in functional capabilities, which entails difficulties in the performance of daily tasks. Within the "Active and Assisted Living Joint Programme" a consortium from Spain, Germany, and Switzerland developed an interactive Exergame software for older adults to maintain their physical abilities and independence within the daily tasks. Subjects and Methods: An interventional study was conducted to validate the software. For 3 months, Swiss and Spanish seniors used the system at least three times a week for minimum half an hour in their homes. The physical condition in terms of maintaining or increasing strength, balance, safety, and mobility of the seniors was assessed by using the Berg Balance Scale and the Senior Fitness Test. In addition, the effect on independence within the activities of daily living was assessed by using the Canadian Occupational Performance Measure, the Performance Quality Rating Scale, and the Iconographical Falls Efficacy Scale. We used the EQ 5D to evaluate the "quality of life." Results: Twenty-nine participants (male; n= 14; female; n= 15) completed the study. Scores of endurance (2 minutes step test; P=0.01, eta(2) = 0.3) increased significantly. Moderate effect sizes in quality of life (r= 0.3), lower body strength (eta(2)= 0.08), and large effect sizes in endurance (eta(2) = 0.3) were detected. A small effect was evaluated within the gait speed (r= 0.2), mobility in the lower body (r= 0.2), and the balance capabilities (r= 0.2). Conclusion: The results of this study lead us to the conclusion that physical training with activity-focused exergames that are related to the everyday tasks of older adults could help to maintain and improve the individual fitness status.

Background: As people become older, the biological process of aging leads to a decline in functional capabilities, which entails difficulties in the performance of daily tasks. Within the ‘‘Active and Assisted Living Joint Programme’’ a consortium from Spain, Germany, and Switzerland developed an interactive Exergame software for older adults to maintain their physical abilities and independence within the daily tasks. Subjects and Methods: An interventional study was conducted to validate the software. For 3 months, Swiss and Spanish seniors used the system at least three times a week for minimum half an hour in their homes. The physical condition in terms of maintaining or increasing strength, balance, safety, and mobility of the seniors was assessed by using the Berg Balance Scale and the Senior Fitness Test. In addition, the effect on independence within the activities of daily living was assessed by using the Canadian Occupational Performance Measure, the Performance Quality Rating Scale, and the Iconographical Falls Efficacy Scale. We used the EQ 5D to evaluate the ‘‘Quality of Life.’’ Results: Twenty-nine participants (male; n = 14; female; n = 15) completed the study. Scores of endurance (2 minutes step test; P= 0.01, g2 = 0.3) increased significantly. Moderate effect sizes in quality of life (r= 0.3), lower body strength (g2 = 0.08), and large effect sizes in endurance (g2 = 0.3) were detected. A small effect was evaluated within the gait speed (r= 0.2), mobility in the lower body (r= 0.2), and the balance capabilities (r= 0.2). Conclusion: The results of this study lead us to the conclusion that physical training with activity-focused exergames that are related to the everyday tasks of older adults could help to maintain and improve the individual fitness status.

We examine the proposition of a stationary assistive robot arm in the kitchen. Based on a preliminary business plan and with the aim of generating engineering requirements, a multi-disciplinary project was established to examine the wider ramifications of such assistive technology in the household, in a Swiss context, in the fields of health and social wellbeing. Additionally the engineering aspects as well as the business aspects were examined. We detail both the individual methodologies used in this study, the results achieved and discuss the results in a wider context.

Despite the fact that professional translation is characterized by human-machine interaction, the ergonomics of the professional translation workplace is relatively under-researched. In order to gain further insights into how translators worldwide have set up and organized their workplaces, an anonymous online survey was developed by a team of researchers in translation studies and occupational therapy as part of an interdisciplinary project. It was made available in six languages (English, French, German, Italian, Portuguese, and Spanish) and distributed through multipliers such as professional organizations. The interest that this topic generated in the professional community was reflected not only in the large number of completed questionnaires (1,850) but also by the comments provided by translators both in the survey itself and in email messages to the research team. This paper reports on the findings of the survey with a focus on differences existing among commercial, institutional, and freelance translators in different countries and the degree to which language technology is involved in professional translation. Findings are compared to good practice recommendations for computer work, and conclusions are drawn with respect to health issues related to suboptimal ergonomics. Alors même que la traduction professionnelle se caractérise par une interaction entre l’humain et la machine, l’ergonomie chez les traductrices et traducteurs professionnels reste un domaine relativement peu exploré. Dans le but de recueillir des informations sur la façon dont les traductrices et traducteurs à travers le monde ont agencé et organisé leur poste de travail, des chercheuses en traductologie et en ergothérapie ont réalisé une étude en ligne anonyme dans le cadre d’un projet interdisciplinaire. Traduit en six langues (français, anglais, allemand, italien, portugais et espagnol), le questionnaire relatif à cette étude fut envoyé par des multiplicateurs, par exemple des organisat

Most professional translators in the Western world are heavy computer users and thus may be exposed to health risks known to be associated with computer work. These include musculoskeletal ailments of the upper extremities, back, shoulders, arms, hands and problems with the eyes. This paper reports on the findings of workplace assessments and interviews with professional translators with respect to the ergonomics of their workplaces and related health issues. A total of 36 professional translators working as freelancers, in institutional settings or in commercial enterprises were visited at their workplaces. Each workplace was assessed and compared to the recommendations about ergonomics available in the literature. In addition, interviews were held with translators immediately after the assessments about their current health status and any recent complaints. Many of the assessed workplaces evinced a high standard of ergonomically appropriate equipment and furniture. However, the equipment was in many cases not adjusted to suit the ergonomic needs of the individual using the workplace. Although the level of complaints was low overall, the highest number of health complaints related to the eyes, eck and shoulder girdle. Frequent breaks, changing position and doing short exercises to loosen up tense muscles would address these problems by helping to reduce tension and pain in the neck, shoulders and back and by providing rest for the eyes. Whenever possible, an ergonomic consultation is recommended. It is also recommended that ergonomic knowledge about proper workplace set-up should be provided in professional training.

Hintergrund: Ältere Menschen wünschen sich möglichst lange unabhängig in der eigenen Wohnung leben zu können. Insbesondere das Arbeiten in der Küche stellt jedoch eine grosse Herausforderung dar. Im Rahmen eines interdisziplinären Projekts untersuchten Forschende der Zürcher Hochschule für angewandte Wissenschaften, der FH St. Gallen verschiedene Fragestellungen, die das Arbeiten älterer Menschen in der Küche betreffen. Das Projekt wurde von der Walder Stiftung finanziert und von Pro Senectute unterstützt. Ziele der Studie: Hauptziel der Studie war es festzustellen, ob ein Roboterarm eine sinnvolle und wirtschaftlich machbare Unterstützung für ältere Menschen in der Küche sein könnte. Dazu wurden folgende Fragestellungen untersucht: - Wie verändert sich die Bedeutung der Küche und des Kochens im Laufe des Lebens? - Welche Einschränkungen erfahren ältere Menschen während der Küchenarbeiten? - Unter welchen Bedingungen würden sie einen Roboterarm akzeptieren? - Wie gross ist das Marktpotential und welche Marktzugänge wären erfolgsversprechend? - Sind die Anforderungen der Personen und des Marktes technisch realisierbar? Methodik: Neben einer Literaturrecherche wurden eine Fokusgruppe und zwei Gruppeninterviews durchgeführt. Mit Hilfe einer Marktanalyse wurde die Wirtschaftlichkeit eines Roboterarms untersucht. Resultate: Die Bedeutung des Kochens verändert sich im Alter. Unterstützung wünschen sie die Teilnehmenden der Fokusgruppen insbesondere bei Tätigkeiten, die viel Kraft und Geschicklichkeit erfordern, die Mobilität betreffen und die unbeliebt und zeitaufwendig sind (z.B. Reinigungsarbeiten). In der Fokusgruppe konnte eine grundsätzliche Offenheit und Technikbereitschaft festgestellt werden. Besonders Menschen mit starken Einschränkungen eigenen sich hilfreiche Strategien an, um den Küchenalltag einfacher zu gestalten. Die Untersuchung der Wirtschaftlichkeit und technischen Machbarkeit ergab, dass der Einbau eines Roboterarms in bestehende Küchen aufgrund der Kos

In dem EU-Projekt "WeTakeCare" wird ein interaktives Computerprogramm entwickelt, welches das Training von Fitness- und Alltagsaktivitäten auf der Basis der Microsoft Kinect Bewegungserkennung ermöglicht und Betroffene wie Angehörige durch Informationen und Vernetzung mit anderen unterstützt. Ziel des Programm ist es, dass ältere, leicht bis moderat körperlich eingeschränkte Personen weiterhin in ihrem Alltag unabhänig bleiben.

Invasive aspergillosis (IA) is a serious hazard to high-risk haematological patients. There are increasing reports of azole-resistant Aspergillus spp. This study assessed the epidemiology of IA and azoleresistant Aspergillus spp. in patients with acute leukaemia in Germany. A prospective multicentre cohort study was performed in German haematology/oncology centres. The incidence of probable and proven aspergillosis according to the revised EORTC/MSG criteria was assessed for all patients with acute leukaemia [acutemyeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL)]. Caseswere documented into a web-based case report form, and centres provided data on standards regarding prophylactic and diagnostic measures. Clinical isolates were screened centrally for azole resistance and, if applicable, underlying resistance mechanisms were analysed. Between September 2011 and December 2013, 179 cases of IA [6 proven (3.4%) and 173 probable (96.6%)] were diagnosed in 3067 patients with acuteleukaemia. The incidence of IA was 6.4% among 2440 AML patients and 3.8% among 627 ALL patients. Mortality at Day 84 was 33.8% (49/145) and attributable mortality was 26.9% (39/145). At Day 84, 53 patients (29.6%) showed a complete response, 25 (14.0%) a partial response and 17 (9.5%) a deterioration or failure. A total of 77 clinical Aspergillus fumigatus isolates were collected during the study period. Two episodes of azole-resistant IA (1.1%) were caused by a TR/L98H mutation in the cyp51A gene. With only two cases of IA due to azole-resistant A. fumigatus, a change of antifungal treatment practices in Germany does not appear warranted currently. (C) 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Infectious complications after allogeneic haematopoietic stem cell transplantation (allo-HCT) remain a clinical challenge. This is a guideline provided by the AGIHO (Infectious Diseases Working Group) of the DGHO (German Society for Hematology and Medical Oncology). A core group of experts prepared a preliminary guideline, which was discussed, reviewed, and approved by the entire working group. The guideline provides clinical recommendations for the preventive management including prophylactic treatment of viral, bacterial, parasitic, and fungal diseases. The guideline focuses on antimicrobial agents but includes recommendations on the use of vaccinations. This is the updated version of the AGHIO guideline in the field of allogeneic haematopoietic stem cell transplantation utilizing methods according to evidence-based medicine criteria.

Reactivation of viral infections is common in patients with solid tumour or haematological malignancy. Incidence and severity depend on the extent of cellular immunosuppression. Antiviral prophylaxis may be effective to prevent viral reactivation. In 2006, the Infectious Diseases Working Party of German Society for Hematology and Medical Oncology (DGHO) published guidelines for antiviral prophylaxis in these patient populations. Here, we present an update of these guidelines for patients with solid and haematological malignancies undergoing antineoplastic treatment but not allogeneic stem cell transplantation. Relevant literature for reactivation of different viruses (herpes simplex virus (HSV), varicella zoster virus (VZV), hepatitis B virus (HBV) and respiratory viruses) is discussed to provide evidence-based recommendations for clinicians taking care of this patient population. We recommend a risk-adapted approach with (val)acyclovir against HSV and VZV in patients treated with alemtuzumab, bortezomib or purine analogues. Seasonal vaccination against influenza is recommended for all patients with solid or haematological malignancies regardless of antineoplastic therapy. Hepatitis B screening is recommended in lymphoproliferative disorders, acute leukaemia, and breast cancer, and during treatment with monoclonal anti-B-cell antibodies, anthracyclines, steroids and in autologous stem cell transplantation. In those with a history of hepatitis B prophylactic lamivudine, entecavir or nucleotide analogues as adefovir are recommended to prevent reactivation.

Particulate vaccine formulations, designed to improve the delivery of antigens to antigen-presenting cells (APCs) and to stimulate an immune response, have been shown to activate the NLRP3 inflammasome. This leads to the processing and secretion of interleukin (IL)-1β, which supports the recruitment of pro-inflammatory immune cells into the tissue and can therefore be beneficial for vaccine potency. Recent work suggested that this may be a common mechanism of action for all particulate formulations. The aim of this study was to investigate whether the activation of the NLRP3 inflammasome was common to many delivery systems. We prepared polymer-based chitosan nanoparticles (CNPs), lipid-based cubosomes, a water in oil emulsion of incomplete Freund's adjuvant (IFA) and alum formulations and examined inflammasome activation in vitro using murine bone-marrow-derived dendritic cells and human peripheral blood mononuclear cells and in vivo in mice. The formulations differed in their morphology, size and zeta-potential. Only the positively charged particles (CNPs and alum) were able to activate the inflammasome and increase the secretion of IL-1β. A decrease in the activation of the inflammasome with these particulates was observed when cathepsin B-mediated effects were blocked, implying a role of lysosomal rupture in the activation process. These findings demonstrate a role for the surface charge of particulates in the activation of the NLRP3 inflammasome, which should be considered when designing a novel vaccine formulation.Immunology and Cell Biology advance online publication, 1 April 2014; doi:10.1038/icb.2014.21.

The Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO) here presents its updated recommendations for the treatment of documented fungal infections. Invasive fungal infections are a main cause of morbidity and mortality in cancer patients undergoing intensive chemotherapy regimens. In recent years, new antifungal agents have been licensed, and agents already approved have been studied in new indications. The choice of the most appropriate antifungal treatment depends on the fungal species suspected or identified, the patient's risk factors (e.g., length and depth of neutropenia), and the expected side effects. This guideline reviews the clinical studies that served as a basis for the following recommendations. All recommendations including the levels of evidence are summarized in tables to give the reader rapid access to the information.

Invasive fungal infections cause substantial morbidity and mortality in immunocompromised patients, particularly in those with haematological malignancies and recipients of allogeneic haematopoietic stem cell transplantation. Difficulties in diagnosing invasive fungal infections and subsequent delays in treatment initiation lead to unfavourable outcomes and emphasise the importance of prophylaxis. Since the recommendations of the Infectious Diseases Working Party of the German Society for Haematology and Oncology in 2009, results of 14 additional clinical studies have been published comprising 2,899 patients and initiating this update. Key recommendations for adult patients are as follows: Posaconazole remains the drug of choice during remission-induction chemotherapy in acute myeloid leukaemia, myelodysplastic syndrome and allogeneic haematopoietic stem cell transplantation with graft versus host disease (AI). In the pre-engraftment period of allogeneic transplantation, several antifungals are appropriate and can be recommended with equal strength: voriconazole (BI), micafungin (BI), fluconazole (BI) and posaconazole (BII). There is poor evidence regarding antifungal prophylaxis in the post-engraftment period of allogeneic haematopoietic stem cell transplantation if no steroids for treatment of graft versus host disease are required. Aerosolised liposomal amphotericin B inhalation in conjunction with fluconazole can be used in patients with prolonged neutropenia (BII).