O presente estudo visou obter informações sobre a epidemiologia da erliquiose canina no Brasil, a partir da caracterização molecular de isolados nacionais e de estudo de prevalência da infecção em cães (Canis familiaris) e carrapatos Rhipicephalus sanguineus. Inicialmente, padronizou-se o isolamento de Ehrlichia canis em cultivo de células DH82, a partir de um cão inoculado com a cepa Jaboticabal, seguida da identificação do isolado pelo sequenciamento de DNA de um fragmento do gene dsb de Ehrlichia. Posteriormente, realizou-se o isolamento de E. canis de um cão naturalmente infectado, atendido no Hospital Veterinário (HOVET) da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo. Este novo isolado foi geneticamente caracterizado a partir da PCR almejando fragmentos dos genes dsb, 16S rRNA e P28. Com o estabelecimento do isolado Jaboticabal em cultivo celular, padronizou-se a Reação de Imunofluorescência Indireta (RIFI), utilizando-a em amostras de soros de 314 cães de áreas urbana e rural do Município de Monte Negro, RO. Finalmente, avaliou-se pela PCR do gene dsb, a freqüência de carrapatos infectados e de cães oriundos de quatro populações de R. sanguineus, uma do município de Monte Negro, RO. e três do estado de São Paulo. Do cão inoculado com o isolado Jaboticabal, constatou-se o crescimento de E. canis em cultivo celular, no 27o dia pós-inoculação, confirmado pela PCR e citologia. Após o seqüenciamento de DNA, o fragmento amplificado a partir do isolado apresentou-se 100% similar a seqüência correspondente ao gene dsb de E. canis depositada no GenBank. O isolamento de E. canis, a partir do cão atendido no HOVET, foi obtido no 14o dia pós-inoculação. Esta nova cepa, designada como isolado São Paulo, apresentou-se idêntica às seqüências do gene dsb e similares às seqüências dos genes 16S r RNA e P28, de outros isolados de E. canis disponíveis no GenBank. Dos soros testados pela RIFI, observou-se prevalência (títulos &plusmn; 40) de 31,2% (98/314), sendo 37,9% (58/153) em cães urbanos e 24,8% (40/161) em cães rurais (P < 0,05) de Monte Negro, Estado de Rondônia. A prevalência de carrapatos infectados (dada como freqüência mínima de infecção) foi de 2,3, 6,2, e 3,7% para as populações 1 (Monte Negro), 2 (Jundiaí, SP), e 3 (São Paulo I, SP), respectivamente (P > 0,05). Nenhum carrapato infectado foi detectado na população 4 (São Paulo II, SP). Os produtos da PCR dos carrapatos e de cães das populações 1, 2 e 3 foram idênticos entre si e à seqüência de E. canis disponível no GenBank. Estes resultados reforçam estudos anteriores, que relataram a infecção por E. canis em cães do Brasil, contudo descreve pela primeira vez no Brasil a infecção natural por E. canis em carrapatos R. sanguineus, tido como o principal carrapatos de cães no país. / The present study was conducted to investigate the canine ehrlichiosis epidemiology in Brazil, through molecular characterization of indigenous isolates and prevalence of infection in dogs (Canis familiaris) and Rhipicephalus sanguineus ticks. Firstly, it was performed the isolation of the Jaboticabal strain of Ehrlichia canis in DH82 cells from an experimentally infected dog, followed by molecular identification of the isolate by sequencing a fragment of the Ehrlichia dsb gene. After that, a new strain of E. canis was isolated from a naturally infected dog, assisted in the Veterinarian Hospital (HOVET) of the Faculty of Veterinary Medicine, University of São Paulo. This isolate was characterized by obtaining dsb, 16S rRNA and P28 nucleotide partial sequences. After the establishment of Jaboticabal strain in DH82 cells, an Indirect Immunofluorescence Test (IFAT) was developed, and 314 urban and rural dogs from Monte Negro Municipality were tested by this technique. Finally the prevalence of E. canis was determined in four different populations of Rhipicephalus sanguineus ticks, being one population from Monte Negro, RO. and three from different areas from São Paulo state using a PCR targeting an erlichial dsb gene fragment. Culture of E. canis Jaboticabal presented positive results by PCR on day 27. The dsb sequence was identical to other E. canis sequences available in GenBank. Cell culture inoculated with material from the dog assisted in the HOVET became positive by day 14 when dsb PCR was positive. This new strain was designated as isolate São Paulo of E. canis and showed to contain identical dsb and high similar partial sequences of 16S rRNA and P28 genes with others E. canis strains available in GenBank. Antibodies Anti-E. canis (titers &plusmn; 40) were detected in 31.2% (98/314) of the dogs, being 37.9% (58/153) in urban and 24.8% (40/161) in rural dogs of Monte Negro; these values were significantly different (P<0.05). The prevalence of infected ticks (given as minimal infection rate) was 2.3, 6.2, and 3.7% for populations 1 (Monte Negro), 2 (Jundiaí, SP), and 3 (São Paulo I, SP), respectively, which were statistically similar (P>0.05). In contrast, no infected tick was detected in population 4 (São Paulo II, SP). DNA sequences were determined for some of the PCR products generated from ticks and dogs from populations 1-3, being all identical to each other and to available sequences of E. canis. These results reinforce previous studies that reported E. canis infecting dogs in Brazil, but report for the first time in Brazil the natural infection of E. canis in its vector, R. sanguineus, which is the commonest tick infesting dog in this country.

Thesis (M.S.P.H.)--University of South Florida, 2009. / Title from PDF of title page. Document formatted into pages; contains 68 pages. Includes bibliographical references.

Resumo: A presença de doenças sistêmicas, uso de medicamentos, e uso de próteses removíveis, entre outros fatores, podem alterar o equilíbrio fisiológico da cavidade bucal favorecendo o estabelecimento de diversas alterações e/ou patologias bucais. Assim, o estudo das prevalências destes fatores, nos pacientes odontológicos, tornam-se importantes pois devem ser considerados para elaborar o diagnóstico e definir a conduta terapêutica. Com o objetivo de delinear um perfil, avaliamos os prontuários de 500 usuários de próteses removíveis atendidos no Serviço de Medicina Bucal da Faculdade de Odontologia de Araraquara - UNESP. Analisamos os dados referentes a: características da população e das próteses removíveis, prevalência das doenças sistêmicas, uso de medicamentos e diagnóstico final das patologias ou alterações bucais. Os resultados obtidos nos permitem concluir que a maioria (74%) dos usuários de próteses removíveis eram mulheres brancas; metade da população pertencia a faixa etária de 41 a 60 anos e, quase a metade (49,2%) usava a combinação de prótese total superior e inferior. As doenças sistêmicas foram relatadas por 57,2% da amostra e a prevalência maior foi de doenças do sistema cardiovascular (25,4%). A maioria (60,4%) da população relatou uso de medicamentos e, dentre os mais freqüentes, a prevalência maior foram dos cardiovasculares (26,4%). A prevalência de patologias ou alterações bucais foi de 99,6%, sendo as relacionadas ao uso de próteses removíveis as mais freqüentes. Dentre estas, a candidose crônica atrófica ocorreu em 81,8% da população estudada e a hiperplasia fibrosa em 29,2%. / Abstract: Systemic diseases, the use of drugs and removable prosthetic appliance wearing, among others conditions, can influence the oral health, promoting the development of various oral mucosal disorders. Thus, the study of those informations on the dental patients becomes important and must be considered to estabilish the diagnosis and therapeutic management. The aim of this study was to provide descriptive epidemiologic information. For that task we have collected and analysed data from 500 files of patients, which are wearers of removable prosthetic appliances who attended at the Oral Medicine Service of Araraquara Dental School - UNESP. The results provide information about characteristics of the population and their removable appliances, prevalences of systemic diseases, use of drugs and diagnosis of oral diseases. The results allowed us to draw a profile of the population, concluding that the majority (74%) of the removable appliances wearers were white women, half of the sample with age between 41 to 60 years and almost half using an association of complete maxillary denture and complete mandibular denture. The health questionnaire indicated 57.2% of the population with systemic diseases, and the highest prevalence was of cardiovascular diseases (25.4%).The majority of the sample (60.4%) reported the use of drugs and the cardiovascular drugs were the more frequent (26.4%). The prevalence of oral diseases was 99.6%, the ones which were related with removable prosthetic were the most frequent. Among these, chronic atrophic candidosis was diagnosed in 81.8% of the sample and fibrous hyperplasia in 29.2%.

O presente estudo visou obter informações sobre a epidemiologia da erliquiose canina no Brasil, a partir da caracterização molecular de isolados nacionais e de estudo de prevalência da infecção em cães (Canis familiaris) e carrapatos Rhipicephalus sanguineus. Inicialmente, padronizou-se o isolamento de Ehrlichia canis em cultivo de células DH82, a partir de um cão inoculado com a cepa Jaboticabal, seguida da identificação do isolado pelo sequenciamento de DNA de um fragmento do gene dsb de Ehrlichia. Posteriormente, realizou-se o isolamento de E. canis de um cão naturalmente infectado, atendido no Hospital Veterinário (HOVET) da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo. Este novo isolado foi geneticamente caracterizado a partir da PCR almejando fragmentos dos genes dsb, 16S rRNA e P28. Com o estabelecimento do isolado Jaboticabal em cultivo celular, padronizou-se a Reação de Imunofluorescência Indireta (RIFI), utilizando-a em amostras de soros de 314 cães de áreas urbana e rural do Município de Monte Negro, RO. Finalmente, avaliou-se pela PCR do gene dsb, a freqüência de carrapatos infectados e de cães oriundos de quatro populações de R. sanguineus, uma do município de Monte Negro, RO. e três do estado de São Paulo. Do cão inoculado com o isolado Jaboticabal, constatou-se o crescimento de E. canis em cultivo celular, no 27o dia pós-inoculação, confirmado pela PCR e citologia. Após o seqüenciamento de DNA, o fragmento amplificado a partir do isolado apresentou-se 100% similar a seqüência correspondente ao gene dsb de E. canis depositada no GenBank. O isolamento de E. canis, a partir do cão atendido no HOVET, foi obtido no 14o dia pós-inoculação. Esta nova cepa, designada como isolado São Paulo, apresentou-se idêntica às seqüências do gene dsb e similares às seqüências dos genes 16S r RNA e P28, de outros isolados de E. canis disponíveis no GenBank. Dos soros testados pela RIFI, observou-se prevalência (títulos &plusmn; 40) de 31,2% (98/314), sendo 37,9% (58/153) em cães urbanos e 24,8% (40/161) em cães rurais (P < 0,05) de Monte Negro, Estado de Rondônia. A prevalência de carrapatos infectados (dada como freqüência mínima de infecção) foi de 2,3, 6,2, e 3,7% para as populações 1 (Monte Negro), 2 (Jundiaí, SP), e 3 (São Paulo I, SP), respectivamente (P > 0,05). Nenhum carrapato infectado foi detectado na população 4 (São Paulo II, SP). Os produtos da PCR dos carrapatos e de cães das populações 1, 2 e 3 foram idênticos entre si e à seqüência de E. canis disponível no GenBank. Estes resultados reforçam estudos anteriores, que relataram a infecção por E. canis em cães do Brasil, contudo descreve pela primeira vez no Brasil a infecção natural por E. canis em carrapatos R. sanguineus, tido como o principal carrapatos de cães no país. / The present study was conducted to investigate the canine ehrlichiosis epidemiology in Brazil, through molecular characterization of indigenous isolates and prevalence of infection in dogs (Canis familiaris) and Rhipicephalus sanguineus ticks. Firstly, it was performed the isolation of the Jaboticabal strain of Ehrlichia canis in DH82 cells from an experimentally infected dog, followed by molecular identification of the isolate by sequencing a fragment of the Ehrlichia dsb gene. After that, a new strain of E. canis was isolated from a naturally infected dog, assisted in the Veterinarian Hospital (HOVET) of the Faculty of Veterinary Medicine, University of São Paulo. This isolate was characterized by obtaining dsb, 16S rRNA and P28 nucleotide partial sequences. After the establishment of Jaboticabal strain in DH82 cells, an Indirect Immunofluorescence Test (IFAT) was developed, and 314 urban and rural dogs from Monte Negro Municipality were tested by this technique. Finally the prevalence of E. canis was determined in four different populations of Rhipicephalus sanguineus ticks, being one population from Monte Negro, RO. and three from different areas from São Paulo state using a PCR targeting an erlichial dsb gene fragment. Culture of E. canis Jaboticabal presented positive results by PCR on day 27. The dsb sequence was identical to other E. canis sequences available in GenBank. Cell culture inoculated with material from the dog assisted in the HOVET became positive by day 14 when dsb PCR was positive. This new strain was designated as isolate São Paulo of E. canis and showed to contain identical dsb and high similar partial sequences of 16S rRNA and P28 genes with others E. canis strains available in GenBank. Antibodies Anti-E. canis (titers &plusmn; 40) were detected in 31.2% (98/314) of the dogs, being 37.9% (58/153) in urban and 24.8% (40/161) in rural dogs of Monte Negro; these values were significantly different (P<0.05). The prevalence of infected ticks (given as minimal infection rate) was 2.3, 6.2, and 3.7% for populations 1 (Monte Negro), 2 (Jundiaí, SP), and 3 (São Paulo I, SP), respectively, which were statistically similar (P>0.05). In contrast, no infected tick was detected in population 4 (São Paulo II, SP). DNA sequences were determined for some of the PCR products generated from ticks and dogs from populations 1-3, being all identical to each other and to available sequences of E. canis. These results reinforce previous studies that reported E. canis infecting dogs in Brazil, but report for the first time in Brazil the natural infection of E. canis in its vector, R. sanguineus, which is the commonest tick infesting dog in this country.

This paper provides a critical review of the prevalence of social phobia in European countries, a description of associated disability and burden and of clinical correlates and risk factors associated with social phobia. On the basis of a comprehensive literature search we identified 21 community studies and two primary care studies. The median lifetime and 12-month prevalence rates of social phobia in community samples referring to DSM-III-R and DSM-IV criteria were 6.65% and 2.0%, respectively. Younger individuals showed the highest rates, and women were more frequently affected than men. Social phobia was shown to be a persistent condition with a remarkably high degree of comorbid conditions, associated impairment and disability. Research deficits lie in a lack of data for most EU countries and in a lack of studies in children and the elderly. No data are available addressing met and unmet needs for intervention and costs, and data for vulnerability and risk factors of malignant course are scarce.

Com o objetivo de estudar a situação epidemiológica da leptospirose bovina, canina e humana nas propriedades rurais do município de Pirassununga, SP, partiu-se de um banco de soros e um banco de dados já estruturados de 86 propriedades amostradas. Através da técnica de soroaglutinação microscópica, 2259 soros de bovinos, 273 de cães e 445 de humanos foram examinados, empregando-se uma coleção de antígenos vivos de 24 sorovares de leptospiras. As prevalências aparentes de focos de leptospirose nas propriedades rurais de Pirassununga, segundo as espécies examinadas foram: 88,4% [79,7-94,3] para os bovinos, sendo Hardjo o sorovar mais provável, com 43,4% [32,1-55,3], seguido do Wolffi com 11,8% [5,6-21,3], Autumnalis e Patoc empatados em 5,3% [1,5-12,9], Australis com 3,9% [0,8-11,1], Hebdomadis com 2,6% [0,3-9,2] e Shermani com 1,3% [0-7,1]; 14,3% [7,4-24,1] para os cães, sendo Bratislava o sorovar mais provável, com 54,5% [23,4-83,3], seguido do Australis,Autumnalis e Pyrogenes empatados com 9,1% [0,2-41,3]; 14,1% [7,5-23,4] para os humanos, sendo Patoc o sorovar mais provável, com 58,3% [27,7-84,8], seguido pelo Pyrogenes com 16,7% [2,1-48,4] e empate entre os sorovares Bratislava, Autumnalis e Icterohaemorragiae com 8,3% [0,2-38,5] cada. A prevalência aparente da leptospirose nos bovinos da área rural do município de Pirassununga foi de 30,3% [28,4-32,2], nos cães de 5,1% [2,8-8,5] e nos humanos de 2,9% [1,6-4,9]. Os fatores de risco associados à condição de foco de leptospirose bovina para qualquer sorovar foram ter mais de 21 cabeças no rebanho, OR =14,354 [1,535-134,215] e presença de cocho para sal mineral, OR = 6,995 [1,180-41,470]. Os fatores de risco associados à condição de foco para os sorovares Hardjo e/ou Wolffi foram ter mais de 21 cabeças no rebanho, OR =15,750 [1,264- 196,269] e presença de cocho para sal mineral, OR = 6,537 [1,008-42,397]. Foram discutidas as implicações destes resultados para o entendimento da epidemiologia da leptospirose na área rural de Pirassununga e também foram feitas recomendações para o controle da doença no rebanho bovino. / With the aim of studying the epidemiologic situation of bovine, canine and human leptospirosis in rural area of Pirassununga, SP, it was used a serologic and data bank already structured of 86 sampled farms. Through the microscopic agglutination test, serum of 2259 bovines, 273 dogs e 445 humans were analyzed for the microscopic agglutination test, using a collection of 24 serovars of Leptospira. The prevalence of infected farms for leptospirosis, according to examined species, were: 88,4% [79,7-94,3] for cattle, where serotype Hardjo was the most often observed - 43,4% [32,1-55,3], followed by Wolffi with 11,8% [5,6-21,3], Autumnalis and Patoc with 5,3% [1,5-12,9] each, Australis with 3,9% [0,8-11,1],Hebdomadis with 2,6% [0,3-9,2] and Shermani with 1,3% [0-7,1].; 14,3% [7,4-24,1] for dogs, where serovar Bratislava was the most often observed with 54,5% [23,4-83,3], followed by Australis, Autumnalis and Pyrogenes with 9,1% [0,2-41,3] each and 14,1% [7,5-23,4] for humans, where serotype Patoc was the most often observed with 58,3% [27,7-84,8], followed by Pyrogenes with 16,7% [2,1-48,4] and Bratislava, Autumnalis and Icterohaemorragiae with 8,3% [0,2-38,5] each. The serologic prevalence of bovine leptospirosis in rural area of Pirassununga, SP, was 30,3% [28,4-32,2], canine leptospirosis was 5,1% [2,8-8,5] and human leptospirosis was 2,9% [1,6-4,9]. The study of risk factors showed that bovine leptospirosis caused by any serovar was associated with herds with more than 21 animals - OR =14,354 [1,535-134,215] ? and presence of mineralized salt feeder - OR = 6,995 [1,180-41,470]. The final model of logistic regression pointed as risk factors of bovine leptospirosis caused by serovars Hardjo and/or Wolffi herds with more than 21 animals - OR =15,750 [1,264-196,269] - and presence of mineralized salt feeder - OR = 6,537 [1,008-42,397]. The impact of these results was discussed in relation to the epidemiology of leptospirosis in rural area of Pirassununga and suggestions were also made in order to control this disease in cattle.

Com o objetivo de estudar a situação epidemiológica da leptospirose bovina, canina e humana nas propriedades rurais do município de Pirassununga, SP, partiu-se de um banco de soros e um banco de dados já estruturados de 86 propriedades amostradas. Através da técnica de soroaglutinação microscópica, 2259 soros de bovinos, 273 de cães e 445 de humanos foram examinados, empregando-se uma coleção de antígenos vivos de 24 sorovares de leptospiras. As prevalências aparentes de focos de leptospirose nas propriedades rurais de Pirassununga, segundo as espécies examinadas foram: 88,4% [79,7-94,3] para os bovinos, sendo Hardjo o sorovar mais provável, com 43,4% [32,1-55,3], seguido do Wolffi com 11,8% [5,6-21,3], Autumnalis e Patoc empatados em 5,3% [1,5-12,9], Australis com 3,9% [0,8-11,1], Hebdomadis com 2,6% [0,3-9,2] e Shermani com 1,3% [0-7,1]; 14,3% [7,4-24,1] para os cães, sendo Bratislava o sorovar mais provável, com 54,5% [23,4-83,3], seguido do Australis,Autumnalis e Pyrogenes empatados com 9,1% [0,2-41,3]; 14,1% [7,5-23,4] para os humanos, sendo Patoc o sorovar mais provável, com 58,3% [27,7-84,8], seguido pelo Pyrogenes com 16,7% [2,1-48,4] e empate entre os sorovares Bratislava, Autumnalis e Icterohaemorragiae com 8,3% [0,2-38,5] cada. A prevalência aparente da leptospirose nos bovinos da área rural do município de Pirassununga foi de 30,3% [28,4-32,2], nos cães de 5,1% [2,8-8,5] e nos humanos de 2,9% [1,6-4,9]. Os fatores de risco associados à condição de foco de leptospirose bovina para qualquer sorovar foram ter mais de 21 cabeças no rebanho, OR =14,354 [1,535-134,215] e presença de cocho para sal mineral, OR = 6,995 [1,180-41,470]. Os fatores de risco associados à condição de foco para os sorovares Hardjo e/ou Wolffi foram ter mais de 21 cabeças no rebanho, OR =15,750 [1,264- 196,269] e presença de cocho para sal mineral, OR = 6,537 [1,008-42,397]. Foram discutidas as implicações destes resultados para o entendimento da epidemiologia da leptospirose na área rural de Pirassununga e também foram feitas recomendações para o controle da doença no rebanho bovino. / With the aim of studying the epidemiologic situation of bovine, canine and human leptospirosis in rural area of Pirassununga, SP, it was used a serologic and data bank already structured of 86 sampled farms. Through the microscopic agglutination test, serum of 2259 bovines, 273 dogs e 445 humans were analyzed for the microscopic agglutination test, using a collection of 24 serovars of Leptospira. The prevalence of infected farms for leptospirosis, according to examined species, were: 88,4% [79,7-94,3] for cattle, where serotype Hardjo was the most often observed - 43,4% [32,1-55,3], followed by Wolffi with 11,8% [5,6-21,3], Autumnalis and Patoc with 5,3% [1,5-12,9] each, Australis with 3,9% [0,8-11,1],Hebdomadis with 2,6% [0,3-9,2] and Shermani with 1,3% [0-7,1].; 14,3% [7,4-24,1] for dogs, where serovar Bratislava was the most often observed with 54,5% [23,4-83,3], followed by Australis, Autumnalis and Pyrogenes with 9,1% [0,2-41,3] each and 14,1% [7,5-23,4] for humans, where serotype Patoc was the most often observed with 58,3% [27,7-84,8], followed by Pyrogenes with 16,7% [2,1-48,4] and Bratislava, Autumnalis and Icterohaemorragiae with 8,3% [0,2-38,5] each. The serologic prevalence of bovine leptospirosis in rural area of Pirassununga, SP, was 30,3% [28,4-32,2], canine leptospirosis was 5,1% [2,8-8,5] and human leptospirosis was 2,9% [1,6-4,9]. The study of risk factors showed that bovine leptospirosis caused by any serovar was associated with herds with more than 21 animals - OR =14,354 [1,535-134,215] ? and presence of mineralized salt feeder - OR = 6,995 [1,180-41,470]. The final model of logistic regression pointed as risk factors of bovine leptospirosis caused by serovars Hardjo and/or Wolffi herds with more than 21 animals - OR =15,750 [1,264-196,269] - and presence of mineralized salt feeder - OR = 6,537 [1,008-42,397]. The impact of these results was discussed in relation to the epidemiology of leptospirosis in rural area of Pirassununga and suggestions were also made in order to control this disease in cattle.

Einleitung: Im Rahmen eines Projekts wird untersucht, ob sich medizinische Laien mit einem neugestalteten internetbasierten Informationssystem besser informieren können, als dieses mit Suchmaschinen und Gesundheitsportalen möglich ist. Die Evaluation eines Systems zur Informationsversorgung von Kopfschmerzpatienten ist nur dann sinnvoll, wenn tatsächlich viele Menschen im deutschsprachigen Raum unter Kopfschmerzen leiden und mit Ihren Beschwerden eher das Internet als einen Arzt konsultieren. Daher wurde in drei Studien die Prävalenz von Kopfschmerzen und die damit verbundene Arztkonsultationsquote untersucht. Methode: Dazu wurden 2000 Versicherte der BARMER Ersatzkasse, ca. 9000 Studenten der Hochschule Bremen und ca. 1000 Studenten der Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik in Tirol, Österreich (UMIT) angeschrieben und gefragt, ob sie unter Kopfschmerzen leiden und wenn ja, ob sie für ihre Kopfschmerzen bereits eine ärztliche Diagnose haben. Insgesamt nahmen 521 Personen an der Untersuchung teil. Ergebnisse: Davon litten 292 Teilnehmer (56 %) unter Kopfschmerzen. Eine ärztliche Diagnose für diese hatten 52 (18 %). Alles in allem zeigt sich damit eine etwas geringere Kopfschmerzprävalenz als in den vorangegangen Studien. Die in der Literatur genannte Arztkonsultationsquote wird bestätigt. Diskussion: Die Auswertung der drei Studien zeigte, dass die Prävalenz von Kopfschmerzen weiterhin hoch und die damit verbundene Arztkonsultationsquote immer noch gering ist. / Introduction: In a project, it is investigated whether a newly designed web-information system can better inform medical laymen than traditional search engines and health portals. The evaluation of a system for providing information to headache patients is only useful when in fact many people suffer from headaches in the German speaking area and if these people with their complaints rather consult the Internet than a practitioner. Therefore, in three studies the prevalence of headache and the associated physician consultation rate was examined. Method: About 9000 students of the University of Applied Sciences Bremen, 2000 insurants of the BARMER, and about 1000 students of the University of Health Sciences, Medical Informatics and technology Tyrol, Austria (UMIT) were asked if they suffer from headaches and if so whether they already have a medical diagnosis. A total of 521 persons participated in the investigation. Results: From headaches suffered 292 (56%) participants. A medical diagnosis for these had 52 (18%). All in all, it shows slightly lower headache prevalence than found in previous studies. The medical consultation rate cited in the literature is confirmed. Discussion: The evaluation of the three studies showed that the prevalence of headache remains high and the associated physician consultation rate is still low.

Auf der Grundlage der Basisuntersuchung einer epidemiologischen prospektiven Verlaufsstudie (1995–1999) an 3021 Personen im Alter zwischen 14 und 24 Jahren werden epidemiologische Befunde zur Häufigkeit von somatoformen Beschwerden und somatoformen Syndromen/Störungen bei Jugendlichen und jungen Erwachsenen berichtet. Die Jugendlichen und jungen Erwachsenen wurden mit Hilfe des M-CIDI, einem standardisierten Interview zur Erfassung psychischer Symptome, Syndrome und Störungen nach dem DSM-IV, befragt. Die Ergebnisse der ersten Untersuchung zeigen, daß 50% der Jugendlichen einmal in ihrem bisherigen Leben unter einem somatoformen Symptom litten. Junge Frauen berichten häufiger von somatoformen Beschwerden als junge Männer (61 vs. 40%). Die im DSM-IV operationalisierten Kriterien einer somatoformen Störung werden nur von wenigen Jugendlichen und jungen Erwachsenen (2,7%) erfüllt. Die Prävalenz erhöht sich jedoch, wenn man nicht ausschließlich voll ausgeprägte somatoforme Störungen, sondern zusätzlich unterschwellige Syndrome in die Betrachtung einschließt: Hier berichten etwa 11% der Jugendlichen von somatoformen Syndromen. Somatoforme Störungen/Syndrome zeigen sich häufig im Verbund mit anderen psychischen Störungen, wobei die Komorbidität mit dem Alter zunimmt. Wie unsere Analysen ergaben, berichten Jugendliche und junge Erwachsene mit somatoformen Störungen, aber auch solche mit unterschwelligen Syndromen, vermehrt Beeinträchtigungen in verschiedenen sozialen Rollenbereichen und der Arbeitsproduktivität. / As part of a longitudinal study, prevalence findings of somatoform symptoms, syndromes and disorders are presented for a random sample of 3021 respondents aged 14 to 24 years. The response rate was 71%. Assessment was made using the computer- assisted Munich-Composite International Interview (M-CIDI). Findings of the first part of the study revealed that 50% (men: 40%; women: 61%) of the sample once had a somatoform symptom in their life. Threshold somatoform disorders were rare with 2.7%. However, when including subthreshold somatoform syndromes (11%), the lifetime prevalence of any somatoform disorder/syndrome was 13%. Somatoform disorders and syndromes are often comorbid with other mental disorders, and comorbidity rises with age. Further, they are associated with disabilities and impairments in social and work domains.

Bovine tuberculosis (TB) is a contagious neglected zoonosis of cattle that is prevalent but under-investigated in Cameroon, hence this study was designed to assess the epidemiology of bovine TB in cattle, risks for M. bovis infection in cattle and humans; and public health implications of zoonotic bovine TB in the highlands of Cameroon. A retrospective study of meat inspection records (1994 – 2010) was done to estimate the prevalence of TB lesions in slaughtered cattle in the North West region. The prevalence of bovine TB and anti-bovine TB antibodies in live cattle based on tuberculin skin tests (2 surveys) and immune-chromatographic assays respectively were carried out in the Western and Adamawa highlands of Cameroon. The performance of the tuberculin tests for bovine TB diagnosis in cattle using various tuberculin skin test cut-off points against the detection of anti-bovine TB antibodies (hypothesised risks of exposure) was compared. Suspected TB lesions from slaughtered cattle and infected human sputa were cultured on Lowentein – Jesen and Middlebrook 7H9 media to isolate mycobacteria agents for molecular genotyping using genomic deletion analysis and spoligotyping. Risk factors for exposure and transmission of zoonotic bovine TB infection of cattle and cattle professionals, and its public health significance were determined using structured questionnaires. Seventeen years of meat inspection record revealed that suspect TB lesions were identified in 599 of 129,165 slaughtered cattle at the Bamenda abattoir. The lungs and associated lymph nodes (over 60%) were the most affected tissues. Other results showed that the prevalence of anti-bovine TB antibodies in cattle in the study regions was 37.17%. Chi square statistics revealed that irrespective of the tuberculin test cut-off value (P<0.05; χ2>48), strong associations existed between the detection of anti-bovine TB antibodies and disease status. A 95% confidence interval analysis of the comparative cervical tuberculin tests revealed that the prevalence rates were 4.67% – 7.15%, 12.02% – 15.67% and 20.56% – 24.98% at the ≥ 4mm, ≥ 3mm and ≥ 2mm cut-off points, respectively. Overall, the best test performance was realised at ≥ 3-mm, though the ≥ 2-mm cut-off point predicted more positive reactors. Age, sex, breed and husbandry practices served as significant (P<0.05) risks to the prevalence and exposure of bovine TB in cattle. The feedbacks from cattle professionals suggested that there was high possibility of cattle to cattle and cattle to human transmission of bovine TB such as intimate and repeated animal / animal and animal / human interactions, consuming unpasteurised milk and eating raw meat. Genomic deletion analysis of cultured isolates showed evidence of M. tuberculosis from cattle and M. bovis from human while spoligotyping identified five cattle M. bovis strains; and four spoligotype patterns that had not been previously described anywhere. The study has important epidemiological and public health implications requiring prompt and decisive actions from the Cameroonian authority towards controlling zoonotic bovine TB in both humans and animals. A multidisciplinary approach is needed for further collaborative research and effective control strategies such as enhancing the awareness of people to this deadly disease through continuous education, proper food handling and personal hygiene, healthy husbandry practices and maintenance of the environment.