BACKGROUND & AIMS: OBJECTIVES:To evaluate screening for retinopathy of prematurity (ROP) in Sweden and to investigate possible modifications of the present screening guidelines. METHODS:Infants in Sweden with a gestational age (GA) of 31 weeks + 6 days or less are screened for ROP. Data from the Swedish national register for ROP (SWEDROP) during 2008 and 2009 were extracted and compared with a national perinatal quality register. RESULTS:In SWEDROP, there were 1791 infants born before a GA of 32 weeks from January 1, 2008, through December 31, 2009. Another 70 infants were registered in the perinatal quality register but not in SWEDROP (dropout rate, 3.8% [70 of 1861 infants]). Seven infants died before termination of screening. In the final study cohort (1784 infants), 15.6% had mild ROP and 8.5% had severe ROP. Treatment was performed in 4.4% of the infants, none of whom had a GA at birth of more than 28 weeks. Nine infants with a GA of more than 28 weeks at birth developed stage 3 ROP, which regressed spontaneously. The total number of examinations was 9286 (964 in infants with a GA of 31 weeks), and the mean (range) number of examinations of each infant was 5.2 (1-30). CONCLUSIONS:The SWEDROP, a quality register for ROP, has a national coverage (ie, participation) of 96%. Data from 2008 to 2009 show that it seems possible to reduce the upper limit for screening in Sweden by 1 week, including only infants with a GA of 30 weeks + 6 days or less. However, such a change should be combined with a strong recommendation to neonatologists to refer also severely ill and more "mature" infants.

背景与目标： 目的：评估瑞典早产儿视网膜病变（ROP）的筛查，并调查对本筛查指南的可能修改。
方法：对瑞典胎龄（GA）为31周6天或更短的婴儿进行ROP筛查。提取了瑞典国家ROP注册机构（SWEDROP）在2008年至2009年期间的数据，并将其与国家围产期质量注册机构进行了比较。
结果：从2008年1月1日到2009年12月31日，在SWEDROP中，有32个星期的GA之前有1791例婴儿出生。另外70例婴儿在围产期质量寄存器中登记，但SWEDROP中未登记（辍学率为3.8％[70的1861名婴儿]）。在终止筛查之前，有7名婴儿死亡。在最后的研究队列中（1784名婴儿），轻度ROP为15.6％，重度ROP为8.5％。在4.4％的婴儿中进行了治疗，这些婴儿出生时都没有GA超过28周。 9例出生时GA超过28周的婴儿发生了3期ROP，并自发性退步。总检查次数为9286次（GA为31周的婴儿为964次），每名婴儿的平均检查（范围）为5.2次（1-30次）。
结论：SWEDROP是ROP的质量注册机构，其全国覆盖率（即参与率）为96％。 2008年至2009年的数据表明，瑞典的筛查上限似乎有可能降低1周，仅包括GA≥30周6天或更短的婴儿。但是，这种改变应与对新生儿科医生的强烈建议相结合，以推荐重病和更“成熟”的婴儿。

BACKGROUND & AIMS: :In the present pilot study, the feasibility of a site-of-care cervicovaginal self-sampling methodology for HPV-based screening was tested in 346 women residing in underserved rural areas of Northern Greece. These women provided self-collected cervicovaginal sample along with a study questionnaire. Following molecular testing, using the cobas® HPV Test, Roche®, HPV positive women, were referred to colposcopy and upon abnormal findings, to biopsy and treatment. Participation rate was 100%. Regular pap-test examination was reported for 17.1%. Among hrHPV testing, 11.9% were positive and colposcopy/biopsy revealed 2 CIN3 cases. Non-compliance was the most prevalent reason for no previous attendance. Most women reported non-difficulty and non-discomfort in self-sampling (77.6% and 82.4%, respectively). They would choose self-sampling over clinician-sampling (86.2%), and should self-sampling being available, they would test themselves more regularly (92.3%). In conclusion, self-sampling is feasible and well-accepted for HPV-based screening, and could increase population coverage in underserved areas, helping towards successful prevention.

背景与目标： ：在本项初步研究中，对希腊北部农村地区服务水平低下的346名妇女进行了基于宫颈癌阴道自我采样方法的HPV筛查的可行性的测试。这些妇女提供了自己收集的宫颈阴道样本以及研究问卷。在进行分子测试后，使用cobas®HPV测试，将Roche®，HPV阳性女性进行阴道镜检查，并在发现异常后进行活检和治疗。参与率为100％。定期进行巴氏试验检查的报道为17.1％。在hrHPV测试中，有11.9％呈阳性，阴道镜检查/活检显示有2例CIN3病例。不遵守是没有参加会议的最普遍原因。大多数妇女在自我抽样中报告没有困难和不舒服（分别为77.6％和82.4％）。他们将选择自采样而不是临床医生采样（86.2％），并且如果可以使用自采样，他们将更定期地进行自我测试（92.3％）。总之，对于基于HPV的筛查，自我抽样是可行的并且被广泛接受，并且可以扩大服务不足地区的人口覆盖率，有助于成功进行预防。

BACKGROUND & AIMS: OBJECTIVE:Unidentified hearing loss at birth can adversely affect speech and language development as well as academic achievement and social-emotional development. Historically, moderate-to-severe hearing loss in young children was not detected until well beyond the newborn period. Around 0.5 to 5 in every 1000 neonates and infants have congenital or early childhood onset sensorineural hearing impairment. When identification and intervention occur at no later than 6 months of age, the infants perform much higher on school-related measures. Therefore, early detection is vitally important. Toward the end of 2009, the Israeli ministry of health issued a directive establishing a universal newborn hearing screening program in all hospitals in the country from 01.01.10. The objectives of this study are to evaluate a newly established universal newborn hearing screening program, to assess performance and to compare measurements of performance to performance benchmarks representing a consensus of expert opinion. The benchmarks are the minimal requirements that should be attained by high-quality early hearing detection programs. METHODS:As specified by the ministry of health, a two-stage screening protocol was implemented using otoacoustic emissions and automated auditory brainstem response. Screening results of all neonates born from the initiation of the program on 15th March 2010 until the end of 2011 were reviewed. RESULTS:The total number of live births during the study period was 5496. Of these, 5334 (97%) started screening for hearing loss but only 5212 completed the screening process, giving a screening coverage of 94.8%. Of the 5212 neonates completing the screening process, 270 (5.18%) were referred for full diagnostic testing. CONCLUSIONS:The newly established universal newborn hearing screening program at the Ziv Medical Center in Zefat closely approaches, but does not yet meet the minimal requirements that should be attained by high-quality early hearing detection programs. Every effort should be made to complete the screening tests before discharge from hospital. Screening staff should actively encourage parents to participate in all stages of early detection.

背景与目标： 目的：出生时身份不明的听力损失会严重影响言语和语言发展以及学业成绩和社会情感发展。从历史上看，直到新生儿期以后才发现幼儿的中度至重度听力下降。每1000例新生儿和婴儿中，约有0.5至5例患有先天性或幼儿发作的感音神经性听力障碍。当识别和干预发生在不超过6个月大时，婴儿在学校相关措施上的表现要高得多。因此，早期检测至关重要。到2009年底，以色列卫生部发布了一项指令，规定从10年1月1日起在该国所有医院建立通用的新生儿听力筛查计划。这项研究的目的是评估一个新建立的通用新生儿听力筛查程序，评估性能并将性能测量结果与代表专家意见的性能基准进行比较。基准是高质量的早期听力检测程序应达到的最低要求。
方法：按照卫生部的规定，采用耳声发射和自动听觉脑干反应实施了两阶段筛查方案。回顾了从该计划于2010年3月15日开始至2011年底出生的所有新生儿的筛查结果。
结果：研究期间的活产儿总数为5496。其中，有5334（97％）开始筛查听力丧失，但只有5212完成了筛查过程，筛查覆盖率为94.8％。在完成筛选过程的5212名新生儿中，有270名（5.18％）被转介进行全面诊断测试。
结论：Zefat的Ziv医学中心新近建立的通用新生儿听力筛查计划非常接近，但尚未满足高质量早期听力检测计划应达到的最低要求。在出院之前，应尽一切努力完成筛查测试。筛查人员应积极鼓励父母参与早期发现的所有阶段。

BACKGROUND & AIMS: BACKGROUND:We modified and reconstructed a high image quality portable non-mydriatic fundus camera and compared it with the tabletop fundus camera to evaluate the efficacy of the new camera in detecting retinal diseases. METHODS:We designed and built a novel portable handheld fundus camera with telemedicine system. The image quality of fundus cameras was compared to that of existing commercial tabletop cameras by taking photographs of 364 eyes from the 254 patients. In all 800 fundus images taken by two camera types, 400 images per camera, were graded with the four image clarity classifications. RESULTS:Using the portable fundus camera, 63% (252/400) images were graded as excellent overall quality, 20.5% (82/400) were good, 11.75% (47/400) were fair, and 4.75% (19/400) were inadequate. Using the tabletop fundus camera, 70.75% (283/400) images were graded as excellent overall quality, 20.4% (51/400) were good, 13.25% (53/400) were fair, and 3.25% (13/400) were inadequate. Common retinal diseases were easily identified from fundus images obtained from the portable fundus camera. CONCLUSION:The new type of non-mydriatic portable fundus camera was qualified to have professional quality of fundus images. The revolutionary screening camera provides a foundational platform which can potentially improve the accessibility of retinal screening programmes.

背景与目标： 背景：我们修改并重建了高图像质量的便携式非散瞳眼底照相机，并将其与台式眼底照相机进行比较，以评估新照相机在检测视网膜疾病中的功效。
方法：我们设计并制造了一种新型的带有远程医疗系统的便携式手持眼底照相机。通过拍摄254名患者的364眼照片，将眼底照相机的图像质量与现有商用台式照相机的图像质量进行了比较。在两种相机类型拍摄的全部800张眼底图像中，每台相机400张图像被分为四个图像清晰度分类。
结果：使用便携式眼底照相机，将63％（252/400）的图像评为总体质量优良，20.5％（82/400）的图像质量良好，11.75％（47/400）的图像质量良好，以及4.75％（19/400）的图像质量）不足。使用台式眼底照相机，将70.75％（283/400）的图像评为总体质量优良，20.4％（51/400）的图像质量良好，13.25％（53/400）的图像质量良好，3.25％（13/400）的图像质量良好不足。从便携式眼底照相机获得的眼底图像很容易识别出常见的视网膜疾病。
结论：新型非散瞳便携式眼底照相机经鉴定具有专业的眼底图像质量。革命性的筛查摄像机提供了一个基础平台，可以潜在地改善视网膜筛查程序的可及性。

BACKGROUND & AIMS: BACKGROUND:The penetrance of hypertrophic cardiomyopathy (HCM) during childhood and adolescence has been only sparsely described. We studied the penetrance of HCM and the short- and long-term outcomes of clinical screening and predictive genetic testing of child relatives of patients with HCM. METHODS AND RESULTS:Ninety probands and 361 relatives were included in a family screening program for HCM (1994-2001). Eleven sarcomere genes, CRYAB, α-GAL, and titin were screened. Sixty-six relatives and 4 probands were <18 years of age at inclusion. Twelve child relatives were mutation carriers (age, 12 ± 5 years), and 26 had unknown genetic status, ie, relatives from families without identified mutations (n = 21) or not tested (n = 5) (age, 11 ± 5 years). Twenty-eight noncarriers (42%; age, 10 ± 4 years) served as control subjects. Two of 38 child relatives (5%) at risk of developing HCM fulfilled diagnostic criteria for HCM at inclusion. After 12 ± 1 years of follow-up, 2 of the 36 (6%; 95% confidence interval, 2-18) at-risk child relatives who were phenotype negative at inclusion had developed the HCM phenotype at 26 and 28 years of age. During follow-up, none of the child relatives experienced serious cardiac events. Participation in the screening program had no long-term negative psychological impact. CONCLUSIONS:The penetrance of HCM in phenotype-negative child relatives at risk of developing HCM was 6% after 12 years of follow-up. The finding of phenotype conversion in the mid-20s warrants continued screening into adulthood. Forty-two percent of the child relatives were noncarriers, and repeat clinical follow-up could be safely limited to the remaining children.

背景与目标： 背景：关于肥厚型心肌病（HCM）在儿童和青少年时期的渗透率仅得到了很少的描述。我们研究了HCM的渗透率以及HCM患者的儿童亲属的临床筛查和预测性基因检测的短期和长期结果。
方法和结果：1994年至2001年，在HCM家庭筛查计划中纳入了90名先证者和361名亲属。筛选了11个肌小节基因CRYAB，α-GAL和titin。六十六名亲戚和四名先证者年龄小于18岁。十二名儿童亲属是突变携带者（年龄为12±5岁），有26名儿童的遗传状况未知，即来自未发现突变的家庭的亲属（n = 21）或未经过测试（n = 5）（年龄为11±5岁） ）。对照组为28名非携带者（42％；年龄为10±4岁）。 38名患HCM的儿童亲属中有2名（5％）符合入选HCM的诊断标准。经过12±1年的随访，在纳入时表现型为阴性的36名高危儿童亲戚中，有2名（6％； 95％置信区间为2-18）在26岁和28岁时出现了HCM表型。 。在随访期间，没有任何一个儿童亲属经历过严重的心脏事件。参与筛查程序不会对心理产生长期负面影响。
结论：随访12年后，表型阴性儿童亲属中HCM的外显率为6％。在20年代中期发现表型转化的情况值得继续筛选，直至成年。 42％的儿童亲属是非携带者，重复进行的临床随访可以安全地限于其余儿童。

BACKGROUND & AIMS: :Cervical screening attendance among women aged 25-29 years in England is lower than at older ages. There is some evidence that pre-notification leaflets motivate women who have not yet considered their response to a health intervention. We aimed to identify key information to motivate young women at their first cervical screening invitation. Six focus groups were conducted, five with young women aged 17-25 registered with a General Practice in Manchester, UK, and one with Practice nurses. Some women took part in two further groups to discuss leaflet design. There was low awareness of the purpose or procedures of cervical screening, and most women were de-motivated by reports of bad experiences. Some intended to be screened, but not immediately after invitation. Screening was viewed as a test for a cancer that affected older women. Since none of the participants believed that they had cervical cancer, screening seemed unnecessary. We conclude that the perception that screening is unimportant when you are young needs to be challenged. Women also need to be better informed of screening procedures. A pre-notification leaflet incorporating key information was designed and will be tested in a randomized trial of complex interventions within the routine cervical screening programme.

背景与目标： ：在英格兰，年龄在25-29岁之间的女性接受子宫颈筛查的比例低于年龄较大的女性。有证据表明，预先通知传单可以激励尚未考虑其对健康干预措施反应的妇女。我们旨在识别关键信息，以激发年轻女性的首次宫颈筛查邀请。进行了六个焦点小组讨论，其中五个在17-21岁的年轻女性中注册了英国曼彻斯特的General Practice，一个在执业护士中进行。一些妇女参加了另外两个小组，讨论传单设计。人们对宫颈筛查的目的或程序认识不足，大多数妇女因不良经历的报道而失去动力。有些打算放映，但不是在邀请后立即放映。筛查被认为是对影响老年妇女的癌症的测试。由于没有一个参与者相信自己患有宫颈癌，因此筛查似乎是不必要的。我们得出的结论是，对年轻时进行筛查并不重要的看法需要受到挑战。还需要使妇女更好地了解筛查程序。设计了包含关键信息的预告传单，并将在常规宫颈筛查计划内的复杂干预措施的随机试验中进行测试。

BACKGROUND & AIMS: JUSTIFICATION:Hearing impairment is one of the most critical sensory impairments with significant social and psychological consequences. Evidence-based, standardized national guidelines are needed for professionals to screen for hearing impairment during the neonatal period. PROCESS:The meeting on formulation of national consensus guidelines on developmental disorders was organized by Indian Academy of Pediatrics in Mumbai, on 18th and 19th December, 2015. The invited experts included Pediatricians, Developmental Pediatricians, Pediatric Neurologists and Clinical Psychologists. The participants framed guidelines after extensive discussions. OBJECTIVE:To provide guidelines on newborn hearing screening in India. RECOMMENDATIONS:The first screening should be conducted before the neonate's discharge from the hospital - if it 'fails', then it should be repeated after four weeks, or at first immunization visit. If it 'fails' again, then Auditory Brainstem Response (ABR) audiometry should be conducted. All babies admitted to intensive care unit should be screened via ABR. All babies with abnormal ABR should undergo detailed evaluation, hearing aid fitting and auditory rehabilitation, before six months of age. The goal is to screen newborn babies before one month of age, diagnose hearing loss before three months of age and start intervention before six months of age.

背景与目标： 证据：听力障碍是最严重的感觉障碍之一，具有重大的社会和心理后果。专业人员在新生儿期筛查听力障碍时，需要以证据为依据的标准化国家准则。
过程：2015年12月18日至19日，印度儿科学会在孟买组织了关于发展性疾病的国家共识指南的制定会议。受邀的专家包括儿科医生，发育儿科医生，儿科神经病学家和临床心理学家。参加者在广泛讨论后制定了指导方针。
目的：为印度新生儿听力筛查提供指导。
建议：应在新生儿出院前进行第一次筛查-如果“失败”，则应在四个星期后或第一次免疫检查时重复进行。如果再次“失败”，则应进行听性脑干反应（ABR）听力测验。所有进入重症监护室的婴儿都应通过ABR进行筛查。所有ABR异常的婴儿应在6个月大之前进行详细评估，安装助听器和进行听觉康复。目的是对一个月大的婴儿进行筛查，在三个月大的婴儿中诊断听力下降，并在六个月大的婴儿开始干预。

BACKGROUND & AIMS: :Plants from Suriname (South-America) and several Annona species, including A. muricata, A. ckerimolia, A. montana and A. glabra were screened for 5-HT(1A) receptor binding activity by ligand-binding-studies (LBS). Crude extracts of all Annona species and from Hibiscus bifurcatus, Irlbarchia purpurascens and Scoparia dulcis showed high activity. The isoquinoline alkaloids asimilobine (1), nornuciferine (2), and annonaine (3) were isolated as the active principles from the fruit of Annona muricata. These results may partially explain the use of Hibiscus bifurcatus and Annona muricata in traditional medicine in Suriname.

背景与目标： ：通过配体结合研究（LBS）筛选了来自苏里南（南美）和几种番荔枝科植物，包括A. muricata，A。ckerimolia，A。montana和A. glabra的植物的5-HT（1A）受体结合活性。 ）。所有番荔枝科植物Annfurus bifurcatus，Irlbarchia purpurascens和Scoparia dulcis的粗提物均显示出高活性。从栗Annona muricata的果实中分离出异喹啉生物碱asimilobine（1），nornuciferine（2）和annonaine（3）作为有效成分。这些结果可能部分解释了芙蓉和芙蓉番荔枝在苏里南的传统医学中的使用。

BACKGROUND & AIMS: Thirteen cultivars of hop (Humulus lupulus L.) were tested by reverse transcription-polymerase chain reaction (RT-PCR) for the presence of apple mosaic virus (ApMV). The virus was detected in various amounts in all tested cultivars. Control hop clones derived from tissue cultures, treated by thermotherapy and maintained in greenhouse were virus-free. The procedure for sample preparation and RT-PCR of ApMV is described in detail.

背景与目标： 通过逆转录-聚合酶链反应（RT-PCR）测试了13个酒花（Humulus lupulus L.）的苹果花叶病毒（ApMV）的存在。在所有测试品种中都检测到了各种数量的病毒。来自组织培养物的对照蛇麻草克隆，经热疗处理并保存在温室中，均不含病毒。详细描述了ApMV的样品制备和RT-PCR步骤。

BACKGROUND & AIMS: :Screening programs can reduce the burden of disease, however, they can be associated with raised levels of anxiety. The risk of endometrial and ovarian cancer is increased in hereditary nonpolyposis colorectal cancer (HNPCC). There is no prospective evidence to support screening for gynecological disease in HNPCC, however, current recommendations include the use of ultrasound and endometrial biopsy. This study assesses the impact of screening for gynecological cancer on self-reported symptoms of anxiety, depression, and perceptions of health. Women from HNPCC families attending gynecological screening (n = 26) completed the Hospital Anxiety and Depression Scale and the ShortForm36v2 questionnaires prior to screening with transvaginal ultrasound, outpatient/office hysteroscopy, endometrial biopsy, and ovarian tumor marker assessment (CA125). The same questionnaires were completed at 3 and 6 months following screening (15/26). Women in HNPCC families attending for gynecological screening did not have excess symptoms of anxiety or depression at baseline in subjective comparison to other populations. The process of screening and false positive screening results had no significant impact on symptoms of anxiety and depression or perceptions of health. We conclude that within the limitations of analysis in this small study group, screening for gynecological disease in HNPCC does not appear to be associated with any psychological morbidity.

背景与目标： ：筛查程序可以减轻疾病的负担，但是，它们可能与焦虑水平上升有关。遗传性非息肉病性结直肠癌（HNPCC）会增加子宫内膜和卵巢癌的风险。没有前瞻性证据支持筛查HNPCC中的妇科疾病，但是，当前的建议包括使用超声和子宫内膜活检。这项研究评估了筛查妇科癌症对自我报告的焦虑，抑郁和健康观症状的影响。来自HNPCC家庭的妇科妇女（n = 26）在通过阴道超声，门诊/宫腔镜检查，子宫内膜活检和卵巢肿瘤标志物评估（CA125）进行筛查之前，完成了医院焦虑和抑郁量表和ShortForm36v2问卷。筛选后的3个月和6个月完成了相同的问卷调查（15/26）。与其他人群相比，从主观上看，参加妇科筛查的HNPCC家庭中的妇女在基线时没有过多的焦虑或抑郁症状。筛查的过程和假阳性筛查结果对焦虑和抑郁症状或健康感知没有显着影响。我们得出的结论是，在这个小型研究小组的分析范围内，HNPCC妇科疾病筛查似乎与任何心理疾病均不相关。

BACKGROUND & AIMS: :Factor V(Leiden) is the most common abnormality detected in patients examined because of hereditary thrombophilia. The most widely used clot-based screening test is based on the activated partial thromboplastin (aPTT) time. This test has a low sensitivity. A comparison of the aPTT-based test with a Russell viper venom time test (RVVT) was performed in matched samples. All samples were analyzed by polymerase chain reaction (PCR) for the factor V(Leiden) defect. We studied 139 samples, of which 109 were PCR-negative; 30 were PCR-positive. Using the manufacturer's suggested threshold ratio of 2, the aPTT test showed a sensitivity of 0.43, a specificity of 0.86, and a positive predictive value (PPV) of 0.97. The RVVT test had a sensitivity of 1.0, a specificity of 0.95, and a PPV of 0.91. Segregation of a subpopulation of this study population into ABO group O vs non-group O showed an effect of ABO group on the aPTT test but not on the RVVT test, consistent with an influence of factor VIII clotting (factor VIII:C) on the aPTT test. The RVVT test seems superior to the unmodified aPTT test as a screening test for factor V(Leiden).

背景与目标： ：因子V（Leiden）是由于遗传性血栓形成而在检查的患者中检测到的最常见异常。最广泛使用的基于凝块的筛选测试是基于活化的部分凝血活酶（aPTT）时间。此测试的灵敏度较低。在匹配的样本中将基于aPTT的测试与Russell毒蛇毒时间测试（RVVT）进行了比较。通过聚合酶链反应（PCR）分析所有样品中的因子V（Leiden）缺陷。我们研究了139个样本，其中109个为PCR阴性。 30个是PCR阳性的。使用制造商建议的阈值比率2，aPTT测试显示灵敏度为0.43，特异性为0.86，阳性预测值（PPV）为0.97。 RVVT测试的灵敏度为1.0，特异性为0.95，PPV为0.91。将该研究人群的亚群分为ABO组O和非O组，显示ABO组对aPTT测试有影响，但对RVVT测试无影响，这与VIII因子凝血（VIII：C因子）对APTT的影响一致。 aPTT测试。 RVVT测试似乎优于未修改的aPTT测试作为因子V（Leiden）的筛选测试。

BACKGROUND & AIMS: :We have examined maternal urine concentrations of beta core, free beta human chorionic gonadotrophin (hCG), and total oestriol in 373 control pregnancies and 43 pregnancies affected by aneuploidy (including 22 cases of Down's syndrome) in an attempt to see if any of the analytes have a value in Down's syndrome screening between the tenth and 14th week of pregnancy. We have compared the performance of these analytes against nuchal translucency measurement combined with maternal serum free beta hCG at the same period of pregnancy. Our results show that levels of urine free beta hCG and beta core are increased in Down's syndrome with average multiple of the median levels of 1.81 and 2.91, respectively. Urine total oestriol was reduced (0.83) whilst maternal serum free beta hCG was increased (1.72). In trisomy 18 the levels of all analytes were reduced, although serum free beta hCG was the most discriminating. The spread of results in the control and the Down's group for urine beta core was more than three times than that for serum free beta hCG and with urine free beta hCG it was two times wider. In combination with maternal age, urine total oestriol had a 32 per cent detection rate at a fixed 5 per cent false-positive rate; urine beta core 34 per cent, urine free beta hCG 36 per cent, maternal serum free beta hCG 44 per cent, and nuchal translucency 82 per cent. In combination with nuchal translucency, urine total oestriol added an extra 1 per cent detection, urine beta core an extra 2 per cent, urine free beta hCG an extra 3 per cent, and serum free beta hCG an extra 5 per cent. It is unlikely that any of the urine markers will be of value in first-trimester screening. Optimal first-trimester screening programmes will rely for the foreseeable future on nuchal translucency, serum free beta hCG, and possibly pregnancy-associated plasma protein A.

背景与目标： ：我们检查了373例非整倍性（包括22例唐氏综合症患者）的对照妊娠和43例孕妇的孕产妇尿液中的β核心，游离β人绒毛膜促性腺激素（hCG）和总雌三醇的浓度，以查看是否存在以下任何一种：在妊娠的第十至十四周期间，分析物在唐氏综合症筛查中具有价值。我们已将这些分析物的性能与在怀孕同一时期与孕妇血清游离βhCG相结合的颈部半透明测量结果进行了比较。我们的结果表明，唐氏综合症患者的无尿β-hCG和β-核心水平增加，平均中位数分别为1.81和2.91。尿中总雌三醇减少（0.83），而孕妇血清游离β-hCG增加（1.72）。在三体性18中，所有血清分析物的含量都降低了，尽管无血清的βhCG最为明显。对照组和唐氏组中尿β-核心的结果分布是无血清β-hCG的三倍以上，而无尿β-hCG的结果则宽了两倍。结合产妇年龄，尿中总雌三醇的检出率为32％，假阳性率为5％。尿β-核心34％，尿β-hCG36％，孕妇血清β-hCG44％，口腔半透明82％。结合颈部半透明性，尿液中总雌三醇的含量增加了1％，尿液β-核心的含量增加了2％，无尿β-hCG增加了3％，​​无血清β-hCG增加了5％。任何尿液标记物在孕早期筛查中都没有价值的可能性很小。最佳的早孕筛查程序将在可预见的将来依赖于颈部半透明性，无血清βhCG以及可能与妊娠相关的血浆蛋白A。

BACKGROUND & AIMS: :The objectives of this study were to examine aspects of organization of a proposed national screening programme based in general practice. The target population of women aged 25-59 years and their general practitioners (GPs), in a defined inner city area, was identified from a population register of persons eligible for free medical services; a computerized system was developed for invitations and record linkage of cytology results. Smears were examined in one laboratory and follow up of women with abnormal smears was undertaken by one gynaecologist. A random sample of non-responders was surveyed by questionnaire. Response following two invitations was only 20%. Practices with male doctors only had significantly lower response rates (P < 0.001) than those with a female doctor/nurse. A survey of non-responders showed that over 20% of addresses were incorrect and 16% of those interviewed were ineligible for smear tests. A preference for a female to undertake smears was expressed by 67%, and 77% believed that the purpose of the cervical smear was to detect cancer. An accurate population register, health promotion, support for GP practices, provision of alternative venues for smear tests, development of computer systems, accurate data entry and fail-safe follow up are aspects of a cervical screening service which must be addressed prior to setting up a national service.

背景与目标： ：这项研究的目的是检查根据一般实践提出的国家筛查计划的组织方面。从有资格获得免费医疗服务的人员的人口登记册中确定了指定市区内25-59岁的妇女及其全科医生的目标人群；开发了用于邀请和记录细胞学结果链接的计算机化系统。在一个实验室对涂片进行了检查，一名妇科医师对涂片异常的妇女进行了随访。通过问卷调查随机抽取未回答者。两次邀请后的回应率仅为20％。男医生的实践仅比女医生/护士的实践有显着降低的响应率（P <0.001）。一项针对无回应者的调查显示，超过20％的地址不正确，而受访者中有16％没有资格进行涂片测试。 67％的女性表示愿意进行涂片检查，而77％的人认为宫颈涂片检查的目的是检测癌症。准确的人口登记，健康促进，对全科医生实践的支持，提供涂片测试的替代场所，计算机系统的开发，准确的数据输入和故障安全的跟进是宫颈筛查服务的各个方面，在建立之前必须解决这些问题一项国民服务。

BACKGROUND & AIMS: :Suramin is a polyanionic compound currently used under evaluation for antineoplastic activity. One of the main problems encountered during clinical trials was an adverse neurotoxic effect, probably due to a direct cytotoxic effect on neural cells. Suramin is also known to trigger differentiation of human colon cancer cells, yet a chronic treatment induces a lysosomal storage disorder. The aim of this study was to evaluate suramin analogs for their effect: (i) on the lysosomal system of the human colon cancer cell clone HT29-D4; and (ii) on C6 glioma cell growth and morphology. One of the derivatives tested, NF036, induced terminal differentiation of HT29-D4 cells without any impairment of the lysosomal system. Furthermore, in contrast to suramin, NF036 did not alter C6 cell growth and morphology. We conclude that there is a relationship between the ability of a suramin derivative to induce a lysosomal storage disorder in human colon cancer cells and its neurotoxic effect. A double screening of suramin analogs on HT29-D4 and C6 cells allowed us to identify a new candidate antineoplastic drug: NF036.

背景与目标： ：Suramin是目前正在评估抗肿瘤活性的聚阴离子化合物。临床试验期间遇到的主要问题之一是不良的神经毒性作用，这可能是由于对神经细胞的直接细胞毒性作用所致。还已知苏拉明会触发人结肠癌细胞的分化，然而长期治疗会引起溶酶体贮积症。这项研究的目的是评估苏拉明类似物的作用：（i）对人结肠癌细胞克隆HT29-D4的溶酶体系统； （ii）C6胶质瘤细胞的生长和形态。测试的衍生物之一NF036诱导了HT29-D4细胞的终末分化，而对溶酶体系统没有任何损害。此外，与苏拉明相反，NF036不会改变C6细胞的生长和形态。我们得出结论，苏拉明衍生物在人结肠癌细胞中诱导溶酶体贮积病的能力与其神经毒性作用之间存在关联。在HT29-D4和C6细胞上对苏拉明类似物的双重筛选使我们能够鉴定出新的候选抗肿瘤药NF036。

BACKGROUND & AIMS: BACKGROUND:Professional organizations have issued guidelines recommending breast cancer screening for women 50 years of age. OBJECTIVE:This study examines the percent of U.S. primary care physicians who report breast cancer screening practices that are not consistent with guidelines, and the characteristics of physicians who reported offering extra test modalities. DESIGN:We analyzed a subset of a 2008 cross-sectional Women's Health Care survey sent to primary care physicians randomly selected from the national American Medical Association (AMA) Physician Masterfile. A subset of physicians received a survey that presented a vignette of a health maintenance visit for an asymptomatic 51-year-old woman who was not at high risk for breast cancer. Responses were weighted to represent physicians nationally. PARTICIPANTS:1,654 U.S. family physicians, general internists, and obstetrician-gynecologists under age 65, who practiced in office or hospital based settings (62.8 % response rate). After exclusions, 553 study physicians remained for analysis. MAIN MEASURE:Physician self-report of breast cancer screening practices that are not consistent with the recommendations of the U.S. Preventive Services Task Force (USPSTF), the American College of Obstetrics and Gynecology (ACOG), and the American Cancer Society (ACS), defined as almost always offering mammography. KEY RESULTS:36.0 % (95 % CI: 31.8 %-40.5 %) of physicians reported offering breast cancer screening tests inconsistent with national guidelines, with most offering extra tests (magnetic resonance imaging [MRI] and/or ultrasound) (33.2 %, 95 % CI 29.1 %-37.6 %). In adjusted analysis, risk-averse physicians and those who believed in the clinical effectiveness of MRI were more likely to offer extra breast cancer screening tests. CONCLUSIONS:Physicians often report offering breast cancer screening test modalities beyond those recommended for a 51-year-old woman. Strategies, such as academic detailing regarding appropriate use of technology and provision of clinical decision support for breast cancer screening, could decrease overuse of resources.

背景与目标： 背景：专业组织已发布指南，建议对50岁以下的女性进行乳腺癌筛查。
目的：本研究调查了报告乳腺癌筛查实践与指南不一致的美国基层医疗医生的百分比，以及报告提供额外测试方式的医生的特征。
设计：我们分析了2008年横断面的妇女健康护理调查的一部分，该调查发送给从美国国家医学会（AMA）医师主文件中随机选择的初级保健医生。一部分医生接受了一项调查，该调查显示了对没有高乳腺癌风险的无症状51岁女性进行健康维持就诊的情况。回答权重代表全国范围内的医师。
参与者：1,654位65岁以下的美国家庭医生，普通内科医师和妇产科医师，他们在办公室或医院工作（应答率为62.8％）。排除后，有553名研究医师留待分析。
主要测量：医师对乳腺癌筛查实践的自我报告与美国预防服务工作队（USPSTF），美国妇产科学院（ACOG）和美国癌症协会（ACS）的建议不一致，被定义为几乎总是提供乳房X光检查。
关键结果：36.0％（95％CI：31.8％-40.5％）的医生报告说提供的乳腺癌筛查检查与国家指南不一致，大多数提供额外的检查（磁共振成像[MRI]和/或超声检查）（33.2％， 95％CI 29.1％-37.6％）。在调整后的分析中，规避风险的医生和那些相信MRI的临床有效性的医生更有可能提供额外的乳腺癌筛查测试。
结论：医师通常报告提供了超出推荐给51岁女性的乳腺癌筛查检查方法。策略，例如关于适当使用技术的学术细节以及为乳腺癌筛查提供临床决策支持，可以减少资源的过度使用。