BACKGROUND & AIMS: OBJECTIVE:To measure chlamydia testing and positivity rates among 16-39 year olds attending Aboriginal Community Controlled Health Services (ACCHSs). METHODS:Retrospective non-identifiable computerised records containing consultation and chlamydia testing data were collected for patients (16-39 years) attending eight ACCHSs during 2008-09 in urban, regional and remote settings for the Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS) system. Annual chlamydia testing and positivity rates were estimated. RESULTS:Over two years, 13,809 patients aged 16-39 years (57.8% female, 82.3% Aboriginal or Torres Strait Islander) attended. The annual overall chlamydia testing rate was 13.0% (2008) and 16.0% (2009). Testing rates were higher among females (p<0.001) and among patients aged 16-29 than 30-39 years (males: p=0.01; females: p<0.001). Chlamydia positivity was 8.5% overall; similar in females (8.7%) and males (7.8%) (p=0.46); highest among 16-19 years (females: 17.4%; males: 13.0%), declining to 1.5% among females 35-39 years (p<0.001) and 4.8% among males 30-34 years (p<0.001). CONCLUSIONS:Chlamydia testing at these ACCHSs approached recommended levels among some patient groups, however, it should increase. High positivity among younger people highlights they should be targeted. IMPLICATIONS:Young people should be targeted for sexual health interventions. ACCHSs are well placed to provide enhanced sexual health services if appropriately resourced.

背景与目标： 目的：测量参加原住民社区控制健康服务（ACCHS）的16-39岁人群的衣原体检测和阳性率。
方法：收集了2008-09年间在城市，区域和偏远地区参加澳大利亚AC衣原体加强前哨监视协作组织（ACCESS）的八个ACCHS的患者（16-39岁）的回顾性，不可识别的计算机记录，其中包含咨询和衣原体检测数据系统。估计每年的衣原体检测和阳性率。
结果：两年多来，共有13809名年龄在16-39岁之间的患者（女性占57.8％，原住民或托雷斯海峡岛民占82.3％）参加了研究。每年的衣原体总检出率分别为13.0％（2008年）和16.0％（2009年）。女性的测试率较高（p <0.001），年龄在16-29岁的患者的测试率高于30-39岁的男性（男性：p = 0.01；女性：p <0.001）。衣原体阳性率为8.5％。女性（8.7％）和男性（7.8％）相似（p = 0.46）；在16-19岁之间最高（女性：17.4％；男性：13.0％），在35-39岁的女性中下降到1.5％（p <0.001），在30-34岁的男性中下降到4.8％（p <0.001）。
结论：这些ACCHS的衣原体检测在某些患者组中已达到推荐水平，但应增加。年轻人中的高度积极性凸显了他们应该成为目标。
后果：应该针对年轻人进行性健康干预。如果资源适当，ACCHS可以提供​​更好的性健康服务。

BACKGROUND & AIMS: :Myocardial extracellular volume fraction (ECV) reflecting diffuse myocardial fibrosis can be measured with T1 mapping cardiovascular magnetic resonance (CMR) before and after the application of a gadolinium-based extracellular contrast agent. The equilibrium between blood and myocardium contrast concentration required for ECV measurements can be obtained with a primed contrast infusion (equilibrium contrast-CMR). We hypothesized that equilibrium can also be achieved with a single contrast bolus to accurately measure diffuse myocardial fibrosis in patients with congenital heart disease (CHD). Healthy controls (n = 17; median age 24.0 years) and patients with CHD (n = 19; 25.0 years) were prospectively enrolled. Using modified Look-Locker inversion recovery T1 mapping before, 15 min after bolus injection, and during constant infusion of gadolinium-DOTA, T1 values were obtained for blood pool and myocardium of the left ventricle (LV), the interventricular septum (IVS), and the right ventricle (RV) in a single midventricular plane in short axis or in transverse orientation. ECV of LV, IVS and RV by bolus-only and bolus-infusion correlated significantly in CHD patients (r = 0.94, 0.95, and 0.74; p < 0.01, respectively) and healthy controls (r = 0.96, 0.89, and 0.64; p < 0.05, respectively). Bland-Altman plots revealed no significant bias between the techniques for any of the analyzed regions. ECV of LV and RV myocardium measured by bolus-only T1 mapping agrees well with bolus-infusion measurements in patients with CHD. The use of a bolus-only approach facilitates the integration of ECV measurements into existing CMR imaging protocols, allowing for assessment of diffuse myocardial fibrosis in CHD in clinical routine.

背景与目标： ：应用基于g的细胞外造影剂前后，可通过T1映射心血管磁共振（CMR）来测量反映弥漫性心肌纤维化的心肌细胞外体积分数（ECV）。 ECV测量所需的血液和心肌造影剂浓度之间的平衡可通过灌注造影剂（平衡造影剂CMR）获得。我们假设通过单次对比推注也可以达到平衡，以准确测量先天性心脏病（CHD）患者的弥漫性心肌纤维化。前瞻性纳入健康对照组（n = 17）；中位年龄24.0岁； CHD患者（n = 19； 25.0岁）。使用改良的Look-Locker反转恢复T1映射，在推注大剂量，之后15分钟以及在持续输注--DOTA期间，获得了左心室（LV），心室间隔（IVS）的血池和心肌的T1值，右心室（RV）在短心轴或横向方向的单个心室中平面内。仅推注和推注输注的LV，IVS和RV的ECV在CHD患者（分别为r = 0.94、0.95和0.74； p <0.01）和健康对照者（r = 0.96、0.89和0.64； p中显着相关）分别<0.05）。布兰德-奥特曼（Bland-Altman）图显示，任何被分析区域的技术之间均无明显偏差。通过仅推注T1测绘测得的LV和RV心肌的ECV与CHD患者的推注量测量非常吻合。仅推注方法的使用有助于将ECV测量值集成到现有的CMR成像协议中，从而可以在临床常规中评估CHD中弥漫性心肌纤维化。

BACKGROUND & AIMS: :Affinity zones are defined as areas within which air quality displays consistent behaviour over space and time. Constructed using multivariate statistical techniques and physiographic and landscape variables reflecting underlying sources and spatial patterns of air pollution, affinity zones provide a spatial structure suited to exploring the representativity of monitoring networks and as a basis for air pollution mapping and exposure assessment. The affinity zone method is demonstrated using European air pollution monitoring sites, and environmental data compiled within a 1 km GIS. Organised into three main stages, this method involves: (i) indicator selection, using principal components analysis, (ii) zonation by cluster analysis to classify areas into distinct types, and (iii) site allocation, to confirm similarity within affinity zones in terms of monitored air pollution concentrations. Ten interpretable and coherent air pollution affinity zones were constructed for Europe, including two rural zones and eight related to different types of densely populated and built up environments. Concentrations between affinity zones differed significantly for NO(2) background and traffic sites and for PM(10) traffic sites only. Not all zones, however, were found to be sufficiently represented by monitoring sites, illustrating the importance of affinity zones in identifying deficiencies in monitoring networks. Spatial modelling within affinity zones is also demonstrated, showing that simple kriging of background NO(2) concentrations within zones (compared to kriging ignoring zones) produced a ca. 22% reduction in errors and increased R(2) by 0.25 at reserved validation monitoring sites. The affinity zone method developed here is a robust, statistical approach that can be used for evaluating the representativity of routine monitoring networks often used in continental level environmental and health risk assessments.

背景与目标： ：亲和区域定义为空气质量在空间和时间上表现出一致行为的区域。使用多元统计技术以及反映空气污染的潜在来源和空间模式的自然和景观变量构建的亲和力区域提供了一种适合探索监测网络代表性的空间结构，并作为空气污染测绘和暴露评估的基础。使用欧洲空气污染监测站点和在1 km GIS中汇总的环境数据演示了亲和区方法。该方法分为三个主要阶段：（i）使用主成分分析进行指标选择；（ii）通过聚类分析将区域划分为不同类型；以及（iii）站点分配，以确认亲和力区域内的相似性监测的空气污染浓度。欧洲共建立了10个可解释且连贯的空气污染亲和区，其中包括2个农村区和8个与不同类型的人口稠密和密集环境相关的区域。对于NO（2）背景和交通站点以及仅PM（10）交通站点，亲和区之间的浓度差异显着。但是，并不是所有区域都能被监视站点充分代表，这说明了亲和力区域在识别监视网络缺陷中的重要性。还演示了亲和区内的空间建模，表明简单的克里格区域内背景NO（2）浓度的克里格法（与忽略区域的克里格法相比）产生了一个ca。在保留的验证监视站点上，错误减少了22％，R（2）增加了0.25。这里开发的亲和区方法是一种可靠的统计方法，可用于评估经常在大陆级环境和健康风险评估中使用的常规监测网络的代表性。

BACKGROUND & AIMS: :Lymph flow and contraction frequency were measured in popliteal efferent lymphatics. Stimulation of the ipsilateral sympathetic chain resulted in an approximate threefold increase in lymph flow, while contraction frequency increased 28% (n = 6). Occlusion of the metatarsal afferent lymphatics with a pneumatic cuff reduced efferent flow from 18 to 4 microliters/min after 25 min (n = 5), indicating that approximately 80% of popliteal efferent lymph is derived from the foot. After occlusion of the afferent lymphatics, sympathetic stimulation failed to increase efferent lymph flow significantly, while efferent contraction frequency still showed a significant rise. It is concluded that lymph formation in the popliteal node does not contribute to the rise in efferent lymph flow following sympathetic stimulation.

背景与目标： ：测定e神经传出淋巴管中的淋巴流量和收缩频率。同侧交感神经链的刺激导致淋巴流量增加约三倍，而收缩频率增加28％（n = 6）。 25分钟后（n = 5），用气动袖带阻塞meta骨传入淋巴管将传出流量从18微升/分钟降低至4微升/分钟（n = 5），这表明80出传入淋巴管中约有80％来自足部。封堵传入淋巴管后，交感刺激未能显着增加传出淋巴流量，而传出收缩频率仍显示显着升高。结论是，在交感神经刺激下，the淋巴结中的淋巴结形成对传出淋巴液流量的增加没有贡献。

BACKGROUND & AIMS: BACKGROUND:High-risk patients undergoing prophylactic mastectomy (PM) may have unsuspected cancers identified on pathology. The optimum way to identify and manage them is controversial. Magnetic resonance imaging (MRI) may identify occult cancer preoperatively. Sentinel lymph node biopsy (SLNB) allows intraoperative staging and axillary dissection during the same operation. We determined the efficacy and cost of MRI and/or SLNB in managing high-risk PM patients. METHODS:We reviewed 192 PMs in 173 patients from 1999 to 2005. Costs were estimated for MRI and SLNB during PM by the 2005 Medicare Resource-Based Relative Value Scale. We also estimated costs and procedures for the four strategies in a larger hypothetical cohort. RESULTS:A total of 19 (10%) of 192 PMs contained occult cancers, 14 ductal carcinoma-in-situ (DCIS) and 5 invasive ductal carcinoma (IDC). In 59 patients, MRI detected an IDC but missed two DCIS and an IDC. Positive MRIs generated an additional average cost of $1,207 per patient. In 56 PMs with SLNB, 6 occult cancers were found, 5 DCIS and 1 IDC, all with negative SLNBs. Adding a SLNB costs an additional average of $644. A theoretical analysis demonstrated that PM alone costs $808 per patient, PM with SLNB costs $1,420, PM with MRI and selective SLNB costs $1,774, and PM with routine MRI and SLNB costs $2,379. CONCLUSIONS:MRI adds great cost and misses most occult cancers in PMs. SLNB allows the rare patient with occult IDC to avoid axillary dissection but adds cost. Given the low rate of unsuspected invasive cancers and the costs of MRI and SLNB, neither is recommended as standard practice for PM patients.

背景与目标： 背景：进行预防性乳房切除术（PM）的高危患者可能在病理学上发现了未怀疑的癌症。识别和管理它们的最佳方法是有争议的。磁共振成像（MRI）可能会在术前识别隐匿性癌症。前哨淋巴结活检（SLNB）允许在同一手术过程中进行术中分期和腋窝淋巴结清扫术。我们确定了MRI和/或SLNB在治疗高危PM患者中的功效和成本。
方法：我们回顾了1999年至2005年间173例患者的192例PM。根据2005年Medicare基于资源的相对价值量表，对PM期间MRI和SLNB的费用进行了估算。我们还在更大的假设队列中估算了这四种策略的成本和程序。
结果：192例PM中共有19例（10％）包含隐匿性癌，14例原位导管癌和5例浸润性导管癌（IDC）。在59例患者中，MRI检测到一个IDC，但错过了两个DCIS和一个IDC。阳性MRI产生的平均额外费用为每位患者1,207美元。在56例SLNB患者中，发现了6例隐匿性癌症，其中5例DCIS和1例IDC均为SLNB阴性。添加SLNB的平均费用为644美元。理论分析表明，每人每人PM需花费808美元，SLNB的PM需1,420美元，MRI和选择性SLNB的PM需1,774美元，常规MRI和SLNB的PM需2,379美元。
结论：MRI增加了巨大的成本并且错过了PM中大多数隐匿性癌症。 SLNB可使罕见的隐匿性IDC患者避免腋窝淋巴结清扫术，但会增加成本。鉴于未预料到的浸润性癌症的发生率低以及MRI和SLNB的费用，均不建议将其作为PM患者的标准做法。

BACKGROUND & AIMS: OBJECTIVE:This study was undertaken to evaluate the deoxyribonucleic acid content and S-phase fraction in advanced epithelial ovarian carcinomas to determine whether lymph node metastases are biologically distinct from peritoneal sites of metastases.

STUDY DESIGN:Thirty-five patients with stage III or IV epithelial ovarian cancer who had undergone complete pelvic and paraaortic lymphadenectomy had representative samples from the primary ovarian tumor, peritoneal metastases, and lymph node metastases analyzed by flow cytometry for deoxyribonucleic acid nuclear content and S-phase fraction.

RESULTS:Diploid cell lines are found in metastatic lymph nodes (52%) significantly more frequently than in peritoneal metastases (25%, p < 0.02) or in primary ovarian tumors (26%, p < 0.001). The ploidy category frequency distribution of peritoneal metastases mirrors that found in the primary tumor, and both are significantly different from the ploidy category frequency distribution found in metastatic lymph nodes. Heterogeneity among sites is common, being identified in 54% of patients. Peritoneal metastases are more likely to be concordant with the primary tumor (69%) than are lymph node metastases (39%, p < 0.001). Mean S-phase fraction did not differ overall by site but was significantly different between diploid and aneuploid samples by site. Diploid lymph node metastases were found to have the lowest mean S-phase fraction (7.2% +/- 3.3%), and aneuploid lymph node metastases had the highest mean S-phase fraction (22.3% +/- 10.2%). Diploidy of the primary tumor is a positive predictor of long-term survival. Tumoral heterogeneity and lymph node metastases are not related to survival in this group of patients who underwent therapeutic pelvic and aortic lymphadenectomy.

CONCLUSIONS:A high proportion of tumor deposits found in metastatic lymph nodes are diploid with a low S-phase fraction. Therapeutic pelvic and aortic lymph node dissection removes disease that, on the basis of flow cytometric characteristics, may be predicted to be resistant to chemotherapy and radiation therapy.

背景与目标： 目的：这项研究旨在评估晚期上皮性卵巢癌中脱氧核糖核酸的含量和S期分数，以确定淋巴结转移是否在生物学上与转移的腹膜部位不同。

研究设计：35名经过完全盆腔和主动脉旁淋巴结清扫术的III或IV期上皮性卵巢癌患者的代表性样本来自原发性卵巢肿瘤，腹膜转移和淋巴结转移，并通过流式细胞术进行了分析

结果：在转移性淋巴结中发现二倍体细胞系（52％）的频率比在腹膜转移中（25％， p <0.02）或原发性卵巢肿瘤（26％，p <0.001）。腹膜转移瘤的倍性类别频率分布反映在原发性肿瘤中，并且两者均与转移性淋巴结中的倍性类别频率分布明显不同。部位之间的异质性很常见，在54％的患者中被发现。与淋巴结转移（39％，p <0.001）相比，腹膜转移更可能与原发肿瘤一致（69％）。平均S相分数在各部位之间总体上没有差异，但在二倍体和非整倍体样品之间，按部位存在显着差异。发现二倍体淋巴结转移的平均S期分数最低（7.2％/-3.3％），非整倍体淋巴结转移的平均S期分数最高（22.3％/-10.2％）。原发肿瘤的二倍体是长期生存的积极预测指标。该组接受盆腔和主动脉淋巴结清扫术的患者的肿瘤异质性和淋巴结转移与生存率无关。

结论：转移性淋巴结中发现大量肿瘤沉积物是具有低S相分数的二倍体。治疗性骨盆和主动脉淋巴结清扫术可根除流式细胞术特征可预测对化疗和放疗有抗药性的疾病。