BACKGROUND & AIMS: :There is strong evidence for an association between overgrowth disorders such as Beckwith-Wiedemann syndrome and the development of neoplasia. An increased cancer risk has also been observed in individuals with isolated hemihyperplasia. We critically review the evidence for tumour surveillance in Beckwith-Wiedemann syndrome and isolated hemihyperplasia and suggest local practice guidelines.

背景与目标： : 有强有力的证据表明，Beckwith-Wiedemann综合征等过度生长性疾病与肿瘤的发展之间存在关联。在孤立的半增生个体中也观察到癌症风险增加。我们严格审查了Beckwith-Wiedemann综合征和孤立性半增生中肿瘤监测的证据，并提出了当地实践指南。

BACKGROUND & AIMS: :DuPage County Health Department collected de-identified data from health forms submitted by participating schools for academic years 2011-2015 for kindergarten, sixth-, and ninth-grade students to determine the prevalence of obesity and elevated blood pressure among public school students. The prevalence of obesity in students for the 2014-2015 school year was 15.1%, and the prevalence of elevated blood pressure was 22.8%. Students in the "obese" body mass index percentile category had an elevated blood pressure prevalence of 44.2%, which was higher than students in the "nonobese" category (P < .001). Significant differences were also observed both by sex and by grade. The results identify the need to support implementation and evaluation of policies to reduce childhood obesity and improve health outcomes. By partnering with schools to obtain preexisting health data, state or local health departments with limited resources may replicate these methods to develop a childhood obesity surveillance system.

背景与目标： : 杜佩奇县卫生部门从参与学校提交的2011-2015学年幼儿园，六年级和九年级学生的健康表格中收集了不识别的数据，以确定公立学校学生中肥胖和血压升高的患病率。2014-2015学年学生的肥胖患病率为15.1%，血压升高的患病率为22.8%。“肥胖” 体重指数百分位类别的学生的血压患病率升高为44.2%，高于 “非肥胖” 类别的学生 (P <.001)。按性别和等级也观察到显着差异。结果表明需要支持实施和评估减少儿童肥胖和改善健康结果的政策。通过与学校合作以获取先前存在的健康数据，资源有限的州或地方卫生部门可以复制这些方法来开发儿童肥胖监测系统。

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：

BACKGROUND & AIMS: BACKGROUND:Patients with early-stage, nonbulky classic Hodgkin lymphoma (cHL) undergo intensive posttreatment radiologic surveillance despite having a low risk of disease recurrence. The current study attempted to evaluate the risk of disease recurrence and the value of radiologic surveillance in patients treated with the combination of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) alone who achieved a complete remission (CR) as noted on posttreatment positron emission tomography (PET). METHODS:Forty-seven patients who underwent therapy with interim and/or posttreatment PET scans were evaluated for disease recurrence during ≥ 24 months of follow-up. Their presenting characteristics and imaging results were assessed and interpreted in relation to clinical outcome. RESULTS:All 47 patients were eligible for analysis. The majority of patients were female (35 patients) with a median age of 28 years (range, 17 years-65 years.). The nodular sclerosing subtype was the predominant histology (41 patients). A total of 34 patients were staged with IIA disease, 6 with IA disease, 6 with IIB disease, and 1 with IIEA disease (lung) (according to Cotswolds modification of the Ann Arbor staging system). All patients completed 6 cycles of planned ABVD therapy and achieved a CR. Two had a positive PET scan (1 interim scan and 1 posttreatment scan); both were biopsy-proven sarcoidosis. Two patients developed disease recurrence at 7 months and 24 months, respectively, after negative interim and posttreatment imaging. One case of recurrence was identified through surveillance imaging and the other was identified simultaneously by the patient and surveillance scan. A total of 45 patients experienced a durable CR; 21 had additional unscheduled imaging/workup during surveillance to investigate symptoms or imaging signs of concern. CONCLUSIONS:Because of a low risk of disease recurrence, posttreatment radiologic surveillance appears to be unnecessary in patients with early-stage, nonbulky (CD20 negative) cHL who achieve a PET-detected CR with the ABVD combination alone. This will reduce cumulative radiation exposure and health care costs in a predominantly young patient population.

背景与目标：

BACKGROUND & AIMS: :Sessile serrated polyps are a recently recognized type of neoplastic polyp that develops along a molecular pathway different from that of conventional adenomas. While the clinical significance of the serrated pathway to colorectal cancer is clear, further study is needed to understand a patient's lifetime colorectal cancer risk posed by serrated neoplasms and the optimal postpolypectomy surveillance interval.

背景与目标： : 无梗锯齿状息肉是最近公认的一种肿瘤性息肉，其沿着与常规腺瘤不同的分子途径发展。虽然锯齿状途径对结直肠癌的临床意义很明确，但需要进一步研究以了解锯齿状肿瘤和最佳息肉切除术后监测间隔对患者一生的结直肠癌风险。

BACKGROUND & AIMS: BACKGROUND:Professional societies recommend posttreatment surveillance for colorectal cancer (CRC) survivors. This study describes the use of surveillance over time, with a particular focus on racial/ethnic disparities, and also examines the role of area characteristics, such as capacity for CRC screening, on surveillance. METHODS:Surveillance, Epidemiology, and End Results (SEER)-Medicare data were used to identify individuals aged 66 to 85 years who were diagnosed with CRC from 1993 to 2005 and treated with surgery. The study examined factors associated with subsequent receipt of a colonoscopy, carcinoembryonic antigen (CEA) testing, primary care (PC) visits, and a composite measure of overall surveillance. RESULTS:Of eligible subjects, 61.0% had a colonoscopy, 68.0% had CEA testing, 77.1% had PC visits, and 43.0% received overall surveillance. After adjustment, blacks were less likely than whites to undergo colonoscopy (odds ratio [OR] 0.76, 95% confidence interval [CI] = 0.69-0.83) and to receive CEA testing and overall surveillance, whereas white/Hispanic rates did not differ. Rates for all outcomes increased from 1993 to 2005, but black/white disparities remained. Individuals in areas with greatest capacity for CRC screening were more likely (OR = 1.09, 95% CI = 1.02-1.18) to receive colonoscopy, and those in areas with the greatest percentage of blacks were less likely (OR = 0.89, 95% CI = 0.83-0.95) to receive colonoscopy. Those living in areas with shortage of PC were less likely to receive PC visits (OR = 0.55, 95% CI = 0.48-0.64) and overall surveillance (OR = 0.83, 95% CI = 0.71-0.98). CONCLUSIONS:Many CRC survivors do not get recommended surveillance, and black/white disparities in rates of surveillance have not improved. Characteristics of the area where an individual lives contribute to the use of surveillance.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Tuberculosis is curable, but community surveys documenting epidemiological impact of the WHO-recommended DOTS strategy on tuberculosis prevalence have not been published. We used active community surveillance to compare the impact of DOTS with earlier programmes. METHODS:We conducted tuberculosis disease surveys using random cluster sampling of a rural population in South India approximately every 2.5 years from 1968 to 1986, using radiography as a screening tool for sputum examination. In 1999, DOTS was implemented in the area. Prevalence surveys using radiography and symptom screening were conducted at the start of DOTS implementation and after 2.5 years. RESULTS:From 1968 to 1999, culture-positive and smear-positive tuberculosis declined by 2.3 and 2.5% per annum compared with 11.9 and 5.6% after DOTS implementation. The 2.5 year period of DOTS implementation accounted for one-fourth of the decline in prevalence of culture-positive tuberculosis over 33 years. Multivariate analysis showed that prevalence of culture-positive tuberculosis decreased substantially (10.0% per annum, 95% CI: 2.8-16.6%) owing to DOTS after only slight declines related to temporal trends (2.1% annual decline, 95% CI: 1.1-3.2%) and short-course chemotherapy (1.5% annual decline, 95% CI: -9.7% to 11.5%). Under DOTS, the proportion of total cases identified through clinical care increased from 81 to 92%. CONCLUSIONS:Following DOTS implementation, prevalence of culture-positive tuberculosis decreased rapidly following a gradual decline for the previous 30 years. In the absence of a large HIV epidemic and with relatively low levels of rifampicin resistance, DOTS was associated with rapid reduction of tuberculosis prevalence.

背景与目标：

BACKGROUND & AIMS: :Bovine tuberculosis (bTB) is a chronic disease of cattle that is difficult to control and eradicate in part due to the costly nature of surveillance and poor sensitivity of diagnostic tests. Like many countries, bTB prevalence in Uruguay has gradually declined to low levels due to intensive surveillance and control efforts over the past decades. In low prevalence settings, broad-based surveillance strategies based on routine testing may not be the most cost-effective way for controlling between-farm bTB transmission, while targeted surveillance aimed at high-risk farms may be more efficient for this purpose. To investigate the efficacy of targeted surveillance, we developed an integrated within- and between-farm bTB transmission model utilizing data from Uruguay's comprehensive animal movement database. A genetic algorithm was used to fit uncertain parameter values, such as the animal-level sensitivity of skin testing and slaughter inspection, to observed bTB epidemiological data. Of ten alternative surveillance strategies evaluated, a strategy based on eliminating testing in low-risk farms resulted in a 40% reduction in sampling effort without increasing bTB incidence. These results can inform the design of more cost-effective surveillance programs to detect and control bTB in Uruguay and other countries with low bTB prevalence.

背景与目标： : 牛结核病 (bTB) 是一种牛的慢性疾病，由于监测的成本高昂和诊断测试的敏感性差，很难控制和根除。与许多国家一样，由于过去几十年来的密集监测和控制工作，乌拉圭的bTB患病率逐渐下降到较低水平。在低流行率的环境中，基于常规测试的基础广泛的监测策略可能不是控制农场间bTB传播的最具成本效益的方法，而针对高风险农场的针对性监测可能为此目的更有效。为了研究目标监测的有效性，我们利用乌拉圭综合动物运动数据库中的数据开发了一个集成的农场内和农场间bTB传播模型。使用遗传算法将不确定的参数值 (例如皮肤测试和屠宰检查的动物级敏感性) 拟合到观察到的bTB流行病学数据。在评估的十种替代监测策略中，基于消除低风险农场测试的策略导致采样工作量40% 减少，而不会增加bTB发生率。这些结果可以为设计更具成本效益的监测计划提供信息，以检测和控制乌拉圭和其他bTB患病率较低的国家的bTB。

BACKGROUND & AIMS: :Influenza virus infections result in considerable morbidity and mortality both in the temperate and tropical world. Influenza surveillance over multiple years is important to determine the impact and epidemiology of influenza and to develop a national vaccine policy, especially in countries developing influenza vaccine manufacturing capacity, such as Vietnam. We conducted surveillance of influenza and influenza-like illness in Vietnam through the National Influenza Surveillance System during 2006-2010. At 15 sentinel sites, the first two patients presenting each weekday with influenza-like illness (ILI), defined as fever and cough and/or sore throat with illness onset within 3 days, were enrolled and throat specimens were collected and tested for influenza virus type and influenza A subtype by RT-PCR. De-identified demographic and provider reported subsequent hospitalization information was collected on each patient. Each site also collected information on the total number of patients with influenza-like illness evaluated per week. Of 29,804 enrolled patients presenting with influenza-like illness, 6516 (22%) were influenza positive. Of enrolled patients, 2737 (9.3%) were reported as subsequently hospitalized; of the 2737, 527 (19%) were influenza positive. Across all age groups with ILI, school-aged children had the highest percent of influenza infection (29%) and the highest percent of subsequent hospitalizations associated with influenza infection (28%). Influenza viruses co-circulated throughout most years in Vietnam during 2006-2010 and often reached peak levels multiple times during a year, when >20% of tests were influenza positive. Influenza is an important cause of all influenza-like illness and provider reported subsequent hospitalization among outpatients in Vietnam, especially among school-aged children. These findings may have important implications for influenza vaccine policy in Vietnam.

背景与目标： : 在温带和热带地区，流感病毒会导致相当大的发病率和死亡率。多年的流感监测对于确定流感的影响和流行病学以及制定国家疫苗政策非常重要，特别是在越南等发展流感疫苗生产能力的国家。我们在2006-2010年期间通过国家流感监测系统对越南的流感和流感样疾病进行了监测。在15个哨点，招募了每个工作日出现流感样疾病 (ILI) 的前两名患者，这些疾病定义为发热，咳嗽和/或喉咙痛，并在3天内发病，并收集了喉咙标本，并通过rt-pcr检测了流感病毒类型和a型流感亚型。取消身份的人口统计学和提供者报告的后续住院信息收集了每位患者。每个站点还收集了每周评估的流感样疾病患者总数的信息。在29,804名出现流感样疾病的患者中，6516 (22%) 为流感阳性。在登记的患者中，2737 (9.3%) 被报告为随后住院; 2737中，527 (19%) 为流感阳性。在ILI的所有年龄组中，学龄儿童的流感感染率最高 (29%)，随后与流感感染相关的住院率最高 (28%)。在2006-2010年期间，流感病毒在越南的大多数年份中共同传播，并且在一年中经常多次达到峰值水平，当> 20% 的测试为流感阳性时。流感是所有流感样疾病的重要原因，提供者报告说越南门诊患者随后住院，尤其是学龄儿童。这些发现可能对越南的流感疫苗政策具有重要意义。

BACKGROUND & AIMS: :We compared serotype distributions of Streptococcus pneumoniae isolates from patients aged <5 and o5 years with invasive pneumococcal disease in New South Wales, Australia, and antibiotic susceptibilities of isolates from the <5 years age group only, before (2002–2004) and after(2005–2009) introduction of the 7-valent pneumococcal conjugate vaccine (PCV7). Overall, there were significant decreases in the mean annual number of referred isolates (770 vs. 515) and the proportion belonging to PCV7 serotypes (74% vs. 38%), but non-PCV7 serotypes, particularly 19A, increased (5% vs. 18%). All changes were more marked in the <5 years age group.Susceptibility testing of isolates from the <5 years age group showed variation in resistance between serotypes, but significant overall increases in penicillin non-susceptibility (23% vs. 31%),ceftriaxone resistance (2% vs. 12%) and multidrug resistance (4% vs. 7%) rates ; erythromycin resistance fell (32% vs. 25%). Continued surveillance is needed to monitor changes following the introduction of 13-valent PCV in 2012.

背景与目标： : 我们比较了澳大利亚新南威尔士州 <5岁和o5岁侵袭性肺炎球菌疾病患者肺炎链球菌分离株的血清型分布，以及 <5岁年龄组分离株的抗生素敏感性，在 (2002-2004) 和 (2005-2009) 引入7价肺炎球菌结合疫苗 (PCV7) 之前。总体而言，平均年转诊分离株数 (770对515) 和属于PCV7血清型的比例显著下降 (74% 对38%)，但non-PCV7血清型，特别是19A，增加 (5% 对18%)。所有变化在 <5岁年龄组中更为明显。来自 <5岁年龄组的分离株的药敏试验显示血清型之间的耐药性差异，但青霉素非药敏总体显着增加 (23% 对31%)，头孢曲松耐药率 (2% 对12%) 和多药耐药率 (4% 对7%); 红霉素耐药率下降 (32% 对25%)。在引入13价PCV 2012年后，需要持续监测以监测变化。

BACKGROUND & AIMS: BACKGROUND:Many studies on migrant health have focused on aspects of morbidity and mortality, but very few approach the relevant issues of migrants' health considering behavioral risk factors. Previous studies have often been limited methodologically because of sample size or lack of information on migrant country of origin. Information about risk factors is fundamental to direct any intervention, particularly with regard to non-communicable diseases that are leading causes of death and disease. Thus, the main focus of our analysis is the influence of country of origin and the assimilation process. METHOD:Utilizing a surveillance system that has been collecting over 30,000 interviews a year in Italy since 2008, we have studied migrants' attitudes and behaviors by country of origin and by length of stay. Given 6 years of observation, we have obtained and analyzed 228,201 interviews of which over 9000 were migrants. RESULTS:While migrants overall present similar conditions to native-born Italians, major differences appear when country of origin or length of stay is considered. Subgroups of migrants present substantially different behaviors, some much better than native-born Italians, some worse. However, integration processes generally produce a convergence towards the behavioral prevalence observed for native-born Italians. CONCLUSIONS:Health programs should consider the diversity of the growing migrant population: data and analyses are needed to support appropriate policies. Many migrants' subgroups arrive with healthier behaviors than those of their adopted country. However, they are likely to have a less favorable social position in their destination countries that could lead to a change towards less healthy behaviors. Interventions capable of identifying this tendency could produce significant better health for this important part of the future (multicultural) populations.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Peripheral arterial disease (PAD) indicates generalized atherosclerosis but is still underdiagnosed and undertreated. METHODS:Data were collected from patients with PAD from the Department of Cardiology and Angiology, University of Heidelberg, Germany. The prevalence of cardiovascular risk factors and medication were documented. RESULTS:Atherogenic risk factors, cardiovascular disease, and cerebrovascular disease were highly prevalent. By continuous care at the university clinic, in addition to family medicine treatment, the use of platelet inhibitors, antihypertensives, and lipid-lowering therapy was increased. Ankle-brachial index and walking distance improved. CONCLUSION:Long-term treatment at the university clinic had positive effects on atherogenic risk factors. The regular use of secondary preventive medication was improved. Still, this patient population remained undertreated and showed a high incidence of vascular event rates and a need for vascular interventions. This study implies the importance of both specialists and general practitioners in the care of these individuals.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Using smokeless tobacco and smoking are behaviors that increase the risk of developing oral cancer, soft-tissue lesions, caries, periodontal disease and other oral conditions. The author conducted a study to examine use of smokeless tobacco and smoking by adolescents. METHODS:The study was a cross-sectional analysis of participants with complete data regarding smoking, smokeless tobacco use and other variables of interest from the 2011 national Youth Risk Behavior Surveillance System survey (n = 9,655). The author performed descriptive analysis and multivariable logistic regression analyses. RESULTS:The unadjusted odds ratio for smokeless tobacco use and smoking was 9.68 (95 percent confidence interval [CI], 7.72-12.13; P < .0001), and the adjusted odds ratio was 3.92 (95 percent CI, 2.89-5.31; P < .0001). Adolescents who used smokeless tobacco were more likely to be male, to smoke and to have engaged in binge drinking. CONCLUSION:Adolescents who were using smokeless tobacco were more likely to be engaging in concomitant smoking and to be participating in other risk-taking behaviors. Practical Implications. Dentists are involved in helping patients with tobacco-use cessation. The association of smoking with using smokeless tobacco needs to be considered in the design of tobacco-use cessation programs for adolescents.

背景与目标：

BACKGROUND & AIMS: :NK cells are highly efficient at preventing cancer metastasis but are infrequently found in the core of primary tumors. Here, have we demonstrated that freshly isolated mouse and human NK cells express low levels of the endo-β-D-glucuronidase heparanase that increase upon NK cell activation. Heparanase deficiency did not affect development, differentiation, or tissue localization of NK cells under steady-state conditions. However, mice lacking heparanase specifically in NK cells (Hpsefl/fl NKp46-iCre mice) were highly tumor prone when challenged with the carcinogen methylcholanthrene (MCA). Hpsefl/fl NKp46-iCre mice were also more susceptible to tumor growth than were their littermate controls when challenged with the established mouse lymphoma cell line RMA-S-RAE-1β, which overexpresses the NK cell group 2D (NKG2D) ligand RAE-1β, or when inoculated with metastatic melanoma, prostate carcinoma, or mammary carcinoma cell lines. NK cell invasion of primary tumors and recruitment to the site of metastasis were strictly dependent on the presence of heparanase. Cytokine and immune checkpoint blockade immunotherapy for metastases was compromised when NK cells lacked heparanase. Our data suggest that heparanase plays a critical role in NK cell invasion into tumors and thereby tumor progression and metastases. This should be considered when systemically treating cancer patients with heparanase inhibitors, since the potential adverse effect on NK cell infiltration might limit the antitumor activity of the inhibitors.

背景与目标： : NK细胞在预防癌症转移方面非常有效，但在原发性肿瘤的核心中很少发现。在这里，我们已经证明了新鲜分离的小鼠和人NK细胞表达低水平的内切-β-D-葡萄糖醛酸苷酶乙酰肝素酶，该酶在NK细胞活化后会增加。在稳态条件下，乙酰肝素酶缺乏症不会影响NK细胞的发育，分化或组织定位。然而，在NK细胞中特异性缺乏乙酰肝素酶的小鼠 (Hpsefl/fl NKp46-iCre小鼠) 在被致癌物甲基胆蒽 (MCA) 攻击时高度容易发生肿瘤。当用已建立的小鼠淋巴瘤细胞系RMA-S-RAE-1β (其过表达NK细胞组2D (NKG2D) 配体RAE-1β) 或接种转移性黑色素瘤、前列腺癌或乳腺癌细胞系时，Hpsefl/fl NKp46-iCre小鼠也比其同窝对照更容易肿瘤生长。NK细胞对原发性肿瘤的侵袭和向转移部位的募集严格取决于乙酰肝素酶的存在。当NK细胞缺乏乙酰肝素酶时，细胞因子和免疫检查点阻断对转移灶的免疫疗法受到损害。我们的数据表明，乙酰肝素酶在NK细胞侵袭肿瘤，从而肿瘤进展和转移中起关键作用。当用乙酰肝素酶抑制剂全身治疗癌症患者时，应考虑这一点，因为对NK细胞浸润的潜在不良影响可能会限制抑制剂的抗肿瘤活性。

BACKGROUND & AIMS: :Much of the mammalian genome is transcribed, generating long non-coding RNAs (lncRNAs) that can undergo post-transcriptional surveillance whereby only a subset of the non-coding transcripts is allowed to attain sufficient stability to persist in the cellular milieu and control various cellular functions. Paralleling protein turnover by the proteasome complex, lncRNAs are also likely to exist in a dynamic equilibrium that is maintained through constant monitoring by the RNA surveillance machinery. In this Review, we describe the RNA surveillance factors and discuss the vital role of lncRNA surveillance in orchestrating various biological processes, including the protection of genome integrity, maintenance of pluripotency of embryonic stem cells, antibody-gene diversification, coordination of immune cell activation and regulation of heterochromatin formation. We also discuss examples of human diseases and developmental defects associated with the failure of RNA surveillance mechanisms, further highlighting the importance of lncRNA surveillance in maintaining cell and organism functions and health.

背景与目标： : 许多哺乳动物基因组被转录，产生长的非编码rna (lncrna)，可以进行转录后监测，因此仅允许非编码转录本的子集获得足够的稳定性，以在细胞环境中持续存在并控制各种细胞功能。与蛋白酶体复合物平行的蛋白质转换，lncrna也可能以动态平衡存在，该动态平衡通过RNA监视机制的持续监测得以维持。在这篇综述中，我们描述了RNA监测因素，并讨论了lncRNA监测在协调各种生物过程中的重要作用，包括保护基因组完整性，维持胚胎干细胞的多能性，抗体-基因多样化，免疫细胞激活的协调和异染色质形成的调节。我们还讨论了与RNA监视机制失败相关的人类疾病和发育缺陷的例子，进一步强调了lncRNA监视在维持细胞和生物功能以及健康方面的重要性。