Consultation rate and chlamydia positivity among ethnic minority clients at STI clinics in the Netherlands.

OBJECTIVES: Although ethnic minority clients (EMs) from STI endemic countries have a higher risk for STI, little is known about their STI clinic consultation rate proportionality. The aim of this study was to assess consultation and chlamydia positivity rates among different EMs visiting STI clinics in the Netherlands. METHODS: We calculated consultation rates in EM groups by dividing the number of STI consultations by the total number of inhabitants in the region belonging to an EM, then compared the EM rates to native Dutch rates. Factors associated with chlamydia positivity were analysed using multivariate regression analysis. RESULTS: A total of 23,841 clients visiting an eastern Netherlands STI clinic between 2011 and 2013 were included in the analysis, of which 7% were EMs. The consultation rate of native Dutch clients was 22.5 per 1000, compared to 8.5 per 1000 among EMs. Consultation rates in all EMs were lower than in Dutch clients, except for Antillean or Aruban EMs and Latin American EMs. The chlamydia positivity rate among all clients was 15.5%, and Antillean or Aruban ethnicity (27.1%) EMs had the highest rates. Multivariate analysis identified the following factors associated with chlamydia positivity: Eastern or Northern European EM, African EM, Antillean or Aruban EM, STI related symptoms, heterosexual preference, partner in a risk group, receiving a partner notification, and having had three or more partners in the past six months. CONCLUSION: On a population level, most EMs visit STI clinics less often than native Dutch clients, but they have a higher rate of positive chlamydia diagnoses. STI clinics should increase outreach activities for EM clients because they are insufficiently reached by current practices, but contribute substantially to chlamydia incidence rates.

Smoking and older age associated with mumps in an outbreak in a group of highly-vaccinated individuals attending a youth club party, the Netherlands, 2012.

We describe a mumps outbreak in a highly-vaccinated population attending a party at a youth club. In a retrospective cohort study with 60 of approximately 100 participants responding, vaccination status was verified for 58/59 respondents, of whom 54 were vaccinated twice and four once. The attack rate was 22% (13 cases, all vaccinated), with smoking at the party (risk ratio (RR) 3.1; 95% confidence interval (CI): 1.6­6.0, p=0.001) and age ≥21 years (RR 4.7; 95% CI: 2.1­10.2, p<0.0001) as risk factors for disease in the binominal regression analysis. Mild upper respiratory illness was also highly prevalent in those who did not meet the mumps case definition (n=46) after the party, suggesting that mumps virus infection may cause mild disease in vaccinated individuals. Our investigation adds toevidence that crowded social events and smoking may facilitate spread of mumps virus among vaccinated populations, with waning immunity playing a role. The suggestion that mumps virus infection in vaccinated individuals may manifest as mild upper respiratory illness could have implications for transmission and warrants further investigation.

Dynamic (19)F-MRI of pulmonary ventilation using sulfur hexafluoride (SF(6)) gas.

A new method for dynamic imaging of pulmonary wash-in and wash-out kinetics of inhaled sulfur hexafluoride (SF(6)) gas was developed. Measurements at the fluorine-19 Larmor frequency were performed in pigs using a gradient echo pulse sequence with 0.5 ms echo time and a measurement time of 9.1 s per image. Dynamic MRI was performed during wash-in and wash-out of SF(6) gas in mechanically ventilated porcine lungs. A postprocessing strategy was developed for quantitative determination of wash-out time constants in the presence of noise. Mean wash-out constants were 4.78 +/- 0.48 breaths vs. 4.33 +/- 0.76 breaths for left and right lung when ventilation was performed with low tidal volume, and 1.73 +/- 0.16 breaths vs. 1.85 +/- 0.11 breaths with high tidal volume ventilation. In conclusion, breath-hold MRI of SF(6) gas is feasible in large animals. Moreover, regional wash-in and wash-out kinetics of SF(6) can be determined noninvasively with this new method. Potential human applications are discussed. Magn Reson Med 45:605-613, 2001.

[19F-MRT of pulmonary ventilation in the breath-hold technic using SF6 gas]. / 19F-MRT der Lungenventilation in Atemanhaltetechnik mittels SF6-Gas.

OBJECTIVE: Development of a method to analyze lung ventilation by 19F-magnetic resonance imaging (MRI) of inspired SF6 gas during breath hold. MATERIAL AND METHODS: Measurements were performed with a Siemens Magnetom Vision 1.5 T scanner using the conventional gradient overdrive. Coronal images of the lung were acquired using ultrafast gradient-echo pulse sequences with TR/TE/alpha = 1.4 ms/0.48 ms/40 degrees without slice selection. With NEX = 200 averages and MA = 32 x 64 raw data matrix, the acquisition time was 9 s/image. Higher spatial resolution of 4.7 x 6.3 x 15 mm3 was obtained with a three-dimensional pulse sequence (TR/TE/alpha = 1.6 ms/0.48 ms/65 degrees, NEX = 20) running for 49 s. Measurements wer performed in three anesthetized and ventilated pigs (18 kg). RESULTS: A nearly linear relation between SF6 concentration and 19F signal intensity was observed. The signal-to-noise ratio in images obtained without slice selection was 30.9, with slice selection it was 14.9. No differences between SF6 distribution to both lungs were observed in the animals. CONCLUSION: Breath-hold MRI of SF6 gas distribution in the lung was demonstrated for the first time. The low spin-density was compensated for by highly repetitive signal averaging. Breath-hold 19F-MR imaging of ventilated airspaces to assess SF6 distribution in the human lung appears to be an interesting new method, which can be implemented with little technical efforts, and does not rely on radioactive isotopes.