'Show me the money': financial incentives increase chlamydia screening rates among tertiary students: a pilot study.

BACKGROUND: We hypothesise that text-messaging and financial incentives would increase tertiary student participation in chlamydia screening. METHODS: A cross-sectional study was conducted over two phases on eight tertiary campuses during 2007. During Phase 1 (6 months) study activities were advertised through student organisations and media. Education and screening were offered during a range of student activities. During Phase 2 (4 days) education and screening were offered via text messages. Non-financial incentives were offered during Phase 1 and a $10 cash incentive was offered during Phase 2. Rates of specimens provided by students and the direct costs incurred during each phase were compared. RESULTS: 2786 students attended the 31 activities conducted in Phase 1. Of these, 627 students (22.5%) provided urine specimens for chlamydia testing. During Phase 2, the dissemination of 866 text messages resulted in urine specimens from 392 students (45.3%). Costs per test were AUD $175.11 in Phase 1 and AUD $27.13 in Phase 2. CONCLUSIONS: Compared with more labour intensive (and therefore more expensive) screening activities conducted over a 6-month period, offering a small financial incentive to tertiary students through text messaging over a 4-day period significantly increased participation in on-campus chlamydia screening. This model could readily be applied to other populations to increase participation in chlamydia screening.

DNA amplification from formalin-fixed decalcified paraffin-embedded bone marrow trephine specimens: does the duration of storage matter?

INTRODUCTION: Examination of bone marrow (BM) trephines has been traditionally limited to histological analysis. With renewed interest in their use in molecular diagnostics, studies assessing the impact of duration of storage on DNA amplification from archived BM trephines are required. METHODS: DNA extraction was performed on 169 formalin-fixed decalcified paraffin-embedded (FFDPE) trephine blocks with a mean duration of storage of 59.4 months (range 4-200 months). An amplification control master mix from the In Vivo Scribe Immunoglobulin Heavy Chain Clonality kit was used to determine DNA amplification at different amplicon sizes [96-600 base pairs (bp)]. RESULTS: Amplification at 96 bp was noted in 145 of 169 specimens (85.8%). Progressive reduction in amplification was noted at higher base pairs with 99 of 169 (58.6%) amplifying at 200 bp, 56 cases (33.1%) at 300 bp, 35 (20.7%) at 400 bp and 19 (11.2%) at 600 bp. The impact of duration of storage on DNA amplification was not statistically significant. CONCLUSIONS: DNA was obtained from archival BM trephine specimens in approximately 86% of cases, indicating good potential for utilisation in polymerase chain reaction (PCR) techniques. The duration of storage of FFDPE tissue had no impact on the ability to amplify specimens.

Occult bone marrow involvement in patients with diffuse large B-cell lymphoma: results of a pilot study.

AIMS: It is known that advanced stage disease in diffuse large B-cell lymphoma (DLBCL) confers a poor prognosis, and staging investigations are routinely performed at diagnosis, including a bone marrow (BM) biopsy. However, examination of the BM is usually limited to routine light microscopy, with the role of ancillary investigations remaining unestablished. The aim of this pilot study was to estimate the incidence of occult marrow involvement using flow cytometry, immunohistochemistry and immunoglobulin heavy chain (IgH) gene rearrangements, and to determine the impact on survival. METHODS: Clinical and pathological data were obtained on 36 patients diagnosed with DLBCL. Immunohistochemistry using CD3, CD45RO, CD20 and CD79a, and polymerase chain reaction (PCR) to look for IgH gene rearrangements were performed on formalin fixed BM trephines. RESULTS: Nine patients had morphologically apparent BM involvement. Occult marrow involvement was found in seven of 36 (19.4%) patients using the additional diagnostic modalities. When these cases were included with morphologically apparent cases in a proposed new definition of marrow involvement, the median survival of patients with BM involvement was statistically worse (p=0.02) than those without involvement. CONCLUSIONS: The results indicate that use of additional tests on BM at diagnosis can upstage disease for a proportion of patients, which appears to correlate adversely with survival.

Pooling of clinical specimens prior to testing for Chlamydia trachomatis by PCR is accurate and cost saving.

The accuracy and cost savings of pooling specimens prior to testing for Chlamydia trachomatis by PCR were evaluated with genital and urine specimens (n = 2,600). There was a 60% reduction in tests without significant loss of accuracy. The efficiency of pooling vaginal swabs is demonstrated for the first time.

Is there an increased maternal-infant prevalence of Factor V Leiden in association with severe pre-eclampsia?

OBJECTIVE: To compare the prevalence of the Factor V Leiden mutation in children and maternal-infant pairs in pregnancies affected by severe pre-eclampsia with unmatched normal controls. DESIGN: Prospective cohort study. SETTING: Department of Women's and Children's Health, The Canberra Hospital, Garran, ACT, Australia. SAMPLE: Forty-eight maternal-infant pairs where the index pregnancy was affected by severe pre-eclampsia; 46 unmatched maternal-infant pairs where the index pregnancy was defined as normal. METHODS: DNA analysis of cheek swab samples obtained from maternal-infant pairs for the Factor V Leiden mutation. MAIN OUTCOME MEASURE: The prevalence of the Factor V Leiden mutation in mothers, infants and maternal-infant pairs in association with severe pre-eclampsia compared with unmatched controls. RESULTS: No difference was detected in the prevalence of Factor V Leiden mutation between the women and children of both groups, nor the maternal-infant pairs from each group. CONCLUSIONS: No evidence was found of an increased prevalence of the Factor V Leiden mutation in either the mothers or children in association with severe pre-eclampsia. This result argues against a Factor V Leiden fetal or maternal contribution to the development of severe pre-eclampsia.