STUDY OF OPERATIVE OUTCOME OF CORNUAL CANNULATION IN HYSTEROLAPAROSCOPY

Tubo-Peritoneal disease is the cause of infertility in approximately 30% of women, and 10–25% of these are due to proximal tubal obstruction. Hysterosalpngography(HSG) can diagnose the proximal tubal block but confirmation needed by hysterolaparoscopic chromopertubation before subjecting patient to expensive reproductive techniques. In our study of 48 cases, we find out the success rate of cornual cannulation by catheter-guidewire system is almost 81.25% with false positive rate of HSG is 27.2% and sensitivity of 86.4%. We also find out that pelvic inflammatory disease and tuberculosis contributes to 43.9% cases of proximal tubal block and success rate was approximately 50% can be achived in this cases. Hysterolaparoscopic cornual cannulation is simple, cost effective and promising treatment for proximal tubal pathology than tubo-cornual anastomosis with minimal complications. So we conclude that it should be offer on priority basis to treat infertile patients.

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Frozen Section of Thyroid and Parathyroid Specimens

Archives of Pathology & Laboratory Medicine ◽

10.5858/2005-129-1575-fsotap ◽

2005 ◽

Vol 129 (12) ◽

pp. 1575-1584 ◽

Cited By ~ 5

Author(s):

Rose C. Anton ◽

Thomas M. Wheeler

Keyword(s):

Thyroid Nodules ◽

Frozen Section ◽

False Positive Rate ◽

Cost Effective ◽

Needle Aspiration ◽

Thyroid Lobectomy ◽

Parathyroid Lesions ◽

Surgical Evaluation ◽

Positive Rate ◽

Accurate Procedure

Abstract Context.—Preoperative fine-needle aspiration of thyroid lesions has greatly diminished the need for surgical evaluation. However, because thyroid nodules are common lesions, many still require surgical intervention and represent a substantial number of cases that the pathologist encounters in the frozen section laboratory. Objective.—Comprehensive reviews of frozen section indications, as well as gross, cytologic, and histologic features of the most common and diagnostically important thyroid and parathyroid lesions, are presented to provide a guideline for proper triage and management of these cases in the frozen section laboratory. The most common pitfalls are discussed in an attempt to avoid discordant diagnoses. Data Sources.—Thyroid lobectomy, subtotal or total thyroidectomy, and parathyroid biopsy or parathyroidectomy cases are included in this review. Conclusions.—The frozen section evaluation of thyroid and parathyroid lesions remains a highly accurate procedure with a low false-positive rate. Gross inspection, complemented by cytologic and histologic review, provides the surgeon with the rapid, reliable, cost-effective information necessary for optimum patient care.

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Clinical and Economic Evaluation after Adopting Contingent Cell-Free DNA Screening for Fetal Trisomies in South Spain

Fetal Diagnosis and Therapy ◽

10.1159/000508306 ◽

2020 ◽

Vol 47 (10) ◽

pp. 749-756

Author(s):

José A. Sainz ◽

María R. Torres ◽

Ignacio Peral ◽

Reyes Granell ◽

Manuel Vargas ◽

...

Keyword(s):

False Positive Rate ◽

Cost Effective ◽

First Trimester ◽

Nuchal Translucency ◽

University Hospitals ◽

Combined Test ◽

Positive Rate ◽

Fetal Malformations ◽

Cfdna Screening ◽

Singleton Pregnancies

Introduction: Contingent cell-free (cf) DNA screening on the basis of the first-trimester combined test (FCT) results has emerged as a cost-effective strategy for screening of trisomy 21 (T21). Objectives: To assess performance, patients’ uptake, and cost of contingent cfDNA screening and to compare them with those of the established FCT. Methods: This is a prospective cohort study including all singleton pregnancies attending to their FCT for screening of T21 at 2 university hospitals in South Spain. When the FCT risk was ≥1:50, there were major fetal malformations, or the nuchal translucency was ≥3.5 mm, women were recommended invasive testing (IT); if the risk was between 1:50 and 1:270, women were recommended cfDNA testing; and for risks bellow 1:270, no further testing was recommended. Detection rate (DR), false-positive rate (FPR), patients’ uptake, and associated costs were evaluated. Results: We analyzed 10,541 women, including 46 T21 cases. DR of our contingent strategy was 89.1% (41/46) at 1.4% (146/10,541) FPR. Uptake of cfDNA testing was 91.2% (340/373), and overall IT rate was 2.0%. The total cost of our strategy was €1,462,895.7, similar to €1,446,525.7 had cfDNA testing not been available. Conclusions: Contingent cfDNA screening shows high DR, low IT rate, and high uptake at a similar cost than traditional screening.

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Classifying Coding DNA with Nucleotide Statistics

Bioinformatics and Biology Insights ◽

10.4137/bbi.s3030 ◽

2009 ◽

Vol 3 ◽

pp. BBI.S3030 ◽

Cited By ~ 5

Author(s):

Nicolas Carels ◽

Diego Frías

Keyword(s):

Success Rate ◽

Homo Sapiens ◽

Stop Codon ◽

False Positive Rate ◽

Regression Line ◽

Compositional Bias ◽

Coding Sequences ◽

Automatic Translation ◽

Positive Rate ◽

Universal Correlation

In this report, we compared the success rate of classification of coding sequences (CDS) vs. introns by Codon Structure Factor (CSF) and by a method that we called Universal Feature Method (UFM). UFM is based on the scoring of purine bias (Rrr) and stop codon frequency. We show that the success rate of CDS/intron classification by UFM is higher than by CSF. UFM classifies ORFs as coding or non-coding through a score based on (i) the stop codon distribution, (ii) the product of purine probabilities in the three positions of nucleotide triplets, (iii) the product of Cytosine (C), Guanine (G), and Adenine (A) probabilities in the 1st, 2nd, and 3rd positions of triplets, respectively, (iv) the probabilities of G in 1st and 2nd position of triplets and (v) the distance of their GC3 vs. GC2 levels to the regression line of the universal correlation. More than 80% of CDSs (true positives) of Homo sapiens (>250 bp), Drosophila melanogaster (>250 bp) and Arabidopsis thaliana (>200 bp) are successfully classified with a false positive rate lower or equal to 5%. The method releases coding sequences in their coding strand and coding frame, which allows their automatic translation into protein sequences with 95% confidence. The method is a natural consequence of the compositional bias of nucleotides in coding sequences.

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Comparing the clinical and economic effects of clinical examination, pulse oximetry, and echocardiography in newborn screening for congenital heart defects: A probabilistic cost-effectiveness model and value of information analysis

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462307070304 ◽

2007 ◽

Vol 23 (2) ◽

pp. 192-204 ◽

Cited By ~ 40

Author(s):

Ingolf Griebsch ◽

Rachel L. Knowles ◽

Jacqueline Brown ◽

Catherine Bull ◽

Christopher Wren ◽

...

Keyword(s):

Cost Effectiveness ◽

Newborn Screening ◽

Pulse Oximetry ◽

Clinical Examination ◽

Heart Defects ◽

False Positive Rate ◽

Research Priorities ◽

Cost Effective ◽

Positive Rate ◽

Clinically Significant

Objectives: Congenital heart defects (CHD) are an important cause of death and morbidity in early childhood, but the effectiveness of alternative newborn screening strategies in preventing the collapse or death—before diagnosis—of infants with treatable but life-threatening defects is uncertain. We assessed their effectiveness and efficiency to inform policy and research priorities.Methods: We compared the effectiveness of clinical examination alone and clinical examination with either pulse oximetry or screening echocardiography in making a timely diagnosis of life-threatening CHD or in diagnosing clinically significant CHD. We contrasted their cost-effectiveness, using a decision-analytic model based on 100,000 live births, and assessed future research priorities using value of information analysis.Results: Clinical examination alone, pulse oximetry, and screening echocardiography achieved 34.0, 70.6, and 71.3 timely diagnoses per 100,000 live births, respectively. This finding represents an additional cost per additional timely diagnosis of £4,894 and £4,496,666 for pulse oximetry and for screening echocardiography. The equivalent costs for clinically significant CHD are £1,489 and £36,013, respectively. Key determinants of cost-effectiveness are detection rates and screening test costs. The false-positive rate is very high with screening echocardiography (5.4 percent), but lower with pulse oximetry (1.3 percent) or clinical examination alone (.5 percent).Conclusions: Adding pulse oximetry to clinical examination is likely to be a cost-effective newborn screening strategy for CHD, but further research is required before this policy can be recommended. Screening echocardiography is unlikely to be cost-effective, unless the detection of all clinically significant CHD is considered beneficial and a 5 percent false-positive rate acceptable.

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A study on the outcome of various methods of administration of intratympanic dexamethasone in tinnitus of cochlear pathology

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20185115 ◽

2018 ◽

Vol 5 (1) ◽

pp. 50

Author(s):

M. Vivek ◽

M. Gowri Shankar ◽

N. Ponraj Kumar ◽

V. Suresh

Keyword(s):

Success Rate ◽

Pure Tone Audiometry ◽

Cost Effective ◽

Decay Test ◽

Cochlear Pathology ◽

Promising Treatment ◽

A Prospective Study ◽

Intratympanic Dexamethasone ◽

Flap Elevation ◽

Intratympanic Steroids

Background: The aim of the study was to compare the outcome of various methods of injecting intra tympanic steroids in patients with tinnitus of cochlear pathology.Methods: A prospective study was conducted on 56 patients with subjective tinnitus of cochlear pathology who were then divided into three groups. After thorough otological and audiological evaluation using standard questionnaire, ENT examination, pure tone audiometry, tone decay test, tinnitogram, CT scans of temporal bone and brain. Each patient underwent one of the three chosen methods of intra tympanic steroids administration randomly. The methods are 1-Tympanomeatal flap elevationand application of steroid soaked gelfoam sponge; 2-Transtympanic steroid injection; 3-Grommet insertion followed by steroid administration. These methods were performed for subjects with tinnitus of cochlear pathology from 2009 to 2011 at a neurotological clinic at Chennai. After following up on 1st, 3rd and 6 months the observations were statistically analysed. Results: Success rate for techniques viz tympanomeatal flap was 70%, transtympanic - 63%, grommet - 50%. But when comparing statistically all the three methods were equally successful.Conclusions: Intratympanic steroids for tinnitus (cochlear pathology) are a safe, simple and promising treatment option. Though all the methods of intra tympanic steroids injection had similar success rate, the tympanomeatal flap elevation method may be preferred since it can be done in a single sitting. However transtympanic injection remains the easiest and cost effective compared to the other two methods.

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A Generative Approach Toward Precision Antimicrobial Peptide Design

10.1101/2020.10.02.324087 ◽

2020 ◽

Cited By ~ 1

Author(s):

Jonathon B. Ferrell ◽

Jacob M. Remington ◽

Colin M. Van Oort ◽

Mona Sharafi ◽

Reem Aboushousha ◽

...

Keyword(s):

False Positive Rate ◽

Membrane Binding ◽

Molecular Simulations ◽

Sampling Technique ◽

Cost Effective ◽

Umbrella Sampling ◽

Generative Model ◽

Screening Process ◽

Knowledge Based ◽

Positive Rate

AbstractAntimicrobial peptides (AMPs) are peptides with promising applications for healthcare, veterinary, and agriculture industries. Despite prior success in AMP design using physics- or knowledge-based approaches, there is still a critical need to create new methodologies to design peptides with a low false positive rate and high AMP activity and selectivity. Toward this goal, we invented a cost-effective approach which utilizes a generative model to produce AMP-like sequences and molecular simulations to select peptides based on their structures and interactions. For a proof of concept, we curated a dataset that comprises 500,000 non-AMP peptide sequences and 8,000 labeled AMP sequences to train the generative model, which generated novel and diverse AMP candidates to potentially target a wide variety of microbes. Following a screening process to select peptides that are cationic and likely helical, we assessed 12 candidates by simulating their membrane-binding tendency to a lipid bilayer model. With the umbrella sampling technique, we determined the free energy change during transfer from the solution to the membrane environments for each peptide. Accordingly, we selected the six peptides with the best membrane-binding tendency, synthesized them, and characterized through spectroscopies and biological assays. Three novel peptides were validated with activity to inhibit bacterial growth. In aggregate, the combination of AMP generator and molecular simulations afford an enhanced accuracy in AMP design. Towards future precision AMP design, our methodology and results demonstrate the viability to design novel AMP-like peptides to target selected pathogens and mechanisms.

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Limitations of multidetector computed tomography angiography for the diagnosis of blunt cerebrovascular injury

Journal of Neurosurgery ◽

10.3171/2017.2.jns163264 ◽

2018 ◽

Vol 128 (6) ◽

pp. 1642-1647 ◽

Cited By ~ 9

Author(s):

Ramesh Grandhi ◽

Gregory M. Weiner ◽

Nitin Agarwal ◽

David M. Panczykowski ◽

William J. Ares ◽

...

Keyword(s):

False Positive ◽

Antithrombotic Therapy ◽

Multidetector Ct ◽

False Positive Rate ◽

Cost Effective ◽

Blunt Cerebrovascular Injury ◽

Cerebrovascular Injury ◽

Current Series ◽

Positive Rate ◽

Level I

OBJECTIVEBlunt cerebrovascular injuries (BCVIs) following trauma carry risk for morbidity and mortality. Since patients with BCVI are often asymptomatic at presentation and neurological sequelae often occur within 72 hours, timely diagnosis is essential. Multidetector CT angiography (CTA) has been shown to be a noninvasive, cost-effective, reliable means of screening; however, the false-positive rate of CTA in diagnosing patients with BCVI represents a key drawback. Therefore, the authors assessed the role of DSA in the screening of BCVI when utilizing CTA as the initial screening modality.METHODSThe authors performed a retrospective analysis of patients who experienced BCVI between 2013 and 2015 at 2 Level I trauma centers. All patients underwent CTA screening for BCVI according to the updated Denver Screening Criteria. Patients who were diagnosed with BCVI on CTA underwent confirmatory digital subtraction angiography (DSA). Patient demographics, screening indication, BCVI grade on CTA and DSA, and laboratory values were collected. Comparison of false-positive rates stratified by BCVI grade on CTA was performed using the chi-square test.RESULTSA total of 140 patients (64% males, mean age 50 years) with 156 cerebrovascular blunt injuries to the carotid and/or vertebral arteries were identified. After comparison with DSA findings, CTA findings were incorrect in 61.5% of vessels studied, and the overall CTA false-positive rates were 47.4% of vessels studied and 47.9% of patients screened. The positive predictive value (PPV) for CTA was higher among worse BCVI subtypes on initial imaging (PPV 76% and 97%, for BCVI Grades II and IV, respectively) compared with Grade I injuries (PPV 30%, p < 0.001).CONCLUSIONSIn the current series, multidetector CTA as a screening test for blunt cerebrovascular injury had a high-false positive rate, especially in patients with Grade I BCVI. Given a false-positive rate of 47.9% with an estimated average of 132 patients per year screening positive for BCVI with CTA, approximately 63 patients per year would potentially be treated unnecessarily with antithrombotic therapy at a busy United States Level I trauma center. The authors’ data support the use of DSA after positive findings on CTA in patients with suspected BCVI. DSA as an adjunctive test in patients with positive CTA findings allows for increased diagnostic accuracy in correctly diagnosing BCVI while minimizing risk from unnecessary antithrombotic therapy in polytrauma patients.

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SARSeq, a robust and highly multiplexed NGS assay for parallel detection of SARS-CoV2 and other respiratory infections

10.1101/2020.10.28.20217778 ◽

2020 ◽

Cited By ~ 2

Author(s):

Ramesh Yelagandula ◽

Aleksandr Bykov ◽

Alexander Vogt ◽

Robert Heinen ◽

Ezgi Özkan ◽

...

Keyword(s):

Influenza A ◽

Respiratory Infections ◽

False Positive Rate ◽

Cost Effective ◽

Rt Pcr ◽

Robust Performance ◽

Saliva Analysis ◽

Positive Rate ◽

Double Blinded ◽

Generation Sequencing

During a pandemic, mitigation as well as protection of system-critical or vulnerable institutions requires massively parallel, yet cost-effective testing to monitor the spread of agents such as the current SARS-CoV2 virus. Here we present SARSeq, saliva analysis by RNA sequencing, as an approach to monitor presence of SARS-CoV2 and other respiratory viruses performed on tens of thousands of samples in parallel. SARSeq is based on next generation sequencing of multiple amplicons generated in parallel in a multiplexed RT-PCR reaction. It relies on a two-dimensional unique dual indexing strategy using four indices in total, for unambiguous and scalable assignment of reads to individual samples. We calibrated this method using dilutions of synthetic RNA and virions to show sensitivity down to a few molecules, and applied it to hundreds of patient samples validating robust performance across various sample types. Double blinded benchmarking to gold-standard quantitative RT-PCR performed in a clinical setting and a human diagnostics laboratory showed robust performance up to a Ct of 36. The false positive rate, likely due to cross contamination during sample pipetting, was estimated at 0.04-0.1%. In addition to SARS-CoV2, SARSeq detects Influenza A and B viruses as well as human rhinovirus and can be easily expanded to include detection of other pathogens. In sum, SARSeq is an ideal platform for differential diagnostic of respiratory diseases at a scale, as is required during a pandemic.

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INFERTILITY

The Professional Medical Journal ◽

10.29309/tpmj/2011.18.02.2051 ◽

2011 ◽

Vol 18 (02) ◽

pp. 195-200

Author(s):

ROBINA KAUSAR ◽

LUBNA YASMEEN ◽

TAHIRA JABBAR ◽

Faiqa Imran

Keyword(s):

Success Rate ◽

Analytical Study ◽

Polycystic Ovary ◽

Clomiphene Citrate ◽

Combined Treatment ◽

Cost Effective ◽

Pregnancy Test ◽

Patient Reported ◽

Infertile Patients ◽

Urine Pregnancy Test

Objective: To measure the success rate of combined clomiphene citrate and gonadotrophin therapy in infertile patients. Study Design: Observational analytical study. Period: June 2009 to June 2010. Methods: In this observational analytical study, total of 100 infertile patients were selected for Combined Clomiphene Citrate and Human Menopausal Gonadotrophin (CC – hMG) regime and maximum of three treatment cycle were given. Results: Out of 100 patients in our study, 74% (2/3 rd) patients were less than 30 years of age and 26% (1/3rd ) were between 30 – 40 yrs of age. Primary infertility was seen also in 2/3rd of patients (73% ) and secondary infertility in remaining 1/3rd (27%) of patients. Polycystic ovary (PCO) was the commonest cause of an ovulation seen in 62% of patients, obesity in 24% of patients and in 14% of patients cause was unknown (unexplained infertility). on average only 4.1 Inj of gonadotrophin were required to get a mature follicle on an average 12th day (12.41 day) of the cycle. As concerned the treatment outcome, 82% of patient reported back after first course of treatment. Urine pregnancy test was positive in 18%. Remaining 64% patent were offered second course of treatment, out of which only 35% agreed for further treatment. After second course of treatment positive urine pregnancy test was seen in only 5% of patients. Remaining 30% of patients were advised third course of treatment. Out of these 30%, 8 patients took gonadotrophin regime, 10 patients agreed on follicle tracking only, 8 % of patients refused further treatment and 4 % did not report back. Conclusions: Our study shows the success rate of 23% with CC-HMG combined treatment which is double the CC alone and equal to HMG alone, thereby reducing the cost of treatment without sacrificing efficacy. In other words combined CC-HMG regime is cost effective technique in the management of infertile patients.

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Incorporation of unique molecular identifiers in TruSeq adapters improves the accuracy of quantitative sequencing

10.1101/114603 ◽

2017 ◽

Author(s):

Jungeui Hong ◽

David Gresham

Keyword(s):

Quantitative Analysis ◽

Frequency Estimation ◽

False Positive Rate ◽

Cost Effective ◽

Next Generation Sequencing Data ◽

Sequencing Data ◽

Pcr Duplicates ◽

Positive Rate ◽

Bona Fide ◽

Multiplex Sequencing

Quantitative analysis of next-generation sequencing data requires discriminating duplicate reads generated by PCR from identical molecules that are of unique origin. Typically, PCR duplicates are defined as sequence reads that align to the same genomic coordinates using reference-based alignment. However, identical molecules can be independently generated during library preparation. The false positive rate of coordinate-based deduplication has not been well characterized and may introduce unforeseen biases during analyses. We developed a cost-effective sequencing adapter design by modifying Illumina TruSeq adapters to incorporate a unique molecular identifier (UMI) while maintaining the capacity to undertake multiplexed sequencing. Incorporation of UMIs enables identification of bona fide PCR duplicates as identically mapped reads with identical UMIs. Using TruSeq adapters containing UMIs (TrUMIseq adapters), we find that accurate removal of PCR duplicates results in enhanced data quality for quantitative analysis of allele frequencies in heterogeneous populations and gene expression.Method SummaryTrUMIseq adapters incorporate unique molecular identifiers in TruSeq adapters while maintaining the capacity to multiplex sequencing libraries using existing workflows. The use of UMIs increases the accuracy of quantitative sequencing assays, including RNAseq and allele frequency estimation, by enabling accurate detection of PCR duplicates.

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