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Low cost diagnostics

L M Mena Bares, E Carmona Asenjo, M V García Sánchez, E Moreno Ortega, F R Maza Muret, M V Guiote Moreno, A M Santos Bueno, E Iglesias Flores, J M Benítez Cantero, J A Vallejo Casas
Chronic diarrhoea is a common entity in daily clinical practice and it leads to a loss in these patients quality of life. It may be the main symptom of multiple ethiologies including bile acid malabsorption (BAM) which has a comparable prevalence to celiac disease. The BAM results from imbalances in the homeostasis of bile acids in the enterohepatic circulation. It can be a consequence of ileal disease or ileal dysfunction (BAM type i), it can be considered idiopathic or primary (BAM type ii) or associated with other gastrointestinal entities (BAM type iii)...
October 17, 2016: Revista Española de Medicina Nuclear e Imagen Molecular
Robert F Riley, Chadwick D Miller, Gregory B Russell, Erin N Harper, Brian C Hiestand, James W Hoekstra, Cedric W Lefebvre, Bret A Nicks, David M Cline, Kim L Askew, Simon A Mahler
INTRODUCTION: The HEART Pathway is a diagnostic protocol designed to identify low-risk patients presenting to the emergency department with chest pain that are safe for early discharge. This protocol has been shown to significantly decrease health care resource utilization compared with usual care. However, the impact of the HEART Pathway on the cost of care has yet to be reported. METHODS AND RESULTS: We performed a cost analysis of patients enrolled in the HEART Pathway trial, which randomized participants to either usual care or the HEART Pathway protocol...
October 5, 2016: American Journal of Emergency Medicine
Houcem Maaoui, Florina Teodoresu, Qian Wang, Guo-Hui Pan, Ahmed Addad, Radhouane Chtourou, Sabine Szunerits, Rabah Boukherroub
Perturbations in glucose homeostasis is critical for human health, as hyperglycemia (defining diabetes) leads to premature death caused by macrovascular and microvascular complications. However, the simple and accurate detection of glucose in the blood at low cost remains a challenging task, although it is of great importance for the diagnosis and therapy of diabetic patients. In this work, carbon quantum dots decorated with copper oxide nanostructures (CQDs/Cu₂O) are prepared by a simple hydrothermal approach, and their potential for electrochemical non-enzymatic glucose sensing is evaluated...
October 18, 2016: Sensors
Yadveer Singh Grewal, Muhammad J A Shiddiky, Stephen M Mahler, Gerard A Cangelosi, Matt Trau
Rapid progress in disease biomarker discovery has increased the need for robust detection technologies. In the past several years, the designs of many immunoaffinity reagents have focused on lowering costs, improving specificity while also promoting stability. Antibody fragments (scFvs) have long been displayed on the surface of yeast and phage libraries for selection, however the stable production of such fragments presents challenges that hamper their widespread use in diagnostics. Membrane and cell wall proteins similarly suffer from stability problems when solubilized from their native environment...
October 20, 2016: ACS Applied Materials & Interfaces
Ahu Gümrah Dumanlı
Cellulose is a natural linear biopolymer, which constitutes through the assembly of cellulose nanofibrils in a hierarchical order. Nanocelluloses in particular show great promise as a cost-effective advanced material for biomedical applications because of their biocompatibility, biodegradability, and low cytotoxicity. Moreover, with their chemical functionality they can be easily modified to yield useful products. While nature uses the hierarchical nanostructure of the cellulose as the load-bearing constituent in plants, a significant amount of research has been directed toward the fabrication of advanced cellulosic materials with various nanostructures and functional properties...
October 14, 2016: Current Medicinal Chemistry
Erin R Weeda, Philip S Wells, W Frank Peacock, Gregory J Fermann, Christopher W Baugh, Veronica Ashton, Concetta Crivera, Peter Wildgoose, Jeff R Schein, Craig I Coleman
We sought to compare length-of-stay (LOS), total hospital costs, and readmissions among pulmonary embolism (PE) patients treated with rivaroxaban versus parenterally bridged warfarin. We identified adult PE (primary diagnostic code = 415.1x) patients in the Premier Database (11/2012-9/2015), and included those with ≥1 PE diagnostic test on days 0-2. Rivaroxaban users (allowing ≤2 days of prior parenteral therapy) were 1:1 propensity score matched to patients parenterally bridged to warfarin. LOS, total costs, and readmission for venous thromboembolism (VTE) or major bleeding within the same or subsequent 2 months were compared between cohorts...
October 18, 2016: Internal and Emergency Medicine
Israel Pena, Erin Y Chew, Barcleigh P Landau, Joseph T Breen, Jose P Zevallos, Jeffrey T Vrabec
OBJECTIVE: To investigate the prevalence of vestibular schwannoma (VS) and asymmetric sensorineural hearing loss in the Veterans Administration hospital population and analyze a more efficient method of diagnosing VS in a population with significant noise exposure. STUDY DESIGN: Retrospective review of South Central (VISN 16) Veterans Administration hospitals. METHODS: Record query for ICD-9 codes for asymmetric sensorineural hearing loss or VS between 1999 and 2012...
October 14, 2016: Otology & Neurotology
Floriana Zennaro, Elena Neri, Federico Nappi, Daniele Grosso, Riccardo Triunfo, Francesco Cabras, Francesca Frexia, Stefania Norbedo, Pierpaolo Guastalla, Massino Gregori, Elisabetta Cattaruzzi, Daniela Sanabor, Egidio Barbi, Marzia Lazzerini
BACKGROUND: The use of point-of-care ultrasonography (POC US) in paediatrics is increasing. This study investigated the diagnostic accuracy of POC US in children accessing the emergency department (ED) when performed by paediatricians under the remote guidance of radiologists (TELE POC). METHODS: Children aged 0 to 18 years accessing the ED of a third level research hospital with eight possible clinical scenarios and without emergency/severity signs at the triage underwent three subsequent US tests: by a paediatrician guided remotely by a radiologist (TELE POC); by the same radiologist (UNBLIND RAD); by an independent blinded radiologist (BLIND RAD)...
2016: PloS One
Amanda K Debes, Robert H Gilman, Carolyne Onyango-Makumbi, Andrea Ruff, Richard Oberhelman, David W Dowdy
BACKGROUND: The objective of this analysis was to assess the cost-effectiveness of TB diagnosis using Microscopic Observation Drug Susceptibility (MODS), Xpert MTB/RIF (Xpert), and empiric treatment for all patients, in addition to current clinical diagnostic practices in children less than 5 years of age in a national tuberculosis (TB) referral hospital in Uganda. METHODS: A decision analysis was conducted from the healthcare perspective, with a primary outcome of incremental cost effectiveness expressed as cost per year of life gained (YLG)...
October 3, 2016: Pediatric Infectious Disease Journal
Baldwin Yeung, Philip Chiu, Anthony Teoh, Linfu Zheng, Shannon Chan, Kelvin Lam, Raymond Tang, Enders K W Ng
Background and study aims: Submucosal tunnelling endoscopic resection (STER) is a novel endoscopic technique to remove submucosal tumour (SMT). We propose a novel, low cost simulator for training of techniques for STER. Patients and methods: The model consisted of an ex-planted porcine oesophagus, stomach and duodenum with marbles embedded surgically in the submucosal plane. Two expert endoscopists with experience in submucosal tunnelling and 5 board-certified endoscopists with no experience in submucosal tunnelling were recruited...
October 2016: Endoscopy International Open
Spoorthi Ravi Banavar, Prashanthi Chippagiri, Rohit Pandurangappa, Saileela Annavajjula, Premalatha Bidadi Rajashekaraiah
Background. Microscopes are omnipresent throughout the field of biological research. With microscopes one can see in detail what is going on at the cellular level in tissues. Though it is a ubiquitous tool, the limitation is that with high magnification there is a small field of view. It is often advantageous to see an entire sample at high magnification. Over the years technological advancements in optics have helped to provide solutions to this limitation of microscopes by creating the so-called dedicated "slide scanners" which can provide a "whole slide digital image...
2016: Analytical Cellular Pathology (Amsterdam)
Kim E M van Kessel, Willemien Beukers, Irene Lurkin, Angelique Ziel-van der Made, Kirstin A van der Keur, Joost L Boormans, Lars Dyrskjøt, Mirari Márquez, Torben F Ørntoft, Francisco X Real, Ulrika Segersten, Núria Malats, Per-Uno Malmström, Wim Van Criekinge, Ellen C Zwarthoff
PURPOSE: Only 3-28% of patients referred to the urology clinic for hematuria are diagnosed with bladder cancer (BC). Cystoscopies lead to high diagnostic costs and patient burden. Therefore, to improve selection of patients for cystoscopy, reduce costs and over-testing we aimed to validate a recently developed diagnostic urine assay MATERIALS AND METHODS: We included 200 patients from three European countries undergoing cystoscopy for hematuria (n=97 BC, n=103 non-malignant). Voided urine samples were collected prior to cystoscopy...
October 13, 2016: Journal of Urology
Douglas Wildes, Warren Lee, Bruno Haider, Scott Cogan, Krishnakumar Sundaresan, David Mills, Christopher Yetter, Patrick Hart, Christopher Haun, Mikael Concepcion, Johan Kirkhorn, Marc Bitoun
We developed a 2.5 x 6.6 mm 2D array transducer with integrated transmit/receive ASIC for 4D ICE (real-time 3D IntraCardiac Echocardiography) applications. The ASIC and transducer design were optimized so that the high voltage transmit, low-voltage TGC (time-gain control) and preamp, subaperture beamformer, and digital control circuits for each transducer element all fit within the 0.019 mm2 area of the element. The transducer assembly was deployed in a 10 Fr (3.3 mm diameter) catheter, integrated with a GE Vivid1 E9 ultrasound imaging system, and evaluated in three pre-clinical studies...
October 12, 2016: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
Ximena Doldán, Pablo Fagúndez, Alfonso Cayota, Justo Laíz, Juan Pablo Tosar
Extracellular vesicles (EVs), namely exosomes and microvesicles, are important mediators of intercellular communication pathways. Since EVs can be detected in a variety of biofluids and contain a specific set of biomarkers which are reminiscent of their parental cells, they show great promise in clinical diagnostics as EV analysis can be performed in minimally-invasive liquid biopsies. However, reliable, fast and cost-effective methods for their determination are still needed, especially if decentralized analysis is intended...
October 13, 2016: Analytical Chemistry
Kimberly Plevniak, Matthew Campbell, Timothy Myers, Abby Hodges, Mei He
Clinical diagnosis requiring central facilities and site visits can be burdensome for patients in resource-limited or rural areas. Therefore, development of a low-cost test that utilizes smartphone data collection and transmission would beneficially enable disease self-management and point-of-care (POC) diagnosis. In this paper, we introduce a low-cost iPOC(3D) diagnostic strategy which integrates 3D design and printing of microfluidic POC device with smartphone-based disease diagnosis in one process as a stand-alone system, offering strong adaptability for establishing diagnostic capacity in resource-limited areas and low-income countries...
September 2016: Biomicrofluidics
Darko Ivanović, Aleksandar Kupusinac, Edita Stokić, Rade Doroslovački, Dragan Ivetić
The diagnosis of metabolic syndrome (MetS) has a leading role in the early prevention of chronic disease, such as cardiovascular disease, type 2 diabetes, cancers and chronic kidney disease. It would be very greatful that MetS diagnosis can be predicted in everyday clinical practice. This paper presents artificial neural network (ANN) prediction of the diagnosis of MetS that includes solely non-invasive, low-cost and easily-obtained diagnostic methods. This solution can extract the risky persons and suggests complete tests only on them by saving money and time...
December 2016: Journal of Medical Systems
Magdalena Lang, Roi Treister, Anne Louise Oaklander
Small-fiber polyneuropathy (SFPN) causes non-specific symptoms including chronic pain, cardiovascular, gastrointestinal, and sweating complaints. Diagnosis is made from history and exam in patients with known risk factors such as diabetes, but objective test confirmation is recommended for patients without known risks. If tests confirm SFPN, and it is "initially idiopathic" (iiSFPN), screening for occult causes is indicated. This study's aim was to evaluate the 21 widely available, recommended blood tests to identify the most cost-effective ones and to learn about occult causes of iiSFPN...
October 11, 2016: Journal of Neurology
Leila Sabour, Maryam Sabour, Saeid Ghorbian
With the advancement and improvement of new sequencing technology, next-generation sequencing (NGS) has been applied increasingly in cancer genomics research fields. More recently, NGS has been adopted in clinical oncology to advance personalized treatment of cancer. NGS is utilized to novel diagnostic and rare cancer mutations, detection of translocations, inversions, insertions and deletions, detection of copy number variants, detect familial cancer mutation carriers, provide the molecular rationale for appropriate targeted, therapeutic and prognostic...
October 8, 2016: Pathology Oncology Research: POR
Gihoon Choi, Daniel Song, Sony Shrestha, Jun Miao, Liwang Cui, Weihua Guan
In response to the urgent need of a field-deployable and highly sensitive malaria diagnosis, we developed a standalone, "sample-in-answer-out" molecular diagnostic system (AnyMDx) to enable quantitative molecular analysis of blood-borne malaria in low resource areas. The system consists of a durable battery-powered analyzer and a disposable microfluidic compact disc loaded with reagents ready for use. A low power thermal module and a novel fluorescence-sensing module are integrated into the analyzer for real-time monitoring of loop-mediated isothermal nucleic acid amplification (LAMP) of target parasite DNA...
October 10, 2016: Lab on a Chip
Katherine V Oliver, Annalisa Vilasi, Amandine Maréchal, Shabbir H Moochhala, Robert J Unwin, Peter R Rich
Cystinuria is the commonest inherited cause of nephrolithiasis (~1% in adults; ~6% in children) and is the result of impaired cystine reabsorption in the renal proximal tubule. Cystine is poorly soluble in urine with a solubility of ~1 mM and can readily form microcrystals that lead to cystine stone formation, especially at low urine pH. Diagnosis of cystinuria is made typically by ion-exchange chromatography (IEC) detection and quantitation, which is slow, laboursome and costly. More rapid and frequent monitoring of urinary cystine concentration would significantly improve the diagnosis and clinical management of cystinuria...
October 10, 2016: Scientific Reports
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