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In he went to Stanford University, where he intermittently enrolled in literature and writing courses until he left in without taking a degree. During the next five years he supported himself as a laborer and journalist in New York City, all the time working on his first novel, Cup of Gold John Steinbeck.

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John Steinbeck's Nobel Prize-winning tale of commitment, loneliness, hope, and loss—now an eBook enhanced with exclusive content, including an interview with James Earl Jones, for the ultimate educational experience. An intimate portrait of two men who cherish the slim bond between them and the dream they share in a world marred by petty tyranny, misunderstanding, jealousy, and callousness. Clinging to each other in their loneliness and alienation, George and his simple-minded friend Lennie dream, as drifters will, of a place to call their own—a couple of acres and a few pigs, chickens, and rabbits back in Hill Country where land is cheap.

But after they come to work on a ranch in the fertile Salinas Valley of California, their hopes, like "the best laid schemes o'mice an' men," begin to go awry.

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Resolved performance characteristics for detection C. Upon analysis of the female patients from whom matched urine and endocervical specimens were obtained, 38 8. Among those 70 infected patients, 11 By testing both urine and endocervical swab specimens, we were able to detect at least For example, for patients with matched specimens, infections in 61 women were detected by AMP CT of endocervical swab specimens and infections in 59 women were detected by AMP CT of urine specimens.

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However, because infections in some patients were detected by AMP CT of an endocervical swab specimen or a urine specimen individually, testing of the combination of specimens detected infections in nine additional women, yielding a Following discrepant analysis of the 33 culture-negative, AMP CT-positive specimens, 28 were resolved to be positive 16 by DFA staining and 12 by TMA with an alternate target , yielding a sensitivity of Target amplification assays are based on the ability of complementary oligonucleotide primers to specifically anneal to target base pairs and to allow enzymatic amplification of the target nucleic acid strands 9.

AMP CT is a nucleic acid amplification system which is sensitive and specific and which has a sensitivity and a specificity comparable to those of currently available amplification tests.

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Recent studies have demonstrated the ability of several nucleic acid amplification assays to detect C. For females from whom both an endocervical swab sample and a urine sample were obtained, both specimens were concordantly positive for only If only endocervical swab specimens were collected, infections in On the other hand, if only female urine had been collected, infections in Thus, testing for C.

In contrast, the sensitivity of culture of endocervical swab specimens was The sensitivity of culture of urethral swab specimens was The differences in the sensitivity of AMP CT with urine and endocervical swab specimens could be a result of several different factors. First, sampling discrepancies may have limited the resolution of AMP CT-positive specimens not only due to the simple fact that collection of the samples originates from two different anatomical sites but also from the fact that collection techniques may vary among clinicians.

Reliable results are dependent on adequate specimen collection techniques; however, it is impossible to guarantee that there was no variability in the specified collection techniques for this or any other assay.

February 17, 2011

Another factor which may have contributed to the differences in sensitivities could be the use of tampons or douching, neither of which were evaluated for their impact on the detection of C. Finally, the finding of a positive culture and a negative AMP CT result may also reflect variance in adequate specimen collection or the presence of inhibitors, or both. It is possible that the presence of inhibitors may cause false-negative results with this product, as is the case for other products.


However, for clinical utility purposes, retesting of all AMP CT-negative specimens to assess the presence of such possible inhibitors is not practical and was therefore not performed. It is noteworthy, however, that such an evaluation is an important step in determining the true reliability of an amplification assay, and some manufacturers are considering adding an internal control to tests for each specimen.

In spite of the presence of widely available and accurate tests, the chlamydia epidemic continues throughout the United States, with 4 million to 4. A large number of asymptomatic carriers who are not tested and who therefore continue to spread the disease through sexual contact contribute to this continuing problem.

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Since the invasive procedures which are usually required to obtain samples often create patient anxieties, people are reluctant to be tested. Hence, urine samples have been investigated as an alternate specimen for testing because of the noninvasive way in which they can be collected.

Initially, urine was widely tested in most immunoassays. Unfortunately, since there are generally lower concentrations of C. By targeting rRNA, which is more abundant than DNA in bacterial cells, a larger number of target molecules are available to a TMA reaction, thereby increasing the reliability of amplification initiation. This is an advantage, particularly when organisms are present in very low numbers. The single-tube format does not include washing steps or the transfer of amplicon for detection, thus minimizing the possibility of cross contamination and false-positive results.

It is also important that carryover contamination is not a major problem due to the labile nature of the RNA amplicon in the laboratory environment. Screening for chlamydia in urine samples for men is particularly important since asymptomatic men rarely seek health care and serve as a reservoir for disease transmission.

Screening of male urine would create access to the reservoir of infected individuals. These results demonstrate that AMP CT is more sensitive than culture in identifying chlamydial organisms in both endocervical swab specimens and male and female urine specimens. The assay is highly sensitive and specific, has a sensitivity and a specificity comparable to those of other currently available nucleic acid amplification tests, and provides a noninvasive means of screening for C.


NOTE: We request your email address only to inform the recipient that it was you who recommended this article, and that it is not junk mail. We do not retain these email addresses. Skip to main content. Chlamydiology and Rickettsiology. Kimberly A.

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View this table: View inline View popup. Table 1. Table 2. Returned for modification 16 September Accepted 30 October OpenUrl PubMed. Barnes R. Bassiri M. Bauwens J. Bianchi A. Bowman J. Chernesky M. DeMarchi J. OpenUrl CrossRef.