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Wang H, Jian M, Fan J, He Y, Wang Z. Scalable synthesis of Au@CeO 2 nanozyme for development of colorimetric lateral flow immunochromatographic assay to sensitively detect heart-type fatty acid binding protein. Talanta 2024; 273:125852. [PMID: 38442564 DOI: 10.1016/j.talanta.2024.125852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/07/2024]
Abstract
Nanozymes with core@shell nanostructure are considered promising biolabeling materials for their multifunctional properties. In this work, a simple one-pot strategy has been proposed for scalable synthesis of gold@cerium dioxide core@shell nanoparticles (Au@CeO2 NPs) with strong localized surface plasmon resonance (LSPR) absorption and high peroxidase-like catalytic activity by redox reactions of Ce3+ ions and AuCl4- ions in diluted ammonia solution under room temperature. A colorimetric lateral flow immunochromatographic assay (LFIA) has been successfully fabricated for sensitive detection of heart-type fatty acid binding protein (H-FABP, an early cardiac biomarker) by using the Au@CeO2 NPs as reporters. The as-developed LFIA with Au@CeO2 NP reporter (termed as Au@CeO2-LFIA) exhibits a dynamic range of nearly two orders of magnitude, and a limit of detection (LOD) as low as 0.35 ng mL-1 H-FABP with nanozyme-triggered 3,3',5,5'-tetramethylbenzidine (TMB) colorimetric amplification. Furthermore, the practicality of Au@CeO2-LFIA has been demonstrated by profiling the concentrations of H-FABP in 156 blood samples of acute myocardial infarction (AMI) patients, and satisfactory results are obtained.
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Affiliation(s)
- Haodong Wang
- Department of Cardiology, The China-Japan Union Hospital of Jilin University, Changchun 130033, China
| | - Minghong Jian
- State Key Laboratory of Electroanalytical Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China
| | - Jiwen Fan
- Department of Cardiology, The China-Japan Union Hospital of Jilin University, Changchun 130033, China
| | - Yuquan He
- Department of Cardiology, The China-Japan Union Hospital of Jilin University, Changchun 130033, China.
| | - Zhenxin Wang
- State Key Laboratory of Electroanalytical Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China; National Analytical Research Center of Electrochemistry and Spectroscopy, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, China.
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Garcia-Castrillo L, Cadamuro J, Dodt C, Lauwaert D, Hachimi-Idrissi S, Van Der Linden C, Bergs J, Costelloe S, Grossmann F, Koca A, Palomäki A, Ruiz JL, Stonys R, Thorsteinsdottir TK, von Meyer A, Vermeersch P, Abellas Alvarez MC, Eker P, Golea A, Kurland L, Lippi G, Zhilenkova Y, Sehmi K. Recommendations for blood sampling in emergency departments from the European Society for Emergency Medicine (EUSEM), European Society for Emergency Nursing (EuSEN), and European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase. Executive summary. Clin Chem Lab Med 2024; 0:cclm-2024-0059. [PMID: 38581294 DOI: 10.1515/cclm-2024-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 04/08/2024]
Abstract
AIM Blood Sampling Guidelines have been developed to target European emergency medicine-related professionals involved in the blood sampling process (e.g. physicians, nurses, phlebotomists working in the ED), as well as laboratory physicians and other related professionals. The guidelines population focus on adult patients. The development of these blood sampling guidelines for the ED setting is based on the collaboration of three European scientific societies that have a role to play in the preanalytical phase process: EuSEN, EFLM, and EUSEM. The elaboration of the questions was done using the PICO procedure, literature search and appraisal was based on the GRADE methodology. The final recommendations were reviewed by an international multidisciplinary external review group. RESULTS The document includes the elaborated recommendations for the selected sixteen questions. Three in pre-sampling, eight regarding sampling, three post-sampling, and two focus on quality assurance. In general, the quality of the evidence is very low, and the strength of the recommendation in all the questions has been rated as weak. The working group in four questions elaborate the recommendations, based mainly on group experience, rating as good practice. CONCLUSIONS The multidisciplinary working group was considered one of the major contributors to this guideline. The lack of quality information highlights the need for research in this area of the patient care process. The peculiarities of the emergency medical areas need specific considerations to minimise the possibility of errors in the preanalytical phase.
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Affiliation(s)
- Luis Garcia-Castrillo
- Emergency Department, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Janne Cadamuro
- Department of Laboratory Medicine, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Christoph Dodt
- Emergency Department, Universitair Ziekenhuis Brussels, Brussels, Belgium
| | - Door Lauwaert
- München Klinik gGmbH, Clinic for Acute and Emergency Care, Munich, Germany
| | - Said Hachimi-Idrissi
- Universiteit Gent Faculteit Geneeskunde en Gezondheidswetenschappen, Emergency Medicine, Gent, Belgium
- Universitair Ziekenhuis Gent, Emergency Medicine, Gent, Belgium
| | | | - Jochen Bergs
- Faculty of Medicine and Life Sciences, Research Group Healthcare & Ethics, Hasselt University, Limburg, Belgium
- Department of Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Netherlands
| | - Sean Costelloe
- Department of Clinical Biochemistry, Cork University Hospital Group, Cork, Ireland
| | | | - Ayca Koca
- Department of Emergency Medicine, Ankara University School of Medicine, Ankara, Türkiye
| | - Ari Palomäki
- Kanta-Häme Central Hospital, Tampere Universities, Hämeenlinna, Finland
| | - Jose Luis Ruiz
- Emergency Department, Hospital Universitario de La Ribera, Valenciana, Spain
| | - Ricardas Stonys
- Center of Laboratory Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | | | | | - Pieter Vermeersch
- KU Leuven University Hospitals Leuven, Laboratory Medicine, Leuven, Belgium
| | | | - Pinar Eker
- Biochemistry and Clinical Biochemistry, Maltepe Universitesi Tip Fakultesi, Istanbul, Türkiye
| | - Adela Golea
- Emergency Department, Cluj-Napoca County Emergency Hospital, Cluj-Napoca, Romania
| | - Lisa Kurland
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, Universita degli Studi di Verona, Verona, Italy
| | - Yulia Zhilenkova
- Department of Laboratory Medicine and Genetics, Almazov National Medical Research Centre, Sankt-Peterburg, Russia
| | - Kawaldip Sehmi
- International Alliance of Patients' Organizations, London, UK
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Elrobaa IH, Khan K, Mohamed E. The Role of Point-of-Care Testing to Improve Acute Care and Health Care Services. Cureus 2024; 16:e55315. [PMID: 38434607 PMCID: PMC10905651 DOI: 10.7759/cureus.55315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 03/05/2024] Open
Abstract
Health care is one of the most important services that need to be provided to any community. Many challenges exist in delivering proper and effective health services, including ensuring timely delivery, providing adequate care through effective management and achieving good outcomes. Point-of-care testing (POCT) plays a crucial role in delivering urgent and appropriate health services, especially in peripheral communities, emergency situations, disaster areas and overcrowded areas. We collected and reviewed secondary data about point-of-care testing from PubMed, Scopus and Google Scholar. Our findings emphasize that POCT provides fast care with minimal waiting time, avoids unnecessary investigations, aids in triage, and provides decision-makers with a clear understanding of the patient's condition to make informed decisions. We recommend point-of-care testing as a frontline investigation in emergency departments, intensive care units, peripheral hospitals, primary health care centers, disaster areas and field hospitals. Point-of-care testing can improve the quality of health services and ensure the provision of necessary health care.
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Affiliation(s)
- Islam H Elrobaa
- Emergency Medicine, College of Medicine, Qatar University, Doha, QAT
- Emergency Medicine, Hamad Medical Corporation (HMC), Doha, QAT
| | - Keebat Khan
- Emergency Medicine, Hamad Medical Corporation (HMC), Doha, QAT
| | - Eslam Mohamed
- Emergency Medicine, Hamad Medical Corporation (HMC), Doha, QAT
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Peng T, Ke Z, Wu H, He J, Sun Y, Zhang S, Gao Q, Shao M, Zhang S, Zhong Z, Lu F, Zhou J. Plug-and-play DPC-based quantitative phase microscope. Biomed Opt Express 2024; 15:1785-1797. [PMID: 38495708 PMCID: PMC10942692 DOI: 10.1364/boe.514887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/03/2024] [Accepted: 02/04/2024] [Indexed: 03/19/2024]
Abstract
Point-of-care testing (POCT) plays an increasingly important role in biomedical research and health care. Quantitative phase microscopes (QPMs) with good contrast, no invasion, no labeling, high speed and automation could be effectively applied for POCT. However, most QPMs are fixed on the optical platform with bulky size, lack of timeliness, which remained challenging in POCT solutions. In this paper, we proposed a plug-and-play QPM with multimode imaging based on the quantitative differential phase contrast (qDPC) method. The system employs a programmable LED array as the light source and uses the GPU to accelerate the calculation, which can realize multi-contrast imaging with six modes. Accurate phase measurement and real-time phase imaging are implemented by the proposed qDPC algorithms for quantitative phase targets and biomedical samples. A 3D electric control platform is designed for mechanical control of field of view and focusing without manual operations. The experimental results verify the robustness and high performance of the setup. Even a rookie could finish the POCT scheme for biomedical applications at the scene using the QPM with a compact size of 140 × 165 × 250 mm3.
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Affiliation(s)
- Tao Peng
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - Zeyu Ke
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - Hao Wu
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - Jun He
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - Yue Sun
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - Shuhe Zhang
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - Qian Gao
- College of Life Science, Anhui Medical University, Hefei 230032, China
| | - Meng Shao
- Anhui Province Key Laboratory of Measuring Theory and Precision Instrument, School of Instrument Science and Optoelectronics Engineering, Hefei University of Technology, Hefei 230009, China
| | - Shengzhao Zhang
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - Zhensheng Zhong
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - FengYa Lu
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - Jinhua Zhou
- School of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
- Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei 230032, China
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Smedemark SA, Laursen CB, Jarbøl DE, Rosenvinge FS, Andersen-Ranberg K. Extended use of point-of-care technology versus usual care for in-home assessment by acute community nurses in older adults with signs of potential acute respiratory disease: an open-label randomised controlled trial protocol. BMC Geriatr 2024; 24:161. [PMID: 38365595 PMCID: PMC10870485 DOI: 10.1186/s12877-024-04774-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 02/03/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Due to ageing-related physiological changes, diagnosing older adults is challenging. Delayed disease recognition may lead to adverse health outcomes and increased hospitalisation, necessitating the development of new initiatives for timely diagnosis and treatment of older adults. Point-of-care technology, such as focused lung ultrasound scan and bedside analysis of blood samples (leucocytes with differential count, electrolytes, and creatinine) conducted in the patients' home, may support clinical decision-making, and potentially reduce acute hospital admissions. We present the protocol for a randomized controlled trial, which aims at assessing the effect of focused lung ultrasound scan and bedside blood analysis during in-home assessments among older adults with signs of potential acute respiratory disease on hospital admissions. METHOD We will use a parallel open-label, individually randomised controlled trial design in an acute community healthcare setting. The trial will initiate on October 2022 and is expected to end one year later. The study population will include older adults (65 + year), with at least one of the following inclusion criteria: Cough, dyspnoea, fever, fall, or rapid functional decline. Expected study sample will comprise 632 participants. Participants in the control group will receive usual care, while the intervention group will undergo extended point-of-care technology (focused lung ultrasound scan and bedside venous blood analysis), in addition to usual care. The primary outcome is acute hospital admission within 30 days follow-up. Secondary outcomes include readmissions, mortality, length of hospital stay, hospital-free days, complications during hospital admission, treatment initiations or changes, functional level, re-referrals to the acute community healthcare service, and contacts to the primary care physician. A tertiary outcome is the diagnostic accuracy of Acute Community Nurses for conducting focused lung ultrasound compared with a specialist. Outcomes will be analysed as intention-to-treat. DISCUSSION To our knowledge, this is the first randomised controlled trial examining the effect of extended use of point-of-care technology conducted in an in-home setting. We expect that the results may contribute to the development of new interventions aiming to improve timely diagnostics, treatment decisions, and reduce acute hospital admissions. TRIAL REGISTRATION www. CLINICALTRIALS org NCT05546073 (Date of registration: September 19th, 2022).
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Affiliation(s)
- Siri Aas Smedemark
- Department of Geriatric Medicine, Geriatric Research Unit, Odense University Hospital, Odense, Denmark.
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Christian B Laursen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Respiratory Medicine, Odense Respiratory Research Unit, Odense University Hospital, Odense, Denmark
| | - Dorte Ejg Jarbøl
- Department of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
| | | | - Karen Andersen-Ranberg
- Department of Geriatric Medicine, Geriatric Research Unit, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Villanueva G, Lowe J, Tentoni N, Taluja A, Villarroel M, Narváez CE, León SA, Valencia Libreros DL, Gonzalez Suárez N, Mikkelsen TS, Howard SC. Access to Methotrexate Monitoring in Latin America: A Multicountry Survey of Supportive Care Capacity. Pediatr Hematol Oncol 2024; 41:135-149. [PMID: 37865916 DOI: 10.1080/08880018.2023.2271013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/15/2023] [Indexed: 10/24/2023]
Abstract
High-dose methotrexate (HDMTX) is used to treat a broad spectrum of cancers. Methotrexate (MTX) monitoring and adequate supportive care are critical for safe drug administration; however, MTX level timing is not always possible in low- and middle-income countries. The aim of this study was to evaluate HDMTX supportive care capacity and MTX monitoring practices in Latin America (LATAM) to identify gaps and opportunities for improvement. A multicenter survey was conducted among LATAM pediatric oncologists. Twenty healthcare providers from 20 institutions answered the online questionnaire. HDMTX was used to treat acute lymphoblastic leukemia (ALL; 100%), non-Hodgkin lymphoma (84.2%), diffuse large B-cell lymphoma (47.4%), osteosarcoma (78.9%), and medulloblastoma (31.6%). Delays in starting HDMTX infusion were related to bed shortages (47.4%) and MTX shortages (21.1%). MTX monitoring was performed at an in-hospital laboratory in 52%, at an external/nearby laboratory in 31.6%, and was not available in 10.5%. Median interval between sampling and obtaining MTX levels was ≤ 2 h in 45% and ≥ 6 h in 30%, related to laboratory location. Sites without access to MTX monitoring reduced the MTX dose for patients with high-risk ALL or did not include MTX in the treatment of patients with osteosarcoma. Respondents reported that implementation of point-of-care testing of MTX levels is feasible. In LATAM, highly variable supportive care capacity may affect the safe administration of MTX doses. Improving accessibility of MTX monitoring and the speed of obtaining results should be prioritized to allow delivery of full doses of MTX required by the current protocols.
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Affiliation(s)
| | - Jennifer Lowe
- Department of Clinical Research, Resonance, Memphis, Tennessee, USA
| | - Nicolás Tentoni
- Department of Clinical Research, Resonance, Memphis, Tennessee, USA
| | - Ankit Taluja
- Department of Clinical Research, Resonance, Memphis, Tennessee, USA
| | - Milena Villarroel
- Department of Pediatric Oncology and Hematology, Hospital Dr. Luis Calvo Mackenna, Santiago de Chile, Chile
| | - Carlos E Narváez
- Department of Pediatric Oncology, Clínica Imbanaco, Grupo Quirón Salud, Cali, Colombia
| | - Sandra Alarcón León
- Department of Pediatric Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | | | | | - Torben S Mikkelsen
- Department of Pediatric Oncology and Hematology, Aarhus University Hospital, Aarhus, Denmark
| | - Scott C Howard
- Department of Clinical Research, Resonance, Memphis, Tennessee, USA
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Arriaga-Cázares HE, Vega-Morales D, Moreno-Treviño CA, Juarez-Juarez JL, Pérez-Arizmendi CA, Martagón-Rosado AJ. Comparison of Two Strategies for Hypercholesterolemia Detection through Point-of-Care Testing. Diagnostics (Basel) 2024; 14:143. [PMID: 38248020 PMCID: PMC10814133 DOI: 10.3390/diagnostics14020143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/30/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Childhood dyslipidemia is a common condition that can lead to atherosclerotic cardiovascular disease in adulthood. It is usually multifactorial. Screening for cholesterol disorders in children varies based on risk factors, with some guidelines recommending cascade screening for children with a clear family history of familial hypercholesterolemia, targeted screening for those with specific risk factors, and universal screening. Point-of-care testing (POCT) cholesterol tests offer potential advantages, including ease of use, portability, increased patient access, low cost, fewer medical or laboratory visits, and instant results. This study aimed to evaluate the effect of POCT cholesterol screening on the diagnosis of hypercholesterolemia in children in a family practice setting. METHODS We used a POCT cholesterol analyzer to perform two different (universal and targeted) screening approaches for dyslipidemia in children. We used the NCEP guidelines for the classification of the results. RESULTS We screened 183 children, 105 in the universal screening group and 78 in the targeted screening group. Eight patients in the targeted screening group had elevated cholesterol levels (p = 0.02). CONCLUSIONS All participants received instant feedback and recommendations. Using a targeted screening approach, POCT could be a practical and effective tool for identifying at-risk children with hypercholesterolemia.
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Affiliation(s)
- Héctor Eliud Arriaga-Cázares
- Instituto Mexicano del Seguro Social, Hospital de Traumatología y Ortopedia N.º 21, Monterrey 64000, Mexico
- Escuela de Medicina, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey 64849, Mexico
| | - David Vega-Morales
- Instituto Mexicano del Seguro Social, Hospital General de Zona 17, Monterrey 64420, Mexico;
| | - Carlos Alberto Moreno-Treviño
- Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar 26, Monterrey 64117, Mexico; (C.A.M.-T.); (C.A.P.-A.)
| | - Juana Lorena Juarez-Juarez
- Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar 26, Monterrey 64117, Mexico; (C.A.M.-T.); (C.A.P.-A.)
| | - Carlos Azael Pérez-Arizmendi
- Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar 26, Monterrey 64117, Mexico; (C.A.M.-T.); (C.A.P.-A.)
| | - Alexandro J. Martagón-Rosado
- Escuela de Medicina, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey 64849, Mexico
- Institute for Obesity Research, Instituto Tecnologico y de Estudios Superiores de Monterrey, Monterrey 64849, Mexico
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México 14080, Mexico
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Ju DU, Park D, Kim IH, Kim S, Yoo HM. Development of Human Rhinovirus RNA Reference Material Using Digital PCR. Genes (Basel) 2023; 14:2210. [PMID: 38137032 PMCID: PMC10742479 DOI: 10.3390/genes14122210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
The human rhinovirus (RV) is a positive-stranded RNA virus that causes respiratory tract diseases affecting both the upper and lower halves of the respiratory system. RV enhances its replication by concentrating RNA synthesis within a modified host membrane in an intracellular compartment. RV infections often occur alongside infections caused by other respiratory viruses, and the RV virus may remain asymptomatic for extended periods. Alongside qualitative detection, it is essential to accurately quantify RV RNA from clinical samples to explore the relationships between RV viral load, infections caused by the virus, and the resulting symptoms observed in patients. A reference material (RM) is required for quality evaluation, the performance evaluation of molecular diagnostic products, and evaluation of antiviral agents in the laboratory. The preparation process for the RM involves creating an RV RNA mixture by combining RV viral RNA with RNA storage solution and matrix. The resulting RV RNA mixture is scaled up to a volume of 25 mL, then dispensed at 100 µL per vial and stored at -80 °C. The process of measuring the stability and homogeneity of RV RMs was conducted by employing reverse transcription droplet digital polymerase chain reaction (RT-ddPCR). Digital PCR is useful for the analysis of standards and can help to improve measurement compatibility: it represents the equivalence of a series of outcomes for reference materials and samples being analyzed when a few measurement procedures are employed, enabling objective comparisons between quantitative findings obtained through various experiments. The number of copies value represents a measured result of approximately 1.6 × 105 copies/μL. The RM has about an 11% bottle-to-bottle homogeneity and shows stable results for 1 week at temperatures of 4 °C and -20 °C and for 12 months at a temperature of -80 °C. The developed RM can enhance the dependability of RV molecular tests by providing a precise reference value for the absolute copy number of a viral target gene. Additionally, it can serve as a reference for diverse studies.
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Affiliation(s)
- Dong U Ju
- Biometrology Group, Korea Research Institute of Standards and Science (KRISS), Daejeon 34113, Republic of Korea
- School of Biomedical Engineering, Korea University, Seoul 02841, Republic of Korea
| | - Dongju Park
- Biometrology Group, Korea Research Institute of Standards and Science (KRISS), Daejeon 34113, Republic of Korea
| | - Il-Hwan Kim
- Biometrology Group, Korea Research Institute of Standards and Science (KRISS), Daejeon 34113, Republic of Korea
| | - Seil Kim
- Biometrology Group, Korea Research Institute of Standards and Science (KRISS), Daejeon 34113, Republic of Korea
- Department of Precision Measurement, University of Science & Technology (UST), Daejeon 34113, Republic of Korea
| | - Hee Min Yoo
- Biometrology Group, Korea Research Institute of Standards and Science (KRISS), Daejeon 34113, Republic of Korea
- Department of Precision Measurement, University of Science & Technology (UST), Daejeon 34113, Republic of Korea
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Tian Y, Fan Z, Xu L, Cao Y, Chen S, Pan Z, Gao Y, Li H, Zheng S, Ma Y, Duan Z, Zhang X, Ren F. CRISPR/Cas13a-assisted rapid and portable HBV DNA detection for low-level viremia patients. Emerg Microbes Infect 2023; 12:e2177088. [PMID: 36735916 PMCID: PMC9946317 DOI: 10.1080/22221751.2023.2177088] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND & AIMS The WHO declared to eliminate hepatitis B virus (HBV) by 2030. However, an increasing number of patients are presenting with low-level viremia (LLV) with the widespread use of antiviral medications. The diagnostic efficiency and coverage area of HBV infection are low. Hence, this study intended to drive the HBV infection detection to effectively adaptable for any small to medium-sized laboratory or field survey. METHODS We established, optimized, and evaluated a colloidal gold test strip for detection of HBV DNA based on CRISPR/Cas13a combined with recombinase-aided amplification (RAA) technology. Furthermore, 180 HBV-infected patients (including patients with different viral loads, LLV patients and dynamic plasma samples of patients on antiviral therapy) were enrolled for clinical validation. RESULTS The strip detection of HBV DNA was established based on RAA-CRISPR-Cas13a technology with a sensitivity of 101 copies/μL and a specificity of 100%. HBV DNA gradient concentration plasmids and clinical samples were effectively identified by this approach. The positive coincidence rate for LLV patients was 87%, while the negative coincidence rate was 100%. The positive coincidence rate reached 100% in LLV patients (viral loading >100 IU/mL). The sensitivity, specificity, positive predictive agreement (PPA) and negative predictive agreement (NPA) values of dynamic plasma detection in patients on antiviral therapy were 100%, 92.15%, 93.75%, and 100%, respectively. CONCLUSIONS We develop rapid and portable RAA-CRISPR/Cas13a-based strip of HBV DNA detection for LLV patients. This study provides a visual and faster alternative to current PCR-based diagnosis for HBV infection.
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Affiliation(s)
- Yuan Tian
- Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China,Beijing Institute of Hepatology, Beijing, People’s Republic of China
| | - Zihao Fan
- Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China,Beijing Institute of Hepatology, Beijing, People’s Republic of China
| | - Ling Xu
- Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China,Beijing Institute of Hepatology, Beijing, People’s Republic of China
| | - Yaling Cao
- Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China,Beijing Institute of Hepatology, Beijing, People’s Republic of China
| | - Sisi Chen
- Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China,Beijing Institute of Hepatology, Beijing, People’s Republic of China
| | - Zhenzhen Pan
- Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China,Beijing Institute of Hepatology, Beijing, People’s Republic of China
| | - Yao Gao
- Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China,Beijing Institute of Hepatology, Beijing, People’s Republic of China
| | - Hao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People’s Republic of China
| | - Sujun Zheng
- Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yingmin Ma
- Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China,Beijing Institute of Hepatology, Beijing, People’s Republic of China
| | - Zhongping Duan
- Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China,Zhongping Duan Beijing Youan Hospital, Capital Medical University, No. 8, Xitou Tiao Road, Youwai Street, Fengtai DistrictBeijing 100069, China
| | - Xiangying Zhang
- Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China,Beijing Institute of Hepatology, Beijing, People’s Republic of China,Xiangying Zhang Beijing Youan Hospital, Capital Medical University, No. 8, XitouTiao Road, Youwai Street, Fengtai DistrictBeijing 100069, China
| | - Feng Ren
- Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China,Beijing Institute of Hepatology, Beijing, People’s Republic of China, Feng Ren Beijing Youan Hospital, Capital Medical University, No. 8, XitouTiao Road, Youwai Street, Fengtai District, Beijing100069, People’s Republic of China
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10
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Soliman C, Faircloth J, Tu D, Mabbott S, Maitland K, Coté G. Exploring the Clinical Utility of Raman Spectroscopy for Point-of-Care Cardiovascular Disease Biomarker Detection. Appl Spectrosc 2023; 77:1181-1193. [PMID: 37487187 DOI: 10.1177/00037028231187963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
A variety of innovative point-of-care (POC) solutions using Raman systems have been explored. However, the vast effort is in assay development, while studies of the characteristics required for Raman spectrometers to function in POC applications are lacking. In this study, we tested and compared the performance of eight commercial Raman spectrometers ranging in size from benchtop Raman microscopes to portable and handheld Raman spectrometers using paper fluidic cartridges, including their ability to detect cardiac troponin I and heart fatty acid binding protein, both of which are well-established biomarkers for evaluating cardiovascular health. Each spectrometer was evaluated in terms of excitation wavelength, laser characteristics, and ease of use to investigate POC utility. We found that the Raman spectrometers equipped with 780 and 785 nm laser sources exhibited a reduced background signal and provided higher sensitivity compared to those with 633 and 638 nm laser sources. Furthermore, the spectrometer equipped with the single acquisition line readout functionality showed improved performance when compared to the point scan spectrometers and allowed measurements to be made faster and easier. The portable and handheld spectrometers also showed similar detection sensitivity to the gold standard instrument. Lastly, we reduced the laser power for the spectrometer with single acquisition line readout capability to explore the system performance at a laser power that change the classification from a Class 3B laser device to a Class 3R device and found that it showed comparable performance. Overall, these findings show that portable Raman spectrometers have the potential to be used in POC settings with accuracy comparable to laboratory-grade instruments, are relatively low-cost, provide fast signal readout, are easy to use, and can facilitate access for underserved communities.
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Affiliation(s)
- Cyril Soliman
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
| | | | - Dandan Tu
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
| | - Samuel Mabbott
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
- Texas A&M Engineering Experiment Station, Center for Remote Health Technologies and Systems, College Station, Texas, USA
| | - Kristen Maitland
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
- Texas A&M Engineering Experiment Station, Center for Remote Health Technologies and Systems, College Station, Texas, USA
- Imaging Program, Chan Zuckerberg Initiative, Redwood City, California, USA
| | - Gerard Coté
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
- Texas A&M Engineering Experiment Station, Center for Remote Health Technologies and Systems, College Station, Texas, USA
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11
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Martín-Rodríguez F, Vaquerizo-Villar F, López-Izquierdo R, Castro-Villamor MA, Sanz-García A, Del Pozo-Vegas C, Hornero R. Derivation and validation of a blood biomarker score for 2-day mortality prediction from prehospital care: a multicenter, cohort, EMS-based study. Intern Emerg Med 2023; 18:1797-1806. [PMID: 37079244 PMCID: PMC10116443 DOI: 10.1007/s11739-023-03268-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 03/31/2023] [Indexed: 04/21/2023]
Abstract
Identifying potentially life-threatening diseases is a key challenge for emergency medical services. This study aims at examining the role of different prehospital biomarkers from point-of-care testing to derive and validate a score to detect 2-day in-hospital mortality. We conducted a prospective, observational, prehospital, ongoing, and derivation-validation study in three Spanish provinces, in adults evacuated by ambulance and admitted to the emergency department. A total of 23 ambulance-based biomarkers were collected from each patient. A biomarker score based on logistic regression was fitted to predict 2-day mortality from an optimum subset of variables from prehospital blood analysis, obtained through an automated feature selection stage. 2806 cases were analyzed, with a median age of 68 (interquartile range 51-81), 42.3% of women, and a 2-day mortality rate of 5.5% (154 non-survivors). The blood biomarker score was constituted by the partial pressure of carbon dioxide, lactate, and creatinine. The score fitted with logistic regression using these biomarkers reached a high performance to predict 2-day mortality, with an AUC of 0.933 (95% CI 0.841-0.973). The following risk levels for 2-day mortality were identified from the score: low risk (score < 1), where only 8.2% of non-survivors were assigned to; medium risk (1 ≤ score < 4); and high risk (score ≥ 4), where the 2-day mortality rate was 57.6%. The novel blood biomarker score provides an excellent association with 2-day in-hospital mortality, as well as real-time feedback on the metabolic-respiratory patient status. Thus, this score can help in the decision-making process at critical moments in life-threatening situations.
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Affiliation(s)
- Francisco Martín-Rodríguez
- Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain
- Advanced Life Support, Emergency Medical Services (SACYL), Valladolid, Spain
- Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain
| | - Fernando Vaquerizo-Villar
- Biomedical Engineering Group, Facultad de Medicina, Universidad de Valladolid, Av. Ramón y Cajal, 7, 47003, Valladolid, Spain.
- CIBER-BBN, Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina, Valladolid, Spain.
| | - Raúl López-Izquierdo
- Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain
- Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain
- Emergency Department, Hospital Universitario Rio Hortega, Valladolid, Spain
| | - Miguel A Castro-Villamor
- Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain
- Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain
| | - Ancor Sanz-García
- Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain
- Health Research Institute, Hospital de la Princesa, Madrid (IIS-IP), Spain
| | - Carlos Del Pozo-Vegas
- Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain
- Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain
- Emergency Department, Hospital Clínico Universitario, Valladolid, Spain
| | - Roberto Hornero
- Biomedical Engineering Group, Facultad de Medicina, Universidad de Valladolid, Av. Ramón y Cajal, 7, 47003, Valladolid, Spain
- CIBER-BBN, Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina, Valladolid, Spain
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12
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Chan JTN, Nguyen V, Tran TN, Nguyen NV, Do NTT, van Doorn HR, Lewycka S. Point-of-care testing in private pharmacy and drug retail settings: a narrative review. BMC Infect Dis 2023; 23:551. [PMID: 37612636 PMCID: PMC10463283 DOI: 10.1186/s12879-023-08480-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/23/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Point-of-care testing (POCT) using rapid diagnostic tests for infectious disease can potentially guide appropriate use of antimicrobials, reduce antimicrobial resistance, and economise use of healthcare resources. POCT implementation in private retail settings such as pharmacies and drug shops could lessen the burden on public healthcare. We performed a narrative review on studies of POCTs in low- and middle-income countries (LMICs), and explored uptake, impact on treatment, and feasibility of implementation. METHODS We searched MEDLINE/PubMed for interventional studies on the implementation of POCT for infectious diseases performed by personnel in private retail settings. Data were extracted and analysed by two independent reviewers. RESULTS Of the 848 studies retrieved, 23 were included in the review. Studies were on malaria (19/23), malaria and pneumonia (3/23) or respiratory tract infection (1/23). Nine randomised controlled studies, four controlled, non-randomised studies, five uncontrolled interventions, one interventional pre-post study, one cross-over interventional study and three retrospective analyses of RCTs were included. Study quality was poor. Overall, studies showed that POCT can be implemented successfully, leading to improvements in appropriate treatment as measured by outcomes like adherence to treatment guidelines. Despite some concerns by health workers, customers and shop providers were welcoming of POCT implementation in private retail settings. Main themes that arose from the review included the need for well-structured training with post-training certification covering guidelines for test-negative patients, integrated waste management, community sensitization and demand generation activities, financial remuneration and pricing schemes for providers, and formal linkage to healthcare and support. CONCLUSION Our review found evidence that POCT can be implemented successfully in private retail settings in LMICs, but comprehensive protocols are needed. High-quality randomised studies are needed to understand POCTs for infectious diseases other than malaria.
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Affiliation(s)
| | - Van Nguyen
- Doctor of Medicine Programme, Duke National University of Singapore (NUS) Medical School, Singapore, Singapore
| | - Thuy Ngan Tran
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | | | | | - H Rogier van Doorn
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sonia Lewycka
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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13
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Donoso Calero MI, Mordillo-Mateos L, Martín-Conty JL, Polonio-López B, López-González Á, Durantez-Fernández C, Viñuela A, Rodríguez Hernández M, Mohedano-Moriano A, López-Izquierdo R, Jorge Soto C, Martín-Rodríguez F. Modified Rapid Emergency Medicine Score-Lactate (mREMS-L) performance to screen non-anticipated 30-day-related-mortality in emergency department. Eur J Clin Invest 2023; 53:e13994. [PMID: 37000120 DOI: 10.1111/eci.13994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/28/2023] [Accepted: 03/23/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND The aim of this study was to compare the ability to predict 30-day in-hospital mortality of lactate versus the modified Rapid Emergency Medicine Score (mREMS) versus the arithmetic sum of the mREMS plus the numerical value of lactate (mREMS-L). METHODS A prospective, multicentric, emergency department delivery, pragmatic study was conducted. To determine the predictive capacity of the scales, lactate was measured and the mREMS and mREMS-L were calculated in adult patients (aged>18 years) transferred with high priority by ambulance to the emergency department in five hospitals of Castilla y Leon between 1 January 2020 and 31 December 2021. The area under the receiver operating characteristic (ROC) curve of each of the scales was calculated in terms of mortality for 30 days. RESULTS A total of 5371 participants were included, and the in-hospital mortality rate at 30 days was of 11.4% (615 cases). The best cut-off point determined in the mREMS was 7.0 points (sensitivity of 67% and specificity of 84%), and for lactate, the cut-off point was 1.4 mmol/L (sensitivity of 88% and specificity of 67%). Finally, the combined mREMS-L showed a cut-off point of 7.9 (sensitivity of 83% and a specificity of 83%). The area under the ROC curve of the mREMS, lactate and mREMS-L for 30-day mortality was 0.851, 0.853, and 0.903, respectively (p < 0.001 in all cases). CONCLUSIONS The new score generated, mREMS-L, obtained better statistical results than its components (mREMS and lactate) separately.
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Affiliation(s)
- M Isabel Donoso Calero
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
| | - Laura Mordillo-Mateos
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
- Technological Innovation Applied to Health Research Group (ITAS), Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | - José L Martín-Conty
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
- Technological Innovation Applied to Health Research Group (ITAS), Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | - Begoña Polonio-López
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
- Technological Innovation Applied to Health Research Group (ITAS), Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | - Ángel López-González
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Albacete, Spain
| | | | - Antonio Viñuela
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
- Technological Innovation Applied to Health Research Group (ITAS), Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | - Marta Rodríguez Hernández
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
- Technological Innovation Applied to Health Research Group (ITAS), Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | - Alicia Mohedano-Moriano
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
- Technological Innovation Applied to Health Research Group (ITAS), Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | | | - Cristina Jorge Soto
- Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain
- CLINURSID Research Group, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Francisco Martín-Rodríguez
- Advanced Life Support, Gerencia de Emergencias Sanitarias, Gerencia Regional de Salud de Castilla y León (SACYL), Valladolid, Spain
- Advanced Clinical Simulation Centre, Faculty of Medicine, University of Valladolid, Valladolid, Spain
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Mangone M, Diko A, Giuliani L, Agostini F, Paoloni M, Bernetti A, Santilli G, Conti M, Savina A, Iudicelli G, Ottonello C, Santilli V. A Machine Learning Approach for Knee Injury Detection from Magnetic Resonance Imaging. Int J Environ Res Public Health 2023; 20:6059. [PMID: 37372646 DOI: 10.3390/ijerph20126059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/27/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
The knee is an essential part of our body, and identifying its injuries is crucial since it can significantly affect quality of life. To date, the preferred way of evaluating knee injuries is through magnetic resonance imaging (MRI), which is an effective imaging technique that accurately identifies injuries. The issue with this method is that the high amount of detail that comes with MRIs is challenging to interpret and time consuming for radiologists to analyze. The issue becomes even more concerning when radiologists are required to analyze a significant number of MRIs in a short period. For this purpose, automated tools may become helpful to radiologists assisting them in the evaluation of these images. Machine learning methods, in being able to extract meaningful information from data, such as images or any other type of data, are promising for modeling the complex patterns of knee MRI and relating it to its interpretation. In this study, using a real-life imaging protocol, a machine-learning model based on convolutional neural networks used for detecting medial meniscus tears, bone marrow edema, and general abnormalities on knee MRI exams is presented. Furthermore, the model's effectiveness in terms of accuracy, sensitivity, and specificity is evaluated. Based on this evaluation protocol, the explored models reach a maximum accuracy of 83.7%, a maximum sensitivity of 82.2%, and a maximum specificity of 87.99% for meniscus tears. For bone marrow edema, a maximum accuracy of 81.3%, a maximum sensitivity of 93.3%, and a maximum specificity of 78.6% is reached. Finally, for general abnormalities, the explored models reach 83.7%, 90.0% and 84.2% of maximum accuracy, sensitivity and specificity, respectively.
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Affiliation(s)
- Massimiliano Mangone
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Anxhelo Diko
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
- Department of Computer Science Sapienza, University of Rome, 00198 Rome, Italy
| | - Luca Giuliani
- San Salvatore Hospital, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Vetoio Stree, 67100 L'Aquila, Italy
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Marco Paoloni
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Andrea Bernetti
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Gabriele Santilli
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Marco Conti
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Alessio Savina
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Giovanni Iudicelli
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Carlo Ottonello
- Fisiocard Medical Centre, Via Francesco Tovaglieri 17, 00155 Rome, Italy
| | - Valter Santilli
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
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15
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Lightowler B, Hodge A, Pilbery R, Bell F, Best P, Hird K, Walker A, Snaith B. Venous blood point-of-care testing (POCT) for paramedics in urgent and emergency care: protocol for a single-site feasibility study (POCTPara). Br Paramed J 2023; 8:34-41. [PMID: 37284603 PMCID: PMC10240860 DOI: 10.29045/14784726.2023.6.8.1.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
The COVID-19 pandemic placed the UK healthcare system under unprecedented pressure, and recovery will require whole-system investment in innovative, flexible and pragmatic solutions. Positioned at the heart of the healthcare system, ambulance services have been tasked with addressing avoidable hospital conveyance and reducing unnecessary emergency department and hospital attendances through the delivery of care closer to home. Having begun to implement models of care intended to increase 'see and treat' opportunities through greater numbers of senior clinical decision makers, emphasis has now been placed upon the use of remote clinical diagnostic tools and near-patient or point-of-care testing (POCT) to aid clinical decision making. In terms of POCT of blood samples obtained from patients in the pre-hospital setting, there is a paucity of evidence beyond its utility for measuring lactate and troponin in acute presentations such as sepsis, trauma and myocardial infarction, although potential exists for the analysis of a much wider panel of analytes beyond these isolated biomarkers. In addition, there is a relative dearth of evidence in respect of the practicalities of using POCT analysers in the pre-hospital setting. This single-site feasibility study aims to understand whether it is practical to use POCT for the analysis of patients' blood samples in the urgent and emergency care pre-hospital setting, through descriptive data of POCT application and through qualitative focus group interviews of advanced practitioners (specialist paramedics) to inform the feasibility and design of a larger study. The primary outcome measure is focus group data measuring the experiences and perceived self-reported impact by specialist paramedics. Secondary outcome measures are number and type of cartridges used, number of successful and unsuccessful attempts in using the POCT analyser, length of time on scene, specialist paramedic recruitment and retention, number of patients who receive POCT, descriptive data of safe conveyance, patient demographics and presentations where POCT is applied and data quality. The study results will inform the design of a main trial if indicated.
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Affiliation(s)
- Bryan Lightowler
- University of Bradford ORCID iD: https://orcid.org/0000-0002-9884-6762
| | - Andrew Hodge
- The Mid-Yorkshire Hospitals NHS Trust ORCID iD: https://orcid.org/0000-0002-2632-2249
| | - Richard Pilbery
- Yorkshire Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0002-5797-9788
| | - Fiona Bell
- Yorkshire Ambulance Service NHS Trust ORCID iD: https://orcid.org/0000-0003-4503-1903
| | - Pete Best
- Yorkshire Ambulance Service NHS Trust ORCID iD: https://orcid.org/0009-0002-7298-1138
| | - Kelly Hird
- Yorkshire Ambulance Service NHS Trust ORCID iD: https://orcid.org/0009-0000-1146-022X
| | - Alison Walker
- Harrogate and District NHS Foundation Trust ORCID iD: https://orcid.org/0009-0000-9235-2676
| | - Beverly Snaith
- The Mid-Yorkshire Hospitals NHS Trust ORCID iD: https://orcid.org/0000-0002-6296-0889
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16
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Sugita S, Takase H, Nakano S. Role of Recent PCR Tests for Infectious Ocular Diseases: From Laboratory-Based Studies to the Clinic. Int J Mol Sci 2023; 24:ijms24098146. [PMID: 37175854 PMCID: PMC10179472 DOI: 10.3390/ijms24098146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/22/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
Infectious uveitis is a vision-threatening condition that requires prompt clinical diagnosis and proper treatment. However, rapid and proper diagnosis in infectious uveitis remains challenging. Several examination tests, including polymerase chain reaction (PCR) tests, are transitioning from laboratory-based basic research-level tests to bedside clinical tests, and recently tests have changed to where they can be performed right next to clinicians. In this review, we introduce an updated overview of recent studies that are representative of the current trends in clinical microbiological techniques including PCR tests for infectious uveitis.
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Affiliation(s)
- Sunao Sugita
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe 650-0047, Japan
| | - Hiroshi Takase
- Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
| | - Satoko Nakano
- Department of Ophthalmology, Oita University, Oita 879-5593, Japan
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17
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Tenorio-Mucha J, Busta-Flores P, Lazo-Porras M, Vetter B, Safary E, Moran AE, Gupta R, Bernabé-Ortiz A. Facilitators and barriers of the implementation of point-of-care devices for cardiometabolic diseases: a scoping review. BMC Health Serv Res 2023; 23:412. [PMID: 37118750 PMCID: PMC10144879 DOI: 10.1186/s12913-023-09419-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/19/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Point-of-care testing (POCT) devices may facilitate the delivery of rapid and timely results, providing a clinically important advantage in patient management. The challenges and constraints in the implementation process, considering different levels of actors have not been much explored. This scoping review aimed to assess literature pertaining to implementation facilitators and barriers of POCT devices for the diagnosis or monitoring of cardiometabolic diseases. METHODS A scoping review of the literature was conducted. The inclusion criteria were studies on the inception, planning, or implementation of interventions with POCT devices for the diagnosis or monitoring of cardiometabolic diseases defined as dyslipidemia, cardiovascular diseases, type 2 diabetes, and chronic kidney disease. We searched MEDLINE, Embase, and Global Health databases using the OVID searching engine until May 2022. The Consolidated Framework of Implementation Research (CFIR) was used to classify implementation barriers and facilitators in five constructs. Also, patient, healthcare professional (HCP), and organization level was used. RESULTS Twenty studies met the eligibility criteria for data extraction. All studies except two were conducted in high-income countries. Some findings are: 1) Intervention: the most widely recognized facilitator was the quick turnaround time with which results are obtained. 2) Outer setting: at the organizational level, the lack of clear regulatory and accreditation mechanisms has hindered the adoption and sustainability of the use of POCT. 3) Inner setting: for HCP, performing POCT during the consultation was both a facilitator and a barrier in terms of time, personnel, and service delivery. 4) Individuals: the implementation of POCT may generate stress and discomfort in some HCP in terms of training and new responsibilities. 5) Process: for patients, it is highly appreciated that obtaining the sample was simple and more comfortable if venipuncture was not used. CONCLUSION This scoping review has described the facilitators and barriers of implementing a POCT device for cardiometabolic conditions using the CFIR. The information can be used to design better strategies to implement these devices and benefit more populations that have low access to cardiometabolic tests.
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Affiliation(s)
- Janeth Tenorio-Mucha
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 445 - Miraflores, Lima, Peru
| | - Patricia Busta-Flores
- CONEVID - Unidad de Conocimiento y Evidencia, Facultad de Medicina "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - María Lazo-Porras
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 445 - Miraflores, Lima, Peru
| | | | | | | | - Reena Gupta
- Resolve to Save Lives, New York, NY, USA
- Department of Medicine of Medicine, University of California, San Francisco, USA
| | - Antonio Bernabé-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 445 - Miraflores, Lima, Peru.
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18
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Rizvi AS, Murtaza G, Zhang W, Xue M, Qiu L, Meng Z. Aptamer-linked photonic crystal hydrogel sensor for rapid point-of-care detection of human immuno-deficiency virus-1 (HIV-1). J Pharm Biomed Anal 2023; 227:115104. [PMID: 36827736 DOI: 10.1016/j.jpba.2022.115104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/22/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022]
Abstract
The detection of the human immunodeficiency virus-1 (HIV) at an early stage is vital and could be realized through its cell surface glycoprotein-120 (gp120) without virus preprocessing. Here, we present an ssDNA-aptamer-linked photonic crystal (APC) hydrogel sensor for HIV detection which is comprised of photonic crystals (PCs) made of polystyrene nanoparticles embedded in the polyacrylamide hydrogel. ssDNA aptamers specific for gp120 are crosslinked in the hydrogel which can selectively bind to gp120 by hydrogen bonding increasing the PCs particle spacing and swelling of the hydrogel. The binding response can be visually monitored as a color change due to the diffraction of light from PCs and can eventually be measured (1-1000 ng mL-1 of gp120) and 100 to 108 VP mL-1 of HIV by the Debye's ring diameter or a UV/Vis spectrometer. APC-hydrogel can be regenerated by Tris-HCl and EDTA washing buffer system. The sensor demonstrates LOD of 7.1 ± 1.55 ng mL-1 for gp120 and 4 VP mL-1 for the whole HIV, a rapid response of 5 min, reusability up to 70 % (in fifth use), and recovery of 95.4 ± 0.1 % to 99.0 ± 0.2 % in plasma samples. The sensor is cost-effect and stable compared to antibody-based sensors and can be utilized to develop point-of-care testing (POCT) devices for HIV diagnosis.
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19
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Westenberg LEH, Been JV, Willemsen SP, Vis JY, Tintu AN, Bramer WM, Dijk PH, Steegers EAP, Reiss IKM, Hulzebos CV. Diagnostic Accuracy of Portable, Handheld Point-of-Care Tests vs Laboratory-Based Bilirubin Quantification in Neonates: A Systematic Review and Meta-analysis. JAMA Pediatr 2023; 177:479-488. [PMID: 36912856 PMCID: PMC10012043 DOI: 10.1001/jamapediatrics.2023.0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Importance Quantification of bilirubin in blood is essential for early diagnosis and timely treatment of neonatal hyperbilirubinemia. Handheld point-of-care (POC) devices may overcome the current issues with conventional laboratory-based bilirubin (LBB) quantification. Objective To systematically evaluate the reported diagnostic accuracy of POC devices compared with LBB quantification. Data Sources A systematic literature search was conducted in 6 electronic databases (Ovid MEDLINE, Embase, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, CINAHL, and Google Scholar) up to December 5, 2022. Study Selection Studies were included in this systematic review and meta-analysis if they had a prospective cohort, retrospective cohort, or cross-sectional design and reported on the comparison between POC device(s) and LBB quantification in neonates aged 0 to 28 days. Point-of-care devices needed the following characteristics: portable, handheld, and able to provide a result within 30 minutes. This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. Data Extraction and Synthesis Data extraction was performed by 2 independent reviewers into a prespecified, customized form. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Meta-analysis was performed of multiple Bland-Altman studies using the Tipton and Shuster method for the main outcome. Main Outcomes and Measures The main outcome was mean difference and limits of agreement in bilirubin levels between POC device and LBB quantification. Secondary outcomes were (1) turnaround time (TAT), (2) blood volumes, and (3) percentage of failed quantifications. Results Ten studies met the inclusion criteria (9 cross-sectional studies and 1 prospective cohort study), representing 3122 neonates. Three studies were considered to have a high risk of bias. The Bilistick was evaluated as the index test in 8 studies and the BiliSpec in 2. A total of 3122 paired measurements showed a pooled mean difference in total bilirubin levels of -14 μmol/L, with pooled 95% CBs of -106 to 78 μmol/L. For the Bilistick, the pooled mean difference was -17 μmol/L (95% CBs, -114 to 80 μmol/L). Point-of-care devices were faster in returning results compared with LBB quantification, whereas blood volume needed was less. The Bilistick was more likely to have a failed quantification compared with LBB. Conclusions and Relevance Despite the advantages that handheld POC devices offer, these findings suggest that the imprecision for measurement of neonatal bilirubin needs improvement to tailor neonatal jaundice management.
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Affiliation(s)
- Lauren E H Westenberg
- Division of Neonatology, Department of Pediatrics, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jasper V Been
- Division of Neonatology, Department of Pediatrics, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Obstetrics and Gynecology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sten P Willemsen
- Department of Obstetrics and Gynecology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Biostatistics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jolande Y Vis
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Andrei N Tintu
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Wichor M Bramer
- Medical Library, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Peter H Dijk
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, the Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynecology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Irwin K M Reiss
- Division of Neonatology, Department of Pediatrics, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Christian V Hulzebos
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, the Netherlands
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20
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Liu X, Du K, Lin S, Wang Y. Deep learning on lateral flow immunoassay for the analysis of detection data. Front Comput Neurosci 2023; 17:1091180. [PMID: 36777694 PMCID: PMC9909280 DOI: 10.3389/fncom.2023.1091180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/13/2023] [Indexed: 01/28/2023] Open
Abstract
Lateral flow immunoassay (LFIA) is an important detection method in vitro diagnosis, which has been widely used in medical industry. It is difficult to analyze all peak shapes through classical methods due to the complexity of LFIA. Classical methods are generally some peak-finding methods, which cannot distinguish the difference between normal peak and interference or noise peak, and it is also difficult for them to find the weak peak. Here, a novel method based on deep learning was proposed, which can effectively solve these problems. The method had two steps. The first was to classify the data by a classification model and screen out double-peaks data, and second was to realize segmentation of the integral regions through an improved U-Net segmentation model. After training, the accuracy of the classification model for validation set was 99.59%, and using combined loss function (WBCE + DSC), intersection over union (IoU) value of segmentation model for validation set was 0.9680. This method was used in a hand-held fluorescence immunochromatography analyzer designed independently by our team. A Ferritin standard curve was created, and the T/C value correlated well with standard concentrations in the range of 0-500 ng/ml (R 2 = 0.9986). The coefficients of variation (CVs) were ≤ 1.37%. The recovery rate ranged from 96.37 to 105.07%. Interference or noise peaks are the biggest obstacle in the use of hand-held instruments, and often lead to peak-finding errors. Due to the changeable and flexible use environment of hand-held devices, it is not convenient to provide any technical support. This method greatly reduced the failure rate of peak finding, which can reduce the customer's need for instrument technical support. This study provided a new direction for the data-processing of point-of-care testing (POCT) instruments based on LFIA.
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Affiliation(s)
- Xinquan Liu
- School of Precision Instrument and Optoelectronics Engineering, Tianjin University, Tianjin, China,Xinquan Liu,
| | - Kang Du
- Tianjin Boomscience Technology Co., Ltd., Tianjin, China
| | - Si Lin
- School of Precision Instrument and Optoelectronics Engineering, Tianjin University, Tianjin, China,Beijing Savant Biotechnology Co., Ltd., Beijing, China
| | - Yan Wang
- School of Precision Instrument and Optoelectronics Engineering, Tianjin University, Tianjin, China,*Correspondence: Yan Wang,
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21
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Collinson P, Aakre KM, Saenger A, Body R, Hammarsten O, Jaffe AS, Kavsak P, Omland T, Ordonez-Lianos J, Karon B, Apple FS. Cardiac troponin measurement at the point of care: educational recommendations on analytical and clinical aspects by the IFCC Committee on Clinical Applications of Cardiac Bio-Markers (IFCC C-CB). Clin Chem Lab Med 2023; 61:989-998. [PMID: 36637984 DOI: 10.1515/cclm-2022-1270] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 01/14/2023]
Abstract
The International Federation of Clinical Chemistry and Laboarator Medicine (IFCC) Committee on Clinical Applications of Cardiac Bio-Markers (C-CB) has provided evidence-based educational resources to aid and improve the understanding of important analytical and clinical aspects of cardiac biomarkers. The present IFCC C-CB educational report focuses on recommendations for appropriate use, analytical performance, and gaps in clinical studies related to the use of cardiac troponin (cTn) by point of care (POC) measurement, often referred to as a point of care testing (POCT). The use of high-sensitivity (hs)-cTn POC devices in accelerated diagnostic protocols used in emergency departments or outpatient clinics investigating acute coronary syndrome has the potential for improved efficacy, reduction of length of stay and reduced costs in the health care system. POCT workflow integration includes location of the instrument, assignment of collection and testing responsibility to (non-lab) staff, instrument maintenance, in-service and recurrent training, quality control, proficiency assessments, discrepant result trapping, and troubleshooting and inventory management.
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Affiliation(s)
- Paul Collinson
- Departments of Clinical Blood Sciences and Cardiology, St George's University Hospitals NHS Foundation Trust, London, UK.,St George's University of London, London, UK
| | - Kristin M Aakre
- Department of Medical Biochemistry and Pharmacology and Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Amy Saenger
- Department of Laboratory Medicine and Pathology, Hennepin Healthcare/HCMC, Minneapolis, MN, USA.,Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Rick Body
- Emergency Department, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Division of Cardiovascular Sciences, The University of Manchester, Manchester, UK.,Healthcare Sciences Department, Manchester Metropolitan University, Manchester, UK
| | - Ole Hammarsten
- Department of Clinical Chemistry and Transfusion Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Allan S Jaffe
- Departments of Laboratory Medicine and Pathology and Cardiology, Mayo Clinic, Rochester, MN, USA
| | - Pete Kavsak
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Torbjørn Omland
- Department of Cardiology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jordi Ordonez-Lianos
- Servicio de Bioquímica Clínica, Institut d'Investigacions Biomèdiques Sant Pau, Barcelona, Spain.,Departamento de Bioquímica y Biología Molecular, Universidad Autònoma de Barcelona, Barcelona, Spain
| | - Brad Karon
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Fred S Apple
- Department of Laboratory Medicine and Pathology, Hennepin Healthcare/HCMC, Minneapolis, MN, USA.,Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
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22
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Yoo J, Hur S, Hwang W, Cha WC. Healthcare Professionals' Expectations of Medical Artificial Intelligence and Strategies for its Clinical Implementation: A Qualitative Study. Healthc Inform Res 2023; 29:64-74. [PMID: 36792102 PMCID: PMC9932312 DOI: 10.4258/hir.2023.29.1.64] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 01/05/2023] [Indexed: 02/10/2023] Open
Abstract
OBJECTIVES Although medical artificial intelligence (AI) systems that assist healthcare professionals in critical care settings are expected to improve healthcare, skepticism exists regarding whether their potential has been fully actualized. Therefore, we aimed to conduct a qualitative study with physicians and nurses to understand their needs, expectations, and concerns regarding medical AI; explore their expected responses to recommendations by medical AI that contradicted their judgments; and derive strategies to implement medical AI in practice successfully. METHODS Semi-structured interviews were conducted with 15 healthcare professionals working in the emergency room and intensive care unit in a tertiary teaching hospital in Seoul. The data were interpreted using summative content analysis. In total, 26 medical AI topics were extracted from the interviews. Eight were related to treatment recommendation, seven were related to diagnosis prediction, and seven were related to process improvement. RESULTS While the participants expressed expectations that medical AI could enhance their patients' outcomes, increase work efficiency, and reduce hospital operating costs, they also mentioned concerns regarding distortions in the workflow, deskilling, alert fatigue, and unsophisticated algorithms. If medical AI decisions contradicted their judgment, most participants would consult other medical staff and thereafter reconsider their initial judgment. CONCLUSIONS Healthcare professionals wanted to use medical AI in practice and emphasized that artificial intelligence systems should be trustworthy from the standpoint of healthcare professionals. They also highlighted the importance of alert fatigue management and the integration of AI systems into the workflow.
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Affiliation(s)
- Junsang Yoo
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul,
Korea
| | - Sujeong Hur
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul,
Korea,AVOMD Inc, Seoul,
Korea
| | - Wonil Hwang
- Department of Industrial and Information Systems Engineering, Soongsil University, Seoul,
Korea
| | - Won Chul Cha
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul,
Korea,Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea,Digital Innovation Center, Samsung Medical Center, Seoul,
Korea
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23
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Vrijsen BEL, Haitjema S, Westerink J, Hulsbergen-Veelken CAR, van Solinge WW, ten Berg MJ. Shorter laboratory turnaround time is associated with shorter emergency department length of stay: a retrospective cohort study. BMC Emerg Med 2022; 22:207. [PMID: 36544114 PMCID: PMC9768765 DOI: 10.1186/s12873-022-00763-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/03/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND A longer emergency department length of stay (EDLOS) is associated with poor outcomes. Shortening EDLOS is difficult, due to its multifactorial nature. A potential way to improve EDLOS is through shorter turnaround times for diagnostic testing. This study aimed to investigate whether a shorter laboratory turnaround time (TAT) and time to testing (TTT) were associated with a shorter EDLOS. METHODS A retrospective cohort study was performed, including all visits to the emergency department (ED) of an academic teaching hospital from 2017 to 2020 during which a standardized panel of laboratory tests had been ordered. TTT was calculated as the time from arrival in the ED to the ordering of laboratory testing. TAT was calculated as the time from test ordering to the reporting of the results, and was divided into a clinical and a laboratory stage. The outcome was EDLOS in minutes. The effect of TTT and TAT on EDLOS was estimated through a linear regression model. RESULTS In total, 23,718 ED visits were included in the analysis. Median EDLOS was 199.0 minutes (interquartile range [IQR] 146.0-268.0). Median TTT was 7.0 minutes (IQR 2.0-12.0) and median TAT was 51.1 minutes (IQR 41.1-65.0). Both TTT and TAT were positively associated with EDLOS. The laboratory stage comprised a median of 69% (IQR 59-78%) of total TAT. CONCLUSION Longer TTT and TAT are independently associated with longer EDLOS. As the laboratory stage predominantly determines TAT, it provides a promising target for interventions to reduce EDLOS and ED crowding.
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Affiliation(s)
- Bram E. L. Vrijsen
- grid.7692.a0000000090126352Department of Internal Medicine, Division Internal Medicine and Dermatology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Saskia Haitjema
- grid.7692.a0000000090126352Central Diagnostic Laboratory, Division Laboratories, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Jan Westerink
- grid.7692.a0000000090126352Department of Internal Medicine, Division Internal Medicine and Dermatology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Cornelia A. R. Hulsbergen-Veelken
- grid.7692.a0000000090126352Central Diagnostic Laboratory, Division Laboratories, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Wouter W. van Solinge
- grid.7692.a0000000090126352Central Diagnostic Laboratory, Division Laboratories, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Maarten J. ten Berg
- grid.7692.a0000000090126352Central Diagnostic Laboratory, Division Laboratories, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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24
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Gao D, Guo X, Yang Y, Shi H, Hao R, Wang S, Li ZJ, Zhao R, Song H. Microfluidic chip and isothermal amplification technologies for the detection of pathogenic nucleic acid. J Biol Eng 2022; 16:33. [PMID: 36457138 DOI: 10.1186/s13036-022-00312-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/17/2022] [Indexed: 12/05/2022] Open
Abstract
The frequency of outbreaks of newly emerging infectious diseases has increased in recent years. The coronavirus disease 2019 (COVID-19) outbreak in late 2019 has caused a global pandemic, seriously endangering human health and social stability. Rapid detection of infectious disease pathogens is a key prerequisite for the early screening of cases and the reduction in transmission risk. Fluorescence quantitative polymerase chain reaction (qPCR) is currently the most commonly used pathogen detection method, but this method has high requirements in terms of operating staff, instrumentation, venues, and so forth. As a result, its application in the settings such as poorly conditioned communities and grassroots has been limited, and the detection needs of the first-line field cannot be met. The development of point-of-care testing (POCT) technology is of great practical significance for preventing and controlling infectious diseases. Isothermal amplification technology has advantages such as mild reaction conditions and low instrument dependence. It has a promising prospect in the development of POCT, combined with the advantages of high integration and portability of microfluidic chip technology. This study summarized the principles of several representative isothermal amplification techniques, as well as their advantages and disadvantages. Particularly, it reviewed the research progress on microfluidic chip-based recombinase polymerase isothermal amplification technology and highlighted future prospects.
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25
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Chen F, Zhang L, Bai X, Wang X, Geng Z. Clinical Application of Thromboelastography in Acute Ischemic Stroke. Clin Appl Thromb Hemost 2022; 28:10760296221131801. [PMID: 36285384 PMCID: PMC9608017 DOI: 10.1177/10760296221131801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Acute ischemic stroke (AIS), characterized by high morbidity and mortality, has imposed a considerable burden on society. Despite rapid development in the treatment of AIS, there is still a high risk of recurrence. Furthermore, there is a time delay in waiting for the results of conventional coagulation tests in candidate patients for intravenous thrombolysis therapy. Heterogeneous responses to antiplatelet, intravascular thrombolysis, and endovascular therapies also worsen the situation. Thromboelastography (TEG), as a global and portable detection method for hemostasis, facilitates clinicians in disease monitoring, treatment evaluation, and prognosis prediction in AIS. In this narrative review, we provided a comprehensive summary of the clinical application of TEG in ischemic stroke and gave insights to further studies.
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Affiliation(s)
- Feng Chen
- Department of Neurology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liren Zhang
- Department of Neurology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaolin Bai
- Department of Neurology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiuzhe Wang
- Department of Neurology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China,Zhi Geng, 600 Yishan Road, Xuhui District, Shanghai, 200233 China.
Xiuzhe Wang, 600 Yishan Road, Xuhui District, Shanghai, 200233 China
| | - Zhi Geng
- Department of Neurology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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26
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Saviñon-Flores AI, Saviñon-Flores F, Trejo G, Méndez E, Ţălu Ş, González-Fuentes MA, Méndez-Albores A. A review of cardiac troponin I detection by surface enhanced Raman spectroscopy: Under the spotlight of point-of-care testing. Front Chem 2022; 10:1017305. [PMID: 36311415 PMCID: PMC9608872 DOI: 10.3389/fchem.2022.1017305] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/29/2022] [Indexed: 11/29/2022] Open
Abstract
Cardiac troponin I (cTnI) is a biomarker widely related to acute myocardial infarction (AMI), one of the leading causes of death around the world. Point-of-care testing (POCT) of cTnI not only demands a short turnaround time for its detection but the highest accuracy levels to set expeditious and adequate clinical decisions. The analytical technique Surface-enhanced Raman spectroscopy (SERS) possesses several properties that tailor to the POCT format, such as its flexibility to couple with rapid assay platforms like microfluidics and paper-based immunoassays. Here, we analyze the strategies used for the detection of cTnI by SERS considering POCT requirements. From the detection ranges reported in the reviewed literature, we suggest the diseases other than AMI that could be diagnosed with this technique. For this, a section with information about cardiac and non-cardiac diseases with cTnI release, including their release kinetics or cut-off values are presented. Likewise, POCT features, the use of SERS as a POCT technique, and the biochemistry of cTnI are discussed. The information provided in this review allowed the identification of strengths and lacks of the available SERS-based point-of-care tests for cTnI and the disclosing of requirements for future assays design.
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Affiliation(s)
- Anel I. Saviñon-Flores
- Centro de Química-ICUAP- Posgrado en Ciencias Ambientales, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | | | - G. Trejo
- Laboratory of Composite Materials and Functional Coatings, Center for Research and Technological Development in Electrochemistry (CIDETEQ), Querétaro, Mexico
| | - Erika Méndez
- Facultad de Ciencias Químicas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Ştefan Ţălu
- Technical University of Cluj-Napoca, The Directorate of Research, Development and Innovation Management (DMCDI), Cluj-Napoca, Romania
| | - Miguel A. González-Fuentes
- Facultad de Ciencias Químicas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
- *Correspondence: Miguel A. González-Fuentes, ; Alia Méndez-Albores,
| | - Alia Méndez-Albores
- Centro de Química-ICUAP- Posgrado en Ciencias Ambientales, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
- *Correspondence: Miguel A. González-Fuentes, ; Alia Méndez-Albores,
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Nadar PM, Merrill MA, Austin K, Strakowski SM, Halpern JM. The emergence of psychoanalytical electrochemistry: the translation of MDD biomarker discovery to diagnosis with electrochemical sensing. Transl Psychiatry 2022; 12:372. [PMID: 36075922 DOI: 10.1038/s41398-022-02138-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/16/2022] [Accepted: 08/23/2022] [Indexed: 01/30/2023] Open
Abstract
The disease burden and healthcare costs of psychiatric diseases along with the pursuit to understand their underlying biochemical mechanisms have led to psychiatric biomarker investigations. Current advances in evaluating candidate biomarkers for psychiatric diseases, such as major depressive disorder (MDD), focus on determining a specific biomarker signature or profile. The origins of candidate biomarkers are heterogenous, ranging from genomics, proteomics, and metabolomics, while incorporating associations with clinical characterization. Prior to clinical use, candidate biomarkers must be validated by large multi-site clinical studies, which can be used to determine the ideal MDD biomarker signature. Therefore, identifying valid biomarkers has been challenging, suggesting the need for alternative approaches. Following validation studies, new technology must be employed to transition from biomarker discovery to diagnostic biomolecular profiling. Current technologies used in discovery and validation, such as mass spectroscopy, are currently limited to clinical research due to the cost or complexity of equipment, sample preparation, or measurement analysis. Thus, other technologies such as electrochemical detection must be considered for point-of-care (POC) testing with the needed characteristics for physicians' offices. This review evaluates the advantages of using electrochemical sensing as a primary diagnostic platform due to its rapidity, accuracy, low cost, biomolecular detection diversity, multiplexed capacity, and instrument flexibility. We evaluate the capabilities of electrochemical methods in evaluating current candidate MDD biomarkers, individually and through multiplexed sensing, for promising applications in detecting MDD biosignatures in the POC setting.
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28
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Collopy KT, Westmoreland A, Powers WF. Patient Care Alterations After Point-of-Care Laboratory Testing During Critical Care Transport. Air Med J 2022; 41:370-375. [PMID: 35750443 DOI: 10.1016/j.amj.2022.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 04/16/2022] [Accepted: 04/25/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Point-of-care laboratory testing (POCT) is associated with a reduced time to testing results and critical decision making within emergency departments. POCT is an essential clinical assessment tool because laboratory data are used to support timely critical decisions regarding acute medical conditions onditions ; however, there is currently limited research to support the use of POCT in the critical care transport environment. Few studies have evaluated the changes in patient care that occur after POCT during critical care transport. This study aims to contribute to the limited data available correlating prehospital POCT and changes in patient care. METHODS After institutional review board approval, a retrospective review of patients transported by a critical care transport team between October 1, 2013 and September 31, 2015 was completed. During the study period, 11,454 patients were transported, and 632 (5.51%) received POCT testing. RESULTS Patient care changes were noted in 244 (38.6%) patient tests. The most frequent patient care alterations were ventilator settings (10.9%), electrolyte changes (10.4%), and unit bed upgrades (7.1%). POCT most frequently altered care for patients with post-cardiac arrest syndrome (64.7%), sepsis/septic shock (61.8%), diabetic ketoacidosis (54.5%), or pneumonia (49.3%). CONCLUSION Patient care alterations occurred in 38.6% of patients undergoing POCT. Patient care was most frequently changed when patients were diagnosed with post-arrest, sepsis/septic shock, diabetic ketoacidosis, and pneumonia.
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Affiliation(s)
- Kevin T Collopy
- AirLink/VitaLink Critical Care Transport, Novant Health New Hanover Regional Medical Center, Wilmington, NC.
| | - Abigail Westmoreland
- AirLink/VitaLink Critical Care Transport, Novant Health New Hanover Regional Medical Center, Wilmington, NC; Department of General Surgery, Novant Health New Hanover Regional Medical Center, Wilmington, NC
| | - William F Powers
- Department of General Surgery, Novant Health New Hanover Regional Medical Center, Wilmington, NC
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Jędrzak A, Kuznowicz M, Rębiś T, Jesionowski T. Portable glucose biosensor based on polynorepinephrine@magnetite nanomaterial integrated with a smartphone analyzer for point-of-care application. Bioelectrochemistry 2022; 145:108071. [DOI: 10.1016/j.bioelechem.2022.108071] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/31/2021] [Accepted: 01/14/2022] [Indexed: 01/08/2023]
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Ye Q, Lu D, Zhang T, Mao J, Shang S. Recent advances and clinical application in point-of-care testing of SARS-CoV-2. J Med Virol 2022; 94:1866-1875. [PMID: 35080017 PMCID: PMC9015580 DOI: 10.1002/jmv.27617] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 01/09/2023]
Abstract
The novel coronavirus 2019 (COVID-19) caused by SARS-CoV-2 spread rapidly worldwide, posing a severe threat to public life and health. It is significant to realize rapid testing and timely control of epidemic situations under the condition of limited resources. However, laboratory-based standardized nucleic acid detection methods have a long turnaround time and high cost, so it is urgent to develop convenient methods for detecting COVID-19. This paper summarizes the point-of-care testing (POCT) developed for novel coronavirus from three aspects: nucleic acid extraction, nucleic acid amplification, and detection methods. This paper introduces a commercial real-time detection system that integrates the abovementioned three steps and the matters needing attention in use. The primary purpose of this review is to provide a reference for emergency response and rapid deployment of COVID-19 and some other emerging infectious diseases.
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Affiliation(s)
- Qing Ye
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthNational Children's Regional Medical CenterHangzhouChina
| | - Dezhao Lu
- School of Life ScienceZhejiang Chinese Medical UniversityHangzhouChina
| | - Ting Zhang
- School of Medical Technology and Information EngineeringZhejiang Chinese Medical UniversityHangzhouChina
| | - Jianhua Mao
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthNational Children's Regional Medical CenterHangzhouChina
| | - Shiqiang Shang
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthNational Children's Regional Medical CenterHangzhouChina
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Van Hoof V, Barglazan D, Blairon L, Braekevelt B, Debois R, De Vos NVJ, Gruson D, Jonckheere J, Lanckmans K, Moens M, Peeters B, Penders J, Roman A, Van Hoovels L, Vanstapel F, Verbakel JY, Verdonck A, Verstraete AG. Organisation and quality monitoring for point-of-care testing (POCT) in Belgium: proposal for an expansion of the legal framework for POCT into primary health care. Acta Clin Belg 2022; 77:329-336. [PMID: 33403928 DOI: 10.1080/17843286.2020.1868906] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND There is a trend towards decentralisation of laboratory tests by means of Point-of-Care testing (POCT). Within hospitals, Belgian law requires a POCT policy, coordinated by the clinical laboratory. There is however no legal framework for POCT performed outside the hospital: no reimbursement, no compulsory quality monitoring and no limits nor control on the prices charged to the patient. Uncontrolled use of POCT can have negative consequences for individual and public health. PROPOSAL We propose that POCT outside hospitals would only be reimbursed for tests carried out within a legal framework, requiring evidence-based testing and collaboration with a clinical laboratory, because clinical laboratories have procedures for test validation and quality monitoring, are equipped for electronic data transfer, are familiar with logistical processes, can provide support when technical issues arise and can organise and certify training. Under these conditions the government investment will be offset by health benefits, e.g. fall in antibiotic consumption with POCT for CRP in primary care, quick response to SARS-CoV2-positive cases in COVID-19 triage centres. PRIORITIES 1° extension of the Belgian decree on certification of clinical laboratories to decentralised tests in primary care; 2° introduction of a separate reimbursement category for POCT; 3° introduction of reimbursement for a limited number of specified POCT; 4° setup of a Multidisciplinary POCT Advisory Council, the purpose of which is to draw up a model for reimbursement of POCT, to select tests eligible for reimbursement and to make proposals to the National Institute for Health and Disability Insurance (RIZIV/INAMI).
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Affiliation(s)
- Viviane Van Hoof
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Dragos Barglazan
- Laboratoire Hospitalier Universitaire de Bruxelles, Universitair Laboratorium Brussel (LHUB-ULB), Brussels, Belgium
| | - Laurent Blairon
- Laboratory Medicine, Iris Hospitals South, Brussels, Belgium
| | - Bob Braekevelt
- Belgische Vereniging Apothekers Specialisten Klinische Biologie (BVASKB), Brussels, Belgium
| | | | - Nathalie Véronique J. De Vos
- Laboratoire Hospitalier Universitaire de Bruxelles, Universitair Laboratorium Brussel (LHUB-ULB), Brussels, Belgium
| | - Damien Gruson
- Medical Biochemistry, Clinique Saint-Luc, UCLouvain, Woluwe-Saint-Lambert, Belgium
| | - Jef Jonckheere
- Belgische Vereniging Apothekers Specialisten Klinische Biologie (BVASKB), Brussels, Belgium
- Algemeen Medisch Laboratorium (AML), Antwerp, Belgium
| | | | - Marc Moens
- Belgische Beroepsvereniging Van Artsen-Specialisten in Medische Biopathologie, Union Professionnelle de Biopathologie Médicale
| | - Bart Peeters
- Department of Clinical Biology, Antwerp University Hospital, Edegem, Belgium
| | - Joris Penders
- Clinical Biology Ziekenhuis Oost Limburg, Genk, Belgium
- Faculty of Medicine and Life Sciences, UHasselt, Belgium
| | - Alain Roman
- Intensive Care Unit, CHU Saint-Pierre, Brussels, Belgium
- ULB - Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - Jan Y. Verbakel
- EPI-Centre, Academisch Centrum Huisartsgeneeskunde, KU Leuven, Leuven, Belgium
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ann Verdonck
- Department of Clinical Biology, UZ Leuven, Leuven, Belgium
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Xing Y, Liu J, Luo J, Ming T, Yang G, Sun S, Xu S, Li X, He E, Kong F, Yan S, Yang Y, Cai X. A Dual-Channel Intelligent Point-of-Care Testing System for Soluble Programmed Death-1 and Programmed Death-Ligand 1 Detection Based on Folding Paper-Based Immunosensors. ACS Sens 2022; 7:584-592. [PMID: 35060694 DOI: 10.1021/acssensors.1c02486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Both programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) are important proteins in cancer immunotherapy. Soluble forms (sPD-1 and sPD-L1) have potential for determining treatment and prognosis monitoring. However, there is a lack of detection methods for point-of-care testing (POCT) of these two proteins, so a low-cost rapid detection platform is urgently needed. To solve this problem, a dual-channel electrochemical platform, including a folding paper-based immunosensor and a POCT system for rapid simultaneous detection of these two proteins was designed and fabricated. The immunosensor consists of a three-electrode system and a reaction cell. The surface of the working electrode was modified with nanocomposites synthesized from amine-functionalized single-walled carbon nanotubes, new methylene blue, and gold nanoparticles. Antibodies to sPD-1 and sPD-L1 were also immobilized on the working electrode surface. A differential pulse voltammetry electrochemical method was adopted. The immunosensor was able to detect sPD-1 and sPD-L1 in the ranges of 50 pg/mL to 50 ng/mL and 5 pg/mL to 5 ng/mL, respectively. The limits of detection were 10 and 5 pg/mL. Using this detection platform, sPD-1 and sPD-L1 in plasma were detected by both enzyme-linked immunosorbent assay and the immunosensor, which has good application potential.
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Affiliation(s)
- Yu Xing
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P.R. China
- School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing 100049, P.R. China
| | - Juntao Liu
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P.R. China
- School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing 100049, P.R. China
| | - Jinping Luo
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P.R. China
- School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing 100049, P.R. China
| | - Tao Ming
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P.R. China
- School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing 100049, P.R. China
| | - Gucheng Yang
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P.R. China
- School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing 100049, P.R. China
| | - Shuai Sun
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P.R. China
- School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing 100049, P.R. China
| | - Shengwei Xu
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P.R. China
- School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing 100049, P.R. China
| | - Xinrong Li
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P.R. China
- School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing 100049, P.R. China
| | - Enhui He
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P.R. China
- School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing 100049, P.R. China
| | - Fanli Kong
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P.R. China
- School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing 100049, P.R. China
| | - Shi Yan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery II, Peking University Cancer Hospital & Institute, Beijing 100142, P.R. China
| | - Yue Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery II, Peking University Cancer Hospital & Institute, Beijing 100142, P.R. China
| | - Xinxia Cai
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P.R. China
- School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing 100049, P.R. China
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Mclamore ES, Moreira G, Vanegas DC, Datta SPA. Context-Aware Diagnostic Specificity (CADS). Biosensors 2022; 12:101. [PMID: 35200361 PMCID: PMC8869940 DOI: 10.3390/bios12020101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 01/06/2023]
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Church DL, Naugler C. Using a systematic approach to strategic innovation in laboratory medicine to bring about change. Crit Rev Clin Lab Sci 2022; 59:178-202. [DOI: 10.1080/10408363.2021.1997899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Deirdre L. Church
- Departments of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Departments of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Christopher Naugler
- Departments of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Departments of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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35
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Kapur A, Boutin S, Lyster K, Irvine J, Sawchuk K. Retrospective application of the HEAR score on patients evacuated for chest pain: Assessing the utility of point-of-care troponin. Can J Rural Med 2022; 27:16-21. [PMID: 34975112 DOI: 10.4103/cjrm.cjrm_23_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction The HEART scoring system codifies the clinical gestalt used by physicians with 0-2 points assigned to 5 criteria (history, electrocardiography, age, risk factors and troponin). This scoring provides a prognostic tool that assists in disposition planning. The use of a truncated HEART score, minus the troponin data (HEAR score), was used for patients presenting with chest pain at one of four outpost nursing stations served by La Ronge Health Centre in northern Saskatchewan. These nursing stations have no onsite physician and no ability to obtain any troponin data. This study set out to determine if there was any utility in conducting point-of-care (PoC) troponins in these nursing outposts. Materials and Methods A retrospective analysis was conducted using the La Ronge regional electronic medical record by searching for all patients for whom an outpost nurse had called a physician regarding chest pain symptoms between 01 January 2011 and 31 December 2016. The HEAR and HEART score were then calculated for each individual presentation of patients with chest pain that met inclusion and exclusion criteria. Results By calculating both the patient's HEART score before evacuation from the outposts and after (i.e. with the troponin data), we were able to determine that, in 89.4% of cases (110/123 events), patients would require evacuation regardless of the troponin values due to a HEART score ≥4. In 10.6% (13/124 events) of cases, the patients who were evacuated had a HEART score ≤3, and in only one case did the troponin data increase this score. Conclusions The majority of patients would continue to be evacuated regardless of the result of their PoC troponin due to an already elevated HEAR score. PoC troponin is unlikely to reduce the rate of evacuation of patients with chest pain from the nursing stations served by the La Ronge Health Centre.
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Affiliation(s)
- A Kapur
- Emergency Medicine, University of Saskatchewan, Regina, SK, Canada
| | - S Boutin
- Emergency Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - K Lyster
- Family Medicine, University of Saskatchewan, Regina, SK, Canada
| | - J Irvine
- Internal Medicine, Regina Qu'appelle Health Region, Regina, SK, Canada
| | - K Sawchuk
- Academic Family Medicine, University of Saskatchewan, LaRonge, SK, Canada
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Ye Q, Lu D, Zhang T, Mao J, Shang S. Application experience of a rapid nucleic acid detection system for COVID-19. Microbes Infect 2022; 24:104945. [PMID: 35093551 PMCID: PMC8801965 DOI: 10.1016/j.micinf.2022.104945] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/13/2022] [Accepted: 01/16/2022] [Indexed: 12/29/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is raging worldwide. The COVID-19 outbreak caused severe threats to the life and health of all humans caused by SARS-CoV-2. Clinically, there is an urgent need for an in vitro diagnostic product to detect SARS-CoV-2 nucleic acid quickly. Under this background, commercial SARS-CoV-2 nucleic acid POCT products came into being. However, how to choose these products and how to use these products in a standardized way have brought new puzzles to clinical laboratories. This paper focuses on evaluating the performance of these commercial SARS-CoV-2 nucleic acid POCT products and helps the laboratory make the correct choice. At the same time, to standardize the use of this kind of product, this paper also puts forward corresponding suggestions from six elements of total quality management, namely, human, machine, material, method, environment, and measurement. In addition, this paper also puts forward some ideas on the future development direction of POCT products.
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Affiliation(s)
- Qing Ye
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China
| | - Dezhao Lu
- School of Life Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Ting Zhang
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Jianhua Mao
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China.
| | - Shiqiang Shang
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China.
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Wahyuni RD, Pasinringi SA, Palutturi S, Sabir M, Mutiarasari D, Miranti, Rasyid M, Harun H, Rahma, Mallongi A, Lewa AF. Hospital laboratory management in dealing with disaster. Gac Sanit 2021; 35 Suppl 2:S180-S182. [PMID: 34929806 DOI: 10.1016/j.gaceta.2021.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aims to identify scientific evidence and knowledge currently available related to clinical laboratory management in the face of disasters with the literature review method. METHOD This is a literature review study. Various references were collected from online databases, including reports, scientific journals, and books in the last ten years. Articles are screened according to the research objectives. The keywords used are laboratories, hospitals, disasters, Point of Care Testing (POCT). RESULTS POCT is defined as the tools of a laboratory diagnostic test used in a disaster situation effectively. It can be operated by anyone who has been trained. However, it is quite constrained by temperature, earthquake shocks, and battery life. Storage and reagents supply, such as the strip test, might be prepare before the disaster. Moreover, maintenance and validation of POCT tools in disaster preparation is necessary. Hospitals must prepare POCT to conquer the limitation of electricity sources, human resources, and buildings situation was using a laboratory diagnostic analyzer not possible. The POCT was suitable to be conveyed anywhere both within the hospital and to disaster sites using the vehicle. CONCLUSION POCT has the enormous potential as an emergency laboratory examination tool both at the hospital and at the disaster site to grip patient safety.
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Affiliation(s)
- Rosa Dwi Wahyuni
- Faculty of Public Health Hasanuddin University, Makassar, Indonesia.
| | - Syahrir A Pasinringi
- Departement of Hospital Management, Faculty of Public Health Hasanuddin University, Makassar, Indonesia
| | - Sukri Palutturi
- Department of Health Policy and Administration, Faculty of Public Health Hasanuddin University, Makassar, Indonesia
| | - Muhammad Sabir
- Department of Microbiology, Faculty of Medicine Tadulako University, Palu, Indonesia
| | - Diah Mutiarasari
- Department of Public Health, Faculty of Medicine Tadulako University, Palu, Indonesia
| | - Miranti
- Faculty of Public Health Hasanuddin University, Makassar, Indonesia
| | - Mariani Rasyid
- Department of Pulmonology and Respiratory, Faculty of Medicine Tadulako University, Palu, Indonesia
| | - Haerani Harun
- Faculty of Public Health Hasanuddin University, Makassar, Indonesia
| | - Rahma
- Faculty of Public Health Hasanuddin University, Makassar, Indonesia
| | - Anwar Mallongi
- Department of Environmental Health, Faculty of Public Health Hasanuddin University, Makassar, Indonesia
| | - Abd Farid Lewa
- Faculty of Public Health Hasanuddin University, Makassar, Indonesia
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Gerlier C, Pilmis B, Ganansia O, Le Monnier A, Nguyen Van JC. Clinical and operational impact of rapid point-of-care SARS-CoV-2 detection in an emergency department. Am J Emerg Med 2021; 50:713-718. [PMID: 34879491 PMCID: PMC8479552 DOI: 10.1016/j.ajem.2021.09.062] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/15/2022] Open
Abstract
Study objective Rapid point-of-care (POC) SARS-CoV-2 detection with Abbott ID NOW™ COVID-19 test has been implemented in our Emergency Department (ED) for several months. We aimed to evaluate the operational impact and potential benefits of this innovative clinical pathway. Methods We conducted a prospective, descriptive, interventional, non-randomized study, before-after trial with the comparison of patient cohorts from two consecutive periods of seven weeks (observational pre-POC period vs interventional POC period). Results In 2020, throughout weeks 37 to 50, 3333 patients were assessed for eligibility and among them 331 (9.9%) were positive for SARS-CoV-2 infections. Among the included patients, 136 (9.2%) were positive for SARS-CoV-2 infection in the pre-POC period and 195 (10.5%) in the POC period. Among positive patients for SARS-CoV-2 related infection in-hospital mortality rate was similar between the two groups but the hospitalization rate was higher in the POC group (81.6% vs. 65.4%; p < 0.001). More patients in the POC period were able to leave the ED within 6 h. We examined rates of antibiotic, anticoagulant, and corticosteroid prescriptions among patients tested for SARS-CoV-2 in the ED. Only the rate of prescribed anticoagulants was found to be higher in the POC period (40% vs. 24.2%; p < 0.003). Conclusion We demonstrated that COVID-19 point-of-care testing speeds up clinical decision-making, improving use of recommended treatments for COVID-19, such as anticoagulants. Moreover, it improves the boarding time and significantly shortened the length of stay in the ED for patients requiring outpatient care.
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Affiliation(s)
- Camille Gerlier
- Service des Urgences, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - Benoît Pilmis
- Equipe Mobile de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, Paris, France; Institut Micalis, UMR 1319, Université Paris-Saclay, INRAe, AgroParisTech, Bactéries Pathogènes et Santé, Châtenay-Malabry, France
| | - Olivier Ganansia
- Service des Urgences, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - Alban Le Monnier
- Institut Micalis, UMR 1319, Université Paris-Saclay, INRAe, AgroParisTech, Bactéries Pathogènes et Santé, Châtenay-Malabry, France; Service de Microbiologie Clinique et Plateforme de Dosage des Anti-infectieux, Groupe Hospitalier, Paris, France
| | - Jean-Claude Nguyen Van
- Service de Microbiologie Clinique et Plateforme de Dosage des Anti-infectieux, Groupe Hospitalier, Paris, France.
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Durantez-Fernández C, Martín-Conty JL, Polonio-López B, Castro Villamor MÁ, Maestre-Miquel C, Viñuela A, López-Izquierdo R, Mordillo-Mateos L, Fernández Méndez F, Jorge Soto C, Martín-Rodríguez F. Lactate improves the predictive ability of the National Early Warning Score 2 in the emergency department. Aust Crit Care 2021; 35:677-683. [PMID: 34862110 DOI: 10.1016/j.aucc.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 10/19/2021] [Accepted: 10/24/2021] [Indexed: 10/19/2022] Open
Abstract
AIMS The aim of this study was to compare the ability to predict 2-, 7-, 14-, and 30-day in-hospital mortality of lactate vs the National Early Warning Score 2 (NEWS2) vs the arithmetic sum of the NEWS2 plus the numerical value of lactate (NEWS2-L). METHODS This was a prospective, multicentric, emergency department delivery, pragmatic cohort study. To determine the predictive capacity of lactate, we calculated the NEWS2 and NEWS2-L in adult patients (aged >18 years) transferred with high priority by ambulance to the emergency department in five hospitals of Castilla y Leon (Spain) between November 1, 2019, and September 30, 2020. The area under the receiver operating characteristic curve of each of the scales was calculated in terms of mortality for every time frame (2, 7, 14, and 30 days). We determined the cut-off point of each scale that offered highest sensitivity and specificity using the Youden index. RESULTS A total of 1716 participants were included, and the in-hospital mortality rates at 2, 7, 14, and 30 days were of 7.8% (134 cases), 11.6% (200 cases), 14.2% (243 cases), and 17.2% (295 cases), respectively. The best cut-off point determined in the NEWS2 was 6.5 points (sensitivity of 97% and specificity of 59%), and for lactate, the cut-off point was 3.3 mmol/L (sensitivity of 79% and specificity of 72%). Finally, the combined NEWS2-L showed a cut-off point of 11.7 (sensitivity of 86% and a specificity of 85%). The area under the receiver operating characteristic curve of the NEWS2, lactate, and NEWS2-L in the validation cohort for 2-day mortality was 0.889, 0.856, and 0.923, respectively (p<0.001 in all cases). CONCLUSIONS The new score generated, NEWS2-L, obtained better statistical results than its components (NEWS2 and lactate) separately.
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Affiliation(s)
- Carlos Durantez-Fernández
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain; Technological Innovation Applied to Health Research Group (ITAS), Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | - José L Martín-Conty
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain; Technological Innovation Applied to Health Research Group (ITAS), Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain.
| | - Begoña Polonio-López
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain; Technological Innovation Applied to Health Research Group (ITAS), Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | | | - Clara Maestre-Miquel
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
| | - Antonio Viñuela
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain; Technological Innovation Applied to Health Research Group (ITAS), Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | | | - Laura Mordillo-Mateos
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain; Technological Innovation Applied to Health Research Group (ITAS), Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | | | - Cristina Jorge Soto
- Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain; CLINURSID Research Group, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Francisco Martín-Rodríguez
- Advanced Clinical Simulation Centre, Faculty of Medicine, University of Valladolid, Valladolid, Spain; Advanced life support. Gerencia de Emergencias Sanitarias. Gerencia Regional de Salud de Castilla y León (SACYL), Valladolid, Spain
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Stamm P, Sagoschen I, Weise K, Plachter B, Münzel T, Gori T, Vosseler M. Influenza and RSV incidence during COVID-19 pandemic-an observational study from in-hospital point-of-care testing. Med Microbiol Immunol 2021; 210:277-282. [PMID: 34604931 PMCID: PMC8487758 DOI: 10.1007/s00430-021-00720-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/09/2021] [Indexed: 12/12/2022]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has forced the implementation of unprecedented public health measures strategies which might also have a significant impact on the spreading of other viral pathogens such as influenza and Respiratory Syncytial Virus (RSV) . The present study compares the incidences of the most relevant respiratory viruses before and during the SARS-CoV-2 pandemic in emergency room patients. We analyzed the results of in total 14,946 polymerase chain reaction point-of-care tests (POCT-PCR) for Influenza A, Influenza B, RSV and SARS-CoV-2 in an adult and a pediatric emergency room between December 1, 2018 and March 31, 2021. Despite a fivefold increase in the number of tests performed, the positivity rate for Influenza A dropped from 19.32% (165 positives of 854 tests in 2018/19), 14.57% (149 positives of 1023 in 2019–20) to 0% (0 positives of 4915 tests) in 2020/21. In analogy, the positivity rate for Influenza B and RSV dropped from 0.35 to 1.47%, respectively, 10.65–21.08% to 0% for both in 2020/21. The positivity rate for SARS-CoV2 reached 9.74% (110 of 1129 tests performed) during the so-called second wave in December 2020. Compared to the two previous years, seasonal influenza and RSV incidence was eliminated during the COVID-19 pandemic. Corona-related measures and human behavior patterns could lead to a significant decline or even complete suppression of other respiratory viruses such as influenza and RSV.
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Affiliation(s)
- Paul Stamm
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Geb. 605, Langenbeckstr. 1, 55131, Mainz, Germany. .,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
| | - Ingo Sagoschen
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Geb. 605, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Kerstin Weise
- Institute for Virology, University Medical Center Mainz, Mainz, Germany
| | - Bodo Plachter
- Institute for Virology, University Medical Center Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Geb. 605, Langenbeckstr. 1, 55131, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Tommaso Gori
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Geb. 605, Langenbeckstr. 1, 55131, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Markus Vosseler
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Geb. 605, Langenbeckstr. 1, 55131, Mainz, Germany
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Zhou H, Xiang H, Cai J, Wang Y, Zhang M, Han Y, Zhang Y. Comparison of a Point-of-Care Testing with Enzyme-Multiplied Immunoassay Technique and Liquid Chromatography Combined With Tandem Mass Spectrometry Methods for Therapeutic Drug Monitoring of Mycophenolic Acid: A Preliminary Study. Ther Drug Monit 2021; 43:630-636. [PMID: 33394991 DOI: 10.1097/ftd.0000000000000861] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 11/29/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND For mycophenolic acid (MPA), therapeutic drug monitoring is an essential tool for dosage optimization in transplant recipients and autoimmune diseases. In China, a new commercial kit using an immunochromatographic assay (FICA) with a point-of-care testing system was approved for therapeutic drug monitoring of MPA. However, corroboration between FICA and clinically used assays remains unknown. The authors evaluated MPA concentrations in heart transplant recipients obtained by FICA, high-performance liquid chromatography combined with tandem mass spectrometry (LC-MS/MS), and enzyme-multiplied immunoassay technique (EMIT). METHODS Nine heart transplant recipients administered a single mycophenolate mofetil (MMF) dose, and 4 administered multiple MMF doses were enrolled. MPA samples were collected before administration, and after 0.5, 1, 1.5, 2, 4, 6, 8, 10, and 12 hours, and assessed by 2 immunoassays (EMIT and FICA) and LC-MS/MS. Consistency between methods was evaluated using Passing-Bablok regression and Bland-Altman analysis. RESULTS For Passing-Bablok regression between FICA and LC-MS/MS, FICA = 0.784 LC-MS/MS + 0.360 (95% CI slope: 0.739 to 0.829, 95% CI intercept: 0.174-0.545). Regardless of a significant observed correlation coefficient (R2 = 0.9126), statistical analyses revealed a significant difference between FICA and the reference LC-MS/MS method. The mean absolute bias was 0.69 mcg/mL between FICA and LC-MS/MS. Bland-Altman plots showed a mean bias of -0.23 mcg/mL (±1.96 SD, -2.19 to 1.72 mcg/mL) and average relative bias of 14.73% (±1.96 SD, -67.91% to 97.37%) between FICA and LC-MS/MS. Unsatisfactory consistency was observed between EMIT and LC-MS/MS, and FICA and EMIT. Differences between pharmacokinetic parameters after a single or 7 days of MMF administration, by LC-MS/MS and FICA, were not statistically significant. CONCLUSIONS The consistency of the new FICA using a point-of-care testing device with LC-MS/MS and EMIT was inadequate, and the accuracy of EMIT and LC-MS/MS was inappropriate. Clinicians should be informed when switching MPA detection methods to avoid misleading results.
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Affiliation(s)
- Hong Zhou
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
- Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan
| | - Hongping Xiang
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
- Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan
| | - Jie Cai
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Yirong Wang
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
- Department of Pharmacy, the Third People's Hospital of Chengdu, Chengdu; and
| | - Min Zhang
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
- Department of Pharmacy, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital and Chongqing Cancer Institute, Chongqing Cancer Hospital, Chongqing, China
| | - Yong Han
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
- Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan
| | - Yu Zhang
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
- Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan
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Bayoumy S, Martiskainen I, Heikkilä T, Rautanen C, Hedberg P, Hyytiä H, Wittfooth S, Pettersson K. Sensitive and quantitative detection of cardiac troponin I with upconverting nanoparticle lateral flow test with minimized interference. Sci Rep 2021; 11:18698. [PMID: 34548577 PMCID: PMC8455528 DOI: 10.1038/s41598-021-98199-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 09/06/2021] [Indexed: 01/09/2023] Open
Abstract
Measurement of cardiac troponin I (cTnI) should be feasible for point-of-care testing (POCT) to diagnose acute myocardial infarction (AMI). Lateral flow immunoassays (LFIAs) have been long implemented in POCT and clinical settings. However, sensitivity, matrix effect and quantitation in lateral flow immunoassays (LFIAs) have been major limiting factors. The performance of LFIAs can be improved with upconverting nanoparticle (UCNP) reporters. Here we report a new methodological approach to quantify cTnI using UCNP-LFIA technology with minimized plasma interference. The performance of the developed UCNP-LFIA was evaluated using clinical plasma samples (n = 262). The developed UCNP-LFIA was compared to two reference assays, the Siemens Advia Centaur assay and an in-house well-based cTnI assay. By introducing an anti-IgM scrub line and dried EDTA in the LFIA strip, the detection of cTnI in plasma samples was fully recovered. The UCNP-LFIA was able to quantify cTnI concentrations in patient samples within the range of 30-10,000 ng/L. The LoB and LoD of the UCNP-LFIA were 8.4 ng/L and 30 ng/L. The method comparisons showed good correlation (Spearman's correlation 0.956 and 0.949, p < 0.0001). The developed UCNP-LFIA had LoD suitable for ruling in AMI in patients with elevated cTnI levels and was able to quantify cTnI concentrations in patient samples. The technology has potential to provide simple and rapid assay for POCT in ED setting.
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Affiliation(s)
- Sherif Bayoumy
- Department of Biotechnology, University of Turku, Turku, Finland.
| | | | - Taina Heikkilä
- Department of Biotechnology, University of Turku, Turku, Finland
| | - Carita Rautanen
- Department of Biotechnology, University of Turku, Turku, Finland
| | - Pirjo Hedberg
- Cancer Research and Translational Medicine Research Unit, Department of Clinical Chemistry, University of Oulu, Kajaanintie 50, 90220, Oulu, Finland
- The Joint Municipal Service Provider of Northern Finland Laboratory Centre (NordLab), Kiviharjuntie 11, 90220, Oulu, Finland
| | - Heidi Hyytiä
- Department of Biotechnology, University of Turku, Turku, Finland
| | - Saara Wittfooth
- Department of Biotechnology, University of Turku, Turku, Finland
| | - Kim Pettersson
- Department of Biotechnology, University of Turku, Turku, Finland
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Wang TH, Hsu YC. Red Cell Distribution Width as a Prognostic Factor and Its Comparison with Lactate in Patients with Sepsis. Diagnostics (Basel) 2021; 11:1474. [PMID: 34441408 PMCID: PMC8394551 DOI: 10.3390/diagnostics11081474] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 12/29/2022] Open
Abstract
Sepsis remains the leading cause of death in critically ill patients. Thus, regular measurement of lactate levels has been proposed in sepsis guidelines. Elevated red cell distribution width (RDW) is associated with mortality risk in patients with sepsis. This study aimed to investigate the association between RDW and the risk of other adverse outcomes in patients with sepsis and to compare the mortality discriminative ability between lactate and RDW levels. This is a single-centered, retrospective, case-control study that included 504 adult patients with sepsis in the emergency department between 1 January 2020 and 31 December 2020. Eligible patients were divided into normal (RDW ≤ 14.5%) and high (RDW > 14.5%) groups. The baseline characteristics and adverse outcomes were recorded and compared. Compared with the normal RDW group, the patients in the high RDW group had a significantly higher rate of ICU admission (48.8% vs. 32.4%, p = 0.03), septic shock (39.2% vs. 23.5%, p < 0.01), and 30-day in-hospital mortality (32.0% vs. 20.7%, p < 0.01). Furthermore, the RDW (area under curve (AUC) = 0.71) had superior mortality discriminative ability compared to lactate (AUC = 0.63) levels (p = 0.02). Clinicians could rely on this simple and rapid parameter for risk stratification to initiate prompt treatment for patients with sepsis.
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Affiliation(s)
- Tsung-Han Wang
- Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan;
| | - Yin-Chou Hsu
- Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan;
- School of Medicine for International Student, I-Shou University, Kaohsiung 82445, Taiwan
- School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung 82445, Taiwan
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Santamaría González M, Ruiz Mínguez MÁ, Arrebola Ramírez MM, Filella Pla X, Torrejón Martínez MJ, Morell García D, Castaño López MÁ, Allué Palacín JA, Albaladejo Otón MD, Giménez Gómez N. An opportunity to emphasize the relevance of laboratory medicine. Adv Lab Med 2021; 2:432-450. [PMID: 37362412 PMCID: PMC10197410 DOI: 10.1515/almed-2021-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/11/2021] [Indexed: 06/28/2023]
Abstract
Objectives Clinical practice guidelines (CPGs) are recommendations based on a systematic review of scientific evidence that are intended to help healthcare professionals and patients make the best clinical decisions. CPGs must be evidence-based and are designed by multidisciplinary teams. The purpose of this study is to assess the topics related to the clinical laboratory addressed in CPGs and evaluate the involvement of laboratory professionals in the CPG development process. Methods A total of 16 CPGs recommended by the Spanish Society of Laboratory Medicine and/or retrieved from PubMed-Medline were included. A review of the information provided in CPGs about 80 topics related to the clinical laboratory was performed. The authorship of laboratory professionals was assessed. Results On average, the 16 CPGs addressed 49% (standard deviation [SD]: 11%) of the topics evaluated in relation to the clinical laboratory. By order of frequency, CPGs contained information about 69% of postanalytical variables (SD: 20%); 52% of preanalytical variables (SD: 11%); and 43% of the analytical variables studied (SD: 18%). Finally, half the CPGs included a laboratory professional among its authors. Conclusions CPGs frequently failed to provide relevant laboratory-related information. Laboratory professionals were co-authors in only half the CPGs. There is scope for improvement, and laboratory professionals should be included in multidisciplinary teams involved in the development of CPGs.
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Affiliation(s)
- María Santamaría González
- Service of Clinical Biochemistry, Miguel Servet University Hospital, Zaragoza, Spain
- Commission of Evidence-Based Laboratory Medicine, Spanish Society of Laboratory Medicine (SEQC), Barcelona, Spain
| | - María Ángels Ruiz Mínguez
- Commission of Evidence-Based Laboratory Medicine, Spanish Society of Laboratory Medicine (SEQC), Barcelona, Spain
- Service of Laboratory Medicine, Fundació Hospital de l’Esperit Sant, Santa Coloma de Gramenet, Barcelona, Spain
| | - María Monsalud Arrebola Ramírez
- Commission of Evidence-Based Laboratory Medicine, Spanish Society of Laboratory Medicine (SEQC), Barcelona, Spain
- Laboratory Clinical Management Unit, Hospital de la Axarquía (AGSEMA), Málaga, Spain
| | - Xavier Filella Pla
- Commission of Evidence-Based Laboratory Medicine, Spanish Society of Laboratory Medicine (SEQC), Barcelona, Spain
- Service of Biochemistry and Molecular Genetics (CDB), Hospital Clinic, IDIBAPS, Barcelona, Spain
- Commission of Evidence-Based Laboratory Medicine, International Federation of Clinical Chemistry (IFCC), Milan, Italy
| | - María José Torrejón Martínez
- Commission of Evidence-Based Laboratory Medicine, Spanish Society of Laboratory Medicine (SEQC), Barcelona, Spain
- Clinical Biochemistry Management Unit (UGC), Hospital Clínico San Carlos, Madrid, Spain
| | - Daniel Morell García
- Commission of Evidence-Based Laboratory Medicine, Spanish Society of Laboratory Medicine (SEQC), Barcelona, Spain
- Service of Laboratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Miguel Ángel Castaño López
- Commission of Evidence-Based Laboratory Medicine, Spanish Society of Laboratory Medicine (SEQC), Barcelona, Spain
- Service of Clinical Biochemistry, Hospital Clínico Universitario Juan Ramón Jiménez, Huelva, Spain
| | - Juan Antonio Allué Palacín
- Commission of Evidence-Based Laboratory Medicine, Spanish Society of Laboratory Medicine (SEQC), Barcelona, Spain
- Synlab Diagnosticos Globales, Sevilla, Spain
| | - María Dolores Albaladejo Otón
- Commission of Evidence-Based Laboratory Medicine, Spanish Society of Laboratory Medicine (SEQC), Barcelona, Spain
- Service of Laboratory Testing and Clinical Biochemistry, Santa Lucía University Hospital, Cartagena, Spain
| | - Nuria Giménez Gómez
- Commission of Evidence-Based Laboratory Medicine, Spanish Society of Laboratory Medicine (SEQC), Barcelona, Spain
- Research Unit, Research Foundation, Mutua de Terrassa, University of Barcelona, Barcelona, Spain
- Laboratory of Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
- Commission of Evidence-Based Laboratory Medicine, International Federation of Clinical Chemistry (IFCC), Milan, Italy
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Taddeo A, Prim D, Bojescu ED, Segura JM, Pfeifer ME. Point-of-Care Therapeutic Drug Monitoring for Precision Dosing of Immunosuppressive Drugs. J Appl Lab Med 2021; 5:738-761. [PMID: 32533157 DOI: 10.1093/jalm/jfaa067] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/03/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Immunosuppressive drugs (ISD) are an essential tool in the treatment of transplant rejection and immune-mediated diseases. Therapeutic drug monitoring (TDM) for determination of ISD concentrations in biological samples is an important instrument for dose personalization for improving efficacy while reducing side effects. While currently ISD concentration measurements are performed at specialized, centralized facilities, making the process complex and laborious for the patient, various innovative technical solutions have recently been proposed for bringing TDM to the point-of-care (POC). CONTENT In this review, we evaluate current ISD-TDM and its value, limitations, and proposed implementations. Then, we discuss the potential of POC-TDM in the era of personalized medicine, and provide an updated review on the unmet needs and available technological solutions for the development of POC-TDM devices for ISD monitoring. Finally, we provide concrete suggestions for the generation of a meaningful and more patient-centric process for ISD monitoring. SUMMARY POC-based ISD monitoring may improve clinical care by reducing turnaround time, by enabling more frequent measurements in order to obtain meaningful pharmacokinetic data (i.e., area under the curve) faster reaction in case of problems and by increasing patient convenience and compliance. The analysis of the ISD-TDM field prompts the evolution of POC testing toward the development of fully integrated platforms able to support clinical decision-making. We identify 4 major areas requiring careful combined implementation: patient usability, data meaningfulness, clinicians' acceptance, and cost-effectiveness.
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Affiliation(s)
- Adriano Taddeo
- Institute of Life Technologies - School of Engineering, HES-SO//University of Applied Sciences, Western Switzerland, Sion, Switzerland
| | - Denis Prim
- Institute of Life Technologies - School of Engineering, HES-SO//University of Applied Sciences, Western Switzerland, Sion, Switzerland
| | - Elena-Diana Bojescu
- Institute of Life Technologies - School of Engineering, HES-SO//University of Applied Sciences, Western Switzerland, Sion, Switzerland
| | - Jean-Manuel Segura
- Institute of Life Technologies - School of Engineering, HES-SO//University of Applied Sciences, Western Switzerland, Sion, Switzerland
| | - Marc E Pfeifer
- Institute of Life Technologies - School of Engineering, HES-SO//University of Applied Sciences, Western Switzerland, Sion, Switzerland
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Nichols JH, Cambridge T, Sanchez N, Marshall D. Clinical Validation of a Novel Quality Management System for Blood Gas, Electrolytes, Metabolites, and CO-Oximetry. J Appl Lab Med 2021; 6:1396-1408. [PMID: 34240148 DOI: 10.1093/jalm/jfab053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/28/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND Quality management of point-of-care (POC) blood gas testing focuses on verifying instrument accuracy and precision, in addition to performing daily quality control (QC) checks every 8 h and with each patient test (unless internal calibration is verified every 30 min). At the POC, a risk-based approach is suitable to address both systemic and transient sample-specific errors that may negatively impact patient care. METHODS We evaluated the performance of the GEM® Premier™ 5000 with next generation Intelligent Quality Management 2 (iQM®2) (Instrumentation Laboratory, Bedford, MA), from the analysis of approximately 84,000 patient samples across 4 sites. Continuous iQM2 was compared to intermittent liquid QC, either manual or automated, at 2 sites. Analysis of error flags for patient samples and statistical characteristics of QC processes, including method sigma and average detection time (ADT) for an error, were examined. RESULTS ADT was approximately 2 min with iQM2 and varied from hours to days with intermittent QC. iQM2 Process Control Solutions (PCS) precision was similar or better (>6 sigma for all analytes) than manual (sigma 3.0 for pO2) or automated internal QC (sigma 1.3 for tHb and sigma 3.3 for pO2). In addition, iQM2 detected errors in ∼1.4% of samples, providing an additional safeguard against reporting erroneous results. CONCLUSIONS The findings in this study demonstrate excellent performance of the GEM Premier 5000 with iQM2 including >6 sigma precision for all analytes and faster error detection times. These benefits address risk in different phases of testing that are not easily detected by intermittent performance of liquid QC (manual or automated).
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Affiliation(s)
- James H Nichols
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tony Cambridge
- Department of Blood Sciences, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Neldis Sanchez
- Department of Pathology - Clinical Laboratories, NYU Langone Health, New York, NY, USA
| | - Debra Marshall
- Adult Respiratory Care/Pulmonary Function Laboratory, Advocate Aurora Christ Medical Center, Oak Lawn, IL, USA
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Casado-Rey P, Vázquez-Iglesias L, Botana-Rial M, Andrade-Olivié MA, Ferreiro-Fernández L, San José Capilla E, Nuñez-Ares A, Bollo de Miguel E, Pajares-Ruíz V, Fernández-Villar A. A rapid calprotectin test for the diagnosis of pleural effusion. PLoS One 2021; 16:e0252714. [PMID: 34111153 DOI: 10.1371/journal.pone.0252714] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/20/2021] [Indexed: 11/25/2022] Open
Abstract
In previous studies, measuring the levels of calprotectin in patients with pleural effusion (PE) was an exceptionally accurate way to predict malignancy. Here, we evaluated a rapid method for the measurement of calprotectin levels as a useful parameter in the diagnosis of malignant pleural effusion (MPE) in order to minimise invasive diagnostic tests. Calprotectin levels were measured with Quantum Blue® sCAL (QB®sCAL) and compared with the gold standard reference ELISA method. Calprotectin levels in patients with benign pleural effusion (BPE) were significantly higher (p < 0.0001) than for MPE patients. We measured the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and positive and negative likelihood ratios (LRs) for a cut-off value of ≤ 14,150 ng/mL; the diagnostic accuracy was 64%. The odds ratio for PE calprotectin levels was 10.938 (95% CI [4.133 − 28.947]). The diagnostic performance of calprotectin concentration was better for predicting MPE compared to other individual parameters. Comparison of two assays showed a slope of 1.084, an intercept of 329.7, and a Pearson correlation coefficient of 0.798. The Bland–Altman test showed a positive bias for the QB®sCAL method compared to ELISA fCAL®. Clinical concordance between both these methods was 88.5% with a Cohen kappa index of 0.76 (95% CI [0.68 − 0.84]). We concluded that QB®sCAL is a fast, reliable, and non-invasive diagnostic tool for diagnosing MPE and represents an alternative to ELISA that could be implemented in medical emergencies.
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Pristupa K, Morphet J, Thompson J, Jones T. Ecstasy and related drug consumption and the effect on emergency department resource use. Australas Emerg Care 2021; 25:41-47. [PMID: 33867316 DOI: 10.1016/j.auec.2021.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/12/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Ecstasy and other recreational related drug use and substance related presentations to the emergency department are increasing. The aim of this study was to identify, quantify, and describe the emergency department resources used to care for patients diagnosed with ecstasy and related drug use. METHOD A retrospective case study design. RESULTS Eighty-nine patients (89%) needed one to one (n=25) and/or one to two nursing care (n=83). Security presence was required for 37 patients (37%) and the Emergency Psychiatric Service team reviewed 29 patients (29%). Most patients (n=80, 80%) received an Emergency Short Stay Unit admission, but continued to receive care in the emergency department, and were not transferred to the short stay unit (n=74, 92.5%). Most patients (n=86, 86%) were discharged home, after 5hr 49mins (median) in the emergency department. CONCLUSION Extensive human resources were required to care for patients diagnosed with ecstasy and related drug use. Nursing staffing levels required to care for this patient cohort during times of peak presentations should be reviewed. It is important the government acknowledges the National Emergency Access Target is not suitable for all presenting patients. A dedicated model of care is recommended to support care requirements and reduce pressure on busy emergency departments.
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Affiliation(s)
- Kathryn Pristupa
- Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria, Australia; Emergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia.
| | - Julia Morphet
- Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria, Australia; Monash Emergency Research Collaborative, Monash Health, Melbourne, Victoria, Australia
| | - John Thompson
- Emergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia; Department of Nursing, University of Melbourne, Parkville, Victoria, Australia
| | - Tamsin Jones
- Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria, Australia
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Alter DN. Point-of-Care Testing for the Emergency Department Patient: Quantity and Quality of the Available Evidence. Arch Pathol Lab Med 2021; 145:308-319. [PMID: 33635952 DOI: 10.5858/arpa.2020-0495-ra] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Point-of-care test (POCT) instruments produce lab results with rapid turnaround times. Based on that fact, emergency department (ED) POCT requests are predicated on the belief that rapid test turnaround times lead to improved care, typically a decreased ED length of stay (LOS). OBJECTIVE.— To compile the available peer-reviewed data regarding use of POCT in the ED with an emphasis on ED-LOS. DATA SOURCES.— An English-language PubMed search using the following free text terms: ("EMERGENCY" AND "POINT OF CARE") NOT ULTRASOUND as well as "RAPID INFECTIOUS DISEASE TESTING." In addition, the PubMed "similar articles" functionality was used to identify related articles that were not identified on the initial search. CONCLUSIONS.— Seventy-four references were identified that studied POCT ED use to determine if they resulted in significant changes in ED processes, especially ED-LOS. They were divided into 3 groups: viral-influenza (n = 24), viral-respiratory not otherwise specified (n = 8), and nonviral (n = 42). The nonviral group was further divided into the following groups: chemistry, cardiac, bacterial/strep, C-reactive protein, D-dimer, drugs of abuse, lactate, and pregnancy. Across all groups there was a trend toward a significantly decreased ED-LOS; however, a number of studies showed no change, and a third group was not assessed for ED-LOS. For POCT to improve ED-LOS it has to be integrated into existing ED processes such that a rapid test result will allow the patient to have a shorter LOS, whether it is to discharge or admission.
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Affiliation(s)
- David N Alter
- From the Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
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Pérez-Ros P, Navarro-Flores E, Julián-Rochina I, Martínez-Arnau FM, Cauli O. Changes in Salivary Amylase and Glucose in Diabetes: A Scoping Review. Diagnostics (Basel) 2021; 11:diagnostics11030453. [PMID: 33800850 PMCID: PMC8001770 DOI: 10.3390/diagnostics11030453] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/11/2021] [Accepted: 03/03/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Diabetes mellitus (DM) is a common long-term disease which can be related with salivary amylase levels. DM has recently been associated with salivary amylase diagnostics that could further impair diagnoses in the diabetic population, as well as being an interesting alternative to traditional methods of determine glucose levels. The main advantage of this method is related to the fact that it is a fast diagnostic method. The DM population experiences changes to their metabolism which affects their salivary parameters, making this an alternative procedure for diagnosis and follow-up of the illness due to the non-invasive nature of salivary analyzes. The objective of this review is to summarize the evidence regarding the changes in salivary amylase and glucose levels, and their relationship with blood markers of glycemic control used in clinical settings such as blood glucose and glycated hemoglobin. The differences in salivary amylase levels depending on the method of saliva collection under fasting or non-fasting conditions. The changes in salivary amylase depends on the type of diabetes, the type of insulin treatment or the quality of glycemic control. CONCLUSIONS Salivary amylase concentration is increased in diabetic patients in most of the studies and salivary glucose concentration in all studies in both fasting and non-fasting (post-prandial) conditions. Salivary amylase and glucose concentration represent potential non-invasive biomarkers to evaluate glycemic control and clinical management of diabetic patients, although it is necessary to evaluate the influence of potential modulating factors such as age, duration diseases, sex and the effects of pharmacological treatments in these outcomes which remained to be elucidated.
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Affiliation(s)
- Pilar Pérez-Ros
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (P.P.-R.); (E.N.-F.); (I.J.-R.); (F.M.M.-A.)
- Nursing Department, University of Valencia, 46010 Valencia, Spain
| | - Emmanuel Navarro-Flores
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (P.P.-R.); (E.N.-F.); (I.J.-R.); (F.M.M.-A.)
- Nursing Department, University of Valencia, 46010 Valencia, Spain
| | - Ivan Julián-Rochina
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (P.P.-R.); (E.N.-F.); (I.J.-R.); (F.M.M.-A.)
- Nursing Department, University of Valencia, 46010 Valencia, Spain
| | - Francisco Miguel Martínez-Arnau
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (P.P.-R.); (E.N.-F.); (I.J.-R.); (F.M.M.-A.)
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Omar Cauli
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (P.P.-R.); (E.N.-F.); (I.J.-R.); (F.M.M.-A.)
- Nursing Department, University of Valencia, 46010 Valencia, Spain
- Correspondence:
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