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Abstract
Although corticosteroid therapy is the standard of care for all patients hospitalized with severe coronavirus disease 2019 (COVID-19), the studies demonstrating the mortality–benefit ratio of corticosteroids were limited to fully evaluate their adverse effects. To determine the severity of corticosteroid-induced hyperglycemia in patients with and without diabetes mellitus, we retrospectively collected data from the medical records of patients hospitalized with COVID-19 before and after corticosteroids were the standard of care. Corticosteroid-induced hyperglycemia was more severe in patients hospitalized with COVID-19 with diabetes than those without diabetes. Additionally, patients with diabetes required higher doses of correctional insulin per day when on corticosteroid therapy, suggesting that intensive point-of-care glucose monitoring could be limited in patients without diabetes mellitus and support cautionary use of corticosteroids in patients with COVID-19 discharged with supplemental oxygen.
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Affiliation(s)
- Kirk B Fetters
- Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA.,Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Stephen P Judge
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
| | - Eric S Daar
- Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA.,Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Timothy J Hatlen
- Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA.,Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA
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2
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Li D, Zhou Z, Sun J, Mei X. Prospects of NIR fluorescent nanosensors for green detection of SARS-CoV-2. Sens Actuators B Chem 2022; 362:131764. [PMID: 35370362 PMCID: PMC8964475 DOI: 10.1016/j.snb.2022.131764] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/22/2022] [Accepted: 03/21/2022] [Indexed: 05/02/2023]
Abstract
The pandemic of the novel coronavirus disease 2019 (COVID-19) is continuously causing hazards for the world. Effective detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can relieve the impact, but various toxic chemicals are also released into the environment. Fluorescence sensors offer a facile analytical strategy. During fluorescence sensing, biological samples such as tissues and body fluids have autofluorescence, giving false-positive/negative results because of the interferences. Fluorescence near-infrared (NIR) nanosensors can be designed from low-toxic materials with insignificant background signals. Although this research is still in its infancy, further developments in this field have the potential for sustainable detection of SARS-CoV-2. Herein, we summarize the reported NIR fluorescent nanosensors with the potential to detect SARS-CoV-2. The green synthesis of NIR fluorescent nanomaterials, environmentally compatible sensing strategies, and possible methods to reduce the testing frequencies are discussed. Further optimization strategies for developing NIR fluorescent nanosensors to facilitate greener diagnostics of SARS-CoV-2 for pandemic control are proposed.
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Key Words
- 5 G, the fifth generation technology standard for broadband cellular networks
- ACE2, Angiotensin-converting enzyme 2
- AIE, aggregation-induced emission
- AIE810NP, an aggregation-induced emission (AIE) nanoparticle (λem = 810 nm)
- AIEgens, AIE luminogens
- ASOs, antisense oligonucleotides
- AuNP, Gold nanoparticle
- CF647, a cyanine-based far-red fluorescent dye
- COVID-19, The pandemic of the novel coronavirus disease 2019
- CP-MNB, capture probe-conjugated magnetic bead particle
- CdS, core/shell lead sulfide/cadmium sulfide
- CoPhMoRe, corona phase molecular recognition
- Cy7Cl, a cationic cyanine dye
- DCNPs, Down-conversion nanoparticles
- DPV, Differential pulse voltammetry
- DSNP, down shifting nanoparticles
- DSNP@MY-1057-GPC-3, active targeting antibody glypican-3 (GPC-3) was conjugated with DSNP@MY-1057
- E, envelope
- EB-NS, prepared by the layered pigment CaCuSi4O10 (Egyptian Blue, EB) via ball milling and facile tip sonication into NIR fluorescent nanosheets
- ENMs, electrospun nanofibrous membranes
- Environmental-friendly
- FLU, an infectious disease caused by influenza viruses
- FRET, fluorescence resonance energy transfer
- Green synthesis
- HA1, hemagglutinin subunit.
- HA1., hemagglutinin subunit
- HAS, serum albumin
- HCC, hepatocellular carcinoma
- IONPs, iron oxide nanoparticles.
- IONPs., iron oxide nanoparticles
- IgG A, IgG aggregation
- IgG, immunoglobulin G
- IgM, immunoglobulin M
- LED, light emitting diode
- LICOR, IRDye-800CW
- Low-toxic
- M, membrane
- MCU, microcontroller unit
- MERS, Middle East respiratory syndrome coronavirus
- N protein, nucleocapsid protein
- N, nucleocapsid
- NIR
- NIR, Near-Infrared
- NIR775, an H2S-inert fluorophore
- Nanosensor
- P, FITC-labelled GzmB substrate peptides
- PBS, Phosphate-buffered saline
- PCR, Polymerase Chain Reaction
- PEG, branched by Polyethylene glycol
- PEG1000 PE, 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[methoxy(polyethylene glycol)− 1000]
- PEG2000 PE, (1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[methoxy(polyethylene glycol)− 2000);
- POC, point-of-care
- PS, polystyrene
- Pb-Ag2S ODs, lead doped Ag2S quantum dots
- QDs, quantum dots
- QY, quantum yield
- R, R represents a common recognition element for the target
- RCA, rolling circle amplification
- RNA, ribonucleic acid
- S RBD, SARS-CoV-2 spike receptor-binding domain
- S protein, spike protein
- S, spike
- SAM, self-assembled monolayer
- SARS-CoV-2
- SARS-CoV-2, Severe acute respiratory syndrome coronavirus
- SPNs, semiconducting polymer nanoparticles.
- SPNs., semiconducting polymer nanoparticles
- SWCNTs, single-walled carbon nanotubes
- Si-RP, silica-reporter probe
- VIS, visible
- VTM, viral transport medium
- pGOLD, plasmonic gold
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Affiliation(s)
- Dan Li
- Department of Basic Science, Jinzhou Medical University, 40 Songpo Road, Jinzhou 121001, China
| | - Zipeng Zhou
- Department of Key Laboratory of Medical Tissue Engineering of Liaoning, Jinzhou Medical University, 40 Songpo Road, Jinzhou 121001, China
| | - Jiachen Sun
- Department of Key Laboratory of Medical Tissue Engineering of Liaoning, Jinzhou Medical University, 40 Songpo Road, Jinzhou 121001, China
| | - Xifan Mei
- Department of Key Laboratory of Medical Tissue Engineering of Liaoning, Jinzhou Medical University, 40 Songpo Road, Jinzhou 121001, China
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Worsley CM, van der Mescht MA, Hoffmann D, Meyer PWA, Ueckermann V, Rossouw TM. Decline in antibody responses to SARS-CoV-2 post-vaccination poses a risk to health care workers. J Infect 2022; 85:334-363. [PMID: 35705136 PMCID: PMC9188487 DOI: 10.1016/j.jinf.2022.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Catherine M Worsley
- Department of Immunology, Faculty of Health Science, University of Pretoria, South Africa; National Health Laboratory Service, South Africa.
| | - Mieke A van der Mescht
- Department of Immunology, Faculty of Health Science, University of Pretoria, South Africa
| | - Daniel Hoffmann
- National Health Laboratory Service, South Africa; Department of Chemical Pathology, Faculty of Health Science, University of Pretoria, South Africa
| | - Pieter W A Meyer
- Department of Immunology, Faculty of Health Science, University of Pretoria, South Africa; National Health Laboratory Service, South Africa
| | - Veronica Ueckermann
- Department of Internal Medicine, Faculty of Health Science, University of Pretoria, South Africa
| | - Theresa M Rossouw
- Department of Immunology, Faculty of Health Science, University of Pretoria, South Africa
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4
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Luo Z, Ye C, Xiao H, Yin J, Liang Y, Ruan Z, Luo D, Gao D, Tan Q, Li Y, Zhang Q, Liu W, Wu J. Optimization of loop-mediated isothermal amplification (LAMP) assay for robust visualization in SARS-CoV-2 and emerging variants diagnosis. Chem Eng Sci 2022; 251:117430. [PMID: 35043022 PMCID: PMC8757654 DOI: 10.1016/j.ces.2022.117430] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 11/15/2021] [Revised: 12/28/2021] [Accepted: 01/07/2022] [Indexed: 11/24/2022]
Abstract
Loop-mediated isothermal amplification (LAMP) is widely used in detection of pathogenic microorganisms including SARS-CoV-2. However, the performance of LAMP assay needs further exploration in the emerging SARS-CoV-2 variants test. Here, we design serials of primers and select an optimal set for LAMP-based on SARS-CoV-2 N gene for a robust and visual assay in SARS-CoV-2 diagnosis. The limit of detectable template reaches 10 copies of N gene per 25 μL reaction at isothermal 58℃ within 40 min. Importantly, the primers for LAMP assay locate at 12 to 213 nt of N gene, a highly conservative region, which serves as a compatible test in emerging SARS-CoV-2 variants. Comparison to a commercial qPCR assay, this LAMP assay exerts the high viability in diagnosis of 41 clinical samples. Our study optimizes an advantageous LAMP assay for colorimetric detection of SARS-CoV-2 and emerging variants, which is hopeful to be a promising test in COVID-19 surveillance.
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Key Words
- COVID-19, coronavirus disease 2019
- CRISPR, clustered regularly interspaced short palindromic repeats
- Coronavirus disease 2019 (COVID-19) pandemic
- Ct, threshold cycle
- Emerging SARS-CoV-2 variants
- IVD, in-vitro diagnosis
- LAMP, Loop-mediated isothermal amplification
- Loop-mediated isothermal amplification (LAMP)
- NGS, next-generation sequencing
- POC, point-of-care
- RT-qPCR, real-time reverse transcriptase quantitative polymerase chain reaction
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis
- VOC, variants of concern
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Affiliation(s)
- Zhen Luo
- Guangdong Provincial Key Laboratory of Virology, Institute of Medical Microbiology, Jinan University, Guangzhou 510632, China.,Foshan Institute of Medical Microbiology, Foshan 528315, China
| | - Chunhong Ye
- Guangdong Provincial Key Laboratory of Virology, Institute of Medical Microbiology, Jinan University, Guangzhou 510632, China
| | - Heng Xiao
- Guangdong Provincial Key Laboratory of Virology, Institute of Medical Microbiology, Jinan University, Guangzhou 510632, China.,Foshan Institute of Medical Microbiology, Foshan 528315, China
| | - Jialing Yin
- Guangdong Provincial Key Laboratory of Virology, Institute of Medical Microbiology, Jinan University, Guangzhou 510632, China
| | - Yicong Liang
- Guangdong Provincial Key Laboratory of Virology, Institute of Medical Microbiology, Jinan University, Guangzhou 510632, China
| | - Zhihui Ruan
- Foshan Institute of Medical Microbiology, Foshan 528315, China
| | - Danju Luo
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Daolong Gao
- Guangdong Longfan Biological Science and Technology Company, Shunde District, Foshan 528315, China
| | - Qiuping Tan
- Guangdong Longfan Biological Science and Technology Company, Shunde District, Foshan 528315, China
| | - Yongkui Li
- Guangdong Provincial Key Laboratory of Virology, Institute of Medical Microbiology, Jinan University, Guangzhou 510632, China.,Foshan Institute of Medical Microbiology, Foshan 528315, China
| | - Qiwei Zhang
- Guangdong Provincial Key Laboratory of Virology, Institute of Medical Microbiology, Jinan University, Guangzhou 510632, China.,Foshan Institute of Medical Microbiology, Foshan 528315, China
| | - Weiyong Liu
- Tongji Hospital of Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jianguo Wu
- Guangdong Provincial Key Laboratory of Virology, Institute of Medical Microbiology, Jinan University, Guangzhou 510632, China.,Foshan Institute of Medical Microbiology, Foshan 528315, China.,Guangdong Longfan Biological Science and Technology Company, Shunde District, Foshan 528315, China
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5
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Shlomo IB, Frankenthal H, Laor A, Greenhut AK. Detection of SARS-CoV-2 infection by exhaled breath spectral analysis: Introducing a ready-to-use point-of-care mass screening method. EClinicalMedicine 2022; 45:101308. [PMID: 35224472 PMCID: PMC8856887 DOI: 10.1016/j.eclinm.2022.101308] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/23/2022] [Accepted: 01/31/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The current SARS-CoV-2 pandemic created an urgent need for rapid, infection screening applied to large numbers of asymptomatic individuals. To date, nasal/throat swab polymerase chain reaction (PCR) is considered the "gold standard". However, this is inconducive to mass, point-of-care (POC) testing due to person discomfort during sampling and a prolonged result turnaround. Breath testing for disease specific organic compounds potentially offers a practical, rapid, non-invasive, POC solution. The study compares the Breath of Health, Ltd. (BOH) breath analysis system to PCR's ability to screen asymptomatic individuals for SARS-CoV-2 infection. The BOH system is mobile and combines Fourier-transform infrared (FTIR) spectroscopy with artificial intelligence (AI) to generate results within 2 min and 15 s. In contrast to prior SARS-CoV-2 breath analysis research, this study focuses on diagnosing SARS-CoV-2 via disease specific spectrometric profiles rather than through identifying the disease specific molecules. METHODS Asymptomatic emergency room patients with suspected SARS-CoV-2 exposure in two leading Israeli hospitals were selected between February through April 2021. All were tested via nasal/throat-swab PCR and BOH breath analysis. In total, 297 patients were sampled (mean age 57·08 ± SD 18·86, 156 males, 139 females, 2 unknowns). Of these, 96 were PCR-positive (44 males, 50 females, 2 unknowns), 201 were PCR-negative (112 males, 89 females). One hundred samples were used for AI identification of SARS-CoV-2 distinguishing spectroscopic wave-number patterns and diagnostic algorithm creation. Algorithm validation was tested in 100 proof-of-concept samples (34 PCR-positive, 66 PCR-negative) by comparing PCR with AI algorithm-based breath-test results determined by a blinded medical expert. One hundred additional samples (12 true PCR-positive, 85 true PCR-negative, 3 confounder false PCR-positive [not included in the 297 total samples]) were evaluated by two blinded medical experts for further algorithm validation and inter-expert correlation. FINDINGS The BOH system identified three distinguishing wave numbers for SARS-CoV-2 infection. In the first phase, the single expert identified the first 100 samples correctly, yielding a 1:1 FTIR/AI:PCR correlation. The two-expert second-phase also yielded 1:1 FTIR/AI:PCR correlation for 97 non-confounders and null correlation for the 3 confounders. Inter-expert correlation was 1:1 for all results. In total, the FTIR/AI algorithm demonstrated 100% sensitivity and specificity for SARS-CoV-2 detection when compared with PCR. INTERPRETATION The SARS-CoV-2 method of breath analysis via FTIR with AI-based algorithm demonstrated high PCR correlation in screening for asymptomatic individuals. This is the first practical, rapid, POC breath analysis solution with such high PCR correlation in asymptomatic individuals. Further validation is required with a larger sample size. FUNDING Breath of Health Ltd, Rehovot, Israel provided study funding.
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Affiliation(s)
- Izhar Ben Shlomo
- Emergency Medicine Program, Zefat Academic College, Safed, Israel
| | - Hilel Frankenthal
- Emergency Medicine Program, Zefat Academic College, Safed, Israel
- Pediatric Intensive Care Unit, Rebecca Sieff Hospital, Safed, Israel
| | - Arie Laor
- Breath of Health Ltd., Rehovot, Israel
| | - Ayala Kobo Greenhut
- Emergency Medicine Program, Zefat Academic College, Safed, Israel
- Corresponding author at: Emergency Medicine Program, Zefat Academic College, Ider 42, Haifa, Safed, Israel
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Park JS, Kim S, Han J, Kim JH, Park KS. Equipment-free, salt-mediated immobilization of nucleic acids for nucleic acid lateral flow assays. Sens Actuators B Chem 2022; 351:130975. [PMID: 36568876 PMCID: PMC9758654 DOI: 10.1016/j.snb.2021.130975] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 06/16/2023]
Abstract
As the world has been facing several deadly virus crises, including Zika virus disease, Ebola virus disease, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and Coronavirus disease 2019 (COVID-19), lateral flow assays (LFAs), which require minimal equipment for point-of-care of viral infectious diseases, are garnering much attention. Accordingly, there is an increasing demand to reduce the time and cost required for manufacturing LFAs. The current study introduces an equipment-free method of salt-mediated immobilization of nucleic acids (SAIoNs) for LFAs. Compared to general DNA immobilization methods such as streptavidin-biotin, UV-irradiation, and heat treatment, our method does not require special equipment (e.g., centrifuge, UV-crosslinker, heating device); therefore, it can be applied in a resource-limited environment with reduced production costs. The immobilization process was streamlined and completed within 30 min. Our method improved the color intensity signal approximately 14 times compared to the method without using SAIoNs and exhibited reproducibility with the long-term storage stability. The proposed method can be used to detect practical targets (e.g., SARS-CoV-2) and facilitates highly sensitive and selective detection of target nucleic acids with multiplexing capability and without any cross-reactivity. This novel immobilization strategy provides a basis for easily and inexpensively developing nucleic acid LFAs combined with various types of nucleic acid amplification.
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Key Words
- AuNPs, gold nanoparticles
- BSA, bovine serum albumin
- Biotin
- Equipment-free
- Immobilization
- LAMP, loop-mediated isothermal amplification
- LF, lateral flow
- LFA, lateral flow assay
- LFIA, lateral flow immuno-assay
- LOD, limit of detection
- Lateral flow assay
- MERS, Middle East respiratory syndrome
- Metal salt
- NALFA, nucleic acid lateral flow assay
- NC, nitrocellulose
- NTC, no-template control
- Nucleic acid lateral flow assay
- POC, point-of-care
- RPA, recombinase polymerase amplification
- RT-qPCR, quantitative reverse transcription-polymerase chain reaction
- SAIoNs, salt-mediated immobilization of nucleic acids
- SARS, severe acute respiratory syndrome
- Streptavidin
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Affiliation(s)
- Jung Soo Park
- Department of Biological Engineering, College of Engineering, Konkuk University, Seoul, Republic of Korea
| | - Seokjoon Kim
- Department of Biological Engineering, College of Engineering, Konkuk University, Seoul, Republic of Korea
| | - Jinjoo Han
- Department of Biological Engineering, College of Engineering, Konkuk University, Seoul, Republic of Korea
| | - Jung Ho Kim
- Department of Biological Engineering, College of Engineering, Konkuk University, Seoul, Republic of Korea
| | - Ki Soo Park
- Department of Biological Engineering, College of Engineering, Konkuk University, Seoul, Republic of Korea
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Kim K, Kashefi-Kheyrabadi L, Joung Y, Kim K, Dang H, Chavan SG, Lee MH, Choo J. Recent advances in sensitive surface-enhanced Raman scattering-based lateral flow assay platforms for point-of-care diagnostics of infectious diseases. Sens Actuators B Chem 2021; 329:129214. [PMID: 36568647 PMCID: PMC9759493 DOI: 10.1016/j.snb.2020.129214] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/03/2020] [Accepted: 11/05/2020] [Indexed: 05/03/2023]
Abstract
This review reports the recent advances in surface-enhanced Raman scattering (SERS)-based lateral flow assay (LFA) platforms for the diagnosis of infectious diseases. As observed through the recent infection outbreaks of COVID-19 worldwide, a timely diagnosis of the disease is critical for preventing the spread of a disease and to ensure epidemic preparedness. In this regard, an innovative point-of-care diagnostic method is essential. Recently, SERS-based assay platforms have received increasing attention in medical communities owing to their high sensitivity and multiplex detection capability. In contrast, LFAs provide a user-friendly and easily accessible sensing platform. Thus, the combination of LFAs with a SERS detection system provides a new diagnostic modality for accurate and rapid diagnoses of infectious diseases. In this context, we briefly discuss the recent application of LFA platforms for the POC diagnosis of SARS-CoV-2. Thereafter, we focus on the recent advances in SERS-based LFA platforms for the early diagnosis of infectious diseases and their applicability for the rapid diagnosis of SARS-CoV-2. Finally, the key issues that need to be addressed to accelerate the clinical translation of SERS-based LFA platforms from the research laboratory to the bedside are discussed.
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Key Words
- AuNPs, gold nanoparticles
- BA, bacillary angiomatosis
- CRISPR, Clustered Regularly Interspaced Short Palindromic Repeat
- HIV, human immunodeficiency virus
- IFA, indirect immunofluorescence assay
- IgG, immunoglobulin G
- IgM, immunoglobulin M
- In vitro diagnostics (IVD)
- Infectious disease
- KSHV, Kaposi’s sarcoma herpes virus
- LFA, lateral flow assay
- Lateral flow assay (LFA)
- NC, nitrocellulose
- NS1, nonstructural protein 1
- POC, point-of-care
- PRV, pseudorabies virus
- Point-of-care (POC)
- RT-PCR, real-time polymerase chain reaction
- SARS-CoV-2
- SARS-CoV-2, severe acute respiratory syndrome-coronavirus-2
- SEB, staphylococcal enterotoxin
- SERS, surface-enhanced Raman scattering
- Si-AuNPs, silica-encapsulated AuNPs
- Surface-enhanced Raman scattering (SERS)
- crRNAs, CRISPR RNAs
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Affiliation(s)
- Kihyun Kim
- Department of Chemistry, Chung-Ang University, Seoul, 06974, South Korea
| | | | - Younju Joung
- Department of Chemistry, Chung-Ang University, Seoul, 06974, South Korea
| | - Kyeongnyeon Kim
- Department of Chemistry, Chung-Ang University, Seoul, 06974, South Korea
| | - Hajun Dang
- Department of Chemistry, Chung-Ang University, Seoul, 06974, South Korea
| | - Sachin Ganpat Chavan
- School of Integrative Engineering, Chung-Ang University, Seoul, 06974, South Korea
| | - Min-Ho Lee
- School of Integrative Engineering, Chung-Ang University, Seoul, 06974, South Korea
| | - Jaebum Choo
- Department of Chemistry, Chung-Ang University, Seoul, 06974, South Korea
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8
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Orija IB, Zahid SH. Pseudohyperglycemia Secondary to High-Dose Intravenous Vitamin C Managed as Diabetic Ketoacidosis: An Endocrinological Catastrophe. AACE Clin Case Rep 2020; 7:239-242. [PMID: 34307844 PMCID: PMC8282517 DOI: 10.1016/j.aace.2020.11.030] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Objective To create awareness among health care professionals and nurses regarding interference with point-of-care (POC) blood glucose (BG) meter by high-dose intravenous vitamin C and other potential substances. We report a case that probably resulted in the death of a patient from an erroneous interpretation of POC-BG readings due to interference from high-dose vitamin C. Methods Retrospective case review Results Our patient was admitted following a syncopal episode associated with an acute non-ST elevation myocardial infarction. She was found to have significant hyperglycemia with blood glucose >600 mg/dL on POC testing, associated with moderate ketoacidosis. She was treated with intravenous insulin as a case of diabetic ketoacidosis (DKA). She developed severe hypoglycemia, which was confirmed on a venous BG, and her condition was complicated by an apparent stroke-like state. The patient deteriorated and subsequently died. We found no report of vitamin C causing apparent DKA, as seen in our case. Conclusion POC-BG monitoring is very commonly used in intensive care unit settings to monitor BG as they are minimally invasive, convenient, and quick. However, physicians and nurses need to be aware that certain substances can interfere with and alter POC-BG levels, leading to incorrect diagnosis of pseudohyperglycemia or pseudohypoglycemia. This may potentially lead to catastrophic consequences and result in increased morbidity and mortality in intensive care unit settings. The Food and Drug Administration advises against the use of POC-BG meters in critical settings, and they should never be used to diagnose DKA.
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Key Words
- AE, adverse events
- BG, blood glucose
- CT, computed tomography
- D5W, dextrose water
- DKA, diabetic ketoacidosis
- FDA, Food and Drug Administration
- GDH-PQQ, glucose dehydrogenase pyrroloquinoline quinone
- ICU, intensive care unit
- IV vitamin C
- IV, intravenous
- POC, point-of-care
- hypoglycemia
- point-of-care blood glucose
- pseudohyperglycemia
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Affiliation(s)
- Israel B Orija
- Department of Internal Medicine, Wellstar Atlanta Medical Center, Atlanta, Georgia
| | - Syeda Hira Zahid
- Department of Internal Medicine, Wellstar Atlanta Medical Center, Atlanta, Georgia
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9
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Reenen AV, Berger M, Moreau E, Bekx E, Bruinink T, Kemper D, Lippen LV, Weusten J, Mrakovic A, Michielsen E, Vissers J, Theije FD, Nieuwenhuis J, Semjonow V, Mair J. Analytical performance of a single epitope B-type natriuretic peptide sandwich immunoassay on the Minicare platform for point-of-care diagnostics. Pract Lab Med 2019; 15:e00119. [PMID: 30984810 PMCID: PMC6444177 DOI: 10.1016/j.plabm.2019.e00119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 07/19/2018] [Revised: 01/23/2019] [Accepted: 03/14/2019] [Indexed: 12/17/2022] Open
Abstract
Point-of-care B-type natriuretic peptide (BNP) testing with adequate analytical performance has the potential to improve patient flow and provide primary care givers with easy-to-use advanced diagnostic tools in the management of heart failure. We present the analytical evaluation of the Minicare BNP immunoassay under development on the Minicare I-20 platform for point-of-care testing. Analytical performance was evaluated using EDTA venous whole blood, EDTA plasma and capillary whole blood. Method comparison with a lab-testing system was performed using samples from 187 patients. Normal values were determined based on 160 healthy adults, aging from 19 to 70 years. Limit of blank (LoB), limit of detection (LoD) were determined to be 3.3 ng/L, 5.8 ng/L. Limit of quantitation (LoQ) in whole blood at 20% and 10% coefficient of variation (CV) was found < 9 ng/L and <30 ng/L respectively without significant differences between EDTA whole blood and EDTA plasma. Total CV was found to be from 6.7% to 9.7% for BNP concentrations between 92.6 and 3984 ng/L. The sample type comparison study demonstrated correlation coefficients between 0.97 and 0.99 with slopes between 1.03 and 1.09 between the different samples. Method comparison between Minicare BNP and Siemens ADVIA Centaur BNP demonstrated a correlation coefficient of 0.92 with a slope of 1.06. The 97.5% URL of a healthy population was calculated to be 72.6 ng/L. The Minicare BNP assay is a robust, easy-to-use and sensitive test for rapid determination of BNP concentrations that can be used in a near-patient setting.
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Key Words
- Analytical performance
- B-type natriuretic peptide
- BNP, B-type Natriuretic Peptide
- CI, confidence interval
- CLSI, clinical laboratory standards institute
- CV, coefficient of variation
- Capillary blood
- Diagnosis
- EDTA, ethylene-diamine-tetraacetic acid
- HAMA, human anti-mouse antibody
- HF, heart failure
- Heart failure
- K2-EDTA, dipotassium ethylene-diamine-tetraacetic acid
- Li-heparin, lithium heparin
- LoB, limit of blank
- LoD, limit of detection
- LoQ, limit of quantitation
- NP, Natriuretic Peptide
- NYHA, New York Heart Association
- POC, point-of-care
- Point-of-care
- RF, rheumatoid factor
- RFID, radiofrequency identification
- RT, room temperature
- SD, standard deviation
- URL, upper reference limit
- fTIR, frustrated total internal reflection
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Affiliation(s)
- Alexander van Reenen
- Minicare BV, Eindhoven, the Netherlands.,Philips BG Emerging Businesses, Eindhoven, the Netherlands
| | - Mario Berger
- Philips BG Emerging Businesses, Eindhoven, the Netherlands
| | | | - Edwin Bekx
- Philips BG Emerging Businesses, Eindhoven, the Netherlands
| | - Tom Bruinink
- Philips BG Emerging Businesses, Eindhoven, the Netherlands
| | | | | | - Jos Weusten
- Philips BG Emerging Businesses, Eindhoven, the Netherlands
| | - Anita Mrakovic
- Department of Internal Medicine III - Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Joost Vissers
- Future Diagnostics Solutions, Wijchen, the Netherlands
| | - Femke de Theije
- Minicare BV, Eindhoven, the Netherlands.,Philips BG Emerging Businesses, Eindhoven, the Netherlands
| | - Jeroen Nieuwenhuis
- Minicare BV, Eindhoven, the Netherlands.,Philips BG Emerging Businesses, Eindhoven, the Netherlands
| | | | - Johannes Mair
- Department of Internal Medicine III - Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
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10
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Holtz KK, Townsend KR, Furst JW, Myers JF, Binnicker MJ, Quigg SM, Maxson JA, Espy MJ. An Assessment of the AdenoPlus Point-of-Care Test for Diagnosing Adenoviral Conjunctivitis and Its Effect on Antibiotic Stewardship. Mayo Clin Proc Innov Qual Outcomes 2017; 1:170-175. [PMID: 30225413 PMCID: PMC6135020 DOI: 10.1016/j.mayocpiqo.2017.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVE To determine the sensitivity and specificity of the AdenoPlus test compared with real-time polymerase chain reaction (PCR) and to determine whether there was a reduction in antibiotic prescriptions with the use of AdenoPlus compared with the previous year. PATIENTS AND METHODS A total of 125 patients with suspected infectious conjunctivitis were accrued from June 4, 2015, through September 27, 2015. Forty-six participants from the prospective cohort completed both AdenoPlus and PCR testing. Two hundred fifty age-matched individuals were in the retrospective cohort. RESULTS There was a significant reduction in the percentage of patients who received an antibiotic ophthalmic prescription in the prospective cohort vs the retrospective cohort (32% vs 45%; χ2P=.01). AdenoPlus test sensitivity was 50% (5 of 10) and specificity was 92% (33 of 36) compared with real-time PCR testing. CONCLUSION The AdenoPlus test has high specificity for diagnosing adenoviral conjunctivitis but lower sensitivity than has been previously published. These data suggest that negative AdenoPlus results should be confirmed by real-time PCR owing to the low overall sensitivity of AdenoPlus observed.
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Affiliation(s)
- Kelly K. Holtz
- Department of Family Medicine, Mayo Clinic, Rochester, MN
| | - Kalie R. Townsend
- Department of Family Medicine, Mayo Clinic, Rochester, MN
- Urgent Care and Emergency Medicine Department, Mayo Clinic Health System Red Cedar, Menomonie, WI
| | | | - Jane F. Myers
- Department of Family Medicine, Mayo Clinic, Rochester, MN
| | - Matthew J. Binnicker
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | | | | | - Mark J. Espy
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
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11
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Sabat J, Gould S, Gillego E, Hariprashad A, Wiest C, Almonte S, Lucido DJ, Gave A, Leitman IM, Eiref SD. The use of finger-stick blood to assess lactate in critically ill surgical patients. Ann Med Surg (Lond) 2016; 10:41-8. [PMID: 27547397 PMCID: PMC4978218 DOI: 10.1016/j.amsu.2016.07.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 04/02/2016] [Revised: 07/23/2016] [Accepted: 07/24/2016] [Indexed: 12/15/2022] Open
Abstract
Background Using finger-stick capillary blood to assess lactate from the microcirculation may have utility in treating critically ill patients. Our goals were to determine how finger-stick capillary lactate correlates with arterial lactate levels in patients from the surgical intensive care unit, and to compare how capillary and arterial lactate trend over time in patients undergoing resuscitation for shock. Methods Capillary whole blood specimens were obtained from finger-sticks using a lancet, and assessed for lactate via a handheld point-of-care device as part of an “investigational use only” study. Comparison was made to arterial blood specimens that were assessed for lactate by standard laboratory reference methods. Results 40 patients (mean age 68, mean APACHEII 18, vasopressor use 62%) were included. The correlation between capillary and arterial lactate levels was 0.94 (p < 0.001). Capillary lactate measured slightly higher on average than paired arterial values, with a mean difference 0.99 mmol/L. In patients being resuscitated for septic and hemorrhagic shock, capillary and arterial lactate trended closely over time: rising, peaking, and falling in tandem. Clearance of capillary and arterial lactate mirrored clinical improvement, normalizing in all patients except two that expired. Conclusion Finger-stick capillary lactate both correlates and trends closely with arterial lactate in critically ill surgical patients, undergoing resuscitation for shock. Finger-stick capillary lactate correlates with blood gas and core lab values. Capillary lactate trends closely over time with arterial lactate. Rising or falling capillary lactate reflects the adequacy of global perfusion. Capillary lactate measurements require a fraction of the time and blood to process. Preliminary results imply capillary lactate may be used in lieu of invasive methods.
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Affiliation(s)
- Joseph Sabat
- Division of Surgical-Critical Care, Department of Surgery, Icahn School of Medicine at Mount Sinai Beth Israel, First Avenue and 16th Street, New York, NY 10003, USA
| | - Scott Gould
- Division of Surgical-Critical Care, Department of Surgery, Icahn School of Medicine at Mount Sinai Beth Israel, First Avenue and 16th Street, New York, NY 10003, USA
| | - Ezra Gillego
- Division of Surgical-Critical Care, Department of Surgery, Icahn School of Medicine at Mount Sinai Beth Israel, First Avenue and 16th Street, New York, NY 10003, USA
| | - Anita Hariprashad
- Division of Surgical-Critical Care, Department of Surgery, Icahn School of Medicine at Mount Sinai Beth Israel, First Avenue and 16th Street, New York, NY 10003, USA
| | - Christine Wiest
- Division of Surgical-Critical Care, Department of Surgery, Icahn School of Medicine at Mount Sinai Beth Israel, First Avenue and 16th Street, New York, NY 10003, USA
| | - Shailyn Almonte
- Division of Surgical-Critical Care, Department of Surgery, Icahn School of Medicine at Mount Sinai Beth Israel, First Avenue and 16th Street, New York, NY 10003, USA
| | - David J Lucido
- Division of Surgical-Critical Care, Department of Surgery, Icahn School of Medicine at Mount Sinai Beth Israel, First Avenue and 16th Street, New York, NY 10003, USA
| | - Asaf Gave
- Division of Surgical-Critical Care, Department of Surgery, Icahn School of Medicine at Mount Sinai Beth Israel, First Avenue and 16th Street, New York, NY 10003, USA
| | - I Michael Leitman
- Division of Surgical-Critical Care, Department of Surgery, Icahn School of Medicine at Mount Sinai Beth Israel, First Avenue and 16th Street, New York, NY 10003, USA
| | - Simon D Eiref
- Division of Surgical-Critical Care, Department of Surgery, Icahn School of Medicine at Mount Sinai Beth Israel, First Avenue and 16th Street, New York, NY 10003, USA
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