Displaying publications 41 - 60 of 71 in total

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  1. Diagnostics on acute myocardial infarction: Cardiac troponin biomarkers
    Fathil MF, Md Arshad MK, Gopinath SC, Hashim U, Adzhri R, Ayub RM, et al.
    Biosens Bioelectron, 2015 Aug 15;70:209-20.
    PMID: 25841117 DOI: 10.1016/j.bios.2015.03.037
    Acute myocardial infarction or myocardial infarction (MI) is a major health problem, due to diminished flow of blood to the heart, leads to higher rates of mortality and morbidity. Data from World Health Organization (WHO) accounted 30% of global death annually and expected more than 23 million die annually by 2030. This fatal effects trigger the need of appropriate biomarkers for early diagnosis, thus countermeasure can be taken. At the moment, the most specific markers for cardiac injury are cardiac troponin I (cTnI) and cardiac troponin T (cTnT) which have been considered as 'gold standard'. Due to higher specificity, determination of the level of cardiac troponins became a predominant indicator for MI. Several ways of diagnostics have been formulated, which include enzyme-linked immunosorbent assay, chemiluminescent, fluoro-immunoassays, electrical detections, surface plasmon resonance, and colorimetric protein assay. This review represents and elucidates the strategies, methods and detection levels involved in these diagnostics on cardiac superior biomarkers. The advancement, sensitivity, and limitations of each method are also discussed. In addition, it concludes with a discussion on the point-of care (POC) assay for a fast, accurate and ability of handling small sample measurement of cardiac biomarker.
    Matched MeSH terms: Point-of-Care Systems*
  2. Usage of airway ultrasound as an assessment and prediction tool of a difficult airway management
    Adi O, Fong CP, Sum KM, Ahmad AH
    Am J Emerg Med, 2021 04;42:263.e1-263.e4.
    PMID: 32994082 DOI: 10.1016/j.ajem.2020.09.011
    Airway assessment is important in emergency airway management. A difficult airway can lead to life-threatening complications. A perfect airway assessment tool does not exist and unanticipated difficulty will remain unforeseen. Current bedside clinical predictors of the difficult airway are unreliable but airway ultrasound can be used as an adjunct to predict difficult laryngoscopy. We report a case of a 60-year-old man presenting to the emergency department with shortness of breath, hoarseness of voice and stridor. Airway ultrasound revealed a large laryngeal mass narrowing the upper airway, extending to bilateral vocal cords with heterogenous echogenicity. In view of impending complete upper airway obstruction, acute respiratory distress and airway ultrasound findings, urgent emergency tracheostomy was chosen as definitive airway over endotracheal intubation or surgical cricothyroidotomy. Point of care ultrasound (POCUS) was used to evaluate this patient with severe upper airway obstruction. A laryngeal mass was detected by ultrasound and this pointed towards the presence of a difficult airway. POCUS was a good non-invasive tool used for airway assessment in this uncooperative and unstable patient. Ultrasound predictors of the difficult airway include the inability to visualize the hyoid bone, short hyomental distance ratio, high pretracheal anterior neck thickness and large tongue size. Besides airway assessment, ultrasound can also help to predict endotracheal tube size, confirm intubation and guide emergency airway procedures such as cricothyroidotomy and tracheostomy. Point of care ultrasound of the upper airway can be used in airway assessment to identify distorted airway anatomy, pathological lesions and guide treatment decisions.
    Matched MeSH terms: Point-of-Care Systems*
  3. Cotton fiber-based assay with time-based microfluidic absorption sampling for point-of-care applications
    Wicaksono DH, Syazwani IN, Ratnarathorn N, Sadir S, Shahir S, Ruckthong L, et al.
    Bioanalysis, 2019 May;11(9):855-873.
    PMID: 31084195 DOI: 10.4155/bio-2018-0190
    Aim: Time-based microfluidic absorption sampling was proposed using cotton fiber-based device made in swab stick. The assay was optimized and compared with conventional pipetted drop sampling using the same device. Materials & methods: Reagents were integrated into cotton fiber device for assessing concentration of analytes by the colorimetric detection method through time-based absorption sampling microfluidic system. All assay parameters were first optimized using conventional pipette-based drop sampling. Results: The color intensity is linear in the relevant concentration range of the analytes. The LOD are 0.189 mM for glucose and 6.56 μM for nitrite, respectively. These values are better than conventional drop sampling. The fiber-containing swab itself functions as sampling, assay and calibration device. Conclusion: Microfluidic cotton fiber-based assay device was fabricated and can determine analyte concentration in artificial salivary samples, colorimetrically, by time-based absorption sampling without the need of complex equipments.
    Matched MeSH terms: Point-of-Care Systems*
  4. Lateral Flow Assay Based on Paper-Hydrogel Hybrid Material for Sensitive Point-of-Care Detection of Dengue Virus
    Choi JR, Yong KW, Tang R, Gong Y, Wen T, Yang H, et al.
    Adv Healthc Mater, 2017 Jan;6(1).
    PMID: 27860384 DOI: 10.1002/adhm.201600920
    Paper-based devices have been broadly used for the point-of-care detection of dengue viral nucleic acids due to their simplicity, cost-effectiveness, and readily observable colorimetric readout. However, their moderate sensitivity and functionality have limited their applications. Despite the above-mentioned advantages, paper substrates are lacking in their ability to control fluid flow, in contrast to the flow control enabled by polymer substrates (e.g., agarose) with readily tunable pore size and porosity. Herein, taking the benefits from both materials, the authors propose a strategy to create a hybrid substrate by incorporating agarose into the test strip to achieve flow control for optimal biomolecule interactions. As compared to the unmodified test strip, this strategy allows sensitive detection of targets with an approximately tenfold signal improvement. Additionally, the authors showcase the potential of functionality improvement by creating multiple test zones for semi-quantification of targets, suggesting that the number of visible test zones is directly proportional to the target concentration. The authors further demonstrate the potential of their proposed strategy for clinical assessment by applying it to their prototype sample-to-result test strip to sensitively and semi-quantitatively detect dengue viral RNA from the clinical blood samples. This proposed strategy holds significant promise for detecting various targets for diverse future applications.
    Matched MeSH terms: Point-of-Care Systems*
  5. Fulltext Multi-organ point-of-care ultrasound for COVID-19 (PoCUS4COVID): international expert consensus
    Hussain A, Via G, Melniker L, Goffi A, Tavazzi G, Neri L, et al.
    Crit Care, 2020 12 24;24(1):702.
    PMID: 33357240 DOI: 10.1186/s13054-020-03369-5
    COVID-19 has caused great devastation in the past year. Multi-organ point-of-care ultrasound (PoCUS) including lung ultrasound (LUS) and focused cardiac ultrasound (FoCUS) as a clinical adjunct has played a significant role in triaging, diagnosis and medical management of COVID-19 patients. The expert panel from 27 countries and 6 continents with considerable experience of direct application of PoCUS on COVID-19 patients presents evidence-based consensus using GRADE methodology for the quality of evidence and an expedited, modified-Delphi process for the strength of expert consensus. The use of ultrasound is suggested in many clinical situations related to respiratory, cardiovascular and thromboembolic aspects of COVID-19, comparing well with other imaging modalities. The limitations due to insufficient data are highlighted as opportunities for future research.
    Matched MeSH terms: Point-of-Care Systems/standards*
  6. Fulltext Advancing stem cell therapy from bench to bedside: lessons from drug therapies
    Srijaya TC, Ramasamy TS, Kasim NH
    J Transl Med, 2014;12:243.
    PMID: 25182194 DOI: 10.1186/s12967-014-0243-9
    The inadequacy of existing therapeutic tools together with the paucity of organ donors have always led medical researchers to innovate the current treatment methods or to discover new ways to cure disease. Emergence of cell-based therapies has provided a new framework through which it has given the human world a new hope. Though relatively a new concept, the pace of advancement clearly reveals the significant role that stem cells will ultimately play in the near future. However, there are numerous uncertainties that are prevailing against the present setting of clinical trials related to stem cells: like the best route of cell administration, appropriate dosage, duration and several other applications. A better knowledge of these factors can substantially improve the effectiveness of disease cure or organ repair using this latest therapeutic tool. From a certain perspective, it could be argued that by considering certain proven clinical concepts and experience from synthetic drug system, we could improve the overall efficacy of cell-based therapies. In the past, studies on synthetic drug therapies and their clinical trials have shown that all the aforementioned factors have critical ascendancy over its therapeutic outcomes. Therefore, based on the knowledge gained from synthetic drug delivery systems, we hypothesize that by employing many of the clinical approaches from synthetic drug therapies to this new regenerative therapeutic tool, the efficacy of stem cell-based therapies can also be improved.
    Matched MeSH terms: Point-of-Care Systems/trends*
  7. Fulltext Point-of-Care Airway Ultrasonography Prior to an Emergency Cricothyroidotomy: Case Report
    Iqhbal M, Noor JM, Karim NA, Ismail I, Sanib H, Mokhtar MA, et al.
    Sultan Qaboos Univ Med J, 2018 May;18(2):e219-e222.
    PMID: 30210855 DOI: 10.18295/squmj.2018.18.02.017
    The use of ultrasonography in acute and critical care medicine is becoming increasingly common. However, use of an airway ultrasound as an adjunct to determine the type of intervention needed and assess complications is not common practice. We report a 56-year-old male who presented to the Emergency Department of the Sungai Buloh Hospital, Selangor, Malaysia, in 2015 with hoarseness, stridor and impending respiratory failure. A point-of-care ultrasound performed to assess the neck and vocal cords indicated a heterogeneous echogenic mass in the larynx, thus ruling out a cricothyroidotomy. The patient was therefore referred for an emergency tracheostomy. This case highlights the importance of point-of-care airway ultrasonography in the assessment of patients with stridor. This imaging technique not only helps to detect the cause of the stridor, but also to determine the feasibility of a cricothyroidotomy in emergency cases.
    Matched MeSH terms: Point-of-Care Systems*
  8. An integrated lateral flow assay for effective DNA amplification and detection at the point of care
    Choi JR, Hu J, Gong Y, Feng S, Wan Abas WA, Pingguan-Murphy B, et al.
    Analyst, 2016 05 10;141(10):2930-9.
    PMID: 27010033 DOI: 10.1039/c5an02532j
    Lateral flow assays (LFAs) have been extensively explored in nucleic acid testing (NAT) for medical diagnostics, food safety analysis and environmental monitoring. However, the amount of target nucleic acid in a raw sample is usually too low to be directly detected by LFAs, necessitating the process of amplification. Even though cost-effective paper-based amplification techniques have been introduced, they have always been separately performed from LFAs, hence increasing the risk of reagent loss and cross-contaminations. To date, integrating paper-based nucleic acid amplification into colorimetric LFA in a simple, portable and cost-effective manner has not been introduced. Herein, we developed an integrated LFA with the aid of a specially designed handheld battery-powered system for effective amplification and detection of targets in resource-poor settings. Interestingly, using the integrated paper-based loop-mediated isothermal amplification (LAMP)-LFA, we successfully performed highly sensitive and specific target detection, achieving a detection limit of as low as 3 × 10(3) copies of target DNA, which is comparable to the conventional tube-based LAMP-LFA in an unintegrated format. The device may serve in conjunction with a simple paper-based sample preparation to create a fully integrated paper-based sample-to-answer diagnostic device for point-of-care testing (POCT) in the near future.
    Matched MeSH terms: Point-of-Care Systems
  9. Graphene-mediated microfluidic transport and nebulization via high frequency Rayleigh wave substrate excitation
    Ang KM, Yeo LY, Hung YM, Tan MK
    Lab Chip, 2016 09 21;16(18):3503-14.
    PMID: 27502324 DOI: 10.1039/c6lc00780e
    The deposition of a thin graphene film atop a chip scale piezoelectric substrate on which surface acoustic waves are excited is observed to enhance its performance for fluid transport and manipulation considerably, which can be exploited to achieve further efficiency gains in these devices. Such gains can then enable complete integration and miniaturization for true portability for a variety of microfluidic applications across drug delivery, biosensing and point-of-care diagnostics, among others, where field-use, point-of-collection or point-of-care functionality is desired. In addition to a first demonstration of vibration-induced molecular transport in graphene films, we show that the coupling of the surface acoustic wave gives rise to antisymmetric Lamb waves in the film which enhance molecular diffusion and hence the flow through the interstitial layers that make up the film. Above a critical input power, the strong substrate vibration displacement can also force the molecules out of the graphene film to form a thin fluid layer, which subsequently destabilizes and breaks up to form a mist of micron dimension aerosol droplets. We provide physical insight into this coupling through a simple numerical model, verified through experiments, and show several-fold improvement in the rate of fluid transport through the film, and up to 55% enhancement in the rate of fluid atomization from the film using this simple method.
    Matched MeSH terms: Point-of-Care Systems
  10. Paper-based capacitive sensors for identification and quantification of chemicals at the point of care
    Hu J, Yew CT, Chen X, Feng S, Yang Q, Wang S, et al.
    Talanta, 2017 Apr 01;165:419-428.
    PMID: 28153277 DOI: 10.1016/j.talanta.2016.12.086
    The identification and quantification of chemicals play a vital role in evaluation and surveillance of environmental health and safety. However, current techniques usually depend on costly equipment, professional staff, and/or essential infrastructure, limiting their accessibility. In this work, we develop paper-based capacitive sensors (PCSs) that allow simple, rapid identification and quantification of various chemicals from microliter size samples with the aid of a handheld multimeter. PCSs are low-cost parallel-plate capacitors (~$0.01 per sensor) assembled from layers of aluminum foil and filter paper via double-sided tape. The developed PCSs can identify different kinds of fluids (e.g., organic chemicals) and quantify diverse concentrations of substances (e.g., heavy metal ions) based on differences in dielectric properties, including capacitance, frequency spectrum, and dielectric loss tangent. The PCS-based method enables chemical identification and quantification to take place much cheaply, simply, and quickly at the point-of-care (POC), holding great promise for environmental monitoring in resource-limited settings.
    Matched MeSH terms: Point-of-Care Systems
  11. Fulltext A Facile and Flexible Method for On-Demand Directional Speed Tunability in the Miniaturised Lab-on-a-Disc
    Tan MK, Siddiqi A, Yeo LY
    Sci Rep, 2017 07 27;7(1):6652.
    PMID: 28751783 DOI: 10.1038/s41598-017-07025-x
    The Miniaturised Lab-on-a-Disc (miniLOAD) platform, which utilises surface acoustic waves (SAWs) to drive the rotation of thin millimeter-scale discs on which microchannels can be fabricated and hence microfluidic operations can be performed, offers the possibility of miniaturising its larger counterpart, the Lab-on-a-CD, for true portability in point-of-care applications. A significant limitation of the original miniLOAD concept, however, is that it does not allow for flexible control over the disc rotation direction and speed without manual adjustment of the disc's position, or the use of multiple devices to alter the SAW frequency. In this work, we demonstrate the possibility of achieving such control with the use of tapered interdigitated transducers to confine a SAW beam such that the localised acoustic streaming it generates imparts a force, through hydrodynamic shear, at a specific location on the disc. Varying the torque that arises as a consequence by altering the input frequency to the transducers then allows the rotational velocity and direction of the disc to be controlled with ease. We derive a simple predictive model to illustrate the principle by which this occurs, which we find agrees well with the experimental measurements.
    Matched MeSH terms: Point-of-Care Systems
  12. Fulltext Detection of Tuberculosis (TB) using gold standard method, direct sputum smears microscopy, PCR, qPCR and electrochemical DNA sensor: a mini review
    Che Engku Noramalina Che-Engku-Chik, Siti Sarah Othman, Helmi Wasoh, Nor Azah Yusof, Jaafar Abdullah, Mohd Hazani Mat Zaid
    Journal of Biochemistry, Microbiology and Biotechnology, 2016;4(2):16-21.
    MyJurnal
    Despite the continued effort globally made to control the growing case of Tuberculosis (TB), it
    continues to be regarded as the second deadliest disease after the HIV. There are various
    methods developed to diagnose TB, most of which having the criteria of sensitive, selective,
    cheap and portable to be used in robust applications. Even with the advancement in medication,
    the important keys including early stage diagnosis is yet to be considered. In diagnosing TB, the
    only technique remained as the gold standard method is the culturing method, which is the Acid
    Fast Bacilli (AFB) staining. On the other hand, molecular technique utilising Polymerase Chain
    Reaction (PCR) assay is preferred as a non-culturing method. Additionally, as molecular
    techniques become advanced, real-time PCR or quantitative PCR (qPCR) using multiple probes
    in one shot has raised interest among researchers, because it can skip the process of gel
    electrophoresis. Recently, researchers have been working on electrochemical DNA sensors
    which are sensitive, selective, rapid, cheap and can meet with point of care (POC) testing
    requirements to diagnose TB.
    Matched MeSH terms: Point-of-Care Systems
  13. Elastic reversible valves on centrifugal microfluidic platforms
    Aeinehvand MM, Weber L, Jiménez M, Palermo A, Bauer M, Loeffler FF, et al.
    Lab Chip, 2019 Feb 20.
    PMID: 30785443 DOI: 10.1039/c8lc00849c
    Reversible valves on centrifugal microfluidic platforms facilitate the automation of bioanalytical assays, especially of those requiring a series of steps (such as incubation) in a single reaction chamber. In this study, we present fixed elastic reversible (FER) valves and tunable elastic reversible (TER) valves that are easy to fabricate, implement and control. In the FER valve the compression of an elastic barrier/patch against a microchamber's outlet prevents the release of liquid. The valve sealing pressure was determined by adjusting the engraving depth of the valve-seat at which the elastic patch was located, this allows to set the sealing pressure during disc fabrication. In the TER valve, the patch compression value and sealing pressure is controlled by the penetration depth of a plastic screw into the valve-seat. The ER valves prevent liquid flow until the centrifugal force overcomes their sealing pressure. Moreover, at a constant spin speed, turning the screw of a TER valve reduces its sealing pressure and opens the valve. Therefore, the TER valve allows for controlling of the liquid transfer volume at various spin speeds. The FER and TER valves' behavior is mathematically described and equations for the prediction of their operation under centrifugal forces are provided. As a point-of-care (POC) application of ER valves, we have developed a microfluidic disc with a series of TER valves and peptide microarrays for automated multiplexed detection of five different proteins from a single serum sample.
    Matched MeSH terms: Point-of-Care Systems
  14. A point-of-care cassette test for detection of Strongyloides stercoralis
    Noordin R, Osman E, Kalantari N, Anuar NS, Gorgani-Firouzjaee T, Sithithaworn P, et al.
    Acta Trop, 2022 Feb;226:106251.
    PMID: 34808116 DOI: 10.1016/j.actatropica.2021.106251
    Strongyloides stercoralis is a parasite that causes strongyloidiasis worldwide. It may lead to a life-long infection in immunocompetent people and hyperinfection in immunosuppressed patients. A point-of-care (POC) rapid test is helpful for patient diagnosis in resource-limited settings and as a detection tool in elimination/control programs. Previously, we reported a rapid IgG4 dipstick test (Ss Rapid®) for Strongyloides suitable for a laboratory setting. A POC cassette format of the test, which is field-applicable, has since been developed. Here, we report on a laboratory-based evaluation of the Ss Rapid® cas sette test on 285 sera. We assessed the diagnostic sensitivity of the Ss Rapid® cas sette with 32 sera, comprising samples from larval and/or DNA positive individuals from three countries. Additionally, we also tested samples from 33 seropositive endemic areas residents. We evaluated the diagnostic specificity of the test using 220 samples, comprising sera from other infections (n = 101), allergy cases with high IgE antibodies (n = 4), and blood donors (n = 115). The test showed high diagnostic sensitivity (97%, 31/32), and all sera of the seropositive endemic residents were reactive. It also showed high diagnostic specificity (94.5%, 208/220), and all false-positive samples tested negative after sera adsorption using recombinant NIE-coated microsphere beads. Additionally, we showed that the test worked with spiked whole blood samples. The study results showed that the SsRapid® cas sette test merits further laboratory and field evaluations.
    Matched MeSH terms: Point-of-Care Systems
  15. Fulltext Community pharmacist-led point-of-care eGFR screening: early detection of chronic kidney disease in high-risk patients
    Jairoun AA, Al-Hemyari SS, Shahwan M, Zyoud SH, El-Dahiyat F
    Sci Rep, 2024 Mar 27;14(1):7284.
    PMID: 38538618 DOI: 10.1038/s41598-024-56765-0
    Adherence to scheduled physician screenings for renal function monitoring in patients with chronic kidney disease (CKD) or those at high risk remains suboptimal despite the endorsement of regular screenings by several clinical practice guidelines. Our study aims to assess the effectiveness of a point-of-care CKD screening program led by these pharmacists using the PICCOLO device while recognizing the unique position of community pharmacists in primary care. We conducted an 11-month prospective point-of-care interventional research study in the United Arab Emirates to evaluate the performance of a community pharmacist-led CKD screening program for high-risk patients. Six diverse community pharmacies were selected based on staff availability, patient volume, and their offered range of services. Eligible individuals with risk factors for CKD were identified during medication evaluations. The PICCOLO Comprehensive Metabolic Panel facilitated on-site blood analysis, delivering estimated Glomerular Filtration Rate (eGFR) results within 10 to 15 min. Data also included eGFR categories, demographic information, and insights into lifestyle and health habits collected through a questionnaire. Pharmacists conducted comprehensive medication reviews and offered referrals and lifestyle guidance as part of the program. The study encompassed a total of 400 patients, with an average age of 69 ± 13.4 years within the study cohort. Notably, 38.8% (155 individuals) of the 400 patients were found to have undiagnosed CKD stages 3-5. Univariate logistic regression analysis revealed a significant association between a higher incidence of CKD stages 3-5 and factors such as older age, a history of hypertension, vascular disease, and diabetes mellitus. In the multivariate regression model, age and a history of diabetes mellitus emerged as significant predictors of an elevated risk of CKD. This study sheds light on the viability and impact of CKD screening programs conducted by community pharmacists, particularly in detecting CKD stages 3-5. The findings have implications for healthcare policies, as they can influence the enhancement of early detection and management of CKD. Moreover, these insights may catalyze focused screening initiatives and strengthen collaboration between community pharmacies and healthcare systems to benefit patients at high risk of CKD.
    Matched MeSH terms: Point-of-Care Systems
  16. Fulltext Latex micro-balloon pumping in centrifugal microfluidic platforms
    Aeinehvand MM, Ibrahim F, Harun SW, Al-Faqheri W, Thio TH, Kazemzadeh A, et al.
    Lab Chip, 2014 Mar 07;14(5):988-97.
    PMID: 24441792 DOI: 10.1039/c3lc51116b
    Centrifugal microfluidic platforms have emerged as point-of-care diagnostic tools. However, the unidirectional nature of the centrifugal force limits the available space for multi-step processes on a single microfluidic disc. To overcome this limitation, a passive pneumatic pumping method actuated at high rotational speeds has been previously proposed to pump liquid against the centrifugal force. In this paper, a novel micro-balloon pumping method that relies on elastic energy stored in a latex membrane is introduced. It operates at low rotational speeds and pumps a larger volume of liquid towards the centre of the disc. Two different micro-balloon pumping mechanisms have been designed to study the pump performance at a range of rotational frequencies from 0 to 1500 rpm. The behaviour of the micro-balloon pump on the centrifugal microfluidic platforms has been theoretically analysed and compared with the experimental data. The experimental data show that the developed pumping method dramatically decreases the required rotational speed to pump liquid compared to the previously developed pneumatic pumping methods. It also shows that within a range of rotational speed, a desirable volume of liquid can be stored and pumped by adjusting the size of the micro-balloon.
    Matched MeSH terms: Point-of-Care Systems
  17. Transesophageal Echocardiography at the Golden Hour: Identification of Blunt Traumatic Aortic Injuries in the Emergency Department
    Osman A, Fong CP, Wahab SFA, Panebianco N, Teran F
    J Emerg Med, 2020 Sep;59(3):418-423.
    PMID: 32591302 DOI: 10.1016/j.jemermed.2020.05.003
    BACKGROUND: Although surface sonography has become an essential diagnostic tool in the evaluation of trauma patients, important limitations of this modality include the evaluation of retroperitoneal hemorrhage and mediastinal pathology, such as blunt traumatic aortic injuries (BTAI). As in other emergency applications where surface sonography can't provide the information needed, focused transesophageal echocardiography (TEE) may represent a valuable diagnostic tool in the evaluation of hemodynamically unstable trauma patients with suspected thoracic pathology such as BTAI.

    CASE SERIES: We present a series of five cases that illustrate the diagnostic value of emergency physician-performed resuscitative TEE in the diagnosis of BTAI in patients presenting with blunt thoracic trauma. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: As the use of point-of-care TEE during resuscitation continues to expand in emergency medicine, the evaluation of patients with BTAI represents a novel application where this emerging modality can allow early diagnosis of these injuries in hemodynamically unstable patients.

    Matched MeSH terms: Point-of-Care Systems
  18. Fulltext Quartz crystal microbalance-based biosensors as rapid diagnostic devices for infectious diseases
    Lim HJ, Saha T, Tey BT, Tan WS, Ooi CW
    Biosens Bioelectron, 2020 Nov 15;168:112513.
    PMID: 32889395 DOI: 10.1016/j.bios.2020.112513
    Infectious diseases are the ever-present threats to public health and the global economy. Accurate and timely diagnosis is crucial to impede the progression of a disease and break the chain of transmission. Conventional diagnostic techniques are typically time-consuming and costly, making them inefficient for early diagnosis of infections and inconvenient for use at the point of care. Developments of sensitive, rapid, and affordable diagnostic methods are necessary to improve the clinical management of infectious diseases. Quartz crystal microbalance (QCM) systems have emerged as a robust biosensing platform due to their label-free mechanism, which allows the detection and quantification of a wide range of biomolecules. The high sensitivity and short detection time offered by QCM-based biosensors are attractive for the early detection of infections and the routine monitoring of disease progression. Herein, the strategies employed in QCM-based biosensors for the detection of infectious diseases are extensively reviewed, with a focus on prevalent diseases for which improved diagnostic techniques are in high demand. The challenges to the clinical application of QCM-based biosensors are highlighted, along with an outline of the future scope of research in QCM-based diagnostics.
    Matched MeSH terms: Point-of-Care Systems
  19. Fulltext Efficacy and safety of the point-of-care procalcitonin test for determining the antibiotic treatment duration in patients with ventilator-associated pneumonia in the intensive care unit: a randomised controlled trial
    Z Mazlan M, A H Ismail M, Ali S, Salmuna ZN, Wan Muhd Shukeri WF, Omar M
    Anaesthesiol Intensive Ther, 2021;53(3):207-214.
    PMID: 34006044 DOI: 10.5114/ait.2021.104300
    INTRODUCTION: This study was conducted to assess the efficacy of point-of-care (POC) procalcitonin (PCT) serial measurement in determining the antibiotic treatment duration in patients with ventilator-associated pneumonia (VAP).

    MATERIAL AND METHODS: One hundred patients were randomly recruited and then further randomly divided into two groups of 50 patients each. The first group used the POC PCT test along with the standard sepsis parameter monitoring, while the second group had the standard monitoring only (C-reactive protein [CRP] level, total white count, temperature and tracheal aspirate culture). Serial PCT test results and CRP levels were monitored on days 1, 3, 7 and 9. The patients were followed up for 28-day mortality.

    RESULTS: Eighty-five patients completed the trial, of whom 43 were in the PCT group and 42 were in the control group. The PCT group had a significantly lower mean (SD) antibiotic treatment duration (10.28 [2.68] days) than the control group (11.52 [3.06]). The mean (SD) difference was -1.25 (95% confidence interval [CI], -2.48 to 0.01; t-statistic [df] = -1.997 [83]; P = 0.049). The PCT group also had a higher number of antibiotic-free days alive during the 28 days after VAP onset than the control group (mean [SD], 10.79 [7.61] vs. 8.72 [6.41]). The Sequential Organ Failure Assessment score was the sole factor for the decrease in duration after VAP onset (regression coefficient β [95% CI], -0.70 [-1.19 to -0.20]; P = 0.006).

    CONCLUSIONS: The POC procalcitonin test can reduce the antibiotic treatment duration in patients with VAP.

    Matched MeSH terms: Point-of-Care Systems
  20. Evaluation of a point-of-care haemozoin assay (Gazelle device) for rapid detection of Plasmodium knowlesi malaria
    Tan AF, Thota P, Sakam SSB, Lew YL, Rajahram GS, William T, et al.
    Sci Rep, 2023 Mar 23;13(1):4760.
    PMID: 36959462 DOI: 10.1038/s41598-023-31839-7
    Plasmodium knowlesi is the major cause of zoonotic malaria in Southeast Asia. Rapid and accurate diagnosis enables effective clinical management. A novel malaria diagnostic tool, Gazelle (Hemex Health, USA) detects haemozoin, a by-product of haem metabolism found in all Plasmodium infections. A pilot phase refined the Gazelle haemozoin identification algorithm, with the algorithm then tested against reference PCR in a larger cohort of patients with P. knowlesi mono-infections and febrile malaria-negative controls. Limit-of-detection analysis was conducted on a subset of P. knowlesi samples serially diluted with non-infected whole blood. The pilot phase of 40 P. knowlesi samples demonstrated 92.5% test sensitivity. P. knowlesi-infected patients (n = 203) and febrile controls (n = 44) were subsequently enrolled. Sensitivity and specificity of the Gazelle against reference PCR were 94.6% (95% CI 90.5-97.3%) and 100% (95% CI 92.0-100%) respectively. Positive and negative predictive values were 100% and 98.8%, respectively. In those tested before antimalarial treatment (n = 143), test sensitivity was 96.5% (95% CI 92.0-98.9%). Sensitivity for samples with ≤ 200 parasites/µL (n = 26) was 84.6% (95% CI 65.1-95.6%), with the lowest parasitaemia detected at 18/µL. Limit-of-detection (n = 20) was 33 parasites/µL (95% CI 16-65%). The Gazelle device has the potential for rapid, sensitive detection of P. knowlesi infections in endemic areas.
    Matched MeSH terms: Point-of-Care Systems
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