Displaying publications 1 - 20 of 72 in total

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  1. Ong YN, James V, Lau KS, Chor YK, Ong GY
    Pediatr Emerg Care, 2022 Apr 01;38(4):183-186.
    PMID: 34608058 DOI: 10.1097/PEC.0000000000002555
    Abdominal pain is one of the most common presenting complaints encountered in the pediatric emergency department. The use of point-of-care ultrasonography by emergency physicians has been shown to expedite the diagnosis of a large variety of conditions and can be used to accurately identify intra-abdominal pathology in children. We describe the case of a pediatric patient who presented to the pediatric emergency department with acute abdominal pain, in whom point-of-care ultrasonography helped expedite the diagnosis of acute portal vein thrombosis and liver abscess.
    Matched MeSH terms: Point-of-Care Systems*
  2. Gan RK, Sanchez Martinez A, Abu Hasan MA, Castro Delgado R, Arcos González P
    J Ultrasound, 2023 Jun;26(2):343-353.
    PMID: 36694072 DOI: 10.1007/s40477-022-00761-5
    INTRODUCTION: Necrotizing fasciitis (NF) is a rapidly progressive necrosis of the fascial layer with a high mortality rate. It is a life-threatening medical emergency that requires urgent treatment. Lack of skin finding in NF made diagnosis difficult and required a high clinical index of suspicion. The use of ultrasound may guide clinicians in improving diagnostic speed and accuracy, thus leading to improved management decisions and patient outcomes. This literature search aims to review the use of point-of-care ultrasonography in diagnosing necrotizing fasciitis.

    METHOD: We searched relevant electronic databases, including PUBMED, MEDLINE, and SCOPUS, and performed a systematic review. Keywords used were "necrotizing fasciitis" or "necrotising fasciitis" or "necrotizing soft tissue infections" and "point-of-care ultrasonography" "ultrasonography" or "ultrasound". No temporal limitation was set. An additional search was performed via google scholar, and the top 100 entry was screened.

    RESULTS: Among 540 papers screened, only 21 were related to diagnosing necrotizing fasciitis using ultrasonography. The outcome includes three observational studies, 16 case reports, and two case series, covering the period from 1976 to 2022.

    CONCLUSION: Although the use of ultrasonography in diagnosing NF was published in several papers with promising results, more studies are required to investigate its diagnostic accuracy and potential to reduce time delay before surgical intervention, morbidity, and mortality.

    Matched MeSH terms: Point-of-Care Systems*
  3. Lai AKH, Noor Azhar AMB, Bustam AB, Tiong XT, Chan HC, Ahmad RB, et al.
    BMC Med Educ, 2020 Aug 12;20(1):263.
    PMID: 32787921 DOI: 10.1186/s12909-020-02173-7
    BACKGROUND: Although gamification increases user engagement, its effectiveness in point-of-care ultrasonographic training has yet to be fully established. This study was conducted with the primary outcome of evaluating its effectiveness in point-of-care ultrasonographic training as compared to conventional approach.

    METHODS: Participants consisting of junior doctors were randomized into either the (1) gamified or the (2) conventional educational approach for ultrasonographic training.

    RESULTS: A total of 31 junior doctors participated in this study (16 participants in gamified arm, 15 in the conventional arm after one participant from the conventional arm dropped out due to work commitment). Two-way mixed ANOVA test showed that there was no statistically significant interaction between the types of educational approach and time of testing (pre-test, post-test, 2 months post-training) for both theoretical knowledge score and practical skills score, with F(2, 58) = 39.6, p point-of-care ultrasonographic training.

    Matched MeSH terms: Point-of-Care Systems*
  4. Zainol Abidin AS, Rahim RA, Md Arshad MK, Fatin Nabilah MF, Voon CH, Tang TH, et al.
    Sensors (Basel), 2017 May 22;17(5).
    PMID: 28531146 DOI: 10.3390/s17051180
    Anxiety is a psychological problem that often emerges during the normal course of human life. The detection of anxiety often involves a physical exam and a self-reporting questionnaire. However, these approaches have limitations, as the data might lack reliability and consistency upon application to the same population over time. Furthermore, there might be varying understanding and interpretations of the particular question by the participant, which necessitating the approach of using biomarker-based measurement for stress diagnosis. The most prominent biomarker related to stress, hormone cortisol, plays a key role in the fight-or-flight situation, alters the immune response, and suppresses the digestive and the reproductive systems. We have taken the endeavour to review the available aptamer-based biosensor (aptasensor) for cortisol detection. The potential point-of-care diagnostic strategies that could be harnessed for the aptasensing of cortisol were also envisaged.
    Matched MeSH terms: Point-of-Care Systems*
  5. Citartan M
    Talanta, 2021 Sep 01;232:122436.
    PMID: 34074421 DOI: 10.1016/j.talanta.2021.122436
    Dot blot assays have always been associated with antibodies as the main molecular recognition element, which are widely employed in a myriad of diagnostic applications. With the rising of aptamers as the equivalent molecular recognition elements of antibodies, dot blot assays are also one of the diagnostic avenues that should be scrutinized for their amenability with aptamers as the potential surrogates of antibodies. In this review, the stepwise procedures of an aptamer-based dot blot assays are underscored before reviewing the existing aptamer-based dot blot assays developed so far. Most of the applications center on monitoring the progress of SELEX and as the validatory assays to assess the potency of aptamer candidates. For the purpose of diagnostics, the current effort is still languid and as such possible suggestions to galvanize the move to spur the aptamer-based dot blot assays to a point-of-care arena are discussed.
    Matched MeSH terms: Point-of-Care Systems
  6. Choi JR, Hu J, Tang R, Gong Y, Feng S, Ren H, et al.
    Lab Chip, 2016 Feb 7;16(3):611-21.
    PMID: 26759062 DOI: 10.1039/c5lc01388g
    With advances in point-of-care testing (POCT), lateral flow assays (LFAs) have been explored for nucleic acid detection. However, biological samples generally contain complex compositions and low amounts of target nucleic acids, and currently require laborious off-chip nucleic acid extraction and amplification processes (e.g., tube-based extraction and polymerase chain reaction (PCR)) prior to detection. To the best of our knowledge, even though the integration of DNA extraction and amplification into a paper-based biosensor has been reported, a combination of LFA with the aforementioned steps for simple colorimetric readout has not yet been demonstrated. Here, we demonstrate for the first time an integrated paper-based biosensor incorporating nucleic acid extraction, amplification and visual detection or quantification using a smartphone. A handheld battery-powered heating device was specially developed for nucleic acid amplification in POC settings, which is coupled with this simple assay for rapid target detection. The biosensor can successfully detect Escherichia coli (as a model analyte) in spiked drinking water, milk, blood, and spinach with a detection limit of as low as 10-1000 CFU mL(-1), and Streptococcus pneumonia in clinical blood samples, highlighting its potential use in medical diagnostics, food safety analysis and environmental monitoring. As compared to the lengthy conventional assay, which requires more than 5 hours for the entire sample-to-answer process, it takes about 1 hour for our integrated biosensor. The integrated biosensor holds great potential for detection of various target analytes for wide applications in the near future.
    Matched MeSH terms: Point-of-Care Systems*
  7. Citartan M, Tang TH
    Talanta, 2019 Jul 01;199:556-566.
    PMID: 30952298 DOI: 10.1016/j.talanta.2019.02.066
    Aptamers are nucleic acid-based molecular recognition elements that are specific and have high binding affinity against their respective targets. On account of their target recognition capacity, aptamers are widely utilized in a number of applications including diagnostics. This review aims to highlight the recent developments of aptasensors expedient for point-of-care (POC) diagnostics. Significant focus is given on the primary assay formats of aptamers such as fluorescence, electrochemical, surface plasmon resonance (SPR) and colorimetric assays. A potpourri of platforms such as paper-based device, lateral flow assay, portable electrodes, portable SPR and smart phones expedient for point-of-care (POC) diagnostics are discussed. Emphasis is also given on the technicalities and assay configurations associated with the sensors.
    Matched MeSH terms: Point-of-Care Systems*
  8. Yap BK, M Soair SN, Talik NA, Lim WF, Mei I L
    Sensors (Basel), 2018 Aug 10;18(8).
    PMID: 30103424 DOI: 10.3390/s18082625
    Over the past 20 years, rapid technological advancement in the field of microfluidics has produced a wide array of microfluidic point-of-care (POC) diagnostic devices for the healthcare industry. However, potential microfluidic applications in the field of nutrition, specifically to diagnose iron deficiency anemia (IDA) detection, remain scarce. Iron deficiency anemia is the most common form of anemia, which affects billions of people globally, especially the elderly, women, and children. This review comprehensively analyzes the current diagnosis technologies that address anemia-related IDA-POC microfluidic devices in the future. This review briefly highlights various microfluidics devices that have the potential to detect IDA and discusses some commercially available devices for blood plasma separation mechanisms. Reagent deposition and integration into microfluidic devices are also explored. Finally, we discuss the challenges of insights into potential portable microfluidic systems, especially for remote IDA detection.
    Matched MeSH terms: Point-of-Care Systems*
  9. Fraga MV, Stoller JZ, Glau CL, De Luca D, Rempell RG, Wenger JL, et al.
    Pediatrics, 2019 11;144(5).
    PMID: 31615954 DOI: 10.1542/peds.2019-1401
    Point-of-care ultrasound is currently widely used across the landscape of pediatric care. Ultrasound machines are now smaller, are easier to use, and have much improved image quality. They have become common in emergency departments, ICUs, inpatient wards, and outpatient clinics. Recent growth of supportive evidence makes a strong case for using point-of-care ultrasound for pediatric interventions such as vascular access (in particular, central-line placement), lumbar puncture, fluid drainage (paracentesis, thoracentesis, pericardiocentesis), suprapubic aspiration, and soft tissue incision and drainage. Our review of this evidence reveals that point-of-care ultrasound has become a powerful tool for improving procedural success and patient safety. Pediatric patients and clinicians performing procedures stand to benefit greatly from point-of-care ultrasound, because seeing is believing.
    Matched MeSH terms: Point-of-Care Systems*
  10. Balakrishnan P, Saravanan S, Vignesh R, Shankar EM
    Indian J Med Res, 2023 Nov 01;158(5&6):447-450.
    PMID: 38063301 DOI: 10.4103/ijmr.ijmr_1616_23
    Matched MeSH terms: Point-of-Care Systems*
  11. 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
  12. 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
  13. 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
  14. 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
  15. 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
  16. 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
  17. 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
  18. 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
  19. Che Engku Noramalina Che-Engku-Chik, Siti Sarah Othman, Helmi Wasoh, Nor Azah Yusof, Jaafar Abdullah, Mohd Hazani Mat Zaid
    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
  20. Obande GA, Banga Singh KK
    Infect Drug Resist, 2020;13:455-483.
    PMID: 32104017 DOI: 10.2147/IDR.S217571
    Nucleic acid amplification technology (NAAT) has assumed a critical position in disease diagnosis in recent times and contributed significantly to healthcare. Application of these methods has resulted in a more sensitive, accurate and rapid diagnosis of infectious diseases than older traditional methods like culture-based identification. NAAT such as the polymerase chain reaction (PCR) is widely applied but seldom available to resource-limited settings. Isothermal amplification (IA) methods provide a rapid, sensitive, specific, simpler and less expensive procedure for detecting nucleic acid from samples. However, not all of these IA techniques find regular applications in infectious diseases diagnosis. Disease diagnosis and treatment could be improved, and the rapidly increasing problem of antimicrobial resistance reduced, with improvement, adaptation, and application of isothermal amplification methods in clinical settings, especially in developing countries. This review centres on some isothermal techniques that have found documented applications in infectious diseases diagnosis, highlighting their principles, development, strengths, setbacks and imminent potentials for use at points of care.
    Matched MeSH terms: Point-of-Care Systems
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