A SIMPLE FINGER STICK, POINT-OF-CARE, ASSAY FOR IDENTIFYING PATIENTS AT RISK FOR ALPHA-1 ANTITRYPSIN (A1AT) DEFICIENCY

AbstractCancer is the third leading cause of death in Kenya. However, there is scarce information on the nutritional status of cancer patients to guide in decision making. The present study sought to assess the risk of malnutrition, and factors associated with malnutrition and cachexia, among cancer out-patients, with the aim of informing nutrition programmes for cancer management in Kenya and beyond. This was a facility-based cross-sectional study performed at Kenyatta National Hospital and Texas Cancer Centre in Nairobi, Kenya. The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool (MUST). Diagnoses of malnutrition and cachexia were done using the European Society of Clinical Nutrition and Metabolism (ESPEN) and Fearon criteria, respectively. A total of 512 participants were assessed. Those at risk of malnutrition were 33·1 % (12·5 % at medium risk, 20·6 % at high risk). Prevalence of malnutrition was 13·4 %. The overall weight loss >5 % over 3 months was 18·2 % and low fat-free mass index was 43·1 %. Prevalence of cachexia was 14·1 % compared with 8·5 % obtained using the local criteria. Only 18·6 % participants had received any form of nutrition services. Age was a predictor of malnutrition and cachexia in addition to site of cancer for malnutrition and cigarette smoking for cachexia. The use of the MUST as a screening tool at the first point of care should be explored. The predictive value of current nutrition assessment tools, and the local diagnostic criteria for malnutrition and cachexia should be reassessed to inform the development of appropriate clinical guidelines and future capacity-building initiatives that will ensure the correct identification of patients at risk for timely care.

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Evaluation of the Xpert HCV Viral Load point-of-care assay from venepuncture-collected and finger-stick capillary whole-blood samples: a cohort study

The Lancet Gastroenterology & Hepatology ◽

10.1016/s2468-1253(17)30075-4 ◽

2017 ◽

Vol 2 (7) ◽

pp. 514-520 ◽

Cited By ~ 89

Author(s):

Jason Grebely ◽

Francois M J Lamoury ◽

Behzad Hajarizadeh ◽

Yasmin Mowat ◽

Alison D Marshall ◽

...

Keyword(s):

Cohort Study ◽

Viral Load ◽

Whole Blood ◽

Point Of Care ◽

Blood Samples ◽

Load Point ◽

Whole Blood Samples ◽

Finger Stick ◽

Point Of Care Assay

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Acceptability of blood-based HIV self-testing among adolescents aged 15–19 years at risk of HIV acquisition in Bangkok

International Journal of STD & AIDS ◽

10.1177/09564624211003742 ◽

2021 ◽

pp. 095646242110037

Author(s):

Pongpak Phongphiew ◽

Wipaporn N Songtaweesin ◽

Nantika Paiboon ◽

Panyaphon Phiphatkhunarnon ◽

Patchareeyawan Srimuan ◽

...

Keyword(s):

At Risk ◽

Point Of Care ◽

Cross Sectional Study ◽

Hiv Treatment ◽

Cross Sectional ◽

Sex With Men ◽

Finger Stick ◽

Hiv Acquisition ◽

Risk Of Hiv Acquisition ◽

Antibody Tests

Introduction: Young men who have sex with men (YMSM) and young transgender women (YTGW) in Thailand are at high HIV risk. HIV self-tests (HIVSTs) are rapidly administrable and prompt linkage to HIV treatment or prevention services. This study assesses the acceptability and feasibility of blood-based HIVST use in adolescents. Methods: A cross-sectional study was conducted among YMSM and YTGW aged 15–19 years with HIV acquisition risk. Participants completed questionnaires on the HIVST and then administered INSTI® independently, an HIVST immunoassay detecting gp41 and gp36 antibodies from finger-stick blood. Confirmatory HIV antibody tests were performed. Results: Between July and September 2020, 90 adolescents were enrolled. Mean (SD) age was 17.6 (1.1) years. Half ( N = 45) were YMSM. Forty-six (51%) were first-time HIV testers, and 32 (36%) had “ever used” HIV pre-exposure prophylaxis (PrEP). Two (2.2%, 95% CI: 0.0–5.3) tested positive, 21 (23.4%) invalid, and 67 (74.4%) negative. Invalidity causes included 17 (81%) insufficient blood, 3 (14%) buffer spillage, and 1 (5%) procedural missteps; all had negative HIV antibody tests. HIV self-test acceptability was 87.8% (95% CI: 81.0–94.5). Most (79%) preferred HIVST performance in hospital rather than at home. Conclusions: HIVSTs are acceptable in HIV at-risk adolescents. Blood-based HIVSTs should be positioned as rapid point-of-care tests with real-time linkage to HIV services.

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Evaluation of a New Point-of-care Test that Measures PAF-mediated Acceleration of Coagulation in Cardiac Surgical Patients

Anesthesiology ◽

10.1097/00000542-199612000-00012 ◽

1996 ◽

Vol 85 (6) ◽

pp. 1311-1323. ◽

Cited By ~ 75

Author(s):

George J. Despotis ◽

Vladimir Levine ◽

Kriton S. Filos ◽

Samuel A. Santoro ◽

J. Heinrich Joist ◽

...

Keyword(s):

At Risk ◽

Blood Loss ◽

Platelet Transfusion ◽

Point Of Care ◽

Postoperative Blood Loss ◽

Clotting Time ◽

Point Of Care Test ◽

Activated Clotting Time ◽

Patients At Risk ◽

Excessive Blood Loss

Background This study was designed to evaluate a new point-of-care test (HemoSTATUS) that assesses acceleration of kaolin-activated clotting time (ACT) by platelet activating factor (PAF) in patients undergoing cardiac surgery. Our specific objectives were to determine whether HemoSTATUS-derived measurements correlate with postoperative blood loss and identify patients at risk for excessive blood loss and to characterize the effect of desmopressin acetate (DDAVP) and/or platelet transfusion on these measurements. Methods Demographic, operative, blood loss and hematologic data were recorded in 150 patients. Two Hepcon instruments were used to analyze ACT values in the absence (channels 1 and 2: Ch1 and Ch2) and in the presence of increasing doses of PAF (1.25, 6.25, 12.5, and 150 nM) in channels 3-6 (Ch3-Ch6). Clot ratio (CR) values were calculated with the following formula for each respective PAF concentration: clot ratio = 1-(ACT/control ACT). These values also were expressed as percent of maximal (%M = clot ratio/0.51 x 100) using the mean CRCh6 (0.51) obtained in a reference population. Results When compared with baseline clot ratios before anesthetic induction, a marked reduction in clot ratios was observed in both Ch5 and Ch6 after protamine administration, despite average platelet counts greater than 100 K/microliter. There was a high degree of correlation between clot ratio values and postoperative blood loss (cumulative chest tube drainage in the first 4 postoperative hours) with higher concentrations of PAF: CRCh6 (r = -0.80), %M of CRCh6 (r = -0.82), CRCh5 (r = -0.70), and %M of CRCh5 (r = -0.85). A significant (P < 0.01) improvement in clot ratios was observed with time after arrival in the intensive care unit in both Ch5 and Ch6, particularly in patients receiving DDAVP and/or platelets. Conclusions Activated clotting time-based clot ratio values correlate significantly with postoperative blood loss and detect recovery of PAF-accelerated coagulation after administration of DDAVP or platelet therapy. The HemoSTATUS assay may be useful in the identification of patients at risk for excessive blood loss and who could benefit from administration of DDAVP and/or platelet transfusion.

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Faculty Opinions recommendation of Evaluation of the Xpert HCV Viral Load point-of-care assay from venepuncture-collected and finger-stick capillary whole-blood samples: a cohort study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727572363.793553789 ◽

2018 ◽

Author(s):

Norah Terrault

Keyword(s):

Cohort Study ◽

Viral Load ◽

Whole Blood ◽

Point Of Care ◽

Blood Samples ◽

Load Point ◽

Whole Blood Samples ◽

Finger Stick ◽

Point Of Care Assay

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LOX-1+ immature neutrophils predict severe COVID-19 patients at risk of thrombotic complications

10.1101/2020.09.15.293100 ◽

2020 ◽

Author(s):

Béhazine Combadiere ◽

Lucille Adam ◽

Paul Quentric ◽

Pierre Rosenbaum ◽

Karim Dorgham ◽

...

Keyword(s):

At Risk ◽

Point Of Care ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Clinical Severity ◽

Icu Patients ◽

Neutrophil Lymphocyte Ratio ◽

Density Lipoprotein Receptor ◽

Patients At Risk ◽

Thrombotic Complications

AbstractRationalLymphopenia and neutrophil/lymphocyte ratio may have prognostic value in coronavirus disease 2019 (COVID-19) severity.ObjectiveWe sought to investigate the representation of neutrophil subsets in severe and critical COVID-19 patients based on Intensive Care Units (ICU) and non-ICU admission.MethodsWe developed a multi-parametric neutrophil profiling strategy based on known neutrophil markers to distinguish COVID-19 phenotypes in critical and severe patients.ResultsOur results showed that 80% of ICU patients develop strong myelemia with CD10−CD64+ immature neutrophils. Cellular profiling revealed two distinct neutrophil subsets expressing either the lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) or the Interleukin-3 receptor alpha (CD123), both significantly overrepresented in ICU patients compared to non-ICU patients. The proportion of LOX-1-expressing immature neutrophils positively correlated with clinical severity, with the cytokine storm (IL-1β, IL-6, IL-8, TNFα), and with intravascular coagulation. Importantly, high proportions of LOX-1+-immature neutrophils are associated with high risks of severe thrombosis.ConclusionsTogether these data suggest that point of care enumeration of LOX-1-immature neutrophils might help distinguish patients at risk of thrombosis complication and most likely to benefit from intensified anticoagulant therapy.

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