scholarly journals Assessing the Reliability of Commercially Available Point of Care in Various Clinical Fields

2019 ◽  
Vol 12 (1) ◽  
pp. 342-368
Author(s):  
Federica Pezzuto ◽  
Antonio Scarano ◽  
Carlotta Marini ◽  
Giacomo Rossi ◽  
Roberta Stocchi ◽  
...  
Keyword(s):  
Biological Fluids ◽  
Point Of Care ◽  
Turnaround Time ◽  
Sample Volume ◽  
Good Reliability ◽  
Disease Identification ◽  
Great Relevance ◽  
Key Features ◽  
Fast Turnaround Time

a Updated and precise molecular diagnostics are essential in disease identification, treatment and management. Conventional technologies are limited to laboratories, which are expensive, require moderate to great volumes of biological fluids and generally create great discomfort among patients. This review discusses some key features of commercially available point of care (POC) devices, such as time to provide results, accuracy and imprecision, in several medical and veterinary fields. We searched Pubmed/Medline using the keywords “point” “of” “care” “device”, selected papers from 1984 to 2019 on the basis of their content and summarized the features in tables. Fast turnaround time and overall good reliability, in terms of accuracy and imprecision, were observed for most of POCs included in the research. POC devices are particularly useful for clinicians since they hold the potential to deliver rapid and accurate results in an inexpensive and less invasive way with an overall improvement of patients' quality of life in terms of time spent at the point-of-care and sample volume withdrawn. These features gain great relevance also in the veterinary practice, where patients’ compliance is generally poor, available sample volumes are quite far from the human ones and analysis costs are higher.

scholarly journals Clinical evaluation of serial blood processing at point of care

1997 ◽  
Vol 43 (2) ◽  
pp. 360-362 ◽  
Author(s):  
Christopher A Estey ◽  
Robin A Felder
Keyword(s):  
Clinical Performance ◽  
Point Of Care ◽  
Turnaround Time ◽  
University Of Virginia ◽  
Community Based ◽  
Blood Separation ◽  
The North ◽  
Blood Specimens ◽  
The University

Abstract The Axial Separation Module (ASM™), which separates whole-blood specimens serially in Axial Process Containers (APC™), was evaluated for clinical performance at the University of Virginia Health Sciences Center (UVA HSC) in a community-based outpatient laboratory (North Ridge Clinic). We hypothesized that moving the task of blood separation to point of care would reduce specimen turnaround time within the main laboratory. Blood drawn into an APC was separated in the ASM at point of care at the North Ridge Clinic. Blood drawn into a Vacutainer Tube™was separated in a conventional centrifuge at the main laboratory. Turnaround time was calculated for the “chem 17” test from files stored in our laboratory information system. Blood serially separated at point of care yielded turnaround time savings for specimens originating from the North Ridge Clinic. Average turnaround time decreased by 24%. Phlebotomists found no appreciable workload increase from incorporating the ASM as a point-of-care blood separation device. Phlebotomists also found that they could immediately detect hemolysis. We concluded that serial separation at point of care reduces specimen turnaround time at the main laboratory. The ASM/APC was found to be better suited for point-of-care blood separation than a conventional centrifuge. We speculate that immediate blood separation has the potential to improve the quality of analytical results.

scholarly journals Challenges to Glycemic Measurement in the Perioperative and Critically Ill Patient: A Review

2009 ◽  
Vol 3 (6) ◽  
pp. 1270-1281 ◽  
Author(s):  
Andrew D. Pitkin ◽  
Mark J. Rice
Keyword(s):  
Point Of Care ◽  
Turnaround Time ◽  
Sample Volume ◽  
Hospital Environment ◽  
Glucose Measurement ◽  
Critically Ill Patient ◽  
Central Laboratory ◽  
Patients With Diabetes ◽  
Measurement Devices ◽  
Glucose Management

Accurate monitoring of glucose in the perioperative environment has become increasingly important over the last few years. Because of increased cost, turnaround time, and sample volume, the use of central laboratory devices for glucose measurement has been somewhat supplanted by point-of-care (POC) glucose devices. The trade-off in moving to these POC systems has been a reduction in accuracy, especially in the hypoglycemic range. Furthermore, many of these POC devices were originally developed, marketed, and received Food and Drug Administration regulatory clearance as home use devices for patients with diabetes. Without further review, many of these POC glucose measurement devices have found their way into the hospital environment and are used frequently for measurement during intense insulin therapy, where accurate measurements are critical. This review covers the technology behind glucose measurement and the evidence questioning the use of many POC devices for perioperative glucose management.

scholarly journals Improving the Preanalytical Process: The Focus on Specimen Quality

2008 ◽  
Vol 27 (3) ◽  
pp. 343-347 ◽  
Author(s):  
Sol Green
Keyword(s):  
Medical Practice ◽  
Cost Reduction ◽  
Clinical Laboratory ◽  
Turnaround Time ◽  
Sample Volume ◽  
Laboratory Practice ◽  
Assay Sensitivity ◽  
Preanalytical Phase ◽  
Specimen Quality

Improving the Preanalytical Process: The Focus on Specimen Quality Trends in clinical laboratory practice place more demands on the quality of patient specimens. Advances in analytical performance (i.e., increased automation, reduced sample volume, increased assay sensitivity), as well as efficiency and cost reduction gains (i.e., throughput, test turnaround time) have improved medical practice. These changes, however, have caused an increased incidence of preanalytical errors, dictating the need for higher-quality specimens. The following paper addresses these errors in addition to methodologies for improving the quality of the preanalytical phase.

scholarly journals Nanoswitch-linked immunosorbent assay (NLISA) for fast, sensitive, and specific protein detection

2017 ◽  
Vol 114 (39) ◽  
pp. 10367-10372 ◽  
Author(s):  
Clinton H. Hansen ◽  
Darren Yang ◽  
Mounir A. Koussa ◽  
Wesley P. Wong
Keyword(s):  
Immunosorbent Assay ◽  
Biological Fluids ◽  
Point Of Care ◽  
Specific Antigen ◽  
Protein Detection ◽  
Basic Research ◽  
Specific Protein ◽  
Sample Volume ◽  
Cross Reactivity ◽  
Single Mutation

Protein detection and quantification play critical roles in both basic research and clinical practice. Current detection platforms range from the widely used ELISA to more sophisticated, and more expensive, approaches such as digital ELISA. Despite advances, there remains a need for a method that combines the simplicity and cost-effectiveness of ELISA with the sensitivity and speed of modern approaches in a format suitable for both laboratory and rapid, point-of-care applications. Building on recent developments in DNA structural nanotechnology, we introduce the nanoswitch-linked immunosorbent assay (NLISA), a detection platform based on easily constructed DNA nanodevices that change conformation upon binding to a target protein with the results read out by gel electrophoresis. NLISA is surface-free and includes a kinetic-proofreading step for purification, enabling both enhanced sensitivity and reduced cross-reactivity. We demonstrate femtomolar-level detection of prostate-specific antigen in biological fluids, as well as reduced cross-reactivity between different serotypes of dengue and also between a single-mutation and wild-type protein. NLISA is less expensive, uses less sample volume, is more rapid, and, with no washes, includes fewer hands-on steps than ELISA, while also achieving superior sensitivity. Our approach also has the potential to enable rapid point-of-care assays, as we demonstrate by performing NLISA with an iPad/iPhone camera for imaging.

An Initial Investigation of the Use of Comparative Referents to Assess Social Anxiety

2018 ◽  
Vol 34 (6) ◽  
pp. 367-375 ◽  
Author(s):  
Laura D. Seligman ◽  
Erin F. Swedish ◽  
Jason P. Rose ◽  
Jessica M. Baker
Keyword(s):  
Social Anxiety ◽  
Discriminant Validity ◽  
Self Report ◽  
Injunctive Norms ◽  
Good Reliability ◽  
Convergent And Discriminant Validity ◽  
Excellent Internal Consistency ◽  
Social Quality Of Life ◽  
Comparison Measures

Abstract. The current study examined the validity of two self-report measures of social anxiety constructed using social comparative referent points. It was hypothesized that these comparison measures would be both reliable and valid. Results indicated that two different comparative versions – one invoking injunctive norms and another invoking descriptive norms – showed good reliability, excellent internal consistency, and acceptable convergent and discriminant validity. The comparative measures also predicted positive functioning, some aspects of social quality of life, and social anxiety as measured by an independent self-report. These findings suggest that adding a comparative reference point to instructions on social anxiety measures may aid in the assessment of social anxiety.

Methods for the Determination of the Purity of Exosomes

2020 ◽  
Vol 25 (42) ◽  
pp. 4464-4485 ◽  
Author(s):  
Katarzyna Kluszczyńska ◽  
Liliana Czernek ◽  
Wojciech Cypryk ◽  
Łukasz Pęczek ◽  
Markus Düchler
Keyword(s):  
Drug Transport ◽  
Biological Fluids ◽  
Drug Carriers ◽  
Biological Functions ◽  
Isolation And Purification ◽  
Pubmed Database ◽  
High Concentrations ◽  
Targeted Release

Background: Exosomes open exciting new opportunities for advanced drug transport and targeted release. Furthermore, exosomes may be used for vaccination, immunosuppression or wound healing. To fully utilize their potential as drug carriers or immune-modulatory agents, the optimal purity of exosome preparations is of crucial importance. Methods: Articles describing the isolation and purification of exosomes were retrieved from the PubMed database. Results: Exosomes are often separated from biological fluids containing high concentrations of proteins, lipids and other molecules that keep vesicle purification challenging. A great number of purification protocols have been published, however, their outcome is difficult to compare because the assessment of purity has not been standardized. In this review, we first give an overview of the generation and composition of exosomes, as well as their multifaceted biological functions that stimulated various medical applications. Finally, we describe various methods that have been used to purify small vesicles and to assess the purity of exosome preparations and critically compare the quality of these evaluation protocols. Conclusion: Combinations of various techniques have to be applied to reach the required purity and quality control of exosome preparations.

Analytical Methods for the Determination of Sartans in Pharmaceutical Formulations and Biological Fluids: A Review

2020 ◽  
Vol 16 (3) ◽  
pp. 208-222
Author(s):  
Miglena Smerikarova ◽  
Stanislav Bozhanov ◽  
Vania Maslarska
Keyword(s):  
Biological Fluids ◽  
Pharmaceutical Preparations ◽  
Improve Patient Care ◽  
Pharmaceutical Formulations ◽  
Treatment Of Hypertension ◽  
Therapeutic Doses ◽  
Reliable Methods ◽  
Improve Patient

Background: Sartans are mostly used as a part of combination with additional medicines in the therapy of essencial hypertension. Preferred combinations are ARB and thiazide diuretics (Hydrochlorothiazide (HCT) and Chlorthalidone (CHL)) or ARB and calcium antagonists. The number of sartans mostly prescribed by specialists is only seven - Candesartan (CDS), Eprosartan (EPS), Irbesartan (IBS), Losartan (LOS), Olmesartan (OMS), Telmisartan (TMS) and Valsartan (VLS). Methods: The widespread use of sartans in the treatment of hypertension requires reliable methods of analysis. Bulk drugs and pharmaceutical preparations should be analyzed to ensure the quality of the medicinal products reaching patients. On the other hand, the analysis of drugs in biological fluids aims to trace and improve patient care by adjusting the therapeutic doses of drugs. According to our knowledge, a review devoted to the analysis of sartans was published in 2014. Results: Spectral methods are widely used in the analysis of bulk drugs and pharmaceutical dosage forms due to their relatively simple procedures, low reagent and sample consumption, speed, precision and accuracy combined with accessibility and comparatively low cost of common apparatus. Many papers for determination of sartans in bulk drugs and pharmaceutical preparations based on liquid chromatographic techniques were published in the available literature. Among these methods, HPLC takes the leading place but UPLC and HPTLC are also present. Conclusion: The widespread use of sartans in the treatment of hypertension requires reliable methods of analysis. Bulk drugs and pharmaceutical preparations should be analyzed to ensure the quality of the medicinal products reaching patients. On the other hand, the analysis of drugs in biological fluids aims to trace and improve patient care by adjusting the therapeutic doses of drugs. Since 2014, many articles have been published on the sartans analysis and this provoked our interest to summarize the latest applications in the analysis of sartans in pharmaceutical formulations and biological media. Articles published from 2014 to 2018 are covered.

scholarly journals Making sense of rapid antigen testing in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostics

Diagnosis ◽  
2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Camilla Mattiuzzi ◽  
Brandon M. Henry ◽  
Giuseppe Lippi
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Point Of Care ◽  
Turnaround Time ◽  
Molecular Testing ◽  
Upper Respiratory Tract ◽  
Making Sense ◽  
Skilled Personnel ◽  
Potential Benefits ◽  
Antigen Testing ◽  
Care Availability

AbstractAlthough the most effective strategy for preventing or containing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks relies on early diagnosis, the paramount and unprecedented number of tests needed to fully achieve this target is overwhelming worldwide testing supply and capacity. Molecular detection of SARS-CoV-2 RNA in nasopharyngeal swabs is still considered the reference diagnostic approach. Nonetheless, identification of SARS-CoV-2 proteins in upper respiratory tract specimens and/or saliva by means of rapid (antigen) immunoassays is emerging as a promising screening approach. These tests have some advantages compared to molecular analysis, such as point of care availability, no need of skilled personnel and dedicated instrumentation, lower costs and short turnaround time. However, these advantages are counterbalanced by lower diagnostic sensitivity compared to molecular testing, which would only enable to identifying patients with higher SARS-CoV-2 viral load. The evidence accumulated to-date has hence persuaded us to develop a tentative algorithm, which would magnify the potential benefits of rapid antigen testing in SARS-CoV-2 diagnostics.

Comparison of 2 glucose analytical methodologies in immature Kemp’s ridley sea turtles: dry chemistry of plasma versus point-of-care glucometer analysis of whole blood

2021 ◽  
pp. 104063872110018
Author(s):  
Justin R. Perrault ◽  
Michael D. Arendt ◽  
Jeffrey A. Schwenter ◽  
Julia L. Byrd ◽  
Kathryn A. Tuxbury ◽  
...  
Keyword(s):  
Whole Blood ◽  
Point Of Care ◽  
Sea Turtles ◽  
Sample Volume ◽  
Specific Reference ◽  
Volume Data ◽  
Analytical Methodology ◽  
Glucose Determination ◽  
Kemp's Ridley Sea Turtles ◽  
Kemp's Ridley

Blood glucose measurements provide important diagnostic information regarding stress, disease, and nutritional status. Glucose analytical methodologies include dry chemistry analysis (DCA) of plasma and point-of-care (POC) glucometer analysis of whole blood; however, these 2 methods differ in cost, required sample volume, and processing time. Because POC glucometers use built-in equations based on features of mammalian blood to convert whole blood measurements to plasma equivalent units, obtained glucose data must be compared and validated using gold-standard chemistry analytical methodology in reptiles. For in-water, trawl-captured, immature Kemp’s ridley sea turtles ( Lepidochelys kempii) from Georgia, USA, we observed significant, positive agreement between the 2 glucose determination methods; however, the glucometer overestimated glucose concentrations by 1.4 mmol/L on average in comparison to DCA and produced a wider range of results. The discordance of these results suggests that POC glucometer glucose data should be interpreted in the context of methodology- and brand-specific reference intervals along with concurrent packed cell volume data.

scholarly journals Family reported outcomes, an unmet need in the management of a patient's disease: appraisal of the literature

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
R. Shah ◽  
F. M. Ali ◽  
A. Y. Finlay ◽  
M. S. Salek
Keyword(s):  
Quality Of Life ◽  
Family Members ◽  
Unmet Need ◽  
Reliability And Validity ◽  
Chronic Health Condition ◽  
Family Quality Of Life ◽  
Good Reliability ◽  
Huge Impact ◽  
The Impact

Abstract Background A person’s chronic health condition or disability can have a huge impact on the quality of life (QoL) of the whole family, but this important impact is often ignored. This literature review aims to understand the impact of patients' disease on family members across all medical specialities, and appraise existing generic and disease-specific family quality of life (QoL) measures. Methods The databases Medline, EMBASE, CINHAL, ASSIA, PsycINFO and Scopus were searched for original articles in English measuring the impact of health conditions on patients' family members/partner using a valid instrument. Results Of 114 articles screened, 86 met the inclusion criteria. They explored the impact of a relative's disease on 14,661 family members, mostly 'parents' or 'mothers', using 50 different instruments across 18 specialities including neurology, oncology and dermatology, in 33 countries including the USA, China and Australia. These studies revealed a huge impact of patients' illness on family members. An appraisal of family QoL instruments identified 48 instruments, 42 disease/speciality specific and six generic measures. Five of the six generics are aimed at carers of children, people with disability or restricted to chronic disease. The only generic instrument that measures the impact of any condition on family members across all specialities is the Family Reported Outcome Measure (FROM-16). Although most instruments demonstrated good reliability and validity, only 11 reported responsiveness and only one reported the minimal clinically important difference. Conclusions Family members' QoL is greatly impacted by a relative's condition. To support family members, there is a need for a generic tool that offers flexibility and brevity for use in clinical settings across all areas of medicine. FROM-16 could be the tool of choice, provided its robustness is demonstrated with further validation of its psychometric properties.

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