scholarly journals The pragmatic role of nasal cytology: a point-of-care testing to implement precision medicine in clinical practice

2018 ◽  
Vol 65 (3) ◽  
pp. 179 ◽  
Author(s):  
Matteo Gelardi ◽  
Massimo Landi ◽  
Giorgio Ciprandi
Keyword(s):  
Clinical Practice ◽  
Precision Medicine ◽  
Point Of Care ◽  
Point Of Care Testing ◽  
Nasal Cytology

Antecedentes: La medicina de precisión es una estrategia actualizada que apunta a individualizar los mecanismos fisiopatológicos precisos. Entonces, la medicina de precisión es la base de la medicina personalizada, como definir el tratamiento apropiado en cada paciente. La citología nasal solo necesita un microscopio óptico, tinturas, gafas y curetas. El procedimiento puede durar muy pocos minutos usando tinción rápida, por lo tanto, se puede considerar una prueba confiable en el punto de atención en el consultorio.Métodos: Estudio transversal que incluyó 5030 pacientes ambulatorios con trastornos nasales: 2612 hombres y 2418 mujeres, edad promedio de 36.8 ± 17.1 años, quienes fueron atendidos en un periodo de cinco años. Los pacientes se subdividieron conforme a la prueba cutánea y la citología nasal en sujetos con rinitis alérgica y con rinitis no alérgica. Las formas celulares se subdividieron en función del citotipo: rinitis no alérgica con predominio de infiltración eosinofílica (NARNE, neutrófilos > 50 % con esporas y bacterias ausentes); rinitis no alérgica con eosinófilos (NARES, eosinófilos > 20%); rinitis no alérgica con predominio de infiltrado de mastocitos (NARMA, mastocitos > 10 %) y rinitis no alérgica con eosinófilos y mastocitos (NARESMA, eosinófilos > 20 % y mastocitos > 10 %).Resultados: 453 (9 %) sujetos tuvieron citología negativa a nasal, 1056 (21 %) rinitis alérgica, 538 (10.7%) NARES, 493 (9.8%) poliposis nasal, 251 (5%) rinosinusitis, 221 (4.4%) NARESMA, 201 (4%) rinitis infecciosa; 131 (2.6%) NARMA y 89 (1.8%) NARNE; los sujetos restantes tenían un perfil inflamatorio-infeccioso misceláneo.Conclusiones: La citología nasal proporciona información rápida sobre el fenotipo y endotipo y puede repetirse en el seguimiento para evaluar los cambios posteriores al tratamiento.

scholarly journals The social role of C-reactive protein point-of-care testing to guide antibiotic prescription in Northern Thailand

2018 ◽  
Vol 202 ◽  
pp. 1-12 ◽  
Author(s):  
Marco J. Haenssgen ◽  
Nutcha Charoenboon ◽  
Thomas Althaus ◽  
Rachel C. Greer ◽  
Daranee Intralawan ◽  
...  
Keyword(s):  
Social Role ◽  
Antibiotic Prescription ◽  
Point Of Care ◽  
Point Of Care Testing ◽  
C Reactive Protein ◽  
Northern Thailand ◽  
Reactive Protein ◽  
The Social

scholarly journals How I use fibrinogen replacement therapy in acquired bleeding

Blood ◽  
2015 ◽  
Vol 125 (9) ◽  
pp. 1387-1393 ◽  
Author(s):  
Jerrold H. Levy ◽  
Lawrence T. Goodnough
Keyword(s):  
Replacement Therapy ◽  
Cardiovascular Surgery ◽  
Point Of Care ◽  
Critical Role ◽  
Clinical Settings ◽  
Point Of Care Testing ◽  
Hemostatic Therapy ◽  
Transfusion Guidelines ◽  
Fibrinogen Replacement Therapy

Abstract Fibrinogen is a critical protein for hemostasis and clot formation. However, transfusion guidelines have variable recommendations for maintaining fibrinogen levels in bleeding patients. An increasing number of studies support the practice of fibrinogen replacement therapy for acquired coagulopathies, and additional studies are underway. Fibrinogen therapy can be administered with cryoprecipitate or fibrinogen concentrates, and clinical practice varies according to their availability and licensing status. Fibrinogen concentrate therapy has been studied in animal models and clinical trials and supports the critical role of fibrinogen repletion in bleeding patients. Point-of-care testing will have an important role in guiding fibrinogen replacement for hemostatic therapy in clinical settings such as cardiovascular surgery, postpartum hemorrhage, and trauma. Fibrinogen therapy is an important component of a multimodal strategy for the treatment of coagulopathic bleeding.

Changes in clinical practice and patient disposition following the introduction of point-of-care testing in a rural hospital

Health Policy ◽  
2010 ◽  
Vol 96 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Katharina Blattner ◽  
Garry Nixon ◽  
Susan Dovey ◽  
Chrystal Jaye ◽  
John Wigglesworth
Keyword(s):  
Clinical Practice ◽  
Point Of Care ◽  
Rural Hospital ◽  
Point Of Care Testing ◽  
Patient Disposition

scholarly journals Novel molecular biomarkers and diagnosis of acute appendicitis in children

2021 ◽  
Author(s):  
Sarah VL Hodge ◽  
Beata Mickiewicz ◽  
Matthew Lau ◽  
Craig N Jenne ◽  
Graham C Thompson
Keyword(s):  
Clinical Practice ◽  
Precision Medicine ◽  
Patient Outcomes ◽  
Point Of Care ◽  
Management Plan ◽  
Diagnostic Strategy ◽  
Laboratory Studies ◽  
Suspected Appendicitis ◽  
Diagnosis And Prognosis ◽  
Diagnostic Sensitivity And Specificity

Reliable and efficient diagnosis of pediatric appendicitis is essential for the establishment of a clinical management plan and improvement of patient outcomes. Current strategies used to diagnose a child presenting with a suspected appendicitis include laboratory studies, clinical scores and diagnostic imaging. Although these modalities work in conjunction with each other, one optimal diagnostic strategy has yet to be agreed upon. The recent introduction of precision medicine techniques such as genomics, transcriptomics, proteomics and metabolomics has increased both the diagnostic sensitivity and specificity of appendicitis. Using these novel strategies, the integration of precision medicine into clinical practice via point-of-care technologies is a plausible future. These technologies would assist in the screening, diagnosis and prognosis of pediatric appendicitis.

scholarly journals Understanding COVID-19 testing pathways in English care homes to identify the role of point-of-care testing: an interview-based process mapping study

2020 ◽  
Author(s):  
Massimo Micocci ◽  
Adam L Gordon ◽  
A. Joy Allen ◽  
Timothy Hicks ◽  
Patrick Kierkegaard ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Point Of Care ◽  
Care Home ◽  
Care Homes ◽  
List Type ◽  
Process Mapping ◽  
Point Of Care Testing ◽  
Testing Procedures ◽  
People With Dementia

AbstractIntroductionCare home residents are at high risk of dying from COVID-19. Regular testing producing rapid and reliable results is important in this population because infections spread quickly and presentations are often atypical or asymptomatic. This study evaluated current testing pathways in care homes to explore the role of point-of-care tests (POCTs).MethodsTen staff from eight care homes, purposively sampled to reflect care organisational attributes that influence outbreak severity, underwent a semi-structured remote videoconference interview. Transcripts were analysed using process mapping tools and framework analysis focussing on perceptions about, gaps within, and needs arising from, current pathways.ResultsFour main steps were identified in testing: infection prevention, preparatory steps, swabbing procedure, and management of residents. Infection prevention was particularly challenging for mobile residents with cognitive impairment. Swabbing and preparatory steps were resource-intensive, requiring additional staff resource. Swabbing required flexibility and staff who were familiar to the resident. Frequent approaches to residents were needed to ensure they would participate at a suitable time. After-test management varied between sites. Several homes reported deviating from government guidance to take more cautious approaches, which they perceived to be more robust.ConclusionSwab-based testing is organisationally complex and resource-intensive in care homes. It needs to be flexible to meet the needs of residents and provide care homes with rapid information to support care decisions. POCT could help address gaps but the complexity of the setting means that each technology must be evaluated in context before widespread adoption in care homes.Key-pointsTesting for COVID-19 in care homes is complex and requires reconfiguration of staffing and environment.Isolation and testing procedures are challenged when providing person-centred care to people with dementia.Point-of-care testing results could give care homes greater flexibility to test in person-centred ways.There was evidence that care home staff interpret testing guidance, rather than follow it verbatim.Each POCT must be evaluated in the context of care homes to understand its effect on care home processes.

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