scholarly journals Tear Osmolarity in the Diagnosis of Systemic Dehydration and Dry Eye Disease

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 387
Author(s):  
Anthony J. Bron ◽  
Catherine Willshire
Keyword(s):  
Dry Eye ◽  
Point Of Care ◽  
Plasma Osmolality ◽  
Tear Film ◽  
The Elderly ◽  
Diagnostic Feature ◽  
High Morbidity ◽  
Point Of Care Test ◽  
Wide Range ◽  
At Risk Populations

Systemic dehydration due to inadequate water intake or excessive water loss, is common in the elderly and results in a high morbidity and significant mortality. Diagnosis is often overlooked and there is a need for a simple, bedside diagnostic test in at-risk populations. Body hydration is highly regulated with plasma osmolality (pOsm) being tightly controlled over a wide range of physiological conditions. By contrast, normal tear osmolarity (tOsm) is more variable since the tear film is exposed to evaporation from the open eye. While plasma hyperosmolality is a diagnostic feature of systemic dehydration, tear hyperosmolality, with other clinical features, is diagnostic of dry eye. Studies in young adults subjected to exercise and water-deprivation, have shown that tOsm may provide an index of pOsm, with the inference that it may provide a simple measure to diagnose systemic dehydration. However, since the prevalence of both dry eye and systemic dehydration increases with age, the finding of a raised tOsm in the elderly could imply the presence of either condition. This diagnostic difficulty can be overcome by measuring tear osmolality after a period of evaporative suppression (e.g., a 45 min period of lid closure) which drives tOsm osmolality down to a basal level, close to that of the pOsm. The arguments supporting the use of this basal tear osmolarity (BTO) in the diagnosis of systemic dehydration are reviewed here. Further studies are needed to confirm that the BTO can act as a surrogate for pOsm in both normally hydrated subjects and in patients with systemic dehydration and to determine the minimum period of lid closure required for a simple, “point-of-care” test.

The validity of point of care tear film osmometers in the diagnosis of dry eye

2021 ◽  
Author(s):  
Azadeh Tavakoli ◽  
Maria Markoulli ◽  
Judith Flanagan ◽  
Eric Papas
Keyword(s):  
Dry Eye ◽  
Point Of Care ◽  
Tear Film

scholarly journals Clinical evaluation of point-of-care testing for wide-range C-reactive protein (wr-CRP) in neonates with suspected sepsis

2019 ◽  
Vol 43 (3) ◽  
pp. 135-140
Author(s):  
Amiel Billetop ◽  
Kerry Grant ◽  
Jennifer Beasmore ◽  
Francesca Mills ◽  
David Odd ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Point Of Care ◽  
Attractive Alternative ◽  
C Reactive Protein ◽  
Suspected Sepsis ◽  
Reactive Protein ◽  
Point Of Care Test ◽  
Wide Range ◽  
The Mean ◽  
Common Laboratory

Abstract Background The aim of this study was to validate a point-of-care C-reactive protein (CRP) test (QuikRead, wide-range [wr] CRP) against standard laboratory testing in neonates with suspected sepsis. Methods This was a single-centre prospective cohort study of neonates (n = 91). The main outcome measure was the paired evaluation of the wr-CRP point-of-care test and automated laboratory CRP tests in neonates with suspected sepsis. Results There were 126 measured CRP-sample pairs. The mean difference between the laboratory CRP and the wr-CRP point-of-care test values was 0.19 (95% confidence interval [CI]:‒1.0–0.65). Pearson’s correlation coefficient was 0.94. The area under the receiver operating characteristic (ROC) curve was 0.99 (95% CI: 0.98–1.00). At a QuikRead CRP cut-off of ≥6.2, the sensitivity and specificity were 77% and 100%, respectively. Conclusions Point-of-care wr-CRP testing can be used as a screening test in neonates with suspected sepsis. Rapid bed-side diagnostics and minimal blood volume requirements present an attractive alternative to common laboratory CRP testing.

scholarly journals Dry Eye Profiles in Patients with a Positive Elevated Surface Matrix Metalloproteinase 9 Point-of-Care Test Versus Negative Patients

2016 ◽  
Vol 14 (2) ◽  
pp. 216-223 ◽  
Author(s):  
Nicole L. Lanza ◽  
Allison L. McClellan ◽  
Hatim Batawi ◽  
Elizabeth R. Felix ◽  
Konstantinos D. Sarantopoulos ◽  
...  
Keyword(s):  
Matrix Metalloproteinase ◽  
Dry Eye ◽  
Point Of Care ◽  
Matrix Metalloproteinase 9 ◽  
Point Of Care Test ◽  
Elevated Surface ◽  
Metalloproteinase 9

scholarly journals Feasibility and Field Performance of a Simultaneous Syphilis and HIV Point-of-Care Test Based Screening Strategy in at Risk Populations in Edmonton, Canada

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Joshua Bergman ◽  
Jennifer Gratrix ◽  
Sabrina Plitt ◽  
Jayne Fenton ◽  
Chris Archibald ◽  
...  
Keyword(s):  
At Risk ◽  
Predictive Value ◽  
Point Of Care ◽  
Field Performance ◽  
Antibody Test ◽  
Screening Strategy ◽  
Test Characteristics ◽  
Point Of Care Test ◽  
Sti Testing ◽  
At Risk Populations

Few studies have evaluated the feasibility of delivering syphilis point-of-care (POC) testing in outreach (nonclinical) settings in resource rich countries. The objectives of the study were to evaluate the feasibility and diagnostic performance of performing both HIV and syphilis POC testing in outreach settings and to document new cases identified in the study population. 1,265 outreach testing visits were offered syphilis and HIV POC testing and 81.5% (n=1,031) consented to testing. In our population, the SD Bioline 3.0 Syphilis Test had a sensitivity of 85.3% [CI (68.9–95.0)], specificity of 100.0% [CI (99.6–100.0)], positive predictive value (PPV) of 100.0% [CI (88.1–100.0)], and negative predictive value (NPV) of 99.5% [CI (98.9–99.8)]. Test characteristics for the INSTI HIV-1/HIV-2 Antibody Test had a 100.0% sensitivity [CI (39.8–100.00], 99.8 specificity [CI (99.3–100)], 66.7% PPV [CI (22.3–95.7)], and 100.0% NPV [CI (99.6–100.0)]. Four new cases of syphilis and four new HIV cases were diagnosed. In summary, at risk population seeking STI testing found POC tests to be acceptable, the POC tests performed well in outreach settings, and new cases of syphilis and HIV were identified and linked to treatment and care.

scholarly journals Automatic detection of the cornea location in video captures of fluorescence

2021 ◽  
Vol 3 (1) ◽  
pp. 55-70
Author(s):  
Tobin Driscoll ◽  
Richard J. Braun ◽  
Carolyn G. Begley
Keyword(s):  
Dry Eye ◽  
Open Source Software ◽  
Visual Inspection ◽  
Initial Conditions ◽  
Tear Film ◽  
Region Of Interest ◽  
Normal Subjects ◽  
Pixel Intensity ◽  
Wide Range ◽  
Corneal Radius

Purpose: Fluorescence imaging is a valuable tool for studying tear film dynamics andcorneal staining. Automating the quantification of fluorescence images is a challenging necessary step for making connections to mathematical models. A significant partof the challenge is identifying the region of interest, specifically the cornea, for collected data with widely varying characteristics. Methods: The gradient of pixel intensity at the cornea–sclera limbus is used as the objective of standard optimization to find a circle that best represents the cornea. Results of the optimization in one image are used as initial conditions in the next imageof a sequence. Additional initial conditions are chosen heuristically. The algorithm iscoded in open-source software. Results: The algorithm was first applied to 514 videos of 26 normal subjects, for a total of over 87,000 images. Only in 12 of the videos does the standard deviation in thedetected corneal radius exceed 1% of the image height, and only 3 exceeded 2%. The algorithm was applied to a sample of images from a second study with 142 dry-eye subjects. Significant staining was present in a substantial number of these images. Visual inspection and statistical analysis show good resuls for both normal and dry-eye images. Conclusion: The new algorithm is highly effective over a wide range of tear film andcorneal staining images collected at different times and locations.

scholarly journals Evolution of Wearable Devices with Real-Time Disease Monitoring for Personalized Healthcare

Nanomaterials ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. 813 ◽  
Author(s):  
Kyeonghye Guk ◽  
Gaon Han ◽  
Jaewoo Lim ◽  
Keunwon Jeong ◽  
Taejoon Kang ◽  
...  
Keyword(s):  
Real Time ◽  
Health Monitoring ◽  
Point Of Care ◽  
Monitoring And Evaluation ◽  
The Elderly ◽  
Wearable Devices ◽  
Medical Diagnostics ◽  
Biomedical Monitoring ◽  
Wide Range ◽  
Barriers And Challenges

Wearable devices are becoming widespread in a wide range of applications, from healthcare to biomedical monitoring systems, which enable continuous measurement of critical biomarkers for medical diagnostics, physiological health monitoring and evaluation. Especially as the elderly population grows globally, various chronic and acute diseases become increasingly important, and the medical industry is changing dramatically due to the need for point-of-care (POC) diagnosis and real-time monitoring of long-term health conditions. Wearable devices have evolved gradually in the form of accessories, integrated clothing, body attachments and body inserts. Over the past few decades, the tremendous development of electronics, biocompatible materials and nanomaterials has resulted in the development of implantable devices that enable the diagnosis and prognosis through small sensors and biomedical devices, and greatly improve the quality and efficacy of medical services. This article summarizes the wearable devices that have been developed to date, and provides a review of their clinical applications. We will also discuss the technical barriers and challenges in the development of wearable devices, and discuss future prospects on wearable biosensors for prevention, personalized medicine and real-time health monitoring.

scholarly journals EFFECTIVENESS OF WARM COMPRESS ON LEVEL OF DRY EYE AMONG ELDERLY CLIENTS IN SELECTED OLDAGE HOMES, CHENNAI

2020 ◽  
pp. 1-2
Author(s):  
Mano Priya Vijayan ◽  
Renuka K
Keyword(s):  
Old Age ◽  
Dry Eye ◽  
Tear Film ◽  
Sampling Technique ◽  
The Elderly ◽  
Structured Interview ◽  
Control Group ◽  
Control Group Design ◽  
And Control ◽  
Experimental Group

Background: Dry eye is the common complaint of patients presenting to ophthalmologist. Warm compresses at 105 0F have been shown to thicken the tear film lipid layer, decrease tear film evaporation, improve tear film break-up time, decrease ocular surface staining and improve dry eye symptoms among elderly clients. The aim of this study was to assess the effectiveness of warm compress on level of dry eye among elderly clients at selected old age home in Chennai. Methods: This study based on quantitative evaluative approach with quasi experimental pre and posttest control group design. The total of 60 elderly clients were selected through non-probability convenience sampling technique among 30 were experimental group from Brindavanam Old age Home and 30 were control group from Vetri Old age Home. The tool was structured interview schedule and Schirmer’s test. The warm compress was applied for 10 minutes intermittently in morning and evening for 7 days on both eyes for experimental group. Results: The elderly clients in experimental group 43.3% were in >76 years of age where as in control group 12(40%) were in >76 years. In experimental and control group of right eye, posttest mean and SD score was 10.063.17 and 7.701.03‘t’ test score was 3.76. In experimental and control group of left eye, posttest mean and SD score was 113.49 and 7.90.94‘t’ value was 4.15, which was significant at P0.05 level. Conclusions: This study concluded that warm compress was effective in reducing the level of dry eye among elderly clients.

scholarly journals The Matrix Metalloproteinase 9 Point-of-Care Test in Dry Eye

2016 ◽  
Vol 14 (2) ◽  
pp. 189-195 ◽  
Author(s):  
Nicole L. Lanza ◽  
Felipe Valenzuela ◽  
Victor L. Perez ◽  
Anat Galor
Keyword(s):  
Matrix Metalloproteinase ◽  
Dry Eye ◽  
Point Of Care ◽  
Matrix Metalloproteinase 9 ◽  
Point Of Care Test ◽  
The Matrix ◽  
Metalloproteinase 9

scholarly journals Field assessment in Cameroon of a reader of POC-CCA lateral flow strips for the quantification of Schistosoma mansoni circulating cathodic antigen in urine

2021 ◽  
Vol 15 (7) ◽  
pp. e0009569
Author(s):  
Estelle Mezajou Mewamba ◽  
Arnol Auvaker Zebaze Tiofack ◽  
Cyrille Nguemnang Kamdem ◽  
Romuald Isaka Kamwa Ngassam ◽  
Mureille Carole Tchami Mbagnia ◽  
...  
Keyword(s):  
Schistosoma Mansoni ◽  
Point Of Care ◽  
High Capacity ◽  
Infection Intensity ◽  
Lateral Flow ◽  
Urine Samples ◽  
Point Of Care Test ◽  
Wide Range ◽  
Low Sensitivity ◽  
Fresh Urine

Background Determining Schistosoma mansoni infection rate and intensity is challenging due to the low sensitivity of the Kato-Katz (KK) test that underestimates the true disease prevalence. Circulating cathodic antigen (CCA) excreted in urine is constantly produced by adult worms and has been used as the basis of a simple, non-invasive point of care test (POC-CCA) for Schistosoma mansoni infections. Although the abundance of CCA in urine is proportional to worm burden, the POC-CCA test is marketed as a qualitative test, making it difficult to investigate the wide range of infection intensities. This study was designed to compare the prevalence and intensity of S. mansoni by KK and POC-CCA and quantify, on fresh and frozen (<-20°C) urine samples, CCA using the visual scores and the ESEquant LR3 reader. Methodology Stool and urine samples were collected from 759 school-aged children. The prevalence and intensity of S. mansoni were determined using KK and POC-CCA. The degree of the positivity of POC-CCA was estimated by quantifying CCA on fresh and frozen urine samples using visual scores and strip reader. The prevalence, the infection intensity as well the relative amounts of CCA were compared. Results The S. mansoni infection rates inferred from POC-CCA and KK were 40.7% and 9.4% respectively. Good correlations were observed between infection intensities recorded by; i) the reader and visual scoring system on fresh (Rho = 0.89) and frozen samples (Rho = 0.97), ii) the reader on fresh urine samples and KK (epg) (Rho = 0.44). Nevertheless, 238 POC-CCA positive children were negative for KK, and sixteen of them had high levels of CCA. The correlation between results from the reader on fresh and frozen samples was good (Rho = 0.85). On frozen samples, CCA was not detected in 55 samples that were positive in fresh urine samples. Conclusion This study confirmed the low sensitivity of KK and the high capacity of POC-CCA to provide reliable data on the prevalence and intensity of S. mansoni infections. The lateral flow reader enabled accurate quantification of CCA under field conditions on fresh and frozen urine samples with less time and effort than KK.

DSM-5 alcohol use disorder features among treatment-seeking older adults

2018 ◽  
Vol 64 (4) ◽  
pp. 185-196 ◽  
Author(s):  
Silke Behrendt ◽  
Barbara Braun ◽  
Randi Bilberg ◽  
Gerhard Bühringer ◽  
Michael Bogenschutz ◽  
...  
Keyword(s):  
Older Adults ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
The Elderly ◽  
Treatment Seeking ◽  
Controlled Clinical Trial ◽  
Dsm 5 ◽  
Wide Range ◽  
And Gender ◽  
International Multicenter

Abstract. Background: The number of older adults with alcohol use disorder (AUD) is expected to rise. Adapted treatments for this group are lacking and information on AUD features in treatment seeking older adults is scarce. The international multicenter randomized-controlled clinical trial “ELDERLY-Study” with few exclusion criteria was conducted to investigate two outpatient AUD-treatments for adults aged 60+ with DSM-5 AUD. Aims: To add to 1) basic methodological information on the ELDERLY-Study by providing information on AUD features in ELDERLY-participants taking into account country and gender, and 2) knowledge on AUD features in older adults seeking outpatient treatment. Methods: baseline data from the German and Danish ELDERLY-sites (n=544) were used. AUD diagnoses were obtained with the Mini International Neuropsychiatric Interview, alcohol use information with Form 90. Results: Lost control, desired control, mental/physical problem, and craving were the most prevalent (> 70 %) AUD-symptoms. 54.9 % reported severe DSM-5 AUD (moderate: 28.2 %, mild: 16.9 %). Mean daily alcohol use was 6.3 drinks at 12 grams ethanol each. 93.9 % reported binging. More intense alcohol use was associated with greater AUD-severity and male gender. Country effects showed for alcohol use and AUD-severity. Conclusion: European ELDERLY-participants presented typical dependence symptoms, a wide range of severity, and intense alcohol use. This may underline the clinical significance of AUD in treatment-seeking seniors.

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