scholarly journals Serologic and Molecular Diagnosis of Anaplasma platys and Ehrlichia canis Infection in Dogs in an Endemic Region

Pathogens ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 488
Author(s):  
Bianca Lara ◽  
Anne Conan ◽  
Mary Anna Thrall ◽  
Jennifer K. Ketzis ◽  
Gillian Carmichael Branford ◽  
...  
Keyword(s):  
Early Stage ◽  
Point Of Care ◽  
False Negative ◽  
Ehrlichia Canis ◽  
Test Results ◽  
Anaplasma Platys ◽  
Endemic Region ◽  
Life Threatening ◽  
Improve Patient Management ◽  
Antibody Levels

Anaplasma platys and Ehrlichia canis are obligate intracellular, tick-borne rickettsial pathogens of dogs that may cause life-threatening diseases. In this study, we assessed the usefulness of PCR and a widely used commercial antibody-based point-of-care (POC) test to diagnose A. platys and E. canis infection and updated the prevalence of these pathogens in dogs inhabiting the Caribbean island of Saint Kitts. We detected A. platys in 62/227 (27%), E. canis in 84/227 (37%), and the presence of both in 43/227 (19%) of the dogs using PCR. POC testing was positive for A. platys in 53/187 (28%), E. canis in 112/187 (60%), and for both in 42/187 (22%) of the samples tested. There was only a slight agreement between A. platys PCR and POC test results and a fair agreement for E. canis PCR and POC test results. Our study suggests that PCR testing may be particularly useful in the early stage of infection when antibody levels are low or undetectable, whereas, POC test is useful when false-negative PCR results occur due to low bacteremia. A combination of PCR and POC tests may increase the ability to diagnose A. platys and E. canis infection and consequently will improve patient management.

scholarly journals The Lifetime Economic Burden of Inaccurate HER2 Testing: Estimating the Costs of False-Positive and False-Negative HER2 Test Results in US Patients with Early-Stage Breast Cancer

2015 ◽  
Vol 18 (4) ◽  
pp. 541-546 ◽  
Author(s):  
Louis P. Garrison ◽  
Joseph B. Babigumira ◽  
Anthony Masaquel ◽  
Bruce C.M. Wang ◽  
Deepa Lalla ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Economic Burden ◽  
False Positive ◽  
Early Stage ◽  
False Negative ◽  
Early Stage Breast Cancer ◽  
Test Results ◽  
Her2 Testing

scholarly journals Ultrasound Detection of the Aquarium Sign at the Bedside

2020 ◽  
Author(s):  
Mihiro Kaga ◽  
Emi Yamashita ◽  
Takeshi Ueda
Keyword(s):  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Test Results ◽  
Mesenteric Ischaemia ◽  
Contrast Enhanced ◽  
Life Threatening ◽  
Hepatic Portal ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
The Relationship

Objectives: The aquarium sign is the name given to a large quantity of bubble-like echoes that suggests the presence of hepatic portal venous gas (HPVG). Few studies in the literature have addressed the relationship between the aquarium sign and HPVG. In some cases, HPVG can only be detected using ultrasonography. HPVG can be observed in a variety of conditions, including those that require emergency surgery, such as acute mesenteric ischaemia (AMI). Therefore, it is important to identify the presence of HPVG as soon as possible.  Materials and methods: We report a case of the aquarium sign, where bubble-like echoes flowed from the right atrium towards the right ventricle, which was identified using bedside cardiac ultrasonography as part of a point-of-care ultrasound test. Results: This aquarium sign finding led to the diagnosis of AMI, which was confirmed using contrast-enhanced computed tomography (CT).  Conclusion: The aquarium sign is a useful finding suggestive of HPVG and mesenteric ischaemia, which can be rapidly and easily observed using bedside cardiac ultrasonography. However, there are very few reports on the aquarium sign. The inability of other more cumbersome diagnostic imaging modalities, such as CT and magnetic resonance imaging, to detect HPVG emphasizes the utility and convenience of detecting the aquarium sign using bedside ultrasonography. This technique can lead to early detection of life-threatening diseases as well as improve the prognosis for patients. The diagnostic implications of the aquarium sign for HPVG are still unclear and require further research.

scholarly journals Diagnostic testing for feline panleukopenia in a shelter setting: a prospective, observational study

2021 ◽  
pp. 1098612X2110053
Author(s):  
Linda S Jacobson ◽  
Kyrsten J Janke ◽  
Jolene Giacinti ◽  
J Scott Weese
Keyword(s):  
Point Of Care ◽  
Diagnostic Testing ◽  
False Negative ◽  
Clinical Signs ◽  
Test Results ◽  
Feline Panleukopenia Virus ◽  
Negative Results ◽  
Copy Numbers ◽  
Rectal Swabs ◽  
Vaccination History

Objectives The aim of this study was to optimize the diagnosis of feline panleukopenia virus (FPV) in a shelter setting by: (1) comparing the results of the canine parvovirus IDEXX SNAP Parvo (SNAP) point-of-care ELISA with a commercial FPV quantitative real-time PCR (qPCR) test; (2) assessing whether vomit and anal/rectal swabs could be used for early diagnosis; and (3) clarifying the interpretation of weak-positive SNAP test results. Methods The study included shelter cats and kittens with incomplete or unknown vaccination history that had clinical signs suspicious for feline panleukopenia and fecal SNAP and PCR tests performed within 24 h of onset. Feces, anal/rectal swabs and vomit were tested using SNAP and PCR, with fecal PCR utilized as the reference standard. Results One hundred and forty-five cats were included. Seventeen were diagnosed with FPV infection and 62 were negative; 66 could not be individually designated because they were co-housed. Sensitivity was as follows: fecal SNAP 55% (n = 102; 95% confidence interval [CI] 32–77); swab SNAP 30% (n = 55; 95% CI 7–65); swab PCR 77% (n = 55; 95% CI 46–95); and vomit PCR 100% (n = 17; 95% CI 16–100). Specificity was high (96–100%) for all sample and test types. For PCR-positive fecal samples, true-positive SNAP tests (including weak positives) had significantly higher DNA viral copy numbers than false-negative SNAP tests ( P = 0.0031). Conclusions and relevance The SNAP ELISA should be viewed as an initial diagnostic test to rule in feline panleukopenia. Positive fecal SNAP test results, including weak positives, are highly likely to be true positives in clinically affected animals. Negative results in clinically affected animals are unreliable and should be followed up with PCR testing.

scholarly journals Role of Pulse Oximetry Screening for Detection of Life Threatening Congenital Heart Detects in Newborn

2018 ◽  
pp. 134-139
Author(s):  
Aso Faeq Salih ◽  
Adnan Mohammed Hamawand ◽  
Riyadh Abd Aljabbar Sattar
Keyword(s):  
Pulse Oximetry ◽  
False Positive ◽  
Congenital Heart ◽  
Early Stage ◽  
Heart Defects ◽  
False Positive Rate ◽  
False Negative ◽  
Positive Rate ◽  
Life Threatening ◽  
Pulse Oximetry Screening

Most ofnewborns with Congenital Heart Defects (CHDs) can be detected by using echocardiography. However, if such defects are not diagnosed in earlier time, therefore a severe hypoxemia, shock, acidosis and death are considered of some potential sequelae. A prospective study from January 2012 to the end of 2013 was performed and 2181 neonates were enrolled in the study. The pulse oximetry screening (POS) for both hands and one foot were obtained within the first 3-6 hours of life, when post ductal saturation was below 90%, it was considered as a positive screening, while when the saturation is between 90-95% and the difference between pre-and post-ductal saturation was more than 3%, the baby was provisionally considered to be screening as a positive then echocardiography is planned. Among 100 positive POS babies, 45 (45%) of them were detected with CHS, 12 (12%) was with a major CHS and 33 (33%) was with a minor CHS. Out of 12 patients with a major CHD 6 of them (50%) were asymptomatic at the time of POS.POS result was a true negative in 2078 patients, a true positive in 45 patients, false negative in 3 patients, and false positive in 55 and 28/55 of the false positive rate with POS had other pathology. The false positive rate with pulse oximetry screening is (55/2081) = 0.26%. Sensitivity, specificity, positive and negative predictive value for POS in detection of major CHD were 80%, 97.29%, 17.9% and 99.80%, respectively. Pulse oximetry screening is significantly improving the detection of life threatening congenital heart disease at an early stage.

scholarly journals 678. Rapid Molecular SARS-CoV-2 Detection by Abbott ID NOW Is Reliable in Pediatric Patients

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S441-S441
Author(s):  
Catherine Murphy ◽  
Emily Sheboy Scarcello ◽  
Sheila M Nolan
Keyword(s):  
Pediatric Patients ◽  
Point Of Care ◽  
False Negative ◽  
Pediatric Primary Care ◽  
Test Results ◽  
Point Of Care Testing ◽  
Conventional Pcr ◽  
Negative Results ◽  
Percent Positivity ◽  
Pcr Test

Abstract Background The COVID-19 Pandemic demonstrated the importance of rapid, accurate, point of care testing to control spread of the virus. The availability of this testing has been crucial to re-opening schools, keeping children safely in schools, and returning children to school quickly following illness. The Abbott ID Now molecular assay to detect SARS-CoV-2 was granted Emergency Use Authorization in March 2020. Reports of lower sensitivity compared with conventional PCR prompted some school districts to require confirmatory conventional PCR for negative rapid molecular results to return children to school. In this study we aim to determine the sensitivity and specificity of the Abbott ID NOW molecular SARS-CoV-2 test in a large pediatric primary care practice. Methods A retrospective observational study was performed using data from 25 pediatric primary care sites in the Boston Children’s Health Physicians network, a large multispecialty pediatric practice in New York and Connecticut. Data were extracted from the electronic health record for all patients 0-22 years of age who had an Abbott ID NOW rapid molecular COVID-19 assay from October 1, 2020 - February 28, 2021. For all patients with rapid tests, we identified patients who had a conventional PCR test sent within 1 day before or 1 day after the ID NOW test. The result of the conventional PCR test was considered the “true” result. All discrepant test results were identified. Results During the study period, 14993 patients had ID NOW testing performed. The percent positivity was 8.5%. The percent positivity in our practices paralleled that in the surrounding community throughout the winter surge of COVID-19. 500 patients had confirmatory testing sent within 1 day before or after the ID NOW test (15 positive and 485 negative results). Based on the conventional PCR test results, 2 of 15 positive results were false positive and only 1 of 485 negative results was a false negative, resulting in a sensitivity of 93% and specificity of 99.6%. The false negative result was in a patient with nasal congestion whose mother was COVID positive. Conclusion Rapid, molecular, point of care testing is an important tool to identify SARS-CoV-2 in pediatric patients and limit school absences. The ID NOW assay is highly sensitive and specific in a real-world pediatric setting. Disclosures All Authors: No reported disclosures

scholarly journals Point of care lung ultrasound in COVID-19: hype or hope?

BJR|Open ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. 20200027
Author(s):  
Abdulrahman M. Alfuraih
Keyword(s):  
World Economy ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
False Negative ◽  
Current Evidence ◽  
Rt Pcr ◽  
Limited Evidence ◽  
Lung Abnormalities ◽  
Diagnostic Role ◽  
Life Threatening

The COVID-19 coronavirus pandemic has critically struck the world economy and healthcare systems. The highly contagious virus spreads rapidly and can result in potentially life-threatening acute respiratory distress. The current established test for diagnosing COVID-19 is using the RT-PCR laboratory test. However, the test requires specialized laboratories and testing kits. Recent reports also showed high false-negative rates. Experts recognize the urgent need to develop a rapid point of care diagnostic tests. Ultrasonography is a widely established safe diagnostic imaging test for detecting various lung abnormalities. Recent publications from China and Italy provided limited evidence on its usefulness for diagnosing COVID-19 in emergency departments earlier than RT-PCR. Ultrasound is sensitive to pleural and subpleural abnormalities, which suggests a great potential diagnostic role given the predilection for COVID-19 in peripheral subpleural regions.This paper reviews the current evidence and discusses the problems with specificity and scoring.

False-Negative Urine Human Chorionic Gonadotropin Testing in the Clinical Laboratory

2019 ◽  
Vol 51 (1) ◽  
pp. 86-93
Author(s):  
Adrianna Z Herskovits ◽  
Yigu Chen ◽  
Niloofar Latifi ◽  
Robert M Ta ◽  
Gila Kriegel
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Clinical Laboratory ◽  
Point Of Care ◽  
Common Factor ◽  
False Negative ◽  
Test Results ◽  
Point Of Care Tests ◽  
Hcg Test ◽  
Missed Diagnoses

Abstract Background Human chorionic gonadotropin (hCG) assays are used to detect pregnancy, and urine point-of-care tests are frequently used to triage patients. Under certain conditions, urine tests can fail to detect pregnancy, which can have serious consequences for patient management. Objectives To understand the prevalence of different factors contributing to false-negative urinary hCG testing results at our institution. Methods Clinical data for patients with negative urine hCG results and subsequent positive or equivocal serum hCG results within a 1-year period were reviewed. Results Out of 9447 negative urine hCG results, 11 potential missed diagnoses were identified, with early gestational age as the most common factor, followed by β-core hook effects. Conclusions Although false-negative urine hCG test results are rare, understanding the commonly encountered reasons for inaccurate testing results can help clinical centers develop strategies to minimize risk for patients.

Gold-Aptamer-Nanoconstructs Engineered to Detect Conserved Enteroviral Nucleic Acid Sequences

2019 ◽  
Author(s):  
Veeren Chauhan ◽  
Mohamed M Elsutohy ◽  
C Patrick McClure ◽  
Will Irving ◽  
Neil Roddis ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
In Silico ◽  
Point Of Care ◽  
Lateral Flow ◽  
Nucleic Acid Sequence ◽  
In Silico Screening ◽  
Lateral Flow Assays ◽  
Life Threatening ◽  
Software And Hardware ◽  
Nucleic Acid Sequences

<p>Enteroviruses are a ubiquitous mammalian pathogen that can produce mild to life-threatening disease. Bearing this in mind, we have developed a rapid, accurate and economical point-of-care biosensor that can detect a nucleic acid sequences conserved amongst 96% of all known enteroviruses. The biosensor harnesses the physicochemical properties of gold nanoparticles and aptamers to provide colourimetric, spectroscopic and lateral flow-based identification of an exclusive enteroviral RNA sequence (23 bases), which was identified through in silico screening. Aptamers were designed to demonstrate specific complementarity towards the target enteroviral RNA to produce aggregated gold-aptamer nanoconstructs. Conserved target enteroviral nucleic acid sequence (≥ 1x10<sup>-7</sup> M, ≥1.4×10<sup>-14</sup> g/mL), initiates gold-aptamer-nanoconstructs disaggregation and a signal transduction mechanism, producing a colourimetric and spectroscopic blueshift (544 nm (purple) > 524 nm (red)). Furthermore, lateral-flow-assays that utilise gold-aptamer-nanoconstructs were unaffected by contaminating human genomic DNA, demonstrated rapid detection of conserved target enteroviral nucleic acid sequence (< 60 s) and could be interpreted with a bespoke software and hardware electronic interface. We anticipate our methodology will translate in-silico screening of nucleic acid databases to a tangible enteroviral desktop detector, which could be readily translated to related organisms. This will pave-the-way forward in the clinical evaluation of disease and complement existing strategies at overcoming antimicrobial resistance.</p>

Telemedicine-guided point-of-care ultrasound can be feasible and effective in a life-threatening situation: The case of a field hospital during the COVID-19 pandemic (Preprint)

2020 ◽  
Author(s):  
Tarso Accorsi ◽  
Karine De Amicis Lima ◽  
Alexandra Brigido ◽  
Deborah Belfort ◽  
Fabio Habrum ◽  
...  
Keyword(s):  
Point Of Care ◽  
Image Interpretation ◽  
Acquisition Time ◽  
Point Of Care Ultrasound ◽  
Field Hospital ◽  
Portable Ultrasound ◽  
Local Staff ◽  
Assessment Protocol ◽  
Life Threatening ◽  
Threatening Situation

BACKGROUND Lightweight portable ultrasound is widely available, especially in inaccessible geographical areas. It demonstrates effectiveness and diagnosis improvement even in field conditions but no precise information about protocols, acquisition time, image interpretation, and the relevance in changing medical conduct exists. The COVID-19 pandemic implied many severe cases and the rapid construction of field hospitals with massive general practitioner (GP) recruitment. OBJECTIVE This prospective and descriptive study aimed to evaluate the feasibility of telemedicine guidance using a standardized multi-organ sonographic assessment protocol in untrained GPs during a COVID-19 emergency in a field hospital. METHODS Eleven COVID-19 in-patients presenting life-threatening complications, attended by local staff who spontaneously requested on-time teleconsultation, were enrolled. All untrained doctors successfully positioned the transducer and obtained key images guided by a remote doctor via telemedicine, with remote interpretation of the findings. RESULTS Only four (36%) general practitioners obtained the appropriate key heart image on the left parasternal long axis window, and three (27%) had an image interpreted remotely on-time. The evaluation time ranged from seven to 42 minutes, with a mean of 22.7 + 12. CONCLUSIONS Telemedicine is effective in guiding GPs to perform portable ultrasound in life-threatening situations, showing effectiveness in conducting decisions.

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