Role of point of care - ST2, Galectin-3 and adrenomedullin in the evaluation and treatment of emergency patients

Abstract Recently, we have read with great interest the article published by Ibarrola et al. (Clin. Sci. (Lond.) (2018) 132, 1471–1485), which used proteomics and immunodetection methods to show that Galectin-3 (Gal-3) down-regulated the antioxidant peroxiredoxin-4 (Prx-4) in cardiac fibroblasts. Authors concluded that ‘antioxidant activity of Prx-4 had been identified as a protein down-regulated by Gal-3. Moreover, Gal-3 induced a decrease in total antioxidant capacity which resulted in a consequent increase in peroxide levels and oxidative stress markers in cardiac fibroblasts.’ We would like to point out some results stated in the article that need further investigation and more detailed discussion to clarify certain factors involved in the protective role of Prx-4 in heart failure.

Download Full-text

Galectin-3 in Heart Failure – Linking Fibrosis, Remodelling and Progression

European Cardiology Review ◽

10.15420/ecr.2010.6.2.33 ◽

2010 ◽

Vol 6 (2) ◽

pp. 33 ◽

Cited By ~ 10

Author(s):

Christopher R deFilippi ◽

G Michael Felker ◽

◽

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Risk Stratification ◽

Cardiac Fibrosis ◽

The Elderly ◽

Preserved Ejection Fraction ◽

Heart Failure Patients ◽

Large Populations ◽

Galectin 3

For many with heart failure, including the elderly and those with a preserved ejection fraction, both risk stratification and treatment are challenging. For these large populations and others there is increasing recognition of the role of cardiac fibrosis in the pathophysiology of heart failure. Galectin-3 is a novel biomarker of fibrosis and cardiac remodelling that represents an intriguing link between inflammation and fibrosis. In this article we review the biology of galectin-3, recent clinical research and its application in the management of heart failure patients.

Download Full-text

Current role of ultrasound in hemodialysis access evaluation

The Journal of Vascular Access ◽

10.1177/11297298211034638 ◽

2021 ◽

pp. 112972982110346

Author(s):

Meola Mario ◽

Jose Ibeas ◽

Jan Malik

Keyword(s):

Turning Point ◽

Point Of Care ◽

Low Cost ◽

Wireless Systems ◽

Future Perspectives ◽

Maturation Period ◽

Surveillance Programs ◽

Dialysis Nurses

Physical examination (PE) is considered the backbone before vascular access (VA) placement, during maturation period and for follow-up. However, it may be inadequate in identifying suitable vasculature, mainly in comorbid patients, or in detecting complications. This review highlights the advantages of ultrasound imaging to manage VA before placement, during maturation and follow-up. Furthermore, it analyses the future perspectives in evaluating early and late VA complications thank to the availability of multiparametric platforms, point of care of ultrasound, and portable/wireless systems. Technical improvements and low-cost systems should favor the widespread ultrasound-based VA surveillance programs. This significant turning point needs an adequate training of nephrologists and dialysis nurses and the standardization of exams, parameters, and procedures.

Download Full-text

Role of pharmacist-provided point-of-care testing

Journal of the American Pharmacists Association ◽

10.1016/s1544-3191(16)30018-8 ◽

2015 ◽

Vol 55 (6) ◽

pp. 574-576

Author(s):

Hilary McCants

Keyword(s):

Point Of Care ◽

Point Of Care Testing

Download Full-text

Biomarkers for the diagnosis and management of heart failure

Heart Failure Reviews ◽

10.1007/s10741-021-10105-w ◽

2021 ◽

Author(s):

Vincenzo Castiglione ◽

Alberto Aimo ◽

Giuseppe Vergaro ◽

Luigi Saccaro ◽

Claudio Passino ◽

...

Keyword(s):

Heart Failure ◽

Risk Stratification ◽

Adverse Outcome ◽

Volume Overload ◽

High Sensitivity ◽

Circulating Biomarkers ◽

Diagnosis And Management ◽

Conflicting Evidence ◽

Galectin 3

AbstractHeart failure (HF) is a significant cause of morbidity and mortality worldwide. Circulating biomarkers reflecting pathophysiological pathways involved in HF development and progression may assist clinicians in early diagnosis and management of HF patients. Natriuretic peptides (NPs) are cardioprotective hormones released by cardiomyocytes in response to pressure or volume overload. The roles of B-type NP (BNP) and N-terminal pro-B-type NP (NT-proBNP) for diagnosis and risk stratification in HF have been extensively demonstrated, and these biomarkers are emerging tools for population screening and as guides to the start of treatment in subclinical HF. On the contrary, conflicting evidence exists on the role of NPs as a guide to HF therapy. Among the other biomarkers, high-sensitivity troponins and soluble suppression of tumorigenesis-2 are the most promising biomarkers for risk stratification, with independent value to NPs. Other biomarkers evaluated as predictors of adverse outcome are galectin-3, growth differentiation factor 15, mid-regional pro-adrenomedullin, and makers of renal dysfunction. Multi-marker scores and genomic, transcriptomic, proteomic, and metabolomic analyses could further refine HF management.

Download Full-text

The role of point-of-care ultrasound in the diagnosis and management of necrotizing soft tissue infections

The Ultrasound Journal ◽

10.1186/s13089-020-0153-4 ◽

2020 ◽

Vol 12 (1) ◽

Cited By ~ 1

Author(s):

Luís Magalhães ◽

Sara Raquel Pereira Martins ◽

Ramon Nogué

Keyword(s):

Soft Tissue ◽

Point Of Care ◽

Point Of Care Ultrasound ◽

Soft Tissue Infections ◽

Diagnosis And Management ◽

Necrotizing Soft Tissue Infections

Download Full-text

The Effects of Real-Time Interactive Multimedia Teleradiology System

BioMed Research International ◽

10.1155/2016/4126841 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Lilac Al-Safadi

Keyword(s):

Real Time ◽

Interactive Multimedia ◽

Point Of Care ◽

Critical Role ◽

Web Based ◽

Teleradiology System ◽

Multimedia Technologies ◽

Referring Physicians ◽

Improving Patient Care

This study describes the design of a real-time interactive multimedia teleradiology system and assesses how the system is used by referring physicians in point-of-care situations and supports or hinders aspects of physician-radiologist interaction. We developed a real-time multimedia teleradiology management system that automates the transfer of images and radiologists’ reports and surveyed physicians to triangulate the findings and to verify the realism and results of the experiment. The web-based survey was delivered to 150 physicians from a range of specialties. The survey was completed by 72% of physicians. Data showed a correlation between rich interactivity, satisfaction, and effectiveness. The results of our experiments suggest that real-time multimedia teleradiology systems are valued by referring physicians and may have the potential for enhancing their practice and improving patient care and highlight the critical role of multimedia technologies to provide real-time multimode interactivity in current medical care.

Download Full-text

Role of emergency physician–performed ultrasound in the differential diagnosis of abdominal pain

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907918808115 ◽

2018 ◽

Vol 27 (2) ◽

pp. 79-86

Author(s):

Nalan Kozaci ◽

Mustafa Avci ◽

Gul Tulubas ◽

Ertan Ararat ◽

Omer Faruk Karakoyun ◽

...

Keyword(s):

Abdominal Pain ◽

Emergency Physician ◽

Gold Standard ◽

Acute Abdominal Pain ◽

Point Of Care ◽

Final Diagnosis ◽

Free Fluid ◽

Emergency Physicians ◽

Abdominal Ultrasonography

Objectives: This prospective study was performed to evaluate the diagnostic accuracy of bedside point-of-care abdominal ultrasonography performed by emergency physician in patients with non-traumatic acute abdominal pain. Methods: The patients, who were admitted to emergency department due to abdominal pain, were included in this study. The emergency physician obtained a routine history, physical examination, blood draws, and ordered diagnostic imaging. After the initial clinical examinations, all the patients underwent ultrasonography for abdominal pathologies by emergency physician and radiologist, respectively. Point-of-care abdominal ultrasonography compared with abdominal ultrasonography performed by radiologist as the gold standard. Results: The study included 122 patients. Gallbladder and appendix pathologies were the most commonly detected in the abdominal ultrasonography. Compared with abdominal ultrasonography, point-of-care abdominal ultrasonography was found to have 89% sensitivity and 94% specificity in gallbladder pathologies; 91% sensitivity and 91% specificity in acute appendicitis; 79% sensitivity and 97% specificity in abdominal free fluid; 83% sensitivity and 96% specificity in ovarian pathologies. Compared to final diagnosis, preliminary diagnoses of emergency physicians were correct in 92 (75.4%) patients. Conclusion: This study showed that emergency physicians were successful in identifying abdominal organ pathologies with point-of-care abdominal ultrasonography after training.

Download Full-text