Point-of-Care Diagnosis of Onychomycosis by Dermoscopy

2017 ◽  
Vol 107 (5) ◽  
pp. 413-418 ◽  
Author(s):  
Myron A. Bodman
Keyword(s):  
Point Of Care ◽  
Laboratory Diagnosis ◽  
Diagnosis And Treatment ◽  
Cost Burden ◽  
Test Results ◽  
Nail Dystrophy ◽  
Aurora Borealis ◽  
Pathologic Diagnosis ◽  
Common Diseases ◽  
Pathology Reports

Background: Onychomycosis is one of the most common diseases of the toenails. The costs of diagnosis and treatment are substantial, and as the population ages, the overall cost burden will continue to escalate. The purpose of this study was to correlate dermoscopic features with pathologic diagnosis to support the accuracy of point-of-care diagnosis by dermoscopic examination. Methods: Nail unit pathology reports of 52 patients with abnormal great toenails were compared with the dermoscopic features detected by nail unit dermoscopy. Results: The dermoscopic analysis predicted the laboratory diagnosis in 90.4% of the study patients. The specific dermoscopic findings of short spikes (P < .001), long striae (P < .001), aurora borealis (P < .001), irregular termination (P = .003), dermatophytoma (P = .011), transverse onycholysis (P = .018), and dry scale (P = .04) patterns were all significantly associated with pathology test results consistent with oncyhomycosis. Transverse onycholysis (P = .018) was significantly associated with negative pathology results consistent with the diagnosis of nail dystrophy. Conclusions: Point-of-care examination by dermoscopy positively correlates with histopathologic tests and could be used to diagnose onychomycosis while reducing diagnostic costs.

scholarly journals Laboratory Diagnosis of COVID-19: Current Issues and Challenges

2020 ◽  
Vol 58 (6) ◽  
Author(s):  
Yi-Wei Tang ◽  
Jonathan E. Schmitz ◽  
David H. Persing ◽  
Charles W. Stratton
Keyword(s):  
Point Of Care ◽  
Random Access ◽  
Laboratory Diagnosis ◽  
Test Results ◽  
Anatomic Site ◽  
Laboratory Staff ◽  
Reverse Transcription Pcr ◽  
Integrated Devices ◽  
The Right ◽  
Etiologic Diagnosis

ABSTRACT The COVID-19 outbreak has had a major impact on clinical microbiology laboratories in the past several months. This commentary covers current issues and challenges for the laboratory diagnosis of infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the preanalytical stage, collecting the proper respiratory tract specimen at the right time from the right anatomic site is essential for a prompt and accurate molecular diagnosis of COVID-19. Appropriate measures are required to keep laboratory staff safe while producing reliable test results. In the analytic stage, real-time reverse transcription-PCR (RT-PCR) assays remain the molecular test of choice for the etiologic diagnosis of SARS-CoV-2 infection while antibody-based techniques are being introduced as supplemental tools. In the postanalytical stage, testing results should be carefully interpreted using both molecular and serological findings. Finally, random-access, integrated devices available at the point of care with scalable capacities will facilitate the rapid and accurate diagnosis and monitoring of SARS-CoV-2 infections and greatly assist in the control of this outbreak.

PERANAN RADIOLOGI PADA KASUS TUMOR WILMS’

2020 ◽  
Vol 4 (1) ◽  
pp. 26-33
Author(s):  
Galuh Ayu Treswari ◽  
Bambang Soeprijanto ◽  
Indrastuti Normahayu ◽  
Lenny Violetta
Keyword(s):  
Differential Diagnosis ◽  
Distant Metastasis ◽  
Wilms Tumor ◽  
Diagnosis And Treatment ◽  
Tumor Extension ◽  
Abdominal Tumors ◽  
Pathology Reports

Wilms’ tumor is the most frequent renal malignancy in childhood with the highest incidence per year, approximately 7,8 cases per 1.000.000in children under 15 years-old and frequently occurred in 2-5 years of age (highest incidences in 3 years-old). There are many differential diagnosis of intra-abdominal tumors and the correct differential diagnosis are detrimental to the prescribed treatments for the patients.Medical imaging along with pathology reports is a precise way to determine the appropriate diagnosis and treatment. Imaging gives information about tumor extension and distant metastasis, especially useful for indicating pre-operative chemotherapy.

scholarly journals Rapid point-of-care (POC) testing for Hepatitis C antibodies in a very high prevalence setting: persons injecting drugs in Tallinn, Estonia

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anneli Uusküla ◽  
Ave Talu ◽  
Jürgen Rannap ◽  
David M. Barnes ◽  
Don Des Jarlais
Keyword(s):  
Hepatitis C ◽  
Point Of Care ◽  
Antibody Test ◽  
Hcv Rna ◽  
Test Results ◽  
Blood Draw ◽  
Persons Who Inject Drugs ◽  
Oral Swab ◽  
High Prevalence ◽  
Hcv Antibody

Abstract Background Between December 2018 and January of 2019, we evaluated the accuracy of the point-of-care Hepatitis C (HCV) antibody test (POC; OraQuick HCV) used at a community-based needle and syringe exchange program serving persons who inject drugs in Tallinn, Estonia. Methods We compared the results of screening for HCV antibodies by OraQuick (oral swab) and enzyme immunoassay (EIA; blood draw) and assessed test results implications in a high prevalence setting. Findings Of the 100 participants, 88 (88%) had reactive POC test results, and 93 were HCV antibody positive on EIA testing. Sensitivity, specificity and negative predictive value (NPV) for the POC assay with EIA as the relevant reference test were as follows: 94.6% (95% CI 90.0–99.2%), 100% and 58.3% (95% CI 30.4–86.2%). Of the 12 testing, HCV-negative with the POC only 7 (58.3%) were true negatives. Conclusions Oral swab rapid testing HCV screening in this nonclinical setting was sensitive and specific but had unacceptably low NPV. In high prevalence settings, POC tests with high sensitivity and that directly measure HCV RNA may be warranted.

scholarly journals Fecal viral DNA shedding following clinical panleukopenia virus infection in shelter kittens: a prospective, observational study

2021 ◽  
pp. 1098612X2110230
Author(s):  
Kyrsten J Janke ◽  
Linda S Jacobson ◽  
Jolene A Giacinti ◽  
J Scott Weese
Keyword(s):  
Small Sample Size ◽  
Point Of Care ◽  
Small Sample ◽  
Enteric Pathogens ◽  
Test Results ◽  
Viral Dna ◽  
Virus Shedding ◽  
Feline Panleukopenia Virus ◽  
Viral Shedding ◽  
Point Of Care Test

Objectives The aims of this study were to determine the magnitude and duration of fecal viral DNA shedding after diagnosis of feline panleukopenia (FP) in a group of shelter cats using quantitative real-time PCR (qPCR); to assess the utility of a negative point-of-care test or the resolution of diarrhea and systemic signs as proxy measures for qPCR positivity; and to investigate patterns of additional enteric pathogens in relation to feline panleukopenia viral shedding duration. Methods Feline panleukopenia virus (FPV) infection in clinically affected shelter cats was confirmed by a commercial qPCR test. Observations were made on days 0, 3, 7, 14 and 21 post-diagnosis. Fecal flotation, FPV qPCR and the canine parvovirus IDEXX SNAP Parvo ELISA (SNAP) test were performed on fecal samples. Results Forty cats and kittens with confirmed panleukopenia were initially enrolled. Sixteen kittens were sampled until day 14, and 12 were followed to day 21. Median DNA viral copy numbers fell below the diagnostic cut-off by day 7, with 13/16, 6/16, 1/16 and 0/12 testing PCR-positive on days 3, 7, 14 and 21, respectively. The SNAP test was positive in 12/16 kittens on day 0 and only 3/16 on day 3. SNAP test results, diarrhea and systemic signs were inconsistent in relation to qPCR positivity post-diagnosis. Additional enteric pathogens were common. The presence of additional pathogen types was suggestive of a longer PCR shedding duration, but this was not tested statistically owing to the small sample size. Conclusions and relevance These findings suggest that cats should be isolated for at least 14 days after a diagnosis of FP, but that release from isolation after this point is reasonable, in association with a multifaceted infection control strategy. The study findings did not support using SNAP test results, diarrhea or systemic signs as proxy measures for virus shedding.

Requiem for the STAT Test: Automation and Point of Care Testing

2019 ◽  
Author(s):  
Gurmukh Singh ◽  
Natasha M Savage ◽  
Brandy Gunsolus ◽  
Kellie A Foss
Keyword(s):  
Point Of Care ◽  
Turnaround Time ◽  
Test Automation ◽  
Test Results ◽  
Point Of Care Testing ◽  
Tube System ◽  
Front End ◽  
Laboratory Test Results ◽  
Batch Testing ◽  
Pneumatic Tube System

Abstract Objective Quick turnaround of laboratory test results is needed for medical and administrative reasons. Historically, laboratory tests have been requested as routine or STAT. With a few exceptions, a total turnaround time of 90 minutes has been the usually acceptable turnaround time for STAT tests. Methods We implemented front-end automation and autoverification and eliminated batch testing for routine tests. We instituted on-site intraoperative testing for selected analytes and employed point of care (POC) testing judiciously. The pneumatic tube system for specimen transport was expanded. Results The in-laboratory turnaround time was reduced to 45 minutes for more than 90% of tests that could reasonably be ordered STAT. With rare exceptions, the laboratory no longer differentiates between routine and STAT testing. Having a single queue for all tests has improved the efficiency of the laboratory. Conclusion It has been recognized in manufacturing that batch processing and having multiple queues for products are inefficient. The same principles were applied to laboratory testing, which resulted in improvement in operational efficiency and elimination of STAT tests. We propose that the target for in-laboratory turnaround time for STAT tests, if not all tests, be 45 minutes or less for more than 90% of specimens.

scholarly journals The Laboratory Diagnosis of HIV Infections

2005 ◽  
Vol 16 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Margaret Fearon
Keyword(s):  
Point Of Care ◽  
Diagnostic Testing ◽  
Clinical Information ◽  
Hiv Infections ◽  
Laboratory Diagnosis ◽  
The United States ◽  
Specific Information ◽  
Antibody Testing ◽  
Diagnostic Laboratory ◽  
Laboratory Results

HIV diagnostic testing has come a long way since its inception in the early 1980s. Current enzyme immunoassays are sensitive enough to detect antibody as early as one to two weeks after infection. A variety of other assays are essential to confirm positive antibody screens (Western blot, polymerase chain reaction [PCR]), provide an adjunct to antibody testing (p24 antigen, PCR), or provide additional information for the clinician treating HIV-positive patients (qualitative and quantitative PCR, and genotyping). Most diagnostic laboratories have complex testing algorithms to ensure accuracy of results and optimal use of laboratory resources. The choice of assays is guided by the initial screening results and the clinical information provided by the physician; both are integral to the laboratory's ability to provide an accurate laboratory diagnosis. Laboratories should also provide specific information on specimen collection, storage and transport so that specimen integrity is not compromised, thereby preserving the accuracy of laboratory results. Point of Care tests have become increasingly popular in the United States and some places in Canada over the past several years. These tests provide rapid, on-site HIV results in a format that is relatively easy for clinic staff to perform. However, the performance of these tests requires adherence to good laboratory quality control practices, as well as the backup of a licensed diagnostic laboratory to provide confirmation and resolution of positive or indeterminate results. Laboratory quality assurance programs and the participation in HIV proficiency testing programs are essential to ensure that diagnostic laboratories provide accurate, timely and clinically relevant laboratory results.

Acquired Circulating Anticoagulants in Children With Acquired Immunodeficiency Syndrome

PEDIATRICS ◽  
1988 ◽  
Vol 82 (5) ◽  
pp. 763-765
Author(s):  
Edward R. Burns ◽  
Ben-Zion Krieger ◽  
Larry Bernstein ◽  
Arye Rubinstein
Keyword(s):  
Acquired Immunodeficiency Syndrome ◽  
Pediatric Patients ◽  
Opportunistic Infections ◽  
Laboratory Diagnosis ◽  
Activated Partial Thromboplastin Time ◽  
Test Results ◽  
Coagulation Test ◽  
Intrinsic Pathway ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

The mechanism underlying the prolonged activated partial thromboplastin time (APTT) seen in some pediatric patients with acquired immunodeficiency syndrome (AIDS) and opportunistic infections was studied. A circulating inhibitor of coagulation was demonstrated in three patients. The inhibitor appears to be an immunoglobulin that interferes with some of the phospolipid-dependent coagulation reactions of the intrinsic pathway. This "AIDS anticoagulant" does not predispose the patient to clinical bleeding despite its ability to cause a marked prolongation of the APTT. As such, careful laboratory diagnosis of the cause of abnormal coagulation test results is necessary for children with AIDS.

scholarly journals Electroanalytical Biosensors for Circulating Tumor DNA Detection—A Brief Review

2021 ◽  
Author(s):  
Zhijia Peng ◽  
Xiaogang Lin ◽  
Weiqi Nian ◽  
Xiaodong Zheng ◽  
Jayne Wu
Keyword(s):  
Real Time ◽  
Point Of Care ◽  
Low Cost ◽  
High Sensitivity ◽  
High Specificity ◽  
Circulating Tumor Dna ◽  
Minimal Invasive ◽  
Diagnosis And Treatment ◽  
Detection Technology ◽  
Tumor Dna

Early diagnosis and treatment have always been highly desired in the fight against cancer, and detection of circulating tumor DNA (ctDNA) has recently been touted as highly promising for early cancer screening. Consequently, the detection of ctDNA in liquid biopsy gains much attention in the field of tumor diagnosis and treatment, which has also attracted research interest from the industry. However, traditional gene detection technology is difficult to achieve low cost, real-time and portable measurement of ctDNA. Electroanalytical biosensors have many unique advantages such as high sensitivity, high specificity, low cost and good portability. Therefore, this review aims to discuss the latest development of biosensors for minimal-invasive, rapid, and real-time ctDNA detection. Various ctDNA sensors are reviewed with respect to their choices of receptor probes, detection strategies and figures of merit. Aiming at the portable, real-time and non-destructive characteristics of biosensors, we analyze their development in the Internet of Things, point-of-care testing, big data and big health.

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