Point-of-care testing with high-sensitivity cardiac troponin assays: the challenges and opportunities

Methods to improve the safety, accuracy and efficiency of assessment of patients with suspected acute coronary symptoms have occupied decades of study and have supported significant changes in clinical practice. Much of the progress is reliant on results of laboratory-based high-sensitivity cardiac troponin assays that can detect low concentrations with high precision. Until recently, point-of-care (POC) platforms were unable to perform with similar analytical precision as laboratory-based assays, and recommendations for their use in accelerated assessment strategies for patients with suspected acute coronary syndrome has been limited. As POC assays can provide troponin results within 20 min, and can be used proximate to patient care, improvements in the efficiency of assessment of patients with suspected acute coronary syndrome is possible, particularly with new high-sensitivity assays.

Point-of-care testing in Paediatric settings in the UK and Ireland: a cross-sectional study

Background Point-of-care testing (POCT) is diagnostic testing performed at or near to the site of the patient. Understanding the current capacity, and scope, of POCT in this setting is essential in order to respond to new research evidence which may lead to wide implementation. Methods A cross-sectional online survey study of POCT use was conducted between 6th January and 2nd February 2020 on behalf of two United Kingdom (UK) and Ireland-based paediatric research networks (Paediatric Emergency Research UK and Ireland, and General and Adolescent Paediatric Research UK and Ireland). Results In total 91/109 (83.5%) sites responded, with some respondents providing details for multiple units on their site based on network membership (139 units in total). The most commonly performed POCT were blood sugar (137/139; 98.6%), urinalysis (134/139; 96.4%) and blood gas analysis (132/139; 95%). The use of POCT for Influenza/Respiratory Syncytial Virus (RSV) (45/139; 32.4%, 41/139; 29.5%), C-Reactive Protein (CRP) (13/139; 9.4%), Procalcitonin (PCT) (2/139; 1.4%) and Group A Streptococcus (5/139; 3.6%) and was relatively low. Obstacles to the introduction of new POCT included resources and infrastructure to support test performance and quality assurance. Conclusion This survey demonstrates significant consensus in POCT practice in the UK and Ireland but highlights specific inequity in newer biomarkers, some which do not have support from national guidance. A clear strategy to overcome the key obstacles of funding, evidence base, and standardising variation will be essential if there is a drive toward increasing implementation of POCT.

Pengaruh Ekstrak Paederia foetida pada Kadar Kolesterol Total Tikus Model Hiperlipidemia yang Diinduksi Deksametason

Hiperlipidemia merupakan istilah yang mengacu pada kelainan yang menyebabkan peningkatan profil lipid dalam tubuh manusia. Menurut WHO, secara global, sepertiga penyakit jantung iskemik dikaitkan dengan kadar kolesterol yang tinggi. Peningkatan kadar kolesterol diperkirakan menyebabkan 94,9 juta disability adjusted life year (DALYs) dan 4,32 juta kematian. Penelitian ini bertujuan untuk mengevaluasi pengaruh ekstrak etanol Paederia foetida (EEPF) pada kadar kolesterol total tikus model hiperlipidemia yang diinduksi deksametason. Penelitian Penelitian eksperimen in vivo ini dilakukan dengan menggunakan desain penelitian post-test only complete randomized design (CRD). Proses penelitian dilaksanakan di Departemen Biokimia, Fakultas Kedokteran, Universitas Airlangga, Surabaya, Indonesia, dari bulan Juni 2021 hingga November 2021. Pembuatan EEPF dilakukan dengan metode maserasi pada pelarut etanol 96%. Hewan coba yang digunakan adalah tikus galur Wistar albino jantan berjumlah 30 ekor, sehat, dan berat badan 150-200 gram. Penelitian dilaksanakan dengan membagi rata hewan coba secara acak menjadi kelompok kontrol normal, kontrol patogen, kelompok simvastatin, kelompok EEPF 250 mg/kg, dan kelompok EEPF 500 mg/kg. Sampel darah diambil dari vena pada bagian ekor dan kadar kolesterol total diukur dengan metode point of care testing (POCT). Analisis data dilakukan dengan One-way ANOVA dilanjutkan dengan uji post hoc Dunnett. Hasil penelitian menunjukkan, pemberian deksametason (10 mg/kg) selama 14 hari menyebabkan peningkatan kadar kolesterol total yang signifikan, sedangkan pada kelompok perlakuan simvastatin, EEPF 250 mg/kg, dan EEPF 500 mg/kg terjadi penurunan signifikan pada kadar kolesterol total jika dibandingkan dengan kelompok kontrol patogenik (P<0,001, P<0,05, P<0,05). Pemberian ekstrak etanol Paederia foetida dapat menurunkan kadar kolesterol total pada tikus model hiperlipidemia yang diinduksi deksametason.