Point-of-care testing(POCT)refers to a category of diagnostic tests that are performed at or near to the site of the patients(also called bedside testing)and is capable of obtaining accurate results in a short time by...Point-of-care testing(POCT)refers to a category of diagnostic tests that are performed at or near to the site of the patients(also called bedside testing)and is capable of obtaining accurate results in a short time by using portable diagnostic devices,avoiding sending samples to the medical laboratories.It has been extensively explored for diagnosing and monitoring patients’diseases and health conditions with the assistance of development in biochemistry and microfluidics.Microfluidic paper-based analytical devices(μPADs)have gained dramatic popularity in POCT because of their simplicity,user-friendly,fast and accurate result reading and low cost.SeveralμPADs have been successfully commercialized and received excellent feedback during the past several decades.This review briefly discusses the main types ofμPADs,preparation methods and their detection principles,followed by a few representative examples.The future perspectives of the development inμPADs are also provided.展开更多
BACKGROUND Point-of-care ultrasound(POCUS)is the use of portable ultrasound devices by trained healthcare professionals to diagnose and monitor medical conditions directly at the patient's bedside,such as in emerg...BACKGROUND Point-of-care ultrasound(POCUS)is the use of portable ultrasound devices by trained healthcare professionals to diagnose and monitor medical conditions directly at the patient's bedside,such as in emergency settings.We described a case where POCUS use,in Pediatric Emergency Department,allowed an early diagnosis and timely management in the surgical department,with a favorable outcome for child.Therefore we write this case because it is desirable to po-pularize ultrasound as the fifth pillar of clinical examination especially in Emer-gency Department CASE SUMMARY A 13-year-old girl with acute gastrointestinal symptoms,such as vomit and abdominal and lumbar pains.Upon physical examination,the patient had lo-calized abdominal pain in the left lower quadrant.Ultrasonography performed at the bedside revealed an enlarged left ovary with an irregular structure containing a 3 cm cyst.These findings raised suspicion of ovarian torsion.The child tran-sferred to Gynecology Surgery Unit,where she was taken emergently to the ope-rating room CONCLUSION It is desirable to spread POCUS in emergency settings where it allows a sig-nificant saving of time in patient management.展开更多
Ultrasound has long been an essential tool in nephrology,traditionally used for procedures like vascular access and kidney biopsies.Point-of-care ultrasonography(POCUS),a rapidly evolving bedside technology,is now gai...Ultrasound has long been an essential tool in nephrology,traditionally used for procedures like vascular access and kidney biopsies.Point-of-care ultrasonography(POCUS),a rapidly evolving bedside technology,is now gaining momentum in nephrology by providing real-time imaging to enhance physical examination findings.Unlike comprehensive radiology-performed ultrasound,POCUS focuses on specific clinical questions,providing immediate and actionable insights.This narrative review examines the philosophy behind POCUS,its expanding applications in nephrology,and its impact on patient care,including its role in diagnosing obstructive uropathy,guiding fluid management,and evaluating hemodynamics in cardiorenal syndrome.Additionally,the review addresses barriers to widespread adoption,such as the need for structured training,competency validation,and interdisciplinary cooperation.By integrating POCUS into routine practice,nephrologists can refine diagnostic accuracy,improve patient outcomes,and strengthen the role of bedside medicine.展开更多
Cardiorenal syndrome reflects a complex interplay between cardiac and renal dysfunction,often compounded by fragmented management between cardiology and nephrology.Traditional phrases such as“the heart likes it dry a...Cardiorenal syndrome reflects a complex interplay between cardiac and renal dysfunction,often compounded by fragmented management between cardiology and nephrology.Traditional phrases such as“the heart likes it dry and the kidneys like it wet”oversimplify care and perpetuate misconceptions about diuretic use and fluid management.Emerging evidence points to venous congestion rather than reduced cardiac output as a key driver of worsening renal function and adverse outcomes in heart failure.This article blends current evidence with the authors’perspective and clinical experience to explore the role of point-of-care ultrasound(POCUS)in the hemodynamic assessment of cardiorenal dysfunction,highlighting practical frameworks and tools.Conventional bedside assessment tools are limited,and static markers such as serum creatinine and physical signs can be misleading.POCUS provides a dynamic,physiology-based evaluation by integrating focused cardiac imaging,venous Doppler,lung ultrasound,and abdominal views.Frameworks such as“pump,pipes,and leaks”and scoring systems like venous excess ultrasound enable realtime visualization and quantification of congestion,shifting practice from assumption-based to data-driven care and fostering alignment between specialties.As training opportunities expand and supporting evidence grows,POCUS should be regarded as a core clinical skill in the management of cardiorenal dysfunction,with the potential to improve diagnostic precision and guide targeted therapy.展开更多
The advent of point-of-care testing(POCT)has revolutionized the approach to patient management,especially for pediatric care.POCT provides rapid,on-the-spot biochemical and microbiological evaluations,bypassing delays...The advent of point-of-care testing(POCT)has revolutionized the approach to patient management,especially for pediatric care.POCT provides rapid,on-the-spot biochemical and microbiological evaluations,bypassing delays typically associated with central laboratory testing,enabling swift clinical decision-making.Additionally,POCT has proven to be a valuable prognostic tool for monitoring electrolyte,lactate,creatinine levels,often a marker of severe illness and poor outcomes.POCT enables its faster identification,allowing for prompt inter-ventions.This capability is essential in managing conditions like sepsis,where timely treatment can significantly impact survival rates.However,the implementation of POCT is not without its challenges.Variability in sample handling,particularly with heparinized syringes,can affect the accuracy of certain measurements,such as potassium levels.The absence of comprehensive follow-up data and cost-effectiveness analyses in some studies indicate the need for continued research to optimize the use of POCT.In conclusion,POCT is a trans-formative tool in critical care,offering prompt and reliable assessments that significantly enhance patient management.As technology advances,the inte-gration of POCT into emergency departments and intensive critical care units holds great promise for improving the quality of healthcare and patient survival rates.展开更多
The level of urinary albumin is a critical indicator for the early diagnosis and management of chronic kidney disease(CKD).However,existing methods for detecting albumin are not conducive to point-of-care testing due ...The level of urinary albumin is a critical indicator for the early diagnosis and management of chronic kidney disease(CKD).However,existing methods for detecting albumin are not conducive to point-of-care testing due to the complexity of reagent addition and incubation processes.This study presents a smartphone-integrated handheld automated biochemical analyzer(sHABA)designed for point-of-care testing of urinary albumin.The sHABA features a pre-loaded,disposable reagent cassette with reagents for the albumin assay arranged in the order of their addition within a hose.The smartphone-integrated analyzer can drive the reagents following a preset program,to enable automatic sequential addition.The sHABA has a detection limit for albumin of 5.9 mg/L and a linear detection range from 7 to 450 mg/L.The consistency of albumin level detection in 931 urine samples using sHABA with clinical tests indicates good sensitivity(95.78%)and specificity(90.16%).This research advances the field by providing an automated detection method for albumin in a portable device,allowing even untrained individuals to monitor CKD in real time at the patient's bedside.In the context of promoting tiered diagnosis and treatment,the sHABA has the potential to become an essential tool for the early diagnosis and comprehensive management of CKD and other chronic conditions.展开更多
Non-traumatic headache is a common presentation in both emergency and outpatient settings,where timely identification of raised intracranial pressure(ICP)is crucial to prevent severe neurological complications.Convent...Non-traumatic headache is a common presentation in both emergency and outpatient settings,where timely identification of raised intracranial pressure(ICP)is crucial to prevent severe neurological complications.Conventional diagnostic methods such as computed tomography and lumbar puncture have important limitations,including invasiveness,delayed availability,and limited sensitivity in certain contexts.Point-of-care ultrasound measurement of the optic nerve sheath diameter(ONSD)has emerged as a rapid,non-invasive tool for detecting elevated ICP at the bedside.The technique is based on the anatomical continuity between the intracranial subarachnoid space and the optic nerve sheath,which expands in response to increased ICP.Evidence from multiple studies and meta-analyses indicates that ONSD measurements above 5.0-5.7 mm in adults strongly correlate with elevated ICP,showing pooled sensitivities and specificities approaching 90%.This modality enables immediate triage,guides urgency of neuroimaging,reduces unnecessary radiation exposure,and can be applied in outpatient and low-resource settings.Despite these advantages,ONSD assessment is subject to operator dependency,variability in threshold values,and reduced accuracy in patients with certain ocular or systemic conditions.Advances in artificial intelligence–assisted measurement,coupled with standardized training protocols,have the potential to improve reproducibility and broaden adoption.Overall,point-of-care ultrasound-based ONSD measurement represents a valuable adjunct in the early evaluation of patients with non-traumatic headache,facilitating faster diagnosis,better resource utilization,and improved patient outcomes.展开更多
The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine.Despite their reliability,traditional laboratories often lag in terms of rapid diagnosis.Point...The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine.Despite their reliability,traditional laboratories often lag in terms of rapid diagnosis.Point-of-care testing(POCT)has emerged as a promising alternative,which is awaiting rigorous validation.We assessed 226 samples from patients at the First Affiliated Hospital of Guangzhou Medical University using a Beckman Coulter AU5821 and a PUSHKANG POCT Biochemistry Analyzer MS100.Furthermore,350 samples were evaluated with a Stago coagulation analyzer STAR MAX and a PUSHKANG POCT Coagulation Analyzer MC100.Metrics included thirteen biochemical indexes,such as albumin,and five coagulation indices,such as prothrombin time.Comparisons were drawn against the PUSHKANG POCT analyzer.Bland-Altman plots(MS100:0.8206-0.9995;MC100:0.8318-0.9911)evinced significant consistency between methodologies.Spearman correlation pinpointed a potent linear association between conventional devices and the PUSHKANG POCT analyzer,further underscored by a robust correlation coefficient(MS100:0.713-0.949;MC100:0.593-0.950).The PUSHKANG POCT was validated as a dependable tool for serum and whole blood biochemical and coagulation diagnostics.This emphasizes its prospective clinical efficacy,offering clinicians a swift diagnostic tool and heralding a new era of enhanced patient care outcomes.展开更多
The present study aims to explore the implementation pathway for practical teaching of basic clinical puncture procedures under the guidance of point-of-care ultrasound(POCUS).The goal of the study is twofold:firstly,...The present study aims to explore the implementation pathway for practical teaching of basic clinical puncture procedures under the guidance of point-of-care ultrasound(POCUS).The goal of the study is twofold:firstly,to address the shortcomings of the current medical education model and,secondly,to enhance medical students’independent thinking abilities and clinical diagnostic skills.The study enrolled 87 clinical medicine interns rotating at Jiangning Hospital in Nanjing from January to December 2024,dividing them into an experimental group(receiving ultrasound-guided puncture procedure training)and a control group(receiving conventional puncture procedure training).It was evident that both groups had successfully completed the requisite two-hour comprehensive course training program.A subsequent analysis of the teaching outcomes was then conducted through intergroup comparison.The findings indicated that the experimental group exhibited lower DOPS assessment scores in comparison to the control group(4.91±1.01 vs.5.84±1.22,p<0.05).However,the satisfaction levels of the experimental group with the teaching method reached 95.45%.This finding indicates that ultrasound-guided puncture techniques may offer a substantial advantage in terms of pedagogical approaches.However,it should be noted that students in the experimental group faced challenges such as high operational complexity and the need to pay attention to numerous details during actual procedures,leading to lower assessment scores.Conducting a systematic analysis of these issues can provide clear directions for the optimization of teaching methods in the future,thereby enhancing students’learning outcomes and clinical application capabilities.展开更多
The coronavirus disease 2019(COVID-19)pandemic has stretched our healthcare system to the brink,highlighting the importance of efficient resource utilization without compromising healthcare provider safety.While advan...The coronavirus disease 2019(COVID-19)pandemic has stretched our healthcare system to the brink,highlighting the importance of efficient resource utilization without compromising healthcare provider safety.While advanced imaging is a great resource for diagnostic purposes,the risk of contamination and infection transmission is high and requires extensive logistical planning for intrahospital patient transport,healthcare provider safety,and post-imaging decontamination.This dilemma has necessitated the transition to more bedside imaging.More so than ever,during the current pandemic,the clinical utility and importance of point-of-care ultrasound(POCUS)cannot be overstressed.It allows for safe and efficient beside procedural guidance and provides front line providers with valuable diagnostic information that can be acted upon in real-time for immediate clinical decision-making.The authors have been routinely using POCUS for the management of COVID-19 patients both in the emergency department and in intensive care units turned into“COVID-units.”In this article,we review the nuances of using POCUS in a pandemic situation and maximizing diagnostic output from this bedside technology.Additionally,we review various methods and diagnostic uses of POCUS which can replace conventional imaging and bridge current literature and common clinical practices in critically ill patients.We discuss practical guidance and pertinent review of the literature for the most relevant procedural and diagnostic guidance of respiratory illness,hemodynamic decompensation,renal failure,and gastrointestinal disorders experienced by many patients admitted to COVID-units.展开更多
AIM: To study the manifestations of perihepatic lymph nodes during the episode of acute hepatitis flare by point-of-care ultrasonography.METHODS: One hundred and seventy-six patients with an episode of acute hepatitis...AIM: To study the manifestations of perihepatic lymph nodes during the episode of acute hepatitis flare by point-of-care ultrasonography.METHODS: One hundred and seventy-six patients with an episode of acute hepatitis flare(ALT value > 5 × upper normal limit) were enrolled retrospectively. Diagnosis of etiology of the acute hepatitis flare was based on chart records and serological and virological assays. The patients were categorized into two groups(viral origin and non-viral origin) and further defined into ten subgroups according to the etiologies. An ultrasonograpy was performed within 2 h to 72 h(median, 8 h). The maximum size of each noticeable lymph node was measured. Correlation between clinical parameters and nodal manifestations was analyzed RESULTS: Enlarged lymph nodes(width ≥ 5mm)were noticeable in 110(62.5%) patients, mostly in acute on chronic hepatitis B(54.5%). The viral group had a higher prevalence rate(89/110 = 80.9%) and larger nodal size(median, 7 mm) than those of the non-viral group(21/66 = 31.8%; median, 0 mm)(P < 0.001 for both). Meanwhile, there were significant differences in the nodal size between acute and chronic viral groups(P < 0.01), and between acute hepatitis A and non-hepatitis A viral groups(P < 0.001). In logistical regression analysis, the nodal width still showed strong significance in multivariate analysis(P < 0.0001) to stratify the two groups. The area under the curve of ROC was 0.805, with a sensitivity of 80.9%, a specificity of 68.2%, positive predictive value of 80.92%, negative predictive value of 68.18%, and an accuracy of 76.14%. CONCLUSION: Point-of-care ultrasonography to detect perihepatic nodal change is valuable for clarifying the etiologies in an episode of acute hepatitis flare.展开更多
Objective To evaluate the effect of point-of-care hemoglobin/hematocrit(POC HGB/HCT) devices and intraoperative blood salvage on the amount of perioperative allogeneic blood transfusion and blood conservation in clini...Objective To evaluate the effect of point-of-care hemoglobin/hematocrit(POC HGB/HCT) devices and intraoperative blood salvage on the amount of perioperative allogeneic blood transfusion and blood conservation in clinical practice. Methods A total of 46 378 medical records of 22 selected hospitals were reviewed. The volume of allogeneic red blood cell and plasma, number of patients transfused, number of intraoperative autologous blood salvage, total volume of autologous blood transfusion, and amount of surgery in the year of 2011 and 2013 were tracked. Paired t-test was used in intra-group comparison, while t-test of two isolated samples carried out in inter-group comparison. P<0.05 was defined as statistically significant difference. Results In the hospitals where POC HGB/HCT device was used(n=9), the average allogeneic blood transfusion volume per 100 surgical cases in 2013 was significantly lower than that in 2011(39.86±20.20 vs. 30.49±17.50 Units, t=3.522, P=0.008). In the hospitals without POC HGB/HCT meter, the index was not significantly different between 2013 and 2011. The average allogeneic blood transfusion volume was significantly reduced in 2013 than in 2011 in the hospitals where intraoperative autologous blood salvage ratio [autologous transfusion volume/(autologous transfusion volume+allogeneic transfusion volume)] was increased(n=12, t=2.290, P=0.042). No significant difference of the above index was found in the hospitals whose autologous transfusion ratio did not grow. Conclusion Intraoperative usage of POC HGB/HCT devices and increasing autologous transfusion ratio could reduce perioperative allogeneic blood transfusion.展开更多
Analysis on a single-cell basis is both fundamental and meaningful in biomedical research and clinical practice.Flow cytometry is one of the most popular approaches in this field with broad applications in cell sortin...Analysis on a single-cell basis is both fundamental and meaningful in biomedical research and clinical practice.Flow cytometry is one of the most popular approaches in this field with broad applications in cell sorting,counting,and identification of rare cells.However,the complicated design and bulky size of conventional flow cytometry have restricted their applications mainly in centralized laboratories.With the recent development of smartphone devices,smartphone-based cytometry has been explored and tested for single-cell analysis.Compared with traditional cytometers,smartphone-based cytometric biosensors are more suitable for point-of-care(POC)uses,such as on-site disease diagnosis and personal health monitoring.In this review article,the history of traditional flowcytometry is introduced,and advances of smartphone-enabled cytometry are summarized in detail based on different working principles.Representative POC applications of smartphone cytometers are also discussed.The achievements demonstrated so far illustrate the potential of smartphone-based cytometric devices to transform single-cell measurement in general,with a significant impact in POC diagnostics,preventive medicine,and cell biology.展开更多
Background:Early diagnosis and classification of infections increase the cure rate while decreasing complications,which is significant for severe infections,especially for war surgery.However,traditional methods rely ...Background:Early diagnosis and classification of infections increase the cure rate while decreasing complications,which is significant for severe infections,especially for war surgery.However,traditional methods rely on laborious operations and bulky devices.On the other hand,point-of-care(POC)methods suffer from limited robustness and accuracy.Therefore,it is of urgent demand to develop POC devices for rapid and accurate diagnosis of infections to fulfill on-site militarized requirements.Methods:We developed a wave-shaped microfluidic chip(WMC)assisted multiplexed detection platform(WMC-MDP).WMC-MDP reduces detection time and improves repeatability through premixing of the samples and reaction of the reagents.We further combined the detection platform with the streptavidin–biotin(SA-B)amplified system to enhance the sensitivity while using chemiluminescence(CL)intensity as signal readout.We realized simultaneous detection of C-reactive protein(CRP),procalcitonin(PCT),and interleukin-6(IL-6)on the detection platform and evaluated the sensitivity,linear range,selectivity,and repeatability.Finally,we finished detecting 15 samples from volunteers and compared the results with commercial ELISA kits.Results:Detection of CRP,PCT,and IL-6 exhibited good linear relationships between CL intensities and concentrations in the range of 1.25–40μg/ml,0.4–12.8 ng/ml,and 50–1600 pg/ml,respectively.The limit of detection of CRP,PCT,and IL-6 were 0.54μg/ml,0.11 ng/ml,and 16.25 pg/ml,respectively.WMC-MDP is capable of good adequate selectivity and repeatability.The whole detection procedure takes only 22 min that meets the requirements of a POC device.Results of 15 samples from volunteers were consistent with the results detected by commercial ELISA kits.Conclusions:WMC-MDP allows simultaneous,rapid,and sensitive detection of CRP,PCT,and IL-6 with satisfactory selectivity and repeatability,requiring minimal manipulation.However,WMC-MDP takes advantage of being a microfluidic device showing the coefficients of variation less than 10%enabling WMC-MDP to be a type of point-of-care testing(POCT).Therefore,WMC-MDP provides a promising alternative to POCT of multiple biomarkers.We believe the practical application of WMC-MDP in militarized fields will revolutionize infection diagnosis for soldiers.展开更多
BACKGROUND:Traditionally performed using a subxiphoid approach,the increasing use of point-of-care ultrasound in the emergency department has made other approaches(parasternal and apical)for pericardiocentesis viable....BACKGROUND:Traditionally performed using a subxiphoid approach,the increasing use of point-of-care ultrasound in the emergency department has made other approaches(parasternal and apical)for pericardiocentesis viable.The aim of this study is to identify the ideal approach for emergency-physician-performed ultrasound-guided pericardiocentesis as determined by ultrasound image quality,distance from surface to pericardial fl uid,and likely obstructions or complications.METHODS:A retrospective review of point-of-care cardiac ultrasound examinations was performed in two urban academic emergency departments for the presence of pericardial eff usions.The images were reviewed for technical quality,distance of eff usion from skin surface,and predicted complications.RESULTS:A total of 166 pericardial effusions were identified during the study period.The mean skin-to-pericardial fl uid distance was 5.6 cm(95%confi dence interval[95%CI]5.2-6.0 cm)for the subxiphoid views,which was signifi cantly greater than that for the parasternal(2.7 cm[95%CI 2.5-2.8 cm],P<0.001)and apical(2.5 cm[95%CI 2.3-2.7 cm],P<0.001)views.The subxiphoid view had the highest predicted complication rate at 79.7%(95%CI 71.5%-86.4%),which was signifi cantly greater than the apical(31.9%;95%CI 21.4%-44.0%,P<0.001)and parasternal(20.2%;95%CI 12.8%-29.5%,P<0.001)views.CONCLUSIONS:Our results suggest that complication rates with pericardiocentesis will be lower via the parasternal or apical approach compared to the subxiphoid approach.The distance from skin to fl uid collection is the least in both of these views.展开更多
BACKGROUND: To evaluate the utilization of point-of-care ultrasound(POCUS) for the assessment of emergency department(ED) patients with musculoskeletal symptoms and the impact of musculoskeletal POCUS on medical decis...BACKGROUND: To evaluate the utilization of point-of-care ultrasound(POCUS) for the assessment of emergency department(ED) patients with musculoskeletal symptoms and the impact of musculoskeletal POCUS on medical decision-making and patient management in the ED.METHODS: This was a retrospective review of ED patients presenting with musculoskeletal symptoms who received a POCUS over a 3.5-year period. An ED POCUS database was reviewed for musculoskeletal POCUS examinations used for medical decision-making. Electronic medical records were then reviewed for demographic characteristics, history, physical examination findings, ED course, additional imaging studies, and impact of musculoskeletal POCUS on patient management in ED. RESULTS: A total of 264 subjects(92 females, 172 males) and 292 musculoskeletal POCUS examinations were included in the fi nal analysis. Most common symptomatic sites were knee(31.8%) and ankle(16.3%). Joint effusion was the most common fi nding on musculoskeletal POCUS, noted in 33.7% of the patients, and subcutaneous edema/cobblestoning was found in 10.2% of the patients. Muscle or tendon rupture was found in 2.3% of the patients, and 1.9% of the patients had joint dislocation. Bursitis or bursa fluid was found in 3.4% of patients, and tendonitis/tendinopathy was found in 2.3%. Twenty percent of them were ultrasound-guided musculoskeletal procedures, and most of them(73.3%) were arthrocentesis. Of the included studies, all except three either changed or helped guide patient management as documented in the patients' medical records.CONCLUSION: Our study fi ndings illustrate the utility of POCUS in the evaluation of a variety of musculoskeletal pathologies in the ED.展开更多
BACKGROUND:We aimed to evaluate the utility of point-of-care ultrasound(POCUS)in the assessment of hand infections that present to the emergency department(ED)and its impact on medical decision making and patient mana...BACKGROUND:We aimed to evaluate the utility of point-of-care ultrasound(POCUS)in the assessment of hand infections that present to the emergency department(ED)and its impact on medical decision making and patient management.METHODS:We conducted a retrospective review of patients who presented to two urban academic EDs with clinical presentations concerning for skin and soft tissue infections(SSTI)of the hand between December 2015 and December 2021.Two trained POCUS fellowship physicians reviewed an ED POCUS database for POCUS examinations of the hand.We then reviewed patients’electronic health records(EHR)for demographic characteristics,history,physical examination findings,ED course,additional imaging studies,consultations,impact of POCUS on patient care and final disposition.RESULTS:We included a total of 50 cases(28 male,22 female)in the final analysis.The most common presenting symptoms and exam findings were pain(100%),swelling(90%),and erythema(74%).The most common sonographic findings were edema(76%),soft tissue swelling(78%),and fluid surrounding the tendon(57%).POCUS was used in medical decision making 68%of the time(n=34),with the use of POCUS leading to changes in management 38%of the time(n=19).POCUS use led to early antibiotic use(11/19),early consultation(10/19),and led to the performance of a required procedure(8/19).The POCUS diagnosis was consistent with the discharge diagnosis of flexor tenosynovitis 8/12 times,abscess 12/16 times,and cellulitis 14/20 times.CONCLUSION:POCUS is beneficial for evaluating of hand infections that present to the ED and can be used as an important part of medical decision making to expedite patient care.展开更多
BACKGROUND Peripherally inserted central catheters(PICCs)have been increasingly applied worldwide owing to many advantages.Even with these advantages,the related complications should not be ignored,especially in neona...BACKGROUND Peripherally inserted central catheters(PICCs)have been increasingly applied worldwide owing to many advantages.Even with these advantages,the related complications should not be ignored,especially in neonates.The available evidence about PICC-related thrombosis was manifold,but the cardiac tamponade,an emergency and life-threatening complication,has been rarely reported.Early recognized cardiac tamponade by ultrasound may reduce mortality.CASE SUMMARY A neonate weighting 2.8 kg was born at 40 wk of gestation.He was admitted to the Surgery Intensive Care Unit due to suspected congenital megacolon.A PICC line was inserted via the left antecubital fossa for the administration of total parenteral nutrition.Three days later,the patient was still on total parenteral nutrition.Cardiac tamponade caused by PICC was found on ultrasound.The patient recovered spontaneously after an emergency pericardiocentesis.CONCLUSION Proficiency in the use of point-of-care ultrasound may save the life of patients,since it enables clinicians to treat patients faster,more accurately,and in a noninvasive way at the point of care.展开更多
In this study,a point-of-care sensing protocol has been reported for rapid and sensitive detection of Microcystin-LR(MC-LR)in water by personal glucose meter.The proposed immunosensor has been fabricated by using a pr...In this study,a point-of-care sensing protocol has been reported for rapid and sensitive detection of Microcystin-LR(MC-LR)in water by personal glucose meter.The proposed immunosensor has been fabricated by using a primary antibody coated ZnFe2O4 nanoparticles to capture the target MC-LR.Consequently,the invertase@secondary antibody-conjugated graphene oxide-Au NPs can be immobilized for formating the sandwich immuno-complexes,which allowed for enzymatic conversion of sucrose to glucose.Thus,the concentration of MC-LR can be refelected by the converted glucose,which can be easily measured by the personal glucose meter(PGM).The PGM readout immunosensing method possessed good reproducibility and stability,which may have significant potential for other applications.展开更多
文摘Point-of-care testing(POCT)refers to a category of diagnostic tests that are performed at or near to the site of the patients(also called bedside testing)and is capable of obtaining accurate results in a short time by using portable diagnostic devices,avoiding sending samples to the medical laboratories.It has been extensively explored for diagnosing and monitoring patients’diseases and health conditions with the assistance of development in biochemistry and microfluidics.Microfluidic paper-based analytical devices(μPADs)have gained dramatic popularity in POCT because of their simplicity,user-friendly,fast and accurate result reading and low cost.SeveralμPADs have been successfully commercialized and received excellent feedback during the past several decades.This review briefly discusses the main types ofμPADs,preparation methods and their detection principles,followed by a few representative examples.The future perspectives of the development inμPADs are also provided.
文摘BACKGROUND Point-of-care ultrasound(POCUS)is the use of portable ultrasound devices by trained healthcare professionals to diagnose and monitor medical conditions directly at the patient's bedside,such as in emergency settings.We described a case where POCUS use,in Pediatric Emergency Department,allowed an early diagnosis and timely management in the surgical department,with a favorable outcome for child.Therefore we write this case because it is desirable to po-pularize ultrasound as the fifth pillar of clinical examination especially in Emer-gency Department CASE SUMMARY A 13-year-old girl with acute gastrointestinal symptoms,such as vomit and abdominal and lumbar pains.Upon physical examination,the patient had lo-calized abdominal pain in the left lower quadrant.Ultrasonography performed at the bedside revealed an enlarged left ovary with an irregular structure containing a 3 cm cyst.These findings raised suspicion of ovarian torsion.The child tran-sferred to Gynecology Surgery Unit,where she was taken emergently to the ope-rating room CONCLUSION It is desirable to spread POCUS in emergency settings where it allows a sig-nificant saving of time in patient management.
文摘Ultrasound has long been an essential tool in nephrology,traditionally used for procedures like vascular access and kidney biopsies.Point-of-care ultrasonography(POCUS),a rapidly evolving bedside technology,is now gaining momentum in nephrology by providing real-time imaging to enhance physical examination findings.Unlike comprehensive radiology-performed ultrasound,POCUS focuses on specific clinical questions,providing immediate and actionable insights.This narrative review examines the philosophy behind POCUS,its expanding applications in nephrology,and its impact on patient care,including its role in diagnosing obstructive uropathy,guiding fluid management,and evaluating hemodynamics in cardiorenal syndrome.Additionally,the review addresses barriers to widespread adoption,such as the need for structured training,competency validation,and interdisciplinary cooperation.By integrating POCUS into routine practice,nephrologists can refine diagnostic accuracy,improve patient outcomes,and strengthen the role of bedside medicine.
文摘Cardiorenal syndrome reflects a complex interplay between cardiac and renal dysfunction,often compounded by fragmented management between cardiology and nephrology.Traditional phrases such as“the heart likes it dry and the kidneys like it wet”oversimplify care and perpetuate misconceptions about diuretic use and fluid management.Emerging evidence points to venous congestion rather than reduced cardiac output as a key driver of worsening renal function and adverse outcomes in heart failure.This article blends current evidence with the authors’perspective and clinical experience to explore the role of point-of-care ultrasound(POCUS)in the hemodynamic assessment of cardiorenal dysfunction,highlighting practical frameworks and tools.Conventional bedside assessment tools are limited,and static markers such as serum creatinine and physical signs can be misleading.POCUS provides a dynamic,physiology-based evaluation by integrating focused cardiac imaging,venous Doppler,lung ultrasound,and abdominal views.Frameworks such as“pump,pipes,and leaks”and scoring systems like venous excess ultrasound enable realtime visualization and quantification of congestion,shifting practice from assumption-based to data-driven care and fostering alignment between specialties.As training opportunities expand and supporting evidence grows,POCUS should be regarded as a core clinical skill in the management of cardiorenal dysfunction,with the potential to improve diagnostic precision and guide targeted therapy.
文摘The advent of point-of-care testing(POCT)has revolutionized the approach to patient management,especially for pediatric care.POCT provides rapid,on-the-spot biochemical and microbiological evaluations,bypassing delays typically associated with central laboratory testing,enabling swift clinical decision-making.Additionally,POCT has proven to be a valuable prognostic tool for monitoring electrolyte,lactate,creatinine levels,often a marker of severe illness and poor outcomes.POCT enables its faster identification,allowing for prompt inter-ventions.This capability is essential in managing conditions like sepsis,where timely treatment can significantly impact survival rates.However,the implementation of POCT is not without its challenges.Variability in sample handling,particularly with heparinized syringes,can affect the accuracy of certain measurements,such as potassium levels.The absence of comprehensive follow-up data and cost-effectiveness analyses in some studies indicate the need for continued research to optimize the use of POCT.In conclusion,POCT is a trans-formative tool in critical care,offering prompt and reliable assessments that significantly enhance patient management.As technology advances,the inte-gration of POCT into emergency departments and intensive critical care units holds great promise for improving the quality of healthcare and patient survival rates.
基金funding by the China Postdoctoral Science Foundation(Grant No.:2021M701628)the National Natural Science Foundation of China(Grant No.:82202625)+3 种基金Science and Technology Projects in Guangzhou,China(Grant No.:SL2022A04J02086)President Foundation of Nanfang Hospital,Southern Medical University,China(Grant Nos.:2021B012,and 2021C050)National Science Fund for Distinguished Young Scholars,China(Grant No.:82025024)Key project of the National Natural Science Foundation of China(Grant No.:82230080).
文摘The level of urinary albumin is a critical indicator for the early diagnosis and management of chronic kidney disease(CKD).However,existing methods for detecting albumin are not conducive to point-of-care testing due to the complexity of reagent addition and incubation processes.This study presents a smartphone-integrated handheld automated biochemical analyzer(sHABA)designed for point-of-care testing of urinary albumin.The sHABA features a pre-loaded,disposable reagent cassette with reagents for the albumin assay arranged in the order of their addition within a hose.The smartphone-integrated analyzer can drive the reagents following a preset program,to enable automatic sequential addition.The sHABA has a detection limit for albumin of 5.9 mg/L and a linear detection range from 7 to 450 mg/L.The consistency of albumin level detection in 931 urine samples using sHABA with clinical tests indicates good sensitivity(95.78%)and specificity(90.16%).This research advances the field by providing an automated detection method for albumin in a portable device,allowing even untrained individuals to monitor CKD in real time at the patient's bedside.In the context of promoting tiered diagnosis and treatment,the sHABA has the potential to become an essential tool for the early diagnosis and comprehensive management of CKD and other chronic conditions.
文摘Non-traumatic headache is a common presentation in both emergency and outpatient settings,where timely identification of raised intracranial pressure(ICP)is crucial to prevent severe neurological complications.Conventional diagnostic methods such as computed tomography and lumbar puncture have important limitations,including invasiveness,delayed availability,and limited sensitivity in certain contexts.Point-of-care ultrasound measurement of the optic nerve sheath diameter(ONSD)has emerged as a rapid,non-invasive tool for detecting elevated ICP at the bedside.The technique is based on the anatomical continuity between the intracranial subarachnoid space and the optic nerve sheath,which expands in response to increased ICP.Evidence from multiple studies and meta-analyses indicates that ONSD measurements above 5.0-5.7 mm in adults strongly correlate with elevated ICP,showing pooled sensitivities and specificities approaching 90%.This modality enables immediate triage,guides urgency of neuroimaging,reduces unnecessary radiation exposure,and can be applied in outpatient and low-resource settings.Despite these advantages,ONSD assessment is subject to operator dependency,variability in threshold values,and reduced accuracy in patients with certain ocular or systemic conditions.Advances in artificial intelligence–assisted measurement,coupled with standardized training protocols,have the potential to improve reproducibility and broaden adoption.Overall,point-of-care ultrasound-based ONSD measurement represents a valuable adjunct in the early evaluation of patients with non-traumatic headache,facilitating faster diagnosis,better resource utilization,and improved patient outcomes.
基金supported by the National Natural Science Foundation of China(No.82302607)the Guangdong Basic and Applied Basic Research Foundation(Nos.2022A1515110555 and 2023A1515010932)+3 种基金the State Key Laboratory of Respiratory Disease(No.SKLRD-Z-202410)the Precision Medicine Joint Foundation of Basic and Applied Basic Research Foundation of Guangdong Province(No.2021B1515230008)the Independent Project of Guangdong-Hong Kong-Macao Joint Laboratory for Respiratory Infectious Diseases(No.GHMJLRID-Z-202102)the Guangdong Zhong Nanshan Medical Foundation(No.ZNSXS-20220015).
文摘The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine.Despite their reliability,traditional laboratories often lag in terms of rapid diagnosis.Point-of-care testing(POCT)has emerged as a promising alternative,which is awaiting rigorous validation.We assessed 226 samples from patients at the First Affiliated Hospital of Guangzhou Medical University using a Beckman Coulter AU5821 and a PUSHKANG POCT Biochemistry Analyzer MS100.Furthermore,350 samples were evaluated with a Stago coagulation analyzer STAR MAX and a PUSHKANG POCT Coagulation Analyzer MC100.Metrics included thirteen biochemical indexes,such as albumin,and five coagulation indices,such as prothrombin time.Comparisons were drawn against the PUSHKANG POCT analyzer.Bland-Altman plots(MS100:0.8206-0.9995;MC100:0.8318-0.9911)evinced significant consistency between methodologies.Spearman correlation pinpointed a potent linear association between conventional devices and the PUSHKANG POCT analyzer,further underscored by a robust correlation coefficient(MS100:0.713-0.949;MC100:0.593-0.950).The PUSHKANG POCT was validated as a dependable tool for serum and whole blood biochemical and coagulation diagnostics.This emphasizes its prospective clinical efficacy,offering clinicians a swift diagnostic tool and heralding a new era of enhanced patient care outcomes.
基金Education Foundation of Kangda College of Nanjing Medical University(Project No.:KDJYYJYB202332)Science Foundation of Kangda College of Nanjing Medical University(Project No.:KD2023KYJJ250)。
文摘The present study aims to explore the implementation pathway for practical teaching of basic clinical puncture procedures under the guidance of point-of-care ultrasound(POCUS).The goal of the study is twofold:firstly,to address the shortcomings of the current medical education model and,secondly,to enhance medical students’independent thinking abilities and clinical diagnostic skills.The study enrolled 87 clinical medicine interns rotating at Jiangning Hospital in Nanjing from January to December 2024,dividing them into an experimental group(receiving ultrasound-guided puncture procedure training)and a control group(receiving conventional puncture procedure training).It was evident that both groups had successfully completed the requisite two-hour comprehensive course training program.A subsequent analysis of the teaching outcomes was then conducted through intergroup comparison.The findings indicated that the experimental group exhibited lower DOPS assessment scores in comparison to the control group(4.91±1.01 vs.5.84±1.22,p<0.05).However,the satisfaction levels of the experimental group with the teaching method reached 95.45%.This finding indicates that ultrasound-guided puncture techniques may offer a substantial advantage in terms of pedagogical approaches.However,it should be noted that students in the experimental group faced challenges such as high operational complexity and the need to pay attention to numerous details during actual procedures,leading to lower assessment scores.Conducting a systematic analysis of these issues can provide clear directions for the optimization of teaching methods in the future,thereby enhancing students’learning outcomes and clinical application capabilities.
文摘The coronavirus disease 2019(COVID-19)pandemic has stretched our healthcare system to the brink,highlighting the importance of efficient resource utilization without compromising healthcare provider safety.While advanced imaging is a great resource for diagnostic purposes,the risk of contamination and infection transmission is high and requires extensive logistical planning for intrahospital patient transport,healthcare provider safety,and post-imaging decontamination.This dilemma has necessitated the transition to more bedside imaging.More so than ever,during the current pandemic,the clinical utility and importance of point-of-care ultrasound(POCUS)cannot be overstressed.It allows for safe and efficient beside procedural guidance and provides front line providers with valuable diagnostic information that can be acted upon in real-time for immediate clinical decision-making.The authors have been routinely using POCUS for the management of COVID-19 patients both in the emergency department and in intensive care units turned into“COVID-units.”In this article,we review the nuances of using POCUS in a pandemic situation and maximizing diagnostic output from this bedside technology.Additionally,we review various methods and diagnostic uses of POCUS which can replace conventional imaging and bridge current literature and common clinical practices in critically ill patients.We discuss practical guidance and pertinent review of the literature for the most relevant procedural and diagnostic guidance of respiratory illness,hemodynamic decompensation,renal failure,and gastrointestinal disorders experienced by many patients admitted to COVID-units.
文摘AIM: To study the manifestations of perihepatic lymph nodes during the episode of acute hepatitis flare by point-of-care ultrasonography.METHODS: One hundred and seventy-six patients with an episode of acute hepatitis flare(ALT value > 5 × upper normal limit) were enrolled retrospectively. Diagnosis of etiology of the acute hepatitis flare was based on chart records and serological and virological assays. The patients were categorized into two groups(viral origin and non-viral origin) and further defined into ten subgroups according to the etiologies. An ultrasonograpy was performed within 2 h to 72 h(median, 8 h). The maximum size of each noticeable lymph node was measured. Correlation between clinical parameters and nodal manifestations was analyzed RESULTS: Enlarged lymph nodes(width ≥ 5mm)were noticeable in 110(62.5%) patients, mostly in acute on chronic hepatitis B(54.5%). The viral group had a higher prevalence rate(89/110 = 80.9%) and larger nodal size(median, 7 mm) than those of the non-viral group(21/66 = 31.8%; median, 0 mm)(P < 0.001 for both). Meanwhile, there were significant differences in the nodal size between acute and chronic viral groups(P < 0.01), and between acute hepatitis A and non-hepatitis A viral groups(P < 0.001). In logistical regression analysis, the nodal width still showed strong significance in multivariate analysis(P < 0.0001) to stratify the two groups. The area under the curve of ROC was 0.805, with a sensitivity of 80.9%, a specificity of 68.2%, positive predictive value of 80.92%, negative predictive value of 68.18%, and an accuracy of 76.14%. CONCLUSION: Point-of-care ultrasonography to detect perihepatic nodal change is valuable for clarifying the etiologies in an episode of acute hepatitis flare.
文摘Objective To evaluate the effect of point-of-care hemoglobin/hematocrit(POC HGB/HCT) devices and intraoperative blood salvage on the amount of perioperative allogeneic blood transfusion and blood conservation in clinical practice. Methods A total of 46 378 medical records of 22 selected hospitals were reviewed. The volume of allogeneic red blood cell and plasma, number of patients transfused, number of intraoperative autologous blood salvage, total volume of autologous blood transfusion, and amount of surgery in the year of 2011 and 2013 were tracked. Paired t-test was used in intra-group comparison, while t-test of two isolated samples carried out in inter-group comparison. P<0.05 was defined as statistically significant difference. Results In the hospitals where POC HGB/HCT device was used(n=9), the average allogeneic blood transfusion volume per 100 surgical cases in 2013 was significantly lower than that in 2011(39.86±20.20 vs. 30.49±17.50 Units, t=3.522, P=0.008). In the hospitals without POC HGB/HCT meter, the index was not significantly different between 2013 and 2011. The average allogeneic blood transfusion volume was significantly reduced in 2013 than in 2011 in the hospitals where intraoperative autologous blood salvage ratio [autologous transfusion volume/(autologous transfusion volume+allogeneic transfusion volume)] was increased(n=12, t=2.290, P=0.042). No significant difference of the above index was found in the hospitals whose autologous transfusion ratio did not grow. Conclusion Intraoperative usage of POC HGB/HCT devices and increasing autologous transfusion ratio could reduce perioperative allogeneic blood transfusion.
基金the Chancellor's Faculty Excellence Program at NC State University.
文摘Analysis on a single-cell basis is both fundamental and meaningful in biomedical research and clinical practice.Flow cytometry is one of the most popular approaches in this field with broad applications in cell sorting,counting,and identification of rare cells.However,the complicated design and bulky size of conventional flow cytometry have restricted their applications mainly in centralized laboratories.With the recent development of smartphone devices,smartphone-based cytometry has been explored and tested for single-cell analysis.Compared with traditional cytometers,smartphone-based cytometric biosensors are more suitable for point-of-care(POC)uses,such as on-site disease diagnosis and personal health monitoring.In this review article,the history of traditional flowcytometry is introduced,and advances of smartphone-enabled cytometry are summarized in detail based on different working principles.Representative POC applications of smartphone cytometers are also discussed.The achievements demonstrated so far illustrate the potential of smartphone-based cytometric devices to transform single-cell measurement in general,with a significant impact in POC diagnostics,preventive medicine,and cell biology.
基金the National Natural Science Foundation of China(81902167,52075138)the Natural Science Foundation of Jiangsu Province(BK20190872).
文摘Background:Early diagnosis and classification of infections increase the cure rate while decreasing complications,which is significant for severe infections,especially for war surgery.However,traditional methods rely on laborious operations and bulky devices.On the other hand,point-of-care(POC)methods suffer from limited robustness and accuracy.Therefore,it is of urgent demand to develop POC devices for rapid and accurate diagnosis of infections to fulfill on-site militarized requirements.Methods:We developed a wave-shaped microfluidic chip(WMC)assisted multiplexed detection platform(WMC-MDP).WMC-MDP reduces detection time and improves repeatability through premixing of the samples and reaction of the reagents.We further combined the detection platform with the streptavidin–biotin(SA-B)amplified system to enhance the sensitivity while using chemiluminescence(CL)intensity as signal readout.We realized simultaneous detection of C-reactive protein(CRP),procalcitonin(PCT),and interleukin-6(IL-6)on the detection platform and evaluated the sensitivity,linear range,selectivity,and repeatability.Finally,we finished detecting 15 samples from volunteers and compared the results with commercial ELISA kits.Results:Detection of CRP,PCT,and IL-6 exhibited good linear relationships between CL intensities and concentrations in the range of 1.25–40μg/ml,0.4–12.8 ng/ml,and 50–1600 pg/ml,respectively.The limit of detection of CRP,PCT,and IL-6 were 0.54μg/ml,0.11 ng/ml,and 16.25 pg/ml,respectively.WMC-MDP is capable of good adequate selectivity and repeatability.The whole detection procedure takes only 22 min that meets the requirements of a POC device.Results of 15 samples from volunteers were consistent with the results detected by commercial ELISA kits.Conclusions:WMC-MDP allows simultaneous,rapid,and sensitive detection of CRP,PCT,and IL-6 with satisfactory selectivity and repeatability,requiring minimal manipulation.However,WMC-MDP takes advantage of being a microfluidic device showing the coefficients of variation less than 10%enabling WMC-MDP to be a type of point-of-care testing(POCT).Therefore,WMC-MDP provides a promising alternative to POCT of multiple biomarkers.We believe the practical application of WMC-MDP in militarized fields will revolutionize infection diagnosis for soldiers.
文摘BACKGROUND:Traditionally performed using a subxiphoid approach,the increasing use of point-of-care ultrasound in the emergency department has made other approaches(parasternal and apical)for pericardiocentesis viable.The aim of this study is to identify the ideal approach for emergency-physician-performed ultrasound-guided pericardiocentesis as determined by ultrasound image quality,distance from surface to pericardial fl uid,and likely obstructions or complications.METHODS:A retrospective review of point-of-care cardiac ultrasound examinations was performed in two urban academic emergency departments for the presence of pericardial eff usions.The images were reviewed for technical quality,distance of eff usion from skin surface,and predicted complications.RESULTS:A total of 166 pericardial effusions were identified during the study period.The mean skin-to-pericardial fl uid distance was 5.6 cm(95%confi dence interval[95%CI]5.2-6.0 cm)for the subxiphoid views,which was signifi cantly greater than that for the parasternal(2.7 cm[95%CI 2.5-2.8 cm],P<0.001)and apical(2.5 cm[95%CI 2.3-2.7 cm],P<0.001)views.The subxiphoid view had the highest predicted complication rate at 79.7%(95%CI 71.5%-86.4%),which was signifi cantly greater than the apical(31.9%;95%CI 21.4%-44.0%,P<0.001)and parasternal(20.2%;95%CI 12.8%-29.5%,P<0.001)views.CONCLUSIONS:Our results suggest that complication rates with pericardiocentesis will be lower via the parasternal or apical approach compared to the subxiphoid approach.The distance from skin to fl uid collection is the least in both of these views.
文摘BACKGROUND: To evaluate the utilization of point-of-care ultrasound(POCUS) for the assessment of emergency department(ED) patients with musculoskeletal symptoms and the impact of musculoskeletal POCUS on medical decision-making and patient management in the ED.METHODS: This was a retrospective review of ED patients presenting with musculoskeletal symptoms who received a POCUS over a 3.5-year period. An ED POCUS database was reviewed for musculoskeletal POCUS examinations used for medical decision-making. Electronic medical records were then reviewed for demographic characteristics, history, physical examination findings, ED course, additional imaging studies, and impact of musculoskeletal POCUS on patient management in ED. RESULTS: A total of 264 subjects(92 females, 172 males) and 292 musculoskeletal POCUS examinations were included in the fi nal analysis. Most common symptomatic sites were knee(31.8%) and ankle(16.3%). Joint effusion was the most common fi nding on musculoskeletal POCUS, noted in 33.7% of the patients, and subcutaneous edema/cobblestoning was found in 10.2% of the patients. Muscle or tendon rupture was found in 2.3% of the patients, and 1.9% of the patients had joint dislocation. Bursitis or bursa fluid was found in 3.4% of patients, and tendonitis/tendinopathy was found in 2.3%. Twenty percent of them were ultrasound-guided musculoskeletal procedures, and most of them(73.3%) were arthrocentesis. Of the included studies, all except three either changed or helped guide patient management as documented in the patients' medical records.CONCLUSION: Our study fi ndings illustrate the utility of POCUS in the evaluation of a variety of musculoskeletal pathologies in the ED.
文摘BACKGROUND:We aimed to evaluate the utility of point-of-care ultrasound(POCUS)in the assessment of hand infections that present to the emergency department(ED)and its impact on medical decision making and patient management.METHODS:We conducted a retrospective review of patients who presented to two urban academic EDs with clinical presentations concerning for skin and soft tissue infections(SSTI)of the hand between December 2015 and December 2021.Two trained POCUS fellowship physicians reviewed an ED POCUS database for POCUS examinations of the hand.We then reviewed patients’electronic health records(EHR)for demographic characteristics,history,physical examination findings,ED course,additional imaging studies,consultations,impact of POCUS on patient care and final disposition.RESULTS:We included a total of 50 cases(28 male,22 female)in the final analysis.The most common presenting symptoms and exam findings were pain(100%),swelling(90%),and erythema(74%).The most common sonographic findings were edema(76%),soft tissue swelling(78%),and fluid surrounding the tendon(57%).POCUS was used in medical decision making 68%of the time(n=34),with the use of POCUS leading to changes in management 38%of the time(n=19).POCUS use led to early antibiotic use(11/19),early consultation(10/19),and led to the performance of a required procedure(8/19).The POCUS diagnosis was consistent with the discharge diagnosis of flexor tenosynovitis 8/12 times,abscess 12/16 times,and cellulitis 14/20 times.CONCLUSION:POCUS is beneficial for evaluating of hand infections that present to the ED and can be used as an important part of medical decision making to expedite patient care.
文摘BACKGROUND Peripherally inserted central catheters(PICCs)have been increasingly applied worldwide owing to many advantages.Even with these advantages,the related complications should not be ignored,especially in neonates.The available evidence about PICC-related thrombosis was manifold,but the cardiac tamponade,an emergency and life-threatening complication,has been rarely reported.Early recognized cardiac tamponade by ultrasound may reduce mortality.CASE SUMMARY A neonate weighting 2.8 kg was born at 40 wk of gestation.He was admitted to the Surgery Intensive Care Unit due to suspected congenital megacolon.A PICC line was inserted via the left antecubital fossa for the administration of total parenteral nutrition.Three days later,the patient was still on total parenteral nutrition.Cardiac tamponade caused by PICC was found on ultrasound.The patient recovered spontaneously after an emergency pericardiocentesis.CONCLUSION Proficiency in the use of point-of-care ultrasound may save the life of patients,since it enables clinicians to treat patients faster,more accurately,and in a noninvasive way at the point of care.
基金the Natural Science Foundation of Shandong(No.ZR2017MB017)for the financial support
文摘In this study,a point-of-care sensing protocol has been reported for rapid and sensitive detection of Microcystin-LR(MC-LR)in water by personal glucose meter.The proposed immunosensor has been fabricated by using a primary antibody coated ZnFe2O4 nanoparticles to capture the target MC-LR.Consequently,the invertase@secondary antibody-conjugated graphene oxide-Au NPs can be immobilized for formating the sandwich immuno-complexes,which allowed for enzymatic conversion of sucrose to glucose.Thus,the concentration of MC-LR can be refelected by the converted glucose,which can be easily measured by the personal glucose meter(PGM).The PGM readout immunosensing method possessed good reproducibility and stability,which may have significant potential for other applications.
