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
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
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
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
Point-of-care ultrasound(POCUS)of the internal jugular vein(IJV)offers a noninvasive means of estimating right atrial pressure(RAP),especially in cases where the inferior vena cava is inaccessible or unreliable due to...Point-of-care ultrasound(POCUS)of the internal jugular vein(IJV)offers a noninvasive means of estimating right atrial pressure(RAP),especially in cases where the inferior vena cava is inaccessible or unreliable due to conditions such as liver disease or abdominal surgery.While many clinicians are familiar with visually assessing jugular venous pressure through the internal jugular vein,this method lacks sensitivity.The utilization of POCUS significantly enhances the visualization of the vein,leading to a more accurate identification.It has been demonstrated that combining IJV POCUS with physical examination enhances the specificity of RAP estimation.This review aims to provide a comprehensive summary of the various sonographic techniques available for estimating RAP from the internal jugular vein,drawing upon existing data.展开更多
The outbreak of COVID-19 has drawn great attention around the world.SARS-CoV-2 is a highly infectious virus with occult transmission by many mutations and a long incubation period.In particular,the emergence of asympt...The outbreak of COVID-19 has drawn great attention around the world.SARS-CoV-2 is a highly infectious virus with occult transmission by many mutations and a long incubation period.In particular,the emergence of asymptomatic infections has made the epidemic even more severe.Therefore,early diagnosis and timely management of suspected cases are essential measures to control the spread of the virus.Developing simple,portable,and accurate diagnostic techniques for SARS-CoV-2 is the key to epidemic prevention.The advantages of point-of-care testing technology make it play an increasingly important role in viral detection and screening.This review summarizes the point-of-care testing platforms developed by nucleic acid detection,immunological detection,and nanomaterial-based biosensors detection.Furthermore,this paper provides a prospect for designing future highly accurate,cheap,and convenient SARS-CoV-2 diagnostic technology.展开更多
Point-of-care testing(POCT)is the practice of diagnosing and monitoring diseases where the patient is located,as opposed to traditional treatment conducted solely in a medical laboratory or other clinical setting.POCT...Point-of-care testing(POCT)is the practice of diagnosing and monitoring diseases where the patient is located,as opposed to traditional treatment conducted solely in a medical laboratory or other clinical setting.POCT has been less common in the recent past due to a lack of portable medical devices capable of facilitating effective medical testing.However,recent growth has occurred in this field due to advances in diagnostic technologies,device miniaturization,and progress in wearable electronics.Among these developments,electrochemical sensors have attracted interest in the POCT field due to their high sensitivity,compact size,and affordability.They are used in various applications,from disease diagnosis to health status monitoring.In this paper we explore recent advancements in electrochemical sensors,the methods of fabricating them,and the various types of sensing mechanisms that can be used.Furthermore,we delve into methods for immobilizing specific biorecognition elements,including enzymes,antibodies,and aptamers,onto electrode surfaces and how these sensors are used in real-world POCT settings.展开更多
Discerning the etiology of acute kidney injury(AKI)in cirrhotic patients remains a formidable challenge due to diverse and overlapping causes.The conventional approach of empiric albumin administration for suspected v...Discerning the etiology of acute kidney injury(AKI)in cirrhotic patients remains a formidable challenge due to diverse and overlapping causes.The conventional approach of empiric albumin administration for suspected volume depletion may inadvertently lead to fluid overload.In the recent past,point-of-care ultrasonography(POCUS)has emerged as a valuable adjunct to clinical assessment,offering advantages in terms of diagnostic accuracy,rapidity,cost-effectiveness,and patient satisfaction.This review provides insights into the strategic use of POCUS in evaluating cirrhotic patients with AKI.The review distinguishes basic and advanced POCUS,emphasizing a 5-point basic POCUS protocol for efficient assessment.This protocol includes evaluations of the kidneys and urinary bladder for obstructive nephropathy,lung ultrasound for detecting extravascular lung water,inferior vena cava(IVC)ultrasound for estimating right atrial pressure,internal jugular vein ultrasound as an alternative to IVC assessment,and focused cardiac ultrasound for assessing left ventricular(LV)systolic function and identifying potential causes of a plethoric IVC.Advanced POCUS delves into additional Doppler parameters,including stroke volume and cardiac output,LV filling pressures and venous congestion assessment to diagnose or prevent iatrogenic fluid overload.POCUS,when employed judiciously,enhances the diagnostic precision in evaluating AKI in cirrhotic patients,guiding appropriate therapeutic interventions,and minimizing the risk of fluid-related complications.展开更多
The overuse of antibiotics has led to the severe contamination of water bodies,posing a considerable hazard to human health.Therefore,the development of an accurate and rapid point-of-care testing(POCT)platform for th...The overuse of antibiotics has led to the severe contamination of water bodies,posing a considerable hazard to human health.Therefore,the development of an accurate and rapid point-of-care testing(POCT)platform for the quantitative detection of antibiotics is necessary.In this study,Cerium oxide(CeO_(2))and Ferrosoferric oxide(Fe_(3)O_(4))nanoparticles were simultaneously encapsulated into N-doped nanofibrous carbon microspheres to form of a novel nanozyme(CeFe-NCMzyme)with a porous structure,high surface area,and N-doped carbon material properties,leading to a considerable enhancement of the peroxidase(POD)-like activity compared with that of the CeO_(2)or Fe3O4 nanoparticles alone.The POD-like activity of CeFe-NCMzyme can be quenched using L-Cysteine(Cys)and subsequently restored by the addition of a quinolone antibiotic(norfloxacin,NOR).Therefore,CeFe-NCMzyme was used as a colorimetric sensor to detect NOR via an“On-Off”model of POD-like activity.The sensor possessed a wide linear range of 0.05–20.0μM(R^(2)=0.9910)with a detection limit of 35.70 nM.Furthermore,a smartphone-assisted POCT platform with CeFe-NCMzyme was fabricated for quantitative detection of NOR based on RGB analysis.With the use of the POCT platform,a linear range of 0.1–20.0μM and a detection limit of 54.10 nM were obtained.The spiked recoveries in the water samples were ranged from 97.73%to 102.01%,and the sensor exhibited good accuracy and acceptable reliability.This study provides a portable POCT platform for the on-site and quantitative monitoring of quinolone antibiotics in real samples,particularly in resource-constrained settings.展开更多
Sweat contains numerous vital biomarkers such as metabolites,electrolytes,proteins,nucleic acids and antigens that reflect hydration status,exhaustion,nutrition,and physiological changes.Conventional healthcare diagno...Sweat contains numerous vital biomarkers such as metabolites,electrolytes,proteins,nucleic acids and antigens that reflect hydration status,exhaustion,nutrition,and physiological changes.Conventional healthcare diagnosis relies on disease diagnostics in sophisticated centralized laboratories with invasive sample collection(e.g.,chemical analyses,plasma separation via centrifugation,tissue biopsy,etc.).Cutting-edge point-of-care diagnostics for sweat biomarker analysis allow for non-invasive monitoring of physiologically related biomarkers in sweat and real-time health status tracking.Moreover,using advanced nanoarchitectures,including nanostructured platforms and nanoparticles,can enhance the specificity,sensitivity,wearability and widen the sensing modality of sweat biosensors.Herein,we comprehensively review the secretory mechanisms,clinical uses of sweat biomarkers,and the design,principle,and latest technologies of sweat biosensors.With an emphasis on cutting-edge technologies for sweat biomarker analysis,this review chronicles the issues associated with the current sweat biomarkers analysis of sweat biomarkers and provides insights into strategies for enhancing the translation of such biosensors into routine clinical practice.展开更多
Point-of-care ultrasonography(POCUS),particularly venous excess ultrasound(VExUS)is emerging as a valuable bedside tool to gain real-time hemodynamic insights.This modality,derived from hepatic vein,portal vein,and in...Point-of-care ultrasonography(POCUS),particularly venous excess ultrasound(VExUS)is emerging as a valuable bedside tool to gain real-time hemodynamic insights.This modality,derived from hepatic vein,portal vein,and intrarenal vessel Doppler patterns,offers a scoring system for dynamic venous congestion assessment.Such an assessment can be crucial in effective management of patients with heart failure exacerbation.It facilitates diagnosis,quantification of congestion,prognostication,and monitoring the efficacy of decongestive therapy.As such,it can effectively help to manage cardiorenal syndromes in various clinical settings.Extended or eVExUS explores additional veins,potentially broadening its applications.While VExUS demonstrates promising outcomes,challenges persist,particularly in cases involving renal and liver parenchymal disease,arrhythmias,and situations of pressure and volume overload overlap.Proficiency in utilizing spectral Doppler is pivotal for clinicians to effectively employ this tool.Hence,the integration of POCUS,especially advanced applications like VExUS,into routine clinical practice necessitates enhanced training across medical specialties.展开更多
Point-of-care ultrasound(POCUS)is a limited ultrasound examination performed by the clinician at the bedside,emerging as a complement to physical examination across various medical specialties.In the field of nephrolo...Point-of-care ultrasound(POCUS)is a limited ultrasound examination performed by the clinician at the bedside,emerging as a complement to physical examination across various medical specialties.In the field of nephrology,its integration has been gradual,primarily limited to guiding procedures like temporary dialysis catheter placement or,in some cases,diagnostic kidney ultrasounds.In reality,the assessment of hemodynamic status at the bedside holds immense value for nephrologists,yet there exists limited awareness among practitioners regarding its implementation.While there is a growing trend towards incorporating multiorgan POCUS training in fellowship programs,private practice nephrologists remain relatively uninformed.This discussion explores the untapped potential of POCUS as a valuable diagnostic tool in everyday nephrology practice,demonstrating its effectiveness in diverse clinical settings,ranging from medical wards to outpatient dialysis units.Additionally,we delve into the challenges hindering its widespread adoption and consider the future trajectory of this innovative approach.展开更多
This article delves into the intricate challenges of acute kidney injury(AKI)in cirrhosis,a condition fraught with high morbidity and mortality.The complexities arise from distinguishing between various causes of AKI,...This article delves into the intricate challenges of acute kidney injury(AKI)in cirrhosis,a condition fraught with high morbidity and mortality.The complexities arise from distinguishing between various causes of AKI,particularly hemodynamic AKI,in cirrhotic patients,who experience hemodynamic changes due to portal hypertension.The term"hepatocardiorenal syndrome"is introduced to encapsulate the intricate interplay among the liver,heart,and kidneys.The narrative emphasizes the often-overlooked aspect of cardiac function in AKI assessments in cirrhosis,unveiling the prevalence of cirrhotic cardiomyopathy marked by impaired diastolic function.The conventional empiric approach involving volume expansion and vasopressors for hepatorenal syndrome is critically analyzed,highlighting potential risks and variable patient responses.We advocate for a nuanced algorithm for AKI evaluation in cirrhosis,prominently featuring point-of-care ultrasonography(POCUS).POCUS applications encompass assessing fluid tolerance,detecting venous congestion,and evaluating cardiac function.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
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.
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.
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Point-of-care ultrasound(POCUS)of the internal jugular vein(IJV)offers a noninvasive means of estimating right atrial pressure(RAP),especially in cases where the inferior vena cava is inaccessible or unreliable due to conditions such as liver disease or abdominal surgery.While many clinicians are familiar with visually assessing jugular venous pressure through the internal jugular vein,this method lacks sensitivity.The utilization of POCUS significantly enhances the visualization of the vein,leading to a more accurate identification.It has been demonstrated that combining IJV POCUS with physical examination enhances the specificity of RAP estimation.This review aims to provide a comprehensive summary of the various sonographic techniques available for estimating RAP from the internal jugular vein,drawing upon existing data.
基金supported by the National Key R&D Program of China(No.2021YFC2301100)the Strategic Priority Research Program of the Chinese Academy of Sciences(No.XDB30000000)+3 种基金the National Natural Science Foundation of China(No.61890940)the Chongqing Bayu Scholar Program(No.DP2020036)Program of Shanghai Academic Research Leaders(No.23XD1420200)Fudan University。
文摘The outbreak of COVID-19 has drawn great attention around the world.SARS-CoV-2 is a highly infectious virus with occult transmission by many mutations and a long incubation period.In particular,the emergence of asymptomatic infections has made the epidemic even more severe.Therefore,early diagnosis and timely management of suspected cases are essential measures to control the spread of the virus.Developing simple,portable,and accurate diagnostic techniques for SARS-CoV-2 is the key to epidemic prevention.The advantages of point-of-care testing technology make it play an increasingly important role in viral detection and screening.This review summarizes the point-of-care testing platforms developed by nucleic acid detection,immunological detection,and nanomaterial-based biosensors detection.Furthermore,this paper provides a prospect for designing future highly accurate,cheap,and convenient SARS-CoV-2 diagnostic technology.
基金supported by the National Research Foundation of Korea(No.2021R1A2B5B03001691).
文摘Point-of-care testing(POCT)is the practice of diagnosing and monitoring diseases where the patient is located,as opposed to traditional treatment conducted solely in a medical laboratory or other clinical setting.POCT has been less common in the recent past due to a lack of portable medical devices capable of facilitating effective medical testing.However,recent growth has occurred in this field due to advances in diagnostic technologies,device miniaturization,and progress in wearable electronics.Among these developments,electrochemical sensors have attracted interest in the POCT field due to their high sensitivity,compact size,and affordability.They are used in various applications,from disease diagnosis to health status monitoring.In this paper we explore recent advancements in electrochemical sensors,the methods of fabricating them,and the various types of sensing mechanisms that can be used.Furthermore,we delve into methods for immobilizing specific biorecognition elements,including enzymes,antibodies,and aptamers,onto electrode surfaces and how these sensors are used in real-world POCT settings.
基金Supported by KidneyCure and the American Society of Nephrology’s William and Sandra Bennett Clinical Scholars Grant.
文摘Discerning the etiology of acute kidney injury(AKI)in cirrhotic patients remains a formidable challenge due to diverse and overlapping causes.The conventional approach of empiric albumin administration for suspected volume depletion may inadvertently lead to fluid overload.In the recent past,point-of-care ultrasonography(POCUS)has emerged as a valuable adjunct to clinical assessment,offering advantages in terms of diagnostic accuracy,rapidity,cost-effectiveness,and patient satisfaction.This review provides insights into the strategic use of POCUS in evaluating cirrhotic patients with AKI.The review distinguishes basic and advanced POCUS,emphasizing a 5-point basic POCUS protocol for efficient assessment.This protocol includes evaluations of the kidneys and urinary bladder for obstructive nephropathy,lung ultrasound for detecting extravascular lung water,inferior vena cava(IVC)ultrasound for estimating right atrial pressure,internal jugular vein ultrasound as an alternative to IVC assessment,and focused cardiac ultrasound for assessing left ventricular(LV)systolic function and identifying potential causes of a plethoric IVC.Advanced POCUS delves into additional Doppler parameters,including stroke volume and cardiac output,LV filling pressures and venous congestion assessment to diagnose or prevent iatrogenic fluid overload.POCUS,when employed judiciously,enhances the diagnostic precision in evaluating AKI in cirrhotic patients,guiding appropriate therapeutic interventions,and minimizing the risk of fluid-related complications.
基金This work was financially supported by Natural Science Foundation of Jiangxi Province(Grant Nos.:20224ACB203016 and 20224BAB203022)Science and Technology Research Project of Jiangxi Provincial Department of Education(Grant No.:GJJ2201322)+1 种基金the National Natural Science Foundation of China(Grant Nos.:32060577 and 32360619)Natural Science Foundation for Distinguished Young Scholars of Hunan Province(Gtant No.:2023JJ10099).
文摘The overuse of antibiotics has led to the severe contamination of water bodies,posing a considerable hazard to human health.Therefore,the development of an accurate and rapid point-of-care testing(POCT)platform for the quantitative detection of antibiotics is necessary.In this study,Cerium oxide(CeO_(2))and Ferrosoferric oxide(Fe_(3)O_(4))nanoparticles were simultaneously encapsulated into N-doped nanofibrous carbon microspheres to form of a novel nanozyme(CeFe-NCMzyme)with a porous structure,high surface area,and N-doped carbon material properties,leading to a considerable enhancement of the peroxidase(POD)-like activity compared with that of the CeO_(2)or Fe3O4 nanoparticles alone.The POD-like activity of CeFe-NCMzyme can be quenched using L-Cysteine(Cys)and subsequently restored by the addition of a quinolone antibiotic(norfloxacin,NOR).Therefore,CeFe-NCMzyme was used as a colorimetric sensor to detect NOR via an“On-Off”model of POD-like activity.The sensor possessed a wide linear range of 0.05–20.0μM(R^(2)=0.9910)with a detection limit of 35.70 nM.Furthermore,a smartphone-assisted POCT platform with CeFe-NCMzyme was fabricated for quantitative detection of NOR based on RGB analysis.With the use of the POCT platform,a linear range of 0.1–20.0μM and a detection limit of 54.10 nM were obtained.The spiked recoveries in the water samples were ranged from 97.73%to 102.01%,and the sensor exhibited good accuracy and acceptable reliability.This study provides a portable POCT platform for the on-site and quantitative monitoring of quinolone antibiotics in real samples,particularly in resource-constrained settings.
基金supported by the JSPS fellowship to M.K.M(Grant Number P20039)support from JST-ERATO Yamauchi Materials Space-Tectonics Project(JPMJER2003)+1 种基金the funding from the Queensland government through the Advance Queensland Fellowship Program(AQIRF043-2020-CV)supported by the National Health and Medical Research Council(NHMRC,1195451).
文摘Sweat contains numerous vital biomarkers such as metabolites,electrolytes,proteins,nucleic acids and antigens that reflect hydration status,exhaustion,nutrition,and physiological changes.Conventional healthcare diagnosis relies on disease diagnostics in sophisticated centralized laboratories with invasive sample collection(e.g.,chemical analyses,plasma separation via centrifugation,tissue biopsy,etc.).Cutting-edge point-of-care diagnostics for sweat biomarker analysis allow for non-invasive monitoring of physiologically related biomarkers in sweat and real-time health status tracking.Moreover,using advanced nanoarchitectures,including nanostructured platforms and nanoparticles,can enhance the specificity,sensitivity,wearability and widen the sensing modality of sweat biosensors.Herein,we comprehensively review the secretory mechanisms,clinical uses of sweat biomarkers,and the design,principle,and latest technologies of sweat biosensors.With an emphasis on cutting-edge technologies for sweat biomarker analysis,this review chronicles the issues associated with the current sweat biomarkers analysis of sweat biomarkers and provides insights into strategies for enhancing the translation of such biosensors into routine clinical practice.
文摘Point-of-care ultrasonography(POCUS),particularly venous excess ultrasound(VExUS)is emerging as a valuable bedside tool to gain real-time hemodynamic insights.This modality,derived from hepatic vein,portal vein,and intrarenal vessel Doppler patterns,offers a scoring system for dynamic venous congestion assessment.Such an assessment can be crucial in effective management of patients with heart failure exacerbation.It facilitates diagnosis,quantification of congestion,prognostication,and monitoring the efficacy of decongestive therapy.As such,it can effectively help to manage cardiorenal syndromes in various clinical settings.Extended or eVExUS explores additional veins,potentially broadening its applications.While VExUS demonstrates promising outcomes,challenges persist,particularly in cases involving renal and liver parenchymal disease,arrhythmias,and situations of pressure and volume overload overlap.Proficiency in utilizing spectral Doppler is pivotal for clinicians to effectively employ this tool.Hence,the integration of POCUS,especially advanced applications like VExUS,into routine clinical practice necessitates enhanced training across medical specialties.
文摘Point-of-care ultrasound(POCUS)is a limited ultrasound examination performed by the clinician at the bedside,emerging as a complement to physical examination across various medical specialties.In the field of nephrology,its integration has been gradual,primarily limited to guiding procedures like temporary dialysis catheter placement or,in some cases,diagnostic kidney ultrasounds.In reality,the assessment of hemodynamic status at the bedside holds immense value for nephrologists,yet there exists limited awareness among practitioners regarding its implementation.While there is a growing trend towards incorporating multiorgan POCUS training in fellowship programs,private practice nephrologists remain relatively uninformed.This discussion explores the untapped potential of POCUS as a valuable diagnostic tool in everyday nephrology practice,demonstrating its effectiveness in diverse clinical settings,ranging from medical wards to outpatient dialysis units.Additionally,we delve into the challenges hindering its widespread adoption and consider the future trajectory of this innovative approach.
基金Supported by Research funding from KidneyCure and the American Society of Nephrology’s William and Sandra Bennett Clinical Scholars Grant(to Abhilash Koratala).
文摘This article delves into the intricate challenges of acute kidney injury(AKI)in cirrhosis,a condition fraught with high morbidity and mortality.The complexities arise from distinguishing between various causes of AKI,particularly hemodynamic AKI,in cirrhotic patients,who experience hemodynamic changes due to portal hypertension.The term"hepatocardiorenal syndrome"is introduced to encapsulate the intricate interplay among the liver,heart,and kidneys.The narrative emphasizes the often-overlooked aspect of cardiac function in AKI assessments in cirrhosis,unveiling the prevalence of cirrhotic cardiomyopathy marked by impaired diastolic function.The conventional empiric approach involving volume expansion and vasopressors for hepatorenal syndrome is critically analyzed,highlighting potential risks and variable patient responses.We advocate for a nuanced algorithm for AKI evaluation in cirrhosis,prominently featuring point-of-care ultrasonography(POCUS).POCUS applications encompass assessing fluid tolerance,detecting venous congestion,and evaluating cardiac function.
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.
