RESUMO
PURPOSE: The aim of the current study was to evaluate point of care ultrasound (POCUS) in geriatric patients by echoscopy using a handheld ultrasound device (HHUSD, VScan) at bedside in comparison to a high-end ultrasound system (HEUS) as the gold standard. MATERIALS AND METHODS: Prospective observational study with a total of 112 geriatric patients. The ultrasound examinations were independently performed by two experienced blinded examiners with a portable handheld device and a high-end ultrasound device. The findings were compared with respect to diagnostic findings and therapeutic implications. RESULTS: The main indications for the ultrasound examinations were dyspnea (44.6â%), fall (frailty) (24.1â%) and fever (21.4â%). The most frequently found diagnoses were cystic lesions 32.1â% (35/109), hepatic vein congestion 19.3â% (21/109) and ascites 13.6â% (15/110). HHUSD delivered 13 false-negative findings in the abdomen resulting in an "overall sensitivity" of 89.5â%. The respective "overall specificity" was 99.6â% (7 false-positive diagnoses). HHUSD (versus HEUS data) resulted in 13.6â% (17.3â%) diagnostically relevant procedures in the abdomen and 0.9â% (0.9â%) in the thorax. Without HHUSD (HEUS) 95.7â% (100â%) of important pathological findings would have been missed. CONCLUSION: The small HHUSD tool improves clinical decision-making in immobile geriatric patients at the point of care (geriatric ward). In most cases, HHUSD allows sufficiently accurate yes/no diagnoses already at the bedside, thereby clarifying the leading symptoms for early clinical decision-making.
Assuntos
Abdome , Sistemas Automatizados de Assistência Junto ao Leito , Ultrassonografia , Abdome/diagnóstico por imagem , Idoso , Humanos , Estudos Prospectivos , Sensibilidade e EspecificidadeRESUMO
Increasing sample numbers for screening and diagnostics using circulating cell-free DNA (ccfDNA) as analyte demands an automated solution for ccfDNA extraction. The efficiency of a new, automated, large volume ccfDNA extraction method was evaluated against a manual reference method. The new kit for automated ccfDNA extraction on the QIAsymphony showed a comparable yield of total ccfDNA from healthy donors as well as a comparable recovery of circulating cancer and fetal DNA. In conclusion, a new kit for automated ccfDNA extraction was established successfully.