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1.
BMC Infect Dis ; 24(Suppl 1): 194, 2024 Feb 29.
Artículo en Inglés | MEDLINE | ID: mdl-38418989

RESUMEN

BACKGROUND: Sexually transmitted infections (STIs) such as syphilis and HIV remain to be a significant public health issue worldwide. Dual rapid point-of-care tests (POCTs) have shown promise for detecting antibodies to HIV and syphilis but have not been fully evaluated in the field. Our study supported the WHO ProSPeRo study on Sexually Transmitted Infection Point-of-Care Testing (STI POCT) by providing external quality assessment (EQA) for HIV and syphilis testing in reference laboratories and their associated clinical sites in seven countries. METHODS: HIV/syphilis serum liquid and dried tube specimen (DTS) panels were prepared by CDC. Liquid panels were distributed to the reference laboratories for three rounds of testing using commercially and locally available laboratory-based serological tests. DTS panels were sent to the clinical testing sites for 8 rounds of POC testing using the Abbott SD BIOLINE HIV/Syphilis Duo test (hereafter referred to as SD BIOLINE) and the Chembio Dual Path Platform (DPP) HIV-Syphilis assay. EQA panels were tested at CDC using the Rapid Plasma Reagin (RPR) test and the Treponema pallidum Particle Agglutination assay (TP-PA) for syphilis antibodies. Genetic Systems HIV-1/HIV-2 Plus O EIA, Geenius HIV Supplemental Assay and the Oraquick Advance HIV test were used to detect HIV antibodies in the EQA panels. Results from the reference laboratories and POCT sites were compared to those obtained at the CDC and a percentage agreement was calculated. RESULTS: Qualitative RPR and TP-PA performed at the reference laboratories demonstrated 95.4-100% agreement with CDC results while quantitative RPR and TP-PA tests demonstrated 87.7% and 89.2% agreement, respectively. A 93.8% concordance rate was observed for qualitative HIV testing in laboratories. EQA testing at clinical sites using dual tests showed 98.7% and 99.1% agreement for detection of HIV antibodies and eight out of 10 sites had > 95.8% agreement for syphilis testing. However, two clinical sites showed only 65.0-66.7% agreement for SD BIOLINE and 84.0-86.7% for DPP, respectively, for syphilis testing. CONCLUSIONS: Overall, laboratories demonstrated high EQA performance in this study. Both HIV/syphilis POCTs gave expected results in the clinic-based evaluations using DTS. However, testing errors were identified in a few testing sites suggesting the necessity for continuous training and monitoring the quality of POC testing.


Asunto(s)
Infecciones por VIH , VIH-1 , Sífilis , Humanos , Treponema pallidum , Anticuerpos Anti-VIH , Infecciones por VIH/diagnóstico , Sensibilidad y Especificidad , Anticuerpos Antibacterianos , Pruebas en el Punto de Atención , Serodiagnóstico de la Sífilis/métodos , VIH-2 , Organización Mundial de la Salud , Sistemas de Atención de Punto
2.
Malar J ; 21(1): 54, 2022 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-35183188

RESUMEN

BACKGROUND: Control efforts in Zanzibar reduced the burden of malaria substantially from 2000 to 2015, but re-emergence of falciparum malaria has been observed lately. This study evaluated the prevalence of malaria and performance of routine diagnostic tests among hospitalized fever patients in a 1.5 years period in 2015 and 2016. METHODS: From March 2015 to October 2016, paediatric and adult patients hospitalized with acute undifferentiated fever at Mnazi Mmoja Hospital, Zanzibar were included. The malaria prevalence, and performance of rapid diagnostic test (RDT) and microscopy, were assessed using polymerase chain reaction (PCR) as gold standard. RESULTS: The malaria prevalence was 9% (63/731). Children under 5 years old had lower malaria prevalence (5%, 14/260) than older children (15%, 20/131, p = 0.001) and persons aged 16 to 30 years (13%, 15/119, p = 0.02), but not different from persons over 30 years old (6%, 14/217, p = 0.7). All cases had Plasmodium falciparum infection, except for one case of Plasmodium ovale. Ten malaria patients had no history of visiting mainland Tanzania. The RDT had a sensitivity of 64% (36/56) and a specificity of 98% (561/575), and microscopy had a sensitivity of 50% (18/36) and  a specificity of 99% (251/254), compared to PCR. The malaria parasitaemia was lower in patients with false negative results on RDT (median 7 × 103 copies/µL, interquartile range [IQR] 2 × 103 - 8 × 104, p = 0.002) and microscopy (median 9 × 103 copies/µL, IQR 8 × 102 - 7 × 104, p = 0.006) compared to those with true positive RDT (median 2 × 105 copies/µL, IQR 3 × 104 - 5 × 105) and microscopy (median 2 × 105 copies/µL, IQR 6 × 104 - 5 × 105). CONCLUSIONS: The study emphasizes that malaria was a frequent cause of febrile illness in hospitalized patients in Zanzibar in the years 2015-2016, particularly among school age children and young adults. We found evidence of autochthonous malaria transmission in Zanzibar. Compared to PCR, both RDT and microscopy had low sensitivity, and false negative results were associated with low parasitaemia. While low parasitaemia identified only by PCR in a semi-immune individual could be coincidental and without clinical relevance, clinicians should be aware of the risk of false negative results on routine tests.


Asunto(s)
Malaria Falciparum , Malaria , Adolescente , Adulto , Niño , Preescolar , Pruebas Diagnósticas de Rutina/métodos , Humanos , Malaria/diagnóstico , Malaria/epidemiología , Malaria Falciparum/diagnóstico , Malaria Falciparum/epidemiología , Plasmodium falciparum , Prevalencia , Sensibilidad y Especificidad , Tanzanía/epidemiología , Adulto Joven
3.
Anaesthesist ; 71(3): 181-189, 2022 03.
Artículo en Alemán | MEDLINE | ID: mdl-35244736

RESUMEN

Postpartum hemorrhage (PPH) nowadays still represents a severe complication of both a vaginal delivery and a cesarean section. In German-speaking areas a new definition of the term has recently become established and the nomenclature with respect to the severe form of PPH was dropped. The handling of misoprostol as a uterotonic during treatment of PPH is also new, which is available in Germany only as a medical direct import. For adequate diagnostics and targeted treatment interdisciplinary and standardized algorithms should be established and the specialist disciplines involved should be sensitized to this problem. In addition to an adequate hemostasis, a developing coagulopathy must be recognized at an early stage and treated with targeted coagulation management. Through implementation concepts, particularly the second pillar (minimization of blood loss) and the third pillar (rational use of blood transfusions) of patient blood management, various aspects for improvement of treatment of a PPH can be identified.


Asunto(s)
Misoprostol , Oxitócicos , Hemorragia Posparto , Transfusión Sanguínea , Cesárea , Femenino , Humanos , Hemorragia Posparto/terapia , Embarazo
4.
Angew Chem Int Ed Engl ; 61(12): e202115907, 2022 03 14.
Artículo en Inglés | MEDLINE | ID: mdl-35064613

RESUMEN

Desirable biosensing assays need to be sensitive, specific, cost-effective, instrument-free, and versatile. Herein we report a new strategy termed CLIPON (CRISPR and Large DNA assembly Induced Pregnancy strips for signal-ON detection) that can deliver these traits. CLIPON integrates a commercial pregnancy test strip (PTS) with four biological elements: the human chorionic gonadotropin (hCG), CRISPR-Cas12a, crRNA and cauliflower-like large-sized DNA assemblies (CLD). CLIPON uses the Cas12a/crRNA complex both to recognize a target of interest and to release CLD-bound hCG so that target presence can translate into a colorimetric signal on the PTS. We demonstrate the versatility of CLIPON through sensitive and specific detection of HPV genomic DNA, SARS-CoV-2 genomic RNA and adenosine. We also engineer a cell phone app and a hand-held microchip to achieve signal quantification. CLIPON represents an attractive option for biosensing and point-of-care diagnostics.


Asunto(s)
Sistemas CRISPR-Cas , Pruebas en el Punto de Atención , Pruebas de Embarazo , ADN/análisis , Femenino , Humanos , Dispositivos Laboratorio en un Chip , Embarazo , ARN Viral/análisis , Reproducibilidad de los Resultados , SARS-CoV-2/genética , Sensibilidad y Especificidad , Virus/aislamiento & purificación
5.
Anal Bioanal Chem ; 412(23): 5671-5681, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32627085

RESUMEN

The direct detection of dopamine (DA) in human body fluids is a great challenge for medical diagnostics of neurological disorders like Parkinson's disease, Alzheimer's disease, senile dementia, and schizophrenia. In this work, a simple and turn off luminescence sensing of DA based on bovine serum albumin (BSA)-capped manganese-doped zinc sulphide quantum dots (Mn:ZnS/BSA QDs) is developed. The Mn:ZnS/BSA QDs were synthesized by a chemical co-precipitation method. Due to the special interaction of DA with BSA and metal ions, Mn:ZnS/BSA QDs can serve as an effective sensing platform for DA. The luminescence of Mn:ZnS/BSA QDs decreased linearly with increasing concentration of DA in the range from 6.6 to 50.6 nM. The limit of detection is 2.02 nM. The driving force for the luminescence quenching is partly provided by ground-state complex formation of QDs with DA. The photo-induced electron transfer from the conduction band of QDs to oxidized dopamine (quinone) also favors quenching. The Mn:ZnS/BSA QDs are barely interfered with by other competing biomolecules except catecholamine neurotransmitter like epinephrine. Moreover, this method is used in the analysis of DA-spiked human serum and human urine samples and good recovery percentages are found. To assess the utility of the developed sensor, paper strip assay was also successfully conducted. Graphical abstract.


Asunto(s)
Dopamina/química , Manganeso/química , Puntos Cuánticos/química , Albúmina Sérica Bovina/química , Sulfuros/química , Compuestos de Zinc/química , Dopamina/sangre , Dopamina/orina , Humanos , Concentración de Iones de Hidrógeno , Luminiscencia , Papel , Análisis Espectral/métodos
6.
Infection ; 47(2): 201-207, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30132249

RESUMEN

BACKGROUND: Respiratory infections are the main causes for hospitalization in children and a common reason for the initiation of antibiotic treatment. Rapid antigen detection tests and point-of-care mPCR-based assays provide a fast detection of viral pathogens. Nonetheless, the prescription rate of antibiotics for respiratory infections is exceedingly high. In particular, human metapneumovirus (hMPV) infections frequently cause antibiotic treatment. METHODS: Children hospitalized in our clinic with an acute respiratory infection between January 2008 and January 2013 were included in the present study. Data of 3799 children were analyzed retrospectively for clinical symptoms, laboratory findings, and antibiotic and inhalation treatment. We performed an in-house m-RT-PCR-ELISA method for pathogen detection. RESULTS: Pathogen detection was possible in 2464 patients. In 6.3%, hMPV and, in 24.0%, RSV were detected. Patients positively tested for hMPV received inhalation therapy in 62.9%; patients positive for RSV in 73.8%. Patients positive for hMPV were treated with antibiotics in 62.3%. Patients with RSV infection received antibiotic treatment in 44.4%; all others in 43.5%. Notably, a positive result in RSV-RADT was associated with reduced number of antibiotic treatment. CONCLUSION: hMPV infections inherit a two times higher probability of antibiotic treatment. There was no significant difference in laboratory findings or body temperature between hMPV infection and infections caused by other pathogens. Clinical symptoms seem not to differ from those in RSV illness. Nonetheless, RSV infections triggered significantly lower antibiotic prescription rates. A considerate application of a POC-mPCR for patients with RSV-like symptoms and age of 1 year and older with a negative RSV-RADT might lead to higher detection rates of hMPV and a reduction in prescription of antibiotics.


Asunto(s)
Antibacterianos/uso terapéutico , Infecciones por Paramyxoviridae/tratamiento farmacológico , Sistemas de Atención de Punto/estadística & datos numéricos , Prescripciones/estadística & datos numéricos , Infecciones por Virus Sincitial Respiratorio/diagnóstico , Preescolar , Femenino , Alemania , Hospitalización , Humanos , Lactante , Recién Nacido , Masculino , Metapneumovirus/fisiología , Infecciones por Paramyxoviridae/virología , Infecciones por Virus Sincitial Respiratorio/virología , Virus Sincitial Respiratorio Humano/fisiología , Estudios Retrospectivos
7.
Epilepsy Behav ; 101(Pt B): 106272, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31171435

RESUMEN

Microribonucleic acids (miRNAs) are short noncoding ribonucleic acids (RNAs) that have been proposed as potential biomarkers for epilepsy, acute seizures, and status epilepticus. Various properties support their potential in this regard, including relative stability and amenability to rapid quantitation in biofluids. Several miRNAs are enriched in the brain and within specific cell types. Dysregulation of miRNAs has been reported in brain regions damaged by status epilepticus and in resected brain tissue from patients with drug-resistant epilepsy. Silencing miRNAs using antisense-like oligonucleotides termed antagomirs has been reported to suppress evoked and spontaneous seizures in animal models, indicating therapeutic applications. The prospect of miRNAs as mechanistic biomarkers is supported by recent studies showing blood levels of brain-enriched miRNAs increase after status epilepticus in rodents, and clinical studies have identified miRNAs upregulated in human cerebrospinal fluid after status epilepticus. It remains unproven, however, whether there are miRNAs that uniquely identify acute seizures, chronic epilepsy, or the process of epileptogenesis. Finally, efforts have turned to the challenge of proving that some of the circulating miRNAs actually originate from the brain. New models that feature a biochemically-labeled protein involved in miRNA function and restricted to specific brain cell types offer opportunities to resolve this issue. This review summarizes recent progress on miRNAs as diagnostic biomarkers of status epilepticus and considers some of the unanswered questions and future directions. This article is part of the Special Issue "Proceedings of the 7th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures.


Asunto(s)
Sistemas de Liberación de Medicamentos/tendencias , MicroARNs/genética , MicroARNs/metabolismo , Estado Epiléptico/genética , Estado Epiléptico/metabolismo , Animales , Biomarcadores/metabolismo , Hipocampo/metabolismo , Hipocampo/patología , Humanos , Oligonucleótidos Antisentido/administración & dosificación , Convulsiones/diagnóstico , Convulsiones/genética , Convulsiones/metabolismo , Estado Epiléptico/tratamiento farmacológico , Regulación hacia Arriba/fisiología
8.
J Dairy Res ; 86(2): 222-225, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31038086

RESUMEN

The performance of a new point-of-care diagnostic (Mastatest), an on-farm test designed to identify bacteria and provide antibiotic sensitivity testing information from milk samples, was compared with standard microbiological culture methods. A total of 292 milk samples from clinical mastitis cases in dairy cows on New Zealand dairy farms were examined, and latent class analysis was used to estimate the performance characteristics of both tests. Two hundred and fifty-six samples (87.7%) demonstrated bacterial infection in standard culture, and 269 (92.1%) using the point-of-care diagnostic. The most common bacterial species detected was Streptococcus uberis, found in 195 samples (66.8%) using standard culture and 190 samples (65.1%) using the point-of-care diagnostic. Latent class analysis found no significant differences in test characteristics between the point-of-care diagnostic and standard culture. The estimated sensitivity and specificity of the point-of-care diagnostic against all targets combined were 94.6 and 72.1% respectively; the corresponding estimates for standard culture were 90.5 and 73.9%. Comparison of antibiotic susceptibility testing using the point-of-care diagnostic and the reference method showed similar trends and, in some cases, identical MIC50 and MIC90 values, with at most one antibiotic dilution difference.


Asunto(s)
Mastitis Bovina/diagnóstico , Sistemas de Atención de Punto , Infecciones Estafilocócicas/veterinaria , Infecciones Estreptocócicas/veterinaria , Animales , Antibacterianos/farmacología , Técnicas Bacteriológicas/veterinaria , Bovinos , Farmacorresistencia Bacteriana , Femenino , Leche/microbiología , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus , Infecciones Estreptocócicas/microbiología , Streptococcus , Consumo de Alcohol en Menores
9.
Sensors (Basel) ; 19(11)2019 Jun 09.
Artículo en Inglés | MEDLINE | ID: mdl-31181849

RESUMEN

Polymerase chain reaction (PCR) and the visual inspection of fluorescent amplicons for detection are commonly used procedures in nucleic acid tests. However, it has been extremely challenging to incorporate PCR onto a lab-on-a-disc (PCR-LOD) as it involves controlling the complicated and precise heating steps during thermal cycling and the measurement of reagent temperature. Additionally, a non-contact temperature control system without any connecting attachments needs to be implemented to facilitate the rotation of the PCR-LOD. This study presents a non-contact temperature control system to integrate conventional PCR onto an LOD. The experimental results demonstrate that our proposed system provides one-stop detection capabilities for Salmonella with a stable PCR amplification in a single PCR-LOD.


Asunto(s)
Dispositivos Laboratorio en un Chip , Reacción en Cadena de la Polimerasa/métodos , Sistemas de Atención de Punto , Temperatura
11.
Anal Bioanal Chem ; 409(10): 2697-2703, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28150019

RESUMEN

We describe the use of a chemometrics-based computational platform to optimize a glucose assay on a microfluidic paper-based analytical device (µPAD). Glucose is colorimetrically detected in the presence of glucose oxidase (GOx), horseradish peroxidase (HRP), and potassium iodide (KI). Using a Y-shaped paper microfluidic chip, the concentration of glucose, volume of reagents, and the length and width of the microfluidic channel were examined. The responses of the microfluidic chips were analyzed at the halfway point of the channel length. Variables affecting the response were screened by using a 24 factorial design, and among them, volume and concentration of the glucose were optimized by applying a rotatable central composite design (CCD). The optimum and experimental responses are 151.58 and 149.80, respectively, with an absolute error of 1.2%.


Asunto(s)
Bioensayo/métodos , Glucosa Oxidasa/metabolismo , Glucosa/análisis , Peroxidasa de Rábano Silvestre/metabolismo , Técnicas Analíticas Microfluídicas/instrumentación , Técnicas Analíticas Microfluídicas/métodos , Papel , Humanos
12.
Int Wound J ; 14(6): 1237-1247, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28745010

RESUMEN

In addition to clinical signs of infection (e.g. inflammation, purulence and pain), a microbial count of ≥105 colony-forming units/g has historically been used to define wound infection. However, it is increasingly recognised that, rather than a high bioburden level alone being detrimental to wound healing, it is the virulence of the invading microorganism and the host's immune status that can affect clinical outcomes. Bacteria, such as Pseudomonas aeruginosa, Staphylococcus aureus and Staphylococcus epidermidis, have developed a range of virulence factors to help them overcome host defences and proliferate within the underlying soft tissue. More specifically, bacterial proteases are one such virulence factor that has been implicated in promoting the invasion and destruction of the host tissue. Because of the complexities of microorganisms, the proteases can negatively impact the wound environment, leading to delayed wound healing. The aim of the present paper is to describe various extracellular bacterial proteases; review the impact they have on the wound environment, the host immune response and biofilms; and discuss potential wound management strategies against them. The evidence discussed suggests that proteases may play a profound role in wound infections, contribute to the development of an inflammatory response and impede wound healing.


Asunto(s)
Infecciones Bacterianas/fisiopatología , Proteínas Bacterianas/metabolismo , Biopelículas/crecimiento & desarrollo , Péptido Hidrolasas/metabolismo , Virulencia/fisiología , Cicatrización de Heridas/fisiología , Infección de Heridas/microbiología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Interacciones Huésped-Patógeno , Humanos , Masculino , Persona de Mediana Edad
13.
Electrophoresis ; 37(12): 1685-90, 2016 07.
Artículo en Inglés | MEDLINE | ID: mdl-27060975

RESUMEN

A novel microfluidic thread/paper-based analytical device (µTPAD) to detect glucose through a colorimetric assay is described. The µTPAD was fabricated from nylon thread trifurcated into three channels terminating at analysis sites comprised of circular zones of chromatography paper, which have previously been spotted with glucose of different concentrations. A solution of glucose oxidase (GOx), horseradish peroxidase (HRP), and potassium iodide (KI) is transported via capillary action to the analysis sites where a yellow-brown color is observed indicating oxidation of iodide to iodine. The device was then dried, scanned, and analyzed yielding a correlation between yellow intensity and glucose concentrations. Both a flat platform constructed mainly of tape, and a cone platform constructed from tape and polyvinyl chloride, are described. Studies to quantitate glucose in artificial urine showed good correlation using the µTPAD.


Asunto(s)
Glucosa/análisis , Técnicas Analíticas Microfluídicas/instrumentación , Color , Glucosa Oxidasa , Peroxidasa de Rábano Silvestre , Yoduro de Potasio
14.
Electrophoresis ; 36(16): 1825-9, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25546700

RESUMEN

We describe the first direct formate fuel cell on a paper microfluidic platform. In traditional membrane-less microfluidic fuel cells (MFCs), external pumping consumes power produced by the fuel cell in order to maintain co-laminar flow of the anode stream and oxidant stream to prevent mixing. However, in paper microfluidics, capillary action drives flow while minimizing stream mixing. In this work, we demonstrate a paper MFC that uses formate and hydrogen peroxide as the anode fuel and cathode oxidant, respectively. Using these materials we achieve a maximum power density of nearly 2.5 mW/mg Pd. In a series configuration, our MFC achieves an open circuit voltage just over 1 V, and in a parallel configuration, short circuit of 20 mA absolute current. We also demonstrate that the MFC does not require continuous flow of fuel and oxidant to produce power. We found that we can pre-saturate the materials on the paper, stop the electrolyte flow, and still produce approximately 0.5 V for 15 min. This type of paper MFC has potential applications in point-of-care diagnostic devices and other electrochemical sensors.


Asunto(s)
Suministros de Energía Eléctrica , Técnicas Electroquímicas/instrumentación , Formiatos/química , Técnicas Analíticas Microfluídicas/instrumentación , Papel , Diseño de Equipo , Metanol , Oxidación-Reducción , Sistemas de Atención de Punto
15.
Biosensors (Basel) ; 14(5)2024 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-38785689

RESUMEN

Graphene-based materials are actively being investigated as sensing elements for the detection of different analytes. Both graphene grown by chemical vapor deposition (CVD) and graphene oxide (GO) produced by the modified Hummers' method are actively used in the development of biosensors. The production costs of CVD graphene- and GO-based sensors are similar; however, the question remains regarding the most efficient graphene-based material for the construction of point-of-care diagnostic devices. To this end, in this work, we compare CVD graphene aptasensors with the aptasensors based on reduced GO (rGO) for their capabilities in the detection of NT-proBNP, which serves as the gold standard biomarker for heart failure. Both types of aptasensors were developed using commercial gold interdigitated electrodes (IDEs) with either CVD graphene or GO formed on top as a channel of liquid-gated field-effect transistor (FET), yielding GFET and rGO-FET sensors, respectively. The functional properties of the two types of aptasensors were compared. Both demonstrate good dynamic range from 10 fg/mL to 100 pg/mL. The limit of detection for NT-proBNP in artificial saliva was 100 fg/mL and 1 pg/mL for rGO-FET- and GFET-based aptasensors, respectively. While CVD GFET demonstrates less variations in parameters, higher sensitivity was demonstrated by the rGO-FET due to its higher roughness and larger bandgap. The demonstrated low cost and scalability of technology for both types of graphene-based aptasensors may be applicable for the development of different graphene-based biosensors for rapid, stable, on-site, and highly sensitive detection of diverse biochemical markers.


Asunto(s)
Técnicas Biosensibles , Grafito , Péptido Natriurético Encefálico , Fragmentos de Péptidos , Transistores Electrónicos , Grafito/química , Fragmentos de Péptidos/análisis , Humanos , Límite de Detección , Oro/química , Aptámeros de Nucleótidos/química , Electrodos , Biomarcadores/análisis
16.
Front Public Health ; 12: 1378508, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38784597

RESUMEN

Introduction: Effective supply chain management (SCM) of point-of-care (POC) tests for diseases like severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) requires active participation from diverse stakeholders, government entities, and regulatory bodies. The responsibility for overseeing various aspects of POC tests, including procurement, quality assurance, storage, inventory management, distribution, and human resource capacity, lies with national, provincial, and local levels of government. This study aimed to collaboratively develop an innovative approach to enhance SCM for SARS-CoV-2 POC diagnostic services in resource-limited settings, using the Mopani District in Limpopo province, South Africa, as a case study. Methods: Key stakeholders were invited to participate in an online workshop using purposive sampling. The study employed the nominal group technique (NGT) for data collection, which consisted of two phases. Phase 1 focused on identifying barriers in the supply chain of COVID-19 rapid tests, while phase 2 aimed to devise strategies to overcome the priority barriers identified in phase 1. Participants used a Likert scale of 1-5 to rank barriers and strategies, and an overall ranking score was calculated for each. The participants were provided with the results of the ranking exercise for their feedback. Results: Eleven key stakeholders from national (n = 1), provincial (n = 4), and local government (n = 2) levels, research entities (n = 3), and non-governmental organizations (n = 1) took part in the study. Participants identified significant barriers in the supply chain, such as the availability of testing kits, unknown demand, information on SCM during a pandemic, methods of controlling stock, and procurement processes. Strategies suggested by key stakeholders included monitoring stock levels and optimizing stock visibility systems to improve test availability, enhancing information visibility and consistent data updates to address unknown demand and improve SCM during a pandemic, employing data capturing and digitization for effective stock control, and implementing demand planning and standardized procurement processes at the national level to enhance stock procurement. Discussion: The successful collaboration with key stakeholders, facilitated by the NGT, resulted in the co-creation of a novel approach to enhance SCM for COVID-19 diagnostic services in resource-limited settings. This study holds the potential to support the provision of COVID-19 diagnostic services in such settings. A recommended follow-up study would assess the feasibility of implementing this approach.


Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/diagnóstico , Sudáfrica , Pruebas en el Punto de Atención , Prueba de COVID-19/métodos , Participación de los Interesados
17.
Int Wound J ; 10(6): 653-60, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22846380

RESUMEN

Chronic wounds represent an aberrant biochemistry that creates a toxic proteolytic milieu which can be detrimental to the healing process. Rebalancing the wound microenvironment and addressing elevated protease activity (EPA) could therefore help facilitate healing. To understand how clinicians currently diagnose and manage excessive proteolytic activity, 183 survey responses from US wound specialists were collated and analysed to find out their perceptions on the role of proteases. The majority of respondents (>98%) believed proteases were important in wound healing and that a point-of-care (POC) protease test could be useful. This study yielded a low response rate (7.1%, n = 183); however, there were adequate data to draw significant conclusions. Specialists perceived that fibrin, slough, granulation tissue and rolled wound edges could indicate EPA. About 43% of respondents, however, failed to give a correct response when asked to review photographs to determine if excessive protease activity was present, and the perceived visual signs for EPA did not correlate with the wounds that had EPA; no statistical differences between professions were observed. Respondents chose debridement, wound cleansing and advanced therapies as important in reducing excessive protease activity. It was concluded that specialists have a need for POC diagnostic tests. On the basis of the responses to wound photos, it was determined that there were no visual cues clinicians could use in determining excessive protease activity. Additional research is recommended to evaluate the efficacy of a POC diagnostic test for protease activity and the treatments and therapies applied when EPA is found.


Asunto(s)
Auditoría Clínica , Péptido Hidrolasas/farmacología , Sistemas de Atención de Punto/normas , Especialización , Traumatología/métodos , Cicatrización de Heridas , Heridas y Lesiones/terapia , Humanos
18.
AACN Adv Crit Care ; 34(2): 119-128, 2023 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-37289632

RESUMEN

Ultrasonography is increasingly applied in the critical care setting. With advancements in technology, ultrasonography has become easier to use, with smaller machines, and more fundamental to patient assessment. Ultrasonography is a hands-on tool that brings real-time, dynamic information to the bedside. Patients in the critical care setting often have unstable hemodynamics or a tenuous respiratory status; thus, the use of ultrasonography to augment the assessment greatly improves patient safety. This article explores how to differentiate the etiology of shock with the adjunct of critical care echocardiography. In addition, the article examines how various ultrasonography techniques can be used to diagnose other life-threatening cardiac conditions, such as pulmonary embolism or cardiac tamponade, and the role of echocardiography in cardiopulmonary resuscitation. Critical care providers can add echocardiography and the information it provides to their repertoire to improve diagnosis, treatment, and patient outcomes.


Asunto(s)
Taponamiento Cardíaco , Embolia Pulmonar , Humanos , Ecocardiografía , Ultrasonografía , Cuidados Críticos , Sistemas de Atención de Punto
19.
Diagnostics (Basel) ; 13(19)2023 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-37835847

RESUMEN

Blood gas analysis plays a central role in modern medicine. Advances in technology have expanded the range of available parameters and increased the complexity of their interpretation. By applying user-centered design principles, it is possible to reduce the cognitive load associated with interpreting blood gas analysis. In this international, multicenter study, we explored anesthesiologists' perspectives on Visual Blood, a novel visualization technique for presenting blood gas analysis results. We conducted interviews with participants following two computer-based simulation studies, the first utilizing virtual reality (VR) (50 participants) and the second without VR (70 participants). Employing the template approach, we identified key themes in the interview responses and formulated six statements, which were rated using Likert scales from 1 (strongly disagree) to 5 (strongly agree) in an online questionnaire. The most frequently mentioned theme was the positive usability features of Visual Blood. The online survey revealed that participants found Visual Blood to be an intuitive method for interpreting blood gas analysis (median 4, interquartile range (IQR) 4-4, p < 0.001). Participants noted that minimal training was required to effectively learn how to interpret Visual Blood (median 4, IQR 4-4, p < 0.001). However, adjustments are necessary to reduce visual overload (median 4, IQR 2-4, p < 0.001). Overall, Visual Blood received a favorable response. The strengths and weaknesses derived from these data will help optimize future versions of Visual Blood to improve the presentation of blood gas analysis results.

20.
Vaccines (Basel) ; 10(12)2022 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-36560559

RESUMEN

The quantification of neutralising antibodies (NAb) for SARS-CoV-2 has become an important tool for monitoring protective immunity following infection or immunisation. In this study, we evaluated using World-Health-Organisation-standard immunoglobulin preparations, a novel point-of-care test that quantitates NAb by time-resolved fluorescent immunoassay. The assay provided robust data of binding antibody units (BAU) in 15 min that were well correlated with NAb values obtained by traditional in vitro neutralisation assay. The data also correlated well to spike-receptor-binding domain-binding antibodies over a broad range of plasma dilutions. The assay was extremely sensitive, able to detect positive samples after dilution 1:10,000 and over a wide range of BAU. Assay specificity was estimated at 96% using Pre-COVID-19 serum samples when applying a cut-off value of 47 BAU/mL, although readings of up to 100 BAU/mL could be considered borderline. This point-of-care diagnostic test is useful for rapid population screening and includes the use of capillary blood samples. Furthermore, it provides results for SARS-CoV-2 NAb in 15 min, which can inform immediate decisions regarding protective immunity levels and the need for continued COVID immunisations.

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