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Biosensors for Disease Diagnosis
Published in Ayodeji Olalekan Salau, Shruti Jain, Meenakshi Sood, Computational Intelligence and Data Sciences, 2022
Ramneet Kaur, Dibita Mandal, Juveria Ansari, Prachi R. Londhe, Vedika Potdar, Vishakkha Dash
Point-of-care testing (POCT) is a quick diagnostic testing that is carried out near the site of inpatient care or at the same place to obtain results in a short span of time. This is the widely used type of diagnostic tool in health management as it ensures rapid disease diagnosis. For this purpose, disposable electrochemical sensors and biosensors are generally used as POCT diagnostic tools. Disposable biosensors are used for the point-of-care assessment of acetylcholinesterase, bacteria, cancer biomarkers and DNA targets. Electrochemical biosensors comprising an array of 32 gold electrodes are used for point-of-care diagnostics in blood serum samples [2].
Syphilis
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Point of care testing is now being used, primarily in resource poor settings. Syphilis Health Check is the only point of care test currently FDA approved. It was approved in 2011, and received waver from the Clinical Laboratory Improvement Amendment (CLIA) to allow the test to be used by untrained personnel and outside of conventional lab settings in 2015. It is a rapid immunochromatographic test that qualitatively screens for antibodies to T. pallidum in serum, plasma, or whole blood. It can be performed on a fingerstick whole blood specimen, and yields result in 12 minutes. It is a screening test, so positive results should be followed up with confirmatory diagnostic testing. If confirmatory testing is not possible, immediate treatment of screen positive women and their partners has the potential to reduce transmission to the fetus and to sexual contacts. A number of logistical and technical problems have been reported with this approach, and so far no clear reduction in perinatal death has been observed. More trials are needed to adequately assess the risks and benefits of this strategy [21].
The Precision Medicine Approach in Oncology
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Overall, there is widespread agreement that miniaturization of the various technologies into “micro-devices” would greatly facilitate their transition into clinical practice. In addition, the processing time and sensitivity of the technologies need to be enhanced if they are to find widespread use in rapid early diagnosis, and treatment staging and monitoring. Although technologies such as CellSearchTM need only 7.5 ml of a blood sample for efficient CTC isolation and detection, progress has been made in the development of CTC-detecting microchips which should be easier to use in a clinical setting. The vision for the future is to produce miniaturized low-cost chip-based devices validated to work with very small blood volumes (e.g., a finger prick sample). Such devices could be used for Point-of-Care testing in a doctor’s surgery, or perhaps be available as consumer products for self-testing. This would not only benefit individuals in terms of early diagnosis and a greater chance of successful treatment and prolonged survival if the presence of cancer is detected, but could also save healthcare systems significant amounts of funding through a reduced burden of late-stage cancer treatments. An example of a chip-based device that can physically capture CTCs without the involvement of antibodies is shown in Figure 11.10.
Point-of-care COVID-19 testing in the emergency department: current status and future prospects
Published in Expert Review of Molecular Diagnostics, 2021
Larissa May, Nam Tran, Nathan A. Ledeboer
The SARS-CoV-2 pandemic has expanded the rise of point-of-care (POC) testing in the emergency department (ED) to improve patient flows and provide results in a timely manner. Point-of-care testing is defined as medical testing at or near the site of patient care and improving outcomes by accelerating the time from test administration to treatment (i.e. therapeutic turnaround time). Point-of-care testing is performed by clinical staff in the ED and result in under 1 hour, whereas near POC tests are performed in the laboratory by trained laboratory personnel and result in under 2 hours. Principles of development of new POC devices have been driven through the World Health Organization guidelines, known as the ASSURED guidelines. The guidelines call for affordable, sensitive, specific, user-friendly, rapid and robust, equipment-free, and test results that are delivered to the end-users [9].
C-Reactive protein testing to guide antibiotic prescribing for COPD exacerbations (PACE study): Discussions from @respandsleepjc (#rsjc)
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2020
Alina J. Blazer, Anju Anand, Matthew B. Stanbrook
Our discussion generated several interesting questions. Regarding the study’s inclusion criteria, we wondered about the choice of using patients with physician-diagnosed COPD as opposed to having a spirometry-confirmed COPD diagnosis, especially given that 240 of 649 patients included in the study had missing spirometry data.2 Dr. Butler clarified that this represented a real-world population who were being treated as COPD patients, regardless of the possibility of an alternate diagnosis such as asthma. In addition, he explained that the goal was to conduct a pragmatic study that fitted well into usual care and was generalizable to most primary care practices. Given that spirometry is time intensive and not readily available in a general practice setting, it was not practical to guide enrollment. Additionally, he indicated the CRP point-of-care testing takes only a few minutes and could easily be accomplished over the course of a 10-minute appointment.3
Advances in technologies for cervical cancer detection in low-resource settings
Published in Expert Review of Molecular Diagnostics, 2019
Kathryn A. Kundrod, Chelsey A. Smith, Brady Hunt, Richard A. Schwarz, Kathleen Schmeler, Rebecca Richards-Kortum
An example of a major success in the field of point-of-care testing is the human immunodeficiency virus (HIV) rapid screening test. The format, subsidized cost, and time-to-result of HIV rapid tests allow for screening to happen nearly anywhere. Major challenges that remain with HIV screening include stigma and lack of interaction with medical systems, presenting obstacles to reaching key populations. In other words, the technology is no longer the limiting factor with HIV screening. Until a format similar to the HIV rapid screening test and sustainable financing for scale-up are achieved on a truly point-of-care HPV DNA test, HPV DNA testing will remain possible only in more centralized facilities with sufficient laboratory infrastructure. As the technology improves, we hope to see more programs that are able to screen people who do not have as much contact with medical systems. In particular, harder-to-reach populations who have been underserved in terms of cervical cancer screening include people living in rural and/or medically underserved areas, undocumented immigrants, women who are homeless or incarcerated and transgender men. While researchers have initiated promising programs to reach out to women who are homeless [141] and transgender men [142], we anticipate greater ability to screen and follow-up with patients with fewer technology barriers. Self-collection of samples with high-performing diagnostics will especially increase ability to screen people who are harder to reach [39].