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1.
Crit Care ; 24(1): 702, 2020 12 24.
Artículo en Inglés | MEDLINE | ID: covidwho-992527

RESUMEN

COVID-19 has caused great devastation in the past year. Multi-organ point-of-care ultrasound (PoCUS) including lung ultrasound (LUS) and focused cardiac ultrasound (FoCUS) as a clinical adjunct has played a significant role in triaging, diagnosis and medical management of COVID-19 patients. The expert panel from 27 countries and 6 continents with considerable experience of direct application of PoCUS on COVID-19 patients presents evidence-based consensus using GRADE methodology for the quality of evidence and an expedited, modified-Delphi process for the strength of expert consensus. The use of ultrasound is suggested in many clinical situations related to respiratory, cardiovascular and thromboembolic aspects of COVID-19, comparing well with other imaging modalities. The limitations due to insufficient data are highlighted as opportunities for future research.


Asunto(s)
/diagnóstico por imagen , Consenso , Ecocardiografía/normas , Testimonio de Experto/normas , Internacionalidad , Sistemas de Atención de Punto/normas , /terapia , Ecocardiografía/métodos , Testimonio de Experto/métodos , Humanos , Pulmón/diagnóstico por imagen , Tromboembolia/diagnóstico por imagen , Tromboembolia/terapia , Triaje/métodos , Triaje/normas , Ultrasonografía/normas
2.
J Transl Med ; 18(1): 488, 2020 12 21.
Artículo en Inglés | MEDLINE | ID: covidwho-992499

RESUMEN

BACKGROUND: The easy access to a quick diagnosis of coronavirus disease 2019 (COVID-19) is a key point to improve the management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to contain its spread. Up to now, laboratory real-time PCR is the standard of care, but requires a fully equipped laboratory and significant infrastructure. Consequently, new diagnostic tools are required. METHODS: In the present work, the diagnostic accuracy of the point-of-care rapid test "bKIT Virus Finder COVID-19" (Hyris Ltd) is evaluated by a retrospective and a prospective analysis on SARS CoV-2 samples previously assessed with an FDA "authorized for the emergency use-EUA" reference method. Descriptive statistics were used for the present study. RESULTS: Results obtained with the Hyris Kit are the same as that of standard laboratory-based real time PCR methods for all the analyzed samples. In addition, the Hyris Kit provides the test results in less than 2 h, a significantly shorter time compared to the reference methods, without the need of a fully equipped laboratory. CONCLUSIONS: To conclude, the Hyris kit represents a promising tool to improve the health surveillance and to increase the capacity of SARS-CoV-2 testing.


Asunto(s)
/métodos , Sistemas de Atención de Punto , /epidemiología , /normas , Diagnóstico Precoz , Humanos , Italia/epidemiología , Límite de Detección , Pandemias , Sistemas de Atención de Punto/normas , Sistemas de Atención de Punto/estadística & datos numéricos , Estudios Prospectivos , Estándares de Referencia , Estudios Retrospectivos , /aislamiento & purificación , Sensibilidad y Especificidad , Investigación en Medicina Traslacional
3.
Ann Clin Lab Sci ; 50(6): 852-854, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: covidwho-984501

RESUMEN

Due to the COVID-19 pandemic, the Food and Drug Administration issued an Emergency Use Authorization to permit developers of certain serological tests to market their product prior to a comprehensive review. Nonetheless, the reliability of these assays is of great importance in order to be useful as a tool in estimating the relative proportions of different populations that have been exposed to SARS-CoV-2. We provide a sampling of 145 individuals from an ambulatory setting simultaneously tested with a qualitative point of care rapid finger prick Lateral Wave® IgM and IgG assay and a sample for the Mayo Clinic enzyme linked immunosorbent assay (ELISA) IgM/IgG antibody assay. Significant discrepancies did exist between the purported antibody responses as demonstrated by each assay.


Asunto(s)
Anticuerpos Antivirales/sangre , Ensayo de Inmunoadsorción Enzimática/métodos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Sistemas de Atención de Punto/normas , /aislamiento & purificación , Bioensayo , /virología , Humanos , Pruebas Serológicas/métodos
4.
Echocardiography ; 38(2): 329-342, 2021 02.
Artículo en Inglés | MEDLINE | ID: covidwho-979838

RESUMEN

In the midst of the COVID-19 pandemic, unprecedented pressure has been added to healthcare systems around the globe. Imaging is a crucial component in the management of COVID-19 patients. Point-of-care ultrasound (POCUS) such as hand-carried ultrasound emerges in the COVID-19 era as a tool that can simplify the imaging process of COVID-19 patients, and potentially reduce the strain on healthcare providers and healthcare resources. The preliminary evidence available suggests an increasing role of POCUS in diagnosing, monitoring, and risk-stratifying COVID-19 patients. This scoping review aims to delineate the challenges in imaging COVID-19 patients, discuss the cardiopulmonary complications of COVID-19 and their respective sonographic findings, and summarize the current data and recommendations available. There is currently a critical gap in knowledge in the role of POCUS in the COVID-19 era. Nonetheless, it is crucial to summarize the current preliminary data available in order to help fill this gap in knowledge for future studies.


Asunto(s)
/diagnóstico , Pulmón/diagnóstico por imagen , Pandemias , Sistemas de Atención de Punto/normas , Ultrasonografía/métodos , /epidemiología , Humanos
6.
Ann Biol Clin (Paris) ; 78(4): 363-382, 2020 Aug 01.
Artículo en Inglés | MEDLINE | ID: covidwho-709296

RESUMEN

The point-of-care tests (POCT) are subject to accreditation. A national inventory survey provides a synthesis of knowledge. The survey distributed 31 questions in 2019. 147 responses were received (75% biologists, 49% CHU, 42% CHG). Only 20.41% are accredited ISO22870, the majority for <50% of the medical departments; 70% say they are going there at the end of 2019 or in 2020. The maps are unknown for 32% (EBMD) and 82% (TROD). Visibility is poor with: medical establishment committee (40%), IT department (31%). Connection is necessary for 87-95% depending on the criterion (QC, authorizations, etc.) and 66% of answers highlight that less than 50% of connexion is effective. The major advantage is the delay of the result (62.5%), then the relationship with the health teams (33.3%). The disadvantages: difficulty of the quality approach (45%), cost of tests (34.3%). Human resource requirements are identified for technicians (82%) and biologists (76%). The multiplicity of sites, devices and operators means that it is difficult to set up and maintain. Biology outside the laboratories, under biological responsibility, must meet a rigorous imperative quality approach.


Asunto(s)
Técnicas de Laboratorio Clínico , Salud Global , Laboratorios/estadística & datos numéricos , Laboratorios/normas , Pruebas en el Punto de Atención , Acreditación , Servicios de Laboratorio Clínico/normas , Servicios de Laboratorio Clínico/estadística & datos numéricos , Técnicas de Laboratorio Clínico/normas , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Francia/epidemiología , Salud Global/normas , Salud Global/estadística & datos numéricos , Historia del Siglo XXI , Humanos , Internacionalidad , Ensayos de Aptitud de Laboratorios/normas , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Sistemas de Atención de Punto/normas , Sistemas de Atención de Punto/estadística & datos numéricos , Pruebas en el Punto de Atención/organización & administración , Pruebas en el Punto de Atención/normas , Pruebas en el Punto de Atención/estadística & datos numéricos , Garantía de la Calidad de Atención de Salud/organización & administración , Encuestas y Cuestionarios
8.
J Am Assoc Nurse Pract ; 32(6): 416-418, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: covidwho-594928

RESUMEN

Our health care landscape is rapidly changing. With the aging population and seemingly increasing outbreak of communicable diseases, it is expected that there will be a continued demand for inpatient/critical care providers. The current COVID-19 pandemic provides a glimpse of a health care system in severe provider shortage. Adult-gerontology acute nurse practitioners (GACNPs) can play a vital part in relieving that shortage. But with the increased role, there is an increased responsibility and need for expansion of AGACNP skill set. This includes the training and utilization of point-of-care ultrasound (POCUS). The case reports and data available from countries that have already combated COVID-19 outbreak show POCUS can play a key part in managing critically ill patients on isolation precautions. This article provides my perspective on POCUS training and competency achievement for AGACNPPs.


Asunto(s)
Competencia Clínica/normas , Enfermería Geriátrica/normas , Enfermeras Practicantes/educación , Sistemas de Atención de Punto/normas , Ultrasonografía/normas , Anciano , Anciano de 80 o más Años , Betacoronavirus , Infecciones por Coronavirus/prevención & control , Cuidados Críticos/normas , Evaluación Geriátrica/estadística & datos numéricos , Humanos , Pandemias/prevención & control , Neumonía Viral/prevención & control
10.
Emerg Microbes Infect ; 9(1): 1356-1359, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: covidwho-381795

RESUMEN

During the Coronavirus disease 2019 (COVID-19) pandemic, logistic problems associated with specimen collection limited the SARS-CoV-2 testing, especially in the community. In this study, we assessed the use of posterior oropharyngeal saliva as specimens for the detection of SARS-CoV-2 in an automated point-of-care molecular assay. Archived nasopharyngeal swab (NPS) and posterior oropharyngeal saliva specimens of 58 COVID-19 patients were tested with the Xpert® Xpress SARS-CoV-2 assay. SARS-CoV-2 was detected in either NPS or saliva specimens of all patients. Among them, 84.5% (49/58) tested positive in both NPS and saliva, 10.3% (6/58) tested positive in NPS only, and 5.2% (3/58) tested positive in saliva only. No significant difference in the detection rate was observed between NPS and saliva (McNemar's test p = 0.5078). The detection rate was slightly higher for N2 (NPS 94.8% and Saliva 93.1%) than that of the E gene target (Saliva: 89.7% vs 82.8%) on both specimen types. Significantly earlier median Ct value was observed for NPS comparing to that of saliva on both E (26.8 vs 29.7, p = 0.0002) and N2 gene target (29.3 vs 32.3, p = 0.0002). The median Ct value of E gene target was significantly earlier than that of the N2 gene target for both NPS (26.8 vs 29.3, p < 0.0001) and saliva (29.7 vs 32.3, p < 0.0001). In conclusion, posterior oropharyngeal saliva and NPS were found to have similar detection rates in the point-of-care test for SARS-CoV-2 detection. Since posterior oropharyngeal saliva can be collected easily, the use of saliva as an alternative specimen type for SARS-CoV-2 detection is recommended.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Bioensayo , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Pandemias , Neumonía Viral/diagnóstico , Sistemas de Atención de Punto/normas , Proteínas del Envoltorio Viral/aislamiento & purificación , Adulto , Betacoronavirus/patogenicidad , Técnicas de Laboratorio Clínico/instrumentación , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Femenino , Hong Kong/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Orofaringe/virología , Neumonía Viral/epidemiología , Neumonía Viral/virología , Saliva/virología , Manejo de Especímenes/métodos
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