scholarly journals Epidemiology and Diagnosis of Mucormycosis: An Update

2020 ◽  
Vol 6 (4) ◽  
pp. 265 ◽  
Author(s):  
Anna Skiada ◽  
Ioannis Pavleas ◽  
Maria Drogari-Apiranthitou
Keyword(s):  
Point Of Care ◽  
Its Region ◽  
Developed Countries ◽  
Underlying Disease ◽  
Population Based ◽  
Screening Tests ◽  
Diagnostic Tools ◽  
Clinical Approach ◽  
Middle Income ◽  
Low Sensitivity

Mucormycosis is an angioinvasive fungal infection, due to fungi of the order Mucorales. Its incidence cannot be measured exactly, since there are few population-based studies, but multiple studies have shown that it is increasing. The prevalence of mucormycosis in India is about 80 times the prevalence in developed countries, being approximately 0.14 cases per 1000 population. Diabetes mellitus is the main underlying disease globally, especially in low and middle-income countries. In developed countries the most common underlying diseases are hematological malignancies and transplantation. Τhe epidemiology of mucormycosis is evolving as new immunomodulating agents are used in the treatment of cancer and autoimmune diseases, and as the modern diagnostic tools lead to the identification of previously uncommon genera/species such as Apophysomyces or Saksenaea complex. In addition, new risk factors are reported from Asia, including post-pulmonary tuberculosis and chronic kidney disease. New emerging species include Rhizopus homothallicus, Thamnostylum lucknowense, Mucor irregularis and Saksenaea erythrospora. Diagnosis of mucormycosis remains challenging. Clinical approach to diagnosis has a low sensitivity and specificity, it helps however in raising suspicion and prompting the initiation of laboratory testing. Histopathology, direct examination and culture remain essential tools, although the molecular methods are improving. The internal transcribed spacer (ITS) region is the most widely sequenced DNA region for fungi and it is recommended as a first-line method for species identification of Mucorales. New molecular platforms are being investigated and new fungal genetic targets are being explored. Molecular-based methods have gained acceptance for confirmation of the infection when applied on tissues. Methods on the detection of Mucorales DNA in blood have shown promising results for earlier and rapid diagnosis and could be used as screening tests in high-risk patients, but have to be validated in clinical studies. More, much needed, rapid methods that do not require invasive procedures, such as serology-based point-of-care, or metabolomics-based breath tests, are being developed and hopefully will be evaluated in the near future.

Mucormycosis

2021 ◽  
pp. 89-92
Author(s):  
Mahesh Babasaheb Kolap ◽  
Abhijeet Vijay Dashwant
Keyword(s):  
Point Of Care ◽  
Its Region ◽  
Developed Countries ◽  
Underlying Disease ◽  
Population Based ◽  
Screening Tests ◽  
Diagnostic Tools ◽  
Clinical Approach ◽  
Middle Income ◽  
Low Sensitivity

Mucor mycosis is an angio invasive fungal infection, due to fungi of the order Mucorales. Its incidence cannot be measured exactly, since there are few population-based studies, but multiple Studies have shown that it is increasing. The prevalence of mucor mycosis in India is about 80 times the prevalence in developed countries, being approximately 0.14 cases per 1000 population. Diabetes mellitus is the main underlying disease globally, especially in low and middle-income countries. In developed countries the most common underlying diseases are hematological malignancies and transplantation. The epidemiology of mucor mycosis is evolving as new immune modulating agents are used in the treatment of cancer and autoimmune diseases, and as the modern diagnostic tools lead to the identification of previously uncommon genera/species such as Apophysomyces or Saksenaea complex. In addition, new risk factors are reported from Asia, including post-pulmonary tuberculosis and chronic kidney disease. New emerging species include Rhizopus homothallicus, Thamnostylum lucknowense, Mucor irregularis and Saksenaea erythrospora. Diagnosis of mucormycosis remains challenging. Clinical approach to diagnosis has a low sensitivity and specificity, it helps however in raising suspicion and prompting the initiation of laboratory testing. Histopathology, direct examination and culture remain essential tools, although the molecular methods are improving. The internal transcribed spacer (ITS) region is the most widely sequenced DNA region for fungi and it is recommended as a first-line method for species identification of Mucorales. New molecular platforms are being investigated and new fungal genetic targets are being explored. Molecular-based methods have gained acceptance for confirmation of the infection when applied on tissues. Methods on the detection of Mucorales DNA in blood have shown promising results for earlier and rapid diagnosis and could be used as screening tests in high-risk patients, but have to be validated in clinical studies. More, much needed, rapid methods that do not require invasive procedures, such as serology-based point-of-care, or metabolomics-based breath tests, are being developed and hopefully will be evaluated in the near future.

scholarly journals Developments in Transduction, Connectivity and AI/Machine Learning for Point-of-Care Testing

Sensors ◽  
2019 ◽  
Vol 19 (8) ◽  
pp. 1917 ◽  
Author(s):  
Shane O’Sullivan ◽  
Zulfiqur Ali ◽  
Xiaoyi Jiang ◽  
Reza Abdolvand ◽  
M Selim Ünlü ◽  
...  
Keyword(s):  
Machine Learning ◽  
Data Analytics ◽  
Point Of Care ◽  
Developed Countries ◽  
Clinical Diagnostics ◽  
Least Developed Countries ◽  
Point Of Care Testing ◽  
Middle Income ◽  
Lab On Chip ◽  
On Chip

We review some emerging trends in transduction, connectivity and data analytics for Point-of-Care Testing (POCT) of infectious and non-communicable diseases. The patient need for POCT is described along with developments in portable diagnostics, specifically in respect of Lab-on-chip and microfluidic systems. We describe some novel electrochemical and photonic systems and the use of mobile phones in terms of hardware components and device connectivity for POCT. Developments in data analytics that are applicable for POCT are described with an overview of data structures and recent AI/Machine learning trends. The most important methodologies of machine learning, including deep learning methods, are summarised. The potential value of trends within POCT systems for clinical diagnostics within Lower Middle Income Countries (LMICs) and the Least Developed Countries (LDCs) are highlighted.

scholarly journals Nanotechnology-Based Approaches for the Detection of SARS-CoV-2

2020 ◽  
Vol 2 ◽  
Author(s):  
Ritika Gupta ◽  
Poonam Sagar ◽  
Nitesh Priyadarshi ◽  
Sunaina Kaul ◽  
Rajat Sandhir ◽  
...  
Keyword(s):  
Point Of Care ◽  
Resonance Energy Transfer ◽  
Resonance Energy ◽  
Cost Effective ◽  
Diagnostic Techniques ◽  
Localized Surface Plasmon ◽  
Diagnostic Tools ◽  
Diagnostic Systems ◽  
Economic Activities ◽  
Low Sensitivity

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a pandemic has been validated as an extreme clinical calamity and has affected several socio-economic activities globally. Proven transmission of this virus occurs through airborne droplets from an infected person. The recent upsurge in the number of infected individuals has already exceeded the number of intensive care beds available to patients. These extraordinary circumstances have elicited the need for the development of diagnostic tools for the detection of the virus and, hence, prevent the spread of the disease. Early diagnosis and effective immediate treatment can reduce and prevent an increase in the number of cases. Conventional methods of detection such as quantitative real-time polymerase chain reaction and chest computed tomography scans have been used extensively for diagnostic purposes. However, these present several challenges, including prolonged assay requirements, labor-intensive testing, low sensitivity, and unavailability of these resources in remote locations. Such challenges urgently require fast, sensitive, and accurate diagnostic techniques for the timely detection and treatment of coronavirus disease 2019 (COVID-19) infections. Point-of-care biosensors that include paper- and chip-based diagnostic systems are rapid, cost-effective, and user friendly. In this article nanotechnology-based potential biosensors for SARS-CoV-2 diagnosis are discussed with particular emphasis on a lateral flow assay, a surface-enhanced Raman scattering-based biosensor, a localized surface plasmon resonance-based biosensor, Förster resonance energy transfer, an electrochemical biosensor, and artificial intelligence-based biosensors. Several biomolecules, such as nucleic acids, antibodies/enzymes, or aptamers, can serve as potential detection molecules on an appropriate platform, such as graphene oxide, nanoparticles, or quantum dots. An effective biosensor can be developed by using appropriate combinations of nanomaterials and technologies.

scholarly journals “Smart Diagnosis” of Parasitic Diseases by Use of Smartphones

2017 ◽  
Vol 56 (1) ◽  
Author(s):  
Muhammad A. Saeed ◽  
Abdul Jabbar
Keyword(s):  
Point Of Care ◽  
Cost Effective ◽  
Rapid Diagnosis ◽  
Diagnostic Tools ◽  
Parasitic Diseases ◽  
Effective Management ◽  
Diagnostic Equipment ◽  
Middle Income ◽  
Middle Income Countries ◽  
Cost Effective Alternative

ABSTRACT Accurate and rapid diagnosis is crucial in combating parasitic diseases that cause millions of deaths worldwide. However, the scarcity of specialized diagnostic equipment in low- and middle-income countries is one of the barriers to effective management of parasitic diseases and warrants the need for alternative, inexpensive, point-of-care diagnostic tools. Due to their multiple built-in sensors, smartphones offer cost-effective alternative to expensive diagnostic devices. However, the use of smartphones in parasitic diagnoses remains in its infancy. This minireview describes various smartphone-based devices applied specifically for the diagnosis of parasitic diseases and discusses challenges and potential implications for their use in future.

scholarly journals Primary Diagnostic Tools for SARS-CoV-2 Infection (COVID-19): Mini Review Based on Current Challenges in Molecular Techniques and Point of Care Testing for Screening

2021 ◽  
pp. 94-104
Author(s):  
K. Kokilavani ◽  
Bindu Salim
Keyword(s):  
Point Of Care ◽  
Developed Countries ◽  
Molecular Techniques ◽  
Diagnostic Methods ◽  
Diagnostic Tools ◽  
Attractive Alternative ◽  
Screening Methods ◽  
Rapid Diagnostics ◽  
Point Of Care Testing ◽  
The Developed Countries

Pandemic outbreaks are always a challenge for the health care management to control the mortality rate when the preventive measures are not established. The challenge is being faced worldwide with the outbreak of COVID-19 including the developed countries. The only solution is to control the spread by conducting massive screening and isolating affected ones from the healthy ones, which needs the development of screening methods that can reach the maximum population. The next step is to come up with vaccines. The research concentration worldwide is focussed on developing rapid diagnostics and screening at an affordable cost. Multiple studies suggest that Reverse Transcription- Polymerase Chain Reaction (RT-PCR), protein testing and Computed Tomography (CT) should be the principal diagnostic methods for routine testing/ screening in patients with COVID-19. But three factors are still indistinct in those diagnostic methods such as rapidity, sensitivity, and specificity. Thus, alternative approaches that provide higher efficiency and rapid are highly appreciated for the super spread infectious disease detection. Presently, microfluidics-based test kits alternatively called as lab-on-a-chip or Point- Of -Care Testing (POCT) have been widely used in cancer and viral detection. The ability of POCT tests to provide short time results, suitable in low resource clinics or even at home should be an attractive alternative. So, the miniaturized tools suitable for COVID-19 detection will replace the current expensive methods. Despite the limitations, the approved tests are still providing good results for this high risk pandemic. Many articles in the recent past highlighted the POCT method is not less than any other screening methods and by reviewing a wide research background, the importance of developing POCTs for screening such pandemic is presented here.

Five-year survival, disability, and recurrence after first-ever stroke in a middle-income country: A population-based study in Joinvile, Brazil

2018 ◽  
Vol 13 (7) ◽  
pp. 725-733 ◽  
Author(s):  
Norberto L Cabral ◽  
Vivian Nagel ◽  
Adriana B Conforto ◽  
Claudio H Amaral ◽  
Vanessa G Venancio ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Survival Rates ◽  
Developed Countries ◽  
Population Based ◽  
Stroke Recurrence ◽  
Average Risk ◽  
Middle Income ◽  
Stroke Registry ◽  
Risk Of Death ◽  
Scale Scores

Background Information about long-term outcomes after stroke in developing countries provided by population-based methodologies is scarce. Aim This study aimed to know outcomes five years after a first-ever stroke in Joinville, Brazil. Methods Data were extracted from the Joinville Stroke Registry about all patients who had strokes in Joinville in 2010 and were followed up to 2015. Stroke recurrence, Kaplan–Meier survival probabilities, functional outcomes, and causes of death were ascertained at 30 days, six months, one and five years. Results A total of 399 strokes were studied. The mean age was 64 (standard deviation 16) years. After five years, 52% (95% confidence interval: 47–57%) survived and 20% (95% confidence interval: 15–26%) of the survivors had modified Rankin scale scores >2. More than half of these patients were institutionalized in nursing or home care settings. The average risk of death per year was ≈7%. Survival rates were significantly lower for subarachnoid hemorrhage and primary intracerebral hemorrhage than for ischemic stroke. The five-year recurrence rate was 12% (95% confidence interval: 9–15%). The index stroke was the cause of death in three quarters of the patients. Conclusions The results showed that 68% of the patients with stroke were either dead or disabled five years after first-ever stroke. This percentage is similar to proportions of other recent cohorts from developed countries, despite the lower age of the patients in this study.

scholarly journals Point-of-Care Diagnostic Device for Traumatic Pneumothorax: Low Sensitivity of the Unblinded PneumoScan™

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
M. Rehfeldt ◽  
A. Slagman ◽  
B. A. Leidel ◽  
M. Möckel ◽  
T. Lindner
Keyword(s):  
Chest Trauma ◽  
Point Of Care ◽  
Diagnostic Tools ◽  
Trauma Room ◽  
Trauma Room Management ◽  
Life Threatening ◽  
Traumatic Pneumothorax ◽  
Low Sensitivity ◽  
Positive Results ◽  
Rule Out

Background. Traumatic Pneumothorax (PTX) is a potentially life-threatening injury. It requires a fast and accurate diagnosis and treatment, but diagnostic tools are limited. A new point-of-care device (PneumoScan) based on micropower impulse radar (MIR) promises to diagnose a PTX within seconds. In this study, we compare standard diagnostics with PneumoScan during shock-trauma-room management. Patients and Methods. Patients with blunt or penetrating chest trauma were consecutively included in the study. All patients were examined including clinical examination with auscultation (CE) and supine chest radiography (CXR). In addition, PneumoScan-readings and thoracic ultrasound scan (US) were performed. Computed tomography (CT) served as gold standard. Results. CT scan revealed PTX in 11 patients. PneumoScan detected two PTX correctly but missed nine. 15 false-positive results were found by PneumoScan, leading to a sensitivity of 20% and specificity of 80%. Six PTX were detected through CE (sensitivity: 54,5%). CXR detected four (sensitivity: 27,3%) and thoracic US two PTX correctly (sensitivity: 25%). Conclusion. The unblinded PneumoScan prototype did not confirm the promising results of previous studies. The examined standard diagnostics and thoracic US showed rather weak sensitivity as well. Until now, there is no appropriate point-of-care tool to rule out PTX.

Improved Outcomes after Reperfusion Therapies for Ischemic Stroke: A “Real-world” Study in a Developing Country

2020 ◽  
Vol 17 (4) ◽  
pp. 361-375
Author(s):  
Victor C. Schulz ◽  
Pedro S.C. de Magalhaes ◽  
Camila C. Carneiro ◽  
Julia I.T. da Silva ◽  
Vivian N. Silva ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Real World ◽  
Time Window ◽  
Functional Dependence ◽  
Developed Countries ◽  
First Year ◽  
Middle Income ◽  
Probability Of Survival ◽  
Stroke Center ◽  
Cerebral Reperfusion

Background: It is unknown if improvements in ischemic stroke (IS) outcomes reported after cerebral reperfusion therapies (CRT) in developed countries are also applicable to the “real world” scenario of low and middle-income countries. We aimed to measure the long-term outcomes of severe IS treated or not with CRT in Brazil. Methods: Patients from a stroke center of a state-run hospital were included. We compared the survival probability and functional status at 3 and 12 months in patients with severe IS treated or not with CRT. From 2010 to 2011, we performed intravenous reperfusion when patients arrived within 4.5 h time-window (IVT group) and after 2011, mechanical thrombectomy (MT) combined or not with intravenous alteplase (IAT group). Those who arrived >4.5 h in 2010-2011 and >6 h in 2012-2017 did not undergo CRT (NCRT group). Results: From 2010 to 2017, we registered 917 patients: 74% (677/917) in the NCRT group, 19% (178/917) in the IVT group and 7% (62/917) in the IAT group. Compared to the NCRT group, IVT patients had a 28% higher (HR: 0.72; 95% CI 0.53-0.96) 3-month adjusted probability of survival and risk of functional dependence was 19% lower (adjusted RR: 0.81; 95% CI 0.73-0.91). For those who underwent MT, the adjusted probability of survival was 59 % higher (HR: 0.41; 95% CI 0.21-0.77) and the risk of functional dependence was 21% lower (adjusted RR: 0.79; 95% CI 0.66-094). These outcomes remained significantly better throughout the first year. Conclusion: CRT led to better outcomes in patients with severe IS in Brazil.

P3352Telemedicine transcends national boundaries in quest of creating a behemoth ami program

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Mehta ◽  
R Botelho ◽  
F Fernandez ◽  
F Feres ◽  
A Abizaid ◽  
...  
Keyword(s):  
Community Health Centers ◽  
Developed Countries ◽  
Population Based ◽  
Primary Pci ◽  
Small Community ◽  
Hub And Spoke ◽  
Web Based ◽  
National Boundaries ◽  
Intelligent Tools ◽  
Time Of Presentation

Abstract Background The Latin America Telemedicine Infarct Network (LATIN) has exploited the remarkable competence of telemedicine for remote guidance. In doing so, LATIN created a mammoth population-based AMI network that employed experts located several hundred miles away to guide the reperfusion strategies for almost 800,000 screened patients. In this pioneering project, telemedicine was initially utilized to guide AMI management within national confines. We speculated whether LATIN telemedicine navigation could outstrip countrywide borders. Purpose To maximally harness the vast possibilities of telemedicine for improving AMI care. Methods During its pilot phase, LATIN began as a hub and spoke, AMI system in Colombia where 20 spokes (small community health centers and rural clinics) were configured with 3 hubs that could perform Primary PCI. These sites were linked through web-based connectivity. Expert cardiologists, located 50–250 miles away in Bogota, Colombia, used sophisticated telemedicine platforms for urgent EKG diagnosis and teleconsultation of the entire AMI process. Based upon the duration of chest pain and travel time to the hub, these experts guided patients through guideline-based strategies of thrombolysis, pharmaco invasive management or primary PCI. Efficiency of the telemedicine process was measured with the new metric of time to telemedicine diagnosis (TTD). Cloud computing, GPS navigation, and numerous business intelligent tools were gradually incorporated into LATIN telemedicine. As systems became more scalable, the program was expanded to Brazil, where LATIN flourished. Over the last 18 months, LATIN telemedicine capabilities have been pressed across national boundaries. Presently, all 82 LATIN centers in Mexico are guided by experts located in Bogota, Colombia and the 7 Argentina centers channeled through Santiago, Chile. Results 784,947 patients were screened for AMI at 350 LATIN centers (Brazil 143, Colombia 118, Mexico 82, Argentina 7). Navigation pathways are depicted in the attached figure. TTD remains extremely low in all four countries, and comparable efficiency and tele-accuracy have been achieved. With expanded geographic reach, 8,448 (1.08%) patients were diagnosed with STEMI and 3,911 (46.3%) urgently reperfused, including 3,049 (78%) with Primary PCI. Time to TTD ranged between 2.8 to 5.8 minutes, with a mean of 3.5 min. Tele-accuracy was 98.5%, D2B 51 min, and in-hospital mortality 5.2%. Various other comparative metrics for the 4 countries are being gathered and will be available at the time of presentation. Conclusions LATIN demonstrates the robust ability of telemedicine to transcend national boundaries to guide AMI management. This strategy can be adopted in under-developed countries in Asia and Africa to provide an umbrella of AMI care for the millions of disadvantaged patients.

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