Point-of-care

Laboratory confirmation is vital to effective treatment of HSV, especially in individuals in whom a clinical diagnosis cannot be obtained. There are several methods by which a definitive diagnosis may be acquired, and these include virologic typing, serologic diagnosis, rapid point-of-care antigen detection, enzyme-linked immunosorbent assay (ELISA), immunoblot, and DNA polymerase chain reaction.27... 

In addition to laboratory blood analyzers and portable point-of-care devices, which require blood collection, continuous monitoring of ion activities in a blood stream via implanted ion-selective electrodes is of great interest. The term biocompatibility refers to the ability of a sensor not to cause toxic or injurious effects while being in contact with living tissue. As dealing with any foreign object introduced into the human body, biocompatibility and hemocompatibility particularly are the most important requirements. 

Such electrodes should be sufficient as a reference electrode for short-term usage or as a disposable electrode. However, the requirement of a pre-hydration time may limit its applications for fast measurements, such as POCT (the point-of-care testing), due to its slow response time. In fact, the lack of long-term stable microreference electrodes will continue to hamper the development of integrated pH sensing systems. 

A.J. Tudos, G.A.J. Besselink, and R.B.M. Schasfoort, Trends in miniaturized total analysis systems for point-of-care testing in clinical chemistry. Lab on a Chip 1, 83-95 (2001). 

Use dedicated medical equipment (e.g., stethoscopes, point-of-care monitors). 

Rapid antigen and point-of-care tests, direct fluorescence antibody test, and the reverse-transcription polymerase chain reaction assay may be used for rapid detection of virus. 

In this chapter we first discuss the fundamentals and the design aspects of an integrated optical YI sensor (Sect. 10.2), followed by a description of the experimental setup (Sect. 10.3). In the result section (Sect. 10.4) both protein and vims detection experiments are discussed. Section 10.5 demonstrates the use of microfluidic chips for efficient sample handling in combination with the YI sensor. This chapter concludes with a discussion on the prospects of the sensor for point-of-care diagnostics. 

The equivalent scalability for molecular sensors applies to the point of care. Scalable biosensors will enable high-capacity diagnostic capabilities to remain sufficiently affordable and small in size to stay in doctors offices or in hospitals... 

Point of care Claims vary may be moderate or high complexity or CLIA waived tests FDA 510(k) or PMA CLIA Oversight depending on categorization of test... 

As occurred with the other antibiotics, commercial immunoassay formats, also available as kits for tetracyclines and penicillins such as the Parallux, the LacTek, or the Charm II, have also been placed on the market for the analysis of sulfonamides (see Table 4). Thus, the Parallux detects sulfamethazine and sulfadimethoxine in raw milk with a LOD of 10 pg L1. The Charm II detects almost all sulfonamides in honey and milk with a LOD in the range from 1 to 10 pg L, whereas LacTek is able to detect sulfamethazine. Moreover, the 5101SULlp and 5101SUDAlp tests reach LOD values for sulfamethazine and sulfadiazine of around 0.2 pg L 1 and they have been applied to the analysis of urine, milk, and plasma. These tests have proved to be efficient as a point of care for on-site applications on farms. Moreover, commercially available antibodies can be found from several sources such as Silver Lake Research, US Biological, Cortex Biochem. Inc., Accurate Chemical Scientific, Fitzgerald Industries International Inc., and Biotrend Chemikalien GmbH. 

Commercial application of the dendrimer-based reagent technology has been demonstrated by the successful development of The Stratus CS STAT fluorometric analyzer [5] marketed by Dade Behring Inc. This rapid automated point of care immunoassay system provides quantitative analysis of whole blood or preprocessed plasma samples via unit use assay test packs. Up to four test packs can be introduced for each sample. All reagents [5-9] required for specimen analyses are contained within the test packs. 

Currently, there is a need for high-throughput determination of nucleic acid sequences. At present, detection systems most commonly employ fluorescence-based methods. However, wide spread applications of such methods are limited by low speed, high cost, size, and number of incubations steps, among other factors. Application of electrochemical methods in affinity DNA sensors presents likely a promising alternative, allowing miniaturization and cost reduction, and potentially allowing application in point-of-care assays. 

Electrochemical ion-selective sensors (ISSs), including potentiometric ion-selective electrodes (ISEs) and potentiometric or amperometric gas-selective sensors (GSSs), attracted the interest of clinical chemistry because they offer fast, reliable, inexpensive analytical results in service-free automated analyzers. In this way, the electrochemical sensors satisfy the present demands of central hospital laboratories and peripheral point-of-care medical service points, such as bedside, emergency or first-contact healthcare centers. 

These versatile microfluidic systems will provide new tools for clinical diagnostics and other important fields of Analytical Chemistry. Future directions point toward the development and refinement of truly self-contained portable p-TAS devices that can be used for point-of-care or on-site analysis. It is foreseeable that in the near future these devices could be routinely employed for the detection of numerous clinically relevant compounds. 

The development of immunosensors for the detection of diseases has received much attention lately and this has largely been driven by the need to develop hand-held devices for point-of-care measurements [67,68]. Immunosensors can incorporate either the antigen or the antibody onto the sensor surface, although the latter approach has been used most often [67]. Optical [69,70] and electrochemical [70] detection methods are most frequently used in immunosensors [67]. Detection by... 

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