仅与支持部门和机构资源进行调查。该的凝血装置（HEMOCHRON 801）被租借制造商不承担责任。在他们的零售价格购买该检测盒。在视频的介绍图修改Sanderink 等12，第二个数字的视频（乙酰肝素酶消化时间过程）与许可来自Inchiosa 等再现。1

1。肝素重建<ol><li>冻干肝素酶I的购得（西门子，纽瓦克特拉华，DadeHepzyme楼盘B4240-10）在小瓶中，含有1微克的纯化蛋白。的蛋白质溶解在0.25毫升的生理盐水（0.9％NaCl）中。 </li></ol> 2。采集血样<ol><li>两个血液样本成柠檬酸钠（0.109M;0.3毫升为3.2％），通过真空绘制缓冲Vacutainer管（流式细胞-Dickinson公司，新泽西州富兰克林湖）;管都是预尖刺与已知浓度的依诺肝素;血容量所绘制为2.7毫升。的总含量，然后3.0毫升。 </li></ol> 3。肝素酶消化<ol><li>的肝素酶，可以被吸入到一个注射器（约0.2​​毫升，80％的小瓶; 0.8μg蛋白）的小瓶，其全部内容被转移到1的Vacutainer管; 0.2毫升的生理盐水（0.9％NaCl）中被添加到第二管，其中的巴塞尔作为国家统计局前的状态，依诺肝素的效果消除。 </li><li>为5分钟的期间，两个Vacutainer管被放置在恒温井的凝血时间装置。 （5分钟的消化时间是否足够与肝素成立于我们此前发表的作品。1） </li></ol> 4。凝血分析<ol><li>的肝素酶孵育结束时，2.0毫升的血液转移到测定盒。在的MAA的管的情况下，它是预先充填了0.1毫升的250mM CaCl 2的启动凝血。商业APTT的测定盒（A104）被设计来启动已卷入Vacutainer管含有枸橼酸钠抗凝全血中的凝血。 </li><li> HEMOCHRON装置血液凝固的完成信号，并保留在几秒钟内的凝血时间。凝血时间的差异之间的肝素酶处理的样品和基线样品，除以凝血钛我为基准样品，得到消除的依诺肝素的百分比减少。正如下面所讨论的，强的线性关系已由chromgenic测定抗Xa％的减少，凝血时间和浓度的依诺肝素样品中添加的全血样本，以及依诺肝素与测量浓度的相关性之间的关系获得活动。抗Xa的依诺肝素浓度检测进行了商业化试剂盒为一个两阶段的显色分析（BIOPHEN; Aniara，梅森，OH）。 </li></ol>

<ol>
	<li>Inchiosa, M. A. J. r., Pothula, S., Kubal, K., Sanchala, V. T., Navarro, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Toward+development+of+a+point-of-care+assay+of+enoxaparin+anticoagulant+activity+in+whole+blood.">Toward development of a point-of-care assay of enoxaparin anticoagulant activity in whole blood.</a> J. Thromb. Thrombolysis. 32, 47-53 (2011).</li><li>Despotis, G. J., Filos, K. S., Levine, V., Alsoufiev, A., Spitznagel, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Aprotinin+prolongs+activated+and+nonactivated+whole+blood+clotting+time+and+potentiates+the+effect+of+heparin+in+vitro.">Aprotinin prolongs activated and nonactivated whole blood clotting time and potentiates the effect of heparin in vitro.</a> Anesth. Analg. 82, 1126-1131 (1996).</li><li>Pothula, S., Inchiosa, M. A., Sanchala, V. T., Sarabu, M., Inchiosa, A. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vitro+effect+of+protamine+excess+on+blood+coagulation+assays.">In vitro effect of protamine excess on blood coagulation assays.</a> Anesth Analg. 96, SCA39 (2010).</li><li>Inchiosa, M., Pothula, S., Sanchala, V., Kubal, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Detection+of+low+plasma+levels+of+low+molecular+weight+heparin.">Detection of low plasma levels of low molecular weight heparin.</a> Anesth Analg. 102, SCA10 (2010).</li><li>Gogarten, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+influence+of+new+antithrombotic+drugs+on+regional+anesthesia.">The influence of new antithrombotic drugs on regional anesthesia.</a> Curr. Opin. Anaesthesiol. 19, 545-550 (2006).</li><li>Gouin-Thibault, I., Pautas, E., Siguret, V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Safety+profile+of+different+low-molecular+weight+heparins+used+at+therapeutic+dose.">Safety profile of different low-molecular weight heparins used at therapeutic dose.</a> Drug Saf. 28, 333-349 (2005).</li><li>Bazinet, A., Almanric, K., Brunet, C., Turcotte, I., Martineau, J., Caron, S., Blais, N., Lalonde, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dosage+of+enoxaparin+among+obese+and+renal+impairment+patients.">Dosage of enoxaparin among obese and renal impairment patients.</a> Thromb. Res. 116, 41-50 (2005).</li><li>El Rouby, S., Cohen, M., Gonzales, A., Hoppensteadt, D., Lee, T., Zucker, M. L., Khalid, K., LaDuca, F. M., Fareed, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+use+of+a+HEMOCHRON+JR.+HEMONOXTM+point+of+care+test+in+monitoring+the+anticoagulant+effect+of+enoxaparin+during+interventional+coronary+procedures.">The use of a HEMOCHRON JR. HEMONOXTM point of care test in monitoring the anticoagulant effect of enoxaparin during interventional coronary procedures.</a> J. Thromb. Thrombolysis. 21, 137-145 (2006).</li><li>Yang, V. C., Bernstein, H., Cooney, C. L., Kadam, J. C., Langer, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Removal+of+the+anticoagulant+activities+of+the+low+molecular+weight+heparin+fractions+and+fragments+with+flavobacterial+heparinase.">Removal of the anticoagulant activities of the low molecular weight heparin fractions and fragments with flavobacterial heparinase.</a> Thromb Res. 44, 599-610 (1986).</li><li>Maddineni, J., Walenga, J. M., Jeske, W. P., Hoppensteadt, D. A., Fareed, J., Wahi, R., Bick, R. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Product+individuality+of+commercially+available+low-molecular-weight+heparins+and+their+generic+versions:+therapeutic+implications.">Product individuality of commercially available low-molecular-weight heparins and their generic versions: therapeutic implications.</a> Clinical and Applied Thrombosis/Hemostasis. 12, 267-276 (2006).</li><li>Wijnhoven, T. J., van de Westerlo, E. M., Smits, N. C., Lensen, J. F., Rops, A. L., vander Vlag, J., Berden, J. H., vanden Heuvel, L. P., van Kuppevelt, T. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterization+of+anticoagulant+heparinoids+by+immunoprofiling.">Characterization of anticoagulant heparinoids by immunoprofiling.</a> Glycoconj. J. 25, 177-185 (2008).</li><li>Sanderink, G. -. J. C. M., Guimart, C. G., Ozoux, M. -. L., Jariwala, N. U., Shukla, U. A., Boutouyrie, B. X. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pharmacokinetics+and+pharmacodynamics+of+the+prophylactic+dose+of+enoxaparin+once+daily+over+4+days+in+patients+with+renal+impairment.">Pharmacokinetics and pharmacodynamics of the prophylactic dose of enoxaparin once daily over 4 days in patients with renal impairment.</a> Thromb. Res. 105, 225-231 (2002).</li></ol>

作者有没有透露。

此法的依诺肝素的疗效，可作为一个重要的选择，以确定相对安全的进行侵入性手术，有一个随之而来的风险，出血或血肿的发展。正在考虑硬膜外注射时，这是特别重要的。大多数的指引，建议等待一段时间注射依诺肝素和一种侵入性手术开始12小时之间。5肾功能受损，肥胖和妊娠可能影响计量的要求，依诺肝素。6,7由于内就可以完成检测10 -分钟的时间内，它也可以被用来在诊所或医生的办公室，在那里将提供的信息是否有足够的抗凝治疗的患者，是在发展的静脉血栓栓塞的风险。即时调整剂量，根据需要，可以制定。 可以测量由一个生色一个，依诺肝素血浆中的浓度SSAY的凝血因子Xa的抑制程度。然而，这仅仅得到它的浓度，特别是其抗凝血剂的功效，个别患者有很大的不同。6-8 我们的研究只进行了使用依诺肝素。然而，可以预计，该方法的，可以适用于任何的低分子肝素（LMWH），是由肝素酶I。降解这已经是已知的情况下，达肝素，低分子量肝素和亭扎肝素9-11我们设计的检测有关的功能凝血时间凝血时间的仪器。该仪器是价格相对低廉，一次性使用血液收集管，肝素安瓿，试验盒，也完成分析一个病人约15亿美元，。因此，可以预计的是适合在不同的临床设置监测抗凝状态。

<table border="1"><tbody><tr><td> 试剂名称 </td><td> 公司 </td><td> 目录编号 </td><td> 评论 </td></tr><tr><td> Hepzyme </td><td>西门子</td><td> B4240 </td><td>肝素我</td></tr><tr><td> "MAA"墨盒</td><td> Technidyne </td><td> FTK-ACT </td><td>高岭土去除修改</td></tr><tr><td> APTT墨盒</td><td> Technidyne </td><td> A104 </td><td></td></tr></tbody></table>

rapid point-of-care assay of enoxaparin anticoagulant efficacy in whole blood

是有需要的临床试验，以确定病人的血液在何种程度上有效的低分子量肝素（LMWH），依诺肝素抗凝。临床上也迫切的情况下，这将是重要的，如果能迅速确定。本试验的目的是实现这一目标。我们只检测人体血液样本，与已知浓度的依诺肝素飙升。本测定法的基本特征是通过降解它来完成与肝素的不活动的病人的血液试样中的依诺肝素的疗效的量化。两个血液样本被卷入Vacutainer管（流式细胞迪肯森新泽西州富兰克林湖），依诺肝素飙升;一个样品与肝素酶消化在37℃下5分钟，其他的样品代表患者的基线抗凝固状态。 ％缩短凝血时间在肝素酶处理的样品相比，到baseline状态，取得了依诺肝素的抗凝血剂的贡献。我们使用的便携式，电池供电的HEMOCHRON 801装置的凝血时间的测量（邮费Technidyne公司，新泽西州Edison）。该仪器具有恒温控制（37°C）测定油井管。在两种类型的检测仪器的制造商提供的墨盒，我们进行了分析。一个墨盒被修改，以增加其灵敏度。我们删除了高岭土FTK-ACT卡匣广泛用蒸馏水冲洗，离开仅在玻璃表面的管子，和可能的检测磁铁，作为活化剂。我们叫这是我们的最低限度的激活试验（MAA）。我们和其他人已研究使用最小激活的测定2-4进行了研究的第二盒是活化部分凝血活酶时间（APTT）测定法（A104）。这被用于从制造商提供。恒温井仪器WERE采用肝素酶消化和凝固分析。该法可在10分钟内完成。 ，MAA检测结果显示强劲的依诺肝素酶消化后，在一个典型的临床浓度范围内变化凝血时间。 0.2抗Xa IU每毫升的血液样本，依诺肝素，肝素酶消化引起的凝血时间平均下降了9.8％（20.4秒）;在1.0 IU每毫升的依诺肝素下降41.4％（148.8秒）。本报告只介绍了实验的分析，还必须建立它的价值，在临床上的应用。

图1给出的结果之间的关系，减少百分之凝血时间，消除了一系列的添加浓度的依诺肝素（0.2，0.4和1.0抗Xa国际单位每毫升）与肝素依诺肝素。结果的MAA和aPTT检测墨盒。依诺肝素从抗-Xa活性的发色底物法测得的浓度，还包括在每个图的横坐标的。 图2给出图相同的数据作为减少百分之生色衡量抗-Xa活性的凝血时间vs。 强的线性相关性，具有较高的统计学意义，发现为所有四个关系。 <img src="/files/ftp_upload/3852/3852fig1.jpg" alt="图1" /> 点的护理决定的依诺肝素对照图1。ibution的培养与肝素后凝血时间的百分比变化（缩短）的基础上加标全血凝血时间。的加标依诺肝素浓度添加到全血中，并测得的抗Xa因子的血浆浓度（平均值±SE，在括号中）放置在各曲线图中的横坐标。凝血时间的所有变化百分比中提出作为装置和SE，连同与平均缩短凝血时间，以秒为单位。来自相同的病人的数据是由虚线连接。用星号在剧情患者的数据一个（MAA结果）的患者在图B，活化部分凝血活酶时间（APTT检测）是相同的。所有的结果代表单一的测定。的Pearson相关系数为R = 0.869（p值= 1.9×10 -5）和r = 0.916（p值= 2.8×10 -5）的与MAA和aPTTassay的分别。转载的许可来自Inchiosa 等。1 图2的查询结果在护理点示于图1A和B的测定凝血时间的变化百分比对血浆的抗因子Xa的浓度作图。，MAA结果，B，APTT的测定。所有的结果都是从单一的凝血时间测定和单一测定抗 - 因子Xa浓度。的Pearson相关系数分别为r = 0.910（p值= 2.5×10 -6）和r = 0.922（p值= 2.0×10 -5），转载许可距离Inchiosa 等分别与MAA和APTT测定的关系1

Watch this Scientific Journal Video about Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood at JoVE.com

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood

示范低分子重量肝素，依诺肝素抑制血液凝固的快速定量测定。消除它的影响力，通过消化与肝素依诺肝素的贡献进行评估。在我们发表的论文中详细介绍较详细地说明检测。<sup&gt; 1</sup&gt;该法还需要临床确认。

快速点护理依诺肝素的抗凝血剂功效的测定全血中

There is the need for a clinical assay to determine the extent to which a patient's blood is effectively anticoagulated by the ...

rapid-point-care-assay-enoxaparin-anticoagulant-efficacy-whole

Research

Education

JoVE Core

JoVE Journal

Pharmacology

Medicine

Unit 1

Cardiovascular Drugs: Anticoagulants and Antianginal Agents

SCIENTISTS IN ACTION

13.7K 次观看.  New York Medical College. 示范低分子重量肝素，依诺肝素抑制血液凝固的快速定量测定。消除它的影响力，通过消化与肝素依诺肝素的贡献进行评估。在我们发表的论文中详细介绍较详细地说明检测。 1该法还需要临床确认。

视频: Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood

Rapid Fractionation and Isolation of Whole Blood Components in Samples Obtained from a Community-based Setting

Collection and processing of whole blood samples in a non-clinical setting offers a unique opportunity to evaluate community-dwelling individuals both with and without preexisting conditions. Rapid processing of these samples is essential to avoid degradation of key cellular components. Included here are methods for simultaneous peripheral blood mononuclear cell (PBMC), DNA, RNA and serum isolation from a single blood draw performed in the homes of consenting participants across a metropolitan area, with processing initiated within 2 hr of collection. We have used these techniques to process over 1,600 blood specimens yielding consistent, high quality material, which has subsequently been used in successful DNA methylation, genotyping, gene expression and flow cytometry analyses. Some of the methods employed are standard; however, when combined in the described manner, they enable efficient processing of samples from participants of population- and/or community-based studies who would not normally be evaluated in a clinical setting. Therefore, this protocol has the potential to obtain samples (and subsequently data) that are more representative of the general population.

We outline a methodology for the processing of whole blood to obtain a variety of components for further analysis. We have optimized a streamlined protocol that enables rapid, high-throughput simultaneous processing of whole blood samples in a non-clinical setting.

快速分馏和全血的成分的分离样品中从社区为基础的设置获得

Collection and processing of whole blood samples in a non-clinical setting offers a unique opportunity to evaluate community-dwelling individuals both ...

科研

医学

Assessment of the Anticoagulant and Anti-inflammatory Properties of Endothelial Cells Using 3D Cell Culture and Non-anticoagulated Whole Blood

In vivo, endothelial cells are crucial for the natural anticoagulation of circulating blood. Consequently, endothelial cell activation leads to blood coagulation. This phenomenon is observed in many clinical situations, like organ transplantation in the presence of pre-formed anti-donor antibodies, including xenotransplantation, as well as in ischemia/reperfusion injury. In order to reduce animal experimentation according to the 3R standards (reduction, replacement and refinement), in vitro models to study the effect of endothelial cell activation on blood coagulation would be highly desirable. However, common flatbed systems of endothelial cell culture provide a surface-to-volume ratio of 1 - 5 cm2 of endothelium per mL of blood, which is not sufficient for natural, endothelial-mediated anticoagulation. Culturing endothelial cells on microcarrier beads may increase the surface-to-volume ratio to 40 - 160 cm2/mL. This increased ratio is sufficient to ensure the &#34;natural&#34; anticoagulation of whole blood, so that the use of anticoagulants can be avoided. Here an in vitro microcarrier-based system is described to study the effects of genetic modification of porcine endothelial cells on coagulation of whole, non-anticoagulated human blood. In the described assay, primary porcine aortic endothelial cells, either wild type (WT) or transgenic for human CD46 and thrombomodulin, were grown on microcarrier beads and then exposed to freshly drawn non-anticoagulated human blood. This model allows for the measurement and quantification of cytokine release as well as activation markers of complement and coagulation in the blood plasma. In addition, imaging of activated endothelial cell and deposition of immunoglobulins, complement- and coagulation proteins on the endothelialized beads were performed by confocal microscopy. This assay can also be used to test drugs which are supposed to prevent endothelial cell activation and, thus, coagulation. On top of its potential to reduce the number of animals used for such investigations, the described assay is easy to perform and consistently reproducible.

We present an in vitro model which allows the study and analysis of coagulation in whole, non-anticoagulated blood. Anticoagulation in the system depends on the natural anticoagulation effect of healthy endothelial cells and endothelial cell activation will result in clotting.

3D 细胞培养和非抗凝全血对内皮细胞抗凝及抗炎作用的评价

In vivo, endothelial cells are crucial for the natural anticoagulation of circulating blood. Consequently, endothelial cell activation leads to blood ...

Evaluation of a Point-of-Care Testing Analyzer for Measuring Peripheral Blood Leukocytes

White blood cell (WBC) is an important indicator of inflammation in the body, and it can help distinguish between bacterial and viral infections. At present, most primary medical institutions in China have a poor percentage of adoption of blood-testing technology, and a hematology detection system with a high price to performance ratio and easy operation is urgently needed in primary healthcare centers. This paper introduces the principle and operation procedures of a point-of-care testing (POCT) card-based leukocyte analyzer (evaluated system), which was used to detect WBC indexes such as neutrophils, lymphocytes, and intermediate group cells (including eosinophils, basophils, and monocytes) in whole blood. The results from the evaluated system were compared to those from two commercial automatic hematology analyzers (reference system). The correlation and consistency between the evaluated system and the commercial reference systems were analyzed. The results showed that WBC count and number of granulocytes detected by the evaluated and reference systems showed a strong positive correlation (rs = 0.972 and 0.973, respectively), while the number of lymphocytes showed a relatively low correlation (rs = 0.851). A Bland-Altman plot showed that the major difference between the values detected by the evaluated system and the reference systems is within 95% limits of agreement (LoA), indicating that the two systems are in good agreement. In conclusion, the evaluated system has an excellent correlation, robust consistency, and a reliable comparison with the results of the widely used automatic hematology analyzers. It is ideal for WBC detection in primary medical institutions where a full-automatic five-category hematology analyzer is unavailable, especially during the COVID-19 normalized prevention and control period.

A protocol to measure peripheral blood leukocytes using a POCT card-based leukocyte analyzer is presented here. Same blood samples were tested by two automated hematology analyzers to evaluate the consistency and accuracy of the results. The results showed that the evaluated analyzer had a good correlation with the reference system.

用于测量外周血白细胞的床旁测试分析仪的评估

White blood cell (WBC) is an important indicator of inflammation in the body, and it can help distinguish between bacterial and viral infections. At ...

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

Acute lower extremity deep venous thrombosis (DVT) is a serious vascular disorder that requires accurate and early diagnosis to prevent life-threatening sequelae. While whole leg compression ultrasound with color and spectral Doppler is commonly performed in radiology and vascular labs, point-of-care ultrasound (POCUS) is becoming more common in the acute care setting. Providers appropriately trained in focused POCUS can perform a rapid bedside examination with high sensitivity and specificity in critically ill patients. This paper describes a simplified yet validated approach to POCUS by describing a three-zone protocol for lower extremity DVT POCUS image acquisition. The protocol explains the steps in obtaining vascular images at six compression points in the lower extremity. Beginning at the level of the proximal thigh and moving distally to the popliteal space, the protocol guides the user through each of the compression points in a stepwise manner: from the common femoral vein to the femoral and deep femoral vein bifurcation, and, finally, to the popliteal vein. Further, a visual aid is provided that may assist providers during real-time image acquisition. The goal in presenting this protocol is to help make proximal lower extremity DVT exams more accessible and efficient for POCUS users at the patient&#39;s bedside.

Traditionally, lower extremity deep venous thrombosis (DVT) is diagnosed by radiology-performed venous duplex ultrasound. Providers appropriately trained in focused point-of-care ultrasound (POCUS) can perform a rapid bedside examination with high sensitivity and specificity in critically ill patients. We describe the scanning technique for focused POCUS DVT lower extremity examination.

下肢近端深静脉血栓形成的即时超声筛查

Acute lower extremity deep venous thrombosis (DVT) is a serious vascular disorder that requires accurate and early diagnosis to prevent life-threatening ...

Point-of-Care Lung Ultrasound in Adults: Image Acquisition

Consultative ultrasound performed by radiologists has traditionally not been used for imaging the lungs, as the lungs&#39; air-filled nature normally prevents direct visualization of the lung parenchyma. When showing the lung parenchyma, ultrasound typically generates a number of non-anatomic artifacts. However, over the past several decades, these artifacts have been studied by diagnostic point-of-care ultrasound (POCUS) practitioners, who have identified findings that have value in narrowing the differential diagnoses of cardiopulmonary dysfunction. For instance, in patients presenting with dyspnea, lung POCUS is superior to chest radiography (CXR) for the diagnosis of pneumothorax, pulmonary edema, lung consolidations, and pleural effusions. Despite its known diagnostic value, the utilization of lung POCUS in clinical medicine remains variable, in part because training in this modality across hospitals remains inconsistent. To address this educational gap, this narrative review describes lung POCUS image acquisition in adults, including patient positioning, transducer selection, probe placement, acquisition sequence, and image optimization.

Point-of-care ultrasound (POCUS) of the lungs provides quick answers in rapidly changing clinical scenarios. We present an efficient and informative protocol for image acquisition for use in acute care settings.

成人床旁肺部超声:图像采集

Consultative ultrasound performed by radiologists has traditionally not been used for imaging the lungs, as the lungs&#39; air-filled nature normally ...

Point-of-Care Ultrasound: A Review of Ultrasound Parameters for Predicting Difficult Airways

Airway management remains a crucial part of perioperative care. The conventional approach to assessing potentially difficult airways emphasizes the LEMON method, which looks for and evaluates the Mallampati classification, signs of obstruction, and neck mobility. Clinical findings help predict a higher likelihood of difficult tracheal intubation, but no clinical result reliably excludes difficult intubation. Ultrasound as an adjunct to clinical examination can provide the clinician with a dynamic anatomical airway assessment, which is impossible with clinical examination alone. In the hands of anesthesiologists, ultrasound is becoming more popular in the perioperative period. This method is particularly applicable for identifying proper endotracheal tube positioning in specific patient populations, such as those who are morbidly obese and patients with head and neck cancer or trauma. The focus is on identifying the normal anatomy, correctly positioning the endotracheal tube, and refining the parameters that predict difficult intubation. Several ultrasound measurements are clinical indicators of difficult direct laryngoscopy in the literature. A meta-analysis revealed that the distance from the skin to the epiglottis (DSE) is most associated with a difficult laryngoscopy. An ultrasound of the airway could be applied in routine practice as an adjunct to the clinical examination. A full stomach, rapid sequence intubation, gross visual anatomical abnormalities, and restricted neck flexibility prevent using ultrasound to assess the airway. The airway evaluation is performed with a linear array transducer of 12-4 MHz, with the patient in the supine position, with no pillow, and with the head and neck in a neutral position. The central axis of the neck is where the ultrasound parameters are measured. These image acquisitions guide the standard ultrasound examination of the airway.

A point-of-care ultrasound (POCUS) is a simple, non-invasive, and portable tool that enables dynamic airway assessment. Several studies have attempted to determine the role of ultrasound parameters as an adjunct to clinical examination in predicting difficult laryngoscopies.

床旁超声:预测困难气道的超声参数综述

Airway management remains a crucial part of perioperative care. The conventional approach to assessing potentially difficult airways emphasizes the LEMON ...

使用 Micro-CFU 方法加速结核病测定

Micro-Colony Forming Unit Assay for Efficacy Evaluation of Vaccines Against Tuberculosis

Tuberculosis (TB), the leading cause of death worldwide by an infectious agent, killed 1.6 million people in 2022, only being surpassed by COVID-19 during the 2019-2021 pandemic. The disease is caused by the bacterium Mycobacterium tuberculosis (M.tb). The Mycobacterium bovis strain Bacillus Calmette-Gu&#233;rin (BCG), the only TB vaccine, is the oldest licensed vaccine in the world, still in use. Currently, there are 12 vaccines in clinical trials and dozens of vaccines under pre-clinical development. The method of choice used to assess the efficacy of TB vaccines in pre-clinical studies is the enumeration of bacterial colonies by the colony-forming units (CFU) assay. This time-consuming assay takes 4 to 6 weeks to conclude, requires substantial laboratory and incubator space, has high reagent costs, and is prone to contamination. Here we describe an optimized method for colony enumeration, the micro-CFU (mCFU), that offers a simple and rapid solution to analyze M.tb vaccine efficacy results. The mCFU assay requires tenfold fewer reagents, reduces the incubation period threefold, taking 1 to 2 weeks to conclude, reduces lab space and reagent cost, and minimizes the health and safety risks associated with working with large numbers of M.tb. Moreover, to evaluate the efficacy of a TB vaccine, samples may be obtained from a variety of sources, including tissues from vaccinated animals infected with Mycobacteria. We also describe an optimized method to produce a unicellular, uniform, and high-quality mycobacterial culture for infection studies. Finally, we propose that these methods should be universally adopted for pre-clinical studies of vaccine efficacy determination, ultimately leading to time reduction in the development of vaccines against TB.

作者聚焦:优化 CFU 测定以有效评估结核病疫苗功效和抗原呈报分析 

The determination of colony-forming units (CFU) is the gold-standard technique for quantifying bacteria, including Mycobacterium tuberculosis which can take weeks to form visible colonies. Here we describe a micro-CFU for CFU determination with increased time efficiency, reduced lab space and reagent cost, and scalability to medium and high throughput experiments.

用于结核病疫苗功效评估的微集落形成单位测定

Tuberculosis (TB), the leading cause of death worldwide by an infectious agent, killed 1.6 million people in 2022, only being surpassed by COVID-19 during ...

Optic Nerve Sheath Point of Care Ultrasound: Image Acquisition

The goal of this protocol is to develop a standardized method for acquiring images of the optic nerve sheath and measuring the optic nerve sheath diameter (ONSD). Diagnostic ultrasound of the ONSD to detect intracranial hypertension has traditionally faced many problems because of methodologic discrepancies. Due to inconsistencies in the measuring techniques, the potential for ONSD to become a non-invasive bedside monitoring tool for ICP has been hampered. However, establishing a transparent, consistent methodology for measuring the ONSD would support its use as a valid and reliable method of identifying intracranial hypertension. This is important as it has both high sensitivity and specificity in acute care settings. This narrative review describes ONSD POCUS image acquisition, including patient positioning, transducer selection, probe placement, the acquisition sequence, and image optimization. Further, visual aids are provided to assist in real-time during image acquisition. This method should be considered for patients for whom there are concerns regarding intracranial hypertension but who do not have an intracranial monitor in place.

Point-of-care ultrasound (POCUS) of the optic nerve sheath diameter (ONSD) has been shown to be useful in identifying patients with increased intracranial pressure (ICP). However, the non-standardized technique for this POCUS has hampered its use. We present a standardized image acquisition protocol for use in the acute care setting.

视神经鞘床旁超声:图像采集

The goal of this protocol is to develop a standardized method for acquiring images of the optic nerve sheath and measuring the optic nerve sheath diameter ...