Purpose The aim of the current study was to evaluate point of care ultrasound (POCUS) in geriatric patients by echoscopy using a handheld ultrasound device (HHUSD, VScan) at bedside in comparison to a high-end ultrasound system (HEUS) as the gold standard.
Materials and Methods Prospective observational study with a total of 112 geriatric patients. The ultrasound examinations were independently performed by two experienced blinded examiners with a portable handheld device and a high-end ultrasound device. The findings were compared with respect to diagnostic findings and therapeutic implications.
Results The main indications for the ultrasound examinations were dyspnea (44.6 %), fall (frailty) (24.1 %) and fever (21.4 %). The most frequently found diagnoses were cystic lesions 32.1 % (35/109), hepatic vein congestion 19.3 % (21/109) and ascites 13.6 % (15/110). HHUSD delivered 13 false-negative findings in the abdomen resulting in an “overall sensitivity” of 89.5 %. The respective “overall specificity” was 99.6 % (7 false-positive diagnoses). HHUSD (versus HEUS data) resulted in 13.6 % (17.3 %) diagnostically relevant procedures in the abdomen and 0.9 % (0.9 %) in the thorax. Without HHUSD (HEUS) 95.7 % (100 %) of important pathological findings would have been missed.
Conclusion The small HHUSD tool improves clinical decision-making in immobile geriatric patients at the point of care (geriatric ward). In most cases, HHUSD allows sufficiently accurate yes/no diagnoses already at the bedside, thereby clarifying the leading symptoms for early clinical decision-making.
W e evaluated automated nucleic acid (NA) extraction from a variety of different biological specimens using the QIAsymphony SP instrument. QIAsymphony DNA kits were used for DNA purification from human blood and from diverse human and animal tissue specimens. RNA was isolated from human blood stabilized in PAXgene Blood RNA tubes with the QIAsymphony PAXgene Blood RNA kit, and from human colon and bladder carcinoma biopsies using the QIAsymphony RNA kit. Photometric measurement, gel electrophoresis, and LabChip analysis on an Agilent 2100 Bioanalyzer (Agilent, Palo Alto, California) showed that the purified NAs were highly pure and intact, and that excellent yields were obtained. The DNA purified from blood and tissues performed well in single nucleotide polymorphism (SNP) array analysis, shown by call rates for the Affymetrix Genome-Wide Human 6.0 SNP arrays of O99%. No significant differences were observed when array results of DNA purified either with magnetic particle technology or silica membrane technology were compared. The quality of the DNA allowed accurate allelic discrimination by TaqMan SNP PCR. Gene expression analyses of purified RNA either by ''Human Endogenous Control Panel'' TaqMan low-density array or on Affymetrix HG U133 plus 2.0 GeneChips revealed high concordance between manually purified samples and those extracted on the QIAsymphony SP.
Increasing sample numbers for screening and diagnostics using circulating cell-free DNA (ccfDNA) as analyte demands an automated solution for ccfDNA extraction. The efficiency of a new, automated, large volume ccfDNA extraction method was evaluated against a manual reference method. The new kit for automated ccfDNA extraction on the QIAsymphony showed a comparable yield of total ccfDNA from healthy donors as well as a comparable recovery of circulating cancer and fetal DNA. In conclusion, a new kit for automated ccfDNA extraction was established successfully.
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