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Dental Research Journal 2023Diabetes mellitus is a dominant metabolic disorder in the current fast paced culture; its prevalence is escalating worldwide and among all age groups. Guidelines...
BACKGROUND
Diabetes mellitus is a dominant metabolic disorder in the current fast paced culture; its prevalence is escalating worldwide and among all age groups. Guidelines recommend universal screening for diabetes; however, the uptake of these tests in individuals suggests challenges owing to invasive nature of blood collection. Thus, there arises the need for a noninvasive investigation for diabetes screening with a minimum paraphilia and for all medical settings.
MATERIALS AND METHODS
We have thus conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, to quantify the association between diabetes and effectiveness of periodic acid-Schiff staining of exfoliative cytology as a screening method. MEDLINE, EMBASE, Cochrane, Scopus, Web of science, CINAHL, and Google Scholar were searched systematically for publications dated till July 20, 2022. Six studies (case-control cross-sectional) were selected and evaluated in depth. The statistical evaluation was done with a forest plot with odds ratio and weightage examined.
RESULTS
It was proved that exfoliative cytology with periodic acid-Schiff (PAS) staining can be used as a screening test for diabetic status evaluation. The findings suggest that the aforesaid noninvasive test is a conclusive screening practice for diabetics.
CONCLUSION
This systematic review and meta-analysis suggest that PAS staining in exfoliative cytology can be used as a noninvasive screening in diabetic individuals to assess the current level of blood glucose. Given the increased risk of diabetes worldwide, higher quality prospective evidence is suggested in larger sample sizes with other metabolic disorders, ethnicity, and oral disorders to further evaluate the plausibility of the results.
PubMed: 37483895
DOI: No ID Found -
Prehospital and Disaster Medicine Feb 2024Existing diagnostics for polytrauma patients continue to rely on non-invasive monitoring techniques with limited sensitivity and specificity for critically unwell... (Review)
Review
INTRODUCTION
Existing diagnostics for polytrauma patients continue to rely on non-invasive monitoring techniques with limited sensitivity and specificity for critically unwell patients. Lactate is a known diagnostic and prognostic marker used in infection and trauma and has been associated with mortality, need for surgery, and organ dysfunction. Point-of-care (POC) testing allows for the periodic assessment of lactate levels; however, there is an associated expense and equipment burden associated with repeated sampling, with limited feasibility in prehospital care. Subcutaneous lactate monitoring has the potential to provide a dynamic assessment of physiological lactate levels and utilize these trends to guide management and response to given treatments.
STUDY OBJECTIVE
The aim of this study was to appraise the current literature on dynamic subcutaneous continuous lactate monitoring (SCLM) in adult trauma patients and its use in lactate-guided therapy in the prehospital environment.
METHODS
The systematic review was conducted in accordance with the PRISMA guidelines and registered with PROSPERO. Searched databases included PubMed, EMBASE via Ovid SP, Cochrane Library, and Web of Science. Databases were searched from inception to March 29, 2022. Relevant manuscripts were further scrutinized for reference citations to interrogate the fullness of the adjacent literature.
RESULTS
Searches returned 600 studies, including 551 unique manuscripts. Following title and abstract screening, 14 manuscripts met the threshold for full-text sourcing. Subsequent to the scrutiny of all 14 manuscripts, none fully met the specified eligibility criteria. Following careful examination, no article was found to cover the exact area of scientific inquiry due to disparity in technological or environmental characteristics.
CONCLUSION
Little is known about the utility of dynamic subcutaneous lactate monitoring, and this review highlights a clear gap in current literature. Novel subcutaneous lactate monitors are in development, and the literature describing the prototype experimentation has been summarized. These studies demonstrate device accuracy, which shows a close correlation with venous lactate while providing dynamic readings without significant lag times. Their availability and cost remain barriers to implementation at present. This represents a clear target for future feasibility studies to be conducted into the clinical use of dynamic subcutaneous lactate monitoring in trauma and resuscitation.
Topics: Adult; Humans; Lactic Acid; Multiple Trauma; Sensitivity and Specificity; Point-of-Care Testing; Emergency Medical Services
PubMed: 38047359
DOI: 10.1017/S1049023X23006623