IDEntifying pAtients With Suspicion of Infection in the ED Who Have Low Disease Severity Using Midregional Proadrenomedullin (MR-proADM) - Pivotal Study
Emergency departments (ED) are becoming increasingly over-crowded, with patients facing prolonged waiting times. Therefore, a safe and rapid assessment that identifies patients with low severity that could be treated as outpatients is essential for improving the workflow within the ED. The rationale of this IDEAL+ study is to safely decrease the number of hospital admissions through identification of low risk patients with the biomarker MR-proADM. This will has already been tested in the IDEAL - pilot study and results should be confirmed with this IDEAL+ study.
PROcalcitonin Impact on Antibiotic Reduction, adverSe Events and AVoidable healthcarE Costs
Trials comparing PCT-guided antibiotic algorithms to standard management show a significant reduction in antibiotic exposure without an increase in mortality or treatment failure. Despite this strong evidence from multiple studies a recent prospective multicentric interventional trial in the US fell short of demonstrating antibiotic reductions by PCT-guided antibiotic management. Amongst other limitations the authors of that study concluded that successful implementation of PCT may require closer educational oversight. As such, this study will compare effectiveness and safety of antibiotic prescription guided by a PCT-algorithm via a Stewardship Team over standard guidelines in hospitalized adult patients with suspected or confirmed LRTI (including sepsis with respiratory focus).
Peroxiredoxin 4: a multifunctional biomarker worthy of further exploration
1区 · 医学
作者: Schulte, Janin
Currently, there is much interest in identifying clinically relevant biomarkers, as they have the potential to be high utility non-invasive tools for early diagnosis and reliable patient monitoring in numerous conditions. Since its discovery almost 15 years ago, research on the ubiquitous antioxidant enzyme peroxiredoxin 4 (Prx4) has culminated in the recognition that Prx4 levels are different in blood drawn from the healthy general population and patients with acute or chronic diseases. In this commentary, the most striking research data from different in vitro approaches, animal models and human observational studies are discussed collectively, highlighting the clinical importance of Prx4 as a multifunctional staging and prognosis biomarker. In this context, the oxidative state of patients may be reflected by intra- and extracellular Prx4 levels, redox state, oligomerization and nitro-oxidative modifications of the enzyme. A consolidated model of the potential role and origin of circulating Prx4 is presented to stimulate further investigations in light of the current biomarker situation.
2009-05-01·Clinical Biochemistry3区 · 医学
Homogeneous time-resolved fluoroimmunoassay for the measurement of midregional proadrenomedullin in plasma on the fully automated system B.R.A.H.M.S KRYPTOR
3区 · 医学
作者: Caruhel, Pascaline ; Mazier, Christian ; Kunde, Jan ; Morgenthaler, Nils G. ; Darbouret, Bruno
Evaluate the first automated assay measuring a mid regional fragment of the proadrenomedullin (MR-proADM).
DESIGN AND METHODS:
B.R.A.H.M.S MR-proADM KRYPTOR is a homogeneous assay.
In 144 healthy individuals, MR-proADM mean (SD) was measured at 0.37 nmol/L (0.09). High correlation with the manual assay, B.R.A.H.M.S MR-proADM LIA, was found on 281 samples from patients suffering from community acquired pneumonia (correlation coefficient 0.97).
This fast assay can be used in low respiratory tract infections.
2008-03-01·Trends in Endocrinology and Metabolism1区 · 医学
Copeptin: clinical use of a new biomarker
1区 · 医学
作者: Morgenthaler, Nils G. ; Struck, Joachim ; Jochberger, Stefan ; Duenser, Martin W.
Arginine vasopressin (AVP) is a key hormone in the human body. Despite the clinical relevance of AVP in maintaining fluid balance and vascular tone, measurement of mature AVP is difficult and subject to preanalytical errors. Recently, copeptin, a 39-amino acid glycopeptide that comprises the C-terminal part of the AVP precursor (CT-proAVP), was found to be a stable and sensitive surrogate marker for AVP release, analogous to C-peptide for insulin. Copeptin measurement has been shown to be useful in various clinical indications, including the diagnosis of diabetes insipidus and the monitoring of sepsis and cardiovascular diseases. Here we review recent findings regarding the relationship between AVP and copeptin, and affirm the value of AVP as a surrogate marker for AVP.