Comparison between B·R·A·H·M·S PCT direct, a new sensitive point-of-care testing device for rapid quantification of procalcitonin in emergency department patients and established reference methods - a prospective multinational trial

Background: Procalcitonin (PCT) is increasingly being used for the diagnostic and prognostic work up of patients with suspected infections in the emergency department (ED). Recently, B·R·A·H·M·S PCT direct, the first high sensitive point-of-care test (POCT), has been developed for fast PCT measurement on capillary or venous blood samples. Methods: This is a prospective, international comparison study conducted in three European EDs. Consecutive patients with suspicion of bacterial infection were included. Duplicate determination of PCT was performed in capillary (fingertip) and venous whole blood (EDTA), and compared to the reference method. The diagnostic accuracy was evaluated by correlation and concordance analyses. Results: Three hundred and three patients were included over a 6-month period (60.4% male, median age 65.2 years). The correlation between capillary or venous whole blood and the reference method was excellent: r2=0.96 and 0.97, sensitivity 88.1% and 93.0%, specificity 96.5% and 96.8%, concordance 93% and 95%, respectively at a 0.25 μg/L threshold. No significant bias was observed (-0.04 and -0.02 for capillary and venous whole blood) although there were 6.8% and 5.1% outliers, respectively. B·R·A·H·M·S PCT direct had a shorter time to result as compared to the reference method (25 vs. 144 min, difference 119 min, 95% CI 110-134 min, p<0.0001). Conclusions: This study found a high diagnostic accuracy and a faster time to result of B·R·A·H·M·S PCT direct in the ED setting, allowing shortening time to therapy and a more wide-spread use of PCT

Predictive value of S100-B and copeptin for outcomes following seizure: the BISTRO International Cohort Study.

OBJECTIVE: To evaluate the performance of S100-B protein and copeptin, in addition to clinical variables, in predicting outcomes of patients attending the emergency department (ED) following a seizure. METHODS: We prospectively included adult patients presented with an acute seizure, in four EDs in France and the United Kingdom. Participants were followed up for 28 days. The primary endpoint was a composite of seizure recurrence, all-cause mortality, hospitalization or rehospitalisation, or return visit in the ED within seven days. RESULTS: Among the 389 participants included in the analysis, 156 (40%) experienced the primary endpoint within seven days and 195 (54%) at 28 days. Mean levels of both S100-B (0.11 μg/l [95% CI 0.07-0.20] vs 0.09 μg/l [0.07-0.14]) and copeptin (23 pmol/l [9-104] vs 17 pmol/l [8-43]) were higher in participants meeting the primary endpoint. However, both biomarkers were poorly predictive of the primary outcome with a respective area under the receiving operator characteristic curve of 0.57 [0.51-0.64] and 0.59 [0.54-0.64]. Multivariable logistic regression analysis identified higher age (odds ratio [OR] 1.3 per decade [1.1-1.5]), provoked seizure (OR 4.93 [2.5-9.8]), complex partial seizure (OR 4.09 [1.8-9.1]) and first seizure (OR 1.83 [1.1-3.0]) as independent predictors of the primary outcome. A second regression analysis including the biomarkers showed no additional predictive benefit (S100-B OR 3.89 [0.80-18.9] copeptin OR 1 [1.00-1.00]). CONCLUSION: The plasma biomarkers S100-B and copeptin did not improve prediction of poor outcome following seizure. Higher age, a first seizure, a provoked seizure and a partial complex seizure are independently associated with adverse outcomes

Comparison of Lumipulse® G1200 with Kryptor and Modular E170 for the measurement of 7 tumor markers

"This is the pre-peer reviewed version of the following article: "Comparison of LUMIPULSE® G1200 With Kryptor and Modular E170 for the Measurement of Seven Tumor Markers", which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1002/jcla.21802/abstract. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving."Background: Tumor marker measurements are becoming essential for prognosis and follow-up of patients in oncology. In this context, we aimed to compare a new analyzer, Lumipulse G1200 (Fujirebio group, distributed in Europe by the Innogenetics group) with Kryptor (Thermo Fisher Scientific B.R.A.H.M.S, Asnières, France) and Modular Elecsys E170 (Roche Diagnostics, Meylan, France) for the measurement of seven tumor markers: PSA, AFP, CEA, CA 15-3, CA 125, CA 19-9 and Cyfra 21-1.Methods: 471 serum samples from patients with elevated tumor markers and 100 serum from healthy patients were analyzed with Lumipulse G1200 and either Kryptor (for AFP) or Modular (for the six other markers). Results: The good precision of Lumipulse G1200 assays was confirmed with CVs 95% and tumor marker kinetics were all similar.Conclusion: We confirmed the analytical performances of Lumipulse tumor marker assays except the CYFRA 21-1 assay, which performances were not acceptable in this study. Also, we demonstrated that 5 out of 7 tumor markers assays results (PSA, AFP, CA 125, CA 15-3, CYFRA 21-1) are directly transferable between Lumipulse and Kryptor or Modular, thus facilitating an eventual replacement of one system by another

La biologie délocalisée appliquée aux dispositifs de mesure de la glycémie capillaire

CHATENAY M.-PARIS 11-BU Pharma. (920192101) / SudocSudocFranceF

Données récentes sur la NGAL ou Lipocaline associée à la gélatinase des polynucléaires neutrophiles (biomarqueur de la néphopathie diabétique ?)

PARIS-BIUP (751062107) / SudocSudocFranceF

La procalcitonine, biomarqueur d'infection (aspects physiopathologiques et applications en médecine d'urgence adulte)

Dans ce travail, nous avons étudié les applications du dosage sérique de la procalcitonine (PCT) en médecine d urgence adulte. Nous avons montré qu il s agissait d un marqueur diagnostique d infection systémique, que le seuil optimal en médecine d urgence était de l ordre de 0,2 ng/ml, que la PCT était avant tout un marqueur pronostique. Nous avons montré que la PCT restait performante pour le diagnostic d infection postopératoire. Nous avons mis en évidence que la dysfonction rénale aiguë influait sur les valeurs de PCT sans altérer les performances diagnostiques du marqueur. Nous avons confirmé que la PCT pouvait être élevée au cours du coup de chaleur, indépendamment d une complication infectieuse associée. En conclusion, il semble exister plusieurs voies d activation de la synthèse de PCT. A ce titre, la PCT pourrait se comporter comme un marqueur de gravité d un certain type de réaction inflammatoire dont l infection bactérienne systémique serait le principalIn this work, we have studied the usefulness of serum PCT measurement in adult emergency medicine setting. We have demonstrated that PCT was an effective diagnostic marker of systemic infection, that the optimal threshold in emergency medicine was near 0.2 ng/ml, that PCT was a prognostic marker. We have observed that PCT was also effective for the diagnosis of postoperative infection. We have observed for the first time that acute impaired renal function influences PCT values but without modifying its diagnostic accuracy. We have confirmed that serum PCT concentrations could rise in heatstroke. This rise was independent of an associated infection, but seemed to correlate with the severity of the disease. As a conclusion, several distinct activation pathways of PCT synthesis could exist. PCT might perform as a biomarker of seriousness in a particular kind of inflammatory reaction observed in various clinical syndromes, the most prevalent being sepsisPARIS-BIUP (751062107) / SudocSudocFranceF