Therapeutische Umschau. Revue thérapeutique
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In contrast to Calcitonin that is primarily synthesized in the thyroid, Procalcitonin is the prohormon that is synthesized in many different tissues of infected organs. In order to be useful for the diagnosis of mild, localized or early infections the assay needs to have a sensitivity that can measure within normal limits (0.02 microg/L). We were able to show that a Procalcitonin algorithm influences the outcome of respiratory infections in terms of minimizing use of antibiotics and duration of antibiotic treatment. ⋯ In this respect, Procalcitonin is superior to other infection markers such as C-reactive Protein (CRP). High Procalcitonin levels can also be seen in non bacterial diseases such as malaria, severe trauma, burns and medullar carcinoma of the thyroid. Together, Procalcitonin has improved the diagnosis of bacterial infections, however should always be used in context with other laboratory markers, clinical exam and medical history.
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Quality assurance in laboratory medicine up to now has been focused mainly on analytical quality. Pre-analytical errors, however, amount to two thirds of all laboratory errors, and their elimination is of particular importance. Flaws of optimal indication contribute to a sometimes ineffective benefit of laboratory medicine. ⋯ If we achieve more reliable laboratory results by better control of influence factors and interference factors as well as by a more standardized pre-analytical process, we will produce more value at the same cost. The decisive prerequisite is awareness of the problem. The means are largely available, and the mission eventually can be accomplished.