Wiki Education Foundation-supported course assignment

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  This article was the subject of a Wiki Education Foundation-supported course assignment, between 7 January 2019 and 1 February 2019. Further details are available on the course page. Student editor(s): Jlee ED. Peer reviewers: Freeman9690. 20:58, 19 January 2022 (UTC)Reply

Wiki Education Foundation-supported course assignment

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  This article was the subject of a Wiki Education Foundation-supported course assignment, between 3 September 2020 and 14 December 2020. Further details are available on the course page. Student editor(s): In Vita Veritas. Primefac (talk) 20:58, 19 January 2022 (UTC)Reply

WikiProject Medical Student Edit

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Hello, I am a 4th year medical student going into emergency medicine. I’m currently enrolled in a Wikiprokect course at the University of Central Florida. Over the next month, I will be updating the article with more current information as to the applications and utility of procalcitonin(PCT) in a variety of medical settings. Since it is a start quality article I hope that I can make some good progress on enhancing the quality of the article.

The following is a list of the aspects of the article I intend to improve:

--More research on the role of PCT in antibiotic stewardship with links to wiki articles on antibiotic resistance -In the medical uses section:

    -I intend to update the Sepsis subsection with the most current information
   -Pneumonia subheading will be updated with most recent data analysis. 
   -I will add a subheading for pediatric infections utilizing the most current meta-analyses.  
   -I will add a subheading for meningitis from a meta-analysis.
   -I will add a subheading for the medical use of PCT in cardiac conditions.

-Please don’t hesitate to give me suggestions on other ways to improve the article or way to better my current plan.

Jlee ED (talk) 20:25, 10 January 2019 (UTC)Reply

WikiProject Medical Student Edit

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Hey James, this is a behemoth of an article, so kudos for tackling it. The article edits were very helpful all in all, and everything is well cited. You may want to include citations after every sentence (I think Dr. Lebowitz mentioned this) instead of one for a few phrases. One general suggestion is that I wouldn't say you have to always write "a meta-anlysis says" or a "review says" because your are already citing the source. This is not a big deal, so if you like it keep it. I organized my other specific edits by section. -->Respiratory illness The value in these protocols are evident since a high PCT level correlates with increased mortality in critically ill pneumonia patients especially those with a low CURB-65 pneumonia risk factor score.[57]  The value of using PCT is supported by a high level correlating with increased mortality in critically ill pneumonia patients, especially those with a low CURB-65 pneumonia risk factor score.[57] what protocols are you referring? I tried to rewrite sentence.

Is acute respiratory capitalized? Did you mean to link it to the wiki article?

The fact that PCT reduces antibiotic exposure is mentioned a few times  maybe consolidate

Using procalcitonin to guide protocol in acute asthma exacerbation led to a reduction in prescriptions for antibiotics in primary care clinics, emergency departments and hospital stays (parallel structure).

I don’t understand the sentence “This was apparent without an increase in ventilator days or risk of intubation” and how it relates to the rest of the paragraph.

-->Cardiovascular PCT serves as a marker in differentiating acute respiratory illness, such as infection, from an acute cardiovascular concern. It also has value as a prognostic lab value in patients with atherosclerosis or coronary heart disease, as its levels correlate with the severity of the illness.

The guidelines use a cutoff of .2 ng/mL to give antibiotics.

-->Meningitis There is a period in the middle of the first sentence that should be a comma.

“These findings are the result of a 2018 literature review.[65]” I don’t think you need this sentence, just cite the prior sentences with this source.

-->GI Disease Evidence shows that an elevated PCT above .5 ng/mL could help diagnose infectious complications of inflammatory bowel disease such as abdominal abscesses, bacterial enterocolitis etc.  etc is a little too casual, I’d just say, including abdominal abscesses and bacterial enterocolitis

-->Kidney disease Procalcitonin can be dialyzed, and so levels are dependent upon when patients receive will be affected after hemodialysis.

-->Septic arthritis PCT, at a cutoff value of .5 ng/mL, was effective at ruling in septic arthritis in an analysis of over 8000 patients across 10 prospective studies.

-->Cancer More so, it is especially effective in diagnosing major life threatening episodes in cancer patients, such as bacteremia and sepsis.

Procalcitonin is a reliable way to monitor recurrence of medullary thyroid carcinoma. In detecting cancer recurrence, PCT had a sensitivity and specificity of 96% and 96%, respectively.[73] Don’t think medullary thyroid cancer is capitalized

-->Pediatrics PCT can help clinical decision making while identifying invasive bacterial infection in children with unexplained fevers.

PCT levels correlate with the degree of illness in pediatric patients with sepsis or urinary tract infections, making it effective as a prognostic lab value in these patients.

Nice job. Freeman9690 (talk) 04:33, 30 January 2019 (UTC)Reply

Considering all presented studies in the article there is no information of the clinical usefulness of PCT

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PCT has over the years become more of a standard test in the ICUs I regularly visit as an ID-consultant. My verdict is that PCT almost never adds anything beyond clinical examination + CRP. The cut off levels are so low that it´s hard to remember when I last saw a patient with a PCT below 0,05. Most patients in advanced ICUs have PCT between 0,2 - 2 regardless the reason for their stay and a lot of them will never present any infection. After a liver transpantation it's not unusual with PCT 20-100 the first days without any infection. The cost for PCT is 20 times higher than CRP so I'm now lobbying to stop using PCT in clinical practice.

A lot of studies have meaningless endpoints like; "PCT is superior to CRP to discriminate bacterial meningitis from viral meningitis". Useless, since we don't use CRP, instead we perform a lumbar puncture. Eda001 (talk) 19:56, 11 March 2024 (UTC)Reply