Sympózium laboratórnej diagnostiky Trenčín,
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1 Sympózium laboratórnej diagnostiky Trenčín,
2
3 The value of in vitro diagnostics Improving people s health
4 The value of in vitro diagnostics Improving people s health Disease prevention Right treatment decision Disease management Screening Diagnosis Prognosis Stratification Monitoring Information Keeping people healthy Getting the right treatment Chronic disease management Increasing efficacy of treatment Reducing hospitalization Avoiding work productivity loss Improving people s health
5 The value of in vitro diagnostics The silent champion of healthcare IVD accounts for ~2 % of worldwide healthcare spending IVD influences >60 % of clinical decision-making Sources: (Rohr et al., 2016)
6 Novinky v diagnostikách Elecsys Sympózium laboratórnej diagnostiky Trenčín,
7 Obsah Rozšírené klinické využitie 1-hodinový algoritmus dg. ACS pomocou hs - TnT natriuretické peptidy a nová kategória antihypertenzív ARNI AMH a predikcia odpovede na riadenú stimuláciu ovárií Nové testy Vitamin D total II AMH Plus Chagas Očakávané diagnostiká
8 Rozšírené klinické využitie
9 hs TnT 1-hodinový algoritmus diagnostiky ACS - v príbalovom letáčiku APACE (Advantageous Predictors of Acute Coronary Syndrome Evaluation), , Basel, Arch. Internal Medicine, 2012, 172, No16, p , n = 1197 APACE , multicentrická štúdia, 6 centier v 3 krajinách Canadian Medical Association Journal, 2015, 187, p. E243 E 252, n = Guideline Európskej kardiologickej spoločnosti Manažment ACS bez perzistentnej ST elevácie voľne dostupné: TRAPID-AMI (High Sensitivity Cardiac Troponin T for Rapid Rule - out of Acute Myocardial Infarction) multicentrická medzinárodná štúdia, 12 centier v 3 krajinách Annals of Emergency Medicine, Vol.68, No 1, July 2016, n = 1282 August update príbalových letákov
10 hs TnT 0/1-hodinový algoritmus, ESC Guideline 2015, p ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment Elevation: European Heart Journal (2016) 37,
11 Natriuretické peptidy a antihypertenzíva ARNI nová trieda antihypertenzív ARNI, s kombinovaným inhibičným účinkom: receptorov angiotenzínu (liek sacubitril) enzýmu neprilysin (liek valsartan), ktorý je zodpovedný za degradáciu NP lepšia perspektíva pre pacientov s HF (nižšie riziko úmrtia a hospitalizácií), štúdia PARADIGM NT-pro BNP je vhodnou molekulou na monitorovanie liečby BNP je substrátom neprilysinu Angiotensin Receptor Neprilysin Inhibition Compared With Enalapril on the Risk of Clinical Progression in Surviving Patients With Heart Failure, Circulation, 2015; 131:54 61
12 AMH (Anti Müllerov hormón) rozšírené klinické využitie posúdenie ovariálnej rezervy pre dobrú koreláciu s antrálnymi folikulmi (obr.) pri riadenej stimulácii predikcia stimulačnej odpovede ROC analýzou bol definovaný cut-off pre nadmernú odpoveď (AUC 0,821) príbalový letáčik verzia 3:
13 Nové testy
14 Vitamin D total II CS Vitamin D total II PC Vitamin D total II eliminácia krížovej reaktivity biologicky neaktívneho metabolitu 24, 25 dihydroxyvitamínu D väzbou na špecifickú protilátku rozšírenie meracieho rozsahu zo 175 na 250 nmol/l, (zo 70 na 100 ug/l) v populačnej štúdii sú uvedené osobitne namerané hodnoty v letných a zimných mesiacoch
15 AMH Plus nový názov, nové katalógové číslo, rozšírené klinické využitie 2017 reagencia bez zmeny očakáva sa rekombinantný humánny FSH, Ferring pribudne ďalšia oblasť klinického využitia: individualizované dávkovanie nového lieku podľa hodnoty AMH Plus prebieha klinická štúdia ESTHER-1
16 Vo vývoji Chagas GDF-15 nezávislý marker ischémie β amyloid (1-42) Taus HIV DUO HCV DUO IGF-1 IGFBP-3 Active B12 PIVKA protein induced by vitamin K absence Androstenedione 17-OH Progesterone EBV
17 Novinky v molekulárnej diagnostike
18 Molekulárna Diagnostika portfólio prístrojov Real-Time PCR platformy - základné špecifikácie LightCycler 2.0 LightCycler 480 II cobas z480 cobas 4800 system
19 Molekulárna Diagnostika cobas 4800 system cobas x 480 izolátor Použitie primárnych a sekundárnych skúmaviek Automatické snímanie čiarových kódov vzoriek a reagencií Optimum: 8, 24, 48, 72 alebo 94 vzoriek cobas z 480 analyzátor Real-Time PCR Technológia LightCycler 96- jamkový formát Detekcia v 4 kanáloch
20 Molekulárna Diagnostika cobas 4800 system - Zoznam parametrov cobas Oncology Assays Open channel cobas Women Health Assays cobas Virology Assays cobas Microbiology Assays
21 Novinky v oblasti POCT
22 cobas h 232 verzia HBM3 vs HBM4 Parametre: Troponin T NT-proBNP D-dimer Myoglobin CK-MB Kvalita výsledkov a princíp merania ostávajú Prúžky a kontrola kvality môžu byť použité aj s novou verziou Dokovacia stanica môže byť použitá aj s verziou cobas h 232 HBM4
23 Testujte a zdieľajte len v 4 krokoch Vložte testovací prúžok Aplikujte vzorku Výsledky k dispozícii o 8-12 min Zdieľajte výsledky bezdrôtovo
24 Testujte a zdieľajte WIFI Prenos dát v rámci nemocnice Načítanie QR kódu snímačom čiarových kódov Aktualizácia zdravotného záznamu pacienta Načítanie QR kódu aplikáciou smartfónu Prenos výsledkov smartfónom RÝCHLY TRANSFER VÝSLEDKOV MENEJ MANUÁLNYCH KROKOV transfer nezávislý na dokovacej stanici Vstavaná WiFi KVALITA PRENOSU DÁT Automatický prenos výsledkov znižuje chybovosť a zvyšuje bezpečnosť
25 Doing now what patients need next
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