@nickmmark we need to create a treaty with EM docs where everyone just agrees that procal isn’t an EM test. In return, the EM docs should agree to stop criticising it. Most of the criticism of procal comes from people who shouldn’t be using it in the first place.

@bbiebelberg @PulmCrit @ABsteward @ApuAkkad1 @dralicehan @IdVilchez @DrToddLee @jlsalinas7 @PrathitKulkarni @sargsyanz @NicholasRebold @cliffreid @BillFoxMD @MarvinBittner @moore_wjustin @matthewmof31 @laxswamy We can check a procal, for example, to decrease the probability that abx will be of benefit. I agree that abx shouldn't be given for a long time. But that's also true of bacterial pneumonia. 3-5 days for a known bacterial CAP.

@ABsteward We need to move past cost effective. The health system is bankrupting the country. We need cost reducing interventions. Had the trial studied 1 procal test, instead of useless daily tests, maybe it would have been cost reducing.

@ABsteward Clear recommendation based on multiple other procal trials, but clinical review if procal not available, yes?

🚨 New post: No Procal, No Problem? 🔍 Do we always need PCT in febrile infant workups? I reviewed key insights from a recent study + shared my critical appraisal & take-home points 🧠 Worth the read for #PEM folks! 📖 https://t.co/I6u5kaiaAK #PEM #MedEd #PCT

@ISNeducation @happiedoc @DaakTor @brammahin @myadla @Dilushiwijay @acssjr @dra_miliflores @ISNkidneycare Interesting that steroids can quell procal rise and these drugs 👇 can increase procal #ECNeph

@JulienPrvost5 @ABsteward @DrToddLee @DiorIzzy Omg. Okay. Initiate tasing protocol. If you can’t tase Initiate nagging. Nagging is inferior in efficacy to tasing (i believe established by RCTs). But superior to placebo. Nag like there’s no tomorrow. Why, ask the doc, did you order the procal if you weren’t going to act on it?

@ABsteward I continue to believe this question is not the right question. Procal is not a diagnostic test. It's use, which is validated in >20 RCTs, is as a prognostic biomarker for safely stopping abx. That is different than a diagnostic. It could be safe to stop abx for many reasons...

@JulienPrvost5 @ABsteward @DrToddLee @DiorIzzy Abx rotation has been studied in cluster randomized trials at the unit level. It doesn't work unless it reduces overall/total abx use. If total abx use goes down, resistance declines. But not otherwise. So...the correct answer is, stop abx. If you need, get a procal to support.

@JulienPrvost5 @ABsteward @DrToddLee @DiorIzzy Can you get him to order a procal?

@JulienPrvost5 @jpcaldas92 @DrToddLee @ABsteward Meropenem+cefedericol+linezolid+amphotericin+ivermectin? Or check a procal, do some deep breathing exercises, meditate, and treat with bronchodilators and steroids and hold abx unless procal is elevated?

interesting proof of concept trial by @dr_dmorgan & co using a bayesian probability framework based on procal, resp viral testing, and imaging! probably could refine further based on clinical symptoms as suggested by their calculator although not sure how valid this approach is

#Procal

Is a pre-op EKG indicated? Should I order a procal even though I know it’s a bacterial PNA? Should I talk about goals of care in this moment? These are not Qs of #diagnosticreasoning They are Qs of #prognosticreasoning Will it be useful for what’s coming next?

Beneran udh sebulan lebih gabaca komik skidipapap anjinkkk grgr lemot betul web nyaa akhhh sebellll😭

Ford Performance Calibration w/ProCal4 for the 2024 F-150 Raptor 3.5L is here! Optimize your Raptor today! https://t.co/2PjDYO8RuU #teamlethal #lethalperformance #f150 #ford #fordperformance #fordracing #raptor #f150raptor #ecoboost #procal

ABL has advised private equity firm Anacacia Capital on the acquisition of a majority stake in Procal Dairies, a prominent family-owned dairy manufacturing and distribution business. Read more: https://t.co/DGyZz1xYsV

@rcmmmy Ga bakal putus sebenernya kalo foto ciuman di photobox, tp kalau udh di share pasti putussss

Procal motors right ? You’ll see me soon bro when I buy As usual I won’t pay 👍 #YourCarGuy