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| 1 | Pilot study of a novel serum mRNA gene panel for diagnosis of acute septic arthritis显示文摘BACKGROUND Septic arthritis is an orthopedic emergency requiring immediate surgical intervention.Current diagnostic standard of care is an invasive joint aspiration.Aspirations provide information about the inflammatory cells in the sample within a few hours,but there is often ambiguity about whether the source is infectious(e.g.bacterial)or non-infectious(e.g.gout).Cultures can take days to result,so decisions about surgery are often made with incomplete data.Novel diagnostics are thus needed.The“Sepsis MetaScore”(SMS)is an 11-mRNA host immune blood signature that can distinguish between infectious and noninfectious acute inflammation.It has been validated in multiple cohorts across heterogeneous clinical settings.AIM To study whether the SMS holds diagnostic validity in determining the etiology of acute arthritis.METHODS We conducted a blinded,prospective,non-interventional clinical study of the SMS.All patients undergoing work-up for a septic primary joint were enrolled.Patients proceeded through the normal standard-of-care pathway,including joint aspiration and inflammatory labs[white blood cell(WBC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)].Venous blood was also drawn into PAX gene RNA-stabilizing tubes and mRNAs were measured using Nano String nCounter?.SMS was calculated blinded to clinical results.RESULTS A total of 20 samples were included,of which 11 were infected based on aspiration or intra-operative cultures.The SMS had an area under the ROC curve(AUROC)of 0.87 for separating infectious from non-infectious conditions.For comparison,the AUROCs for ESR=0.58,CRP=0.6,and WBC=0.59.At 100%sensitivity for infection,the specificity of the SMS was 40%,meaning nearly half of non-septic patients could have been ruled out for further intervention.CONCLUSION In this pilot study,SMS showed a high level of diagnostic accuracy in predicting septic joints compared to other diagnostic biomarkers.This quick blood test could be an important tool for early,accurate identification of acute septic joints and need for emergent surgery,improving clinical care and healthcare spending. | Blake J Schultz Timothy Sweeney Malcolm R DeBaun Melissa Remmel Uros Midic Purvesh Khatri Michael J Gardner | 2019 | World Journal of Orthopedics2019，10，12： | 1 |
| 2 | Functional analy-sis of UGT1A4(P24T) and UGT1A4(L48V) variant enzymes显示文摘 | ZHOU J ARGIKAR U A REMMEL R P | 2011 | Pharmacogenomics2011，12，12： | 1 |
| 3 | Simultaneous HPLC assay for quantification of indinavir,nelfinavir,ritonavir,and saquinavir in human plasma显示文摘 | REMMEL R P KAWLE S P WEJLLER D | 2000 | Clin Chem2000，46，1： | 1 |
| 4 | Pyloric gland type adenoma of the gallbladder with squamoid spindle cell metaplasia显示文摘 | Kushima R Remmele W Stolte M | 1996 | Pathol Res Pract1996，192，： | 1 |
| 5 | Protect from light: photode gradation and prteinbiologics显示文摘 | KERWIN B A REMMELE R L | 2007 | Journal of Pharmaceutical Sciences2007，96，6： | 1 |
| 6 | IntCa104 tenestrial radiocarbon age calibration, 0-26 cal kyr BP 显示文摘 | Reimer P J Baillie M G L Bard E Bayliss A Beck J W Bertrand C J H Blackwell P G Buck C E Burr G S Cutler K B Damon P E Edwards R L Fairbanks R G Friedrich M Guilderson T P Hogg A G Hughen K A Kromer B McCormac G Manning S Ramsey C B Reimer R W Remmele S S J R Stuiver M Talamo S Taylor F W van der Plicht J Weyhenmeyer C E | 2004 | Radiocarbon2004，46，3： | 1 |
| 7 | Exploring spatial variety in patterns of activity - travel behaviour: initial results from the Toronto Travel - Activity Panel Survey ( TTAPS ) 显示文摘 | Buliung R N Roorda M J Remmel T K | 2008 | Transportation2008，35，6： | 1 |
| 8 | Incorporation of an isoleucine zipper motif enhances the biological activity of soluble CD40L(CD154)显示文摘 | Morris AE Remmele RL Jr Klinke R | 1999 | J Biol Chem1999，274，1： | 1 |
| 9 | Marine14 Marine radiocarbon age calibration, 0-26 cal kyr BP 显示文摘 | Hughen K A Baillie M G Bard E Beck J W Bern'and C J H Blackwell P G Buck C E Burr G S Cutler K B Damon P E Edwards R L Fairbanks R G Friedrich M Guilderson T P Kromer B McCormac G Manning S Ramsey C B Reimer P J Reimer R W Remmele S Southon J R Stuiver M Talamo S Taylor F W van der Plicht J Weyhenmeyer C E | 2004 | Radiocarbon2004，46，3： | 1 |
| 10 | IntCal04 terrestrial radiocarbon age calibration, 0- 26 cal kyr BP 显示文摘 | Reimer P J Baillie M G L Bard E Bayliss A Beck J W Bertrand C J H Blackwell P G Buck C E Burr G S Cutler K B Damon P E Edwards R L Fairbanks R G Friedrich M Guilderson T P Hogg A G Hughen K A Kromer B McCormac G Manning S Ramsey C B Reimer R W Remmele S Southon J R Stuiver M Talamo S Taylor F W van der Plicht J Weyhenmeyer C E | 2004 | Radiocarbon2004，46，3： | 1 |
| 11 | Open source spatial analysis and activity-travel behavior research: capabilities of a space package 显示文摘 | Buliung R N Remmel T K | 2008 | Journal of Geographical Systems2008，2，： | 1 |
| 12 | Incorporation of an isoleucine zipper motif enhances the biological activity of soluble CD40L (CD154)显示文摘 | Morris AE Remmele RL Jr Klinke R | 1999 | J Biol Chem1999，274，1： | 1 |
| 13 | Variation in glucuronidation of lamotrigine in human liver mierosomes显示文摘 | Argikar U A Remmel R P | 2009 | Xenobiotica2009，39，5： | 1 |
| 14 | Incorporation of an isoleucine zipper motif enhances the biological activity of soluble CD40L(CD154)显示文摘 | Morris A E Remmele R J Klinke R | 1999 | J Biol Chem1999，274，1： | 1 |
| 15 | An inexpensive eye movement monitor using the scleral search coil technique 显示文摘 | REMMEL R S | 1984 | IEEE Transactions on Biomedical Engineering1984，31，4： | 1 |
| 16 | Recommendation for uniform definition of an immunoreactive score (IRS) for immunohis- tochemical estrogen receptor detection (ER-ICA) in breast cance tissue 显示文摘 | Remmele W Stegne r HE | 1987 | Pathologe1987，8，3： | 1 |
| 17 | Functional analysis of UGTIA4 (P24T) and UGT1A4 (L48V) variant enzymes 显示文摘 | ZHOU J ARGIKAR U A REMMEL R P | 2011 | Pharmacogenomics2011，12，12： | 1 |
| 18 | Hydroxyl sites in SiO2 glass: A note on infrared and Raman spectra显示文摘 | MCMILLAN P F REMMELE R L | 1986 | American Mineralogist1986，71，56： | 1 |
| 19 | Ventilator-associated pneumonia in criticallyill stroke patients:frequency,risk factors,and outcomes显示文摘 | Kasuya Y Hargett JL Lenhardt R Heine MF Doufas AG Remmel KS | 2011 | J Crit Care2011，26，3： | 1 |
| 20 | Concise review of the eytochrome P450s and their role in toxi- cology 显示文摘 | OMIECINSKI C J REMMEL R P HOSAGRAHARA V P | 1991 | Toxicological Sciences1991，48，2： | 1 |
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