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Although the patient's wellbeing is the primary aim of Laboratory Medicine, great attention should be given to laboratory efficiency, particularly for reagent expenses. Without quantitative data it is difficult for a laboratory manager to know the relationship between the number of assays that theoretically can be performed with a reagent package and the number of produced reports. Many factors can affect these data; for instance, the calibration frequency or the number of repetitions of a sample, the scheduled turnaround time for the assay, the number of samples to run or the reagent stability. In this study, a software for the laboratory warehouse management was used to evaluate the actual yield of reagent packs and to estimate the real cost of measurements. Costs for reagent purchase in a 12-month time period and data of 1440 different product stock movements for issuing 550,000 reports were analyzed for tests ranging from less than 100 to over 250,000 requests/year. The distribution of the calculated yield for reagent packs was between 16.7% and 98.5%, with a median value of 65.5% (confidence interval, 55.0-79.0). On average, the percentage yield for reagent packs rapidly grows in proportion to the number of determinations performed up to 10,000 tests per year. For assays with a request number exceeding 10,000 the yield was almost always >80%.

Dall'Olio G.,Laboratorio Of Chimica Clinica Ed Ematologia
Rivista Italiana della Medicina di Laboratorio | Year: 2011

In 1859, Paolo Mantegazza, a young italian physician, went back to Italy from South America where he had been staying for four years. He published a paper on his medical observations on the use of Erythroxylon coca leaves by the people of the places where he stayed an practised medicine. The first major effect he observed in native people chewing a bolus of coca leaves, was the vigour that the juice ingested caused in their body making them capable to tolerate the cold, the lack of food, bad weather, heavy and debilitating works also at considerable altitude. The therapeutic properties of the coca leaves, chewed or taken as an infusion, that were considered more important by Mantegazza were the beneficial effects on digestion and stomach disorders. Furthermore on nervous system the use of coca leaves have remarkable influence, but the matter requires further evidences. Mantegazza reported some cases of excessive use and consequent addiction and the results of the experiment performed on himself after ingestion of rising amounts of coca juice from chewing. The Mantegazza work will be widely mentioned by Sigmund Freud, the famous Austrian neurologist, in his 'Über coca' (1884) concerning the effects of cocaine, an alkaloid extracted from coca leaves by the chemist Albert Niemann in 1859. For his monograph Mantegazza received in 1858 the prestigious Dell'Acqua award and many scientists recognized his merits for the pioneering work regarding the therapeutic effects of Erythroxylon coca leaves. © 2011 Springer-Verlag Italia.

Dall'Olio G.,Laboratorio Of Chimica Clinica Ed Ematologia
Rivista Italiana della Medicina di Laboratorio | Year: 2011

In the 19th Century oil of bitter almonds, which contains hydrocyanic acid (prussic acid) in variable percentages, was the cause of accidental and suicidal poisoning because of its widespread use in cosmetics and preparations used in handicrafts. In this paper I report four cases of oil of bitter almonds poisoning taken from the medical journals of that time, three of which had a favourable outcome and one of which was a fatal acute intoxication. In the reports were described in detail the symptoms and the course of the poisoning following pharmacological treatments. The symptoms and some easy laboratory tests for the differential diagnosis of hydrocyanic acid and nitrobenzene intoxication are also reported. The latter substance was frequently used in place of oil of bitter almonds because of its lower price and the fact that its organoleptic properties are almost identical. © Springer 2011.

SAH denotes a bleeding between the arachnoid membrane and the pia mater. In the first days following the event, the computed tomography (CT) recognises >95% of SAH; however, this high sensitivity decreases with time. In two-three weeks, the CSF examination for the presence of hemoglobin (or its catabolite, bilirubin) becomes the most sensitive test for SAH diagnosis. Since the presence of hemoglobin in the CSF can be caused by traumatic collection, special attention should be paid to preanalytical conditions. Bilirubin gives a yellow colouring to CSF that can be detected by visual inspection. However, this colouring, also named xantochromia, could not be accurately perceived by the human eye. The 2008 United Kingdom guidelines for SAH diagnosis are based on the spectrophotometric analysis of the CSF that represents at present the reference method. However, this procedure is complex, requires skilled specialists and a sufficient number of cases to maintain the competence. Furthermore, its availability as emergency test can be difficult. This is probably the reason why the vast majority of laboratories continue to evaluate the presence of xantochromia by visual inspection. The automation of the bilirubin measurement on clinical chemistry analysers has been proposed. This method is certainly less accurate than spectrophotometric analysis; however, it can be performed on common analysers and made results available for emergency situations, with a short turnaround time.

Carta M.,Laboratorio Of Chimica Clinica Ed Ematologia
Rivista Italiana della Medicina di Laboratorio | Year: 2013

Summary: Measurements of glucose are used worldwide to diagnose diabetes and to identify patients at risk of developing diabetes. Furthermore the glycemia is very important in the management of diabetic patients. For both diagnosis and risk assessment, fixed cutpoints of plasma concentrations are used to classify patients and to make decisions regarding management. For this reason all step in the analytical process require careful attention. Now clinical laboratories achieve an accurate measurement of glucose, but, by contrast, the preanalytical issues surrounding this dosage have not been solved. Especially the instability of glucose in blood introduces errors in the classification of individual patients. This brief review examines the main causes of variability of glucose measurements. © 2013 Springer-Verlag Italia. Parole chiave: Glicemia DiabeteGlicolisiCurva da carico orale di glucosio.

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