Unita Operativa di Diagnostica Ematochimica

Parma, Italy

Unita Operativa di Diagnostica Ematochimica

Parma, Italy
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Manoni F.,Servizio Of Medicina Of Laboratorio | Gessoni G.,Servizio Of Medicina Of Laboratorio | Alessio M.G.,Servizio Of Medicina Of Laboratorio | Caleffi A.,Unita Operativa di Diagnostica Ematochimica | And 7 more authors.
Clinica Chimica Acta | Year: 2014

Objective: We performed a multicenter study to calculate the upper reference limits (URL) for urine particle quantification in mid-stream samples by using automated urine analyzers. Design & methods: Two laboratories tested 283 subjects using a Sysmex UF-100, two other laboratories tested 313 subjects using Sysmex UF-1000i, whereas two other laboratories tested 267 subjects using Iris IQ®200. Results: The URLs of UF-100 in females and males were 7.8/μL and 6.7/μL for epithelial cells (EC), 11.1/μL and 9.9/μL for red blood cells (RBC), 10.2/μL and 9.7/μL for white blood cells (WBC), and 0.85/μL and 0.87/μL for cylinders (CAST). The URLs of UF-1000i in females and males were 7.6/μL and 7.1/μL for EC, 12.2/μL and 11.1/μL for RBC, 11.9/μL and 11.7/μL for WBC, and 0.88/μL and 0.86/μL for CAST. The URLs of Iris IQ®200 in females and males were 7.8/μL and 6.6/μL for EC, 12.4/μL and 10.1/μL for RBC, 10.9/μL and 9.9/μL for WBC, and 1.1/μL and 1.0/μL for CAST. Conclusion: The URLs obtained in this study were comparable to the lowest values previously reported in the literature. Moreover, no gender-related difference was observed, and analyzer-specific upper reference limits were very similar. © 2013.

Buoro S.,Laboratorio Analisi Chimico Cliniche | Gustinetti R.,Laboratorio Analisi Chimico Cliniche | Dominoni P.,Laboratorio Analisi Chimico Cliniche | Alessio M.G.,Laboratorio Analisi Chimico Cliniche | And 5 more authors.
Clinical Biochemistry | Year: 2012

Objective: To evaluate analytical performance of Sysmex UF-1000i for peritoneal fluid analysis. Methods: Functional sensitivity, imprecision, linearity and comparison studies were performed on peritoneal fluids. Results: Total imprecision was 1.6-4.7%, functional sensitivity 27/μL for white blood cell (WBC) and 32/μL for total nucleated cell (TNC) count. Linearity was excellent up to 983. cell/μL, carry-over < 0.2%, correlation with manual microscopy always greater than 0.992. Conclusion: The instrument exhibited optimal performance at the conventional WBC diagnostic thresholds. © 2012 The Canadian Society of Clinical Chemists.

Buoro S.,Unita Operativa Laboratorio Of Analisi Chimico Cliniche | Esposito S.A.,Unita Operativa Laboratorio Of Analisi Chimico Cliniche | Ottomano C.,Unita Operativa di Diagnostica Ematochimica | Alessio M.G.,Unita Operativa Laboratorio Of Analisi Chimico Cliniche | And 6 more authors.
Biochimica Clinica | Year: 2014

This study was planned to assess the diagnostic performance of the automated urine particle analyzer Sysmex UF-1000i for the rapid screening of cerebrospinal fluid (CSF) in patients with suspected meningitis. Cytometric analyses with either optical microscopy (OM) or UF-1000i, along with assessment of glucose and protein in CSF, were performed on 101 consecutive CSF of patients with suspected meningitis. In 50 out of 101 samples, cultural analysis was also performed with different culture media. Four different diagnostic combination were developed, with different mix of the tested parameters. A high correlation was found between OM and UF-1000i (r=0.99; mean bias, -4.9/μL). The diagnostic agreement was 0.90 in adults and 0.97 in children. The diagnostic agreement between CSF culture and bacterial count by UF-1000i was 0.98, with 1.00 sensitivity and 0.98 specificity. Results showed that the diagnostic combination based on CSF glucose and total proteins, cytometric analysis (leukocyte count ± neutrophilia) and bacterial count on UF1000i exhibited the best performance when compared with microbiological examination (area under ROC curve, 1.00). In conclusion, the results of this study show that the combination of two rapid clinical chemistry tests such as glucose and total proteins with UF-1000i analysis could represent a valid approach for supporting more complex analyses or even for replacing OM and CSF culture during stat examination and to achieve a quick detection of central nervous system infections.

Buoro S.,Laboratorio Analisi Chimico Cliniche | Ottomano C.,Unita Operativa di Diagnostica Ematochimica | Esposito S.A.,Laboratorio Analisi Chimico Cliniche | Gherardi P.,Laboratorio Analisi Chimico Cliniche | And 5 more authors.
Journal of Medical Biochemistry | Year: 2013

Background: We evaluated the performance of Sysmex UF- 1000i for cell counting and differential cell count, as well as for assessment of bacteria load in cerebrospinal fluid (CSF), as a potential approach for the rapid screening of meningitis or bacterial encephalitis. Methods: We analyzed 77 consecutive CSF samples, 34 of which (44%) displayed leukocyte count >5 white blood cell (WBQ/̌iL with optical microscopy. Results on the UF-1000i were compared with those obtained by microscopic analysis. Imprecision was evaluated by testing three CSF samples with leukocyte values between 3.5 and 28.8 WBC/nL in 10 repli- cates. Carry-over was evaluated with the Broughton formula on three CSF pools with leukocyte counts between 93.5 and 132.5 WBC/̌L. Linearity was assessed according to CLSI document EP6-A. In the presence of bacteria, identification and antibiogram were performed with Vitex (Biomerieux), except for Neisserie meningitidis (ApiNH, Biomerieux). Sensitivity tests were performed with Vitex and disc diffusion. Results: Optimal correlation was found between UF-1000i and optical microscopy, displaying Pearson's correlation of 0.99 and mean bias of-3.5 WBC/̌L (95% Cl, from -7.0 to 0.0 WBC/nL). Imprecision varied between 12 and 16%. Li- nearity was excellent, 4-278 WBC/nL. Carry-over was neg- ligible. ROC analysis yielded AUC of 0.99 for both WBC and bacterial counts. The agreement at threshold >4 WBC/nL was 0.91, with sensitivity and specificity of 1.00 and 0.84. At S19 bacteriǎnL cut-off, accuracy was 0.98, sensitivity 1.00 and specificity 0.97. Conclusions: According to these results, CSF screening with UF-I000i seems a reliable approach in terms of instrument performance, turnaround time and overall laboratory effi- ciency.

Buoro S.,Laboratorio Analisi Chimico Cliniche | Ottomano C.,Unita Operativa di Diagnostica Ematochimica | Gustinetti R.,Laboratorio Analisi Chimico Cliniche | Galliani C.,Laboratorio Analisi Chimico Cliniche | And 4 more authors.
Biochimica Clinica | Year: 2013

The aim of this study was to evaluate the performance of Sysmex XE-2100 for automated flow cytometric analysis of biological fluids. The results of 106 consecutive peritoneal samples and 20 pleural samples were compared with optical microscopy. A good agreement was found in total nucleated cells (TNC) count between Sysmex XE-2100 and manual microscopy (y=0.98x+3.2, r=0.99; mean bias, -9.5 TNC/μL). The percentage of cells with high fluorescence in XE-2100 correlated with that of macrophages and mesothelial cells at microscopy (r=0.67; P <0.001). The CV of TNC determination on XE-2100 ranged between 1.6% and 11.7%. At the 20% CV, the analytical sensitivity of XE-2100 was 29/μL for TNC, 50/μL for polymorphonuclear leukocytes (PMN) and 66/μL for mononuclear elements. The linearity between 30 and 944 TNC/μL was excellent (r=0.998, P <0.001), whereas the carry-over was <1%. At thresholds of ≥250 PMN/μL in peritoneal fluid and ≥50% PMN or ≥50% lymphocytes in pleural fluid, the diagnostic accuracy of XE-2100 was 96.8%, with Cohen's kappa of 0.90 (P <0.001). We conclude that automated flow cytometric analysis on Sysmex XE-2100 may be a viable options for screening of peritoneal and pleural fluids.

Lippi G.,Unita Operativa di Diagnostica Ematochimica | Ippolito L.,Unita Operativa di Diagnostica Ematochimica
Biochimica Clinica | Year: 2013

We describe the case of a 82 years old female, who has been referred to the emergency department for a gross trauma of the right knee after an accidental fall. Physical examination revealed a palpable mass in the right pelvis, which was then identified as a large intramuscular hematoma of the right iliacus muscle by computerized tomography scan. The most suggestive laboratory findings were anemia and a prolonged activated partial thromboplastin time (APTT) (ratio 1.33), with physiological platelet count and prothrombin time. After ten days of hospitalization, when a spontaneous hematoma developed in the right arm, APTT had steadily increased, up to a value of 3.33. A mixing study and assessment of coagulation factors were rapidly performed. The former test was not effective to normalized the APTT, whereas concentrations of all factors were within the reference interval, except for factor VIII (0.6%). Factor VIII inhibitor titration using Bethesda assay confirmed the diagnosis of acquired hemophilia A, yielding a value of 77 Bethesda units. Acquired hemophilia A, which is caused by autoantibodies against coagulation factor VIII, is a rare condition that can be frequently overlooked or misdiagnosed. The role of laboratory diagnostics is thereby as important as the clinics, wherein serious hemorrhages accompanied by variable APTT prolongations onset in a previously asymptomatic patient. Along with discussion about laboratory and clinical aspects of acquired hemophilia A, we present a diagnostic algorithm for efficiently troubleshooting prolonged APTT values in clinical laboratories.

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