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Manoni F.,Servizio Of Medicina Of Laboratorio | Gessoni G.,Servizio Of Medicina Of Laboratorio | Caleffi A.,Unita Operativa Diagnostica Ematochimica | Alessio M.G.,Servizio Of Medicina Of Laboratorio | And 6 more authors.
Clinical Biochemistry | Year: 2013

Objectives: The purpose of this Italian multicenter study was to define pediatric upper reference values for urine particle quantification by using automated flow cytometry. Design and methods: Four hospital-based clinical laboratories participated in this multicenter investigation, which included a total study population of 161 Italian children aged from 1 to 12. years. Two laboratories used Sysmex UF-100 and analyzed 86 children, whereas the other two used Sysmex UF-1000i and analyzed 75 subjects. Particle quantification included the analysis of white blood cells (WBC), red blood cells (RBC), squamous epithelial cells (EC), transitional epithelial cells (TC), casts (CAST) and bacteria (BACT). Results: The upper reference values in subjects tested with the Sysmex UF-100 were 9.7. WBC/μL, 10.1. RBC/μL, 7.5. EC/μL, 2.5. TC/μL, 0.7. CAST/μL and 3090. BACT/μL, whereas the upper reference values in subjects tested with the Sysmex UF-1000i were 10.5. WBC/μL, 8.3. RBC/μL, 7.2. EC/μL, 2.9. TC/μL, 0.7. CAST/μL and 48. BACT/μL. No statistically significant differences between genders were found in the value distribution of any of the parameters tested. Similarly, no statistically significant differences were observed between the two urine analyzers, except for BACT. Conclusions: Automated analysis of urine particles appears a suitable means to optimize the workflow of routine urinalysis of children specimens. The upper reference limits for pediatric subjects obtained in this study were comparable to those previously reported in the literature, with no significant differences between genders and analyzers. © 2013 The Canadian Society of Clinical Chemists.


Lippi G.,Unita Operativa Diagnostica Ematochimica | Avanzini P.,Unita Operativa Diagnostica Ematochimica | Campioli D.,Laboratorio Analisi Chimico Cliniche | Da Rin G.,Struttura Complessa Medicina Of Laboratorio | And 4 more authors.
Clinical Biochemistry | Year: 2013

Objectives: Despite manufacturers' claim that systematical assessment of serum indices does not impact on testing efficiency, there is widespread perception that this practice may increase the turnaround time (TAT). A multicenter investigation was planned to verify TAT and performance of serum indices on five different clinical chemistry analyzers. Design and methods: Twenty study samples prepared from pooled sera of outpatients, emergency department, intensive care unit and dialyzed patients were divided in aliquots and shipped to 5 different laboratories. According to local instrumentation (Beckman Coulter AU5800, Roche Cobas 6000, Siemens Dimension Vista 1500, Abbott Architect c 16000 and Ortho Vitros 5.1/FS) and reagents, 13 clinical chemistry parameters were assayed on all study samples, with or without contextual assessment of serum indices. Results: The TAT with assessment of serum indices modestly or even negligibly increased, and varied from 0.2 to +. 5.0% (i.e., from 3 to +. 85. s). When using the lowest thresholds for sample acceptability, the agreement of hemolysis index (HI) among different instruments was comprised between 0.62 and 1.00 (all p. <. 0.01), but was higher than 0.80 in only 4/10 cases. The agreement of icteric and lipaemic indices could not be estimated due to the low number of samples exceeding acceptability criteria. Conclusions: The results of this study confirm that systematical measurement of serum indices does not impair instrument efficiency. The comparison of HI also suggests that major harmonization may be advisable for this measure among different manufacturers and instrumentations. © 2013 The Canadian Society of Clinical Chemists.


Myths have played essential social functions throughout human history, and modern medical culture makes no exception. Despite ongoing scientific efforts, clinicians still encounter biological phenomena that they can hardly explain. In this ocean of uncertainty they continue, either consciously or unconsciously, to convey a number of myths, which are also used as professional tools. Although in recent decades clinical research and randomized trials have emerged as the main arbiters of truth in medicine, there are still large areas of uncertainty that are consistently filled up with tradition, common sense and experience. In this context, mysticism seldom represent a latent source of error, especially when it penetrates education and medical literature, so growing to the role of indisputable truth, which can hardly be eradicated. The aim of this article is to discuss some paradigmatic examples of medical myths, such as the use of beta-blockers in patients with heart failure, the risk of administering opioids in patients with abdominal pain, the suggestion to drink at least eight glasses of water per day, the risk of using contrast media in patients with shellfish allergy, the indiscriminate prescription of a huge number of laboratory tests to achieve an efficient diagnosis, the use of garlic for treat a kaleidoscope of human disorders, fructose as a viable replacement for sucrose, the relationship between obesity and mortality or between sex and caloric consumption, and the cognitive biases.


Da Rin G.,Struttura Complessa Medicina Of Laboratorio | Lippi G.,Unita Operativa Diagnostica Ematochimica
Journal of Laboratory Automation | Year: 2014

The aim of this study was to assess whether preanalytical management of coagulation samples through an open total laboratory automation system may impair the reliability of routine hemostasis tests as compared with loading of centrifuged plasma specimens directly into the coagulation analyzer for routine testing. Forty inpatient samples were divided into two aliquots. The former was centrifuged and directly loaded in a hemostasis analyzer, whereas the latter was entered into a 16.5 m long track-line system (FlexLab), where it was automatically centrifuged and conveyed to the same coagulation analyzer. An analytically significant difference was found between values of samples directly loaded in the coagulation analyzer and those entered in the track-line system for prothombin time (19.6 ± 1.7 versus 19.2 ± 1.6 s; p < 0.001) and activated partial thromboplastin time (38.0 ± 1.4 versus 37.5 ± 1.3 s; p = 0.021) but not for fibrinogen (305 ± 12 versus 304 ± 12 mg/dL; p = 0.97). Nevertheless, the mean percentage bias of prothombin time (–1.8%), activated partial thromboplastin time (–1.0%), and fibrinogen (0.4%) was modest and always lower than the total allowable error and was thereby considered not clinically significant. The results of this study confirm that connection of coagulation analyzers to track-line systems is a viable solution for modern clinical laboratories. © 2013 Society for Laboratory Automation and Screening.


Cervellin G.,Unita Operativa Pronto Soccorso e Medicina dUrgenza | Benatti M.,Unita Operativa Pronto Soccorso e Medicina dUrgenza | Carbucicchio A.,Unita Operativa Pronto Soccorso e Medicina dUrgenza | Aloe R.,Unita Operativa Diagnostica Ematochimica | Lippi G.,Unita Operativa Diagnostica Ematochimica
Biochimica Clinica | Year: 2014

Computerized tomography (CT) remains the best option for diagnosis of head trauma, although it carries several drawbacks. Among a large number of putative biomarkers proposed for initial evaluation of mild head trauma, protein S100B and NSE exhibit the best diagnostic performance. We performed a prospective study, where these biomarkers were assessed in 68 patients consecutively admitted to the Emergency Department (ED) with mild head trauma. The CT scan revealed brain lesions in 11 patients (16%). Concentrations of both biomarkers in serum were found to be more elevated in patients with positive CT than in those with negative scans. The area under the ROC curve (AUC) of protein S100B (0.89, 95% confidence interval: 0.81-0.97) was, however, significantly greater than that of NSE (0.77, 95% confidence interval: 0.64-0.90) (P=0.044). It was estimated that determination of protein S100B in all patients presenting to the ED with mild head trauma could safely save up to 50% CT execution, reducing the overall healthcare expenditure by ∼1/3.


PubMed | Struttura Complessa Medicina Of Laboratorio and Unita Operativa Diagnostica Ematochimica
Type: Journal Article | Journal: Journal of laboratory automation | Year: 2016

The aim of this study was to assess whether preanalytical management of coagulation samples through an open total laboratory automation system may impair the reliability of routine hemostasis tests as compared with loading of centrifuged plasma specimens directly into the coagulation analyzer for routine testing. Forty inpatient samples were divided into two aliquots. The former was centrifuged and directly loaded in a hemostasis analyzer, whereas the latter was entered into a 16.5 m long track-line system (FlexLab), where it was automatically centrifuged and conveyed to the same coagulation analyzer. An analytically significant difference was found between values of samples directly loaded in the coagulation analyzer and those entered in the track-line system for prothombin time (19.6 1.7 versus 19.2 1.6 s; p < 0.001) and activated partial thromboplastin time (38.0 1.4 versus 37.5 1.3 s; p = 0.021) but not for fibrinogen (305 12 versus 304 12 mg/dL; p = 0.97). Nevertheless, the mean percentage bias of prothombin time (-1.8%), activated partial thromboplastin time (-1.0%), and fibrinogen (0.4%) was modest and always lower than the total allowable error and was thereby considered not clinically significant. The results of this study confirm that connection of coagulation analyzers to track-line systems is a viable solution for modern clinical laboratories.

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