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Editor-in-chief
Maria Stella Graziani

Deputy Director
Martina Zaninotto

Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada

Publisher
Biomedia srl
Via L. Temolo 4, 20126 Milano

Responsible Editor
Giuseppe Agosta

Editorial Secretary
Andrea di Bello
Biomedia srl
Via L. Temolo 4, 20126 Milano
Tel. 0245498282
email: biochimica.clinica@sibioc.it

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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091

BC: Articoli scritti da M. Berardi

Inspiegabili alterazioni di esami coagulativi
Unexpected coagulation test abnormalities
C. Camilleri \| AM. Gori \| R. Marcucci \| M. Vivoli Vega \| LA. Alessandrello \| AP. Cellai \| A. Rogolino \| M. Berardi \| F. Balboni \|
<p>A 72 year-old female was screened before a minor orthopaedic surgery with routine coagulation tests, that resulted highly altered. Prothrombin time and activated partial thromboplastin time (PT and aPTT) could not be calculated because the system registered a biphasic curve, protein C and protein S (PC and PS) levels were not measurable and antiphospholipid antibodies were highly positive. Reviewing previous laboratory findings, a serum protein electrophoresis showing the presence of a monoclonal peak in the gamma region was retrieved. A serum immunofixation was then performed, and an IgM kappa monoclonal component was typed; a cryoglobulin test was positive for cryoglobulin type II. To investigate the possible relationship between these laboratory findings, a pool of normal plasma was spiked with the patient IgM monoclonal component at progressively higher concentrations registering a prolongation of PT and aPTT and a slight reduction of PC and PS. The presence of an IgM paraprotein, although not quantitatively relevant, was therefore functionally able to interfere with the coagulation time calculation system. Although coagulation abnormalities in monoclonal gammopathy of undetermined significance are uncommon, these should be attentively investigated, to guarantee a correct laboratory report.</p>
Biochimica Clinica ; 45(1) e7-e10 Casi clinici - Case report

Lab Tests Online Italia. Attività del 2020

G. Messeri \| M. Berardi \| F. Biancalani \|

Biochimica Clinica ; 45(1) 100 Notizie SIBioC - SIBioC News

Rischio clinico ed ematologia di Laboratorio: è possibile affidarsi al solo Volume Corpuscolare Medio per scoprire l’errata identificazione del paziente?
Clinical risk management in laboratory haematology: is Mean Corpuscular Volume a reliable marker to recognize identification errors?
M. Berardi \| F. Balboni \| S. Buoro \|
<p>Identification errors in laboratory medicine are a major issue. Delta checks rules have a fundamental function to identify this type of errors. In the haematology section of the laboratory, the mean corpuscular volume (MCV) is one of the parameters which delta checks rely on. Unfortunately, this approach is sub-optimal since many patients show similar MCV. We present here a case illustrating the problem and the potential drawbacks for patient safety.</p>
Biochimica Clinica ; 45(1) e4-e6 Casi Clinici - Case Report

Il “Libro Bianco” dei Giovani Professionisti di Medicina di Laboratorio in Italia: risultati dell’indagine del Gruppo di Studio SIBioC Young Scientists
The "white paper" of young Laboratory Medicine professionals in Italy: results from a survey by the SIBioC - Young Scientists Working Group
C. Bellini \| S. Nannini \| M. Berardi \| A. Mosca \| S. Bernardini \| G. Sancesario \|
<p>Introduction: Laboratory Medicine is continuously changing because of the advent of new technologies and perspectives, such as automation, Big Data and omics sciences. Professionals’ profiles are changing concurrently, developing the new technological, clinical and management skills required nowadays. In order to assess training needs as well as education and working conditions, the SIBioC Young Scientists Working Group (YS-WG) promoted a questionnaire directed to professionals ≤40 years old.<br />Methods: the questionnaire was prepared using Survey Monkey and was sent to the 587 SIBioC members ≤40 years old; it was also diffused via the YS-WG social media pages, and through personal e-mails with the help of Specialty School Offices. The questionnaire included 54 questions examining different aspects: participation in SIBioC activities, scientific interests, working conditions, evaluations of training and education experiences, expectations for the future professional life.<br />Results: during three months, 282 responses have been collected. The most represented professionals are Biologists (PhD) (46%), followed by Medical Doctors (24%). 33% of participants has an open-ended contract, 15% temporary, 17% freelance and 17% has a scholarship/research grant; 46% of them do not receive any remuneration. Around 60% work in public institutions (Universities or Hospitals); 52% are involved in clinical area, 29% in research. Residents’ evaluation on educational quality of Specialty Schools is rather heterogeneous. Among the 193 SIBioC members, 35% is actively participating in at least one of the society’s Working Group. Most of the participants are regular readers of the SIBioC official journal (Biochimica Clinica), consult LabTestsOnline web site, and participate to SIBioC scientific events and/or to the Society e-learning courses.<br />Conclusions: the results of the survey are a key point for the Society, allowing to understand the young laboratory professionals needs, so that they can be accompanied and encouraged in a full development of their future professional life.</p>
Biochimica Clinica ; 44(4) 351-358 Contributi Scientifici - Scientific Paper

Lab Tests Online Italia, oggi

M. Berardi \| G. Messeri \|

Biochimica Clinica ; 44(1) 106-107 Notizie SIBioC - SIBioC News

Lab Tests Online: un successo che parte da lontano

M. Berardi \|

Biochimica Clinica ; 43(2) 245-247 Notizie SIBioC - SIBioC News

Un caso di mieloma multiplo IgG kappa in cui la misura delle catene leggere libere ha evidenziato precocemente una ripresa di malattia di tipo “light chain escape”
A case of IgG kappa multiple myeloma where the measurement of the free light chains was an early marker of a “light chain escape” relapse
M. Berardi \| M. Staderini \| A. Terreni \| C. Nozzoli \| T. Biagioli \| M. Brogi \| L. Torreni \| A. Gironi \| F. Cassani \| B. Bosi \| A. Caldini \|
<p>Light chain escape (LCE) is a type of relapse where a serum free light chains (FLC) increase is observed, in the absence of a parallel increase of the original monoclonal component; this particular kind of relapse seems to be influenced by new therapeutic regimens. We present a case of a 55-years old man with a IgG kappa multiple myeloma (MM), who underwent double autologous bone marrow transplantation as first line therapy; after relapse, the patient was treated with lenalidomide/dexamethasone (LD). After more than three years of LD treatment, in September 2014, an increase of FLCs was observed, while serum and urine immunofixations remained negative until January and February 2015 respectively, when a LCE was diagnosed. Despite the new treatment, the patient died in June 2016. The FLCs measurement, although not reaching the IMWG criteria, detected relapse earlier than immunofixation. This case indicates that FLCs should be routinely performed during follow up of MM patients to ensure that LCE is not missed.</p>
Biochimica Clinica ; 41(3) e22-e24 Casi clinici - Case report

Armonizzazione in Medicina di Laboratorio
Harmonization in Laboratory Medicine
F. Ceriotti \| M. Panteghini \| A. Tosetto \| V. Valentini \| L. Politi \| R. Rolla \| T. Guastafierro \| T. Köken \| E. Capoluongo \| C. Mazzaccara \| V. D'Argenio \| V. D'Argenio \| G. Lippi \| M. Plebani \| D. Giavarina \| M. Berardi \| A survey on sample matrix and preanalytical management in clinical laboratories \| D. Bozzato \| G. Messeri \| M. Zaninotto \| M. Vidali \| A. Padoan \| M. Panteghini \| F. Braga \| G. Gessoni \| M. Montagnana \| N. Doğan \| M. Barberis \| M. Barberis \| A. Marchetti \| F. Borrillo \| L. Bonfanti \| P.M. Ness \| G. Messeri \| S. Nannini \| J. Queraltò \| E. Fiorio \| L. Crinò \| M. A. V. Willrich \| A. Modenese \| M. Berardi \| G. Nordera \| M. Girelli \| R. Tomaiuolo \| R. Danesi \| M. Locatelli \| M. Savoia \| S. Bernardini \| C. Domenichini \| M. Lamonaca \| P. Pradella \| A. D'Avolio \|

Biochimica Clinica ; 39(6) 546-547 Editoriale - Editorial

Armonizzazione in Medicina di Laboratorio
Harmonization in Laboratory Medicine
F. Ceriotti \| M. Panteghini \| A. Tosetto \| V. Valentini \| L. Politi \| R. Rolla \| T. Guastafierro \| T. Köken \| E. Capoluongo \| C. Mazzaccara \| V. D'Argenio \| V. D'Argenio \| G. Lippi \| M. Plebani \| D. Giavarina \| M. Berardi \| A survey on sample matrix and preanalytical management in clinical laboratories \| D. Bozzato \| G. Messeri \| M. Zaninotto \| M. Vidali \| A. Padoan \| M. Panteghini \| F. Braga \| G. Gessoni \| M. Montagnana \| N. Doğan \| M. Barberis \| M. Barberis \| A. Marchetti \| F. Borrillo \| L. Bonfanti \| P.M. Ness \| G. Messeri \| S. Nannini \| J. Queraltò \| E. Fiorio \| L. Crinò \| M. A. V. Willrich \| A. Modenese \| M. Berardi \| G. Nordera \| M. Girelli \| R. Tomaiuolo \| R. Danesi \| M. Locatelli \| M. Savoia \| S. Bernardini \| C. Domenichini \| M. Lamonaca \| P. Pradella \| A. D'Avolio \|

Biochimica Clinica ; 39(6) 546-547 Editoriale - Editorial

Un caso di gammopatia monoclonale di significato renale in un paziente con glomerulopatia immunotattoide
A case of monoclonal gammopathy of renal significance in a patient affected by immunotactoid glomerulopathy
A. Terreni \| F. Bergesio \| E. Buti \| M. Berardi \| E. Dervishi \| C. Nozzoli \| A. Caldini \|
<p>Monoclonal gammopathy of renal significance is defined by the causal relationship between a small B-cell clone and the renal disease. Immunotactoid glomerulopathy is a rare glomerular disease characterized by<br />highly organized crystalline structure of Congo Red-negative immune deposits in the absence of systemic disease. We describe a 54 years-old man with non-nephrotic proteinuria and chronic renal failure. Laboratory findings revealed a serum monoclonal component. Renal histology showed a morphological pattern of membrano-proliferative glomerulonephritis; electron microscopy evidenced micro tubular structures within the mesangium measuring approximately 20 nm in thickness, similar to cryoglobulins. Renal immunofluorescence demonstrated in the deposits the same monoclonal component observed in serum, leading to a final diagnosis of immunotactoid glomerulopathy.</p>
Biochimica Clinica ; 39(6) e22-e24 Casi clinici - Case report

Valutazioni preliminari per la proposta di un unico dispositivo di campionamento per la ricerca dell’emoglobina su materiale fecale
Preliminary assessments for a standard sampling device for fecal hemoglobin detection
S. Rapi \| C.G. Fraser \| F. Cellai \| M. Berardi \| T. Rubeca \|
<p>Sampling of feces is strongly affected by the lack of harmonisation, with differences up to 20 times in the mass collected for immunological tests for fecal hemoglobin (Hb) used in colorectal cancer screening. Aim of this study was to acquire information on fecal sampling and on the interaction between feces and analytical methods to obtain a reference design for a sampling dipstick. Bias and imprecision of sample collection dipsticks were estimated using gravimetry. Dissolution times of feces were monitored throughout the study. The effect of increasing amount of feces on Hb concentrations was investigated in saline and buffers of different manufacturers using a single analytical method (OC-Sensor, Eiken Chemical Co.). Fecal mass recovered with different devices ranged from 56 to 121% of declared amount (CV range: 8.6÷31.1%). Time of dissolution up to 2 h was observed when lumps of materials were collected. In saline a rapid decrease of Hb values was observed, which was related to the overall amount of feces. Increased Hb values were<br />observed by adding feces to manufacturers’ buffers. Solubilisation time, bias and imprecision of sampling of feces were related to device design. Analytical methods are designed to use specific ratios between feces and buffers. The introduction of a standard dipstick design to reduce preanalytical variability may represent a crucial step for fecal test harmonization.</p>
Biochimica Clinica ; 39(6) 563-567 Contributi scientifici - Scientific Papers

Comunicare nell’infosfera: sfide e opportunità per la Medicina di Laboratorio
Communicating in the infosphere: challenges and opportunities for Laboratory Medicine
V. D'Argenio \| E. Iorio \| R. Tomaiuolo \| C. Bellini \| M. Lenski \| E. Giannella \| M. Berardi \| S. Fares Taie \| G. Sancesario \|
<p>Communication is becoming more important than ever for health care and health care professionals, as the recent COVID-19 pandemic has dramatically highlighted. The fast evolution of the mass and social media and the continuous development of new health-related platforms and applications are imposing new challenges that involve also laboratory medicine and that need to be carefully considered. In fact, these novel, fast and effective strategies of communication are inherently prone to the risk of publishing misleading, incorrect or fake information which can spread uncontrollably and diffuse all over the world in a very short time. However, social media are undoubtedly a great opportunity to communicate, in a responsible and credible way, health-related data and scientific updates and discoveries. As for the therapeutic alliance, it is now required to establish an “information alliance” between different healthcare professionals which, based on a trustworthy relationship, will allow the correct diffusion of health-related information and will contribute to citizens’ education.</p>
Biochimica Clinica ; 17(1) Opinioni - Opinions