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BC: Articoli scritti da M. Carta

Una variante emoglobinica rara
A rare hemoglobin variant
<p>When arrived to our observation, BS was an African origin newborn of a few days. His hemoglobin concentration and complete blood count were within normal ranges, and he had no jaundice; however, his parents are heterozygous carriers of hemoglobin variant: HbC trait the mother and HbS trait the father. Screening was therefore required for hemoglobin variants. The request is appropriate since the evidence of a double heterozygosis S/C (SCD) would allow timely treatment of these patients. Screening was performed in capillary electrophoresis but was not conclusive because the presence of a small concentration of HbS and of another variant did us not allow to make a diagnosis, although the presence of HbA allowed to exclude the state of SCD. Hemoglobin electrophoresis was then performed, but it was not conclusive. It was necessary resorting to the molecular analysis, that highlights the presence of HbS trait and a mutation in heterozygosis at the charge of the gamma-globin chain consistent with HbF Granada. The recognition of HbF Granada was meaningless from a clinical point of view, but allowed to exclude the presence of a hemoglobin compound, the main clinical question of this clinical case.</p>
Biochimica Clinica ; 44(3) e019-e021
Casi Clinici - Case Report
 
Il tipo di campione per la curva da carico orale di glucosio è fondamentale per una corretta identificazione del diabete mellito gestazionale
An appropriate sample for oral glucose tolerance test is fundamental for a correct identification of gestational diabetes mellitus
<p>Background: Gestational Diabetes Mellitus (GDM) is diagnosed by the oral glucose tolerance test (OGTT) using Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study-derived definite cut-off values, where reference glucose is determined in sodium fluoride (NaF) containing tubes immediately centrifuged. The aim of the present study is to evaluate the effect of the use of the recommended citrate containing tubes, as immediate glycolisis inhibitor, for OGTT as screening for GDM, comparing them with NaF containing tubes, used in routine laboratory conditions.<br />Methods: a total of 83 pregnant women were enrolled in the study; OGTT (75 g) was carried out in the Clinical Laboratories of Brescia and Vicenza in all the subjects for screening of GDM. All subjects signed written informed consent to participate in the study. Glucose determination was performed using three different types of glycolysis inhibitor: [sodium fluoride (NaF, in both laboratories), a lyophilized acidified mixture (FC-MIX, in Vicenza), and a liquid acidified mixture (GlucoEXACT, in Brescia)]. The glucose concentration was measured by an hexochinase method on Dimension Vista systems from Siemens Healtheers. The International Association of Diabetes and Pregnancy Study Groups (IAPDGS) criteria, derived from the HAPO study, were used for the diagnosis of GDM.<br />Results: Using NaF and FC-mix tubes, 6/51 (11.8%) and 12/51 (23.5%) women respectively, were diagnosed having GDM in Vicenza. Using NaF and GlucoEXACT tubes 2/31 (6.5%) and 6/31 (18.8%) women respectively, were diagnosed having GDM in Brescia. There was a statistically significant difference (p&lt;0.05) between NaF and citrate acidified mixture in the glucose measurements at all time points.<br />Conclusions: The use of the tubes containing a mixture of NaF, EDTA and citrate is a useful and necessary pre-analytical tool for an accurate OGTT, when utilized for the screening of GDM. Tubes containing NaF alone should no longer be used for screening of GDM because their use results in underdiagnosis of GDM.</p>
Biochimica Clinica ; 44(2) 143-148
Contributi Scientifici - Scientific Papers
 
Impatto delle variabili preanalitiche e analitiche sulla diagnosi di diabete melito gestazionale
M. Carta  |  D. Giavarina  |  G. Bonetti  | 
Biochimica Clinica ; 44(2) 206-208
Lettere all'Editore - Letters to the Editor
 
La tele-ematologia nel consolidamento dei laboratori clinici
Tele-haematology in the consolidation of clinical laboratories
D. Giavarina  |  M. Carta  | 
<p>Haematological laboratory diagnostics couldbenefit widely from telematics, but some critical issues need to be addressed for a successful organization. Imagetransmission is probably the most critical item. In fact, specific competences are required for the selection of thesamples to be reviewed, preparing of the slides, choosing fields and cells to be examined, and so on. Thetransmission of the entire blood film could be a good solution, but it is not yet available for laboratory haematology,while expert automated systems are nowadays ready for high performance processes without the need of specificskills.<br />Digitization of laboratory haematology can harmonize the activities utilizing the same rules of selection of thepreparations to be reviewed, and for the control, verification and validation of the analysed samples and finally forreporting. It offers support for consultancy and training. When these needs involve different sites far from each other,the transmission of data and images effectively requires automation technologies for preparing and reading thepreparations, information technologies for an integrated management of all the necessary data helpful for thediagnosis and a suitable network to make communications travel in suitable quantities and speeds.<br />The new frontiers of artificial intelligence will probably have a greater role both in the management of process, in theverification of automatic validations, and finally in the recognition of pathological morphological patterns. All this toolscannot replace the specialized expertise in the final supervision of haematological diagnoses, but will allow simpler,faster and safer management of haematological analyses and revisions, meeting the changing needs of modernlaboratory medicine.</p>
Biochimica Clinica ; 43(2) 125-134
Rassegne - Reviews
 
Raccomandazioni per l’ottimizzazione della fase pre-analitica per una corretta determinazione della glicemia in ambito diabetologico
Correct determination of glycemia in the management of diabetes: recommendations for the optimization of the pre-analytical phase
G. Bonetti  |  M. Carta  |  A. Lapolla  |  R. Miccoli  |  R. Testa  |  A. Mosca  | 
<p>The time-dependent decrease of glucose in tubes after venipuncture may cause artificially lower values, if glycolysis is not appropriately inhibited by the correct anticoagulant. In this work we have extensively reviewed the current literature about the possible use of citrate buffer together with sodium EDTA and sodium fluoride. We conclude that, for screening and diagnosis of diabetes mellitus, including gestational diabetes, glucose has to be determined in plasma by using the above mentioned ternary mixture either as solid or in liquid state (in this case the correct numerical conversion factor has to be employed). For the measurement of glucose in patients with already known diabetes and following monitoring, lithium heparin tubes may be used providing that plasma separation should be rapidly performed. Alternatively, serum-separating tubes with particles promoting rapid clotting could also be employed.</p>
Biochimica Clinica ; 42(3) 263-265
Documenti SIBioC - SIBioC Documents
 
Inibizione della glicolisi e accuratezza preanalitica nella misura della glicemia: la posizione del Gruppo di Studio SIBioC-SIPMeL Diabete Mellito
Glycolysis inhibition and reliable plasma glucose results: the position of the SIBioC-SIPMeL Study Group on Diabetes Mellitus
Biochimica Clinica ; 39(3) 223-224
Lettere all'Editore - Letters to the Editor
 
Raccomandazioni 2015 per l’esecuzione dell’esame da carico orale di glucosio
2015 recommendations for oral glucose tolerance testing (OGTT)
M. Carta  |  A. Mosca  |  A. Lapolla  |  R. Testa  | 
<p>Despite its large use and importance, OGTT is&nbsp;still plagued by poor reproducibility and sometimes is not appropriately performed. In 2006 the joint Study Group on&nbsp;Diabetes mellitus made recommendations concerning OGTT in order to harmonize the test procedure according to&nbsp;WHO and American Diabetes Association guidelines. This document should be regarded as an updated version of the&nbsp;original 2006 recommendations, including some improvements and changes, particularly regarding the use of OGTT for&nbsp;the diagnosis of gestational diabetes in agreement with the 2010 guidelines of the Italian Ministry of Health. The list of&nbsp;drugs having effect on the glucose tolerance has been updated too.</p>
Biochimica Clinica ; 39(2) 135-140
Documenti SIBioC - SIBioC Documents
 
Refertazione dell'emoglobina glicata in presenza di varianti emoglobiniche
Glycated hemoglobin reporting in presence of hemoglobin variants
M. Carta  |  A. Mosca  | 
Biochimica Clinica ; 35(1) 42
DOCUMENTI - DOCUMENTI