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BC: Articoli scritti da A. Dolci

Raccomandazioni per l’identificazione e la gestione dei risultati critici nei laboratori clinici
Recommendations for the detection and management of critical results in clinical laboratories
<p>Critical results, (also known as panic or alarm results) identify a laboratory test result associated with a serious risk for the patient&rsquo;s health, requiring immediate communication to the physician to establish appropriate therapeutic interventions. The adoption of an efficient procedure for the communication of critical values/results is crucial for clinical, ethical, organizational reasons, because it is a requirement for laboratory accreditiation and because of potential legal consequences related to the lack of notification of harmful laboratory results. In 2008, the Italian Society of Clinical Biochemistry and Laboratory Medicine (SIBioC) published its first consensus-based recommendation for the detection and management of critical values in clinical laboratories, with the aim to improve the implementation of standardized and universally accepted procedures, promoting an essential policy toward rational and efficient solutions to this issue. These new recommendations represent a complete review of the first document. Using the same consensus conference method between experts of scientific societies, the main aspects of clinical risk, patient safety and legal liability of health care workers were re-considered. The SIBioC and the Italian Society of Laboratory Medicine (SIPMeL), Intersociety Study Group on Standardization of extra-analytical variability of laboratory results, together with the Italian Society of Ergonomics and Human Factors (SIE) collaboration, issued the present join document.</p>
Biochimica Clinica ; 42(2) 167-179
Documenti SIBioC - SIBioC Documents
 
Anemia acquisita da ospedalizzazione: il ruolo delle perdite di sangue a scopo diagnostico
Hospital-acquired anemia: the role of diagnostic blood loss
<p>Hospital-acquired anemia (HAA) is defined by a reduction of blood hemoglobin concentrations in hospitalized patients, in absence of bleeding episodes occurring during the hospital stay. One of the most important causes of HAA is the considerable amount of blood drawn for diagnostic purposes, which mainly affects critical patients in the intensive care units. Although usually underestimated by healthcare providers, HAA can be a significant problem, because it may increase the necessity of allogenic transfusions, the morbidity and mortality rates and healthcare costs. Strategies to minimize diagnostic blood loss should be implemented by both clinical wards and laboratories within wider patient blood management programs, with the aim of improving patient clinical outcome. These should include using small-volume test tubes, reduction of sample waste, optimization of testing frequency, early removal of central catheters and healthcare professional education.</p>
Biochimica Clinica ; 41(3) 208-215
Rassegne - Reviews
 
Validazione per l’impiego clinico delle determinazioni di emoglobina ed ematocrito sull’emogasanalizzatore GEM Premier 4000
Validation of clinical use of hemoglobin and hematocrit measurements on GEM Premier 4000 blood gas analyzer
Biochimica Clinica ; 41(2) 189-191
Lettere all'Editore - Letters to the Editor
 
Verifica dell’accuratezza di tre glucometri “point-of-care” per l’utilizzo in ambito ospedaliero
Verification of accuracy of 3 glucose point-of-care testing (POCT) devices for their use in a hospital setting
<p>Inaccuracy in glucose POCT can lead to inappropriate therapeutic decisions. In this study, we evaluated the performance of 3 POCT glucometers by comparing results to those by an automated system traceable to higher-order references. Thirty-one heparinized venous blood samples were collected and assayed in duplicate for whole blood glucose concentrations with Roche Accu-Check Compact Plus, Nova Biomedical NovaPro and OK Biotech OKmeterDirect glucometers. All systems were calibrated to report plasma-equivalent results. Samples were then centrifuged and plasma glucose immediately determined by the hexokinase assay on Abbott Architect c16000 platform. The traceability of Abbott assay was checked by comparison with the hexokinase reference procedure performed on 3 samples. POCT performance was evaluated according to Cinical and Laboratory Standards Institute (CLSI) POCT12-A3 criteria [max. 5% of results &gt;&plusmn;12 mg/dL (for reference results &lt;100 mg/dL) or &gt;&plusmn;12.5% (for reference results &ge;100 mg/dL)] and consensus error grid (CEG) analysis. The Architect assay was perfectly standardized (mean bias, 0.2%). Sample glucose concentrations ranged from 62 to 326 mg/dL, with hematocrit spanning from 0.27 to 0.58 L/L. Average CV on duplicates was 3.5% for Roche, 3.6% for Nova and 5.9% for OK Biotech. All meters gave more than 5% of results (Roche 19.4%, Nova 16.1% and OK Biotech 22.6%) outside the CLSI criteria. However, all results, except two borderline values for OK Biotech, were within the low-risk zone according to CEG. In conclusion, by using CLSI acceptability criteria, the evaluated glucometers were not accurate enough for clinical use in a hospital setting. CEG analysis suggests, however, that this inaccuracy would not have any significant impact on patients&rsquo; outcome.</p>
Biochimica Clinica ; 41(1) 079-084
Contributi scientifici - Scientific papers
 
Verifica locale dei sistemi di prelievo nei laboratori clinici: adattamento delle linee guida EFLM
Blood collection systems in clinical laboratories: local adaptation of the EFLM guidelines
<p>The importance of the process of purchasing or changing blood collection devices is often overlooked. This is likely attributable to many factors such as the limited knowledge that policymakers, healthcare administrators and also laboratory managers have on the significance of preanalytical quality, but also to the lack of validated criteria for analyzing the quality of blood collection devices. Since a gap remains to be filled between companies&rsquo; and laboratory&rsquo;s validation, the EFLM Working Group on Preanalytical Phase (WG-PRE) has published a comprehensive document, which contains essential prerequisites and technical issues (e.g., physical imperfections, defects of functioning, safety deficiencies) to support local clinical laboratories for the development of tenders for blood tubes and for the validation of new materials ahead of local routine use. This consensus document is a national adaptation of these guidelines.</p>
Biochimica Clinica ; 40(4) 347-352
Documenti SIBioC - SIBioC Documents
 
Diminuzione del “turnaround time” intralaboratorio della troponina attraverso un processo di miglioramento organizzativo continuo
Decreasing troponin intralaboratory turnaround time through a process improvement study
Biochimica Clinica ; 40(1) 69-71
Lettere all'Editore - Letters to the Editor
 
Indicazioni per la quantificazione delle componenti monoclonali nel siero
Recommendations for the quantification of serum monoclonal components (MC)
<p>The quantification of MC&nbsp;provides a surrogate for monitoring the size of the population of malignant cells in patients affected by plasma cell&nbsp;disease (PCD). Consequently, clinical and laboratory guidelines on diagnosis, risk stratification and monitoring of PCD&nbsp;recommend MC quantification as a key information for patient management. To do that, liquid phase immunochemical&nbsp;determination of IgG, IgA and IgM in serum should not be used, because of the inability of the technique to distinguish&nbsp;between monoclonal and polyclonal immunoglobulins. However, new available immunoassays specifically measuring&nbsp;free light chains, or the &ldquo;so-called&rdquo; Hevylite assay, may reliably quantify specific MC. As a general recommendation, MC&nbsp;should be quantified on agarose gel electrophoresis by scanning densitometry or from capillary zone electrophoresis&nbsp;readout only, provided that a high resolution electrophoresis is performed and a low concentration MC obscured by other&nbsp;proteins is not present. For integration of the MC peak on electrophoresis, perpendicular drop method is recommended.&nbsp;MC is a critical &ldquo;analyte&rdquo; as the potential analytical pitfalls (detection limit depending on the position of the MC and on&nbsp;the polyclonal background, poor linearity of scanning methods, precision performance) show. Thus, a comprehensive&nbsp;program of IQC of MC quantification should be implemented as well as an EQAS.</p>
Biochimica Clinica ; 39(3) 199-207
Documenti SIBioC - SIBioC Documents
 
Determinazione della vitamina B12 nel siero: indicazioni per la richiesta e l’interpretazione dei risultati
Determination of vitamin B12 in serum: recommendations for test request and result interpretation
S. Ferraro  |  A. Dolci  |  R. Mozzi  |  M. Panteghini  | 
<p>The&nbsp;measurement of vitamin B<sub>12</sub> (B12) in serum has an overall poor capability to rule out subjects for B12 deficiency.&nbsp;Furthermore, trying to identify those subjects by resorting to one solely test threshold level (e.g., the lower reference&nbsp;limit) may mislead the clinical diagnosis. Clinical laboratories should therefore optimize the test interpretation by&nbsp;replacing in their report the standard reference interval with a categorization of risk for B12 deficiency. Accordingly, a&nbsp;B12 concentration &lt;100 ng/L may indicate a probable B12 deficiency and the need for vitamin supplementation. A&nbsp;possible or unlikely deficiency may be associated with marker results, respectively, below and above 300 ng/L.&nbsp;Finally, in subjects with B12 concentrations &gt;400 ng/L, the vitamin deficiency may be excluded. Hemodialysis patients&nbsp;and pregnant woman have emerged as a target for B12 testing, although cost-effectiveness evaluations are difficult&nbsp;to perform in absence of reliable literature data. Monitoring B12 concentrations in serum to evaluate the effectiveness&nbsp;of B12 supplementation is not clinically useful.</p>
Biochimica Clinica ; 38(4) 326-329
Documenti - Documents
 
Determinazione dell’omocisteina plasmatica: indicazioni per la richiesta
Determination of plasma homocysteine: recommendations for test requesting
D. Szőke  |  A. Dolci  |  U. Russo  |  M. Panteghini  | 
<p>High plasma homocysteine&nbsp;concentrations can be caused by various factors, including low blood concentrations of B-complex vitamins.&nbsp;Hyperhomocysteinemia is widely believed to be associated with an increased risk of atherosclerotic disease; recent&nbsp;emerging evidence made, however, doubtful its role as cardiovascular risk factor. The aim of this document was to&nbsp;examine the appropriateness of homocysteine requesting in our clinical setting. Clinical guidelines, meta-analyses&nbsp;and systematic reviews were used as source of high level evidence. During the last two decades, the role of&nbsp;hyperhomocysteinemia was examined in a number of clinical conditions; however, the analysis of available data&nbsp;made us clear that determination of plasma homocysteine has only limited clinical role. Test requesting results to be&nbsp;appropriate only in case of suspected homocystinuria (an inherited disorder of the metabolism of the amino acid&nbsp;methionine), in patients with previous venous or arterial thromboembolism and in patients with severe (&gt;100 &mu;mol/L)&nbsp;[and possibly moderate (&gt;30 &mu;mol/L)] hyperhomocysteinemia treated with B-complex vitamins. Determination of&nbsp;plasma homocysteine is not recommended as a primary prevention tool for cardiovascular disease in the general&nbsp;population.</p>
Biochimica Clinica ; 38(3) 234-237
Documenti - Documents
 
La misura delle proteine totali per la quantificazione del crioprecipitato è “evidence-based”?
Is the total protein measurement for cryocrit quantification evidence-based?
F. Braga  |  A.  Dolci  |  M. Panteghini  | 
Biochimica Clinica ; 38(1) 73
Lettere all'Editore - Letters to the Editor
 
Catene leggere libere delle immunoglobuline nel siero: un marcatore a metà del guado
Immunoglobulin free light chains in serum: a midstream biomarker
Biochimica Clinica ; 37(5) 344-346
Editoriale - Editorial
 
Valutazione delle prestazioni del sistema analitico SPAPLUS per la misura delle catene leggere libere del siero
Evaluation of the performance of SPAPLUS system for the measurement of free light chains in serum
<p>Measurements of serum immunoglobulin <span style="font-family:symbol">k</span> and <span style="font-family:symbol">l</span> free light chains (FLC) and FLC ratio calculation are recommended&nbsp;for the evaluation of plasma cell disorders. In this study we evaluated the performance of SPAPLUS analyzer using&nbsp;Freelite<span style="font-size:x-small"><sup>TM</sup></span> reagents (both from The Binding Site) for FLC determination. Particularly, we compared the system&nbsp;performance with allowable goals for bias, imprecision and total error derived from biological variation of FLC. We&nbsp;evaluated the SPAPLUS FLC using data collected during a 10-month period of routine use, employing three different&nbsp;reagent lots. The two-level (N and H) SPAPLUS control material was used for bias estimate by comparing the obtained&nbsp;long-term experimental means (n=54, both levels) to the corresponding manufacturer&rsquo;s assigned values. The protocol&nbsp;for CV evaluation employed the liquid-frozen Bio-Rad Liquichek unassayed chemistry control, measured in each&nbsp;performed run (n=48). Inaccuracy was checked by results from five UK-NEQAS exercises [system-specific (SPAPLUS)&nbsp;consensus value as reference]. Average cumulative bias was -1.5% (control N) and -1.4% (control H) for <span style="font-family:symbol">k</span> FLC, and&nbsp;+6.6% (N) and +6.3% (H) for <span style="font-family:symbol">l</span> FLC, respectively. Overall CV at physiological concentrations resulted in 10.6% for <span style="font-family:symbol">k</span> FLC, 8.0% for <span style="font-family:symbol">l</span> FLC and 9.9% for FLC ratio. On EQAS evaluation, all <span style="font-family:symbol">l</span> FLC, four <span style="font-family:symbol">k</span> FLC and three FLC ratio results&nbsp;were within the minimum allowable total error. Considering our previous experience with other analytical systems, the&nbsp;SPAPLUS solution undoubtedly represents a significant step forward. However, a further improvement in measurement&nbsp;imprecision is probably needed to fulfill the stringent analytical goals derived from FLC biological variation.</p>
Biochimica Clinica ; 37(5) 370-375
Contributi Scientifici - Scientific Papers
 
Variabilità biologica delle catene leggere libere delle immunoglobuline nel siero
Biologic variation of immunoglobulin free light chains in serum
<p>The measurement of serum <span style="font-family:symbol">k</span> and <span style="font-family:symbol">l</span> free light&nbsp;chains (FLC) and <span style="font-family:symbol">k</span>/<span style="font-family:symbol">l</span> FLC ratio calculation are recommended for screening, prognostic evaluation and monitoring of&nbsp;multiple myeloma and related plasma cell disorders. Given the lack of reliable data available in literature, in this study&nbsp;we assessed biologic variability components of FLCs and FLC ratio by an accurately designed protocol. We collected&nbsp;five blood specimens from each of 21 healthy volunteers (9 men and 12 women; age range, 23-54 years) on the same&nbsp;day, every two weeks for two months. Serum specimens were stored at -80 &deg;C until analysis and analyzed in a single&nbsp;run in duplicate using a SPAPLuS immunoturbidimetric platform and Freelite reagents (The Binding Site). Data were&nbsp;analyzed by ANOVA. Serum <span style="font-family:symbol">l</span> FLC concentrations were significantly (P &lt;0.01) higher in men. The inter-individual&nbsp;variance of <span style="font-family:symbol">l</span> FLC was higher than that of <span style="font-family:symbol">k</span> FLC. Within- and between-subject CVs were 8.1% and 14.1% for <span style="font-family:symbol">k</span> FLC,&nbsp;7.0% and 27.5% for <span style="font-family:symbol">l</span> FLC, and 4.5% and 15.3% for FLC ratio. All parameters had marked individuality showing that&nbsp;the use of population-based reference intervals could be inadequate for test interpretation. The reference change&nbsp;value was between 20% and 30% depending from the assay imprecision. Desirable analytical goals for imprecision&nbsp;(CV), bias and total error were &lt;4.0%, &plusmn;4.1% and &plusmn;10.7% for <span style="font-family:symbol">k</span> FLC, &lt;3.5%, &plusmn;7.1% and &plusmn;12.9% for <span style="font-family:symbol">l</span> FLC, and&nbsp;&lt;2.3%, &plusmn;4.0% and &plusmn;7.7% for FLC ratio.</p>
Biochimica Clinica ; 37(5) 376-382
Contributi Scientifici - Scientific Papers
 
Proposta di una “checklist” per il prelievo di sangue venoso
Proposal of a checklist for venous blood collection
<p>The collection of venous blood is central in clinical laboratory&nbsp;activity. Although there is widespread perception that this practice is simple and free of complications and side effects,&nbsp;it is undeniable that the vast majority of laboratory errors arises from ignorance, incompetence or negligence during&nbsp;venipuncture. It has hence become advisable to prepare a document in simplified form of checklist, consisting of a&nbsp;concise but comprehensive list of activities to be completed or verified in order to prevent errors during venous blood&nbsp;collection. In the intention of authors, this synthetic checklist is a modular tool, adaptable to different local contexts,&nbsp;it can be easily and gradually implemented, it is supported by scientific evidence and consensus of experts and&nbsp;created with the support of different healthcare professionals and it is adherent to the best practices and requires&nbsp;minimal resources for implementation. It is reasonable to assume that this checklist may be able to withstand system&nbsp;and individual changes, strengthening the standards for safety of both operators and patients, limiting potential failure&nbsp;patterns. We hope that the checklist may be implemented in all healthcare facilities where routine venous blood&nbsp;collection is performed, after adaptation to suit characteristics of local organization.</p>
Biochimica Clinica ; 37(4) 312-317
Documenti SIBioC - SIBioC Documents
 
Determinazione dell’epcidina: ma cosa stiamo “misurando”?
Quantification of hepcidin: what are we measuring?
Biochimica Clinica ; 37(2) 135-137
Lettere all'Editore - Letters to the Editor
 
Rilevazione, monitoraggio e trattamento di non conformità nella fase preanalitica: l’esperienza di un ospedale universitario metropolitano
Recording, monitoring, and managing pre-analytical issues in a metropolitan university hospital
<p>Errors in laboratory testing process may have an adverse impact on patient care. The pre-analytical phase is responsible for ~70% of these errors. In this study we present our experience in assessing the frequency of pre-analytical errors in our university hospital, by monitoring their trend over time and comparing data with goals suggested in literature. The impact of corrective actions, if any, was also checked. A comprehensive retrospective analysis of pre-analytical nonconformities (NC) recorded through laboratory information system over a 5-year (2007-2011) time span was undertaken. Retrieved data were evaluated on a yearly basis, first for NC type and then for type of sample, laboratory section and hospital department involved. The relatively most frequent NC was the test request without the corresponding sample, accounting on average for 2.3% of all requested tests. Hemolysis occurred for in average 1.15% of all requested tests, affecting ~20,000 determinations per year, mostly interesting clinical wards taking care of critical patients, i.e. neonatology, oncology, and emergency department. Clotted and not sufficient samples showed a significant reduction over time after changing the analytical system measuring erythrocyte sedimentation rate and adopting more reliable tubes, easier to fill in and mix up. NC related to samples conveyed at wrong temperature were also relatively frequent. Our results show that recording, monitoring, and critically evaluating pre-analytical issues in laboratory testing process is mandatory for providing a good laboratory service, permitting to identify causes of NC and to apply corrective interventions that may help to reduce their incidence.</p>
Biochimica Clinica ; 37(2) 095-099
Contributi scientifici - Scientific Papers
 
Saturazione della transferrina: c’era una volta il test
Transferrin saturation: once upon a time there was the test
D. Szoke  |  F. Braga  |  A.  Dolci  |  M. Panteghini  | 
<p>Despite the growing interest in hepcidin and other new biomarkers, guidelines and clinical pathways continue to recommend traditional markers, such as serum transferrin saturation (TS) and ferritin, as laboratory tests for the diagnostic evaluation of iron-related disorders. Here we aimed to critically evaluate the diagnostic role of TS relying on the highest level of available evidence by a comprehensive literature search. The role of TS in iron deficiency (ID) and iron overload (IO) syndrome as well as a risk marker was evaluated. The low accuracy of TS in the diagnosis and management of ID conditions does not permit recommending its use, even if recently published guidelines still consider the TS investigation as a complementary test for serum ferritin. If an IO is suspected, TS is often used even if it may not be the best test for detecting this condition. Nevertheless, clinical guidelines strongly recommend the use of TS as a first-level test for performing genetic&#160;diagnosis of hereditary hemochromatosis. Recent data indicating elevated TS as a risk factor for diabetes mellitus,cancer, and total mortality may provide useful additions to the debate over whether or not screen for IO using TS.</p>
Biochimica Clinica ; 36(5) 339-348
Rassegna - Reviews
 
Atlante ipertestuale dei sedimenti urinari
Hypertextual atlas of the urinary sediment
A.  Dolci  | 
Biochimica Clinica ; 36(3) 211
Recensioni -
 
Aspetti metodologici nella ricerca e caratterizzazione delle componenti monoclonali nel siero
Methodological issues in detection and typing of serum monoclonal components.
<p>Serum protein electrophoresis (SPE) is a screening test widely used in clinical practice to identify patients with monoclonal gammopathies. SPE, performed on agarose gel (AGE) or by capillary zone electrophoresis (CZE), is the only technique able to recognize a monoclonal immunoglobulin. To detect monoclonal components (MC), SPE must be visually inspected. The two available techniques show similar sensitivity for MC detection (CZE 95%, AGE 91%), with a higher specificity for AGE (99% vs. 78% for CZE). Any MC detected must be reported, because also small B-cell clones could be dangerous. Once detected, MCs need to be quantitatively measured directly on the SPE pattern by setting the limits of the corresponding peak. A concentration-related bias in MC quantitation between AGE and CZE exists. Immunotyping is the further mandatory test for confirmation and characterization of MC by either immunofixation (IFE) or immunosubtraction (ISE). In general, IFE is more sensitive than ISE, but high resolution (HRIFE) must be warranted. However, &#126;25% of IFE carried out on commercially available kits are difficult to interpret and thus not reportable. For identification of&#160; amyloidogenic light chain MC, sensitivity of the manual HR-IFE is 95% vs. 80% of conventional semiautomated assays. The recently introduced quantitative serum assay for immunoglobulin free light chains (FLC) is an accurate index of clonality, particularly for FLC myeloma and AL amyloidosis. To reach the highest sensitivity in MC detection a comprehensive screening panel including SPE, HR-IFE and FLC determination is recommended.</p>
Biochimica Clinica ; 36(2) 084-089
Rassegna - Reviews
 
Quando l’urina diventa rossa: un’inattesa macroematuria
If urines become red: an unexpected case of gross hematuria.
D. Szőke  |  C. Valente  |  F. Braga  |  A. Dolci  |  M. Panteghini  | 
<p>The physiological colour of urine is usually yellow. Urine discoloration is a common situation in clinical practice and a variety of colours may be seen. When a patient complains of green or blue urine, there is no confusion with a pathological origin. However, when the urine is red, the first thought is usually hematuria leading to anxiety for patient himself and for physicians too. We present a case of a 54 years old man presenting with asymptomatic apparent gross hematuria ruled out by chemical urinalysis and visual microscopic evaluation of the sediment showing neither hemoglobin nor red blood cells in his urine specimen. Possible causes of red urine not related to presence of blood are critically presented and discussed.</p>
Biochimica Clinica ; 36(2) 139-143
Casi Clinici - Case Report
 
Raccomandazioni di consenso SIBioC-SIMeL per la rilevazione e gestione dei campioni emolisati e utilizzo dell'indice di emolisi
SIBioC-SIMeL consensus recommendations for the identification and management of hemolysed specimens and the implementation of hemolysis index
<p><strong>SIBioC-SIMeL consensus recommendations for the identification and management of hemolysed specimens</strong><br /><strong>and the implementation of hemolysis index.</strong> The presence of hemolysis in a biological blood sample is mainly<br />caused by hemolytic anemia or hemolysis in vitro. The latter is caused by inappropriate collection and processing of biological samples, which may affect the reliability of test results. Hemolysis is assessed by free hemoglobin quantification, whose limit is 0.02 g/L in plasma and 0.05 g/L in serum, and visually observed when the concentration of free hemoglobin exceeds 0.30 g/L. Since hemolysis is the most frequent cause of unsuitable biological samples in clinical laboratories, with a prevalence approaching 3% of all received samples, these recommendations have been drafted specifically to assist laboratory professionals in detection and management of hemolysed specimens. In summary, the recommended approach is based on: (i) systematic detection and quantification of hemolysis, by visual inspection and subsequent quantification of the hemolysis index on all samples with visually detectable hemolysis; (ii) immediate notification to the referring department of the presence of hemolysis in the sample, as locally determined; (iii) suppression of all results affected by the presence and/or degree of hemolysis; and (iv) timely request of a second sample, on which the previously deleted tests can be performed.</p>
Biochimica Clinica ; 35(6) 481-490
DOCUMENTI SIBioC - DOCUMENTI SIBioC
 
Biomarcatori del carcinoma della prostata: la caccia è sempre aperta
Biomarkers for prostate cancer: the hunt is still open
Biochimica Clinica ; 35(5) 353
EDITORIALE - EDITORIALE
 
Impact of the implementation of highly sensitive cardiac troponin T assay in a university hospital setting
Impact of the implementation of highly sensitive cardiac troponin T assay in a university hospital setting
Biochimica Clinica ; 35(4) 301
CONTRIBUTI SCIENTIFICI - CONTRIBUTI SCIENTIFICI
 
Valutazione della sensibilità diagnostica per l'infarto miocardico senza sopraslivellamento del tratto ST (NSTEMI) di due metodi ad alta sensibilità per la troponina cardiaca
Evaluation of the sensitivity of two highly sensitive troponin assays for early detection of non ST-elevation myocardial infarction (NSTEMI).
Biochimica Clinica ; 35(3) 186
CONTRIBUTI SCIENTIFICI - CONTRIBUTI SCIENTIFICI
 
Crioglobuline: un esame da raccomandare "caldamente"
Cryoglobulins: a laboratory test "warmly" recommended
A. Dolci  | 
Biochimica Clinica ; 34(3) 169
EDITORIALE - EDITORIALE