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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 F. Manoni

Esame fisico, chimico e morfologico delle urine: raccomandazioni per la fase postanalitica del Gruppo Interdisciplinare Laboratorio e Clinica Apparato Urinario (GIAU)
Physical, chemical and morphological urine examination: recommendations for the postanalytical phase from the Interdisciplinary Urinalysis Group (GIAU)
<p>This document of the Interdisciplinary Urinalysis Group (GIAU) is aimed to provide recommendations on how to improve and standardize the postanalytical approach to physical, chemical and morphological urine examination (ECMU). The main tool to emphasize the value of the ECMU is the development of a laboratory report suitable for the clinical needs. As a consequence, these recommendations are mainly related to the structure and content of the report. They include: the layout, the parameters to be included, the measurement units, the reference values, the inclusion of interpretative comments. Really, an important section of the report is dedicated to the interpretative comments: these are a real add-on value and are tailored on the type of laboratory performing the analysis (general or with a specific section dedicated to the urine examination). The different levels of the laboratory competence determine the category of possible comments. The basic one concerns comments that evaluate the non-conformity of the sample (i.e. presence of urethral, seminal, vaginal, faecal contamination; too concentrated/too diluted samples). The second level of comments is dedicated mainly to the reporting of the discrepancies between the biochemical analysis and the microscopy examination (i.e. presence of haemoglobin and no erythrocyte detection; presence of leucocyte esterase and no leucocyte detection). The third level requires a specific competence of the pathologist together with a strict collaboration with the clinic; these comments are elaborated on the basis of a specific clinical request. The detection of the &ldquo;decoy cells&rdquo; in immunosuppressed solid organ transplant recipients, that are typical of a poliomavirus infection, is a good example of the third level of interpretative comments. A final section of the document is dedicated to the opportunity to implement and adopt specific programs of external evaluation of the urinary sediment.<br />After the issuing of the recommendations dedicated to pre-analytical and analytical phases, this GIAU document gives suggestions for the standardisation and harmonisation of post-analytical phase in the attempt to emphasize the diagnostic importance of ECMU.</p>
Biochimica Clinica ; 44(1) 086-099
Documenti SIBioC - SIBioC Documents
 
Esame fisico, chimico e morfologico delle urine: proposta di linee guida per la fase analitica del Gruppo Intersocietario Analisi delle Urine (GIAU)
Physical, chemical and morphological urine examination: proposed guidelines for the analytical phase by the Intersociety Urinalysis Group
<p>With these guidelines, the Intersociety Urinalysis Group (GIAU) aims to stimulate the following aspects: a) improvement and standardization of the analytical approach to physical, chemical and morphological urine examination (ECMU); b) to emphasize the value added to ECMU by automated analyzers for the study of the morphology of the corpuscular fraction urine; c) improvement of the chemical analysis of urine with particular regard to the reconsideration of the diagnostic significance of parameters that are traditionally evaluated in dipstick analysis, together with an increasing awareness of the limits of sensitivity and specificity of this analytical method; d) to increase the awareness of the importance of professional skills in the field of urinary morphology and of the relationships with clinicians; e) implementation of a policy for the evaluation of the analytical quality by using, in addition to traditional IQC and EQA, a program for the evaluation of morphological competence; f) to stimulate the diagnostic industry to focus research efforts and development methodology and instrumental catering to the needs of clinical diagnosis. The hope is to revalue the enormous diagnostic potential of ECMU, by implementing an urinalysis based on personalized diagnostic needs.</p>
Biochimica Clinica ; 40(4) 353-382
Documenti SIBioC - SIBioC Documents
 
Discordance between phenotype and genotype study in Factor V Leiden carriers: a real life experience
<p>Factor V Leiden (FVL) mutation causes activated protein C (APC) resistance by decreasing the susceptibility of FVa&nbsp;to APC-mediated inactivation. In our Laboratory, the usual approach to the identification of FV deficit includes a&nbsp;combination of genetic and functional tests. The aim of this paper was to highlight the importance to investigate both&nbsp;the genotype and the phenotype in the diagnosis of FVL-APC resistance related thrombophilia. Among a group of&nbsp;292 subjects examined for thrombophilia, we observed three patients with discordant results of genetic test for the&nbsp;detection of G1691A FV gene mutation and functional APCr assay: the first subject has a mild APC resistance with&nbsp;a wild type genotype; the second one, and her sister, shows a severe APC resistance with a heterozygous genotype.&nbsp;To determine the FV deficit, it is important to associate the molecular analysis of G1691A mutation with the APC&nbsp;resistance test.</p>
Biochimica Clinica ; 40(3) e22-e26
Casi clinici - Case report
 
Flow citometry for screening acute urinary tract infections and differentiation between Gram positive and Gram negative bacteria
<p>Urine culture is the most frequent test in microbiology laboratories. A screening tool, providing fast and reliable results&nbsp;to rule-out urinary tract infection (UTI), would be of great importance. We studied 1043 consecutive urine samples by&nbsp;Sysmex UF-1000i analyzer. Comparison was made by robotic urine culture on chromogenic agar with 1 &mu;L loop,&nbsp;using 10<sup>5</sup> CFU/mL as a limit of positive growth. We evaluated bacteria quantification for rapid exclusion of UTI and&nbsp;bacteria forward scatter (B_FSC) in preliminary discrimination of UTI caused by Gram positive or Gram negative&nbsp;bacteria. For exclusion of UTI, the best cut-off value was 130 bacteria/&mu;L. At this threshold, the sensitivity (SE) was&nbsp;0.98 and the specificity (SP) 0.75. For exclusion of UTI sustained by Gram positive bacteria, the best cut-off value for&nbsp;B_FSC was 25ch. At this threshold, SE was 0.68 and SP was 0.89.</p>
Biochimica Clinica ; 38(6) 625-629
Contributi scientifici - Scientific Papers
 
Comparison of Sysmex UF-100 and UF-1000i with urine culture for the diagnosis of urinary tract infections
<p>Urinary tract infections (UTI) are a common clinical condition. The gold standard for diagnosis is still the bacterial culture, even though a large proportion of evaluated samples are negative. Unnecessary cultures can be reduced by an effective screening test. The aim of this study was to compare two cytometers for rapid diagnosis of UTI. Using 209 urine samples submitted to our laboratory for microbiological examination, we evaluated the analytical performance of the new urine cytometer UF-1000i in comparison with the previous generation analyzer UF-100 (both from Sysmex). We compared bacteria (BACT) and leukocyte (WBC) counts performed by UF-1000i and UF-100 with colony-forming units (CFU) quantification on citrate lactose electrolytes deficient (CLED) agar to assess the best cutoff values. Moreover, a correlation between BACT and WBC quantification performed by the two instruments was carried out. In comparison with 1x108 CFU/L, cut-off values of 1.25x108 BACT/L and 4x107 WBC/L by using UF-1000i, and 3x109 BACT/L and 3.5x107 WBC/L by using UF-100 were obtained, respectively. While WBC quantification by UF-1000i and UF-100 showed a strong correlation (r=0.98), BACT quantification displayed a poor correlation (r=0.59).&#65279;</p>
Biochimica Clinica ; 36(2) 107-111
Contributi Scientifici - Scientific Papers
 
Field evaluation of the GeneXpert system for detection of thrombophilia associated mutations: a six-month experience in a small laboratory
<p>Factor V Leiden G1691A mutation (FVL) and prothrombin G20210A mutation (GPro) are the most common inherited mutations associated with thrombophilia. GeneXpert HemosIL Factor II and Factor V assay is a fully automated assay that is able, in less than 35 min, to allow simultaneous detection of FVL and GPro. Test format, based upon single test cartridge, was designed to minimize waste and to permit daily analytical sessions. In this study we evaluated the performance of GeneXpert system in detection of FVL and GPro mutations. 211 consecutive patients, enrolled from March to August 2011, were studied. All samples were evaluated by using the GeneXpert system in comparison with Roche Light Cycler assay. By using both assays, 51 FVL heterozygous, 3 FVL homozygous, 1 GPro homozygous, 10 GPro heterozygous, 5 combined FVL-GPro heterozygous and 141 normal subjects were identified, with a 100% concordance between the two assays. During six months we observed 15 invalid sample results using GeneXpert (7.1%) that were retested after dilution. Consequently, the tests/results ratio was 1.07. In our experience, the assay was therefore affordable and characterized by a good rate between number of carried out tests and released results.</p>
Biochimica Clinica ; 36(1) 20-24
Contributi Scientifici - Scientific Papers
 
L'esame chimico, morfologico e colturale delle urine: proposta di linea guida peruna procedura standardizzata della fase preanalitica
Chemical, morphological, and microbiological urine examination: a proposal of guidelines for standardization of preanalytical phase.
Biochimica Clinica ; 35(2) 131
DOCUMENTI SIBioC - SIBioC Documents
 
Questionario conoscitivo sull'Esame Chimico Morfologico delle Urine in Italia a cura del Gruppo Interdisciplinare Laboratorio e Clinica dell’Apparato Urinario
Results of the survey on chemical and morphological examination of urine in Italy issued by the Italian Interdisciplinary Urinalysis Group
R. Ravasio  |  MA. Burgio  |  F. Balboni  |  F. Manoni  | 
<p>Introduction: the Italian Interdisciplinary Urinalysis Group (GIAU) is a study group aimed to harmonize the standard chemical and morphological urine examination in Italy. The aim of this paper is to present the results of a survey recently released. The survey has been prepared to evaluate the state of the art of the routine standard urine examination in Italy after the issuing by GIAU of the recommendations related to the pre-analytical, analytical and post-analytical phases of the Urine Chemical Morphological Examination (ECMU).<br />Methods: the questionnaire (47 questions) was made available through the web-based Survey Monkey platform to the members of the two Italian Laboratory Medicine scientific societies (SIBioC and SIPMel).<br />Results: 553 replies were collected. Regarding the pre-analytical phase, the most critical issue is the use of a monitored (time and temperature) sample transportation to the clinical laboratory only by a small percentage of the laboratories (30%). More than 80% of the laboratories recommends the collection of the mid-stream urine. Regarding the analytical phase, the majority of the participants utilizes dedicated automated analyzers for urine sediment. Only 15.5% of the participants includes the albumin to creatinine ratio in the standard urine examination.<br />Discussion: the results of the survey give a picture of the state of art of the standard urine examination in Italy. From the comparison with the GIAU previous surveys, it can be concluded that the urinalysis practice in Italy is nowadays more compliant to the indications of the available recommendations and that a general improvement of this laboratory test is observed. Some unsatisfactory answers have been collected for a number of issues, so the role of the GIAU is and will remain fundamental to guide all the laboratory professionals who operate in this laboratory medicine field, towards further advancements.</p>
Biochimica Clinica ; 17(1)
Contributi Scientifici - Scientific Papers