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BC: Articoli scritti da A. Papa

I commenti interpretativi nel referto ematologico di laboratorio
Interpretative comments in the laboratory hematology report
<p>Interpretative comments in the laboratory reports&nbsp;can improve the quality of diagnostic information. The complete blood count with differential (CBC-diff) is one of the&nbsp;hematology laboratory tests with demonstrated clinical usefulness. CBC-diff may include a peripheral blood smear if&nbsp;numerical or morphological review criteria are fulfilled. As such, hematologists need specific skill for interpreting and&nbsp;conveying the diagnostic information to clinicians by using adequate communication approaches. A survey carried&nbsp;out by the SIBioC Diagnostic Hematology Study Group (GdS-DE) showed a heterogeneous situation about the use&nbsp;of the hematological interpretative comments. In each laboratory, different descriptions were used even for the same&nbsp;cell abnormalities. Moreover, some laboratories omit to report relevant morphological abnormalities, such as&nbsp;activated or atypical lymphocytes as well as immature granulocytes, which are often necessary for the diagnosis.&nbsp;Therefore, the GdS-DE has decided to select appropriate comments and to propose a standardized reporting system.&nbsp;First, 423 comments from 13 laboratories were analyzed. These comments were revised with the purpose of: a)&nbsp;reducing the number, b) standardizing the language, c) providing an information in a format that could be easily&nbsp;understood by patients and clinicians, and d) increasing the quality of clinical information. The GdS-DE decided to&nbsp;provide written information for both physicians and patients or for physician&rsquo;s use only. The former is represented by&nbsp;59 comments using a simple and not frightening language, whereas the latter is a letter for the physician in which&nbsp;more specific information is provided.</p>
Biochimica Clinica ; 40(3) 255-269
Documenti SIBioC - SIBioC Documents
 
Valore predittivo della determinazione di neutrofili e granulociti immaturi nel sangue periferico per il rischio di mortalità in soggetti con patologie cardiopolmonari
Predictive value of the neutrophil and immature granulocyte blood counts for the mortality risk in subjects with cardiopulmonary disease
A. Papa  |  C. Bauleo  |  M. Fornaro  |  F. Cocci  | 
<p>&nbsp;An increase in the peripheral blood of immature granulocytes (IG) provides&nbsp;information on enhanced bone marrow activity and has been shown to be useful as predictor of infection and sepsis&nbsp;both in adults and pediatric subjects. The association between an elevated neutrophil count (NEU) and risk for cardiac&nbsp;and overall mortality has yet been proven, but in hospitalized adult patients the contribution of IG to prediction of&nbsp;death remains to be clarified. The aim of this study was to retrospectively evaluate the admission complete blood&nbsp;count and white blood cell differential generated with a Cell-Dyn Sapphire analyzer (Abbott Diagnostics) from 139&nbsp;patients affected by cardiac and/or pulmonary disease. Patients were divided into 3 groups: group A (controls)&nbsp;consisted of 40 patients with NEU and IG within reference limits; group B included 47 subjects with an increased&nbsp;NEU, but physiological values of IG; group C was formed of 52 patients with neutrophilia combined with elevated IG.&nbsp;The median neutrophil count and IG of group C were 16.56x10<sup>9</sup>/L [interquartile range (IQR): 11.01-21.87] and 6.2%&nbsp;(IQR: 4.2-9.9), respectively. At multivariate analysis, IG emerged as the best predictor of 24-month mortality (hazard&nbsp;ratio, 2.62; P=0.006). Kaplan-Meier analysis showed a significant worsening in the survival of patients with presence&nbsp;of IG during hospitalization (87.2%, 71.2% and 41.9% for A, B and C group, respectively). Elevated NEU and IG&nbsp;predict future adverse events in cardiopulmonary patients and might be included in a risk prediction algorithm.</p>
Biochimica Clinica ; 40(3) 225-228
Contributi scientifici - Scientific Papers
 
Valutazione multicentrica dei conteggi cellulari ottenuti con 8 analizzatori ematologici automatici
Multicenter evaluation of blood cell counts on 8 automated hematology analyzers
<p>The cellular analysis&nbsp;performed on hematology analyzers is based on the interaction of cells with electrical or optical signals. The&nbsp;heterogeneity of adopted methods and technologies by different analyzers can translate in a lack of homogeneity in&nbsp;analytical performance. This study compares 8 hematological analyzers vs. optical microscopy (OM) and, where&nbsp;possible, also compares the analyzers among each other. Correlations were assessed by Pearson&#39;s coefficient of&nbsp;correlation, Passing and Bablock regression and Bland-Altman bias plot analysis. The comparison among analyzers&nbsp;regarding leukocyte differential counts showed a good level of agreement, except for the basophil cell count. For this&nbsp;&ldquo;critical population&rdquo;, the bias ranged from -5,8% (Cell-Dyn Sapphire vs. XN-9000) to 30,6% (Advia 2120i vs. XE-2100). The comparison between automated differential leukocyte counts and OM showed also a good level of&nbsp;agreement, with a bias ranging from -0,9% to 8.9%. The bias for basophil cell count was however very high (79.5%).</p>
Biochimica Clinica ; 40(3) 195-203
Contributi scientifici - Scientific Papers
 
Armonizzazione del referto ematologico con l’impego di unità di misura conformi al Sistema Internazionale
Harmonization of the hematology test report by using units according to the International System (SI)
<p>The&nbsp;need for harmonizing hematology reporting units remains an important challenge for the clinical laboratory community.&nbsp;In 2014, the SIBioC Diagnostic Hematology Study Group (GdS-DE) carried out a survey to assess the state-of-the-art&nbsp;of the Italian hematology laboratories. The survey showed that the majority of laboratories report results using units of&nbsp;measurement that do not conform to SI. In some European countries, initiatives to harmonize hematology reporting&nbsp;units were taken some years ago. In particular, in the UK for the reporting of laboratory hematology results the SI units&nbsp;have been used since April 2013 (this includes hemoglobin and mean corpuscular hemoglobin concentrations in g/L).&nbsp;The aim of this GdS-DE proposal is to advocate a national initiative for promoting the adoption of SI units for&nbsp;hematology reporting. This will optimise the comparability of results among different laboratories and prevent the&nbsp;misinterpretation of data, which may worsen the patient&#39;s outcome.</p>
Biochimica Clinica ; 39(6) 627-630
Opinioni - Opinions
 
Stato dell’arte della diagnostica ematologica nei servizi di Medicina di Laboratorio in Italia
State of the art of diagnostic hematology in clinical laboratories in Italy
<p>One of the challenges for laboratories&nbsp;performing diagnostic hematology is the harmonization of diagnostic process. This is a consequence of the rapid&nbsp;technological advancement that has characterized the recent development of automated blood cell counters, with&nbsp;new automation models and new types of parameters provided. In this context, the SIBioC Study Group of Diagnostic&nbsp;Hematology has conducted a survey among Italian laboratories. The aim was to focus on the different ways of&nbsp;organizing the service. The questionnaire consisted of 36 questions, made available on the SIBioC website for&nbsp;members and non members of the society. Responses were received via e-mail, regular mail or fax from 78&nbsp;laboratories. The survey showed differences among laboratories with regard to the organizational models adopted,&nbsp;degree of automation and completeness of final laboratory reports. However, a relative homogeneity in the validation<br />rules, review rate, turnaround time and amount and type of available resources was observed. An unexpected finding&nbsp;was the low relevance that the majority of laboratories gave to the occurrence of atypical lymphocytes, thus not&nbsp;reporting the presence of these cells in interpretative comments.</p>
Biochimica Clinica ; 39(1) 025-040
Contributi scientifici - Scientific Papers