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Maria Stella Graziani

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Giampaolo Merlini
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Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

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Giuseppe Agosta

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Arianna Lucini Paioni
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email: biochimica.clinica@sibioc.it



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BC: Articoli scritti da G. Passerini

La diagnosi di liquorrea nasale e post-chirurgica
Diagnosis of cerebrospinal fluid (CSF) rhinorrhoea and of post-surgical CSF leakage
<p>Pathological CSF leakage&nbsp;outside central nervous system is a very dangerous situation with high risk of meningitis and cerebral abscess.&nbsp;Rhinorrhoea and post-surgical CSF leakage are the most frequent conditions. Diagnosis is made by combination of&nbsp;imaging procedures, radionucleide cisternography via lumbar puncture (fluorescein) and biochemical tests, which utilize&nbsp;markers suggesting the presence of CSF in suspected fluid. Low CSF glucose concentrations suggest rhinorrhoea, as&nbsp;glucose is absent in nose secretion, but cannot be used in post-surgical leakage, as blood is nearly almost present. CSF&nbsp;proteins are the best biomarkers and intrathecal synthesized <span style="font-family:symbol">b</span>-trace protein and transferrin are the best choice. For&nbsp;quantitative analysis, nephelometric <span style="font-family:symbol">b</span>-trace protein measurement has the best performance, as it can be easily&nbsp;automatically performed, also for stat analysis, but relatively high volume of sample is needed. Isoelectricfocusing or high&nbsp;resolution electrophoresis followed by immunodetection are the most sensitive and specific methods for detecting&nbsp;asialotransferrin, but they are time consuming, unsuitable for stat analysis, even if they need low amounts of sample.&nbsp;Other quantitative tests include prealbumin/albumin ratio, having insufficient sensitivity in blood contaminated samples,&nbsp;and zone electrophoresis of protein pattern that, however, has too low sensitivity. New methods like capillary&nbsp;electrophoresis have been recently proposed.</p>
Biochimica Clinica ; 38(3) 183-190
Rassegne - Reviews
 
L’analisi del liquido cefalorachidiano
Cerebrospinal fluid (CSF) analysis
<p>The laboratory investigation of CSF has been developed over the years as a&nbsp;diagnostic tool for many neurological diseases. Although minimally invasive, CSF is obtained with a traumatic&nbsp;procedure; therefore, the whole laboratory process should be established to maximize the analytical performance.&nbsp;Based on the review of international guidelines and on the experience developed by members of the SIBioC Working&nbsp;Group, the present document provides practical information for laboratory professionals to better address the CSF&nbsp;analysis in different diagnostic situations. The report faces the pathophysiologic meaning of the determination of&nbsp;biochemical parameters, such as glucose, lactate, albumin, immunoglobulins, <span style="font-family:symbol">b</span>-amyloid, tau protein, and the cellular&nbsp;content, providing also evidence on the proper methodological approach. Quantitative and qualitative CSF parameters&nbsp;useful to diagnose an inflammatory process of the central nervous system are discussed, particularly with reference to&nbsp;multiple sclerosis. Indications on how laboratory data should be presented to meet international recommendations are&nbsp;also included.</p>
Biochimica Clinica ; 38(3) 238-254
Documenti - Documents
 
Rispondono gli Autori dell’articolo in questione
In reply
Biochimica Clinica ; 38(1) 74
Lettere all'Editore - Letters to the Editor