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BC: Articoli scritti da D. Szőke

Determinazione della concentrazione dell’inibitore C1 esterasi nel siero: un invito alla standardizzazione
Determination of C1-esterase inhibitor concentration in serum: a call for standardization
Biochimica Clinica ; 42(1) 79-81
Lettere all'Editore - Letters to the Editor
Valutazione dell’imprecisione dell’esame emocromocitometrico eseguito con analizzatore Sysmex XN-9000
Evaluation of imprecision of automated complete blood cell count performed on Sysmex XN-9000 platform
Biochimica Clinica ; 40(3) 282-284
Lettere all'Editore - Letters to the Editor
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
Impiego dell’indice itterico come esame di primo livello per l’identificazione dei campioni con concentrazioni anormali di bilirubinemia
Suitability of icteric index (II) as front-line test for the identification of blood samples with abnormal total bilirubin (TB) concentrations
<p>The use of II as a front-line test for the preliminary identification of blood samples with&nbsp;abnormal TB concentrations was recently proposed. However, laboratories should validate this approach on their own&nbsp;analyzers. In this study we validated the diagnostic accuracy of II on the Abbott Architect c16000 platform. TB&nbsp;concentrations (diazo-based colorimetric assay) and corresponding II values (derived from absorbance&nbsp;measurements of samples diluted with saline) in heparinised plasma and serum samples were collected for a 3-&nbsp;month period. Linear regression analysis (LRA) (II vs. TB) was performed for both samples. The diagnostic&nbsp;performance of II to discriminate between abnormal (&gt;1.2 mg/dL) and physiological TB concentrations was evaluated&nbsp;using the ROC curve analysis. The optimal II cut-off was selected at a negative predictive value (NPV) &gt;99% for&nbsp;detection of abnormal TB values. TB and relative II were obtained from 18,486 serum and 3700 plasma samples.&nbsp;LRA showed a strong correlation between II and TB (serum: <em>r</em><sup>2</sup>=0.951; plasma: <em>r</em><sup>2</sup>=0.941). ROC curve analysis gave&nbsp;the following areas under the curve: serum, 0.948 (CI: 0.945-0.951), and plasma, 0.922 (CI: 0.913-0.930), showing&nbsp;the high accuracy of II for detecting abnormal TB on both sample types. An II &le;0.8 reliably excluded abnormal (&gt;1.2&nbsp;mg/dL) TB concentrations (serum, prevalence 25.4%: sensitivity 99.6%, NPV 99.7%; plasma, prevalence 16.7%:&nbsp;sensitivity 98.6%, NPV 99.4%). In our laboratory the use of an II value 0.8 as front-line test should allow the accurate&nbsp;&ldquo;zero-cost&rdquo; detection of samples with normal TB concentrations avoiding TB measurement in ~35% of serum and&nbsp;<span style="font-family:symbol">~</span>40% of plasma samples.</p>
Biochimica Clinica ; 39(4) 270-274
Contributi scientifici - Scientific Papers
Inibizione della glicolisi e accuratezza preanalitica nella misura della glicemia: come gestire l’impatto sul paziente?
Glycolysis inhibition and reliable plasma glucose results: is the clinical impact carefully considered?
Biochimica Clinica ; 39(1) 076-077
Lettere all'Editore - Letters to the Editor
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
Riferibilità metrologica e standardizzazione: report dal 7th CIRME International Scientific Meeting
Metrological traceability and standardization: report from the 7th CIRME International Scientific Meeting
D. Szőke  | 
Biochimica Clinica ; 37(6) 512-515
Notizie SIBioC - SIBioC News
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
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