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BC: Articoli scritti da A. Tripodi

Indagine sulla modalità di refertazione dell’esame D-dimero nei laboratori nazionali e indicazioni per una sua armonizzazione
A survey on D-dimer test reporting in Italian laboratories and some suggestions for its harmonization
G. Lippi  |  B. Morelli  |  A. Tripodi  | 
<p>D-dimer&nbsp;assessment represents a cornerstone in the diagnostic approach and therapeutic management of several thrombotic&nbsp;disorders, namely venous thromboembolism and disseminated intravascular coagulation. Nevertheless, this test is still&nbsp;plagued by an insufficient degree of analytical and post-analytical standardization. In particular, despite the existence&nbsp;of national guidelines, result reporting is quite heterogeneous. A specific on-line, 5-item questionnaire was&nbsp;disseminated to the SIBioC members to obtain a picture of the current national situation. As regards to the units, a&nbsp;modest prevalence (53%) of D-dimer unit (DDU) over fibrinogen equivalent unit (FEU) (47%) was found. The most&nbsp;widespread measurement unit was &ldquo;ng/mL&rdquo; (60%), followed by &ldquo;&mu;g/L&rdquo; (18%), &ldquo;mg/L&rdquo; (15%) and &ldquo;&mu;g/mL&rdquo; (6%). The vast&nbsp;majority of laboratories (90%) did not use an age-adjusted cut-off. The data distribution did not differ among different&nbsp;types of healthcare settings (i.e., general hospital, university hospital or private facilities). The use of at least 16 different&nbsp;unit approaches for D-dimer emerged from the survey is quite alarming and calls for a standardization, using a single&nbsp;result reporting as .</p>
Biochimica Clinica ; 39(6) 591-594
Contributi scientifici - Scientific Papers
 
Documento di consenso di “Academy of Emergency Medicine and Care”, Comitato Italiano per la Standardizzazione dei Metodi Ematologici e di Laboratorio, SIBioC - Medicina di Laboratorio e Società Italiana di Medicina di Laboratorio sull’utilizzo del dosaggi
Consensus document of Academy of Emergency Medicine and Care, Italian Committee for Standardization of Hematology and Laboratory Methods, SIBioC-Laboratory Medicine and Italian Society of Laboratory Medicine on D-dimer testing for suspected venous thrombo
G. Lippi  |  I. Casagranda  |  B. Morelli  |  S. Testa  |  A. Tripodi  | 
<p>The&nbsp;assessment of D-dimer represents the biochemical standard for diagnosing venous thromboembolism (VTE) and it&nbsp;is hence included in all diagnostic algorithms. Despite the unquestionable diagnostic value, there is broad evidence&nbsp;that the clinical usefulness of D-dimer may be biased by preanalytical, analytical and post-analytical issues. This is&nbsp;particularly true in emergency departments, where a large number of patients with suspected VTE is admitted, triaged&nbsp;and managed. Therefore, representatives of societies listed in the title have drafted this consensus document aimed&nbsp;to cover the most important critical areas in D-dimer testing, providing tentative recommendations to improve its&nbsp;clinical effectiveness for diagnosing VTE in the emergency department.</p>
Biochimica Clinica ; 38(2) 136-138
Documenti SIBioC - SIBioC Documents
 
Documento di consenso di Federazione dei Centri per la Diagnosi della Trombosi e la Sorveglianza delle Terapie Antitrombotiche (FCSA), Società Italiana di Medicina di Laboratorio (SIMeL), SIBioC e Comitato Italiano per la Standardizzazione dei Metodi Emat
Consensus document of Italian Federation of Thrombosis Services (FCSA), Italian Society of Laboratory Medicine (SIMeL), SIBioC e Italian Committee for Standardization of Laboratory Tests (CISMEL) on laboratory monitoring of the therapy with novel oral ant
G. Lippi  |  G. Di Iorio  |  S. Testa  |  C. Manotti  |  A. Tripodi  | 
<p>Oral anticoagulant therapy is used to prevent and&nbsp;treat thromboembolic disease. The new oral anticoagulants (NOAs) can be prescribed at fixed dosage without&nbsp;adjustment by laboratory testing. However, this does not necessarily mean that the laboratory does not play a role&nbsp;for their management. This position paper reports the consensus of Italian scientific societies dealing with laboratory&nbsp;issues in thrombosis and hemostasis. It is aimed at reviewing: a) which test(s) should be used to evaluate the&nbsp;anticoagulant effect of each of the NOAs presently available (i.e., dabigatran, rivaroxaban and apixaban), b) the&nbsp;patients to be investigated and c) the timing of investigation.</p>
Biochimica Clinica ; 37(4) 301-302
Documenti SIBioC - SIBioC Documents
 
Il D-dimero nella pratica di laboratorio
D-Dimer Testing in Laboratory Practice
A. Tripodi  | 
<p>D-Dimer is a reliable and sensitive index of fibrin deposition and stabilization. As such, its presence in plasma should be indicative of thrombus formation. There are many conditions unrelated to thrombosis in which D-dimer concentrations are high, however, making its positive predictive value rather poor. Notwithstanding these limitations, D-dimer can be regarded as a most valuable laboratory tool to diagnose and manage a vast array of thrombosisrelated clinical conditions, including (a) diagnosis of venous thromboembolism (VTE), (b) identification of individuals at increased risk of first thrombotic event (both arterial and venous), (c) identification of individuals at increased risk of recurrent VTE, (d) establishment of the optimal duration of secondary prophylaxis after a first episode of VTE, (e) pregnancy monitoring, and (f) diagnosis/monitoring of disseminated intravascular coagulation (DIC). This article is aimed at reviewing the merits and pitfalls of these applications. From my analysis of the literature, I draw the following conclusions: (a) D-dimer, as measured by a sensitive test, can be safely used to exclude VTE in symptomatic outpatients, provided that it is used in combination with the pretest clinical probability; (b) high concentrations of Ddimer are associated with an increased risk of recurrent VTE; (c) patients who present with D-dimer above cut-off after stopping the regular course of oral anticoagulation benefit from extended prophylaxis; (d) finally, D-dimer can be used as a fibrin-related degradation marker for the diagnosis/management of patients with DIC.</p>
Biochimica Clinica ; 36(3) 196-203
Il Meglio di Clinical Chemistry - Clinical Chemistry highlights