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BC: Articoli scritti da S. Valverde

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
Effect of dabigatran and rivaroxaban treatment on a prothrombinase-based assay for assessment of activated C protein resistance
G. Gessoni  |  S. Valverde  |  R. Valle  | 
<p>We present a report about the interference due to factor IIa and factor Xa direct oral inhibitors on activated C protein&nbsp;resistance ratio (APCr), evaluated with a prothrombinase-based assay, in a patient heterozygous for factor V Leiden&nbsp;treated first with dabigatran and then with rivaroxaban. In this patient dabigatran increased the APCr ratio to a degree compatible with values observed in homozygous wild-type carriers, thus causing a potential misdiagnosis. We also&nbsp;found that rivaroxaban therapy was effective in lowering the APCr ratio.</p>
Biochimica Clinica ; 39(1) 073-075
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
Idiopatic acquired hemophilia A in two women in Chioggia
<p>Acquired hemophilia A (AHA) is a rare, but often life-threatening hemorrhagic disorder characterized by antibodies&nbsp;directed against coagulation factor VIII. We report clinical and laboratory investigations of two cases with AHA&nbsp;observed in our hospital. These patients were two elderly women (73 and 62 years old), who presented with&nbsp;subcutaneous bleeding, intramuscular hematoma and a prolonged activated partial thromboplastin time (aPTT). On&nbsp;the basis of these findings as well as decreased factor VIII activities and the presence of factor VIII inhibitors, we&nbsp;made a diagnosis of AHA. Both patients were referred to a specialized hospital for treatment. The diagnosis of AHA&nbsp;should be considered in any elderly patient who presents with bleeding and prolonged aPTT. Moreover, the&nbsp;coexistence of a series of underlying diseases associated with AHA should be always searched for.</p>
Biochimica Clinica ; 37(6) 500-503
Casi clinici - Case report
Increasing efficiency and quality by automation and consolidation of tests: the experience of a hospital-based laboratory
S. Valverde  |  L. Penzo  |  G. Gessoni  | 
<p>In this study we evaluated efficiency and quality in our laboratory after the implementation of total laboratory automation for clinical chemistry and immunochemistry assays. Thermo EnGen pre-analytical automation with a track system connecting two Vitros Fusion 5.1 and two Tosoh AIA-2000 analyzers were implemented. For Vitros Fusion 5.1, CVs were &lt;8% (within-run) and &lt;10% (inter-assay), except for measurement of anti-streptolysin O titre (CV 22.7%-27.7%). For Tosoh AIA-2000 analyzers, within-run CVs were &lt;10% and between-run CVs &lt;11%. No drift effects were observed, neither there was any carry-over. When evaluating the functionality of the whole automation system, we observed a turnaround time (TAT) 90% &lt;10 min for tubes needing check-in and exit only. For tubes needing check-in and centrifugation &ndash; exit cycle, TAT 90% was &lt;30 min. Result availability for clinical chemistry and/or immunochemistry on-line analyzers showed a TAT 90% &lt;120 min. The adopted automation system effectively reduced the labor associated with specimen processing, possibly decreasing the number of laboratory errors that occur with specimen sorting, labeling and aliquoting, and improved the integrity of specimen handling throughout steps of specimen processing.</p>
Biochimica Clinica ; 37(1) 23-29
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