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Editor-in-chief
Maria Stella Graziani

Deputy Director
Martina Zaninotto

Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

EIC Assistant
Francesco Busardò

International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada


Publisher
Biomedia srl
Via L. Temolo 4, 20126 Milano

Responsible Editor
Giuseppe Agosta

Editorial Secretary
Chiara Riva
Biomedia srl
Via L. Temolo 4, 20126 Milano
Tel. 0245498282
email: biochimica.clinica@sibioc.it

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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091



BC: Articoli scritti da C. Bellini

Interpretazione degli esami relativi all’emostasi in corso di gravidanza
Interpretation of hemostasis tests during physiological pregnancy
<p>Pregnancy is associated with significant modifications of the hemostatic system (endothelium, platelets, coagulation and fibrinolysis) resulting in a prothrombotic state. This is mainly due to an increase in the activity of some procoagulant factors and to the decrease of some physiological inhibitors. The plasma concentrations of these hemostatic system components therefore show important modifications during the three trimesters of pregnancy; as a consequence, the clinical laboratory should report specific reference intervals for the three trimesters of pregnancy or at least add a comment to the laboratory report. The screening tests (although very differently) are also influenced by this hypercoagulability condition and therefore also for PT, APTT, fibrinogen, antithrombin and D-dimer, different reference intervals for the three trimesters of pregnancy should be considered. Global tests have been used (viscoelastometric techniques and thrombin generation test) for monitoring the hemostatic imbalance that occurs during pregnancy; these techniques are very promising but, except for the use of viscoelastometry in monitoring post-partum hemorrhagic risk, they are still far from clinical practice.</p>
Biochimica Clinica ; 46(3) S055-S068
Rassegne - Reviews
 
Errori di identificazione del paziente: un progetto SIBioC orientato alla gestione di un problema persistente
Wrong blood in tube: a SIBioC project for a persistent problem
A. Aita  |  A. Padoan  |  R. Guerranti  |  M. Fiorini  |  C. Bellini  |  F. Tosato  |  M. Pelloso  |  E. Piva  |  R. Pajola  |  M. Lorubbio  |  B. Cremonesi  |  A. Bassi  |  R. Rolla  |  G. Introcaso  |  M. Plebani  |  S. Buoro  |  F. Balboni  | 
<p>Introduction: recently, multi-analytes delta-check (MDC) has been proposed as a more effective tool in identification errors (IE) prevention. In this context, &ldquo;Haematology&rdquo; and &ldquo;Clinical Risk&rdquo; SIBioC working groups launched a project aiming to develop a cell blood count (CBC) MDC. This work is aimed to describe the project and some preliminary results.<br />Methods: the project consists of four phases: collection of CBC results from 15 Italian laboratories to create an original dataset (OD); pilot study on a smaller dataset (SD) i.e., creation of an artificial mix-up dataset-MD containing IE by casual resampling of the SD and identification of the best statistical model to create a MDC; identification of the most accurate MDC on OD; testing the MDC in involved labs and verification of its effectiveness.<br />Results: the SD included 2,367 pair of consecutive results for the same patient (patients&rsquo; age: 0-100 years; the majority of repetitions were within days). The SD casual resampling generated a MD with 2,000 pair of patient-mixed consecutive results. When one of the most frequent used delta-check alert (&Delta;MCV=7fL) was applied to detect IE in MD, the method accuracy was low (AUC=0.542). On the contrary, testing of a multivariate model, obtained by a stepwise logistic analysis, allowed to obtain a more accurate MDC in IE detection (AUC=0.931, sensitivity=91.6%, specificity=94%).<br />Conclusions: MDC may offer a practical strategy to identify IE prior to test reporting, improving patient safety. However a good planning of project workflow, selection of methodology, tools and staff competence are key elements to reach the objectives.</p>
Biochimica Clinica ; 46(1) 051-057
Contributi Scientifici - Scientific Papers
 
Comunicare nell’infosfera: sfide e opportunità per la Medicina di Laboratorio
Communicating in the infosphere: challenges and opportunities for Laboratory Medicine
<p>Communication is becoming more important than ever for health care and health care professionals, as the recent COVID-19 pandemic has dramatically highlighted. The fast evolution of the mass and social media and the continuous development of new health-related platforms and applications are imposing new challenges that involve also laboratory medicine and that need to be carefully considered. In fact, these novel, fast and effective strategies of communication are inherently prone to the risk of publishing misleading, incorrect or fake information which can spread uncontrollably and diffuse all over the world in a very short time. However, social media are undoubtedly a great opportunity to communicate, in a responsible and credible way, health-related data and scientific updates and discoveries. As for the therapeutic alliance, it is now required to establish an &ldquo;information alliance&rdquo; between different healthcare professionals which, based on a trustworthy relationship, will allow the correct diffusion of health-related information and will contribute to citizens&rsquo; education.</p>
Biochimica Clinica ; 45(3) 290-298
Opinioni - Opinions
 
Il “Libro Bianco” dei Giovani Professionisti di Medicina di Laboratorio in Italia: risultati dell’indagine del Gruppo di Studio SIBioC Young Scientists
The "white paper" of young Laboratory Medicine professionals in Italy: results from a survey by the SIBioC - Young Scientists Working Group
<p>Introduction: Laboratory Medicine is continuously changing because of the advent of new technologies and perspectives, such as automation, Big Data and omics sciences. Professionals&rsquo; profiles are changing concurrently, developing the new technological, clinical and management skills required nowadays. In order to assess training needs as well as education and working conditions, the SIBioC Young Scientists Working Group (YS-WG) promoted a questionnaire directed to professionals &le;40 years old.<br />Methods: the questionnaire was prepared using Survey Monkey and was sent to the 587 SIBioC members &le;40 years old; it was also diffused via the YS-WG social media pages, and through personal e-mails with the help of Specialty School Offices. The questionnaire included 54 questions examining different aspects: participation in SIBioC activities, scientific interests, working conditions, evaluations of training and education experiences, expectations for the future professional life.<br />Results: during three months, 282 responses have been collected. The most represented professionals are Biologists (PhD) (46%), followed by Medical Doctors (24%). 33% of participants has an open-ended contract, 15% temporary, 17% freelance and 17% has a scholarship/research grant; 46% of them do not receive any remuneration. Around 60% work in public institutions (Universities or Hospitals); 52% are involved in clinical area, 29% in research. Residents&rsquo; evaluation on educational quality of Specialty Schools is rather heterogeneous. Among the 193 SIBioC members, 35% is actively participating in at least one of the society&rsquo;s Working Group. Most of the participants are regular readers of the SIBioC official journal (Biochimica Clinica), consult LabTestsOnline web site, and participate to SIBioC scientific events and/or to the Society e-learning courses.<br />Conclusions: the results of the survey are a key point for the Society, allowing to understand the young laboratory professionals needs, so that they can be accompanied and encouraged in a full development of their future professional life.</p>
Biochimica Clinica ; 44(4) 351-358
Contributi Scientifici - Scientific Paper
 
La Medicina di Laboratorio: gli specialisti di domani
Laboratory Medicine: specialists of tomorrow
<p>Laboratory Medicine rides the wave of technological progress, the metamorphosis of information systems and data management. The Young Specialist is not a mere observer, but rather takes a leading role in this change, taking advantage of the opportunities offered by &ldquo;omics&rdquo; technologies, capturing new ideas and innovative stimuli that lead to a new concept of work and research oriented to health and prevention. Thanks to the support of international web platforms, training and exchange programs supported by the International Scientific Societies and Federations that favor professional and scientific growth, Young Scientists work in a global context. In this scenario, the SIBioC Young Scientists Study Group, with the auspices of SIBioC, EFLM and IFCC, organized a meeting on &quot;Laboratory Medicine: Specialists of tomorrow&quot; with the aim of discussing and highlighting some of the most important challenges, such as technological progress, training and internationalization of young people. Finally, the future of laboratory medicine looks at a multidisciplinary approach that leads to integrated diagnosis, identification of the frail patient, the use of the Point of Care Testing as an indispensable tool in crisis areas, making the dialogue between physician and laboratory specialist a fundamental step for the diagnosis and treatment with the final aim of a better outcome for the patient.</p>
Biochimica Clinica ; 43(4) 424-434
Documenti - Documents
 
Ruolo del laboratorio nella valutazione di un donatore di organi con sospetta emofilia A
Role of the laboratory in the evaluation of an organ donor with reported haemophilia A
<p>The case concerns a 82-year-old patient, organ donor, affected by diabetes mellitus, hypertension and reported type A haemophilia, showing a traumatic severe cerebral haemorrhage. The Medical Committee started the donor evaluation process: the liver was compatible for a recipient in life-threatening conditions. Although the first level coagulation tests were within the normal range, the Regional Center for Organ and Tissue Allocation of the Tuscany Region - Italy requested further investigations in order to clarify the reported diagnosis of haemophilia and to exclude the presence of a specific FVIII inhibitor. FVII activity was evaluated to assess the protein synthesis of the liver, and FVIII for suspected haemophilia; both of them were normal. Considering the importance of the diagnosis, the parallelisms of both FVII and FVIII were performed; the tests were negative for the presence of inhibitors. Second-level tests therefore rejected the diagnosis of haemophilia and excluded the presence of a specific inhibitor of FVIII. The absence of coagulative alterations allowed the liver explant, which was successfully transplanted on a 59-year-old male recipient.</p>
Biochimica Clinica ; 42(3) e37-e39
Casi clinici - Case report
 
Big Data e Intelligenza Artificiale in Medicina di Laboratorio
Artificial intelligence and big data in laboratory medicine
<p><span style="color:rgb(33, 29, 30); font-family:calibri,sans-serif; font-size:9pt">In the last few years, artificial intelligence (AI) is gaining attention in several medical disciplines, including laboratory medicine (LM). The raised interest on AI has been fueled not only by the huge amounts of information daily generated, but also by the special natural context offered by laboratories, where digitalization have already occupied an important part of the routine workflow of patients&rsquo; data. Motivated by these topics and under the auspices of SIBioC, a conference on AI and big data was organized in May 2022 in Bologna, Italy. This conference covered several topics of AI and big data, including but not limited to the current and future perspectives, comprising ethical challenges and the role of laboratory specialists, including young professionals, the productive integration of AI with information technologies and with other digital infrastructure, such as the LOINC and the block chain. Furthermore, some examples of real application of AI in LM were reported, including diagnosis and monitoring of familiar hypercholesterolemia, management of insulin treatments for diabetes, reference intervals identification and verification by indirect methods, COVID-19 diagnosis and the monitoring of outpatients monoclonal gammopathy treatment by digital healthcare</span></p>
Biochimica Clinica ; 17(1)
Documenti - Documents
 
Big data e intelligenza artificiale in medicina di laboratorio: una indagine SiBioC nei i laboratori clinici italiani
A survey on Artificial Intelligence and Big Data utilisation in Italian Clinical Laboratories
<p>Objectives: the Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC) Big Data and Artificial Intelligence (BAI) Working Group promoted a survey to frame the knowledge, skills, and technological predisposition in Clinical Laboratories. Methods: questionnaire, focusing on digitization, IT infrastructures, data accessibility, and BAI projects underway was sent to 1351 SIBioC participants. The responses were evaluated using SurveyMonkey software and Google Sheets. Results: the 227 respondents (17%) from all over Italy (47% of 484 labs), mainly biologists, laboratory physicians and managers, mostly from laboratories of public hospitals, revealed lack of hardware, software and corporate Wi-Fi, and dearth of PCs. Only 25% work daily on clouds, while 65%-including Laboratory Directors-cannot acquire health data from sources other than laboratories. Only 50% of those with access can review a clinical patient&rsquo;s health record, while the other access only to laboratory information. The integration of laboratory data with other health data is mostly incomplete, which limits BAI-type analysis. Many are unaware of integration platforms. Over 90% report pulling data from the LIS, with varying degrees of autonomy. Very few have already undertaken BAI projects, frequently relying on IT partnerships. The majority consider BAI as crucial in helping professional judgments, indicating a growing interest. Conclusions: the questionnaire received relevant feedback from SIBioC participants. It highlighted the level of expertise and interest in BAI applications. None of the obstacles stands out more than the others, emphasising the need to allaround work: IT infrastructures, data warehouses, BAI analysis software acquisition, data accessibility and training.</p>
Biochimica Clinica ; 17(1)
Contributi Scientifici - Scientific Papers