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Maria Stella Graziani

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Martina Zaninotto

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Ferruccio Ceriotti
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Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

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International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
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Eric Kilpatrick UK
Magdalena Krintus Poland
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Giuseppe Agosta

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

BC: Articoli scritti da M. Lorubbio

Importanti informazioni dall’esame dello striscio periferico
Important information from the peripheral smear examination
<p><span style="font-size:9pt">Rarely, platelets can interact with other blood elements, forming platelet aggregates. This paper presents an isolated case of platelet satellitism around neutrophils, lymphocytes and monocytes with platelet phagocytosis by both neutrophils and monocytes. The subject was an 89-year-old woman with breast cancer on anti-estrogenic hormone cancer therapy. Whole blood sample collected in a tube with K</span><span style="font-size:5pt">2</span><span style="font-size:9pt">EDTA anticoagulant was analysed within 4 hours, using Sysmex XN-9000 analyzer. The complete blood count presented the following results: white blood cell 4.0x10</span><span style="font-size:5pt">9</span><span style="font-size:9pt">/L, red blood cell 3.58x10</span><span style="font-size:5pt">12</span><span style="font-size:9pt">/L, haemoglobin 116 g/L, haematocrit 34.9%, mean corpuscular volume 97.5 fL, mean corpuscular haemoglobin 32.5 pg, mean corpuscular haemoglobin concentration 332 g/L, red blood cell distribution width 14.6% and platelet 136x10</span><span style="font-size:5pt">9</span><span style="font-size:9pt">/L. The present case report describes the platelet satellitism around neutrophils, lymphocytes and monocytes and the interesting, and very rare phenomenon of platelet phagocytosis by not only neutrophils but also by monocytes.</span></p>
Biochimica Clinica ; 46(4) e25
Casi Clinici - Case Report
I cambiamenti fisiologici dell’ematopoiesi e patologie associate in gravidanza
Physiological changes in hematopoiesis during pregnancy and associated pathologies
M. Lorubbio  |  R. Rolla  |  G. Da Rin  | 
<p>Pregnancy is a state characterized by multiple changes at haematological level as a consequence of the physiological adaptation of the organism. This review describes both the physiological modifications that can be observed during pregnancy and the associated pathological conditions as well. The main physiological changes consist in the increa-se of the plasma volume, in the leukocyte and immunological function, in the onset of mild thrombocytopenia and in changes in the coagulation and fibrinolysis systems. During pregnancy, the white blood cell count is increased by 36% compared to the values found in non-pregnant women. In normal pregnancies, the number of neutrophils in all three trimesters is significantly higher than the lymphocyte count, while pregnant women who develop preeclampsia have a lower neutrophil to lymphocyte ratio (NLR) caused by the increase in lymphocytes. Both the increase in plasma volume (approximately 50%), the delayed production and the shorter lifespan of red blood cells cause physiological decreases in hemoglobin and hematocrit, resulting in what is known as &ldquo;physiological anemia&rdquo;. Given the increased physiologi-cal demand, the most frequent causes of anemia in pregnancy are those from nutritional deficiencies of iron, folate and vitamin B12. Mean platelet counts decreased during pregnancy in all the women, beginning in the first trimester and continuing throughout pregnancy, with the nadir occurring at the time of delivery. Thrombocytopenia in pregnant patients is due to a number of causes. The clinical laboratory plays a fundamental role in monitoring physiological pregnancy and for detecting pathological conditions that can arise from conception to childbirth.</p>
Biochimica Clinica ; 46(3) S019-S030
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