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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
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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 R. Rolla

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
SARS-CoV-2 e la nuova era dei vaccini - Parte I: Introduzione sulle tipologie dei vaccini e sui loro meccanismi di azione
SARS-CoV-2 and the new era of vaccines - Part I: Introduction to the available vaccine platforms and their mechanism of action
<p>The introduction of vaccination programs aiming at inducing an active immune response against pathogens dates back to the first experimental approaches at the end of the 18th century and, since then, has represented a turning point in public health measures to contrast infections. The scientific improvements of the last few years in the field of molecular biology, immunology and genetic engineering have allowed to design new vaccines able to solve, at least in part, the hurdles of conventional vaccine platforms. From the first vaccines based on the inoculation of the whole microorganism, the scientific research has gone in the direction of platforms able to carry only a few or even a single antigenic component of the pathogen, ranging from subunit vaccines to those based on mRNA or DNA. This achievement has made vaccines easier and quicker to develop and, above all, much safer, and it has involved scientific fields that extend far beyond the attempt to fight infectious diseases, such as cancer research. The purpose of this review is to present an overview of the currently available vaccine platforms, their mechanism of action, and the advantages and pitfalls behind each approach.</p>
Biochimica Clinica ; 46(1) 009-015
Rassegne - Reviews
SARS-CoV-2 e la nuova era dei vaccini – Parte II: I vaccini oggi in uso per contrastare la pandemia da COVID-19 e il ruolo del laboratorio nella campagna vaccinale
SARS-CoV-2 and the new era of vaccines – Part II Currently available vaccines to fight the COVID-19 pandemic and the laboratory role in the vaccination campaign
<p>The COVID-19 pandemic has prompted an unprecedented race to find the means to contrast the SARS-CoV-2 infection, resulting in a huge common effort to develop an efficacious vaccine as soon as possible and an exceptional acceleration of the review process to ensure its safety and efficacy. Many technological platforms are currently under investigation or have already been approved, including those based on the inactivated virus, mRNA- or DNA-based vaccines expressing viral antigens, recombinant SARS-CoV-2 proteins and vector-based vaccines exploiting chimeric adenoviruses. The emergence of new viral variants has represented ad additional challenge and has induced the entire scientific community to potentiate the monitoring process of the ongoing vaccination campaigns. In this scenario, laboratory medicine certainly plays a pivotal role not only in the diagnosis of the infection but also in monitoring the immune response to vaccines and in the detection and prevention of clinically significant adverse events, ultimately contributing to the determination of the biological and clinical efficacy of the available vaccines. This review offers an overview of the most recent and updated data on anti-SARS-CoV-2 vaccines and the technological principles behind them as well as on the resources that laboratory medicine can offer to support the vaccination campaigns. All these aspects represent a rapid step forward in the clinical field which transcends the COVID-19 outbreak and that will certainly pave the way for the future scientific research.</p>
Biochimica Clinica ; 46(1) 016-033
Rassegne - Reviews
Indagine conoscitiva sulla qualità del referto dell’esame emocromocitometrico
A survey on the quality of the hematological reporting among the Italian laboratories
<p>Introduction: the Working Groups &ldquo;Hematology&rdquo; and &ldquo;Extra-Analytical Variability&rdquo; of the Italian Society of Clinical Biochemistry (SIBioC) promoted a survey investigating the quality of the complete blood count reporting among Italian Laboratories.<br />Methods: the survey included 36 questions and was sent to all the SIBioC members. 251 laboratories participated in the survey.<br />Results: there is a full concordance in reporting the traditional parameters (leukocytes, erythrocytes and platelet count, hemoglobin, hematocrit and the calculated indices, plus the leukocytes differential count), while other relatively new parameters, like the mean platelet volume (MPV) and the platelet distribution width (PDW) are reported by 70% of the laboratories. A low percentage of laboratories (20-30%) do not report the presence of abnormal cell populations, if detected (blasts, immature granulocytes, plasma cells, prolymphocytes and erythroblasts). 70% of laboratories do not report the erythrocyte and leukocyte related parameters available on the new analyzers. Specific reference intervals for gender and age are adopted by 68% of the laboratories, but only 50% have instrument-specific intervals. 83% of the laboratories include interpretative comments in the report, but only in less than half of them these are harmonized according to the recent available recommendations. 83% of the laboratories have a shared document to manage critical values, that are communicated to the requesting physician by 90% of the laboratories.<br />Discussion: activities promoted by the SIBioC Hematology working group to harmonize the hematological report have been effective on traditional parameters reporting with a substantial improvement compared to the 2014 survey. Two issues remain however unresolved: the inclusion of interpretative comments and of the recent available parameters in the report.</p>
Biochimica Clinica ; 44(2) 129-142
Contributi Scientifici - Scientific Papers
La diagnosi di malaria: ruolo dell’esame emocromocitometrico nello screening
The diagnosis of malaria: the role of the haematology analyzers as first level screening
R. Rolla  |  G. Da Rin  |  V. Granero  |  F. Dima  |  A. Fanelli  |  S. Francione  |  C. Ortolani  |  S. Pipitone  |  S. Buoro  | 
<p>The diagnosis of malaria: the role of the haematology analyzers as first level screening. Malaria is one of the three most common infectious diseases worldwide, and is caused mainly by four species of Plasmodium: P. falciparum, P. vivax, P. malariae and P. ovale. The disease is endemic in developing countries but it is also gradually involving Western Countries like Italy. Albeit in 1970 the World Health Organization has included Italy among the malaria-free countries, malaria has become the most frequently imported tropical disease.&nbsp; Microscopic examination of the peripheral blood smear is the gold standard for diagnosing malaria. Although this test is quick, cheap and readily applicable, it has also some drawbacks such as low sensitivity and the need of qualified personnel. Therefore, an effective screening test for detecting malaria in cases with low clinical suspicion or characterized by non-specific symptoms is increasingly necessary, especially in Countries where the disease is not endemic. A new generation of hematological analyzers, whose performance may be potentially useful for the screening of subjects with suspected malaria infection has made available. Many fully-automated hematological analyzers, using different techniques (optical-cytochemical, optical fluorescence, multiangle polarized dispersion and volume-conductance-scatter), can now identify the presence of the malarial parasites in peripheral blood, producing specific cell distributions. The blood count can hence be regarded as a new diagnostic opportunity in malaria infection, since it is one of the basic investigations performed in febrile patients, and is also a simple and fast test, that can be performed in virtually all clinical laboratories.</p>
Biochimica Clinica ; 42(3) 191-209
Rassegne - Reviews
Armonizzazione in Medicina di Laboratorio
Harmonization in Laboratory Medicine
F. Ceriotti  |  M. Panteghini  |  A. Tosetto  |  V. Valentini  |  L. Politi  |  R. Rolla  |  T. Guastafierro  |  T. Köken  |  E. Capoluongo  |  C. Mazzaccara  |  V. D'Argenio  |  V. D'Argenio  |  G. Lippi  |  M. Plebani  |  D. Giavarina  |  M. Berardi  |   A survey on sample matrix and preanalytical management in clinical laboratories  |  D. Bozzato  |  G. Messeri  |  M. Zaninotto  |  M. Vidali  |  A. Padoan  |  G. Parigi  |  A. Clerico  |  L. Sciacovelli  |  M. Ciaccio  |  G.L. Salvagno  |  G. Barberio  |  G. Barberio  |  G.L. Salvagno  |  M. Pepe  |  M. Panteghini  |  F. Braga  |  G. Gessoni  |  M. Montagnana  |  N. Doğan  |  M. Barberis  |  M. Barberis  |  A. Marchetti  |  F. Borrillo  |  L. Bonfanti  |  P.M. Ness  |  G. Messeri  |  S. Nannini  |  J. Queraltò  |  M. Zaninotto  |  A. Mosca  |  BM. Henry  |  G. Santini  |  A. Coglianese  |  V. D'Argenio  |  E. Fiorio  |  L. Crinò  |  M. A. V. Willrich  |  A. Modenese  |  M. Berardi  |  G. Nordera  |  M. Girelli  |  R. Tomaiuolo  |  D. Giavarina  |  R. Dittadi  |  L. Pighi  |  V. Guaraldo  |  G. Bambagiotti  |  E. Franceschini  |  R. Danesi  |  M. Locatelli  |  F. Balboni  |  D. Cosseddu  |  M. Savoia  |  S. Bernardini  |  C. Domenichini  |  M. Lamonaca  |  M. Perrone  |  M. Perrone  |   per il Gruppo di Studio Intersocietario SIBioC-SIPMeL Diabete Mellito  |  P. Pradella  |  A. Padoan  |  M.T. Sandri  |  L. Belloni  |  A. D'Avolio  |  T. Trenti  |  A. Fortunato  |  T. Trenti  | 
Biochimica Clinica ; 39(6) 546-547
Editoriale - Editorial