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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 S. Testa
Il laboratorio nella terapia anticoagulante orale
The role of laboratory medicine in monitoring oral anticoagulant therapy
<p>The oral anticoagulant therapy is used in the prevention and treatment of venous and arterial thromboembolism in many different clinical settings. For this purpose, vitamin K antagonists (VKA), which indirectly reduce the activity of factors II, VII, IX and X preventing the vitamin K-mediated carboxylation of specific glutamic acid residues, and direct oral anticoagulants (DOAC), providing direct inhibition of thrombin (factor IIa) or factor Xa, are available. The VKA monitoring represents a daily challenge for clinical laboratories, due to the increasing number of patients, frequency of needed controls and the management complexity. Several solutions have been proposed to improve the management of patients treated by VKA, such as surveillance in dedicated clinics and use of portable monitors to allow patient self-testing and self-management. Although DOAC have been declared not requiring a standard laboratory monitoring, laboratory testing for measuring drug anticoagulant activity is however needed in many situations, such as in case of bleeding or thromboembolic complications, surgery or invasive procedures, suspected overdose and drug interactions, noncompliance or presence of renal or liver disease.</p>
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
<p>The assessment of D-dimer represents the biochemical standard for diagnosing venous thromboembolism (VTE) and it is hence included in all diagnostic algorithms. Despite the unquestionable diagnostic value, there is broad evidence that the clinical usefulness of D-dimer may be biased by preanalytical, analytical and post-analytical issues. This is particularly true in emergency departments, where a large number of patients with suspected VTE is admitted, triaged and managed. Therefore, representatives of societies listed in the title have drafted this consensus document aimed to cover the most important critical areas in D-dimer testing, providing tentative recommendations to improve its clinical effectiveness for diagnosing VTE in the emergency department.</p>
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
<p>Oral anticoagulant therapy is used to prevent and treat thromboembolic disease. The new oral anticoagulants (NOAs) can be prescribed at fixed dosage without adjustment by laboratory testing. However, this does not necessarily mean that the laboratory does not play a role for their management. This position paper reports the consensus of Italian scientific societies dealing with laboratory issues in thrombosis and hemostasis. It is aimed at reviewing: a) which test(s) should be used to evaluate the anticoagulant effect of each of the NOAs presently available (i.e., dabigatran, rivaroxaban and apixaban), b) the patients to be investigated and c) the timing of investigation.</p>
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