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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
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada

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


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

BC: Articoli scritti da L. Zardo

Proposta di un protocollo per la gestione degli approfondimenti in ambito coagulativo nel percorso preoperatorio
Proposal for a protocol aimed to investigate the alterations of the coagulation tests in patients undergoing surgical procedures
<p>A hemostatic assessment is usually included in the evaluation of patients undergoing surgical procedures. The aim of this work is to present a protocol shared with the Intensive Care, Hematology and Clinical Laboratory Units of the San Giacomo Hospital (Castelfranco Veneto, Treviso, Italy) to investigate the causes of the prolonged coagulation tests in these patients. In case of altered coagulation screening tests, a form is filled in with the pertinent anamnestic information and sent to the laboratory together with an adequate amount of blood. Following a pre-defined algorithm, the clinical laboratory performs the second level tests. The most relevant one for the purpose is the mixing test that permits an easy identification of the appropriate subsequent tests. The results of these tests allow clinicians to take the appropriate decisions. In case of a negative bleeding anamnesis, and/or in presence of a factor XII deficiency or a lupus anticoagulant positive test, the patient undergoes the surgical intervention; in other cases, the hematologist carefully evaluates the hemorrhagic risk of the specific patient.<br />In 2017, the protocol was applied to 37 cases of prolonged PT/APTT. In 8% of the patients the alteration was not confirmed, in 11% of cases the investigations could not identify the cause of the alterations. In the remaining 81% ofcases, the identification of the specific coagulative defect was possible.<br />The application of this protocol can achieve a number of benefits: it reduces the number of accesses to the hospital for the patients, only the appropriate tests are performed on the basis of reflex testing procedures, the clinician is provided with all the relevant tests at one time with no need to request the tests one after another. The value of the mixing test in this clinical scenario is confirmed.</p>
Biochimica Clinica ; 44(2) 168-173
Documenti - Documents
Medicina di laboratorio e Medicina d’urgenza: un connubio indissolubile
Laboratory Medicine and Emergency Medicine: an essential partnership
<p>Laboratory Medicine and Emergency Medicine: an essential partnership. A better understanding of the pathophysiological bases of many pathologies, along with the considerable technological advances occurred over last few years, have allowed to broaden number and complexity of in vitro diagnostic tests. The emergency department is the clinical setting with the highest risk of forensic disputes, and this explains the inclination that many emergency physicians have towards defensive medicine. Disproportionate request of laboratory tests, with poor awareness on the impact of inappropriateness, is one of the leading negative aftermath of this attitude. The predictable consequences are economic, but also encompass the risk of generating direct damage to the patients, especially in the presence of false positive test results. Since diagnostic appropriateness represents an essential element for patient safety and for sustainability of the National Healthcare System, the Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC) and the Academy of Emergency Medicine and Care (AcEMC) have organized a joint meeting entitled &quot;Laboratory Medicine and Emergency Medicine: an essential partnership&quot;, of which this document is a summary. The issues that have been discussed represent major diagnostic dilemmas faced by emergency physicians, and for which the contribution of laboratory medicine may be decisive. These include acute systemic infections, acute abdominal pain, acute chest pain, head injury and acute bleeding. Since timely transmission of test results is an additional critical element for the clinical decision making in emergency settings, the document will also include considerations on sample transportation from the emergency room to the laboratory.</p>
Biochimica Clinica ; 42(4) 335-342
Documenti - Documents
La determinazione delle catene leggere libere nel siero nella valutazione del rischio di progressione della gammopatia monoclonale di incerto significato (MGUS): proposta di un protocollo di monitoraggio clinico differenziato
Serum free light chain measurement in the assessment of risk of progression in monoclonal gammopathy of undetermined significance (MGUS): proposal for a clinical follow-up protocol
Biochimica Clinica ; 37(5) 435-437
Lettere all'Editore - Letters to the Editor
Linee guida per la gestione dei programmi di Valutazione Esterna di Qualità
Guidelines for External Quality Assessment Scheme organization
Biochimica Clinica ; 35(2) 107