Mario Plebani

..The role of laboratory professionals has undergone a radical change, which calls for greater analytical accuracy, and more stringent test selection, and interpretation of results...

..However, the information on quality specifications that should be communicated to clinicians, and the way in which this information should be given, is still widely debated...

..It requires good multidisciplinary working and a willingness to reflect on and learn from errors to achieve a patient-centred and safer system...

..Appropriateness plays a key role in programs for quality improvement...

..Powerful tests, such as cardiac troponins, on which critical decisions will rest need highly reliable methods, quality control and external quality assurance schemes...

..These data should stimulate debate in the scientific community and encourage more clinical laboratories to use the same indicators to improve clinical effectiveness and clinical outcomes within the healthcare service...

..Characterization of allergens at a molecular and submolecular level and, where necessary, the use of recombinant allergens can reduce cross-reactions and further improve the quality of immunoassays...

..The aim of this study was to assess the cytokine profile in the rectal mucosa of patients affected by perianal CD and to understand its relations with the systemic cytokine profile and inflammatory parameters and the need for surgery...

..AGA IgA II and AGA IgG II have recently been suggested as reliable tools for celiac disease (CD) diagnosis. We compared their utility for diagnosis and monitoring CD in children with that of tTG IgA, an established CD marker...

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..We assessed the association of new and established cagA and vacA polymorphisms with disease...

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..CONCLUSION: The preoperative determination of tumor grade and blood AFP mRNA status may potentially refine the prognostic evaluation of HCC patients and improve the selection process for radical therapies...

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..Here, we report the state of critical value reporting in a large cohort of Italian laboratories and comparison with Q-Probes surveys from the College of American Pathologists as representatives of the US situation...

..The aim of the present study was to explore the application of SELDI proteomic patterns in serum for distinguishing between cases of pancreatic cancer, chronic pancreatitis, type 2 diabetes mellitus and healthy controls...

..This work examined the interplay between the microbiota adherent to the ileal pouch mucosa and the mucosal immune system in chronic/relapsing pouchitis...

..Our aim was to identify the pancreatic cancer diabetogenic peptide...

..We ascertained whether gene therapy with FCY1-FUR1 is effective in killing pancreatic cancer cells after 5-fluorocytosine (5-FC) treatment...

..VEGF and AFP mRNA determinations in the blood are promising prognostic factors for patients with HCC. This study explores their potential prognostic synergy in a cohort of HCC patients evaluated for potentially curative therapies...

..The analytical and clinical performance of the Evidence Cardiac Panel were evaluated...

..Heart-type fatty acid-binding protein (H-FABP) appears to be one of the best candidates among the new early cardiac markers studied...

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..We hypothesized that the chronic inflammatory process, involved in the future atherosclerotic injury, could be found during the fetal period...

..CONCLUSIONS: We identified a tumor-derived peptide of 14 amino acids sharing a 100% homology with an S-100 calcium binding protein, which is probably the pancreatic cancer-associated diabetogenic factor...

..Whether this is a potential molecular tool by means of which transplanted partial livers promote their regeneration remains to be seen in a larger number of patients...

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..We sought to determine whether a relationship exists between ultrasound detection of lung congestion, NT-proBNP, and BIVA in patients with acute dyspnea...

..This review describes the changes and their implications for analysis of errors associated with laboratory testing...

..We compared the diagnostic accuracy of three new tests proposed for CD screening with that of the well established IgA tTG, and ascertained whether any combination of these tools might enhance accuracy in diagnosing CD...

..The usefulness of serum antibodies to common food antigens (immunoglobulin G4; IgG4) assay in management of patients suffering from food intolerance was assessed...

..These biomarkers have proven to be of particular value in the management of chronic and acute heart failure patients, and in the outpatient and the emergency setting...

..The relationship between asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) plasma concentrations and acute heart failure is unknown. We evaluated ADMA and SDMA in patients with acute dyspnea...

..An IgA deficiency is the most frequent immunodeficiency in humans and, in general, high frequency of this disorder was demonstrated in those with autoimmune diseases...

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..A total of 371 patients under stable warfarin therapy were retrospectively selected to develop a pharmacogenetic algorithm to identify the individual maintenance dose...

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..We ascertained whether the knowledge of KLK3 genetics would enhance prostate specific antigen diagnostic performance in patients with clinical suspicion of prostate cancer...

..The main aim of the activities of an EQAP in Laboratory Medicine is to sustain improvements in the quality of services provided by participating laboratories for the benefit of patients...

..In conclusion, in laboratory medicine, technology represents a tool for improving clinical effectiveness and patient outcomes, but it has to be managed by qualified laboratory professionals...

..However, patients with normal troponin values are not necessarily risk-free for major cardiac events...

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..The communication also improves the likelihood of reaching the physician on call and may provide important decision support...

..In a modern approach to total quality, centered on patients' needs and satisfaction, the risk of errors and mistakes in pre- and post-examination steps must be minimized to guarantee the total quality of laboratory services...

..2% of results. Although in the post-analytical phase the frequency of incomplete or incorrect data was high, no adverse events were found to be related to this type of error...

..25 P < 0.05). In conclusion, this study demonstrates that acute-phase markers of inflammation are associated with nephropathy status and GBM thickening, suggesting a role for inflammation in the pathogenesis of diabetic glomerulopathy...

..There is therefore an urgent need for an evaluation of errors and risks of error in POCT that is based on the entire testing process and uses well-designed studies aiming to improve clinical outcomes and increase patient safety...

..The anti-tTG test correlates with the degree of mucosal destruction and is suitable for verifying patient compliance to dietary treatment...

..The aim of the present paper is to evaluate the relevance of component-resolved in vitro diagnosis in comparison to extract-based diagnosis and the relative global costs in relation to clinical outcomes...

..The mission of the WG-LEPS is to promote and encourage investigations into errors in laboratory medicine, collect data available on this issue and recommend strategies and procedures for improving patient safety...

..Permanent MGUS after LT does not entail a significant risk of malignancy, but it is associated with a higher risk of serious infections and CKD...

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..The lesson we have learned is that each practice must examine its own total testing process to discover its weaknesses and identify appropriate remedies...

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..New challenges to EQA schemes for coagulation testing derive from the introduction of innovative tests, genetic analysis, and the need to assess not only analytical procedures but also all steps included in the total testing process...

..The higher prevalence of antibodies in diabetic patients compared to controls may reflect the common pattern of antigens shared by peripheral nerve and pancreatic islet cells...

..72 for HYPO% and 0.68 for %Hypo-He; best cutoff values, 5.8 and 2.7, respectively). The newly proposed Ret-He and %Hypo-He can provide clinicians with information equivalent to CHret and HYPO%...

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..We have investigated variations in the C-reactive protein levels in groups of patients with left ventricular dysfunction of various causes...

..The aims of the study were 1) to assess the performance of this method in different conditions of iron metabolism disorders; 2) to assess the diagnostic validity of non-invasive serum biomarkers in the identification of iron overload...

..Clinical laboratories can therefore work to improve clinical effectiveness, without forgetting that everything should be designed to provide the best outcomes for patients...

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..In conclusion, to compare previous results obtained by M-protein densitometric scanning with those obtained by direct measurement of CZE peaks, the calculation of a univocal transforming factor appears to be unreliable...

..The findings demonstrate that participation in EQA schemes provided an opportunity for participating laboratories to continuously improve the quality of their services...

..CONCLUSIONS: NT-proBNP measurement represents a useful biochemical tool helping the ER physician in the rapid and reliable recognition of cardiac involvement in patients presenting in the ER with acute-severe dyspnea...

..In the absence of better laboratory standardization, having a single reference range for the parameters provided by flow-cytometric studies of reticulocytes remains problematic...

..In the present paper a heterophilic antibody interference in the tacrolimus measurement is described...

..Among those are studies on the genetic variation of genes encoding outer membrane proteins and the mimicry of host antigens, factors that alter host-cell metabolism and factors that modulate the host's immune response...

..The aim of this work was to evaluate Neurosoft-Sebia, an expert system developed to discriminate between regular and anomalous serum protein electrophoresis patterns performed on Capillarys2...

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..Moreover, quality assurance programs and an appropriate clinical audit are required to evaluate and improve upon this activity...

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..In Italy, a program for continuing education in medicine (Educazione Continua in Medicina (ECM)) has recently been promoted by the National Government...

..Moreover, a fundamental shift in improving patient safety in laboratory medicine is to move from error reporting to risk management...

..According to this point of view, the ESR would seem a semi-quantitative test instead of a real hematological test with any clinical importance. The new millennium has consolidated ESR automation and a QC plan cannot be postponed...

..Due to unclear reasons, allergy to lipid transfer protein (LTP) is frequent in Mediterranean countries but rare in Northern Europe...

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..The results were positive for both screening methods, confirming the efficacy of two simultaneous methods with different cut-off levels...

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..2% of patients with other neurological diseases. The present findings suggest that neither elevated HS Abs titres nor increased homocysteinemia may represent a useful biochemical marker for the diagnosis of VD...

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..CONCLUSIONS: Unlike liver GAPDH, NO appears to be involved in PC associated DM. In portal sera, the absence, rather than the presence, of specific fragments, appears to be correlated with the development of DM...

..The purpose of this study is to measure levels and mRNA expression of Th1- and Th2-type cytokines in patients with active vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC)...

..A consensus should be achieved in the scientific community on these issues to assure better utilization of laboratory data and, ultimately, improved clinical outcomes...

..Finally, to monitor analytic performance, a comparison was made between results from the measurement of ESR in specimens stored at 4 degrees C for 24 hours and results obtained in fresh samples...

..This study was designed to assess the role of fecal lactoferrin and calprotectin as markers of intestinal inflammation in patients with Crohn's disease who have undergone ileocolonic resection...

..The clinical significance of ANCA in these disorders is still unclear. Aims: To explore the clinical and diagnostic significance of ANCA in CLD...

..This is usually achieved by comparing a laboratory test result with the reference range/decisional limit (RL), and by providing consultation for the interpretation of data, advice, and follow-up testing...

..However, at present, little is known upon how "old" and "new" biochemical markers of myocardial damage are utilized in daily clinical practice...

..To study levels and activity of matrix metalloproteinase (MMP)-1 and -9 and their tissue inhibitor (TIMP-1) in tears of patients with vernal keratoconjunctivitis (VKC), with and without severe corneal damage...

..Biochemical markers of myocardial necrosis may have normalized, depending on the length of time that has passed since the infarct developed; 2) pathologic findings of a healed or healing MI...

..Biochemical markers of myocardial necrosis may have normalized, depending on the length of time that has passed since the infarct developed; 2) pathologic findings of a healed or healing MI...

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..Critical values' reporting is an essential requisite for clinical laboratories. Local policies were investigated within an indicative cohort of Italian laboratories to monitor the situation and establish a performance benchmark...