Clin Chem Lab Med
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Practice Guideline
Recommendations for the implementation of international standardization of glycated hemoglobin in Italy.
This document is issued by the Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC) and a number of other National Scientific Societies and Associations in order to promote a coordinated plan for implementing the standardization of glycated hemoglobin (HbA(1c)) measurement in Italy according to the recommendations by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). Changes in reporting HbA(1c) results, new units, how to relate old and new units, a timeline for changes and definition of the analytical goals are the main issues discussed.
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A reliable early marker is required for diagnosis of cobalamin deficiency. We calculated an appropriate holotranscobalamin (HoloTC) cut-off point for identifying cobalamin deficiency using an immunoenzymatic assay. ⋯ Our results confirmed the analytical reliability of the AxSYM HoloTC assay. The method is adequate for routine use and a cut-off threshold of 40 pmol/L is appropriate for assessing cobalamin deficiency in populations with reduced tB(12) values.
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Conventional cardiac markers used for the biochemical diagnosis of acute coronary syndromes (ACS) have a high specificity but low sensitivity within 2-4 h of symptoms onset. The red blood cell distribution width (RDW), reflecting the size variability of circulating red blood cells, has been shown to be independently associated with an increased risk of major cardiovascular events. We assessed whether there is an association between RDW at admission and cardiac troponin T (cTnT) elevation in patients with chest pain. ⋯ As RDW is widely available to clinicians as a part of the complete blood count, and therefore incurs no additional costs, it might be considered with other conventional cardiac markers for the risk stratification of ACS patients admitted to emergency departments.
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The differential diagnosis between bacterial and viral meningitis is not easy in some cases. Cerebrospinal fluid (CSF) analysis is essential for establishing this diagnosis. The objectives were to quantitate lactic acid (LA) concentrations in bacterial and viral meningitis, and other central nervous system (CNS) diseases in order to evaluate the diagnostic utility of CSF LA for discriminating bacterial from viral meningitis. ⋯ CSF LA is a powerful test to discriminate bacterial from viral meningitis with high sensitivity, specificity and predictive values. CSF LA can help in the cases with diagnostic uncertainty.
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Analysis of exhaled breath is a promising diagnostic method. Sampling of exhaled breath is non-invasive and can be performed as often as considered desirable. There are indications that the concentration and presence of certain of volatile compounds in exhaled breath of lung cancer patients is different from concentrations in healthy volunteers. This might lead to a future diagnostic test for lung cancer. ⋯ SPME is a relatively insensitive method and compounds not observed in exhaled breath may be present at a concentration lower than LOD. The main achievement of the present work is the validated identification of compounds observed in exhaled breath of lung cancer patients. This identification is indispensible for future work on the biochemical sources of these compounds and their metabolic pathways.