Valutazione dell'esattezza della determinazione della creatinina nel siero: risultati su un campione di laboratori nazionali

Ferruccio Ceriotti*, Ilenia Infusino, Paola Luraschi, Mauro Panteghini
*Diagnostica e Ricerca San Raffaele S.p.A., Milano

Biochimica Clinica: 2007; 31(1): 19-23 [Article in italian]

ABSTRACT. Evaluation of the trueness of serum creatinine measurement: results of a group of italian laboratories. This note reports the results of the Italian part of a larger European experiment performed to verify accuracy of the creatinine measurement in serum. Three commutable control materials with target value assigned with the reference method were distributed to 35 laboratories and analyzed in five replicates in one run with 10 different analytical systems. The results demonstrated that the majority of commercial systems largely overestimate creatinine concentrations, especially on the low level sample. Only some of the systems using enzymatic assays were able to provide accurate results. Until the standardization of creatinine measurement will be reached, the lack of comparability of creatinine results obtained by different methods will hamper the possibility of routinely adopting formulas for glomerular filtration rate estimation

Valutazione dei metodi per la determinazione della transferrina carboidrato-carente

Immacolata Amoroso*, Daniela Giardiello, Rita Fiore, Agnese Morani, Patrizia Padulano, Luigi Vrenna
*Polo Tossicologico di Riferimento Territoriale per le Farmacodipendenze e le Patologie Correlate "S.M. Loreto Crispi", ASL Napoli 1

Biochimica Clinica: 2007; 31(1): 24-30 [Article in italian]

ABSTRACT. Comparison among analytical methods for carbohydrate-deficient transferrin determination. The diffusion of alcohol consumption has been associated to abuse and dependence, leading to relevant socioeconomic problems and the need for forensic medicine to produce clear clinical and therapeutic identifications. Although alcohol is a legal substance of common and free use, it is classified as addiction substance and its increasing use causes public health problems, making mandatory prevention and improvement of therapeutic politics against alcohol dependence and related problems . Alcohol abuse is both a general and individual risk factor, because it is dangerous for the abuser as well as for the community, (e.g. job and saturday night traffic accidents). The phenomenon is complex and accurate biological markers are needed in order to distinguish between acute use, dependence and chronic abuse of alcohol. Currently, the preferred biomarker is carbohydrate-deficient transferrin, (CDT) because of its particular biochemical characteristics allowing both rapid diagnosis and prevention actions of all alcohol-related problems. Today, to determine carbohydrate-deficient transferrin, several reliable methods, characterized by high analytical and diagnostic performances in terms of specificity and sensibility, are available. At the "Laboratory of centre of drug addiction" of the S.M. Loreto Crispi hospital, A.S.L. Napoli 1, different techniques for carbohydrate deficient transferrin determination such as turbidimetric and nephelometric immunoassays, capillary electrophoresis and high performance liquid chromatography have been checked to evaluate analytical performances, calculate the best cutoff and define accuracy for diagnosis and follow-up of chronic alcohol abuse, as well as for checking continuous abstinence, considering that carbohydrate deficient transferrin isoforms are related to the ingested alcohol amount.

HLA class II in atopic and non atopic members of asthmatic family pedigrees

Olfat Shaker*, Mona El-Raziky, Khaled Salama, Hisham Waheed, Mohamed Taha4, Randa Talaat
*Departments of Medical Biochemistry

Biochimica Clinica: 2007; 31(1): 31-34 [Article in english]

ABSTRACT. Asthma is an inflammatory disease with a strong genetic predisposition. There is a strong relationship between the immune response to several antigens, and specific HLA-DQ/DR haplotype. Objectives: The aim of this study was to determine the HLA class II (DRB1 and DQB1) phenotypic frequencies in atopic and non- atopic members of asthmatic family pedigrees and to analyze the relationship between these phenotypes and any type of asthma. Patients and methods: A series of 41 asthmatic individuals from 20 asthmatic family pedigrees assigned either to the atopic (24-AA) or to the non-atopic (17-NAA) groups were studied and compared with 15 healthy age and sex matched controls. HLA class II DRB1 and DQB1 typing were done to all patients and controls using polymerase chain reaction (PCR) technique. Results: The comparison between the AA and NAA groups of patients revealed an increase in DRB1 alleles(01, 103, 15, 16, 17, 18+, 04, 07, 09, 10, 11, 12 ,13.1 ,14.2, 53) and in DQB1 alleles (2,3(8), 3(7), 3(8,9), 2,3(7,9) 4) while DRB1 alleles (08,13.3,13.4,14.1,14.3,14.4,52,51) and DQB1 alleles (5,6,2) were reduced, but none of these tendencies was statistically significant. Also analysis of the AA group and NAA group versus controls showed no statistical significant findings. Conclusion: Although there are some differences in HLA phenotypic distribution in asthma patients, no definitive HLA association could be established with atopic or non atopic asthma in the population studied. Nonetheless, although HLA by itself may not determine the asthma process, this does not exclude its involvement with other genetic systems which may be implicated in the susceptibility to this disease.

Endothelin-1 and D-Dimer as early predictors of multiple organ dysfunction in critically ill patients with sepsis

Jehan A. El-Kholy*, Omayma A. El-Kholy, Aisha E. Saleh
*Anesthesiology, Faculty of Medicine Cairo University, Cairo, Egypt

Biochimica Clinica: 2007; 31(1): 35-42 [Article in english]

ABSTRACT. Severe sepsis is a serious worldwide health problem and is a leading cause of death in intensive care units. Severe sepsis and septic shock are associated with vast cardiovascular changes and multiple organ dysfunction. The study was designed to assess the level of endothelial and vascular dysfunction in patients with severe sepsis and septic shock. Forty two critically ill patients suffering from sepsis as well as fifteen age and sex matched normal controls constituted the subjects of this prospective study. Severity of illness, sepsis and organ dysfunction were assessed by the Acute Physiology Score and Chronic Health Evaluation (APACHE) II Score and the Sepsis Severity Score and the Multiple Organ Dysfunction Score (MODS) respectively. Endothelin-1(ET-1) and D-dimer (DD) values were compared between patients without, with organ dysfunction and patients who did not survive at the end of the study period (groups I, II and III respectively). ET-1 and D-dimer were determined at time of diagnosis (baseline), 6-, 24- and 48-hours following the diagnosis of severe sepsis or septic shock. A significant increase was present regarding the baseline mean levels of ET-1 and D-dimer in all patient groups (I, II and III) compared to controls. The highest levels were found in group III patients. The baseline mean levels of the APACHE II Score and the Sepsis Score and the Multiple Organ Dysfunction Score (MODS) were significantly higher in group II and III compared to group I. ET-1 and D-dimer levels were also higher in group II compared to group I at 6, 24 and 48 hours. In group I, ET-1 and D-dimer levels increased non-significantly after 6 hours compared to baseline levels, then decreased after 24- and 48- hours reaching near baseline values; in group II patients, ET-1 and D-dimer levels increased significantly after 6- and 24- hours compared to baseline levels, and although decreased but did not reach baseline values after 48 hours. ROC curve analysis revealed a cutoff value and positive predictive value (2.5 and 98% for ET-1) and (400 and 99% for DD) respectively. The sensitivity of ET-1 and DD were 99% and 95% respectively. Endothelial dysfunction and hypercoagulation represented by increased ET-1 and D-dimer levels appear to be early and sensitive predictors of the severity of septic shock and of multiple organ dysfunction development. Thus, a therapeutic strategy to improve the microcirculation in such patients could be studied and accomplished based on these levels.

Torna al Numero 5-6/2006 | Vai all'Indice di Biochimica Clinica

Per chi desidera pubblicare su BC, sono disponibili le Istruzioni per gli Autori
Per chi desidera sottoscrivere l'abbonamento a BC, è disponibile la Cedola di Registrazione

1997, BIOMEDIA srl, tutti i diritti riservati
The material on this site may not be reproduced or otherwise
used without the prior permission of BIOMEDIA.