Valutazione delle prestazioni analitiche dei metodi per la misura di Tg, AbTg e AbTPO: risultati del programma di VEQ Tg-check

Not availableIl programma di Valutazione Esterna di Qualit? Tg-check ? attivo da 5 anni; i laboratori nel ciclo 2008 sono 110 e circa il 70% di questi partecipa trasmettendo i risultati via internet collegandosi al sito web dei programmi di VEQ EQAS-CNR (http:/eqas.ifc.cnr.it). Dall\u27analisi cumulativa dei risultati dei 6 esercizi di controllo del ciclo 2007 risulta che i metodi per la misura della Tireoglobulina (Tg), nonostante l\u27uso di standard calibrati verso la stessa preparazione di riferimento (1? IRP CRM 457), continuano a produrre risultati molto diversi tra loro in particolare nei campioni contenenti anticorpi AbTg. In questi campioni, la variabilit? totale (CV tra-laboratori, tra-metodi) osservata nella VEQ ? molto elavata (74-83%) a causa dell\u27interferenza degli anticorpi endogeni nella misura della Tg; ? noto infatti che, ad oggi, tutti i metodi risultano pi? o meno interferiti dalla presenza di AbTg nel campione e questo provoca l\u27allargamento delle differenze sistematiche tra metodi. Nei campioni negativi per AbTg, invece, le differenze sistematiche tra metodi si riducono notevolmente (CV tra-laboratori, tra-metodi 20-40%)

Multicenter Evaluation of the TOSOH AIA-Pack Second-Generation Cardiac Troponin I Assay

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Right ventricular overload and cardiovascular neuroendocrine derangement in systemic sclerosis

Aim Systemic sclerosis (SSc) may be associated with right ventricular overload, secondary to pulmonary hypertension. In heart failure patients, neuroendocrine derangements can influence clinical evolution and prognosis. The aim of this study was to investigate neurohormonal control affected in SSc patients with and without right ventricular impairment. Methods and results A prospective series of 28 patients with SSc was studied. In addition to conventional evaluations, extensive neuroendocrine studies were done, including assays of both the vasoconstrictor system (plasma renin activity [PRA], aldosterone and catecholamines) and vasodilatory molecules (brain natriuretic peptide [BNP] and atrial natriuretic peptide [ANP]). A significant relation was observed between echo-Doppler estimated pulmonary systolic pressure (PAP) and neurohormonal activation, in particular between PAP and BNP (R = 0.58, p = 0.004), ANP (R = 0.65, p 40 mmHg confirmed at cardiac catheterization) had higher levels of ANP and BNP (147 +/- 26 vs 34 +/- 6 pg/mL and 344 86 vs 30 7 pg/mL, respectively, p < 0.001), PRA (6.4 +/- 1.9 vs 1.8 +/- 0.4 ng/ mL/h, p < 0.001) and aldosterone (257 +/- 86 vs 114 +/- 22 pg/mL, p = 0.02). These patients had increased plasma noradrenaline, but not adrenaline (701 87 vs 452 66 pg/mL, p < 0.001). Conclusion SSc patients with right heart failure have a neurohormonal derangement, showing overactivity of the vasoconstrictive system, counteracted by oversecretion of cardiac natriuretic hormones. (C) 2004 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved

Osteocalcin (bone GLA protein) levels, vascular calcifications, vertebral fractures and mortality in hemodialysis patients with diabetes mellitus

Background and aims: Diabetes mellitus is recognized as one of the major causes of end stage kidney disease. Bone Gla protein (BGP) is a vitamin K-dependent protein involved in bone mineralization and vascular calcifications (VC). Our goal was to characterize BGP and undercarboxylated BGP (ucBGP) in DM patients on HD, compared to HD patients without DM, and their association with vascular and bone disease. Methods: 387 HD patients from 18 dialysis centers in Italy. Associations of DM, levels of BGP, vitamin D and VC were evaluated. Time-to-event analysis for all-cause mortality was performed by the Kaplan\u2013Meier. Results: Patients with DM had lower levels of total BGP (139.00 vs. 202.50 mcg/L, p &lt; 0.001), 25(OH)D (23.4 vs. 30.2&nbsp;ng/ml, p &lt; 0.001), and ucBGP (9.24 vs. 11.32 mcg/L, p = 0.022). In regression models, the geometric means of total BGP and ucBGP were 19% (p = 0.009) and 26% (p = 0.034) lower in diabetic patients. In univariate Cox regression analysis, DM patients had a higher risk of all-cause mortality (HR:1.83, 95% CI 1.13\u20132.96, p = 0.014). Adjustment for confounders confirmed the significant DM-mortality link. We included VC and warfarin into the Cox model, the DM-mortality link was no longer significant, suggesting a role of these risk factors as causal mediators leading to increased mortality in dialysis patients. Conclusions: HD patients have an increased mortality risk associated with DM. Furthermore, we found an association between DM and decreased BGP levels. Although our study does not support the notion that BGP levels act as mediator in the DM-mortality link, to our knowledge this is the first study in HD patients suggesting a potential protective role of BGP in the bone, endocrine and vascular pathway