Evoluzione dei programmi di Valutazione Esterna di Qualit?

Not availableL\u27Istituto di Fisiologia Clinica del CNR di Pisa (IFC-CNR) organizza da oltre 20 anni i programmi di Valutazione Esterna di Qualit? (VEQ) di ormoni e marcatori tumorali. Nel corso degli anni, per rendere pi? facilmente interpretabili i riepiloghi preparati per i partecipanti, numerose modifiche sono state introdotte nella elaborazione e nella presentazione dei dati. inoltre l\u27applicazione della ICT (Information and Communication Techonology), ha apportato importanti e significativi miglioramenti alle modalit? di gestione e di trasmissione dell\u27informazione (invio a IFC-CNR del modulo risposta, invio ai laboratori dei riepiloghi periodici e cumulativi, comunicazioni ai partecipanti)

Scoring system to evaluate analytical performance of laboratories participating in an EQA scheme for hormones

To allow laboratories an easy evaluation of thei own analytical performance, a new scoring system has been adopted in the External Quality Assessment (EQA) scheme for hormones (Immunocheck EQA; 1300 participants in Italy and in France; 18 control samples/year; 16 analytes). The score is assigned both to the results of a single assay (assay score) and cumulatively to all results of samples assayed in a control cycle (cycle score). Assay score. Each result is scored according to its deviation from target value expressed in SD units (Z-value). In detail the scores are: 4 (excellent) if Z <0.5, 3 (good) if 0.5<Z<1, 2 (sufficient) if 1<Z<2, 1 (inadequate) if 2<Z<3, -2 (unacceptable) if Z>3. Z-value is computed as ratio of percent deviation from target and "state-of-the-art" imprecision. Method mean is assumed as target; "state-of-the-art" imprecision is computed as mean CV of the methods most used in the survey (within-method, between-laboratories imprecision). Cycle score. The sum of score assigned to all samples assayed in a control cycle, normalised by the maximum achievable total score and expressed as tenth, describes the analytical performance off the laboratory. As an example, cycle score for fT4 assay was found better than 6/10 for 82% of participants, between 3/10 and 6/10 for 14% and worse than 3/10 for the remaining 4%.NON DISPONIBIL

eEQAS: Internet in External Quality Assessment Schemes

Not availableIFC-CNR si occupa da oltre 20 anni di programmi di Valutazione Esterna di Qualit? (External Quality Assessment Schemes, EQAS) in immunometria. Oltre 1000 laboratori italiani e di altri paesi europei partecipano ai programmi Immunocheck (ormoni), Oncocheck (marcatori tumorali) e Serocheck (marcatori di infettivit?). Un nuovo sistema di gestione basato sul web ? stato sviluppato per Immunocheck. L\u27utilizzo nell\u27EQAS dell\u27ICT (Information and Communication Tecnology) e di un sistema di gestione basato sul web velocizza i processi automatici e manuali (evidenziando risultati anomali), aumenta l\u27interazione permettendo ai laboratori un accesso diretto ai propri dati, velocizza la produzione dei report, riduce la probabilit? di errori e incrementa l\u27affidabilit? statistica delle informazioni attraverso la capacit? di gestire un numero elevato di partecipanti. I dati sono archiviati per mezzo di un database relazionale la cui interfaccia ? costituita da un sito web di amministrazione (gestione dell\u27anagrafica e dei dati relativi agli esercizi di controllo, analisi statistica) e da un sito web dedicato ai partecipanti; quest\u27ultimo permette di inserire i risultati delle analisi effettuate sui campioni di controllo. La correttezza dei dati inseriti ? verificabile dai laboratorio grazie alla ricevuta inviata immediatamente e automaticamente tramite e-mail. I laboratori possono ottenere il report, prodotto in formato PDF, via e-mail o scaricandolo a richiesta dal sito; il report viene generato nel momento in cui viene richiesto (on-demand), utilizzando i dati pi? recenti disponibili in archivio. Il formato PDF offre ulteriori vantaggi quali la possibilit? di stampare il report con un layout definito all\u27origine e non variabile e la possibilit? di apporre al file del report una firma digitale con valore legale. I dati contenuti nel report, corredati di informazioni aggiuntive, sono disponibili per i laboratori anche attraverso pagine web dinamiche. Tutto il sistema ? stato sviluppato utilizzando software libero. Il numero dei partecipanti Immunocheck che usa Internet ? in costante aumento; tuttavia il massimo vantaggio ottenibile dal sistema si avr? con l\u27adesione di tutti i partecipanti rendendo possibile una consistente riduzione del tempo che intercorre tra le analisi dei laboratori e la produzione dei report

The PPARγ2 P12A polymorphism is not associated with all-cause mortality in patients with type 2 diabetes mellitus

The high mortality risk of patients with type 2 diabetes mellitus may well be explained by the several comorbidities and/or complications. Also the intrinsic genetic component predisposing to diabetes might have a role in shaping the risk of diabetes-related mortality. Among type 2 diabetes mellitus SNPs, rs1801282 is of particular interest because (i) it is harbored by peroxisome proliferator-activated receptor-γ2 (PPARγ2), which is the target for thiazolidinediones which are used as antidiabetic drugs, decreasing all-cause mortality in type 2 diabetes mellitus, and (ii) it is associated with insulin resistance and related traits, risk factors for overall mortality in type 2 diabetes mellitus. We investigated the role of PPARγ2 P12A, according to a dominant model (PA + AA vs. PP individuals) on incident all-cause mortality in three cohorts of type 2 diabetes mellitus, comprising a total of 1672 patients (462 deaths) and then performed a meta-analysis of ours and all available published data. In the three cohorts pooled and analyzed together, no association between PPARγ2 P12A and all-cause mortality was observed (HR 1.02, 95 % CI 0.79–1.33). Similar results were observed after adjusting for age, sex, smoking habits, and BMI (HR 1.09, 95 % CI 0.83–1.43). In a meta-analysis of ours and all studies previously published (n = 3241 individuals; 666 events), no association was observed between PPARγ2 P12A and all-cause mortality (HR 1.07, 95 % CI 0.85–1.33). Results from our individual samples as well as from our meta-analysis suggest that the PPARγ2 P12A does not significantly affect all-cause mortality in patients with type 2 diabetes mellitus

Elevated soluble receptor for advanced glycation end product levels in patients with acute coronary syndrome and positive cardiac troponin I

Objectives High levels of soluble receptor for advanced glycation end products (sRAGE) have been shown to have an atheroprotective role; however, no data are available on this molecule in acute coronary syndromes (ACS). We evaluated sRAGE levels in patients with non-ST segment elevation ACS (NSTE-ACS) or with chronic stable angina. Methods We studied 265 patients, 190 of whom had NSTE-ACS and 75 had chronic stable angina. Results Plasma sRAGE values were comparable in the two groups (P= 0.19). However, in the patients with NSTEACS,sRAGE levels were significantly higher in patients with cardiac troponin-I (cTnI) of more than or equal to 0.04 lg/l compared with those with cTnI of less than 0.04 lg/l [758 pg/ml (493-1536 pg/ml) vs. 454 pg/ml (167-899 pg/ml); P = 0.0037]. A significant correlation(r= 0.323, P = 0.0045) was found between sRAGE and cTnI levels in patients with NSTE-ACS.Conclusion Plasma sRAGE levels are elevated in patients with NSTE-ACS with positive cTnI, suggesting that they could be related to myocardial cell damage

EQA Scheme for hormone immunoassay: evaluation of laboratory performance through a scoring system

The External Quality Assessment (EQA) scheme Immunocheck for hormone immunoassay has been organised by our Institute since 1996 in co-operation with ProBioQual (Lyon, France); at present time more than 1000 laboratories are involved in the scheme which includes 18 analytes. Participants assay 18 control samples every year; statistics of the collected results are circulated sending back to the laboratories periodic and cumulative reports. To allow participants an easy evaluation of their own analytical performance, a new scoring system has been adopted. Each result is scored according to its deviation (from target value) expressed in SD unita (Z-score). In detail the scores are: 4(excellent) if Z <0.5, 3(good) if 0.5<Z<1, 2(sufficient) if 1 <Z<2, 1 (inadequate) if 2<Z<3, -2 (outlier) if Z >3. The sum of scores for all samples assayed in a control cycle, normalised by the maximum achievable total score, describes the analytical performance of the laboratory. Z-score is computed as the ratio of percent deviation from target and &#034;state-of-the-art&#034; imprecision. Method mean is assumed as target; state-of-the-art imprecision is computed as mean imprecision of the methods most used in the survey. To take account that imprecision depends on the analyte concentration, 3 CVs are computed corresponding to 3 concentration range. The table, in the document attached, reports for each analyte the concentration ranges and the state-of-the-art CVs (within-method, between-laboratories imprecision) computed from the Immunocheck data-base (results collected during 2001 EQA cycle).Non disponibil

I programmi "Immunocheck"

Not AavailableIl programma Immunocheck per la valutazione Esterna di Qualit? (VEQ) in Immunometria ? condotto dall\u27Istituto di Fisiologia Clinica del CNR di Pisa (IFC-CNR) in collaborazione con ProBioQual (Centre Lyonnais d\u27?tudes pour la Promotion de la Biologie et du controle de Qualit?, Lyon, France), che organizza in Francia un programma di VEQ cui partecipano circa 650 laboratori. Partecipano al programmai laboratori della Regione Lombardia (tramite convenzione Regione/CNR) e delle Regioni Toscana, Piemonte, Valle d\u27Aosta, Umbria, Marche e Abruzzo (coordinati dal Centro Regionale di Riferimento e Controllo di Qualit? della A.O. Careggi, Firenze); i laboratori delle Regioni Veneto, Trentino Alto Adige e Friuli Venezia Giulia che partecipano al programma sono coordinati dal Centro Regionale di Ricerca Biomedica di Castelfranco Veneto. Complessivamente il programma coinvolge circa 1350 laboratori. Per gli aspetti organizzativi IFC-CNR si avvale della collaborazione di Polymed (Firenze) che cura la preparazione e la distribuzione dei campioni di controllo. A partire dal ciclo 2004, Immunocheck si articoler? in quattro programmi: Immunocheck Ormoni 1 :T3, fT3, T4, fT4, TSH, LH, FSH, HCG, prolattina, insulina, cortisolo, estradiolo, progesterone, testosterone; Immunocheck Ormoni 2 : aldosterone, c-peptide, delta-4-androstenedione, DHEA-solfato, gastrina, HGH, 17alfaOH-progesterone, testosterone libero; Immunocheck Marcatori Tumorali : CEA, AFP, CA 19-9, CA 125, CA 15-3, PSA totale, PSA libero; Immunocheck Anemia : ferritina, folati, vitamina B12. Il ciclo 2004 dei programmi Immunocheck Ormoni 1, Marcatori Tumorali, Anemia prevede la distribuzione di 18 campioni di controllo (6 esercizi di 3 campioni ciascuno). Tutti gli analiti dei 3 programmi si misurano nello stesso siero di controllo. Per il programma Ormoni 2 invece, saranno distribuiti 12 campioni di controllo (6 esercizi di 2 campioni ciascuno). Il laboratorio riceve inoltre i moduli risposta da usare per comunicare i risultati a IFC-CNR e un raccoglitore per archiviare i riepiloghi dei risultati. I campioni di controllo, trattati come normali campioni di routine, vengono misurati dai partecipanti alle date stabilite e i risultati vengono trasmessi a IFC-CNR; l\u27invio dei risultati pu? avvenire tramite fax o internet. L\u27uso di internet per la trasmissione dei risultati ? da preferire rispetto al fax in quanto si evitano gli eventuali errori di lettura/trascrizione del fax e si accellerano le procedure di archiviazione dei dati. Per questo i laboratori devono aprire il sito dei programmi EQAS-IFC all\u27indirizzo: http://ifc.cnr.it/eqas dove trovano il modulo risposta/pagina web e le istruzioni per la sua compilazione. Per trasmettere i risultati (che il laboratorio introduce direttamente nel database Immunocheck) ? necessario disporre di una password che il laboratorio deve richiedere a [email protected]. I risultati raccolti dai laboratori sono analizzati per la preparazione di riepiloghi periodici e cumulativi. Il riepilogo periodico (un riepilogo per ciascun campione di controllo e per ogni analita) riporta: A) numero di risultati, istogramma dei risultati, media, CV, range per tutti i risultati e per i risultati suddivisi per metodo; B) punteggio di merito assegnato al risultato del laboratorio (sulla base dello scarto dal valore bersaglio); C) grafico cumulativo dei punteggi conseguiti dal laboratorio negli ultimi 12 campioni di controllo. A cadenza annuale viene preparato un riepilogo cumulativo contenente stime di precisione e di accuratezza dei principali metodi ricavate dall\u27analisi di tutti i campioni di controllo misurati nel ciclo. I riepiloghi sono inviati ai laboratori per posta. I laboratori che usano internet per la trasmissione dei risultati ricevono il riepilogo (in formato PDF) anche per e-mail; questo consente loro di ridurre il tempo intercorrente tra la misura dei campioni di controllo e la valutazione delle proprie prestazioni

transient upregulation of translational efficiency in prodromal and early symptomatic tg2576 mice contributes to aβ pathology

Abstract Tg2576 mice show high levels of human APP protein with Swedish Mutation during prodromal and early symptomatic stages. Interestingly, this is strictly associated with unbalanced expression of its two RNA binding proteins (RBPs) regulators, the Fragile-X Mental Retardation Protein (FMRP) and the heteronuclear Ribonucleoprotein C (hnRNP C). Whether an augmentation in overall translational efficiency also contributes to the elevation of APP levels at those early developmental stages is currently unknown. We investigated this possibility by performing a longitudinal polyribosome profiling analysis of APP mRNA and protein in total hippocampal extracts from Tg2576 mice. Results showed that protein polysomal signals were exclusively detected in pre-symptomatic (1 months) and early symptomatic (3 months) mutant mice. Differently, hAPP mRNA polysomal signals were detected at any age, but a peak of expression was found when mice were 3-month old. Consistent with an early but transient rise of translational efficiency, the phosphorylated form of the initial translation factor eIF2α (p-eIF2α) was reduced at pre-symptomatic and early symptomatic stages, whereas it was increased at the fully symptomatic stage. Pharmacological downregulation of overall translation in early symptomatic mutants was then found to reduce hippocampal levels of full length APP, Aβ species, BACE1 and Caspase-3, to rescue predominant LTD at hippocampal synapses, to revert dendritic spine loss and memory alterations, and to reinstate memory-induced c-fos activation. Altogether, our findings demonstrate that overall translation is upregulated in prodromal and early symptomatic Tg2576 mice, and that restoring proper translational control at the onset of AD-like symptoms blocks the emergence of the AD-like phenotype

Partial response to first generation SSA guides the choice and predict the outcome of second line therapy in acromegaly

Treatment of acromegaly resistant to first generation somatostatin analogues (first gen-SSA) is often difficult. We aimed to investigate the role of partial response and resistance to first gen-SSA in the choice of second line treatments and their outcomes

Benefits of glucocorticoids in non-ambulant boys/men with Duchenne muscular dystrophy: A multicentric longitudinal study using the Performance of Upper Limb test

The aim of this study was to establish the possible effect of glucocorticoid treatment on upper limb function in a cohort of 91 non-ambulant DMD boys and adults of age between 11 and 26 years. All 91 were assessed using the Performance of Upper Limb test. Forty-eight were still on glucocorticoid after loss of ambulation, 25 stopped steroids at the time they lost ambulation and 18 were GC naive or had steroids while ambulant for less than a year. At baseline the total scores ranged between 0 and 74 (mean 41.20). The mean total scores were 47.92 in the glucocorticoid group, 36 in those who stopped at loss of ambulation and 30.5 in the naive group (p <0.001). The 12-month changes ranged between -20 and 4 (mean -4.4). The mean changes were -3.79 in the glucocorticoid group, -5.52 in those who stopped at loss of ambulation and -4.44 in the naive group. This was more obvious in the patients between 12 and 18 years and at shoulder and elbow levels. Our findings suggest that continuing glucocorticoids throughout teenage years and adulthood after loss of ambulation appears to have a beneficial effect on upper limb function. (C) 2015 The Authors. Published by Elsevier B.V