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40) Lippi, G; Fontana, R; Avanzini, P; Aloe, R; Ippolito, L; Sandei, F; Favaloro, EJ (2012) Influence of mechanical trauma of blood and hemolysis on PFA-100 testing BLOOD COAGULATION & FIBRINOLYSIS 23(1):82-86 IF=1.408 [Article] Although the appropriate quality of samples is essential for platelet function testing, information is lacking on interference from mechanical trauma of blood and hemolysis on PFA-100 analyzer. Citrated blood collected from nine healthy volunteers was divided into three aliquots. The first aliquot ('A') was processed without further manipulation, whereas the second and third were subjected to mechanical trauma by two ('aliquot B') or four passages ('aliquot C') through a very fine needle (30 gauge) to produce hemolysis and cell trauma mimicking poor sample collection. Samples were tested on PFA-100 and Advia 2120, and plasma then separated and tested for lactate dehydrogenase (LDH) and hemolysis index. Negligible hemolysis was present in aliquot A (hemolysis index 0.2 +/- 0.1, cell-free hemoglobin 0- 0.5 g/l), whereas an increasing amount was present in aliquots B (hemolysis index of 13.1 +/- 1.8, cell-free hemoglobin 6.0-6.5 g/l) and C (hemolysis index 24.0 +/- 1.1, cell-free hemoglobin 11.5-12.0 g/l). Increases in LDH, and concomitant reductions in platelet and red blood cell counts were observed in aliquots B and C. In hemolyzed aliquots B, four out of nine samples yielded 'flow obstruction' with both PFA-100 agonist cartridges, whereas the closure times were dramatically prolonged in the remaining five samples. In hemolyzed aliquots C, flow obstruction was recorded in six of nine samples for collagen and ADP and all samples for collagen and epinephrine, whereas closure times of collagen and ADP in the remaining three samples were dramatically prolonged. Mechanical trauma of blood causing hemolysis makes PFA-100 testing unreliable. When flow obstructions are observed, the potential presence of hemolysis should be investigated. Blood Coagul Fibrinolysis 23:82-86 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. 41) Lippi, G; Ippolito, L; Russello, T; Ponzo, V; Salvagno, GL; Guidi, GC (2012) Analytical performance of the new ACL AcuStar HemosIL D-Dimer BLOOD COAGULATION & FIBRINOLYSIS 23(2):164-167 IF=1.408 [Article] Several lines of clinical evidence as well as guidelines and recommendations suggest that the overall diagnostic performance of D-dimer testing outstrips that of any other biomarker in the diagnostic approach of patients with venous thromboembolism or disseminated intravascular coagulation. Along with specific technical characteristics, the analytical performance of each D-dimer immunoassay should, however, be assessed before implementation in clinical practice. The aim of this study was to evaluate the analytical performance of HemosIL AcuStar D-Dimer immunoassay, a novel chemiluminescent immunoassay specifically designed for the instrument Instrumentation Laboratory ACL AcuStar. The within and between-run imprecision (n=20) was comprised between 3.6 and 5.8%. The linearity was excellent up to 16 200 ng/ml (r=1.00; P
and accurate quantification of D-dimer in clinical laboratories. Blood Coagul Fibrinolysis 23:164-167 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. 42) Lippi, G; Mercadanti, M; Aloe, R; Targher, G (2012) Erythrocyte mechanical fragility is increased in patients with type 2 diabetes EUROPEAN JOURNAL OF INTERNAL MEDICINE 23(2):150-153 IF=1.657 [Article] Background: Anemia is common among patients with type 2 diabetes. We determined whether type 2 diabetic patients significantly differed in erythrocyte mechanical fragility as compared with nondiabetic subjects. Methods: We recruited 25 Caucasian patients with type 2 diabetes (14 men and 11 women; mean age 58 +/- 8 years) and 25 age-, race- and sexmatched nondiabetic individuals. The fragility of erythrocytes was tested by inducing mechanical hemolysis by double aspiration of K(2)EDTA blood through a 0.5 mL insulin syringe equipped with a very thin needle. The plasma was then separated from the blood cells by centrifugation at 2000 xg for 15 min at room temperature. A Beckman Coulter DxC 800 was used to measure the hemolysis index by direct spectrophotometry. Results: Compared with matched nondiabetic controls, type 2 diabetic patients had a significantly increased mechanical fragility of erythrocytes (hemolysis index ratio 21 +/- 13 vs. 14 +/- 10, p=0.02). Univariable linear regression analysis revealed that there was a strong positive association between percent hemolysis and fasting plasma glucose (r=0.669, p
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