Janne Cadamuro

Janne Cadamuro
Paracelsus Medical University Salzburg · University Institute of Laboratory Medicine

Doctor of Medicine
Lord of Glencoe writing his next novel.

About

107
Publications
67,076
Reads
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1,612
Citations
Additional affiliations
October 2003 - present
Paracelsus Medical University Salzburg
Position
  • Medical Doctor
Position
  • Paracelsus medizinische Privatuniversität Salzburg
Position
  • Austria Fachhochschule Salzburg

Publications

Publications (107)
Article
Objectives Although laboratory result presentation may lead to information overload and subsequent missed or delayed diagnosis, little has been done in the past to improve this post-analytical issue. We aimed to investigate the efficiency, efficacy and user satisfaction of alternative report formats. Methods We redesigned cumulative (sparkline for...
Article
Background Recommendations on the optimal preservation of 24 h urine for the metabolic work-up in urolithiasis patients are very heterogeneous. In case two such tests with different storage condition recommendations are being analysed, multiple collections would be needed, challenging especially elderly and very young patients. We therefore aimed t...
Article
Full-text available
Context.— Underuse of laboratory testing has been previously investigated in preselected populations, such as documented malpractice claims. However, these numbers might not reflect real-life situations. Objective.— To evaluate the underuse and misuse of laboratory follow-up testing in a real-life hospital patient population with microcytic anemia...
Article
Full-text available
Since the beginning of laboratory medicine, the main focus was to provide high quality analytics. Over time the importance of the extra-analytical phases and their contribution to the overall quality became evident. However, as the initial preanalytical processes take place outside of the laboratory and mostly without its supervision, all professio...
Article
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During a dual-center study on obese and normal weight children and adolescents, focusing on glucose metabolism, we observed a marked difference in glucose results (N = 16,840) between the two sites, Salzburg, Austria and Uppsala, Sweden (P < 0.001). After excluding differences in patient characteristics between the two populations as cause of this...
Conference Paper
Full-text available
The extra-analytical parts of the total laboratory testing process have been neglected for a long time. In the past few years, the interest in preanalytical topics increased, but not in post-analytical issues, despite being one of the most important process steps regarding the medical impact of laboratory medicine. In both pre- and post-analytical...
Article
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Bereits vor über 40 Jahren, im Jahr 1976, schrieb Alan M. Bold »An unattractive, uninformative, or confusing report may fail to do justice to an excellent analytical service. Unfortunately, relatively little effort has been expended on achieving the best possible report, and individual enthusiasm and initiative has led to widely diverse practices i...
Article
Full-text available
Cladribine (CLAD) is a lymphodepleting agent approved for active relapsing multiple sclerosis (MS). The impact of CLAD on the adaptive humoral immune system has not sufficiently been studied. This study aimed to assess the influence of CLAD treatment on specific antibody titers to common pathogens. We included 18 MS patients treated with CLAD. Seru...
Article
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Laboratory medicine has evolved from a mainly manual profession, providing few selected test results to a highly automated and standardized medical discipline, generating millions of test results per year. As the next inevitable evolutional step, artificial intelligence (AI) algorithms will need to assist us in structuring and making sense of the m...
Article
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Objectives: Legal regulations and guidelines such as the Guidelines of the German Medical Association for the Quality Assurance of Laboratory Medical Examinations (Rili-BAEK) and ISO 15189 apply to electronic laboratory reports. However, many laboratories struggle with prac- tical implementation of these regulations and guidelines. Methods: Laborat...
Article
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Inappropriate laboratory test selection in the form of overutilization as well as underutilization frequently occurs despite available guidelines. There is broad approval among laboratory specialists as well as clinicians that demand management strategies are useful tools to avoid this issue. Most of these tools are based on automated algorithms or...
Article
In laboratory medicine, much effort has been put into analytical quality in the past decades, making this medical profession one of the most standardized with the lowest rates of error. However, even the best analytical quality cannot compensate for errors or low quality in the pre or postanalytical phase of the total testing process. Guidelines fo...
Article
Aims: Blood coagulation is one of the most important host-defending mechanisms in vivo by maintaining the blood pressure after injury. However, besides maintaining homeostasis, blood coagulation and the contributing factors are directly linked to pathological conditions, such as thromboembolism and inflammation, leading to cardiovascular diseases,...
Article
Background Exercise training is a cornerstone of the treatment of COPD in all disease stages. Data about the training effects with supplemental oxygen in non-hypoxemic patients remains inconclusive. In this study we set out to investigate the training and oxygen effects on inflammatory markers, vascular function and endothelial progenitor cells in...
Article
Full-text available
To ensure that clinical laboratories produce results that are both accurate and of clinical utility it is essential that only samples of adequate quality are analysed. Although various studies and databases assessing the stability of analytes in different settings do exist, guidance on how to perform and report stability studies is lacking. This re...
Article
Full-text available
Objectives: An accurate knowledge of blood collection times is crucial for verifying the stability of laboratory analytes. We therefore aimed to (i) assess if and how this information is collected throughout Europe and (ii) provide a list of potentially available solutions. Methods: A survey was issued by the European Federation of Clinical Chemis...
Article
Full-text available
Laboratory analyses are crucial for diagnosis, follow-up and treatment decisions. Since mistakes in every step of the total testing process may potentially affect patient safety, a broad knowledge and systematic assessment of laboratory errors is essential for future improvement. In this review, we aim to discuss the types and frequencies of potent...
Article
Background Laboratory overutilization is associated with diagnostic error and potential patient risk. We applied a demand management strategy in collaboration with the local Department of Cardiology to reduce the cardiac markers high-sensitive troponin T (hsTropT) and N-terminal pro brain natriuretic peptide (NTproBNP) in laboratory ordering profil...
Article
Background Quality assurance (QA) in point-of-care testing (POCT) is an important issue for organizing POCT structures within the healthcare sector. In Germany, only one device needs to participate in an external QA program, if the responsible core laboratory is supervising internal quality controls of all other identical POCT devices. This flexibl...
Article
Background: Many trauma centres have adopted the administration of fixed ratios of packed red blood cells (PRBCs), platelet concentrates and fresh frozen plasma (FFP) for bleeding patients. However, the haemostatic efficacy of this concept is not well proven. Objective: Our objective was to characterise the haemostatic profile of different ratio...
Article
Isntroduction Too frequent HbA1c measurements may lead to unnecessary treatment modifications of diabetic patients. The aim of this study was to estimate the percentage of falsely elevated HbA1c results in two hospitals, Landeskrankenhaus/Uniklinikum Salzburg (LKH) and Landesklinik St. Veit (STV), as well as to retrospectively investigate the effec...
Article
Introduction. The appropriate use of laboratory diagnostics is increasingly at stake. The aim of this study was to depict some paradigmatic examples of under- and overutilization, as well as possible solutions across Europe. Methods. We collected six examples from five European countries where a rise or decline of orders for specific laboratory par...
Article
Full-text available
Background: Pharmacological treatment options for adolescents with obesity are very limited. Glucagon-like-peptide-1 (GLP-1) receptor agonist could be a treatment option for adolescent obesity. Objective: To investigate the effect of exenatide extended release on body mass index (BMI)-SDS as primary outcome, and glucose metabolism, cardiometabol...
Article
Background Laboratory tests are an essential aspect of current medical practice and their use has grown exponentially. Several studies however have demonstrated inappropriate use of laboratory testing. This inappropriateness can lead to delayed or wrong diagnosis, negatively impacting patient safety and an increase in health care expenditure. The a...
Article
Full-text available
The European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase (WG-PRE) was originally established in 2013, with the main aims of (i) promoting the importance of quality in the preanalytical phase of the testing process, (ii) establishing best practices and providing guidance for critical acti...
Article
Niniejszy dokument zawiera zalecenia dotyczące pobierania krwi żylnej, opracowane wspólnie przez European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE) oraz Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin America Confederation of Clinical Biochemistry...
Article
Full-text available
Although the importance of guaranteeing a high level of preanalytical quality in routine diagnostic testing has already been largely acknowledged over the past decades, minor emphasis is currently being placed on the fact that accurate performance and standardization of many preanalytical activities are also necessary prerogatives of clinical trial...
Article
Hemolysis is conventionally defined as membrane disruption of red blood cells and other blood cells that is accompanied by subsequent release of intracellular components into the serum or plasma. It accounts for over 60% of blood sample rejections in the laboratory and is the most common preanalytical error in laboratory medicine. Hemolysis can occ...
Article
Background. Published evidence on the risk of additive carryover during phlebotomy remains elusive. We aimed to assess potential carryover of citrated and heparinized blood and the relative volume needed to bias clinical chemistry and coagulation tests. Methods. We simulated standardized phlebotomies to quantify the risk of carryover of citrate and...
Article
Full-text available
Objective: To delineate potential mechanisms for fasting hyperglucagonemia in childhood obesity by studying the associations between fasting plasma glucagon concentrations and plasma lipid parameters and fat compartments. Methods: Cross-sectional study of children and adolescents with obesity (n=147) and lean controls (n=43). Differences in free...
Article
Full-text available
Introduction: Compared to other activities of the testing process, the preanalytical phase is plagued by a lower degree of standardization, which makes it more vulnerable to errors. With the aim of providing guidelines and recommendations, the EFLM WG-PRE issued a survey across European medical laboratories, to gather information on local preanaly...
Article
Full-text available
Introduction: No guideline currently exists on how to detect or document haemolysis, icterus or lipemia (HIL) in blood samples, nor on subsequent use of this information. The EFLM WG-PRE has performed a survey for assessing current practices of European laboratories in HIL monitoring. This second part of two coherent articles is focused on HIL. M...
Conference Paper
Laboratory values may be influenced by several controllable anduncontrollable preanalytical variables. One of the former is thefasting condition of the patient prior to blood collection. Food, water,alcohol and coffee intake as well as smoking potentially alterlaboratory test results. Although this circumstance may have asignificant impact on the i...
Article
Full-text available
This document provides a joint recommendation for venous blood sampling of the European federation of clinical chemistry and laboratory medicine (EFLM) Working Group for preanalytical phase (WG-PRE) and Latin American working group for preanalytical phase (WG-PRE-LATAM) of the Latin America confederation of clinical biochemistry (COLABIOCLI). It of...
Article
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Background Marinobufagenin (MBG) is an endogenous cardiotonic steroid (CTS) that inhibits the Na+/K+-ATPase. Human MBG is significantly increased in end-stage renal disease and immunization against MBG attenuates cardiovascular fibrosis in a rat model of uremic cardiomyopathy. Mineralocorticoid antagonists (MRA) block MBG binding sites and decrease...
Data
Dataset as xlsx file from the GECOH Study. Data from baseline visit(s) and follow-up. (XLSX)
Article
Full-text available
The European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase (WG-PRE) was originally established in 2013, with the main aims of (i) promoting the importance of quality in the preanalytical phase of the testing process, (ii) establishing best practices and providing guidance for critical acti...
Article
Transportation of blood samples is a major part of the preanalytical pathway and can be crucial in delaying laboratory results to the clinicians. A variety of aspects however makes sample transportation a complex, challenging and often overlooked task that needs thorough planning and dedicated resources. The purpose of this review is to outline the...
Article
Background Reference intervals are a prerequisite for the interpretation of laboratory data related to diagnostic issues and treatment strategies. In adolescents, biomarker concentrations change with age, necessitating a continuous age-related definition of the reference intervals. The purpose of this pilot study was to evaluate the reference inter...
Article
Full-text available
Background The inappropriate use of laboratory resources, due to excessive number of tests not really necessary for patient care or by failure to order the appropriate diagnostic test, may lead to wrong, missed or delayed diagnosis, thus potentially jeopardizing patient safety. It is estimated that 5–95% of tests are currently used inappropriately,...
Article
Background Nowadays over-the-counter (OTC) drugs and dietary supplements are widely used. Their use can have a significant impact on the validity of laboratory results. The aim of this multicenter European study was to determine the frequency of consumption of various dietary products and OTC drugs among patients and explore their level of knowledg...
Article
Full-text available
This document provides a joint recommendation for venous blood sampling of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE) and Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin America Confederation of Clinical Biochemistry (COLABIOCLI). It of...
Article
Full-text available
Automatic assessment of hemoglobin (H), lipaemia (L) and icterus (I) in serum or plasma (HIL indices) is the mainstay for evaluating sample quality. We planned this study to verify whether in-house prepared internal quality control (IQC) materials may be suitable for quality assurance of HIL indices. Pools containing different values of each of the...
Data
Variation of triglycerides, total cholesterol, total and unconjugated bilirubin after the first freezing-thawing cycle. Significance of difference was assessed with one-way analysis of variance (ANOVA). L, Low; M, Medium; H, High. (DOC)
Article
Several lines of evidence now confirm that the vast majority of errors in laboratory medicine occur in the extra-analytical phases of the total testing processing , especially in the preanalytical phase. Most importantly , the collection of unsuitable specimens for testing (either due to inappropriate volume or quality) is by far the most frequent...
Article
Full-text available
The new generation of clinical chemistry and coagulation analyzers is equipped with technical features allowing a systematic check of sample quality, including an assessment of the so-called HIL ("hemolysis", "icterus", "lipemia") indices. These measures enable an accurate and reproducible assessment of sample hemol-ysis in serum or plasma, hence t...
Article
The presence of interfering substances like free hemoglobin, bilirubin or lipids compromises sample quality and potentially affects laboratory analysis and test results. Recently, the use of serum indices for objectively assessing sample quality has become commonplace and many preanalytical platforms, as well as clinical chemistry and coagulation a...
Article
Introduction: Practical and ethical challenges as well as time and costs have restricted the generation of pediatric reference intervals. Therefore, pediatric reference intervals on coagulation parameters based on solid evidence are still scarce. Furthermore, reference intervals by age-group cannot reflect the dynamics of age and sex specific coag...
Article
The presence of hemolysis (H), icterus (I) and lipaemia (L) in serum or plasma samples may be regarded as an important preanalytical drawback, since an abnormal concentration of these substances may derange the global quality and reliability of the total testing process. Although the assessment of sample quality before testing by means of the so-ca...
Article
Full-text available
Introduction Although centrifugation is performed in almost every blood sample, recommendations on duration and g-force are heterogeneous and mostly based on expert opinions. In order to unify this step in a fully automated laboratory, we aimed to evaluate different centrifugation settings and their influence on the results of routine clinical chem...
Article
Background. Inappropriate utilization of laboratory resources is an increasing concern especially in high-throughput facilities. Until now, no reliable information has been published addressing to which extent laboratory results are actually used for clinical decision-making. Therefore, we aimed to close this gap using a novel retrospective approac...
Article
We suggest here a pragmatic approach for managing results of clinical chemistry testing in hemolyzed samples collected from adults/older children, attempting to balance the need to produce quality laboratory data with clinical urgency of releasing test results. Automatic measurement of the hemolysis index (H-index) in serum or plasma is highly advi...
Article
The measurement of fasting plasma glucose may be biased by a time-dependent decrease of glucose in blood tubes, mainly attributable to blood cell metabolism when glycolysis is not rapidly inhibited or blood cells cannot be rapidly separated from plasma. Although glycolysis inhibitors such as sodium fluoride (NaF) in combination with potassium oxala...
Article
Full-text available
Zusammenfassung Für die Gewinnung von Blut für die Diagnostik ist die periphere venöse Blutentnahme das häufigste Vorgehen. Eine fehlerhafte Blutentnahme ist eine relevante Quelle fehlerhafter Befunde. Aus diesem Grund werden als Anleitung für die Abnehmenden die wichtigen Schritte praxisnah detailliert beschrieben. Zu den dargestellten Schritten z...
Article
Full-text available
Interleukin (IL)-16, a polypeptide cytokine, plays a crucial role in the inflammatory process, acting as a chemoattractant for peripheral immune cells and has been linked to various inflammatory diseases. However, its role in patients with acute myocardial infarction (AMI) is unclear. We retrospectively analyzed serum levels of IL-16 in blood of pa...
Article
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Visual inspection may seriously jeopardize patient safety, finally tipping the balance towards replacing manual management with routine use of serum or plasma indices for assessing sample quality. With an adaptation of the foremost Marco Tullio Cicerone’s speech, we can provokingly conclude… “visual assessment of sample quality: quo usque tandem?”
Article
Under-diagnosis of HIT is potentially life-threatening, but also an over diagnosis of this condition may have serious clinical consequences; thus, an efficient diagnostic approach designed to improve appropriateness is crucial. According to the results of our investigation, we can conclude that implementation of the HIT-4Ts scoring into a physician...
Article
The improving quality of laboratory testing requires a deep understanding of the many vulnerable steps involved in the total examination process (TEP), along with the identification of a hierarchy of risks and challenges that need to be addressed. From this perspective, the Working Group “Laboratory Errors and Patient Safety” (WG-LEPS) of Internati...
Article
Background: Novel biomarkers representing different pathobiological pathways and their role in patients with acute myocardial infarction (AMI) were studied. Methods: We retrospectively analyzed serum levels of soluble suppression of tumorigenicity (sST2), growth-differentiation factor-15 (GDF-15), soluble urokinase plasminogen activator receptor...
Article
Subcutaneous calcifications can lead to complications, including pain, inflammation, ulceration and immobilization. Studies on the pathophysiology of mineral compositions and effective treatment modalities are limited. We therefore studied 14 patients with subcutaneous calcifications. Mineral material was collected and analysed by Fourier transform...
Article
Full-text available
We report on a preanalytical issue we encountered during routine clinical chemistry analyses, potentially leading to deviated analysis results and believe that it might help other laboratories to overcome similar problems. In a heparin-gel tube we measured an implausible glucose value of 0.06 mmol/L. Re-measurement of the same sample resulted in a...
Article
Full-text available
The preanalytical phase is crucial for assuring the quality of in vitro diagnostics. The leading aspects which contribute to enhance the vulnerability of this part of the total testing process include the lack of standardization of different practices for collecting, managing, transporting and processing biological specimens, the insufficient compl...
Article
Full-text available
NADPH oxidases of human cells are not only functional in defense against invading microorganisms and for oxidative reactions needed for specialized biosynthetic pathways, but during the last few years have been established as signaling modules. It has been shown that human Nox4 is expressed in most somatic cell types and produces hydrogen peroxide,...