Laboratory diagnostics (i.e., the total testing process) develops conventionally through a virtual loop, originally referred to as ''the brain to brain cycle'' by George Lundberg. Throughout this complex cycle, there is an inherent possibility that a mistake might occur. According to reliable data, preanalytical errors still account for nearly 60%-70% of all problems occurring in laboratory diagnostics, most of them attributable to mishandling procedures during collection, handling, preparing or storing the specimens. Although most of these would be ''intercepted'' before inappropriate reactions are taken, in nearly one fifth of the cases they can produce inappropriate investigations and unjustifiable increase in costs, while generating inappropriate clinical decisions and causing some unfortunate circumstances. Several steps have already been undertaken to increase awareness and establish a governance of this frequently overlooked aspect of the total testing process. Standardization and monitoring preanalytical variables is of foremost importance and is associated with the most efficient and well-organized laboratories, resulting in reduced operational costs and increased revenues. As such, this article is aimed at providing readers with significant updates on the total quality management of the preanalytical phase to endeavour further improvement for patient safety throughout this phase of the total testing process.

Urinalysis is one of the most common examinations in microbiological and chemical laboratories as well as at points of care. In addition to bacterial cultures, the term urinalysis encompasses here most common chemical tests related to diseases of the urinary tract and urine particle counting (urine microscopy).Several existing documents can be consulted for details on the microbiological examination of urine [1][2][3][4][5][6]. While quite a few national guidelines covering aspects of urinalysis have also been published [7-9], there is no general international standard or consensus document applicable for, for example, accreditation or validation of new technology available.Recently, a group chaired by Dr Timo Kouri, Tampere, Finland published the European Guidelines for Urinalysis [10] under the auspices of the European Confederation of Laboratory Medicine (ECLM). The complete text of this supplement is available in electronic form from Taylor & Francis at http:// www.tandf.no/sjcli. These guidelines were prepared together with the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Working Party on Urinalysis, moderated by Dr Vanya Gant, London, UK, to guarantee the quality of the written guidelines from the microbiological point of view. Several experts from most European countries have also contributed to the review of the draft document. An introduction to the project and the recently published paper for clinical chemists is given elsewhere [11]. This paper aims to introduce the guidelines to European clinical microbiologists.The ECLM European Urinalysis Guidelines discuss the complete process of clinical urine analysis. They embrace indications for urinalysis at several stages: diagnostic strategies;

Cystatin C is a non-glycated, 13-kDa basic protein produced by all nucleated cells. Recent studies have indicated that the plasma concentration of cystatin C is a better marker for glomerular filtration rate (GFR) than plasma creatinine, which is most commonly used for this purpose. We established reference values for plasma cystatin C in pre- or full-term infants and children. For comparison we also measured the creatinine concentration in the same samples. Cystatin C was measured by a commercially available immunoturbidimetric method with a Hitachi 704 analyzer in sera obtained from 58 pre-term infants, 50 full-term infants and 299 older children (132 girls, 167 boys, median age 4.17 years, range 8 days to 16 years). No sex differences were found. The pre-term infants had higher cystatin C concentrations (mean 1.88 mg/l, SD 0.36 mg/l) than the full-term (mean 1.70 mg/l, SD 0.26 mg/l, P=0.0145). The reference interval for pre-term infants calculated non-parametrically was 1.34-2.57 mg/l and for full-term infants 1.36-2.23 mg/l. The cystatin C concentration decreased rapidly after birth, and above 3 years of age did not depend on age. The reference interval for children 3-16 years of age calculated non-parametrically was 0.51-1.31 mg/l. Younger children (<1 year: 0.75-1.87 mg/l; 1-3 years: 0.68-1.60 mg/l) had slightly, but significantly, higher plasma cystatin C levels.

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