Diagnostic Biochemistry and Clinical Medicine: Facts and Fallacies

1963 ◽  
Vol 9 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Oscar Bodansky
Keyword(s):  
Clinical Medicine ◽  
Clinical Biochemistry ◽  
Hereditary Disease ◽  
Malignant Carcinoid ◽  
Laboratory Error ◽  
Interlaboratory Variability ◽  
Enzyme Defects ◽  
Precision And Accuracy ◽  
Clinical Biochemist ◽  
Made In

Abstract In this paper we have attempted to define the relationships between clinical medicine and diagnostic or, as it is more frequently termed, clinical biochemistry. We have indicated first, the role that general biochemistry has played in elucidating mechanisms of disease and in providing the clinician with procedures that aid him in the diagnosis of disease and in the care of the patient. We have illustrated this role by reviewing very briefly some of the recent contributions such as the expanded diagnostic use of serum enzymes; the correlation of subcellular structure in human tissues with function at enzymatic levels; the investigation of enzyme variants; the metabolism of epinephrine and norepinephrine in pheochromocytoma; the metabolism of tryptophan in malignant carcinoid; and enzyme defects in hereditary disease. We noted the reservations with which the clinician frequently views the specific results that he obtains from the diagnostic biochemistry laboratory and have attempted to analyze the bases for these reservations. In this connection we considered the phenomenon of interlaboratory variability, the nature of the random and the constant errors that may exist within a laboratory, and the measures that the clinical biochemist may take to counteract these errors. We have tried to indicate the steps the clinician may take in a fuller and more knowledgeable utilization of the data from the diagnostic biochemistry laboratory. These involve a recognition of the efforts and advances that are being made in increasing precision and accuracy within the laboratory and the role that the clinician himself can play in contributing to this precision and accuracy. The phenomenon of intraindividual and interindividual variability of biochemical parameters, and the significance of this phenomenon in diagnosis, are also worthy of the clinicians attention. Finally, the clinician should abjure the concept that a seeming discrepancy between his formulation and laboratory results usually means a laboratory error. Thoughtful review, in cooperation with the biochemist, of such discrepancies are of value both for clinical medicine and clinical biochemistry.

scholarly journals Granulocyte transfusions: current status

Blood ◽  
1980 ◽  
Vol 55 (1) ◽  
pp. 2-8 ◽  
Author(s):  
DJ Higby ◽  
D Burnett
Keyword(s):  
Bone Marrow ◽  
Acute Leukemia ◽  
Clinical Medicine ◽  
Bone Marrow Failure ◽  
Current Status ◽  
Granulocyte Transfusion ◽  
Transfusion Therapy ◽  
Neutropenic Patients ◽  
Ongoing Evaluation ◽  
Made In

Abstract Since granulocyte transfusions first became widely used in clinical medicine, there have been advances in the treatment of acute leukemia and improvement in prevention and management of infection in neutropenic patients. Improved understanding now exists concerning prognosis of infections in such patients, and advances have been made in procurement of granulocytes. Granulocyte transfusions should be given for specific indications, and used adjunctively to other established antiinfective therapy. Once initiated, transfusions should be given in adequate doses at daily intervals (at least) with ongoing evaluation and periodic reassessment of the whole antiinfective program. Serious complications of granulocyte transfusion therapy are relatively rare, but the physician should be prepared to manage them intelligently. Research continues in discerning exactly how granulocyte transfusion work, in preservation of granulocytes, and in delineation of immunologic phenomena affecting the efficiacy of such therapy. Granulocyte transfusions will continue to be important in the management of acute leukemia, and other reversible bone marrow failure states, and in marrow transplantation and autotransplantation.

Introduction to medical physiology: cellular membranes and transmembrane transport of solutes and water.

1996 ◽  
Vol 271 (6) ◽  
pp. S2
Author(s):  
D J Benos
Keyword(s):  
Clinical Medicine ◽  
Conceptual Basis ◽  
University Of Alabama ◽  
Basic Sciences ◽  
Basic Principles ◽  
Cellular Physiology ◽  
School Of Medicine ◽  
Introductory Session ◽  
The University ◽  
Made In

This article summarizes the comments made in the introductory session of the Medical Physiology course taught at the University of Alabama School of Medicine. The main thesis is that learning physiology is easier when fundamental principles are first delineated. Four general principles of physiology (mass balance, force-flow, capacitance, and equilibrium) are discussed. Clinical medicine becomes more comprehensible when these basic principles are understood. Cellular Physiology is taught first because it forms the conceptual basis for what follows in the course. The idea that the root of clinical medicine lies in the basic sciences is emphasized.

scholarly journals Guidelines for management of thyroid cancer in adults: implications for clinical biochemistry

2003 ◽  
Vol 40 (5) ◽  
pp. 435-438 ◽  
Author(s):  
Graham H Beastall
Keyword(s):  
Thyroid Cancer ◽  
Patient Management ◽  
Clinical Biochemistry ◽  
Thyroid Stimulating Hormone ◽  
Management Team ◽  
Detailed Knowledge ◽  
Cancer Management ◽  
Specialist Centre ◽  
Support Team ◽  
Clinical Biochemist

The implementation of recently published guidelines for the management of thyroid cancer in adults should result in improved clinical outcomes for patients with this condition. A clinical biochemist should be part of the support team for the local multidisciplinary thyroid cancer management team. Serum thyroid-stimulating hormone assays should have a minimum detection limit of 0.10mU/L or lower and good baseline security. The measurement of both thyroglobulin and calcitonin is challenging and clinical biochemists should have detailed knowledge of the performance characteristics and limitations of the assays that they report, including those referred to a specialist centre, in order to facilitate clinically valid decisions on patient management.

Tutorial software for clinical chemistry incorporating interactive multimedia clinical cases

1995 ◽  
Vol 41 (9) ◽  
pp. 1345-1348 ◽  
Author(s):  
J Hooper ◽  
J O'Connor ◽  
R Cheesmar ◽  
C P Price
Keyword(s):  
Clinical Medicine ◽  
Clinical Biochemistry ◽  
Clinical Chemistry ◽  
Real Life ◽  
Deep Understanding ◽  
Learning Assessment ◽  
Biochemical Processes ◽  
Computer Based ◽  
Physiological And Biochemical ◽  
Clinical Problems

Abstract We have developed computer-based clinical case histories incorporating multimedia elements to aid the learning of medicine in a problem-based manner. Topics have been developed in the specialty of Clinical Biochemistry but the approach used is suitable for any branch of clinical medicine. Each topic has material aimed at medical students and also postgraduate candidates for professional examinations. A browser program is also incorporated. Emphasis is made on interaction through the case and modeling of real-life decisions in diagnosis and treatment. Advantages of the program are self-paced learning, assessment of understanding, feedback, and emphasis on deep understanding of the basic physiological and biochemical processes underlying clinical problems.

scholarly journals The art of medicine: a developing country version

2020 ◽  
Vol 19 (4) ◽  
pp. 778-779
Author(s):  
Naseeb Muhammad Irshadullah
Keyword(s):  
Developing Countries ◽  
Developing Country ◽  
Medical Practice ◽  
Clinical Medicine ◽  
Medical Science ◽  
Level Of Care ◽  
Academic Environment ◽  
Art Of Medicine ◽  
Practice Of Medicine ◽  
Made In

‘The art of medicine’ is a commonly discussed topic in clinical medicine. It is that aspect of medical practice which makes the physicians more humane over medical scientists. Though frequently reminded by the teachers in academic environment, in a developing country like Bangladesh, the art of medicine is barely practised at any level of care. An effort is made in this article to depict the practice of medicine in developing countries mostly devoid of art, the reasons behind, and some suggestions. Bangladesh Journal of Medical Science Vol.19(4) 2020 p.778-779

scholarly journals Microcirculation: Physiology, Pathophysiology, and Clinical Application

2019 ◽  
Vol 49 (1-2) ◽  
pp. 143-150 ◽  
Author(s):  
Goksel Guven ◽  
Matthias P. Hilty ◽  
Can Ince
Keyword(s):  
Clinical Medicine ◽  
Point Of Care ◽  
Response To Therapy ◽  
Inadequate Response ◽  
Analysis Software ◽  
Paper Briefly ◽  
Central Function ◽  
Central Target ◽  
Instant Availability ◽  
Made In

This paper briefly reviews the physiological components of the microcirculation, focusing on its function in homeostasis and its central function in the realization of oxygen transport to tissue cells. Its pivotal role in the understanding of circulatory compromise in states of shock and renal compromise is discussed. Our introduction of hand-held vital microscopes (HVM) to clinical medicine has revealed the importance of the microcirculation as a central target organ in states of critical illness and inadequate response to therapy. Technical and methodological developments have been made in hardware and in software including our recent introduction and validation of automatic analysis software called MicroTools, which now allows point-of-care use of HVM imaging at the bedside for instant availability of functional microcirculatory parameters needed for microcirculatory targeted resuscitation procedures to be a reality.

scholarly journals Granulocyte transfusions: current status

Blood ◽  
1980 ◽  
Vol 55 (1) ◽  
pp. 2-8
Author(s):  
DJ Higby ◽  
D Burnett
Keyword(s):  
Bone Marrow ◽  
Acute Leukemia ◽  
Clinical Medicine ◽  
Bone Marrow Failure ◽  
Current Status ◽  
Granulocyte Transfusion ◽  
Transfusion Therapy ◽  
Neutropenic Patients ◽  
Ongoing Evaluation ◽  
Made In

Since granulocyte transfusions first became widely used in clinical medicine, there have been advances in the treatment of acute leukemia and improvement in prevention and management of infection in neutropenic patients. Improved understanding now exists concerning prognosis of infections in such patients, and advances have been made in procurement of granulocytes. Granulocyte transfusions should be given for specific indications, and used adjunctively to other established antiinfective therapy. Once initiated, transfusions should be given in adequate doses at daily intervals (at least) with ongoing evaluation and periodic reassessment of the whole antiinfective program. Serious complications of granulocyte transfusion therapy are relatively rare, but the physician should be prepared to manage them intelligently. Research continues in discerning exactly how granulocyte transfusion work, in preservation of granulocytes, and in delineation of immunologic phenomena affecting the efficiacy of such therapy. Granulocyte transfusions will continue to be important in the management of acute leukemia, and other reversible bone marrow failure states, and in marrow transplantation and autotransplantation.

scholarly journals An Inter-Laboratory Quality-Assurance Survey of Emergency Clinical Biochemistry Tests

1984 ◽  
Vol 21 (6) ◽  
pp. 494-497 ◽  
Author(s):  
L R Watkinson ◽  
C G Fraser
Keyword(s):  
Quality Assurance ◽  
Clinical Biochemistry ◽  
State Of The Art ◽  
Analytical Performance ◽  
Serum Chemistry ◽  
Air Cargo ◽  
Serum Samples ◽  
Laboratory Error ◽  
Target Values ◽  
Routine Basis

One hundred and thirteen Australian laboratories participated in a state-of-the-art quality-assurance survey of emergency clinical biochemistry tests. Two liquid-reconstituted lyophilised human-based serum samples, which had previously been analysed in the national general serum chemistry programme, were sent by air cargo, together with their own previously completed request forms, for analysis as emergency tests on a previously nominated date. The standard of performance of ten of the eleven most commonly performed tests was inferior to that obtained on a routine basis, as judged by the number of results outside present limits of total laboratory error from target values which had been previously set by reference laboratories. The standard of analytical performance achieved for emergency tests can and should be improved.

scholarly journals Quantitative analyses of maxillary sinus using computed tomography

2003 ◽  
Vol 11 (3) ◽  
pp. 229-233 ◽  
Author(s):  
Andréia Perella ◽  
Sara dos Santos Rocha ◽  
Marcelo de Gusmão Paraiso Cavalcanti
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Percentage Error ◽  
Ct Reconstruction ◽  
Linear Measurements ◽  
Observer Error ◽  
Quantitative Analyses ◽  
Precision And Accuracy ◽  
3D Ct Reconstruction ◽  
Made In

The aim of this study was to evaluate the precision and accuracy of linear measurements of maxillary sinus made in tomographic films, by comparing with 3D reconstructed images. Linear measurements of both maxillary sinus in computed tomography CT of 17 patients, with or without lesion by two calibrated examiners independently, on two occasions, with a single manual caliper. A third examiner has done the same measurements electronically in 3D-CT reconstruction. The statistical analysis was performed using ANOVA (analyses of variance). Intra-observer percentage error was little in both cases, with and without lesion; it ranged from 1.14% to 1.82%. The inter-observer error was a little higher reaching a 2.08% value. The accuracy presented a higher value. The perceptual accuracy error was higher in samples, which had lesion compared to that which had not. CT had provided adequate precision and accuracy for maxillary sinus analyses. The precision in cases with lesion was considered inferior when compared to that without lesion, but it can't affect the method efficacy.

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