Estrategias para la reconversión del ejercicio profesional: Proyecto Bioquímico Nexo / Strategies for the reconversion of professional practice: Biochemical Nexus Project

El avance de la ciencia y la tecnología en el área de la bioquímica clínica ha ocasionado la necesidad de reflexionar acerca de una reingeniería de la práctica profesional. El proceso diagnóstico es complejo y dinámico, requiere del trabajo interdisciplinario y de la comunicación efectiva, además de un cambio en el accionar profesional, con el eje centrado en el paciente y en un laboratorio "a puertas abiertas". En este marco se planteó el Proyecto Bioquímico Nexo (BN) con el propósito de lograr las competencias y habilidades necesarias para formar profesionales bioquímicos clínicos integrales que puedan cumplir con este nuevo rol sobre la base de una construcción colectiva de los saberes (AU)

Advances in science and technology in the area of clinical biochemistry have prompted the need to reflect on the reengineering of professional practice. The diagnostic process is complex and dynamic, requiring interdisciplinary work and effective communication, as well as a change in professional action, with the focus on the patient and an "open-door" laboratory. Within this framework, the Biochemical Nexus Project (BN) was proposed with the purpose of achieving the competencies and skills necessary to comprehensively train clinical biochemists who can fulfill this new role based on a collective construction of knowledge (AU)

[Could the publication of new european guidelines change practices in France?] / La publication au JO de nouveaux règlements européens sur les dispositifs médicaux pourrait-elle changer la pratique du diagnostic oncogénétique en France ?

The use of predictive biomarkers in the diagnosis and prediction of the efficacy of targeted therapies for the individualized management of patients is generally based on the use of in vitro medical diagnosis devices that are now covered by the guidelines 90/385/EEC, 93/42/EEC and 98/42/EEC. On 25 May 2017, the European Parliament and Council Regulations 2017/745 and 2017/746 of 5 April 2017, related to medical devices and in vitro medical diagnosis devices, respectively, were published, disrupting years of practices based on European directives. They tend to bring the in vitro diagnosis in Europe closer to the American regulation in order to improve the use of safety diagnosis tests, while the United States have been changing their practices in the face of biomedical, technological and digital evolutions. We will describe the different regulations of diagnostic tests and discuss their applications in the field of oncology.

[Data-driven integrated diagnostics: the natural evolution of clinical chemistry?] / Data-gedreven integrale diagnostiek.

In the near future, making a correct medical diagnosis will be increasingly supported by artificial intelligence. The development of algorithms that integrate all data from an individual into the diagnostic process calls for a multidisciplinary approach that includes not only healthcare professionals and patients, but also data scientists. Because of the position of the clinical chemist in the current health care process, this medical specialist is naturally suited to initiate the development of self-learning diagnostic algorithms and to take the lead in the process to take big data to the next level and create value for health care.

Clinical Laboratory Reference Intervals in Ethiopia: Current Status and Future Considerations: Review.

Background: Clinical laboratory reference intervals are derived from a sample of selected healthy population and they are used for disease diagnosis, management, and monitoring. International guidelines recommended that laboratories and manufacturers are supposed to establish their own RIs for a certain group of population. Therefore, the aim of this narrative review is to summarize the current status and to show future directions regarding reference intervals of clinical laboratory parameters among Ethiopian population. Methods: PubMed, Google Scholar, and Google databases were searched to access relevant reference interval studies in Ethiopia. Journal articles, guidelines, reports, and related documents published in English language were included without publication period restriction. Results: Fifteen studies were conducted to establish local reference intervals for hematology, immunology, and clinical chemistry parameters in Ethiopia from 1999 - 2018. The majority of those studies determined clinical laboratory reference intervals for adults only. Some other Ethiopian reference interval studies did not include the majority of routine hematology and clinical chemistry parameters. In addition, the studies we reviewed did not consider the cultural, ethnic, demographic, and geographical diversity of Ethiopian population. Conclusions: There is limited data regarding locally established reliable clinical laboratory reference intervals in Ethiopia though attempts are made. Therefore, further local reference interval studies should be undertaken considering the cultural, ethnic, demographical, and geographical diversity of the Ethiopian population.

British Journal of Biomedical Science in 2017: What have we learned?

In 2017 the British Journal of Biomedical Science published 35 articles in the various disciplines that comprise biomedical science. These were 6 reviews, 22 original articles, 6 'In Brief' short reports and one guideline. Of these, the majority were in clinical chemistry (one review, six data papers), microbiology (one review, four data papers), cellular pathology (four data papers) and virology (one review, two data papers). There were two data papers in transfusion science, whilst haematology, cytopathology and immunology were each represented by one review and one data paper. Reflecting the increasing complexity of the laboratory, five data papers crossed barriers between traditional disciplines, and so may be described as multidisciplinary. The present report will summarise key aspects of these publications.

Recent trends in determination of thiamine and its derivatives in clinical practice.

Over the last five decades, many methods to analyze thiamine (vitamin B1) and its phosphorylated forms in urine, whole blood, serum, plasma and erythrocytes have been proposed. Some of the methods are presently used in routine practice, but analytical problems regarding reproducibility, standardization, lack of automation, time consuming procedures for pretreatment and analysis are often discussed. With modern approaches to bioanalysis in clinical research of vitamins, whole processes can be automated, making analysis less time consuming, with reduced consumption of solvents and samples. This review critically discusses various analytical techniques, their advantages and disadvantages that are used for determination of thiamine and its derivatives in clinical practice, with emphasis on accurate, reliable and fast analytical procedures.

Oscillatory multiphase flow strategy for chemistry and biology.

Continuous multiphase flow strategies are commonly employed for high-throughput parameter screening of physical, chemical, and biological processes as well as continuous preparation of a wide range of fine chemicals and micro/nano particles with processing times up to 10 min. The inter-dependency of mixing and residence times, and their direct correlation with reactor length have limited the adaptation of multiphase flow strategies for studies of processes with relatively long processing times (0.5-24 h). In this frontier article, we describe an oscillatory multiphase flow strategy to decouple mixing and residence times and enable investigation of longer timescale experiments than typically feasible with conventional continuous multiphase flow approaches. We review current oscillatory multiphase flow technologies, provide an overview of the advancements of this relatively new strategy in chemistry and biology, and close with a perspective on future opportunities.

Standardization of FT4 and harmonization of TSH measurements - a request for input from endocrinologists and other physicians.

Given the prevalence of thyroid disorders and the subtle signs and symptoms that may accompany subclinical disease, reliable laboratory testing for serum TSH and free thyroid hormones is important for both primary care physicians and endocrinologists. The laboratory community has recognized the need for standardization of thyroid function tests to achieve comparability of measurement results between methods. This applies in particular to tests for free T4 (FT4), which may be considered controversial in terms of clinical and analytical validity. However, variability is also observed with TSH testing - a fact which has not been emphasized in ongoing discussions regarding lowering the upper limit of normal and/or common decision limits to start treatment for hypothyroidism. In response to this need, the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Committee for Standardization of Thyroid Function Tests worked over the years towards the goal of standardization of FT4 and TSH testing.

The future of laboratory medicine - a 2014 perspective.

Predicting the future is a difficult task. Not surprisingly, there are many examples and assumptions that have proved to be wrong. This review surveys the many predictions, beginning in 1887, about the future of laboratory medicine and its sub-specialties such as clinical chemistry and molecular pathology. It provides a commentary on the accuracy of the predictions and offers opinions on emerging technologies, economic factors and social developments that may play a role in shaping the future of laboratory medicine.