Otto Folin: America's First Clinical Biochemist. Samuel Meites

Isis ◽  
1990 ◽  
Vol 81 (1) ◽  
pp. 134-135
Author(s):  
Joseph S. Fruton
Keyword(s):  
Clinical Biochemist

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 Elimination of 72-Hour Quantitative Fecal Fat Testing by Restriction, Laboratory Consultation, and Evaluation of Specimen Weight and Fat Globules

2018 ◽  
Vol 3 (3) ◽  
pp. 357-365
Author(s):  
Michael Korostensky ◽  
Steven R Martin ◽  
Mark Swain ◽  
Maitreyi Raman ◽  
Christopher T Naugler ◽  
...  
Keyword(s):  
Roc Curves ◽  
Geographic Region ◽  
Discrimination Power ◽  
Fat Globules ◽  
Fecal Fat ◽  
Southern Alberta ◽  
Specimen Weight ◽  
Qualitative Test ◽  
Fat Excretion ◽  
Clinical Biochemist

Abstract Background The 72-h quantitative fecal fat test has been mostly obsolete for many years. Our objective was to reduce and eliminate the use of this test, while providing suitable alternatives. Methods We assessed (2010–2016) utilization of the fecal fat test in Calgary, Central Alberta, and Southern Alberta, Canada. Alternatives were identified through literature review and consultation with gastroenterologist stakeholders. Logistic regression and ROC curves were used to characterize discrimination power of 72-h specimen weight on abnormal fat excretion. This was also examined in 91 subspecimens that were additionally tested for the presence of fat globules. Results As 69% of fecal fat tests (total, 106/year) were on adults (age ≥ 18), stakeholders agreed that adult specimens should not be tested until ordering physicians consulted with a clinical biochemist. This change reduced fecal fat testing by 81% to 20/year in 2015. The 72-h specimen weight was a significant predictor of abnormal fat excretion [P < 0.001; area under curve (AUC) = 0.75–0.79, n = 115–417] in historic fecal fat data. A similar result was observed among subspecimens (AUC = 0.70), which improved when additionally considering the presence of fat globules (AUC = 0.74). Stakeholders consented to replacing fecal fat with a comparison of specimen weight to cutpoints with 80% specificity for abnormal fat excretion, and the test for fat globules. Conclusion Through stakeholder engagement, we implemented changes that eliminated 72-h quantitative fecal fat testing in a large geographic region in Alberta, Canada. Future fecal fat orders would be reflexed to an assessment of 72-h specimen weight and a qualitative test for fat globules in stool.

The role of the clinical biochemist in health care

Pathology ◽  
1979 ◽  
Vol 11 (2) ◽  
pp. 318
Author(s):  
P.R. Pannall
Keyword(s):  
Health Care ◽  
Clinical Biochemist

scholarly journals DUTIES AND RESPONSIBILITIES OF CLINICAL BIOCHEMIST IN PSYCHIATRY HOSPITAL

2020 ◽  
Vol 8 (9) ◽  
pp. 837-840
Author(s):  
Phukan J.K ◽  
◽  
Bora G.K ◽  
Yadav S ◽  
◽  
...  
Keyword(s):  
Research Education ◽  
General Rules ◽  
Clinical Biochemist

The duties and responsibilities of Clinical Biochemists are evolving. Some of theclassical duties and responsibilities of Clinical Biochemists in a Tertiary Psychiatry hospital are basically in the area of research, education and service. Some general rules of success for younger Clinical Biochemist in his/her fieldare also important topic of discussion. We are living in very competitive timesand Clinical Biochemists mustlearn to adapt very quickly to the continuing changes in our discipline. We are yet to realize the best times of this exciting profession.

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.

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