BIOCHEMICAL-CLINICAL ANALYSES
A. General Part
Interpretation and appropriateness in laboratory medicine. Reasons for requesting laboratory tests
Biological variability and interpretation of laboratory tests
Interpretation criteria for optimal use of laboratory tests
Preanalytic phase
B. Special part
Diagnosis of diabetes mellitus
The laboratory in cardiovascular risk assessment
Laboratory diagnostics of hepatopathies
Biochemical evaluation of acute and chronic pancreatic diseases
Biochemical study of renal function
Biochemical neoplasm markers
Biochemical markers in the diagnosis and monitoring of heart diseases
Biochemical indicators of bone remodeling
Clinical biochemistry of plasma proteins
Clinical biochemistry of changes in iron metabolism
Laboratory diagnostics of the main vitamin deficiencies. Biomarkers in gastro-intestinal diseases.
Acid-base balance diagnostics.
Biomarkers in neurological diseases
A. General Part
1. Interpretation and appropriateness in laboratory medicine. Reasons for requesting laboratory tests
2. Biological variability and interpretation of laboratory tests
1. definitions
1. Controllable biological variability
2. inter-individual biological variability
3. intra-individual biological variability
4. analytical and interpretative relevance of biological variables
5. field of application
2. Definition of analytical goals according to biological variability
1. metrological premises
2. imprecision goals
3. goals of inaccuracy
4. analytical goals for different quality levels
3. relevance of biological variability for the interpretation of results
1. critical difference
2. reference values
4. medical relevance of biological variability
1. index of individuality
3. Interpretative criteria for the optimal use of laboratory tests
1. Reference intervals
1. factors that influence and characterize the reference population
2. internal laboratory factors that influence and characterize the reference values
3. recommendations for the production of reference values
4. definition of the terminology
5. operational strategies for determining "reference values" and "reference limits"
6. statistical treatment of reference values to obtain the reference interval
2. comparison of the results with the previous results of the same patient
3. decision-making levels
4. the interpretation of the results in probabilistic terms
1. clinical sensitivity
2. clinical specificity
3. "ROC" curves
4. likelihood ratio or likelihood ratio
5. multivariate reference regions
6. differential diagnosis (discriminant analysis)
7. the interpretation of the results by deterministic rules
8. the criterion of the outcome of the disease (outcome)
4. Pre-analysis phase
1. patient-related variables
1. biological variability
2. pre-analytical variability, related to the preparation and the state of the patient
2. sample-related variables
1. request for inappropriate examination or necessary examination not required (appropriateness of the request)
2. insufficient sample
3. coagulated sample
4. hemolyzed sample
5. lipemic sample
6. jaundice sample
7. sampling order
8. recommendations for venipuncture
9. pre-analytical treatment problems in the laboratory
B. Special part
1. Diagnosis of diabetes mellitus
1. physiopathological and clinical bases
1. carbohydrate metabolism and its regulation
a. the phases of energy homeostasis
2. metabolic alteration in different conditions
a. hyperglycemia
b. hypoglycemia
c. diabetic ketoacidosis
d. coma osmolar
e. dyslipidemia
3. epidemiology, etiopathogenesis and classification of diabetes mellitus
a. epidemiology
b. etiology
c. classification
2. laboratory evaluations
1. methodological aspects
a. glycemia
b. glycated hemoglobin
c. glycated plasma proteins
d. chetonic bodies
e. microalbuminuria
2. choice and interpretation of laboratory examinations
a. criteria for the diagnosis of diabetes mellitus
b. interpretative criteria of laboratory tests
2. The laboratory in the evaluation of cardiovascular risk
1. physiopathological and clinical bases
1. lipoproteins and their metabolism
a. lipoproteins containing apolip
Ciaccio-Lippi Biochimica clinica e Medicina di laboratorio III ed. Ed EDISES 2020
Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier Saunders: St. Louis, 2022
Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier Saunders: St. Louis, 2017
The educational activities include classroom lessons where, through computer support (powerpoint files), the course contents are addressed. In-depth topics will be made available on the E-Learning platform.
The supplementary didactic activity foreseen by the course (12 hours) will be organized during the year, based on the possibility of supplementary monothematic seminars, in-depth analysis of single topics, laboratory visit to illustrate the work flows.
Students will be received by the teacher by appointment via email (francesco.pallotti@uninsubria.it)