eNewsletter 2013 March - April

The Russian Scientifically-Practical Society of Specialists in Laboratory Medicine (RSPSSLM) historically was founded in 1947 just like the Association of Staff of Clinical Diagnostic Laboratories in USSR. Professor E. A. Kost was the initiator of establishment of the society and its first chairman. Professor A.S. Petrov and Professor B.F. Korovkin were elected chairmen of the Board of the Society during the next years. At present,  Professor Vadim Menshikov is Chair of the National Society.

RSPSSLM is a full IFCC member. The IFCC information booklet was translated and published in Russian and distributed in different regions of Russian Federation.

In connection with the proposal of the IFCC and EFLM on introduction of the name of specialists of our profession our association received a new name "Russian Scientifically-practical society of specialists in Laboratory Medicine". RSPSSLM incorporates laboratory specialists from 51 subjects of the Russian Federation. The creation of  the RSPSSLM Web Page became a new stage of development of our Society (http://www.labmedicina.ru).

The overall objectives of the RSPSSLM are:

•  development and improvement of clinical laboratory diagnostics as an applied clinical discipline;

• scientific research  in the field of Laboratory Medicine;

• improvement of Management in Laboratory Medicine in Russia;

• training of members of society, increased qualifications, protection of professional and civil interests;

• integration of the Russian clinical laboratory service into the world community.

Main forms of activity of RSPSSLM:

• organizing of Annual all-Russian scientific and practical forums "National days of Laboratory Medicine of Russia";

• regular carrying out regional meetings in Laboratory Medicine of local offices of the Society;

• edition of the Journal "Clinical Laboratory Diagnostics" and some other professional Journals;

• edition of textbooks, monographs, guidelines on actual problems of Laboratory  Medicine;

• participation in development of National Standards in Laboratory Medicine and other regulating documents in Management of Laboratory Service.

Members of Russian Scientifically-Practical Society of Specialists in Laboratory Medicine that are involved in  IFCC and EFLM activities:

1. Prof. Lina Khorovskaya (Pavlov State Medical University, Russian Federation) - National Representative of Russian Scientifically-Practical Society of Specialists in  Laboratory Medicine (RSPSSLM)
2. Dr. Svjetlana Kovalevskaya (Pavlov State Medical University, Russian Federation) - Corresponding member of the EFLM Working group on Preanalytical Phase, EFLM WG-PA.
3. Dr. Alexey Bugrov (Russian Medical Academy of Postgraduate Education, Moscow, Russian Federation) - Corresponding Member of the EFLM Working Group on Test Evaluation, EFLM WG-TE.
4. Dr. Karina Kasoyan (Russian Medical Academy of Postgraduate Education, Moscow, Russian Federation) - Congresses and Postgraduate Education (WG-CPE).
5. Dr. Darya Kisilichina (Russian Medical Academy of Postgraduate Education, Moscow, Russian Federation) - Full Member-Young Scientist of the EFLM Working Group on Distance Education and e-Learning (WG-DE).
6. Dr. E. Rusanova (Pavlov State Medical University, Russian Federation) - Member of the IFCC Task Force for Young Scientists (TF-YS).

IFCC and EFLM speakers participate in annual all-Russian scientific and practical RSPSSLM forums "National days of Laboratory Medicine of Russia" (pic.1). EFLM speaker Professor P. Schuff-Werner (Germany) delivered 2 presentations for Russian specialists in Laboratory Medicine  in Moscow and St.-Petersburg in October 2012 (pic.2).

Forum "National days of laboratory medicine of Russia-2013" will be held in Moscow, October 1-3, 2013. In the programme of this meeting Dr. Wim Huisman, Chair of the EFLM Committee on Quality and Regulations will give a talk on experience and benefits of application of the standard ISO 15189 in Laboratory practice in Europe.

Last year, Laboratory Medicine professionals started a campaign of promoting their work for a correct understanding of laboratory tests by the other medical professionals and by the patients. The web site www.Labtestsonline.com has been a success, being an important help for many people in 12 different countries, explaining the benefits of laboratory tests, how we work in a laboratory, what are the advances of the laboratory methods, what are the limits, the interferences of the tests, how can they correctly interpret  the results of the tests in a clinical context.

When Graham Beastall , the President of IFCC , encouraged us with the words:"Many small people, from many small places, making many small things, can change the world", I decided to find my own way to promote laboratory medicine among my colleagues. So I did.

I organized, each year, together with the Medical Society of General Practitioners from Sibiu, my town, "The  month of Laboratory Medicine for the General Practitioners". During 4 weeks, I gave lectures about the practical way of lookingat  a lab result and  discussing  different  pathologies. We started 5 years ago and now my lectures"Laboratory Medicine in a practical way"is a well known event in  March, for everybody who wants to find out news about laboratory medicine tests.

The subjects presented concern all areas of laboratory medicine, including haematology, biochemistry and microbiology.

Last year's subject was "Geriatrics-biological changes during aging" taking into discussion the lab test for the most frequent pathologies of the older  patients: cardiovascular diseases, tumor markers and  ending with a very modern subject: vitamin D deficiency. This year we changed the programme  completely  and took into discussion the variability of lab tests during childhood: "The child is not only a small adult", focusing on the most important diseases of the children - parasitic, bacterial and viral infectious diseases, passing through the normal ranges for children in haematology and biochemistry tests and  ending with the growing pathology of allergies and the role of specific allergen  determination in the diagnosis  of allergy in children.

Not only were the lectures but also case discussions, so  that everybody could find an explanation to their everyday  questions about lab tests results. What were the most frequent questions? Why do I have different results from different laboratories? What other test should I do to confirm the diagnose? When do I have to repeat the test?

After taking into account all the questions I concluded that, in our time, the laboratory specialist has solved the main analytical problems, but still has a lot to work in explaining the variability of tests results and also has a big role in promoting the new tests and new technologies that will change the medical practice in the near future.

The medical laboratory specialist should always be an interface with the clinicians, trying to understand their needs for solving the case and giving them a helpful hand with the right lab test for the disease.

If you are interested in promoting Laboratory Medicine, join my lectures: "Laboratory Medicine in a practical way", in March 2014 in Sibiu, known, after Forbes, as "Europe`s 8^th most idyllic place to live".

The SEQC recently inaugurated a new lecture hall, the Aula Enric Concustell, to hold scientific symposia and conferences. The room is fully equipped with state-of-the-art audio-visual equipment, built-in LCD projection screens and Wi-Fi.

To celebrate the inauguration of this centre, a series of humanistic lectures have been organized for 2013:

• The opening lecture, Brain and Power was given by Adolf Tobeña, professor of Psychiatry at the Autonomous University of Barcelona, on February 14. Dr. Tobeña analysed the common traits of people who occupy positions of power, showing that individuals who are astute, dominant, persuasive, false, manipulative and audacious are optimal candidates to seek such roles.
• On March 14^th, Maria Barbal will present a lecture entitled The Building of a Novel. Her bookStone in a Landslide (Pedra de Tartera) has over fifty editions and has been translated into thirteen languages.
• The next lecture will take place on June 13^th. It is entitled Communication and Happiness, and the speaker will be Sebastià Serrano, professor of Linguistics and Communication Theory at the University of Barcelona and author of several books.
• On October 17^th, Fernando Bandrés, professor of Toxicology and Legal Medicine at the Complutense University of Madrid, will present his lecture entitled Medicine, Ethics, Values and Law.
• The closing lecture in this cycle, 200 Years of Giuseppe Verdi, will be delivered by Marcel Gorgori, a radio and television journalist whose speciality is opera.

There is a shortage of trained scientists in Chemical Pathology/Clinical Biochemistry and an increasing demand to train discipline-specific scientists in order to expand their numbers in South Africa and sub-Saharan Africa. The Honours and Masters training programme in Chemical Pathology at the University of Pretoria has been in existence for many years and fulfils a growing need in the discipline of Chemical Pathology/ Clinical Biochemistry.

The BSc Hons degree course has been offered by the Department of Chemical Pathology since 1998, with senior medical scientists in the department serving as programme co-ordinators. Several SAACB members have fulfilled this role over the years, including Prof Job Ubbink and Prof Rhena Delport. Since 2008, the programme has been run by Dr Chantal van Niekerk and Nicky Oosthuizen, producing seven graduates. In order to be admitted to the programme, a student must have a BSc degree that includes relevant major subjects for which an average of at least 60% was attained in the final year.

The programme is comprised of the following modules: a) Principles and Practice of Clinical Chemistry; b) Pathophysiology; c) Laboratory Management; d) Medical Biostatistics; e) Molecular Pathology; and f) Applied Research.  The curriculum is supported by the prescribed Clinical Chemistry textbook and tuition takes the form of a series of structured lectures throughout the year. The Medical Biostatistics module is presented over fourteen weeks by lecturers from the department of Statistics at the University of Pretoria. The Molecular Pathology module, delivered by senior scientists from various Pathology disciplines, runs from March to October and includes weekly lectures and several practicals. Theoretical knowledge is assessed by formal written tests and final year-end examinations in both Chemical Pathology and Molecular Pathology. Each student is required to participate in a research project under supervision and to present and write up their work in the form of a mini-dissertation. Satisfactory attendance of the university's 'Applied Research Methodology' course is compulsory. Skills taught during practical sessions and rotation through the diagnostic laboratory at Steve Biko Academic Hospital, are honed by performing semi-independent laboratory work on the bench during the course of conducting the research project.

On completing the BSc Hons degree, many graduates proceed to enrol for the MSc in Chemical Pathology or allied disciplines. Three of the four MSc presently-enrolled students in the department are graduates of the BSc Hons programme. The Masters is a full research-based masters and topics of current projects are: Analysis of the FOXL2, RSPO1 and WNT4 genes in ovotesticular disorder of sex development (DSD); Mutations in the androgen receptor and fibrillin-3 genes in women with polycystic ovary syndrome; Identification of CYP21A2 mutations in South African patients with congenital adrenal hyperplasia; and Genetic analysis of hypophosphataemic rickets. BSc Hons graduates who do not undertake further postgraduate study, find employment in diagnostic or research laboratories and in the pharmaceutical or medical diagnostics industries.

Dear AACC Past President,

The AACC Board of Directors today announced that it has appointed Janet B. Kreizman Chief Executive Officer effective April 1, 2013.

Since 2009, Kreizman has served as Deputy Executive Director & Chief Policy Officer of The Endocrine Society, providing executive management for health and science policy advocacy, strategic communications, patient education, marketing, membership and governance initiatives for the $30 million organization representing more than 16,000 scientists and clinicians.

Elaine Davis
202-835-8713 - 1-800-892-1400 x1713
AACC Executive Department
1850 K Street, NW - Suite 625
Washington, DC 20006

Contributed by A. Grigoratou,
Member of the scientific committee of Greek Society of Clinical Chemistry-Clinical Biochemistry (agrigoratou@hotmail.com)

The 10th Greek Conference on Clinical Chemistry was successfully held in Athens, from 19 to 20 October 2012, at the 251 Air Force General Hospital.

The Young Scientists Committee Round Table presented "The map of the Greek public hospital clinical labs" by Myrto Rizou and " The importance of Proficiency Testing Schemes" by Effie Haviara.

The next round table was dedicated to the clinical lab accreditation (Chair: Dr. Angeliki Ferderigou) and included two lectures, "The ISO15189:2007, Medical laboratories. Particular requirements for quality and competence" by Joanna Athanasiadou and "ESYD: the Hellenic Accreditation System S.A." by Dr. Aliki Stathopoulou.

A round table referred to bacterial resistance to antibiotics (Chairs: Evangelos Vogiatzakis, Violeta Kapsimali): phenotypes of bacterial resistance to antimicrobial agents, the automated systems diagnosis, antibiotic resistance genes, phylogeny and epidemiology of antibiotic resistant pathogens and consisted of three lectures by Prof. Josef Papaparaskevas, Prof. Panayiotis Tassios, of Prof. Leonidas Tzouvelekis (Medical School, Athens University).

Russell Watts (MRSC, Waters Corporation, Manchester) spoke on "The routine use of LCMSMS in the clinical laboratory" in an industry-sponsored lecture.

It was followed by George Kollios' (Ioannina University hospital) lecture on "The sex hormone-binding globulin (SHBG) in the polycystic ovary syndrome"

A very interesting round table on "Evidence-based clinical guidelines in patient testing "(Chairs: Loukas Dadiotis, Ioannis Papasotiriou) included the lectures of Prof. Argyri Gialeraki "Clinical recommendations on testing for thrombophilia", and Prof. Demetrios Rizos "Pre-genetic diagnosis of chromosomal abnormalities" (Medical School, Athens University), of Alexandra Tsirogianni (Evangelimos Hospital, Athens) "The immunology lab - clinical interface", and Vassilis Barbounis (Hippocratio Hospital, Athens) "Tumor markers in clinical practice".

On the first day of the conference the cultural program included an exciting lecture on the Antikythera wreck: the ship, the treasures and the mechanism, by Dr.Elena Vlahoghianni (Greek National Archaeology Museum).

The next day the first round table covered "The contribution of genetic variation to complex disease traits" (Chairs: Michael Koupparis, Andreas Scorilas). It consisted of the lectures of Dr. Athanassios Kalogeridis (Hippocratio General Hospital, Thessaloniki): "The biological importance of nucleic acid polymorphisms"; Prof. Evi Lianidou (Chemistry School, Athens University): "Next generation sequencing"; Prof. Vassilios Spyropoulos (Technological Education Institute of Athens): "The mathematical complexity and the contribution of the emerging technologies in diagnosis and decision making ".

The last, but not least, round table informed us about the activities of our society (GSCC-CB): Dr. Othon Panagiotakis (Evangelimos Hospital, Athens): "ESEAP: the national External Quality Assessment Scheme for clinical chemistry in Greece and Cyprus"; Dr. Alexander Haliassos: "LAB TESTS ON LINE, a public resource on clinical lab testing from laboratory professionals who do the testing"; Prof. Christos Kroupis (Medical School, Athens University): "The Greek participation in the IFCC WG: in vitro diagnostics-working group", and Prof. Evi Lianidou (Chemistry School, Athens University): "Education and Management Division EMD".

A lot of health professionals and students from all over Greece attended the 2012 Conference. It was a successful Conference and it had a high quality scientific program although it was organized in the current gloomy financial circumstances.

From the left to the right: The president of GSCC-CB Dr. Katerina Psarra, the President of the 10th Greek Conference on Clinical Chemistry Dr. Panagiota Spyropoulou, and the president of the Organising Committee Dr. Effie Botoulaa	Dr. Katerina Psarra, President of GSCC-CB

The Visiting Lecturer Programme of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC), supported by Abbott Laboratories, together with the African Federation of Clinical Chemists (AFCC ) and Zimbabwe Association of Clinical Biochemists (ZACB) facililate the holding of a  Laboratory Quality Management course at the University of Zimbabwe,  College of Health Sciences (UZ CHS) at Parirenyatwa Referral Hospital from 25th to 26th March 2013. It was a special commemorating event as the ZACB has been existence for 21 Years.

The course was co-ordinated by Jocelyn MB Hicks and Hilda TM Matarira, ZACB President. The two past Presidents of the IFCC namely Jocelyn MB Hicks from Washington DC (USA) and Donald S Young from Pennsylvania (USA), the President of the South African Association of Clinical Biochemists (SAACB), Rajiv T Erasmus from Stellenbosch University in Cape Town, South Africa, and  two members of ZACB from the UZ CHS, Department of Chemical Pathology, namely Terence Nyamayaro and Witmore B Mujaji, facilitated the course.    

The course was the first to be held in Zimbabwe by the IFCC. It was well attended by 90 delegates from around Zimbabwe and a delegate from Sudan International University in South Sudan. The delegates included the following: Director in the Ministry of Science and Development, Directors and Deputy Director in the Ministry of Health and Child Welfare National Health (Public)Laboratories (NHLs),Managing/ Deputy Managing Directors of 5 Private laboratories, Director of Zimbabwe National Quality Assurance Programme, CEO of Chitungwiza Referral Hospital, 30 Laboratory Managers notably from 3 Referral Teaching Hospitals, Private, Public, University and Government Veterinary laboratories.

Prof J Hicks	Prof D. Young	Hilda TM Matarira, ZACB President

The course participants were largely students and medical professionals from different back grounds i.e. Clinical Scientists in Clinical Biochemistry, Haematology, Immunology, Medical Microbiology, Histology from certificate, degree, up to doctorate level; Medical Practitioners, Nurses and Pharmacists. The honoured guest was Hon. Deputy Minister of Health and Child Welfare Dr Douglas Mombeshora, who officially opened the course. He informed the delegates that the Zimbabwe Health service, adopted and implements quality management systems in the national health laboratory service which currently has a training and mentorship programme in 20 laboratories. These programmes are in the Strengthening of Laboratory Management Towards Accreditation (SLMTA) Programme. Of these, 5 laboratories have attained 1 star status by WHO assessors. By June 2013, 3 of these laboratories are expected to be accredited. Accompanying him was the Executive Dean of UZ CHS Professor Midion Chodzonga who represented the UZ Vice Chancellor Professor Levy Nyagura. The Executive Dean, in his speech, highlighted the need for all medical service providers to embrace the concept of "Best Practice". He emphasized that diagnostic results must be reliable, acceptable and instill adequate confidencein  both physicians and patients. Both guests welcomed the course as it assisted in the strengthening of laboratory quality management programmes in Zimbabwe.

The President and National representative of the ZACB, Hilda Tendisa Marima- Matarira, welcomed the honoured and distinguished IFCC facilitators and delegates. She appreciated the long distances that had been travelled by 3 facilitators and a delegate from South Sudan.This was an inspiration to ZACB members to see such a dedication to the profession. It was motivating for ZACB to take Clinical Biochemistry to higher levels beyond the traditional boundaries as we were reviewing the only  MSc course in Clinical Biochemistry on the African continent since 1996 and to improve on the clinical skills. ZACB was now planning to introduce a new Doctor in Laboratory Medicine (MD) qualification, a 6 year course after 'A' level qualifications. This has been made possible by a strong Diaspora Brain Gain Home link project with ZACB. It is attracting Zimbabweans qualified in Clinical Biochemistry living in South Africa, United Kingdom, Canada, Australia, Switzerland etc to participate in local initiatives.

She also informed the delegates that in the 30 years of service of some of the ZACB members at UZ CHS, some 5000 doctors, 70 graduates at MSc and 10 graduates at PhD levels were trained through leadership, innovation and links particularly with the United Kingdom and South Africa. The links with the UK assisted greatly in the establishment of a new Department of Clinical Immunology in UZ CHS and Zimbabwe External Quality Assurance Programme (ZEQAS) which was transformed later in 1994 into Zimbabwe National Quality Assurance Programme (ZINQAP). It has so far recruited 136 public and private laboratories who regularly participate. 

The course which was planned for over 9 months by a national organization of 16 ZACB members including the 6 executive board members, had a secretariat of 12 members, some of whom are current MSc students in Clinical Biochemistry. The course was covered in 6 sessions i.e. morning, mid-morning and afternoon. A wide variety of topics in laboratory management were taught namely:

1. Internal and External Quality Control, Document Management
2. Validation of Methodology in Quality Assurance
3. The Zimbabwe National Quality Assurance Programme 1994 to 2012
4. Laboratory Organisation: Laboratory direction, staff, choice of equipment and physical layout
5. Training and Competency Assessment: Basic training, continuing education and ongoing testing of personnel
6. Pre-analytical and Post- analytical Issues: Phlebotomy, specimen processing and patient issues
7. Patients, employees and the environment
8. Managing a Point- of- Care Testing Programme
9. Providing Emergency Tests
10. Financial and Strategic Planning: Budget setting, short and long term planning, personnel and information technology
11. Optimizing the use of the Clinical Laboratory: The Laboratory's Role in Educating Physicians

 Each session had a chairman and a rapporteur; the lectures were followed by 20 minutes of vibrant debate which was recorded and a 20 minutes tea break. The Medical Laboratory and Clinical Scientists Council in Zimbabwe accredited the course with 20 continuous professional development (CPD) points. This was highly appreciated by ZACB members as it was a significant contribution to the mandatory 40 points required annually by members to be kept on the professional practicing register.

The 2 day courses provided an opportunity for delegates to :

1. Gain basic and higher level of knowledge "State of the Art" in laboratory quality management.  Delegates will get 20 CPD points in addition for this. 
2. Network, twine, allowed mentoring, creation of new friendships and renewing old ones
3. Strengthen local, regional and international collaboration. ZACB was recruited into UZ CHS Research and Support Unit " Good Laboratory and Clinical Practice" Programme. There were 3 local corporate recruitments namely, AiBST, CIMAS Laboratories and PMSI. The later 2 laboratories also donated generously towards the hosting of  the course and pledged future funding.
4. Form a ZACB Management Committee of Heads of Public and Private Laboratories
5. Identify new courses on a needs basis e.g. training of accrediting inspectors
6. Communicate ZACB activities with clients, the public, and publicise future courses in Molecular Diagnostics level 2 in October 2013 and Flow Cytometry in March 2014
7. Lobbied for more funding for the national laboratories  currently at 0.0025% of GDP; training and research funding. ZACB will follow up on offers made of scholarships, funds for research and training pledged by Ministry of Science and Technology

ZACB members shared a common Vision of Clinical Biochemistry beyond the traditional the limits of the field

All in all, it was a rewarding experience having the IFCC and Laboratory Medicine supported two day course. It was greatly appreciated.