Please see my previous email.
Why should we perform an assay "routinely" because it is useful in identifying a specific cause of infantile diarrhoea?
The frightening answer might be that we have uncoupled our processes from clinical questions in the interests of efficient laboratory workflow.
Dr Jonathan Kay
University of Oxford
"Breimer, Lars {PDC2~Welwyn}" wrote:
> Dear Friends
>
> Is it the opinion of this House that the routine measurement of serum chloride and bicarbonate should be made a punishable offence?
>
> There is a rare inherited diarrhoea of infancy which is caused by a chloride losing enteropathy.
>
> May I suggest that someone in the ACB performs a simple international survey of what is standard practice in this area and communicate it to the members?
>
> Kind regards
>
> Lars Breimer
>
> -----Original Message-----
> From: [log in to unmask]
> [mailto:[log in to unmask]]
> Sent: 08 January 2001 08:41
> To: [log in to unmask]
> Subject: Re: usefulness of chloride measurements
>
> BUt some analysers don't automatically do bicarbonate so the anion gap cannot be measured easily. Due to the continual wobble of our chloride & bicarb electrodes we stopped reporting anion gap 5 years ago. No one noticed they'd gone.
>
> TIM
>
> **************************************************************************
> Prof. Tim Reynolds,
> Clinical chemistry Dept.,
> Queen's Hospital,
> Belvedere Rd.,
> Burton-on-Trent.
> tel: +44 (0) 1283 511511 ext 4035
> fax: +44 (0) 1283 593064
> email: [log in to unmask]
>
> -----Original Message-----
> From: c=GB;a=NHS;p=NHS NATIONAL
> INT;dda:RFC-822=ACB-CLIN-CHEM-GEN(a)JISCMAIL.AC.UK;
> Sent: 05 January 2001 19:45
> To: c=GB;a=NHS;p=NHS NATIONAL
> INT;dda:RFC-822=ACB-CLIN-CHEM-GEN(a)JISCMAIL.AC.UK;
> Subject: usefulness of chloride measurements
>
> I am surprised by this view about the usefulness of chloride
> measurement. I have always found it very useful (even
> essential) in patients with a metabolic acidosis, to help define
> normal and raised anion-gap groups. We have successfully taught
> generations of junior doctors (even surgeons!) to make use of
> it. I can't believe we are alone in this.
>
> Best wishes
>
> Ian Young
>
> On Fri, 5 Jan 2001 17:20:35 +0100 Nils Tryding <[log in to unmask]>
> wrote:
>
> > Since 34 years we have stopped the analyses of chloride in the Central
> > Hospital of Kristianstad Sweden because of no need in clinical practice.
> > please see http://www.svls.se/sektioner/sfkk/keynumb/eng_index.htm
>
> > [log in to unmask] wrote:
> >
> > > Perhaps the solution is to stop reporting the chlorides. I doubt that many (even any?) physician would notice their loss, and it is certain that no surgeon would.
>
> ----------------------
> Professor IS Young
> Department of Clinical Biochemistry
> Institute of Clinical Science
> Royal Victoria Hospital
> Grosvenor Road
> Belfast BT12 6BJ
> Northern Ireland
> tel: +44 2890 263106
> fax: +44 2890 236143
> [log in to unmask]
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