I have read the discussions on this list for some years now and have been
amused, educated and amazed by what I have read.Finally, today I am
prompted to join and make a comment about the discussion on Interpretative
NEQAS 147.I declare an interest in that it was my comment that was used as
the high scoring comment ( although my comment on the previous case was
used as a low scoring comment), so this is not a case of blowing my own
trumpet ( I play viola and piano!).We had exactly this case scenario only a
few weeks before the case was posted, and I adopted a hopefully scientific
approach to answering the question posed by the clinician.Which was to
contact the lab which measures our oestradiol and testosterone and ask if
they could help. They dissolved some of the implant in saline ( we don't
have organic solvents in our bodies, so physiologically aqueous type
solvent would seem appropriate) and measured oestradiol and testosterone on
the centrifuged solution, which was positive for one and negative for the
other.We were asked a question and (rarely in Clinical Biochemistry) we
were able to answer it clearly.The application of a small amount of
scientific thought resulted in a happy clinician and patient who had the
relevant implant replaced ( and also two rather pleased clinical scientists
in two small laboratories who were pleased that they had not forgotten
everything that they were taught a number of years ago).I hope Helen Grimes
was not serious about whether we should do such things as it makes me
despondent that we may have been so CPAd,governanced and NICEd to death
that we are fast becoming Clinical Robots.I agree with Gordon's scientific
views.
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