How about Aldolase, BetaHydroxybutyricacid DeHydrogenase, CK/LD isoenzyme electroforesis, VMA and HVA, urine polarimetry, etc.

Dr. B.E.P.B. Ballieux
Clinical Biochemist
Leiden University Medical Centre
P.O.box  9600
2300 RC  Leiden
The Netherlands
Tel:+3171-5262165/2278
Fax: +3171-5266753
email: [log in to unmask]

-----Original Message-----
From: Mainwaring-Burton Richard (RGZ) [mailto:[log in to unmask]]
Sent: vrijdag 9 mei 2003 13:50
To: [log in to unmask]
Subject: ESR - was amylase inhibition

It seems to me the reluctance is a difficulty in actively changing existing practice to reflect recent advances.
What appears to happen is that protocols and treatment regimes are established around current technology (viz temporal arteritis and ESR) and no cognisance is taken of later tests which may be better than the original 'old' test.
 
Is this a research issue or a governance issue ? There is no doubt that best practice should be to use the best test, but who will force the abolition of the historic approach ? We (most of us !) have managed to get rid of isocitrate dehydrogease and thymol turbidity, so perhaps we should be more pro-active in switching off useless tests.
 
I could cite several instances of 'unscientific' test usage which I have come across but my pet ones are :
 
Cytotoxic dosing based on 24hr creatinine clearance - the original paper was a letter to an eminent oncological journal based on 10 patients !
 
The belief in a one-off hCG being able to diagnose ectopic pregnancy

with best wishes

Richard

Richard Mainwaring-Burton
Consultant Biochemist
Queen Mary's Hospital
Sidcup, Kent
DA14 6LT
020-8308-3084

-----Original Message-----
From: Mohammad Al-Jubouri [mailto:[log in to unmask]]
Sent: 09 May 2003 12:03
To: [log in to unmask]; [log in to unmask]
Subject: Re: Amylase inhibitor

You will find fierce resistance from clinicians if you try to eliminate ESR/plasma viscosity from lab repetoire. It is their beloved crude weapon to ascertain whether the non specific symptoms of their patients should be seriously taken in clinical terms. I agree it is wrong.

Mohammad




Dr. M Al-Jubouri, Consultant Chemical Pathologist

>From: "Mainwaring-Burton Richard (RGZ)" <[log in to unmask]>
>Reply-To: "Mainwaring-Burton Richard (RGZ)" <[log in to unmask]>
>To: [log in to unmask]
>Subject: Re: Amylase inhibitor
>Date: Fri, 9 May 2003 10:45:36 +0100
>
>would it not be easier to eliminate the ESR test rather than the amylase
>activity ?
>
>with best wishes
>
>Richard
>
>Richard Mainwaring-Burton
>Consultant Biochemist
>Queen Mary's Hospital
>Sidcup, Kent
>DA14 6LT
>020-8308-3084
>
>
>-----Original Message-----
>From: dr. C.H.H. Schoenmakers [mailto:[log in to unmask]]
>Sent: 08 May 2003 15:04
>To: [log in to unmask]
>Subject: Amylase inhibitor
>
>
>Dear colleague,
>
>Does anybody know how to inhibit amylase completely in combination with
>keeping the
>sample matrix intact?
>
>In order to make a control material to check our erythrocyte sedimentation
>rate we
>added eloHAES, an artificial starch-based colloid, to blood. This works fine
>for some
>hours, after which amylase in the sample has degraded the eloHAES. Therefore
>I would
>like to eliminate amylase activity.
>
>Best regards,
>
>
>Christian
>dr. C.H.H. Schoenmakers, European Clinical Chemist
>Department of Clinical Chemistry, Elkerliek Hospital
>P.O. box 98, 5700 AB Helmond
>The Netherlands
>(+)31-492-595555 (tel), (+)31-492-595691 (fax)
>[log in to unmask]
>
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------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.

ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/

------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.

ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/