B027740 - CLINICAL BIOCHEMISTRY AND CLINICAL MOLECULAR BIOLOGY

Meaning and purposes of Clinical Biochemistry. The laboratory in the evaluation of dyslipidemia, diabetes and metabolic syndrome, alterations in plasma proteins, uric acid levels, iron levels, organ function (liver and kidney, bones), heart attack, and in the diagnosis of inborn errors of metabolism and celiac disease. Concepts of nutrigenetics, nutrigenomics and epigenetics. Nutrition and tumors

Ciaccio M e Lippi G. Biochimica clinica e Medicina di Laboratorio. EdiSES Università
G. Arienti. Le basi molecolari della nutrizione. Piccin
D.R. Ferrier Le basi della Biochimica. Zanichelli

The course aims at providing the basic knowledge and understanding of laboratory medicine and clinical biochemistry, through the application of chemical and biochemical principles for the selection, evaluation and interpretation of diagnostic tests for diagnosing and monitoring diseases in humans.
The fundamentals of biochemistry will be introduced to understand markers' diagnostic value better.
The teaching contributes to the following Learning Objectives of the course of study:
- Acquire knowledge and understanding of the biochemical and technical bases for evaluating normal and pathological conditions relevant for Nutrition
- learn the fundamentals of human pathology, integrating the pathophysiological and pathological study with clinical methodology and diagnostic procedures that allow the evaluation of the main morbid conditions.
Learning Outcomes
Upon completion of this course, the student should
- be able to identify significant alterations in the most common chemical and biochemical markers and their correlation with disease status;
- understand and apply understand and apply the principles of biological and analytical variability to the interpretation of analytical results;
- be able to assess the significance of the alteration of an analytical parameter with reference to the disease state;
- - be able to compare analyte levels under physiological and pathological conditions;
- - be able to evaluate and interpret the results of analytical procedures in the clinical and diagnostic classification of metabolic dysfunctions, also linked to particular nutritional problems, in the monitoring of the state of health and the control of human nutrition.

Knowledge of general biochemistry and physiology

Lectures

Theoretical and practical ADEs of healthy cooking will be organised. Within the course, "Lessons with Experts" and with Nutritionists will alternate

Oral exam to ascertain the acquired knowledge and the student’s diagnostic skills

An introductory topic of your choice plus 2/3 other questions.
The dates of the exam sessions are communicated through the exam notice board on Sol (official exam sessions) or through messages from the teacher on Moodle.
To register for the exam, students must communicate the date via email to the teacher and wait for confirmation. After confirmation I can register on Sol.
Grades will basically reflect four levels of preparedness
- sufficient: basic knowledge of markers and associated pathologies;
- adequate: having acquired the basic ability to evaluate and interpret analytical results;
- - good: having developed an ability to correlate with major pathologies;
- - thorough: very sound knowledge of the topics and instruments, with the ability to analytically relate them to patients' conditions.

MACRONUTRIENTS. DIGESTION and ENERGY METABOLISM: Integration and regulation. The specialization of organs: brain, muscle, adipose tissue and liver. Hormonal regulation: metabolic effects of insulin, glucagon and adrenaline on energy metabolism. Eating-fasting cycle. Hormones that regulate appetite and body mass (leptin and adiponectin)
WATER AND MICRONUTRIENTS. Metabolism and alterations Iron, Vitamins (Folic acid, B12)
CLINICAL BIOCHEMISTRY. Definition and purpose. Fields of interest in clinical biochemistry. Preanalytical variability. Analytical variability: sensitivity, specificity, accuracy and precision. Biological variability. Analytical goals. Reference and decision-making values. Diagnostic sensitivity and specificity. Positive and negative predictive value
CONGENITAL METABOLIC DISEASES: CONGENITAL ERRORS OF METABOLISM
Nucleotide polymorphisms: definition. SNP. Mutations. Genetic variants. Congenital metabolic diseases. General consideration. Types of congenital errors. Prenatal screening. Nutritional therapy.
Diseases of amino acid metabolism. (Phenylketonuria), of the urea cycle (Ammoniaemia), of carbohydrate metabolism (fructose, lactose, galactose, glycogen). Prenatal Diagnosis
Toxic and non-toxic reactions to foods
Celiac disease: Characteristics and level I and II diagnostic investigations..
- Plasma lipids and lipoproteins. Lipid chemistry, lipoprotein physiology and metabolism.
- Plasma proteins. Electrophoretic profiling of plasma proteins and interpretation. The function of plasma proteins and their diagnostic significance.
- Clinical enzymology in the assessment of organ damage and organ function.
- Markers of inflammation
- Carbohydrate metabolism. General description of carbohydrates, hormonal control of glycaemia, hyperglycaemia and hypoglycaemia. Differential diagnosis and monitoring of diabetic disease.
- Bilirubin metabolism and jaundice.
- Bone remodelling markers.
Markers of Acute Myocardial Infarction (AMI) and heart failure: Myoglobin. Creatine kinase-MB. Troponins. Natriuretic factors
Hyperuricemia and gout
BIOCHEMICAL-CLINICAL EXPLORATION OF ORGAN FUNCTION
KIDNEY: general aspects and functions. Markers of renal function: Proteinuria, Azotemia, Creatinine LIVER: General aspects and functions. Laboratory tests of liver function (Markers of protosynthesis, conjugation, cytolysis and cholestasis). Ethanol metabolism and characteristics of alcoholic liver disease
NUTRIGENETICS AND NUTRIGENOMICS
Nutrigenomics. Conceptual bases and purposes. Regulation of gene expression by dietary components: transcription factors. Genome integrity and stability. Epigenetics. Effects linked to the intake of micronutrients. Nutrigenetics: diet as a risk factor. Diet and genetic individuality: some examples. Nutraceuticals (polyphenols).
NUTRITION and CANCERS