Clinical Laboratory

The Program of Quality Control, developed in all sections, has given this department high reliability in terms of reported results, which provide the doctors with real information for the diagnosis and treatment of their patients. The laboratory never emits results if the quality controls are not within the desired ranges. This is of crucial importance.

We are inscribed in the Randox International Quality Assessment Scheme, RIQAS, with headquarters in Belfast, Northern Ireland, United Kingdom. Every 15 days our controls are evaluated in the Chemical Clinic, Hematology and Immunology and the results are received in 24 hours by electronic transmission, thus making it possible to carry out the necessary adjustments in the shortest time possible.

Internal Control is also conducted in all departments on a daily basis. In the Chemical Clinic, other than the RIQAS program, the inter-laboratorial program, Quality Control BioRad, is used daily to enable us to make evaluations and comparisons worldwide with the other laboratories using this system.

Virtual Tour

From the time when the scientists James Watson and Francis Crick decoded the structure of DNA, decades ago, the way of looking at our organism has been changing. This secret code is hidden in our genes, is unique and unrepeatable, and gives us the necessary information to know what we are made up of even before birth.

Today we can diagnose a variety of illnesses precisely and help the medical specialist have a precise and reliable panorama of what is happening within our body.

Molecular Biology is is the medicine of the future; a tiny blood sample given to the doctor is sufficient to provide him with valuable information and enable him to make clinical decisions about the condition of his patients.

It is estimated that up to seventy percent of all medical decisions are based on findings of the clinical laboratory. Since its inception, the help of the specialist of microbiology has been the key to the diagnosis of illnesses and the monitoring of patients. Its contribution to public health has increased with the passing of years. Early manual work, using very basic methods to discover certain viruses and bacteria through cultures and the use of the microscope, has made the leap to automatization, with robotic equipment which, thanks to the skill of the specialist, can forecast precise data before the illness evolves. Also it contributes to the opportune treatment in the case of a carrier of any disease.

Molecular Biology is the science that has allowed us to look our existence in a different way, as well as to prevent, treat and in particular save lives. It managed to transform the clinical laboratory, by using traditional and molecular tests together.

Infinite possibilities

Thanks to that discovery, today we can know our genetic inheritance, from the genes which predispose us to certain illnesses and genes associated with the resistance to antibiotics (valuable information for medical treatment), to prenatal diagnosis, mutations, diagnosis of tumors, and sexually transmitted diseases, among others.

Evolution

The advances in diagnosis at the Clinical Laboratory coincide with the emergence and discoveries of new technologies, and thus we are able to speak about the emergence of the modern laboratory at the beginning of the last century with its very basic methods of analysis, like the culture of bacteria and the use of the microscope, which at that time could give the physician somewhat limited information to help his diagnosis.

During many years laboratory work was manual using different methodology and techniques according to the times and although the work was adequately performed, its elaboration was very tedious, and its precision or sensitivity was not as good as it is today.

The advent of the automatization of the Clinical Laboratory in the 1980s caused a boom in the development of great laboratories and of many new diagnostic tests that could be made in less time with a greater volume of work, lowering of costs, and at the same time offering diagnosis to more people.

In the 1990s “the boom” in molecular diagnosis exploded with the discovery of new techniques for the amplification of genetic material and DNA. Modern technology has the possibility of making all types of automatized molecular tests for diagnostic use, follow-up or control of infectious agents or diseases, which have made a significant impact on the improvement of medical diagnosis and therefore on the health of the patients.

Today

The emergence of DNA diagnostic testing has changed the traditional concept of the clinical laboratory in the way it had been working during many years, even though traditional testing strongly complements molecular testing, offering a wide range of possibilities in the diagnostic areas such as:

• Forensic medicine
• Prenatal diagnosis of hereditary diseases
• Genes associated with a resistance to antibiotics
• Detection of genes with a predisposition to diseases
• Point mutations
• Genotypes and viral loads
• Diagnosis of tumors
• Drug efficiency
• Detection of infectious agents of difficult diagnosis among others

In our laboratory at the Clínica Bíblica Hospital we have always supported innovation and we were the first to develop a Molecular Biology department within a private hospital. In the succeeding two years, there has been a very decided development in the diverse tests of molecular diagnosis, proving its contribution and the confidence that the doctor has in making clinical decisions for his patients, using analyses which were once almost impossible to provide.

Setting the pace

Among the features of the Clinical Laboratory at the Clínica Bíblica Hospital , equipment may be found which specializes in molecular diagnosis and whose function is to produce millions of copies of DNA to be identified.

Using existing exams it is possible to obtain an early diagnosis to ascertain whether you carry genes that indicate a tendency to suffer from venous thrombosis and strokes, or if you have a predisposition to develop celiac disease, as well as identifying certain genes whose characteristics determine whether you might have some type of breast or colon cancer, among others. Another advance in medical science is the possibility to identify diverse alterations in genetic material leading to illnesses.

On some occasions, these mutations are also the reason why some medications against certain microorganisms or pathogenic agents are not effective. This is especially true in the treatment of tuberculosis, for the patient cannot overcome the disease if the bacteria are highly resistant to the prescribed drugs. With the existing tests, we can determine the ideal therapy or treatment for each patient, depending on the grade of resistance to infectious bacteria.

Molecular analysis that can be performed:

• Mutations indicating thrombotic risk

Venous thromboembolic disease (TED) can be due to multiple factors that coincide at a certain moment. It has a clearly hereditary component and appears in people whose families have a previous history of thrombosis, as well as in young people without any apparent cause.

Ideally all those with familiar antecedents of TED should undergo genetic analysis to determine whether they are carriers of factors of thrombotic risk, in order to take the necessary measures (anticoagulation treatment) to avoid thrombotic occurrences.

The presence of these mutations in a patient can represent an increase of from 2 to 7 times more than a person without these mutations.

• Celiac disease: detection of haplotypes HLA

This is a chronic intestinal disorder of inflammatory nature. It occurs in people genetically predisposed to respond to the ingestion of gluten or related proteins. It can appear at any age and the susceptibility of development depends in part on the presence of HLA-DQ2 or HLA-DQ8 (sets of genes). An analysis or the detection of these HLA haplotypes is recommended in the following cases:

To determine if the patient is celiac, particularly when the rest of the diagnostic analyses, like serology and biopsy, are inconclusive;

For the study of families of celiacs (especially brothers and sisters), due to its hereditary character which increases their probability of becoming celiac too.

• Identification of genotypes and the human papilloma virus (HPV)

This is the principal cause of cervical cancer in women, as well as an important risk factor in other types of cancer, like anal and oropharyngeal cancers. The majority of these viruses are transmitted through sexual relations.

More than one hundred and fifty different genotypes of this virus have been identified and are associated with risk factors in the evolution of cervical cancer. The types HPV16 and HPV18 have been clearly implicated as causal agents in the majority of the cases.

At the Clinical Laboratory it is possible to identify twenty-eight different genotypes using the technique of the polymerase chain reaction in real time that amplifies the viral DNA present in the patient´s sample. The sample consists of a cervical brushing by the gynecologist (similar to the one used in the Pap test). In the case of male patients, the sample consists of a smear of the genital region.

Diagnosis of sexually transmitted infections using DNA detection techniques

Sexually transmitted diseases (STD) refer to a great variety of infections produced by bacteria, viruses, or parasites acquired through sexual activity.

Some produce diseases like syphilis and gonorrhea; others produce nonspecific illnesses like urethritis, inflammatory pelvic disease, infertility, ectopic pregnancy whose causal agents tend to be misidentified, as they can evolve into other infections. Also it must be mentioned that these infections tend to be asymptomatic in their initial phases, especially in women.

For their characteristics these pathogens were once very difficult for the Clinical Laboratory to identify; actually, the development of clinical laboratory tests based on molecular technology has made a very important advance in the accurate diagnosis of STD. In the majority of cases, samples are used that are considered minimally invasive, like urine, swabs in the urethral, vaginal and cervical areas, and liquid cytology. Moreover, this allows for medical assessments and follow-up of even asymptomatic patients.

Today we count on two tests which can be solicited in our laboratory. The first is known as “Detection of sexually transmitted infections by PCR” that consists of a qualitative analysis for the simultaneous detection of the genetic material of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, Ureaplasma urealyticum (bacterias) y Trichomonas vaginalis (protozoario), and the other test is“Herpes virus: Detection by PCR” This exam confirms the presence or absence of these microorganisms in the samples or co-infections.

If the STD are diagnosed in an early and timely manner, the majority of patients experience satisfactory recovery through treatment, and the consequences are minimum or non-existent.

Virtual Tour

The Blood Bank at the Clínica Bíblica Hospital is a division of the Clinical Laboratory. It is managed by a specialist in microbiology and immunohematology, and the assigned technicians are duly trained in their responsibilities in this field.

All donors are volunteers and accepted after a rigorous selection process, as it is our intention to choose the best donor with the best product. All blood or its derivative, before being transfused, passes through a screening process, which includes tests for hepatitis B and C, HIV, VDRL, Chagas disease, and the HTLV type 1 and type 2 viruses, and studies of necessary antibodies in order to ensure a safe procedure.

The quality controls of the Blood Bank are exceedingly rigorous. Also there is a digital file available of all studies that have been made.

We bring our clinical laboratory to your home! We take the sample of your laboratory tests at your home or office and with the support and quality of our clinical laboratory. The service is provided for the metropolitan area (restrictions apply) and has a shipping cost depending on location.

From Monday to Friday from 7:00 a.m. to 1:00 p.m. You can contact us by the following means:

“We are committed to the protection of information of our clients by means of levels of restricted access to the exams, available only to personnel authorized by the director of the Laboratory. Conscious of the importance of the results generated by our laboratory, we avoid the loss of information with procedures of periodic back-up of the results, together with the protection and maintenance of our computer systems. Aware of the need for confidentiality of our clients, we ensure through correct identification of our clients that the information produced belongs only to the client and to the medical personnel attending them, if requested. Our personnel are committed to safeguard the information and the samples for analysis, and not to disclose them to unauthorized people.”