Biochemistry and Clinical Biochemistry

Introduction: body composition and homeostasis concept. Nutritional needs. Energy needs, body mass index, basal and functional metabolism, induced thermogenesis. Plastic requirements, indispensable aminoacids and nitrogen balance.
Carbohydrate, lipids and proteins: structure and metabolic and structural roles.
Enzymes: Energy aspects, principles of enzymatic catalysis, activation energy. Enzyme activity. Meaning of Km, competitive and non-competitive inhibition. Enzymes in metabolic pathways. Principles of the regulation of enzymatic activity, allosterism. Nomenclature of enzymes. Vitamins and coenzymes.
Metabolism. Anabolism and catabolism, ADP phosphorylation at the substrate level and oxidative phosphorylation, the mitochondrial respiratory chain, ATP biosynthesis, regulation, inhibitors and decouplers.
Cellular communication. Signal molecule/receptor interaction, cell surface receptors, signal molecules, first and second messengers. Hypothalamic/pituitary/endocrine gland axis.
Carbohydrate: Digestion, absorption and transport. Hormonal regulation of blood sugar, insulin/glucagon. Glycolysis, energy balance and its regulation. The pentose phosphate cycle, products and regulation. Glycogen metabolism and its regulation.
Lipids: Digestion, absorption and transport of lipids. Lipoprotein metabolism. Oxidative metabolism of fatty acids, mitochondrial oxidation. Metabolism of ketone bodies. Regulations and energy yields. Catabolism and biosynthesis of endogenous triglycerides. Biosynthesis, elongation and desaturation of fatty acids and their regulation. Complex lipid metabolism. Cholesterol metabolism and its regulation. Focus on vitamins and cofactors involved in lipid metabolism.
The Krebs Cycle energy balance and its regulation.
Gluconeogenesis
Proteins: digestion and amino acid metabolism. Transamination, oxidative deamination, urea cycle, biogenic amines, ammonia toxicity. Focus on vitamins and cofactors involved in nitrogen metabolism.
Nucleotides: purine and pyrimidine metabolism, biosynthesis, catabolism and metabolic regulations.
Functional biochemistry: metabolic relationships between lipids, carbohydrates and amino acids in different tissues. Biochemistry of adipose tissue. Muscle and liver biochemistry. Biochemistry of the extracellular matrix, bone and dental tissue. Iron metabolism. Biochemistry of nervous tissue.

Principles and applications of the main genetic investigation techniques.
Congenital metabolic diseases of metabolism.

General Clinical Biochemistry
Introduction, purpose, potential and limits of laboratory tests. Levels of laboratory intervention. Diagnostic test concepts and their purposes (screening, in-depth diagnostic, disease monitoring). Analytical profile concept. Examination of organ or apparatus function. Operation of a centralized Laboratory and Point-of-Care; organizational, technical and economic aspects.
The pre-analytic phase and its sources of variability. The preparation of the patient. Collection, treatment and storage of biological samples for diagnostic purposes: blood, urine and feces cephalorachidian fluid (liquor), fluids pouring into the serous cavities, synovial fluid, amniotic fluid, seminal fluid, gastric juice, sweat. Acceptability criteria for biological samples by the Analytical Laboratory. Post-analytical variability: Lab-report.
Analytical and biological variability. Types of errors. Reliability of a dosing method. Analytical variability and factors that influence it. . Biological variability and factors that influence it. Analytical goals. Overview of quality control.
The terms of comparison of biochemical-clinical data: reference intervals, desirable levels, decision levels and critical values, critical difference.
Diagnostic logic: sensitivity and clinical specificity predictive values, ROC curves
Clinical Biochemistry of Systems
Deepening of some topics of the teacher's choice (for example: Role of the laboratory in the diagnosis and surveillance of diabetes, in the diagnosis of liver diseases, in the diagnosis of jaundice, lipid structure, renal function, saliva, coagulative function, cardiac markers, plasma proteins, markers ... Principles and applications of the main techniques used in clinical biochemistry. Enzymes and other macromolecular markers of function and lesion. Diagnostic potential of plasma proteins. Evaluation of haemostatic functionality