Russian Clinical Laboratory Diagnostics

The history of the Department of Clinical Laboratory Diagnostics of the RMAСPЕ begins in 1925, when, on the initiative of E.A. Kost, in the city hospital named S.P. Botkin, an assistant professor course for advanced training of laboratory doctors was created at the Moscow City Health Department. In 1936 the course was transformed into the Department of Clinical Laboratory Diagnostics as part of the Central Institute for Advanced Training of Doctors. Until the 60s of the last century the department was the main center for training clinical laboratory diagnostic doctors for the country’s laboratory service. During the Great Patriotic War the department trained doctors for hospital laboratories, published a short manual on laboratory technology for hospital laboratory doctors, and employees of the department worked in military hospitals. In the 70s the department became the main place for training teachers of clinical laboratory diagnostics and organizers of laboratory services for the republics of the Soviet Union. Constant work is being carried out to improve the training plans for specialists, teaching aids, and scientific and methodological publications. The department annually organizes conferences and constantly travels to regional events on clinical laboratory diagnostics. In the 80s and subsequent years, the heads and staff of the department determined state policy in the field of laboratory medicine, were organizers and leaders of specialized scientific and practical societies, editors and members of the editorial boards of specialized journals, authors of manuals and educational literature, dissertation councils, participated in international cooperation in the preparation of educational programs. The department has been participating in the public life of the country’s laboratory services since its formation and has been for a century. The department celebrates its 100th anniversary, having a high educational and scientific rating, valuable personnel potential and a decent material and technical base. The department carries out a wide range of educational, scientific, methodological, organizational tasks, develops the level of laboratory service specialists, focusing on the highest indicators, ensures the process of introducing medical products into laboratory diagnostics, and carries out high-tech laboratory research for clinical practice.

Background: Additional professional education ensures that an employee’s qualifications correspond to changing working conditions and the social environment, allows them to update knowledge and acquire the necessary new skills. To improve the quality of educational services, it is necessary to systematically analyze the requests of specialists regarding training, but there is no unified methodology for solving this problem.

Aim: To assess the need of specialists in clinical laboratory diagnostics for advanced training.

Materials and methods: In the period from 10/25/2024 to 11/20/2024, an anonymous online survey of 400 specialists in clinical laboratory diagnostics on professional development issues was conducted. The collection of votes was carried out on a voluntary basis. The questionnaire was developed using Google Forms and consisted of 8 basic open and semi-closed single and multiple choice questions. The results were entered into an electronic database with subsequent processing using the Microsoft Office Excel 2018 program and presented in the form of tables and graphs.

Results: 400 specialists between the ages of 20 and 80 participated in the survey. Among those surveyed, 62% ( n =248) of respondents have higher medical education, 38% ( n =152) have higher non–medical education. Work experience in the specialty is less than 5 years for 10% ( n =40) of respondents, from 5 to 20 years for 44% ( n =177), more than 20 years for 46% ( n =183). The vast majority of 95% ( n =382) of the respondents claimed to work in a state laboratory, 5% ( n =18) — in a private one. The majority of the participants preferred a mixed learning format — 41% ( n =164), 34% ( n =134) of the respondents stated their desire to study remotely, 25% ( n =101) — full-time. The duration of professional development of 144 hours or more was chosen by 47% ( n =188) of respondents, 63% ( n =212) preferred shorter courses. 16% ( n =62) of respondents are ready to finance their own education, the vast majority are ready to study at the expense of the Federal Budget or the funds of the organization in which they work — 84% ( n =338).

Conclusion: The emergence of innovative research methods, the introduction of new technologies, and the improvement of the regulatory framework all dictate the need for continuous training and advanced training, especially in such a practice-oriented specialty as clinical laboratory diagnostics. The content and format of professional development programs should be updated on a regular basis, depending on the needs of specialists.

This review presents an analysis of the current literature on the achievements in the development of the latest high-tech biomedical technologies and the prospects for their implementation in the practice of clinical diagnostic laboratories. The publications were searched in the MEDLINE, PubMed, Scopus, Cochrane Library and Google Scholar databases. The advent of high-tech research methods has revolutionized biomedical research. Many of the most promising technologies of personalized medicine are combined within the framework of omix technologies: genomics, transcriptomics, proteomics, metabolomics, lipidomics, etc. The main methods used in clinical diagnostic laboratories for the diagnosis of circulating biomarkers of various diseases are considered. The introduction of high-tech technologies in the activities of clinical diagnostic laboratories will change the approach to medical diagnostics, making it more accurate, faster and personalized. These technologies represent a synthesis of scientific discoveries, engineering solutions and high standards of analytical chemistry. They open up new opportunities for doctors and researchers, offering innovative approaches to the study of biological processes, which leads to an understanding of the molecular and cellular foundations of pathology.

Background: Bacillus cereus is a widespread type of bacilli and the causative agent of a number of diseases. The etiopathogenetic role of B. cereus in ulcerative colitis remains unexplored.

Aim: Detection of ultrastructural features of B. cereus strains associated with ulcerative colitis.

Materials and methods: The ultrastructural features of reference strains of B. cereus and strains of B. cereus isolated from ulcerative colitis were studied dynamically using light and electron (scanning and transmission) microscopy.

Results: It has been shown that reference and freshly isolated B. cereus strains from clinical material, when cultured in vitro , demonstrate a similar ability to spore formation, manifested by the formation of spores of a typical structure consisting of a core, cortex, shell, and exosporium. At the same time, B. cereus strains of clinical origin are characterized by the presence of atypical ribbon-like and lamellar inclusions — ultrastructural features that are absent in the reference strains of B. cereus .

Conclusion: The ultrastructural details found may reflect the ecologically determined features of the sporulation of B. cereus strains of clinical origin. The involvement of ribbon-like and lamellar inclusions in the pathogenesis of ulcerative colitis requires further study. Electron microscopic examination may be useful in the framework of the clinical and bacteriological diagnosis of ulcerative colitis.

Background: In the development of clinical laboratory diagnostics around the world, the direction has been taken towards the centralization of laboratory research. A centralized laboratory information system based on cloud technology is a single system with a single database that ensures data synchronization between various clinical and diagnostic laboratories and the ability to prepare any type of consolidated financial statements. The choice of a single Laboratory Information System (LIS) platform for citywide use with the possibility of replication to all laboratories of the city, taking into account cost-effectiveness, adaptability, efficiency, ease of integration with other IT medical products of the city among the available laboratory information systems led to the decision to create a new unified laboratory information system for all laboratories of the city of Moscow.

Aim: Summarizing the experience of implementing a unified regional (urban) laboratory information system in a multidisciplinary medical organization.

Material and methods: The Moscow Department of Health provided the LIS EFIR system based on a cloud architecture with unified reference books. To coordinate actions during the implementation of the project, a working group was created consisting of responsible employees of the clinical diagnostic laboratory No. 1 and specialists of the Moscow Department for the implementation of LIS. Taking into account the risks during the transition from one LIS to another and the preventive measures taken minimized the possible risks during the switch.

Results: Taking into account the risks during the transition from one LIS to another and the preventive measures taken minimized the possible risks during the switch. The transition to another LIS without stopping the laboratory process, without reducing the volume of testing and maintaining the timing of the results, led to an increase in the workload of the laboratory staff. This led to an increase in the number of inconsistencies, but the situation was stabilized and not only returned to the original percentage of defects, which was 2–2.5%, but also reduced it to 1%.

Conclusion: As a result of the implementation of the LIS, Moscow City Hospital No. 52 received a modern, reliable tool for managing the work of the entire laboratory complex. The implementation process went better than expected, which was confirmed by all project participants. The LIS EFIR implementation project has been successfully implemented, and this experience can be used in other medical organizations in the city.