LABORATORY ANALYSIS APPLIED TO SPORTS
Learning outcomes of the course unit
The integrated course of “Laboratory Analysis applied to Sport” aims to provide the student with essential knowledge about the main characters of Clinical Biochemistry, Applied Histopathology, General Pathology, Microbiology and Laboratory Medicine, Dermatology.
Furthermore, it will supply the ability of using the acquired knowledge and understanding as useful tools for a conscious approach to the diseases characteristic of each course.
In particular the course aims to provide the knowledge about:
The dosage of biochemical and clinical parameters in the blood and in the urine useful to control the health of amateur and professional athletes;
comprehension and interpretation of the data obtained in the laboratory of chemical-clinical analysis, and particular attention will be on possible alterations of the metabolism caused by the physical activity and their consequences.
Furthermore the students will practise the strategies applied for the laboratory analysis that are aimed at contrasting the use of prohibited expedients or substances: direct identification, recognition of induced biochemical or metabolic alterations and their identification also outside the laboratory.
The nomenclature, etiology, physio-pathology and anatomical bases of diseases that have a specific relevance in the professional and recreational practice of sports. These include cerebro-spinal trauma, sudden cardiac death of the athlete and neuro-muscular pathology;
prevention, diagnosis and counseling of these disorders;
the basic physio-pathology of cerebral trauma including hemorrhage, edema, brain hypertension, herniation and ischemia;
the causes, the pathological bases and the clinical features of the main traumatic injuries of brain and spinal cord;
the etiology, risk factors, pathological manifestations, early symptoms and strategies of prevention of sudden cardiac death of the athlete;
the causes, the pathology and the laboratory and clinical features of the most common hereditary and acquired diseases of the skeletal muscle and peripheral nerve;
the differences between myopathies and muscle denervation injuries and their differential diagnosis;
the role of muscle and peripheral nerve biopsy in the management of neuro-muscular disorders;
strategies to prevent sudden cardiac death in the athlete and in the identification of subjects at risk;
identification and immediate management of spinal and brain trauma injuries;
prevention of traumatic brain and spinal injuries in sports;
screening of subjects with potential neuro-muscular disorders.
The mechanisms underlying post-exercise tissue damage and diseases due to drug abuse.
MICROBIOLOGY AND LABORATORY MEDICINE
The main characters of the principal etiologic agents of infectious diseases (viruses, bacteria, fungi, parasites), the possible transmission routes, laboratory diagnosis techniques, the immune prophylaxis and therapy.
There are no obligatory prerequisites for the integrated course of “Laboratory Analysis applied to Sport” but it would be advantageous for the students to have sufficient notions of biology, anatomy, chemistry, biochemistry, physiology, general pathology and general microbiology.
Course contents summary
The integrated course of “Laboratory Analysis applied to Sport” is composed by some courses (Clinical Biochemistry, Applied Histopathology, General Pathology, Microbiology and Laboratory Medicine, Applied Dermatology) regarding the different laboratory techniques, the main diseases and the way of intervention in the fields of sports and sport medicine. Below are listed the contents of each course:
The first part of the course will concern the study of biological samples to know their characteristics and their possible alterations. This part will be related to the patients preparation for taking the blood sample and to the conservation of the sample itself (pre-analytic variability), in particular will be deepened the aspects concerning the sport and training activities.
In the second part of the course will be supplied the basic knowledge for the comprehension and the use of the most common marker of organs damage and functionality. In particular will be considered the management of the athletes and the main general pathologies: basic biochemical profile, cytolysis indexes, cardiac, muscle-skeletal, hepatic and renal functionality markers, urine analysis, operative strategies in case of laboratory analysis of prohibited substances.
The lessons will focus on the following topics:
Laboratory medicine with regard to sport and to the doping prevention.
Laboratory tests: definition, typology, request modality.
Biological sample: properties and characteristics.
Pre-analytical and analytical variables affecting the laboratory data, particular attention will be on the Point of care testing (POCT) instrumentation.
Strategy about laboratory investigation of prohibited substances or methods: direct detection or recognition of biochemical alteration induced on the metabolisms.
Basic biochemical analysis profiles.
Markers of muscle damage.
Meaning of the most common Chemical-Clinical parameters, markers of functionality and/or metabolic, organs and tissue damages.
Biological samples and their treatment.
Lessons will discuss relevant issues in: i) the pathology of the brain and spinal cord trauma, in particular sport injuries; ii) the pathology of sudden cardiac death; iii) the diseases of the skeletal muscle and nerve. Emphasis will be given to the relevance of the tissue approach to the study of disease and to the clinical use of muscle and peripheral nerve biopsy.
The lessons will focus on the following topics:
Traumatic injury of the brain and the spinal cord
• Basic concepts in brain circulation.
• Brain edema.
• Brain concussion and contusion.
• Diffuse axonal injury.
• Brain hemorrhage (epidural, subdural, subarachnoidal e parenchymal).
• Closed spinal trauma.
Sudden cardiac death: epidemiology, etiology and prevention
Pathology of skeletal muscle
• Basic concepts on the neuro-mucolar unit.
• The morphological approach to the study of skeletal muscle and the muscle biopsy.
• Myopathies and muscolar dystrophies.
• Infectious and non-infectious myositis.
• Denervation injury.
Pathology of the peripheral nerve
• The morphological approach to the study of peripheral nerve and the nerve biopsy.
• Neuronal diseases and assonopathies.
• Demyelinating diseases.
• Traumatic injury of the peripheral nerve.
Lectures will concern:
a) strenuous exercise and tissue damage
b) the PostExercise ImmunoSuppression (PEIS)
c) disorders referable to androgen/EPO abuse
d) laboratory in
For each course are recommended specific books, in particular:
- Kellerman G. “Valori anormali di laboratorio”. Mc Graw Hill
- S.D.Ferrara. “Doping Antidoping” –Piccin
Robbins & Cotran, Pathologic basis of diseases, Elsevier, 8° Ed. (specific chapters).
Rubin, Pathology, Mosby 2006 (specific chapters).
-J.A.M Maier & M.Mariotti “Elementi di Patologia generale e
Fisiopatologia”, McGraw-Hill Companies
T.D. Spector & J.S. Axford " Introduzione alla Patologia Generale", II ed.,
Casa Editrice Ambrosiana
G.M. Pontieri "Patologia Generale e Fisiopatologia generale, per i corsi
di laurea in Professioni Sanitarie" II ed., Piccin
MICROBIOLOGY AND LABORATORY MEDICINE
M. Bendinelli, C. Chezzi, G. Dettori, N. Manca, G. Morace, L. Polonelli, M.A.Tufano
“Microbiologia Medica: gli agenti infettivi dell’uomo – biologia, azione patogena, laboratorio”.
Virologia – Batteriologia – Micologia - Parassitologia
"Dermatologia Pediatrica" (autore: G. Fabrizi).
" Nevi e melanomi nel bambino" (autori: G. Fabrizi, G. Massi).
"Dermatologia Manuale pratico di consultazione" (autori: R. Graham-Brown, T. Burns).
Lectures accompanied by visual aids specific for each part of the course will be used to convey critical information on the topics relating to the course content. Moreover for the course of clinical Biochemistry will be simulated professional situations relating to different kind of activity (gym, sport society, professional athletes, schools).
Assessment methods and criteria
Learning outcomes will be verified through an oral examination. Questions on the topics relating to the course content will aim to check the student’s knowledge and understanding in the field, in order to test his ability of applying the acquired knowledge to a conscious approach to theoretical and practical situations related to each part of the course.