Haematology involves the diagnosis and treatment of patients who have disorders of the blood and bone marrow. Whilst a major part of a haematologist’s time is spent in providing direct clinical care to patients, diagnostic work in the laboratory is also a significant part of their work.

WHY IS HAEMATOLOGY IMPORTANT?

Haematology is the specialty responsible for the diagnosis and management of a wide range of benign and malignant disorders of the red and white blood cells, platelets and the coagulation system in adults and children.

Haematologists care directly for patients on hospital wards and out patient clinics. Their patients may have a serious life- threatening illness such as leukaemia, lymphoma or myeloma that requires chemotherapy. They also advise GPs about how to care for patients in their homes. Some haematologists specialise in diseases affecting the blood coagulation system such as haemophilia, while others  provide expertise in the areas of blood transfusion or disorders of haemoglobin such as sickle cell disease.

THE ROLE OF THE HAEMATOLOGIST

Haematologists work very closely with other health professionals including GPs, pharmacists and specialist nurses, advising colleagues in hospital and primary care.

Haematologists perform a wide range of laboratory tests to produce and interpret results assisting clinicians in their diagnosis and treatment of disease whilst supporting hospital departments including A&E, intensive care, operating theatres, special care baby units and oncology.

For example, haematologists are the pathologists who receive blood samples from GP surgeries and check them for abnormalities. They look at blood film and, for example, if they suspect leukaemia, can assess the patient, explain concerns, perform a bone marrow biopsy and examine and interpret the samples. The diagnosis can be done within a few hours, since in some cases treatment must be started immediately.

Haematologists also diagnose and treat patients with anaemia (a lower than normal number of red blood cells).

Some haematologists are involved in transfusion medicine, ensuring that adequate stocks of safe blood are available when needed for blood transfusions. They confirm which donated blood is the right match for the patient’s blood group.  For example, haematologists work in the NHS Blood and Transplant service  providing vital support for blood transfusion, organ and stem cell transplantation.

They also undertake research into diseases such as leukaemia. By gaining understanding of diseases they also research therapies to help improve survival rates of patients.

Biochemistry is the branch of science that explores the chemical processes within and related to living organisms. It is a laboratory based science that brings together biology and chemistry. By using chemical knowledge and techniques, biochemists can understand and solve biological problems.

Biochemistry focuses on processes happening at a molecular level. It focuses on what’s happening inside our cells, studying components like proteins, lipids and organelles. It also looks at how cells communicate with each other, for example during growth or fighting illness. Biochemists need to understand how the structure of a molecule relates to its function, allowing them to predict how molecules will interact.

Biochemistry covers a range of scientific disciplines, including genetics, microbiology, forensics, plant science and medicine. Because of its breadth, biochemistry is very important and advances in this field of science over the past 100 years have been staggering. It’s a very exciting time to be part of this fascinating area of study.

What do biochemists do?

• Provide new ideas and experiments to understand how life works
• Support our understanding of health and disease
• Contribute innovative information to the technology revolution
• Work alongside chemists, physicists, healthcare professionals, policy makers, engineers and many more professionals

Autoimmunity: A misdirected immune response that occurs when the immune system goes awry and attacks the body itself.

Autoimmunity is present to some extent in everyone and is usually harmless. However, autoimmunity can cause a broad range of human illnesses, known collectively as autoimmune diseases. Autoimmune diseases occur when there is progression from benign autoimmunity to pathogenic autoimmunity. This progression is determined by genetic influences as well as environmental triggers.

Autoimmunity is evidenced by the presence of autoantibodies (antibodies directed against the person who produced them) and T cells that are reactive with host antigens.

WHAT IS HISTOPATHOLOGY?

Histopathology is the diagnosis and study of diseases of the tissues, and involves examining tissues and/or cells under a microscope. Histopathologists are responsible for making tissue diagnoses and helping clinicians manage a patient’s care.

WHY IS HISTOPATHOLOGY IMPORTANT?

Histopathologists are doctors who work closely with other clinical specialties. They can reach a diagnosis by examining a small piece of tissue from the skin, liver, kidney or other organ. This is called a biopsy.

They examine the tissue carefully under a microscope, looking for changes in cells that might explain what is causing a patient’s illness. Around 20 million histopathology slides are examined in the UK each year.

CANCER DIAGNOSIS

Histopathologists provide a diagnostic service for cancer; they handle the cells and tissues removed from suspicious ‘lumps and bumps’, identify the nature of the abnormality and, if malignant, provide information to the clinician about the type of cancer, its grade and, for some cancers, its responsiveness to certain treatments.

With the help of sophisticated imaging techniques, biopsy tissue can now be obtained from previously inaccessible sites such as the pancreas or retroperitoneum (behind

the peritoneum, the membrane lining the abdominal cavity). Tissue is then processed, usually overnight, before being examined under a microscope.  In certain limited circumstances using special techniques, the specimen can be examined immediately. With rapidly  changing developments in molecular pathology, pathologists are leading the way with new techniques such as fluorescence in-situ hybridization.

(FISH) and polymerase chain reaction (PCR), to map the genetic material in tissues or tumours, which are essential in the management of many cancers.

Cytology: The medical and scientific study of cells. Cytology refers to a branch of pathology, the medical specialty that deals with making diagnoses of diseases and conditions through the examination of tissue samples from the body.

Cytologic examinations may be performed on body fluids (examples are blood, urine, and cerebrospinal fluid) or on material that is aspirated (drawn out via suction into a syringe) from the body. Cytology also can involve examinations of preparations that are scraped or washed (irrigated with a sterile solution) from specific areas of the body. For example, a common example of diagnostic cytology is the evaluation of cervical smears.

In order for cytologic evaluation to be carried out, the material to be examined is spread onto glass slides and stained. A pathologist then uses a microscope to examine the individual cells in the sample.

Micro-organisms and their activities are vitally important to virtually all processes on Earth. Micro-organisms matter because they affect every aspect of our lives – they are in us, on us and around us.

Microbiology is the study of all living organisms that are too small to be visible with the naked eye. This includes bacteria, archaea, viruses, fungi, prions, protozoa and algae, collectively known as ‘microbes’. These microbes play key roles in nutrient cycling, biodegradation/biodeterioration, climate change, food spoilage, the cause and control of disease, and biotechnology. Thanks to their versatility, microbes can be put to work in many ways: making life-saving drugs, the manufacture of biofuels, cleaning up pollution, and producing/processing food and drink.

Microbiologists study microbes, and some of the most important discoveries that have underpinned modern society have resulted from the research of famous microbiologists, such as Jenner and his vaccine against smallpox, Fleming and the discovery of penicillin, Marshall and the identification of the link between Helicobacter pylori infection and stomach ulcers, and zur Hausen, who identified the link between papilloma virus and cervical cancer.

Microbiology research has been, and continues to be, central to meeting many of the current global aspirations and challenges, such as maintaining food, water and energy security for a healthy population on a habitable earth. Microbiology research will also help to answer big questions such as ‘how diverse is life on Earth?’, and ‘does life exist elsewhere in the Universe’?

Molecular diagnostics is a collection of techniques used to analyse biological markers in the genome and proteome.

Hormones are your body’s chemical messengers. They travel in your bloodstream to tissues or organs. They work slowly, over time, and affect many different processes, including

• Growth and development
• Metabolism – how your body gets energy from the foods you eat
• Sexual function
• Reproduction
• Mood

Endocrine glands, which are special groups of cells, make hormones. The major endocrine glands are the pituitary, pineal, thymus, thyroid, adrenal glands, and pancreas. In addition, men produce hormones in their testes and women produce them in their ovaries.

Hormones are powerful. It takes only a tiny amount to cause big changes in cells or even your whole body. That is why too much or too little of a certain hormone can be serious. Laboratory tests can measure the hormone levels in your blood, urine, or saliva. Your health care provider may perform these tests if you have symptoms of a hormone disorder. Home pregnancy tests are similar – they test for pregnancy hormones in your urine.