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BIOCHEMISTRY LABORATORYUrine
laboratory
Ð
Within the biochemistry
laboratory we assess a large
scale of analysis, sorted accordingly to the area of expertise.
Metabolism of Carbohydrates - glucose, C-peptide, Insulin,
oral glucose tolerance test and HbA1c.
Peptides & Proteins
-
albumin, total proteins,
total globulins, CRP (C-reactive protein),
ASTO
(antistreptolisine O), IgG (immunoglobulin G), IgM
(immunoglobulin M),
IgA (immunoglobulin A), RF (rheuma factor), C3c
and C4 (complement components), microalbuminury,
alpha1-microglobulin, beta2-microglobulin
and protein electrophoresis.
Lipid status - cholesterol, HDL (high
density lipoproteins) and LDL (low
density lipoproteins), TG (triglycerides),
APO A-1 and APO B (apolipoproteins A-1
and B).
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Enzymes
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ALT (alanine
aminotransferase), AST (aspartate
aminotransferase), Gama-GT (gamma-glutamyl transferase), ALP (alkaline
phosphatase),
ACP (acid phosphatase total), ACPP (prostatic acid
phosphatase),
CK (creatine kinase), CK-MB (creatine
kinase
MB
isoenzyme),
LDH (lactate
dehydrogenase), alpha
and
pancreatic
amylase,
lipase,
cholinesterase and
ACE (angiotenzyme converting enzyme).
Iron metabolism
-
iron, TIBC
(total iron binding capacity)
and UIBC
(unsaturated iron binding capacity), ferritine,
vitamine B12,
folate, transferrin,
haptoglobin
and
erythropoetine.
Electrolytes
and
Microelements -
potassium,
sodium,
chloride, magnesium,
phosphorous and
calcium.
Metabolites -
urea, creatinine,
uric acid and
bilirubine (total
and direct).
Other -
troponine I
and T,
homocysteine
and bicarbonates.
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Adequate preparation of
the patient is necessary for most of the laboratory
assessments, because the accuracy of
test results depends in more
than one way from that factor.
Adequate patient preparation implies sampling on an empty stomach, in
the morning between 8 to 10h, and 12
hours after the last meal.
Beside the adequate preparation of the
patient it
is also important to have correct data on the age of the patient, time when
the sample was taken (circadian rhythm), phase of cycle or week of
pregnancy, current diseases and medications so the appropriate reference
values range could be chosen and to obtain the
proper information on optimal dosage.
Biochemical test are performed with standard methods on
automatic analysers of
renowned world manufacturers that have a high precision and
automatisation of the entire process, so the results can be obtained
within a day:
1.
Olympus AU400, Olympus
2. Hitachi 902,
Roche/Hitachi
3.
Screen Lyte, Hospitex
Medical
indications
Metabolism of Carbohydrates
- Glucose -
carbohydrates metabolism monitoring.
- C-peptide - plays different roles in
insulin synthesis and functionality. Determination of C-peptide gives an
estimation of internal insulin secretion reserves in patients with diabetes
mellitus and is considered a reliable indicator of insulin secretion more
than the determination of insulin itself.
- Insulin - primary effect of insulin is to lower glucose concentration
in blood. Increase of glucose level in blood above the certain value is
a signal for insulin secretion. Accelerates glucose absorption in liver,
muscle and fat tissue cells and enhances its further metabolism.
- Oral Glucose Tolerance Test - is used in diagnostics of glucose
metabolism disorders and capability to regulate the level of blood glucose. Glycemia is monitored trough specific intervals of time (30, 60, 90, 120,
180 minutes) after the administration of the designated dose of glucose.
-
HbA1c -
level of HbA1c is in correlation with the average blood glucose level in the
preceding two to three months. Accordingly gives more reliable information
in glycemia monitoring than individual assessment of glucose.
Peptides
& Proteins
-
Proteins - diagnosis and treatment of various
diseases, including liver, kidney and bone marrow, and also metabolic and
nutritional diseases.
-
Albumin - protein metabolism disorders.
- CRP - acute phase protein, increased during inflammatory disorders.
- ASTO - ASO antibodies are found in patient serums as a response
to infection of hemolytic streptococcus group A, C or G. High titer of
anti-ASO antibodies is found in serum of patients with rheumatoid fever
and glomerulonefritis. Titer of anti-ASO antibodies should be monitored
within a period of 4 to 6 weeks, every second week.
-
RF - diagnostics and
monitoring of patients with rheumatoid diseases, especially rheumatoid
arthritis.
Immunoglobulins are a B
cell product. There are five basic types: IgG,
IgA, IgM, IgE and IgD.
- IgG - most represented among all immunoglobulins in serum. Has
significant antiviral and antibacterial effect, and large capability
of opsonization and neutralization of toxins.
- IgA - especially efficient antibodies in securing anti-microbe
protection of various mucosal membranes.
- IgM - present in cytoplasm and on surface of B cells in
different phases of growth. It is an antibody that B cells extract first
during
primary response of antibodies.
- IgE - type consists of classic anaphylactic antibodies,
important for the presusceptibility reaction type I (allergic reaction).
- C3c and C4 - components of
the complement. Complement system consists of around 20 different proteins with
various roles in the inflammatory process. C3 assessment is used in
diagnosis and monitoring of inflammatory processes of diverse etiology. C4
assessment is primary used for evaluation of course of hipocomplementary conditions.
- Microalbuminury - assessment of albumin in morning midstream
urine or in 24h urine specimen. It is of use for early detection of kidney
function disorder.
- α1-microglobulin - assessed from second morning
midstream urine or 24h urine specimen. It is used as a marker for
diagnostics of early phase of tubular-interstitial nephropathy.
- β2-microglobulin
- assessed from serum, second morning midstream
urine and 24h urine specimen. It is used as a test for evaluation of tubular function of kidneys. Increased in serum in all conditions related to
immune system activation.
- Protein electrophoresis -
serum proteins are dismounted into
fractions
(albumin, α1-globulins, α2-globulins, β-globulins
and
γ-globulins). It is used in diagnostics of
malignant, especially hematopoetic neoplasm (monoclonal gamma pathology
detection).
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Lipid status
-
Cholesterol -
gives just the basic information for further laboratory
testing of lipoproteins metabolism (HDL, LDL and
triglycerides). Cholesterol represents an essential
component of cell membranes and lipoproteins, and
is also a precursor for synthesis of steroid
hormones and gall acids.
- HDL-cholesterol - low HDL is a risk factor which is
non-dependant from the
concentration of total cholesterol. Assessment of HDL-cholesterol is used for early recognition of
atherosclerosis risk.
- LDL-cholesterol - high LDL is connected to high risk of
developing cardiovascular diseases.
- TG (triglycerides) - clinically, the assessment of TG is used
for classification of genetic and metabolic diseases
and for risk evaluation for atherosclerosis and
coronary artery diseases.
- APO A-1 and APO B - the purpose of quantitative determination
of apolipoprotein A-1 and B is risk evaluation for
atherosclerosis and coronary artery diseases.
Enzymes
- ACP/ACPP - increased ACP can be
found in serum of males with prostate cancer, and is useful for disease state
evaluation. Assessment of prostatic ACP is used for prostate malignant
re-emission or comeback evaluation and efficiency estimation of different
treatment regimes. It is physiological increased in children during the
period of extensive growth.
- CK/CK-MB - CK assessment is primary used in diagnosis and
treatment of myocardium infarction, and also as the most sensitive indicator of muscle
damage. Proportionally, the increase of CK-MB fraction is, in some way,
dependant on the severity of myocardium damage.
- LDH - highly specific enzyme is found in liver, heart muscle,
kidneys and RBC. Main part of total LDH is found in the detection of small
tissue damages.
- Amylase - diseases that cause elevated alpha-amylase values in plasma
are acute pancreatitis, parotitis, alcoholism, renal insufficiency, virus
hepatitis and upper abdomen trauma.
- Pancreatic amylase - diagnosis and monitoring of acute and
chronic pancreas inflammation. It is considered a organ specific enzyme.
- Lipase - determination of serum and plasma lipase is explicitly
used for detection of pancreas disorders, most often pancreatitis.
- Cholinesterase - levels of cholinesterase in serum can be useful
as an indicator of insecticide poisoning, detection of patients with
atypical forms of enzymes or as a test for liver
functions. Cholinesterase assessment is recommended as a
pre-operational screening for the identification of patients with high risk
of complications.
- ACE - diagnosis and monitoring of sarcoidosis,
respiratory distress syndrome in newborns, adult tuberculosis and many
pathological lung and liver conditions
- ALT
- control of liver, heart, muscle and other internal
organs.
- AST - monitoring of hepatobiliar
diseases, myocardium infarct and skeleton muscle damages.
- Gamma-GT - increased in patients with infective hepatitis, liver
lipemia, in acute and chronic pancreatitis and in patients on anticonvulsive
drugs therapy (Phenitoin and Phenobarbital).
- Alkaline phosphatase (ALP) -
increased levels could be found in primary bone diseases (osteomyelitis,
vitamin D intoxication and primary bone cancer), also with some secondary
bone diseases (metastasis, multiple myeloma, acromegalia, renal
insufficiency hypertireoidisma, ectopic ossification, sarcoidosis, bone
tuberculosis and fractures). It is physiological increased in children during the
period of intense growth and in pregnant women.
Iron
Metabolism
- Iron - involved in various vital processes in organism, like
transport and transfer of oxygen to the cells. Iron level is determined as a part
of diagnosis and monitoring of anemia, and also for defect of liver, kidney
and gastrointestinal tract.
- UIBC - unsaturated or latent iron binding capacity.
- TIBC - total iron binding capacity, maximum iron concentration
that proteins in serum can bind.
- Ferritine - serum ferritine is a sensitive indicator of the
state of iron
in organism. Values of ferritine in serum below 10 μmol/L
can indicate anemia, iron deficit, while ferritine level is increased in
chronic diseases. Serum ferritine is increased in aplastic, syderoblast and
chronic hemolytic anemia.
- Transferrin -
diagnosis, differential diagnosis and monitoring
of iron metabolism disorders of different etiology.
- Haptoglobin - glycoprotein that irreversibly binds hemoglobin and
is used for diagnosis and monitoring of hemolytic diseases.
- Erytropoetine - glycoprotein hormone that is mostly secreted in
kidneys and liver and regulates the production of RBC, that is erythropoesis.
It is used for treatment of anemia in humans.
- Vitamin B12 - humans receive vitamin B12 solely from food of
animal origin (meat, eggs, milk) and the organism uses its supplies quite
economical. Deficiency of vitamin B12 manifests in pernicious anemia and
neurological disorders.
- Folate - with vitamin B12, folates are essential for DNK
synthesis that is necessary for the forming of normal red blood strain. Folate deficiency causes macrocyte anemia.
Electrolytes
and Microelements
-
Potassium/Sodium/Chloride-
electrolytes influence most of the
metabolic processes. Their part is to maintain osmotic pressure and hydratation of various body fluids and proper pH in organism, and in
regulation of corresponding heart and muscle functions.
- Magnesium- represents a necessary factor in many enzymatic
reactions, and is an integral part of metaloenzymes, glycolyse activator,
cell resorption and trans-membrane potassium transport. It has a tight connection with calcium metabolism.
- Calcium - calcium assessment is used in diagnosis and
treatment of parathyroid disease, chronic renal diseases, urothyliasis and
tetania.
- Phosphorous - is assessed within the monitoring and diagnosis
of disorders of vitamin D metabolism, PTH (parathyroid hormone),
malabsorption, kidney disease, etc.
Меtabolites
- Urea - ending product of
protein and amino-acid metabolism. In the differential diagnosis of kidney
function the assessment of urea and creatinine in serum
are, most frequently, done together.
- Creatinine - metabolic product of creatinine and phosphocreatine
in muscles. Assessment of creatinine is used in diagnosis and treatment of
kidney diseases.
- Uric Acid
- main product of purine catabolism. Most of
the uric acid production takes place in liver and is eliminated through kidneys,
during which the "pool" of uric acid in organism represents the balance
between synthesis and elimination.
- Total/direct
bilirubine -
is produced in a series of hemoglobin reaction in liver.
The increase of bilirubine concentration in blood results in
the appearance of yellow skin color, in other words jaundice. |
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Other
- Troponine I
and T
- along with troponine C form a troponine
complex which, aided by calcium ion, regulates
muscle contraction by controlling the interactions
between actine and myosin in muscle fibers.
Heart troponine I and T are a very sensitive and
specific indicator of heart myocardium damage.
Their assessment helps in differentiation of
unstable angina from infarct in patients with
present chest pain. It is important to emphasize
that heart troponines are markers of heart
muscle damage overall, and not just the heart
damage caused by infarct.
- Homocysteine - amino acid that is normally found in all cells in
small amounts. It originates by demethylation of
methionine, an essential amino acid that can't be
synthesize in organism but only introduced with
food. If there is a disordered in metabolism of homocysteine, either because of enzyme defects
or deficit of needed cell cofactors, homocysteine is accumulated in cells and
transported into circulation. It is established
that increased level of homocysteine is connected
with high risk of coronary artery diseases,
stroke and thromboembolism (vein clog) in
patients who have normal level of cholesterol.
- Bicarbonates - used for diagnosis of disorders in acid-alkali balance. Increased values occur
in compensated respiratory acidosis and metabolic
alkalosis, and decreased values in compensated
respiratory alkalosis and metabolic acidosis.
The prices of all of our laboratory services you may find in our
price list.
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URINE
LABORATORYBIOCHEMISTRY
LABORATORYÎ
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Qualitative
urinalysis consists of macroscopic examination that
is performed with test strips, and of microscopic
examination of urine sediment. Having in mind that
kidney and urinary tract functions disorders are
manifested in urine composition changes,
urinalysis is a useful screening in asymptomatic
patients.
For
qualitative urinalysis fresh first
midstream urine is taken. First morning urine is
suitable for qualitative analysis because it has
retained in the bladder long enough so his
composition is not dependant of daily variations in
food or fluid administration, nor of physical
activity.
To obtain valid
results, urine specimen collection procedure must be
followed in full for every urine sample.
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Collection of midstream first urine specimen
A "mid-stream
clean catch" urine sample is necessary so that any bacteria present around the
urethra and on the hands do not contaminate the specimen. For urine sampling use
a sterile urine collection cup, that can be obtained in our laboratory or bought
in any pharmacy.
1.
Wash and dry your hands thoroughly.
2. Remove the urine cup's lid and set it aside. Do not touch inner surfaces
of the urine collection cup.
3. Wash your uro-genital area ("lower
parts") and dry with a towelette or a towel.
4. Pass a small amount of urine into the
toilet. This initial stream of urine may be contaminated with skin and urethral
bacteria.
5. Then midway through urination, urinate
into the urine cup. The urine cup should only be 1/2 to 2/3 full.
6. Replace the lid and tighten firmly and
remember to wash your hands thoroughly after collecting the specimen.
Bring specimen to the laboratory within 2h from collection.
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For quantitative urinalysis
the entire volume of urine excreted within the period of 24h has to be
taken.
Collection of 24h Urine
During the 24-hour collection, You ought to drink
at least 6 X 8 oz (250 mL) glasses of water (1,5 L).
- First thing in the morning, empty the
bladder completely and discard all urine.
- Collect ALL urine
specimens during the day, evening and night,
with a period of 24h and add to the previous samples in a plastic
bottle.
- Exactly 24h later completely discard the
bladder and add all urine to the previous. This is the last specimen
that completes you 24h urine collection.
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The prices of
all of our laboratory services you may find in our
price list. |
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