Montenegrin || English || Pусский


E-mail: diagnostica@t-com.me Web: http://www.diagnostica.me

RECOMMNEDATIONS AND ADVICES

 

Blood sampling

Blood sampling is performed by blood vessel puncture (puncturing needles for sampling into the vein or extremely into artery), or stabbing a special instrument (equipment) - the lancet through the skin, usually a fingertip or ear lobe. The sample taken by using one of these methods can be analyzed as a whole blood sample (blood cells and liquid part), or after separation of the cellular elements from the liquid (blood serum or plasma).

Proper preparation of patients for blood sampling involves taking a sample in an appropriate manner and at appropriate time.

Diagnostica.meThe blood sample for some tests, e.g. determination of blood cells count, sedimentation rate, examination of the concentration of certain hormones and tumor markers, can be taken at any time, without any special preparation. For other analysis, patient is advised not to consume food prior blood sampling (depending on the type of analysis), meaning on an empty stomach. In this case, it is advised to take sample in the morning between 8 – 10 a.m., and 12 hours after the last meal.

In some tests, it is necessary to take a sample by using certain schedule, at a certain time of the day (e.g. determination of some parameters in diabetes) or sampling period depends on the specific period of time (e.g. in determining the concentrations of sex hormones).

In addition to proper patient preparation, it is important to record data on patients’ age, time of sampling (circadian rhythm), the phase of the cycle or week of pregnancy, actual illness, taking of medications...

Hematological and biochemical analysis are performed using standard methods on instruments of world-recognized manufacturers, which have a high level of reliability and automation of the whole process, so the results are obtained during the same day.

COMPLETE BLOOD COUNT TEST

diagnostica.meCOMPLETE BLOOD COUNT TEST podrazumijeva određivanje ukupnog broja svih ćelijskih elemenata krvi (eritrociti, leukociti i trombociti), količine hemoglobina, odredjivanje hematokrita, leukocitarne formule, kao i parametara MCV (srednja zapremina eritrocita), MCH (srednja količina hemoglobina u eritrocitu) i MCHC (prosječna koncentracija hemoglobina na litar eritrocita). Većinu ovih parametara hematološki analizator odreduje, a neke od njih izračunava računarskim programom.

THE ERYTHROCYTE SEDIMENTATION RATE

The erythrocyte sedimentation rate is a measure of the settling of red blood cells in a tube, after taking blood sample, in a defined period of time. It is usually measured during one hour, or two hours, in a full blood sample

BIOCHEMICAL ANALYSIS

Analyzing of biochemical parameters is a measuring of the different compounds and elements permanently present in blood, in certain common values, or present in certain conditions. It is tested in blood serum (or blood plasma in certain tests). For some analysis it is possible to use liquor, sweat, tears, and some other samples.

HORMONES

Hormones diagnostica.me are biomolecules normally produced in the body in a certain rate, specific to each of them, related to gender, age or a certain condition. They regulate various processes in the body. Determination of hormones level (volume, concentration) is performed in the serum sample.

TUMOR MARKERS

diagnostica.meTumor markers are specific biomolecules produced by the organism, as a metabolic or immune response of healthy cells to malignant cells, or they are produced by malignant cells, as a component biomolecules associated with the presence of malignancy. Tumor markers may include enzymes, specific proteins, different antigens, hormones, and other specific receptors. It has been discovered over 100 different tumor markers, but in laboratory practices, about twenty of them are used. They are usually determined in a serum sample.

OCCULT (OBSCURE) BLEEDING

It is normal to lose 0.5 to 1.5 mL of blood daily in the gastrointestinal tract, and melena usually is identified when more than 150 mL of blood are lost in the upper gastrointestinal tract. Occult gastrointestinal bleeding usually is discovered when fecal occult blood test (FOBT) results are positive or iron deficiency anemia is detected. In patients without symptoms indicating an upper gastrointestinal tract source or in patients older than 50 years, colonoscopy usually should be performed first. About one half of patients with gastrointestinal bleeding do not have an obvious source of the bleeding. Fecal occult blood testing methods vary. FOBTs have sufficient sensitivity to detect bleeding that is not visible in the stool. There are three classes of FOBTs: guaiac-based tests, hemeporphyrin tests, and immunochemical tests. If certain substances are in the stool, the results may be false positive. Patients usually are warned not to eat red meat or certain fruits and vegetables for 72 hours before testing. Use of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided for one week before testing. False-negative results may occur in patients taking vitamin C; patients should be advised not to take vitamin C in the week before testing. Patients are encouraged to eat foods high in fiber for one week before testing to cause more rapid stool transit.

DRUG TESTS

Tests used for determining the presence of various narcotics (drugs), such as: canabinoides (THC), opiates, amphetamine… They are performed mostly in urine or blood sample.

FOOD INTOLERANCE BLOOD TEST

Food intolerance blood tests are used to find out, which types of food organism do not tolerate. This provides information which types of food is more appropriate for organism. Tests are performed in blood serum.

URINE SAMPLING FOR BIOCHEMICAL-CYTOLOGICAL ANASYIS

diagnostica.meURINE SAMPLING FOR BIOCHEMICAL-CYTOLOGICAL ANASYIS Urine sampling for biochemical-cytological analysis should be done in a way, that the person giving the sample, urinate in a suitable container, which does not need to be sterile, but it should be chemically pure, without presence of various chemicals, traces of cleaning agents, surfactants or other substances that could affect the results of test. The amount required for analysis is 50-100 mL. The sample should be submitted to the laboratory, as soon as taken (it is desirable that the time from sampling to delivery to the laboratory is not longer than one hour).

URINE CULTURE SPECIMEN COLLECTION

It is necessary to take the middle "clean" stream, to avoid possible contamination by bacteria from the genital skin, the hands or the wall of the urinary canal (urethra). Sample must be collected in sterile urine cup, which can be obtained in the laboratory or the pharmacy.

Procedure:

  • 1. Wash and dry your hands carefully.
  • 2. Remove the cap of container and put it on side, having internal side upwards.
  • 3. Wash genital area (outer genital organs) and dry with clean towel (previously ironed) or sterile gauze. In males, pull back the foreskin, over glens penis, as much as possible, to visualize external urethral orifice.
  • 4. Drain a small amount of urine into the toilet, because the initial flow may be contaminated with bacteria from the skin or the wall of the urinary tube (urethra).
  • 5. Drain the middle stream into container for urine collection. Container should be load, at least, to cover the bottom (minimum 5 - 10 mL). Of course, it can be loaded even more.
  • Put the cap on, tighten it well and do not forget to wash your hands well after collecting a urine sample.

diagnostica.meThe sample should be submitted to the laboratory, as soon as taken (it is necessary that the time from sampling to delivery to the laboratory is not longer than one hour).

SWABS

diagnostica.meSamples for microbiological testing of different surfaces, skin and mucous membranes are obtained by sweeping this area with sterile equipment (swabs). All samples for microbiological examination should be taken before antibiotic therapy or at least 12h after local application of antiseptic agents (except in special cases, if a physician decides otherwise).

  • Throat swab - it is the best to take swabs in the morning, before breakfast and teeth washing. If the swab is taken during the day, the period between eating and swab taking should be two hours.
  • Nasal and nasopharyngeal swabs should be taken from both nostrils, with the same equipment (if it is not differently defined from some reason)
  • Swab taken from superficial wound or skin surface changes should be wiped from changed part, and if there is pus or discharge it is necessary to collect them too.
  • Swab (or sample for direct microscopic examination) from the urethra in men should be taken with the prior preparation, following procedure which involves that patient have not urinated for at least two hours (the longer, the better) before sampling. It is not desirable to have sexual intercourse at least 24 hours.
  • - Vaginal and cervical swabs (or sample for direct microscopic examination) should be taken in the period when a woman has no menstrual bleeding. It is not desirable to have sexual intercourse at least 48 hours prior testing. If any gynecological examination has been done previously (the speculum, colposcopy, ultrasound vaginal sonde), sampling is preferably to be done 48 hours after.

diagnostica.meIf test is negative (if bacteria that can cause disease are not found on the spot from which sample was taken) results can be obtained within, an average, 24 - 48 hours. In opposite, the analysis may take approximately 3 - 5 days.


The control sample upon antibiotic therapy should be taken after at least 3 days after completion of therapy.

MYCOLOGICAL ANALYSIS

Confirmation of the presence of fungi (yeasts and molds) in various samples (skin and mucous membrane swabs, stool, sputum, urine) is performed routinely, often parallel with bacteriological investigations. Detection may be made by direct microscopic examination of skin and nail scrapings or hair, as well as by cultivation on artificial nutrient medium (cultivation, isolation). To isolate fungi that belong to the genus Candida, the diagnostic process usually takes 48 hours, and it is possible, if necessary, to identify to the species level and to determine their sensitivity to antifungal, which requires additional time. Isolation and identification of dermatophytes - fungi that cause diseases of the skin, nails and hair, requires incubation of up to three weeks.

PARASITOLOGICAL ANALYSIS

Confirmation of the presence , of intestinal parasites, helminthes (Nematoda, Cestoda, Trematoda) and intestinal protozoa (Entamoeba,Giardia, Balantidium ...) is performed in stool samples.

Detection of Enterobius vermicularis (pinworm) is performed from the perianal (cellophane, Sotch-tape) swab. This sample should be taken in the morning, before defecation (stool). At least 12 h before taking the perianal swab, anal region must not be washed, smudged or talcum.

Detection of Demodex spp. is performed from the skin print or skin scrapings.

Detection of the parasite Trichomonas vaginalis in various samples (vaginal, urethral discharge, urine) is usually performed by examining the microscopic slides. In some cases, cultivation in the special growing media can be done.

SEROLOGICAL ANALYSIS

Detection of various microorganisms, as well as proving of their recent or previous contact with the organism, can be done by examining the presence of antibodies in the serum of a patient, directed against these microorganisms. Blood sampling for these tests is performed in the same manner as the sampling for biochemical tests, with no special preparation.

VIRAL SEROLOGICAL ANALYSIS

Detection of antibodies to viruses:

Adenovirus, Coxsackie B, Rubella, Varicella-zoster virus, Epstein-Barr, Hepatitis, HIV, Herpes type 1 and 2, Cytomegalovirus, Influenza A and B. ..

PARASITOLOGICAL SEROLOGICAL ANALYSIS

Detection of antibodies to parasites:

Toxoplasma gondii, Echinococcus granulosus, Trichinella spiralis, Taenia solium, Toxocara canis ...

BACTERIOLOGICAL SEROLOGICAL ANALYSIS

Detection of antibodies to bacteria:

Treponema palidum, Borrelia burgdorferi, Bordetella pertussis, Brucella spp. ...

RAPID ANTIGEN TESTS

These tests detect different microorganisms from various samples (swabs, stool, urine ...)

  • Detection of influenza virus from throat swab
  • Detection of beta-hemolytic group A streptococci in throat swab
  • - Detection of rotavirus, adenovirus, Helicobacter pylori, Clostridium difficile toxin A + B in the stool
MICROBIOLOGICAL CONTROL

Bacteriological control of work surfaces, air, sterile instruments...

Biological and chemical control of sterilization efficiency of wet and dry sterilizers