The medical-biochemical laboratory provides services in the field of routine and specialist medical-biochemical tests.
The goal is to provide services to patients with the help of professional, friendly and discreet staff using highly sophisticated equipment and quality reagents to gain and justify the trust of our patients.
Quality assurance of laboratory work is carried out daily and periodically. Internal assessment of the quality of work is ensured by carrying out two-level controls, by use of normal and pathological control serums.
External evaluation of the work control is carried out periodically, three times a year in cooperation with the Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM). The control includes all measurement parameters that the laboratory performs.
In quality assurance, we follow the HRN EN ISO 15189 standards.
Laboratory Tests
LABORATORY HAEMATOLOGY
- blood count – KS (number of erythrocytes, leukocytes and platelets, hemoglobin, hematocrit, erythrocyte constants; MCV; MCH; MCHC; RDW, MPV)
- complete blood count – KKS (number of erythrocytes, leukocytes and platelets, hemoglobin, hematocrit, erythrocyte constants; MCV; MCH; MCHC; RDW, MPV, differential blood count)
reticulocytes
- erythrocyte sedimentation rate-SE
- smear for eosinophils
COAGULATION
- activated partial thromboplastin time – APTV and ratio
- d-dimer
- fibrinogen
- prothrombin time – PV (proportion and ratio)
GENERAL BIOCHEMICAL TESTS
- Albumin
- Antistreptolysin titer – AST/ASO
- alanine aminotransferase – ALT
- alkaline phosphatase – ALP
- aspartate aminotransferase – AST
- amylase
- bilirubin (total, conjugated and unconjugated)
- assessment of glomerular filtration rate – eGFR
- phosphates- P
- gamma clutamyltransferase – GGT
- globulins
- glucose
- HDL-cholesterol
- calcium, total – Ca
- potassium – K
- chlorides – Cl
- cholesterol
- creatine kinase- CK
- creatinine
- lactate dehydrogenase- LD
- LDL-cholesterol (direct or calculated)
- Lipase
- magnesium – Mg
- sodium – Na
- unsaturated iron binding capacity – UIBC
- proteins, total- UP
- rheumatism factor – RF
- triglycerides
- total iron binding capacity – TIBC
- urates
- urea
- iron – Fe
SPECIAL BIOCHEMICAL TESTS
- C3-component of complement
- C4-component of complement
- C-reactive protein- CRP
- ferritin
- glycated hemoglobin – HbA1c
- homocysteine
- Immunoglobulin A
- Immunoglobulin E
- Immunoglobulin G
- Immunoglobulin M
- N-terminal proBrain Natriuremic Peptide- Nt-pro BNP
TUMOUR MARKERS
- alpha-feto protein – AFP
- CA 125
- CA 15-3
- CA 19-9
- CA 72-4
- Carcinoembryonic antigen – CEA
- Cyfra 21-1
- Human epididymal protein- HE4
- neuron specific enolase – NSE
- prostate specific antigen, total- PSA
- free PSA-fPSA
- ROMA index – Risk of Ovarian Malignancy Algorithm
VITAMINS
- Folic acid
- vitamin B12
- vitamin D
HORMONES
- adrenocorticotropic hormone – ACTH
- anti Miller’s hormone – AMH
- anti thyroglobulin (thyroglobulin antibodies) – antiTg
- antibodies to thyroid peroxidase – anti TPO
- beta human chorionic gonadotropin – betaHCG
- C-peptide
- Dihydroepiandrostenedione sulfate- DHEAS-S
- estradiol- E2
- follicle stimulating hormone – FSH
- globulin that binds sex hormones – SHBG
- HOMA-IR- Homeostatic model of assessment of insulin resistance
- free testosterone index – FTI
- insulin
- cortisol, free
- cortisol, total
- luteinizing hormone – LH
- parathormone- PTH
- progesterone
- prolactin
- macroprolactin
- testosterone
- thyroglobulin- Tg
- thyroid stimulating hormone – TSH
- thyroxine- T4
- thyroxine, free-fT4
- triiodothyronine- T3
- triiodothyronine, free-fT3″
URINE TEST
- routine urine test with a test strip (appearance, colour, pH, specific gravity, leukocytes, erythrocytes, nitrites, ketone, bilirubin, urobilinogen, glucose, proteins)
- quantitative examination of urine (albumin, amylase, phosphates, calcium, potassium, chlorides, creatinine, magnesium, sodium, total proteins)
- functional tests, creatinine clearance
STOOL TEST
- fecal calprotectin
- helicobacter pylori test
- test for occult bleeding – hemocult
INFECTIOUS DISEASES MARKERS
- anti HBS
- anti HCV
- anti HIV
- SARS-COV-2 antigen test; PCR (POC) on SARS-COV-2
- antibodies to Helicobacter pylori
- IgG antibodies to SARS COV-2
- TPHA (syphilis)
- VDRL (syphilis)
- Demodex folliculorum test
- Sarcoptes scabiei test
Instructions for Patient Preparation
the instructions serve to prepare patients for laboratory tests so that your results are a reflection of your health, in order to avoid the most common wrong results of tests resulting from the pre-analytical laboratory phase, i.e. improper preparation for laboratory tests. This is in your best interest as well as your doctor’s.
For routine laboratory tests, blood sampling is carried out in the morning (7-11 am) on an empty stomach, while you are rested and before all other diagnostic and therapeutic procedures. It is important to know that the reference values for routine biochemical parameters are determined from samples of healthy persons, the reference population, taken in the morning, so the assessment of your findings is also based on a comparison with these values.
- The day before blood collection, it is necessary to avoid intensive physical activity, take the usual daily meals.
- After 10:00 PM, the day before going to the laboratory, do not eat, drink alcohol and juices and do not smoke. You are allowed to drink water.
- 48 hours before going to the laboratory, do not take any medication except those prescribed by the doctor as mandatory.
- Report to the laboratory staff all the medications you took before the blood sampling (including any vitamins and similar).
- It is recommended that you wait in the waiting room for at least 15 minutes after having your blood drawn.
- If you are taking any regular therapy, take it immediately after the blood draw.
INSTRUCTIONS FOR COLLECTING 24 HOUR URINE
- Collect the urine in a clean bottle or in the designated containers
- choose the time of urine collection, in the morning around 8 o’clock and empty the bladder
- collect all subsequent portions of urine during the day and night in the selected container
- the next morning at the same time the urine is added to the same container for collection
- during urine collection, it must be kept cold (refrigerated)
submit the entire amount of collected urine to the laboratory. Otherwise, there will be an error in the calculation of the result and an incorrect finding.
- the analysis is not recommended for women during and immediately before or after menstruation.
INSTRUCTIONS FOR GIVING A SINGLE URINE SAMPLE
- do not urinate for 4-8 hours before giving a single urine sample. It is best to give the first morning urine
- After washing the genitals, one should urinate in a clean, sterile and dry container, and do so in such a way that the first stream is discharged into the toilet, and the middle stream into the container.
- the analysis is not recommended for women during and immediately before or after menstruation, and for women with heavy vaginal discharge.
INSTRUCTIONS FOR PATIENT PREPARATION PRIOR TO LIPID STATUS DETERMINATION
- Two weeks before determining the lipid status (cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol), do not change your diet, eat normally
- 48 hours before taking a blood sample, avoid intense physical activity, do not drink alcohol and do not eat fatty meals
- The evening before blood sampling (about 12 hours earlier) do not eat, drink alcohol, or smoke. You are allowed to drink water.
- Cholesterol determination should not be carried out before 8 weeks have passed since:
- Acute myocardial infarction
- Stroke
- Surgical operations
- Trauma
- Acute infections
INSTRUCTIONS FOR PATIENT PREPARATION PRIOR TO IRON DETERMINATION
- 24-48 hours before the determination of iron, do not drink juices enriched with vitamins
- The blood sample should be taken between 7 and 10 AM because iron has a large daily variation in values (up to 70%)
- If the patient is under therapy with iron preparations and/or multivitamin preparations, control of iron in the blood is performed
- At least up to 10 days after oral iron preparations
- 3 days after administration of intravenous preparations
- One month after intramuscular administration of iron
- Determination of iron should not be done during or immediately after an acute infection
- Iron results are affected by acetylsalicylic acid, chloramphenicol, oral contraceptives, some chemotherapy agents”
INSTRUCTIONS FOR PREPARING PATIENTS BEFORE PERFORMING A TEST ON OCCULT BLEEDING IN THE STOOL
- Start the diet three days before the test and during the test (collection of stool samples)
- Seven days before collecting stool samples, the patient must not take acetylsalicylic acid (aspirin) and other non-steroidal anti-inflammatory drugs and iron preparations. The test should be postponed in case of diarrhea, menstruation, bleeding from hemorrhoids.
- Foods to avoid: undercooked red meat (lamb, beef), poorly cooked meat, liver, liver sausages, beetroot, horseradish, melons, watermelons, bananas, tomatoes… fresh fruits and vegetables in general, ascorbic acid (food rich in vitamin C).
- Recommended food: well cooked meat, chicken, turkey, fish, yoghurt and milk, cooked fruits and vegetables, salads. High-fibre foods, stone fruits and berries, cereals, wholemeal bread.
- Medicines: two days before the test, it is not recommended to take these medicines: aspirin, ibuprofen, indomethacin, phenylbutazone, reserpine, corticosteroids, anticoagulants, antimetabolites and drugs for chemotherapy treatment. Warn the laboratory personnel about the medicines you have to take regularly!
- Do not take alcohol, do not use antiseptic substances that contain iodine.
INSTRUCTIONS FOR PERFORMING AN ORAL GLUCOSE TOLERANCE TEST (OGTT)
- 3 days before the test, eat the usual meals, without restrictions on physical activity.
- The day before the test, you should not exert yourself more physically (gym, chopping wood…)
- The evening before the test, do not eat after 10 PM, do not drink alcohol or sweet drinks; only water is allowed.
- During the performance of the test, you should rest, do not eat, do not drink anything but water and do not smoke.
INSTRUCTIONS FOR THE DETERMINATION OF SEX HORMONES
- Sex hormones (LH; FSH; E2) are determined from the 3rd to the 5th day of the menstrual cycle
- Progesterone is determined on the 21st to 23rd day of the menstrual cycle
- Prolactin is determined 3 to 4 hours after waking up. Before blood sampling, rest for 30 minutes.
- Testosterone determination in men is performed in the morning on an empty stomach, and in women it is recommended in the morning during the follicular phase of the menstrual cycle.
INSTRUCTIONS FOR THE DETERMINATION OF TUMOUR MARKERS
- Blood sampling for PSA determination must be carried out before any manipulation of the prostate and at least 5 days after a digitorectal examination, biopsy, traumatic catheterization…
- Otherwise, accurate analysis results will not be obtained, and the examination must be repeated after a certain period of time has passed since the examination.
- Blood for determining CA 125 should not be taken during menstruation, which can increase the value of the marker by 2 to 3 times.
