Author: anamarija.trenchevska@avicena.com.mk

What is gluten and what foods contain it?
Gluten is a complex vegetable protein found in certain cereals such as wheat, barley, rye and oats. It consists of the proteins gliadin and glutenin and gives the elasticity of the dough prepared from the flour of these cereals, that is, it helps the food to keep its shape, acting as a glue. Due to this property, gluten is added to many other foods, to improve the texture, to thicken, to stabilize. So, in addition to pasta and pastries, gluten is an integral part and can be found in many other food products such as beer, juices, ketchup, meat products, ice cream, desserts, cosmetics for skin and hair, medicines and more. Due to its presence in all products, gluten has become a topic of considerable interest and research in recent years, for various medical and non-medical reasons, and the interest has led to a huge amount of literature and information that is occasionally confusing and misleading. This review categorizes gluten-related diseases and conditions based on confirmed medical facts and studies.
Celiac disease, gluten intolerance and gluten allergy are conditions of the body that are directly affected by gluten and whose primary treatment is the avoidance of gluten. Although similar in symptoms, there is a difference between each of these specific conditions.

What is celiac disease?
Celiac disease is a congenital gastrointestinal autoimmune disease characterized by sensitivity to gluten-containing foods. If gluten is ingested with food, even in minimal amounts, the body’s immune system has a strong reaction to gluten. Over time, inflammatory processes cause damage to the villi of the small intestine, the intestinal mucosa becomes flat, intestinal function is impaired, and the absorption of nutrients through food is reduced or disabled. Food simply does not stay in the body, so it is excreted through liquid and abundant stools, which further complicates the process of resorption of nutrients.

Symptoms: The signs and symptoms of celiac disease can vary greatly in children and adults. Digestive signs and symptoms in adults include diarrhea, fatigue, weight loss, bloating and gas, abdominal pain, nausea and vomiting, constipation. However, more than half of adults with celiac disease have signs and symptoms unrelated to the digestive system, including anemia, osteoporosis, headaches, dermatological changes, joint and muscle pain, neurological changes including brain fog, numbness, tingling in the feet, and hands, to anxiety and depression.

What is food intolerance?
Non-celiac gluten sensitivity, commonly known as gluten intolerance, is usually a delayed reaction of the body to gluten, which is not autoimmune in nature as in celiac disease, nor is immunoglobulin E (IgE) involved in allergies, ie it is a reaction that is completely different from an allergic reaction. It is a low degree of persistent (long-lasting) chronic inflammatory reaction that lasts as long as gluten is ingested.
The symptoms of gluten intolerance and celiac disease are very similar. Although both conditions cause the body to respond negatively to gluten, both types of responses differ in the intensity, duration, and effects they have on the body.
In people with intolerance, gluten intake causes short-term bloating and abdominal pain and usually does not cause long-term damage to the body, ie, there is no damage to the intestinal villi and small intestinal tissue.
The symptoms of intolerance are highly variable. These include bloating, abdominal pain and diarrhea, symptoms that mimic irritable bowel syndrome. Other intestinal manifestations include nausea, acid reflux, constipation. Individuals may have non-intestinal symptoms such as general malaise, fatigue, headaches, blurred vision, numbness, joint pain, or chronic skin changes. A person may have one or more symptoms.
The clinical symptoms of gluten intolerance and celiac disease overlap, making it difficult to distinguish between the two conditions on the basis of symptoms alone.

Gluten allergy
Gluten allergy is a specific immune reaction of the body to gluten in which a certain type of white blood cell, called B-cell, produces immunoglobulin E (IgE) antibodies to attack gluten molecules. At the same time, local tissues in the body send out natural chemical messengers to warn the rest of the body that there is a problem. This reaction occurs very quickly (within minutes to hours) and can include a range of symptoms ranging from nausea, abdominal pain, itching, swelling of the lips and tongue, to breathing problems or anaphylaxis (a life-threatening reaction). The symptoms of a gluten allergy can be very similar to those of an intolerant person and may not always be clearly differentiated, but there are differences: allergies are usually acute onset (2 hours or less), while intolerance is slower – with a delayed and unrecognizable onset of problems (up to 72 hours), allergies can also be caused by the presence of traces of allergens, while the amount of food is important in intolerance.
Diagnosis
Due to the similarity in the symptoms, it is very difficult to make a clear differentiation between these 3 conditions and to make an accurate diagnosis, given that these symptoms overlap with other diseases and conditions. Therefore, it is necessary to consult a doctor who, in accordance with the clinical manifestation and the patient’s medical history, will recommend that appropriate laboratory tests be performed. It is especially important that the laboratory tests used are reliable, certified and by a proven manufacturer, such as the tests performed in Avicenna Laboratory, which can quickly and easily determine the cause of the symptoms, ie, make a clear differentiation between intolerance. , gluten allergy and celiac disease.
The food intolerance test performed in Avicenna Laboratory is from a proven German manufacturer R-Biopharm and is organized in the form of a panel, which in addition to gluten also determines the possible intolerance of 90 additional food types or food ingredients.
It works with only one blood draw, and the results are ready the same day. More …
The Avicenna Laboratory also manufactures state-of-the-art quantitative blood tests, unique on the market with a standard curve calibrated according to the standard of the World Health Organization “2nd WHO IRP 75/502 for human IgE”.
The tests are organized in the form of panels (nutritional, pediatric, inhalation, combined and specially adapted for our area) and include 20 individual allergens, including gluten. They are made through blood, and the results are ready in just a few hours.

Treatment
Treatment for celiac disease and gluten allergy is adherence to a strict gluten-free diet. Even the smallest amount of trace gluten can cause a serious reaction in the body.
In gluten intolerance, the degree to which gluten should be eliminated from the lifestyle depends on the severity of the symptoms and the level of tolerance of the individual.

Molecular test for celiac disease
Real-time PCR test to determine genetic predisposition to developing celiac disease (gluten enteropathy)
Celiac disease is an autoimmune disease (also called enteropathy), which is characterized by gluten intolerance. It is also defined as a multifactorial disease with a strong genetic component1. Genetic susceptibility to celiac disease involves the presence of HLA-DQ2 / HLA-DQ8 heterodimers, which play a key role in the pathogenesis of the disease, in activating the immune response. In 90-95% of patients with celiac disease there is expression of the HLA-DQA1 * 05 / DQB1 * 022 heterodimer.
A highly sensitive molecular test for genetic predisposition to celiac disease is available at Avicenna Laboratory by DNA analysis isolated from a patient’s blood.
The test is based on RT PCR technology for fast and accurate identification of HLA class II alleles – specific for celiac disease.
Genetic susceptibility to celiac disease involves the presence of HLA-DQ2 / HLA-DQ8 heterodimers, which play a key role in the pathogenesis of the disease through their ability to present antigen and activate the immune response.
. A diagnostic test that helps diagnose celiac disease.
This test is especially important in cases where there are discrepancies between serological blood tests and / or intestinal biopsy.
. Genetic testing is also used to identify people predisposed to celiac disease, especially in high-risk groups, such as first-degree relatives of people with celiac disease.
. Patients with other autoimmune diseases (type I diabetes, thyroiditis and multiple sclerosis) or genetic diseases (Down syndrome, Turner syndrome or Williams syndrome).
Knowledge of the HLA class II genotype in those at risk for celiac disease may improve diagnostic strategies, prognosis, and clinical follow-up.

World Cancer Day, celebrated every February 4, is a global initiative led by the Union for International Cancer Control (UICC). By raising world awareness, improving education, and catalyzing personal, collective, and governmental action, we all work together to build a world where millions of cancer deaths are saved and access to life-saving treatment and care is equal for all. – no matter who you are or where you live. Thus, the theme of this year’s World Cancer Day, Close the Care Gap, is merely raising awareness of this inequality gap that affects almost everyone, in high- and low- and middle-income countries, and costs lives.

There are currently 19.3 million new cases of cancer in one year worldwide. However, 30-50% of all cancers can be prevented. Reduce your risk of cancer with healthy living habits, regular screening, early detection and timely treatment. The best prevention is regular check-ups, regular check-ups and a visit / consultation with a doctor. Your doctor may recommend that you have several types of blood tests done to get a clearer picture of what is going on in your body.

Tumor markers are substances (proteins, enzymes, hormones, etc.) that are secreted in the body as a result of its response in the presence of a benign or malignant phenomenon. Their measurement and identification is useful in assisting in the diagnosis, as well as in monitoring the progression / course of the disease and the success of therapy. What do the values ​​of the tumor markers indicate? In chemotherapy, hormone and radiation therapy, the movement of marker values ​​in the blood can be used to assess the effectiveness of therapy. If the values ​​decline, it is an indication that there is a response to therapy. Conversely, elevated levels of tumor markers on screening suggest a recurrence of the tumor or metastasis (and they do so up to six months before the X-ray or ultrasound examination), so the treatment strategy should be changed.

There are several types of tumor markers available in the Avicenna Laboratory, depending on which part of the body needs to be screened:

AFP (Alpha – Fetoprotein)
Serum alpha-fetoprotein levels serve as markers for hepatocellular carcinoma and metastatic liver tumor. In addition, this marker is used to assess the risk of fetal defects (eg neural tube defects)

(CA 15-3) (“cancer antigen” – cancer antigen 15-3)
This marker is of great importance in controlling the course of the disease in patients with malignant breast neoplasms. The height of the marker values ​​is largely dependent on the activity of the disease and can be used for differential-diagnostic purposes in diseases of the breast of women. Joint determination of SA 15-3 and SEA detects breast cancer metastasis with 80% certainty.

(CA 19 – 9)
This marker is important primarily in tumors of the pancreas and bile ducts. Tumors that can frequently give elevated SA 19-9 values ​​are: pancreatic malignancies, bile duct cancer, gastric and colon cancer.

CA 125
CA 125 is primarily relevant as a tumor marker for the detection of malignant ovarian neoplasms. Other diseases that can give elevated levels of SA 125 are: cirrhosis of the liver, acute pancreatitis (inflammation of the pancreas), acute cholecystitis (inflammation of the gallbladder) and other benign gynecological diseases or inflammation.

CA 72-4
Tumor marker for multiple adenocarcinomas, including gastric cancer. The values ​​of this marker in the serum coincide with the stage of the disease. The more advanced the stage of the disease, the higher the serum values ​​of CA 72-4.

S 100 protein
S – 100 has prognostic value and diagnostic value in patients with malignant melanoma.

CEA (carcino-embryonic antigen)
Nonspecific tumor marker that is determined in combination with specific tumor markers for monitoring and prognosis in patients with various types of cancer, such as colorectal cancer. Determination of SEA values ​​plays an important role in colon cancer, where the height of the values ​​is directly dependent on the stage of the tumor.

PAP (prostatic acid phosphatase) and PSA (prostate specific antigen)
Pap smears, along with PSA, are markers for monitoring prostate cancer patients. For early detection of prostate cancer, in addition to the clinical examination, it is important to determine the markers that will prove the existence of the disease. Total PSA, acid phosphatase, and PAP (prostatic acid phosphatase) are the most important markers for early detection of prostate cancer, in combination with medical examination and other clinical trials.

HE-4 (human epididymis protein 4) and NE-4 + SA-125 (ROMA INDEX)
HE-4 (human epididymis protein 4) is a serum biomarker whose concentration is significantly increased in patients with epithelial ovarian cancer and has a higher sensitivity and specificity than the SA-125 marker. It is used as an aid in diagnosis, as well as monitoring the response to therapy in patients with ovarian cancer. When combined with the SA-125 marker, the sensitivity and specificity of the SA-125 marker itself is greatly increased.
The combination of NE-4 + SA-125 (ROMA INDEX) is a new tool for differential diagnosis in determining whether the tumor mass in the pelvis is benign or malignant in both premenopausal and postmenopausal women and provides risk stratification and direction for further treatment.

What do the results mean?
The test results must be interpreted carefully as several factors can affect the test results.
In addition, keep in mind that non-cancerous conditions can sometimes cause abnormal test results.
Your doctor must review your test results and give you directions for further testing and / or treatment.

Preventive measures

• Smoking is a proven cause of cancer. Therefore, this is a reason that can be easily influenced
• Alcohol consumption can also be prevented
• Weight and obesity – one of the best ways to reduce the risk of cancer, after quitting smoking, is to maintain a healthy weight
• Physical inactivity – being inactive increases the risk of a number of cancers
• diet – of all the things in our lifestyle that are related to cancer, our diet is perhaps the most talked about. A balanced diet rich in fiber, fruits and vegetables and low levels of red and processed meats, saturated fats and salt can reduce the risk of cancer
• UV radiation from the sun and solariums – although we need a small amount of UV to make vitamin D, excessive amounts can cause skin cancer
• Infections – Although people cannot get cancer from each other, some cancers are caused by infections with viruses and bacteria. Therefore, it is important to look out for protected sex that can prevent the transmission of hepatitis B and C, which can lead to liver cancer; and HPV, which causes several types of cancer, including almost all cases of cervical cancer.

January 22-28 marks “Cervical Cancer Awareness Week.” Cervical cancer (RGM) is the second most common malignant disease in women in the world and in the Republic of Macedonia. Over 80% of cervical cancer cases and deaths from this disease are registered in developing countries. According to information from the Institute of Public Health, cervical cancer most often occurs in women aged 30-45 years. *

Dr. Konstantin Icev, Head of the Department of Microbiology and Molecular Diagnostics at Avicenna Laboratory, on the occasion of World Awareness Week for RGM, answers the most frequently asked questions about the HPV virus.

What is HPV?
Doctor’s Answer: DNA viruses of the Papillomaviridae family. The genotypes that are important to human medicine are called HPV (Human papillomavirus).
They are the cause of genital infections that are very common in the sexually active population, about 40 million cases per year. Many people infected with HPV have no symptoms or signs of infection, while others cause changes called papillomas or genital warts that lead to cervical cancer, which is also associated with cancer of the vagina, vulva, anus. , penis and oropharynx

How can I get HPV?
Doctor’s Answer: If you are sexually active, you can become infected with HPV. It is transmitted through genital contact, usually through vaginal or anal sex. Most people who are infected do not know they have the virus or that they can pass it on to their partner. It is important to know that condoms do not provide 100% protection against HPV, because the virus is also found in the skin around the genitals, it can very easily pass from a man’s genital area to a woman’s vagina, vulva or anus.

Does HPV cause cervical cancer?
Doctor’s Answer: In most cases (9 out of 10) the immune system will fight off the virus and the HPV infection will go away on its own.
However, when HPV infection persists for some time, cancer (cancer of the cervix or other parts of the body) can develop over the years.

Can cervical cancer be (prevented) prevented?
Doctor’s answer: Yes. There are tests that can detect early signs before symptoms develop. In this way, the problem will be found and solved before it develops into cancer.
What is the difference between a PAP test and an HPV test?
Doctor’s answer: Both tests allow cervical cancer screening. The PAP test looks for precancerous changes in the cells. The HPV test detects and genotypes the HPV virus that causes these changes.
The World Health Organization (WHO) recommends HPV detection and typing in the population for screening and prevention of cancer.

Will I get cervical cancer if I have HPV?
Doctor’s answer: If you follow the advice and instructions of a gynecologist for proper testing and treatment, the risk of getting cancer is reduced to a very small percentage. If you have HPV, your gynecologist will recommend more frequent check-ups and tests, in order to find any changes early and to treat them appropriately. Therefore, follow the advice of your gynecologist.

If I have HPV, will I be able to get pregnant and have a healthy baby?
Answer by a doctor: The presence of HPV does not reduce the chance of pregnancy, but it could spread to the baby (occurrence of respiratory papilloma of the larynx).
However, if you need treatment for abnormal cervical cells (caused by HPV), the treatment itself can affect your chances of getting pregnant. Consult your gynecologist about this.

Where can I get an HPV test?
Doctor’s answer: Proper diagnosis of HPV is of paramount importance and crucial for the patient’s further treatment.
The Avicenna Laboratory performs state-of-the-art tests, with Multiplex real-time PCR technology, Anyplex ™ II HPV28 from the manufacturer Seegene (South Korea), for highly sensitive and specific molecular detection and genotyping of HPV virus (Human papillomavirus). The only qualitative and semi-quantitative clinically proven test recommended by the World Health Organization. This type of test detects and individually genotypes the following types of HPV:
›19 HIGH-RISK TYPES OF HPV
(16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 69, 73, 82)
›9 LOW RISK TYPES OF HPV
(6,11, 40, 42, 43, 44, 54, 61, 70)

These HPV genotypes are responsible for over 97% of cases of cervical dysplasia and cervical cancer. The tests are based on internal control based on the detection of the human β-globin gene, which completely eliminates the possibility of false negative results.

The tests are validated and CE certified, they work with fully automated Real Time PCR instruments

What is chlamydia?
Chlamydia are intracellular bacteria that cause genital (Chlamydia trachomatis), respiratory and eye infections (trachoma).
How common are genital infections caused by

Chlamydia trachomatis?
They are one of the most commonly detected sexually transmitted infections. It is most often detected in young people. Two-thirds of new chlamydia-related infections occur in people aged 15-24. It is estimated that 1 in 20 sexually active young women aged 14-24 have chlamydia. (1-2)

How do people get chlamydia?
Chlamydia is transmitted through unprotected vaginal, anal, or oral sex with a person infected with chlamydia. Chlamydia can also be passed from mother to baby during childbirth.
Who is at risk for chlamydia?
Anyone who is sexually active can get chlamydia. It is a very common sexually transmitted disease, especially in young people.

What are the symptoms of chlamydia?
Chlamydia is known as a “silent” infection because most infected people are asymptomatic and have no abnormal examination results. However, due to the relatively slow cycle of bacterial replication, symptoms may appear only a few weeks after unprotected contact with an infected person.
In women, chlamydia most commonly causes cervicitis and endometritis by colonizing the cervix (mucous-purulent endocervical discharge, lightly induced endocervical bleeding), and urethritis. In men, chlamydia infection can lead to urethritis, with mucous or watery discharge from the urethra. Some men develop epididymitis with testicular pain, tenderness, and swelling.

What complications can result from an infection caused by chlamydia?
Chlamydia infection often goes unnoticed because a large percentage of people remain asymptomatic. However, if left untreated, chlamydial infections can lead to serious health problems with both short-term and long-term consequences.
In women, untreated chlamydia infection can spread to the uterus or fallopian tubes and cause pelvic inflammatory disease (PID), which can lead to fallopian tube obstruction, infertility, or risky pregnancy.
In pregnant women, untreated chlamydia is associated with preterm delivery, as well as inflammation of the eyes (conjunctivitis) and pneumonia in the newborn.

Who should be tested for chlamydia?
Anyone who is sexually active can become infected with chlamydia. Anyone with genital symptoms such as:

• discharge,
  -burning during urination,
  -unusual sores or rashes
  you should contact your doctor immediately!

Which laboratory tests detect chlamydia?
Several types of tests for Chlamydia Trachomatis are available at Avicena Laboratory:

1. Test for detection of C. trachomatis by direct immunofluorescence
   High-specific and sensitive test in routine detection of chlamydia, which is done from genito-urinary samples and conjunctival swab.
2. Serological tests for antibodies to C. trachmatis
   Serological tests for antibodies to chlamydia indicate the body’s immune response to acute or past infection.
3. PCR molecular method of detection of C.trachmatis
   Molecular tests are highly specific and highly sensitive tests to detect the genetic material (DNA) of the microorganism itself, and the result is obtained in just 2 hours.
   A new molecular test, CE-IVD certified and superior in its sensitivity and specificity, is available at Avicenna Laboratory.

Consult your doctor / gynecologist about your health condition.

References:
1.O’Farrell N, Morison L, Moodley P, et al. Genital ulcers and concomitant complaints in men attending a sexually transmitted infections clinic: implications for sexually transmitted infections management. Sexually transmitted diseases 2008; 35: 545-9.

2. White JA. Manifestations and management of lymphogranuloma venereum. Current opinion in infectious diseases 2009; 22: 57-66.
   The information and statistics in the text are taken from CDC – Center for Disease Control: https://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm#_ENREF_1

A high-specific molecular rReal-Time PCR test is available at Avicena Laboratory for simultaneous detection, identification and differentiation between the new coronavirus SARS-CoV-2 and seasonal influenza.

In the winter, when seasonal colds and flu are common, during a COVID-19 pandemic, many people try to find the answer to the question – what are the key symptoms that can be used to distinguish between these diseases?

COVID-19, influenza, and colds share a number of features and a wide range of similar or identical symptoms that make it difficult to differentiate early in the disease.

For proper treatment of any respiratory disease, it is always very important to know the true cause of the disease, in order to act in a timely and targeted manner to the appropriate cause.

There are many different symptoms that occur in people with COVID-19. Many of them appear the same or similar in colds and seasonal flu, and less often in allergies. The most common symptoms characteristic of SARS-CoV-2 virus and influenza A and B virus (Influenza A / Influenza B) are: fever / fever, cough, shortness of breath / wheezing, sore throat, stuffy nose, muscle aches, headaches, and in some people, diarrhea and vomiting occur.

The main difference in symptoms is the loss of taste and smell, reported in a certain percentage of people infected with SARS-CoV-2, i.e patients in whom COVID-19 was confirmed. Of course, there is a difference in the incubation period of the viruses, i.e the time when the symptoms of the risky contact appear, their intensity and duration.

However, due to the similarity between the symptoms of these infections, it is very difficult to distinguish, so the most accurate diagnostic tool is laboratory tests, in consultation with a doctor.

With this PCR test patients will have the opportunity with early detection to determine the cause of respiratory disease (SARS-CoV-2, influenza A and B virus and RSV) and according to the results obtained to receive appropriate therapy that will help them better and to deal with the infection faster.

The combined molecular rReal-Time PCR for detection of COVID-19 and seasonal flu is available in Avicena Laboratory in Skopje, Taftalidze, without an appointment.

What is glucose?

Glucose is a type of sugar that the cells of the human body use as the main source of energy. Our body breaks down the food we eat into glucose and other substances. The liver stores extra glucose and can produce it when we are not eating. Glucose goes into our bloodstream, where a hormone called insulin helps get glucose into our body cells.
For the normal functioning of the organism, it is necessary that the concentration of glucose in the bloodstream does not fluctuate.

The role of glucose testing
There are several different reasons why your doctor may recommend a glucose test. These include screening, diagnosis, and monitoring.

Screening
Screening means using tests to find health problems before those problems cause any symptoms or signs that you or your doctor may notice.
If you are over 40, overweight, or have an increased risk of developing diabetes, your doctor may recommend one or more glucose screening tests to detect prediabetes or diabetes. People with prediabetes have glucose levels that are higher than normal but not high enough to be diagnosed with diabetes.

Diagnose
The diagnosis is based on tests and procedures to determine the health condition that is causing the symptoms.
If you have symptoms of diabetes, high blood sugar or low blood sugar, your doctor may recommend a glucose test. Glucose testing may be accompanied by other blood or urine tests to make an accurate diagnosis.

Monitoring
If you have been diagnosed with diabetes or prediabetes, your doctor may want to monitor your blood glucose levels with a home glucose tester or monitor. Your doctor may also recommend periodic laboratory tests to review your condition.
Too much blood glucose can be a sign of diabetes, a serious health condition that can cause tissue and organ damage if left unchecked. Diabetes can develop if your body cannot produce enough insulin or if your body cells have trouble accepting insulin.

Who should have a blood glucose test?
The glucose test is one of the tests routinely performed during a regular annual checkup. Your doctor may want to do a high glucose test if you have a higher than average risk of diabetes. Risk factors for diabetes include:
• Age 45 years or older
• Overweight or obesity
• Heart disease, high blood pressure or high cholesterol
• Prediabetes
• Family members with diabetes
• Lack of physical activity
• Polycystic ovary syndrome
In pregnant women, your doctor may recommend a glucose test to assess gestational diabetes, a type of diabetes associated with hormonal changes during pregnancy. Gestational diabetes can be harmful to both mother and fetus if left untreated and can increase the risk of developing diabetes later in life.

Your doctor may also recommend a glucose test if you have symptoms of diabetes, including:

• Frequent urination
• Excessive hunger or thirst
• Tingling or loss of sensation in the arms or legs
• Blurred vision
• Abnormal number of infections
• Unexplained weight loss
• Fatigue
• Dry skin
• Wounds that do not heal quickly

Glucose testing is also an important part of monitoring for prediabetes and diabetes after they are diagnosed.

Types of glucose tests

Several different glucose tests are usually done for screening and diagnosis.

1.Fasting glucose test:
This test measures the amount of glucose in the blood after you get up, without eating or drinking anything but water for at least 8 hours. This test is usually performed in the morning.

2.Glucose Tolerance Test (OGTT):
This test measures how much glucose is in your bloodstream after you do not eat overnight and then drink a sugary drink. The glucose tolerance test usually requires more than one blood test over several hours.

3.Urine glucose test
Urine glucose testing is often part of a routine urine test.

4.Hemoglobin A1c (HBA1C):
Although the hemoglobin A1c test does not measure glucose directly, it reflects average blood glucose levels over the past three months by measuring the amount of hemoglobin bound to glucose.
The higher the concentration of glucose (blood sugar), the higher the concentration of HbA1c.
Hemoglobin A1c (HbA1c) is used to help diagnose and monitor the treatment of diabetes (diabetes).
HbA1c is prescribed for people who have symptoms or an increased risk of developing diabetes, as well as for people who already have a diagnosis of diabetes, in order to periodically monitor therapy.
Sample: venous blood
Results: the same day in just a few hours

Remove all sweeteners
Artificial sweeteners can raise insulin levels and contribute to insulin resistance. Natural sweeteners that you can consume in moderation are stevia, xylitol, erythritol.
Stevia and erythritol have a glycemic index equal to zero, which means that they do not raise blood sugar, ie. there is no sudden jump after consuming these sweeteners.
On the other hand, xylitol, ie. Birch sugar has a glycemic index between 7-13, so it will have little effect on blood sugar levels after digestion.

Eat food that is rich in fiber
Studies show that fiber-rich foods can be just as effective as antidiabetic drugs for lowering blood sugar without side effects.
Fiber slows the absorption of sugar into the bloodstream from the intestines. Eat a wide variety of plant foods rich in fiber, including nuts, seeds, fruits, vegetables…

Have a good night’s sleep
Make sleep a top priority for normalizing insulin levels. Avoid eating for three hours before bed and enjoy a warm bath before bed to increase body temperature and relax muscles.

Excercise

Exercise can be the most powerful medicine for regulating blood sugar. Exercise makes cells more sensitive to insulin. Combining cardio with weight training provides the most effective way to normalize blood sugar and insulin levels.

In the month of November dedicated to men’s health, “Movember” – a movement that aims to raise awareness among the male population about their health and prevention of certain diseases, such as prostate cancer, testicular cancer and ect…

Avicenna Laboratory is an institution that strives to promote health and always supports events of this type. For that purpose, Dr. Branko Jaglikovski, specialist in medical biochemistry from Avicenna Laboratory will answer the most common questions related to the importance and significance of laboratory tests in the interest of male health.

What is screening and why are regular blood tests important?

Screening involves the application of laboratory tests for early detection of diseases, at a time when the symptoms of the disease are not present. The importance of regular blood tests should be taken seriously and placed at the top of the list of priorities. Only in this way, together with the medical examination, a clear picture of health can be obtained. Early detection of potential health problems enables easier, faster and more efficient solution of the problem, and in some cases life-saving.

What mandatory examinations / tests should every man do?

The need for laboratory tests and their dynamics / frequency depends on several factors such as current health status, age, medical history of the patient, etc. Accordingly, the type of analysis that needs to be done also changes.

Routine blood and urine tests are a basic diagnostic tool for a quick and clear picture of current health and are recommended to be done at least twice a year. Pathological deviations of the reference values ​​indicate more frequent controls and impose the need for additional analysis.

Diseases of the cardiovascular system still remain the leading cause of death, both worldwide and in our country. Studies show that men, unlike women, start this type of disease earlier, and when it comes to preventive examinations, the numbers say that women are 33% more likely to see their doctor than men.
All markers are available at Avicena Laboratory for early screening, risk assessment for cardiovascular disease or monitoring of already started therapy. In addition to routine blood lipid status, by checking for “good” and “bad” cholesterol, there are markers that indicate the status of fat that is not dependent on diet and is related to the genetic predisposition of the organism, as well as markers that can predict future development of cardiovascular disease, combined with clinical examination by a physician.

Malignant diseases are the second leading cause of death worldwide, and prostate cancer is one of the most common malignancies in men. Starting today, a discount on PSA analysis is available at Avicenna Lab throughout the month of November.
Recommendations are that every man over the age of 50 should have a screening test and determination of PSA in the blood. This limit is reduced to 45 or 40 years if patients are at high risk, such as having a close family member with the disease.

In Avicena Laboratory are available modern laboratory tests, which, together with the clinical examination, enable early screening of prostate cancer, as well as other tumor markers, which are used by doctors to assess the condition of certain groups of patients.

Sexually transmitted diseases are a large group of diseases that affect both men and women and it is very important that they are recognized and detected in time, so that they do not have more serious consequences for both the reproductive and general health of each individual.

The Avicena Laboratory performs highly sensitive tests for sexually transmitted diseases, from different types of samples, to detect different causes of diseases, in patients with and without symptoms of a disease: chlamydia, gonorrhea, genital herpes, syphilis, genital warts, HPV HIV and AIDS

Accurate and accurate laboratory results play a vital role in screening for various diseases, accurate diagnosis, risk assessment, therapy monitoring, prognosis and many other aspects when important medical decisions and solutions are needed.

For any questions and additional information, contact us on 02 3179 001 or visit our laboratories.

There are over 30 different bacteria (Chlamidia trachomatis, Ureaplasma urealiticum, Micoplasma hominis), viruses (HPV, HSV, HIV, hepatitis B и C) and parasites ( Sarcoptes scabiei, Phthirius pubis ) transmitted through intercourse. Sexually transmitted diseases are significant, because they are very common, widespread and its possible consequences might cause infertility, ectopic pregnancy, negative impact on pregnancy, illness or death of the fetus, etc.

Human papillomavirus (HPV)

Today, there are more than 150 known types of HPV, and about 40 of them cause changes in the genitals. Usually the HPV infection occurs spontaneously as a result of the immune response of the infected person (in about 90% of cases, after two years of infection). Genital HPV&nbsp infections can be manifested in different ways . The most common visible changes manifest as pointed or flat warts. There are invisible changes that can be detected only by special techniques of magnifying and coloring. It is the so called intraepithelial neoplasia (premalignant condition) of the neck, uterus, vagina, vulva, penis, scrotum and anus. These changes usually manifest no symptoms. Persistent incurable chronic HPV infection in women can lead to the development of cancer of the cervix/neck of the uterus, vagina and vulva, and penis in men.

Proper diagnosis of HPV is very important and is crucial for the patient’s further treatment. The latest test with Multiplex real-time TOCE PCR technology for high-sensitivity and specific molecular detection and genotyping of the HPV virus (Human Papillomavirus) are availabe in Avicena Laboratory. The only qualitative and semiquantitative clinical proven test recommended by the WHO. This test makes detection and individual genotyping of the following types of HPV:

> 19 High- Risk HPV Tipes

(16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 69, 73, 82)

> 9 Low – Risk HPV Tipes

(6,11, 40, 42, 43, 44, 54, 61, 70)

The above-mentioned HPV genotypes are responsible for over 97% of cases of cervical dysplasia and cervical cancer. The tests have internal control based on the detection of the human β-globin gene, which completely eliminates the possibility of false-negative results.

The tests are validated and CE certified, are operated with fully automated Real Time PCR instruments and are approved for diagnostic use.

Chlamidia trachomatis

Chlamydia trachomatis is the most common sexually transmitted bacteria. It is transmitted through sexual intercourse, during delivery from mother to baby, and through eye secretion. The likelihood of contracting the infection after sexual intercourse with an infected person is 20-50%. Symptoms that may occur are mucous purulent vaginal discharge, difficulty urinating, unpleasant and painful intercourse, vaginal bleeding, pain in the lower parts of the abdomen, and conjunctivitis. Starting from the cervix, the bacteria can spread all the way up to the fallopian tubes and might cause blocking of these canals, which can later lead to a risky pregnancy or infertility..

Cervical smears for women and urethral swabs for men are based on diagnostics.

Herpes simplex virus (HSV)

There are two types of HSV viruses: HSV type 1 and HSV type 2. In 90% of the cases, genital herpes is caused by HSV type 2 virus, which is related to HSV type 1 virus (both are members of the herpes virus family). HSV type 1 virus causes a sore on the lips (herpes labialis) or cold sore, but in 10% of the cases HSV 1 is the cause of genital herpes. After the initial outbreak (primary infection of HSV virus), the virus travels in the ganglion, sets at the base of the spine where it can remain inactive for months or even years. The recurrences of the disease are very frequent i.e. recurrences of HSV 2 symptoms and outbreaks (secondary virus infection). The recurrences can be triggered by severe stress, but also by other emotional conditions, physical stress, exhaustion, long term insomnia, menstrual period, prolonged exposure to sun, cold, and deteriorated immunity.

Both of the Herpes viruses can cause skin changes in the area of the vagina, penis, the area around the anus, buttocks, and thighs. Sometimes the skin changes occur in other parts of the body where the virus penetrated the body through damaged skin.

Sexual health is an important part of human life and as such it has a major impact upon our health as a whole. The World Health Organization has defined sexual health as “a state of physical, emotional, intellectual and social aspects in a sexually active person, in a way that it enriches and emphasizes the individuality, spirituality, communication and love.” Taking care for your health includes taking care of your sexual health, too.

Avicena Laboratory offers modern, fast and accurate tests for screening and detection of all sexually transmitted diseases.

WHAT IS OSTEOPOROSIS?
Worldwide, one in three women and one in five men aged 50 and over will experience an osteoporotic fracture. Osteoporosis causes bones to become weak and fragile, so they break easily – even as a result of a minor fall, impact, or sudden movement. Fractures caused by osteoporosis can be life-threatening and a major cause of pain and long-term disability.

Source: https://www.worldosteoporosisday.org/about-osteoporosis

Can osteoporosis and fractures be prevented? Yes, if diagnosed in time!
Osteoporotic fractures have a devastating effect on millions of people around the world. However, despite effective medical advances in reducing fractures, a small group of men and women are receiving appropriate treatment.

Only 20% of patients with osteoporotic fractures are actually diagnosed or treated for osteoporosis.

Diagnostic tests:
In addition to a doctor’s examination and “imaging” methods to obtain a picture of bone tissue, laboratory tests are also of great importance.

Several laboratory tests are available at Avicenna Laboratory that provide a complete insight into the metabolism of Vitamin D, which plays a key role in the condition of bone tissue.
-Determination of Vitamin D Concentration
-Intact PTH (Parathormon)
-Electrolytes (of which the most important for bone tissue is Calcium)
Enzymes (Alkaline phosphatase as a marker for bone metabolism)
-Calcitonin (hormone involved in calcium metabolism)
-Hormonal status for assessment of menopause / andropause, as a risk factor for osteoporosis

NEW! Package Vitamin D + PTH + Ionized calcium
In addition to the World Osteoporosis Day, a new package for Vitamin D metabolism is available at Avicena Laboratory.
Read more at the following link.

PNEUMOSLIDE is an immunofluorescence test for simultaneous detection of 9 species of bacteria and viruses, the most common triggers of respiratory infections that are not detected by classical methods

Atypical pathogens

A large number of respiratory infections are ATYPICAL PNEUMONIAS, which are caused by ATYPICAL PATHOGENS that look line an usual cold, but do not respond to the usual therapy. Instead, they might prolong and exacerbate the condition, may cause complications and prolong the recovery.

Microorganism detected by Pneumoslide:

Mycoplasma pneumoniae

Legionella pneumophila

Chlamidya pneumoniae

Coxiella burnetii

Adenovirus

Respiratory Syncytial Virus

Influenza A,B

Parainfluenza (serotypеs 1,2,3)

These are the causes of infections that are very common, but very difficult to identify and for that reason – difficult to treat!

IDENTIFICATION OF THE RIGHT CAUSE OF THE DISEASE IS CRUCIAL FOR PROPER TREATMENT

When should Pneumoslide be offered?

– Any respiratory infection is an INDICATION!

– Prolonged respiratory infections which do not respond to the usual therapy

– COPD (chronic obstructive pulmonary disease)

– Immunocompromised patients (Patients with impaired immune system)

– Cardiac, dermatological, neurological, rheumatological, gastrointestinal and hematological manifestations

Pneumoslide is important for:

– Quick etiologic diagnosis

– Detection of the most common causes of respiratory infections

– Adequate etiologic therapy

– No risk of developing drug resistance

– Shortens the duration of the illness

– Prevents development of complications

– Economic testing – DETECTION OF 9 PATHOGENIC AT ONCE!!