Internal medicine packages

About the package

This condition is also known as "leaky gut". The number of people in Europe suffering from a diet-related digestive disorder is increasing. There are many factors that can trigger these civilisation diseases, from the ingestion of preservatives to the use of antibiotics. This imbalance causes unexpected symptoms, the origins of which have only recently received more attention.

How to prepare for the test?

Please come to the examination on an empty stomach, which means fasting for 12 hours (water is recommended).

Package parameters

• Aspartate aminotransferase (ASAT, GOT)
• Alanine aminotransferase (ALT, GPT)
• Gamma-glutamyltransferase (GGT)
• Alkaline phosphatase (ALP)
• Total bilirubin
• Urea
• Creatinine
• Uric acid
• Glucose (blood sugar)
• Sodium (Na)
• Potassium (K)
• Iron (Fe)
• Transferrin
• Total protein
• Albumin
• C reactive protein (CRP)
• Cholesterol
• HDL cholesterol
• Triglyceride
• Automatic blood count (qualitative blood count)
• Immunoglobulin A
• Stool zonulin
• Stool beta defensin
• Stool flora status 220+ intolerance
• Stool digestion
• Stool PMN elastates
• Faecal secretory IgA

About the package

The test pack provides information about the body's sugar balance. It is recommended for patients who are suspected of having hyperglycaemia (high blood sugar) or hypoglycaemia (low blood sugar). The test can also be used to screen for gestational diabetes and can be used to screen for complications in the case of diagnosed diabetes.

Who is it recommended for?

The package is recommended for people who are overweight or obese and want to exclude the risk of related diseases.

How to prepare for the test?

Please present for the test on an empty stomach, which means fasting for 12 hours (drinking water is recommended).  

Package parameters

• Alanine aminotransferase (ALAT, GPT)
• General urinalysis with sediment
• Aspartate aminotransferase (ASAT, GOT)
• C reactive protein (CRP)
• Gamma-glutamyl transferase (GGT)
• Glucose (blood sugar)
• HDL cholesterol
• Hemoglobin A1c (HbA1c)
• Uric acid
• Potassium (K)
• Urea
• Cholesterol
• Creatinine
• LDL cholesterol
• Urine microalbumin + urine creatinine (spontaneously excreted)
• Sodium (Na)
• Triglycerides
• Blood count with automatic blood count (qualitative blood count)
  

About the package

Cardiovascular disease is the leading cause of death in Hungary and worldwide, accounting for nearly half of all deaths. Heart attacks, strokes, heart failure and coronary heart disease are prominent in terms of their prevalence. Their risk is increased by age and hereditary factors, certain diseases (hypertension, diabetes) and lifestyle factors such as obesity, physical inactivity, smoking and increased psychosocial stress. In the case of cardiovascular disease, screening for early detection is also of paramount importance. In addition to detailed cardiological examinations, laboratory tests are essential to identify additional risk factors.

Who is it recommended for?

We recommend the basic cardiovascular package to patients who want to get a comprehensive picture of the state of their cardiovascular system. For preventive purposes, we recommend it for men over the age of 40 and for women at menopause. It may also be useful for patients who are about to change their lifestyle or who wish to monitor the success of their lifestyle change, who are exposed to increased physical and/or psychological stress at work, or who are affected by risk factors known to increase the risk of developing cardiovascular disease.

How to prepare for the test?

Please present for the test on an empty stomach, which means fasting for 12 hours (water consumption is recommended).  

Package parameters

• CK-MB concentration
• CRP (ultrasensitive)
• D-dimer quant. determined
• Glucose (blood sugar)
• HDL cholesterol
• Homa index
• Homocysteine
• Insulin
• Urea
• Cholesterol
• Creatinine (+ eGFR)
• Creatine kinase (CK)
• Lactate dehydrogenase (LDH)
• LDL cholesterol
• Lipoprotein(a)
• Triglycerides
• TSH (supersensitive)
• Blood count with automated blood count (qualitative blood count)
  
  

About the package

Cardiovascular disease is the leading cause of death in Hungary and worldwide, accounting for nearly half of all deaths. In terms of their prevalence, myocardial infarction, stroke, heart failure and coronary heart disease are prominent. Their risk is increased by age and hereditary factors, certain diseases (hypertension, diabetes) and lifestyle factors such as obesity, physical inactivity, smoking and increased psychosocial stress. In the case of cardiovascular disease, screening for early detection is also of paramount importance. In addition to detailed cardiological examinations, laboratory tests are essential to identify additional risk factors.

The expanded package also provides information on the risk of heart failure, as well as on parameters potentially involved in inflammation of the blood vessel walls and atherosclerosis, and includes testing for one of the most common genetic mutations responsible for increased risk of thrombosis.

Who is it for?

We offer our extended cardiovascular package to patients who want to get a comprehensive picture of the state of their cardiovascular system. It is recommended for men over 40 and women at menopause for preventive purposes. The package may also be useful for patients who are about to change their lifestyle or who wish to monitor the success of their lifestyle change, who are exposed to increased physical and/or psychological stress at work, or who are affected by risk factors known to increase the risk of developing cardiovascular disease.

How to prepare for the test?

Please present for the test on an empty stomach, which means fasting for 12 hours (water consumption is recommended). 

Package parameters

• CK-MB concentration
• CRP (ultrasensitive)
• D-dimer quant. determined
• Glucose (blood sugar)
• HDL cholesterol
• Homa index
• Homocysteine
• Insulin
• Urea
• Cholesterol
• Creatinine (+ eGFR)
• Creatine kinase (CK)
• Lactate dehydrogenase (LDH)
• LDL cholesterol
• Lipoprotein (a)
• Lipoprotein associated phospholipase
• A2 PLAC test
• NT-proBNP
• Triglycerides
• TSH (supersensitive)
• Factor V Leiden mutation
• Automated blood count (qualitative blood count)
  

Physiological, pathophysiological background

Hepatitis B is an infectious disease of the liver caused by the hepatitis B virus. The disease can be acute or chronic. The average time to onset of symptoms is 75 days, but can be as long as 30-180 days. In some cases, the infection may become chronic, leading in some cases to cirrhosis or liver cancer. It is a global health problem, affecting an estimated 257 million people worldwide, according to the World Health Organisation (WHO). In 2015, around 887,000 people died as a result of the infection. The hepatitis B virus is 50-100 times more infectious than HIV and can remain viable outside the body for up to 7 days. HBV can be transmitted through direct contact with human blood, through sexual contact and from mother to newborn. It can also be transmitted through piercing, tattooing, infected needle stick, but not through food, water, coughing, sneezing, handshaking.

Infection can be prevented with commercially available vaccines. Two to three doses of the hepatitis B vaccine are required to achieve long-term immunity. In Hungary, vaccination against hepatitis B has been mandatory since 1999, at the age of 13-14 years. Clinical significance The infection is often asymptomatic and cannot be clinically distinguished from other hepatitis infections. Symptoms of acute hepatitis B may include fever, jaundice, dark urine, fatigue, lethargy, abdominal pain, nausea, vomiting, loss of appetite. Chronic hepatitis B (HBsAg detectable for > 6 months) may result in liver cirrhosis or hepatocellular carcinoma. Infection during childhood is more likely to develop chronic disease.

Interpretation of results

HBsAg: the appearance of hepatitis B surface antigen precedes any symptoms by 2-4 weeks. Its presence indicates infection and infectivity.

anti-HBs: the antibody appears after the hepatitis B infection has progressed or after successful vaccination. After vaccination, only anti-HBs antibody is detectable in case of adequate immunity (> 10 mIU/ml), the other markers are negative. Checking for the appearance of antibody should be performed at least 4-6 weeks after the last vaccination. anti-HBc: antibody that appears at the same time as the symptoms (1-4 weeks after HBsAg) and can be detected in acute, chronic and cured infections. It may persist for years (lifetime) after infection.

anti-HBc-IgM: an indicator of acute infection, detectable for months after infection. HBeAg: positivity indicates active viral replication in both acute and chronic infection. anti-HBe: not detectable in acute infection; detectable after cured infection or in chronic HBV infection.  

Package parameters

• HBsAg,
• anti-HBs,
• anti-HBc.

Parameters to be taken between 7 and 9 in the morning

At our clinic, laboratory tests are available throughout the day. In order to maintain the most reliable results, the following values are exceptions to this (which are recommended to be taken between 7 and 9 in the morning):

• 17-OH-progesterone (17OHP)
• Adiponectin
• Adrenocorticotropic hormone (ACTH)
• Aldosterone
• Androstenedione
• Anti-Müllerian Hormone (AMH plus)
• Beta crosslaps
• C-peptide
• Dehydroepiandrosterone sulfate (DHEA-S)
• Inhibin B
• Insulin-like growth f. IGF-I
• Calcitonin
• Cortisol
• Leptin
• Fetal risk I (PAPP-A, Free Beta HCG)
• Fetal risk II (AFP, HCG, Unconj. estriol, Imhibin-A)
• Growth hormone (h-GH)
• Osteocalcin (N-MID)
• Parathyroid hormone, intact
• Prolactin
• Renin - direct
• Reverse T3
• Sexual Hormone Binding Globulin (SHBG)
• Thyroid-Stimulating Hormone, supersensitive (TSH)

Parameters to be taken after 8 hours of fasting The following values require 8 hours of fasting, which can be taken at any time of the day:

• Alanine aminotransferase (ALT, GPT)
• Albumin Alpha-1 antitrypsin
• Alkaline phosphatase
• Alkaline phosphatase, bone-specific isozyme
• Aspartate aminotransferase (ASAT, GOT)
• Vitamin B12
• Beta-2 microglobulin
• Bilirubin, conjugated
• Bilirubin, total C reactive protein (CRP)/ultrasensitive CRP
• Zinc - serum
• CK (Creatine Kinase)
• CK-MB (Creatine kinase, MB isozyme)
• Ceruloplasmin
• DAO - Histamine intolerance
• Protein
• ELFO (serum)
• Protein
• ELFO + paraprotein identification
• Ferritin
• Phosphate
• Glucose, not loaded / not timed
• Glucose- with OGTT
• Gastropanel (Pepsinogen 1-2, Helicobacter pylori, Gastrin-17)
• Haptoglobin
• Homocysteine
• Uric acid
• IgG subclasses
• Immunoglobulin A (IgA)
• Immunoglobulin E, (total IgE)
• Immunoglobulin G (IgG)
• Immunoglobulin M (IgM)
• Insulin
• Potassium
• Urea
• Complement C3
• Complement C4
• Lactate dehydrogenase (LDH)
• Total protein
• Selenium - serum
• Thyroglobulin (TG)
• Transferrin
• Iron
• Trace elements: Zinc, Selenium Vitamin tests: Coenzyme Q10, vitamin A, vitamin C, vitamin D3 (1,25(OH)2), vitamin E, vitamin K, vitamin B1, vitamin B2, vitamin B3, vitamin B5, vitamin B6, active vitamin B12 (holo-transcobalamin), vitamin H, folic acid, vitamin B12, vitamin D (25OH)
• I. and II. trimester samples