Men’s preventive care

As part of the Men’s preventive care package and its variants, the following parameters are investigated:

Each variant consists of a different number of parameters (ranging from 11 to 29). Choose an examination according to your age or the number of parameters.

Parameters:

PSA
The PSA acronym stands for prostate-specific antigen, a protein produced as a proteolytic enzyme mainly by the cells of the prostate gland. PSA is a sensitive indicator of prostate health. Increased amounts are secreted from the prostate gland into the blood in case of various diseases such as cancer, inflammation, or benign hyperplasia (enlargement) of the prostate. Elevated levels can also be detected after physical stimulation of the prostate gland, e.g. after a prostate examination performed by a physician or after riding a bicycle. For that reason, it is necessary to follow the instructions from your doctor and/or the laboratory prior to the test. After determining PSA levels, the ratio of free (fPSA) to total PSA is established.

fPSA
fPSA is the free fraction of PSA and its testing is recommended for distinguishing prostate cancer from benign prostatic hyperplasia (BPH), in low and moderately elevated total PSA values. Men with prostate cancer with a normal or only slightly enlarged prostate gland have a lower percentage of free PSA compared to men with BPH.

ALT
This acronym stands for Alanine Aminotransferase, which is an enzyme present in the cytoplasm of cells of certain tissues. It is crucial in the formation and breakdown of amino acids, while also playing a role in nitrogen and glucose metabolism. Increased ALT activity occurs when the integrity of cells, particularly liver cells, is compromised. As a laboratory marker, it is used in preventive screening to identify liver diseases, which occur in instances such as taking certain medications, suffering from infectious diseases, or poisoning.

Glucose
Glucose, commonly referred to as blood sugar, is a simple carbohydrate serving as the main source of energy for cells. In diabetes, glucose cannot enter the cells and the blood glucose level rises in response.

Blood count with differential
This test can detect anaemia and the resulting impaired oxygen supply to tissues. In addition, it can rule out the risk of infection or immune system disorders, suspected blood clotting disorders, or the potential risk of blood clot formation. A blood count examination also includes a differential blood count.

Creatinine
Creatinine is a nitrogenous compound produced by the breakdown of a substance called creatine, which supplies the energy necessary for muscle contraction. It is primarily synthesised in the liver. Creatinine is excreted exclusively by the kidneys. The test measuring the level of creatinine in the blood along with glomerular filtration rate calculation therefore allow for the detection of kidney function disorders.

Uric acid
Uric acid (UA) is a nitrogenous substance formed as the end product of purine metabolism in humans. UA is a potent antioxidant (capturing free oxygen radicals) and is one of the parameters of metabolic syndrome. When its level increases in the body, it can get deposited in the form of crystals in the tissues, as it is characterised by poor water solubility.

TSH – thyroid-stimulating hormone
TSH (thyrotropin, thyroid-stimulating hormone) is a hormone produced by the cells of the anterior lobe of the pituitary gland. It affects the metabolism of thyroid cells and stimulates the production and secretion of thyroid hormones, especially thyroxine (T4) and triiodothyronine (T3).

Vitamin D
Vitamin D is a critically important fat-soluble vitamin, essential for the proper functioning of numerous metabolic processes in the body, including the proper growth and development of bones and teeth. There are two basic forms of vitamin D: vitamin D3 (cholecalciferol), which is produced in the skin following sunlight exposure and can be obtained in small amounts from animal food sources, and vitamin D2 (ergocalciferol), which comes from plant foods and is part of most vitamin supplements.

Chemical urinalysis
The basic chemical urinalysis includes a pH examination and a urine specific gravity test, along with the qualitative evidence for the presence of protein, glucose/sugar, ketone bodies, bilirubin, urobilinogen, nitrites, haemoglobin, and leukocytes. It is primarily intended for the assessment of kidney function, as well as the functioning of other organs.

Urine sediment
Urine sediment provides an overview of cellular components, i.e. erythrocytes (red blood cells), leukocytes (white blood cells), epithelial cells that line the urethra and bladder, inorganic components including crystals, and the organic presence of microorganisms.

fT4
Free T4 (fT4) is a physiologically active form of the hormone called thyroxine, which is produced by the thyroid gland. Thyroxine is one of the main hormones produced by the thyroid gland and represents a natural part of its regulatory system. It affects the overall metabolism of the body, while also serving as a prohormone for triiodothyronine (T3). Since it predominantly binds to proteins in the bloodstream, it is preferable to determine its free fraction (fT4) over the total T4, as the level of fT4 is unaffected by proteins and reflects the actual state of the thyroid gland.

Magnesium
Magnesium (Mg) is one of the main minerals in the body. It is involved in the functioning of numerous enzymes, plays a part in bone and muscle metabolism as well as intestinal and renal metabolism, and takes part in maintaining the balance of the internal environment.

HDL cholesterol
HDL cholesterol is a high-density lipoprotein and is referred to as the so-called good cholesterol. Keeping its levels within the reference range contributes to the reduction in the risk of vascular disease. Its most important function is removing excess cholesterol from tissue cells and blood vessels and transporting it to the liver, thereby maintaining the optimal amount of cholesterol and reducing the risk of cardiovascular disease.

Cholesterol
The levels of triglycerides and cholesterol (total, HDL, and LDL) are the primary indicators of lipid metabolism. Their level depends mainly on the metabolic function as a whole, but also on dietary intake and physical activity.

Lipase
Lipase is an important enzyme that is useful for diagnosing and monitoring inflammation of the pancreas (pancreatitis) and other pancreatic diseases.

Triglycerides
Triglycerides (TGs) are simple lipids which the body gets from food along with cholesterol. They function as the primary indicators of lipid metabolism and their level depends mainly on the metabolic function as a whole, but also on the food and alcohol intake and the level of physical activity.

Calcium
Calcium (Ca) is one of the most important minerals in the body. It is involved in the functioning of numerous enzymes and muscles, contributes to blood clotting and the production and secretion of hormones, and is also the primary building block of bones and teeth.

LDL cholesterol
LDL cholesterol is a low-density lipoprotein referred to as the so-called bad cholesterol. The small, dense LDL particles (sd-LDL) play a key role in the development and progression of atherosclerosis. They form in the liver as VLDL, where they get converted following the delivery of triglycerides, and apolipoprotein B-100 binds to their surface. The main function of LDL is to transport cholesterol into cells, where it is utilised in the building of tissue cell membranes and in the metabolism of hormones.

Potassium
Potassium is an important cation found inside cells. It plays an irreplaceable role in cellular metabolism; together with sodium and chlorides, it maintains intracellular osmotic pressure and acid-base balance, and regulates muscle and nerve function. Its imbalance causes heart rhythm disturbances and general fatigue.

HbA1c
HbA1c stands for glycated haemoglobin, which provides indirect information about the average blood sugar level (glycaemia) over the last 2-3 months.

Sodium
Sodium is the most abundant mineral in the human body. Together with other electrolytes, it ensures normal cellular function and regulates the amount of water in the body. Its blood level assessment is also used when dealing with non-specific health problems such as dehydration or oedemas.

Chlorides
Chlorides (Cl) are the main anions and together with sodium and potassium are classified as electrolytes. They are involved in maintaining a constant internal environment, including osmotic pressure or acid-base balance.

ALP
ALP (Alkaline Phosphatase) is an enzyme that is mainly found in liver and bone cells, involved in the active transport of substances. It is highly sensitive to changes in liver and bile duct function, as well as to the development of bone disease.

AST
AST (Aspartate Aminotransferase) is an enzyme present inside cells, especially those of the liver and muscles. Its blood level is usually elevated in case of damage to liver cells, most commonly in viral hepatitis, alcohol consumption, or fatty liver.

Total protein
Total protein indicates the concentration of all proteins in blood plasma. Proteins are fundamental building blocks of all cells and tissues. They are important not only for physical growth, but also perform other functions such as transporting water-insoluble substances and maintaining cellular oncotic pressure and appropriate blood pH. They ensure proper immune response and contribute to blood clotting.

GGT
GGT (Gamma-Glutamyl Transferase) is an enzyme bound to cellular membranes and found mainly in the liver. It is highly sensitive to changes in hepatic function and to bile duct injury, which may occur, for example, as a result of taking medications or consuming alcohol.

Urea
Urea is the end product of the metabolism of dietary protein. The by-product of this process is ammonia, which is toxic to the central nervous system, liver, and kidneys. The urea cycle takes place in the liver. Urea is released into the bloodstream and transported to the kidneys, where it is filtered into urine or reabsorbed into the blood.
The production of urea affects the acid-base balance in the body. Its blood concentration depends on dietary protein intake and overall metabolism. The test is a suitable indicator of renal function, body hydration levels, protein catabolism, and for determining the nitrogen level.

Serum protein electrophoresis
Protein electrophoresis is a simple method for detecting altered serum protein levels or for providing evidence of the presence of paraprotein, produced by a pathological cell clone. Serum proteins are separated into 5 major fractions on the carrier in the electric field: albumin, alpha-1-globulins, alpha-2-globulins, beta-globulins, and gamma-globulins.

We do not recommend entry of patients/clients with clinical signs of disease (temperature, cough, signs of respiratory tract infection, etc.) to undergo this test.
We recommend hand disinfection prior to entry to the clinics/collection points.

It is advised to fast for a minimum of 8 hours by refraining from eating or drinking anything expect water. Faiing to fast before the test may affect result quality. If you are currently on medications, consult your healtcare provider to determine whether you should continue taking them prior to the test.

PREPARATION FOR BLOOD COLLECTION
The recommended time to collect blood is between 7 a.m. and 9 a.m., to obtain comparable results from different blood draws. To assess the numerical test result, so-called reference intervals are used, which are based on morning fasting collections and are used for population comparison. This time interval is also recommended in light of the biological cycles that naturally take place in the body.

GENERAL PRE-SAMPLING INSTRUCTIONS
• It is necessary to come to the testing site earlier, so that you can rest in the waiting room for approximately 20 minutes to have a relatively relaxed body and mind.
• It is not advisable to draw blood before collection.
• It is necessary to arrive on an empty stomach for the collection itself, in the case of collections at a later time in the day, at least three hours on an empty stomach. At home, it is desirable to drink a sufficient amount of pure water (at least up to half a liter) - this is important for a successful blood collection. Mineral water, juice, coffee and tea are not recommended.
Herbs included in tea may contain substances affecting the blood count. Coffee and black tea increase gastric acid production and release insulin from the pancreas, thereby affecting glucose metabolism. Since everything in the body is interrelated, they can impact other tests. Another extreme is when your body is running out of fluids. In this case, the number of red blood cells, the level of protein and lipids bound to the protein increase and the level of urea in the blood can also increase. It is therefore advisable to drink pure water when you wake up.


Generally, it is recommended to:
• around 6 p.m. eat only light meals, do not eat fatty food (cheese, butter, cream, meat, smoked meat, bacon) and sweet meals,
• fast for 10-12 hours (Attention: it is not advisable to starve for more than 16 hours!), in the case of later collection (after 9:30 a.m.), a lighter breakfast is allowed, no later than 3 hours before collection,
• drink non-alcoholic beverages and drinks without sugar in the usual quantity, in the case of adult clients 24 hours before blood collection (Alcohol in the blood changes lipid levels, the level of glucose is reduced, uric acid levels increase and liver enzymes are released into the blood),
• take only prescribed medicines in the evening,
• avoid increased physical activity, and strength and endurance exercise the day before blood collection (Lipid, glucose, some enzyme levels in the blood and other parameters may change during physical activity. The recovery of normal values to maintain the accuracy of laboratory results may take a longer time, depending on the duration of the exercise, your physical fitness in general and other factors. We recommend maintaining normal daily physical activity such as light stretching, short cycling to work, gardening, etc.),
• avoid psychological stress, which raises blood glucose levels and causes the release of stress hormones in particular,
• avoid smoking for at least 6 hours prior to blood collection because it increases the level of carbonylhemoglobin produced by the reaction of the blood dye with carbon monoxide and alters the permeability and elasticity of the vessels, affecting the ratios of blood analytes,
• do not chew gum for at least 6 hours before blood collection, as this may affect glucose and enzyme levels,
• do not undergo stressful diagnostic or therapeutic interventions for at least 24 hours prior to blood collection.
If any of the tests you have selected require special preparation, you will be informed of the fact by email with the order and blood collection instructions attached. These specific instructions have priority over the general recommendations for preparation.


MEDICINES
It is recommended to have blood collected before the planned doses of medicines. If it is not possible to take the medicine later, you should inform the nurse during blood collection and specify what medication you have taken.
Take the medicines prescribed by your doctor in the morning or bring them with you to take them after blood collection (thyroid medicines, antihypertensive medicines, blood thinners, contraceptives, etc.) In the case of later collection (after 9:30 a.m.), you can take the prescribed medication in the morning.
Do not take iron, vitamin, nutritional supplements or other supplements, including homeopathics, for at least three (3) days prior to blood collection.


SPECIFIC SITUATIONS
In order to obtain the appropriate answers to your questions with regard to the laboratory tests, it is important to accurately notify the nurse at the healthcare provider about the following facts prior to your blood test:
• regularly used medicines and supplements (ideally come with a written list to the blood collection site),
• infectious diseases you suffer from (e.g., HIV, hepatitis, mononucleosis...),
• contact with an infected person or presence in an infectious environment,
• if you have received an infusion within the last 5 days, specify into which limb,
• intramuscular injections within 3 days prior to the blood collection date,
• long-term immobilisation, lost ability to move,
• activities at higher altitudes,
• allergy to common band-aids,
• if you feel unwell when looking at blood or needles, please also notify our blood collection staff of the fact.


OTHER FACTORS
Please note that prolonged use of medication or other important factors may affect the values measured by the tests you have selected. For more information, please see the description of the specific test. To obtain objective test results, take the time to properly prepare for your blood collection.

PREPARATION FOR URINALYSIS

If you have chosen a chemical analysis of urine and urine sediment based on the first morning urine sample, do not forget to obtain a collection tube, either at the pharmacy or at any of our sampling points. If urine culture is tested, this tube must be sterile.
 

INSTRUCTIONS TO FOLLOW
It is recommended to follow the standard drinking regime prior to urine collection, to avoid coffee and alcohol (in the case of adult clients) that are diuretic and could dilute the urine as a result of its increased production. 24 hours prior to urine collection, sexual intercourse is not appropriate because the number of cellular particles and protein in the urine will increase.
Girls and women undergo this test outside their menstrual cycle, it is not recommended to collect urine samples 3 days before or 3 days after the cycle, when red blood cells that are not produced in the urinary tract may be present. The results can be evaluated as false positives.
 

HYGIENE
Immediately before the urine collection, it is important to thoroughly clean the genitourinary tract so that urine is not contaminated with mucus, bacteria or soap. When urinating, women and girls will separate their labia and wash their external genital organs with lukewarm water. Men and boys will pull back their foreskin and wash their penis. Your hands must be clean when doing so.
 

PROCEDURE
The medium (released after one third of the urine has been emptied) morning urine should be collected. Allow the first part of the urine to end in the toilet to ensure that bacteria from the outer urinary tract have been removed and cells peeled from the urethral meatus have been eliminated. The second (medium) part of the urine shows the actual state of the urinary tract. Urine should be collected directly into a 10 ml collection tube. The remaining urine is drained back into the toilet. Close the tube tightly and rinse with water. Carefully close with the test tube cap. Do not touch the bottom of the cap with your hands, and do not place its inner side on washbasins or bathtubs. Hold the cap of the test tube only around its outer perimeter to prevent any contamination of the collected urine by bacteria on your hands or furniture. Do not pour the urine from other containers, as it may get contaminated by bacteria or fibres attached to such containers. Always collect urine samples directly into the tube.
 

STORAGE AND TRANSPORT
The sample should be delivered for analysis within 4 hours after its collection and should be maintained at 4-8 °C to avoid the decomposition of cellular elements in the urine or the bacterial proliferation at higher temperatures. Biochemical quantitative urine assay A sample of spontaneous urination is collected for examination. A urine collection tube should be prepared in the evening before the test date. If you do not have an original urine collection tube, a 3dcl jar is sufficient. The jar must be clean, rinsed with boiling water and left to dry. Collect all of the urine in the jar after performing morning genitourinary tract hygiene, then pour approximately 10 ml of urine into the collection tube. You will obtain a mixed representative sample needed to determine creatinine, total protein, albumin levels or urine electrophoresis.
One common, clean urine collection tube, usually with a yellow cap, is sufficient for the chemical analysis of urine and urinary sediment. For culture testing, urine should be collected in a sterile tube, usually with a red cap. The use of empty bottles and other household urine collection containers is not appropriate due to the presence of bacteria and other components. One common, clean urine collection tube, usually with a yellow cap, is required for a quantitative biochemical assay. Proper preparation prior to the urine collection is a must for a correct result. A correct result is one of the conditions to reach the correct diagnosis.
 

SPECIFIC SITUATIONS
In order to obtain relevant answers to your questions through laboratory tests, it is important to accurately inform about the following facts before your blood test:
•    regularly used medicines and supplements (ideally present a written list right before the blood test)
•    infectious diseases you suffer from (HIV, hepatitis, mononucleosis...)
•    contact with an infected person or presence in an infectious environment