Endocrinology

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Hormones regulate almost all bodily functions, from reproduction,  through growth and development, to responses to stress. Tesla Medical has  top internists-endocrinologists, specialists in glandular disorders, and  diseases resulting from these disorders – diabetes, increased or  decreased thyroid function, infertility, metabolic disorders, heart  disease, osteoporosis, obesity…

SERVICES

WHAT IS EXAMINATION OF THE INTERNIST ENDOCRINOLOGIST?

The doctor of internal medicine specialists, the subspecialist of endocrinology, deals with gastrointestinal diseases. The review starts with an anamnesis, or a discussion with a patient. The endocrinological examination is completely painless, lasting for an average of 20-30 minutes and, if necessary, longer.

Review includes:

  • Anamnesis – talk with the patient about current problems, chronic diseases (if they suffer from them), previous operations, previous hospital treatments, family illnesses, life habits, etc. …
  • Insight into the previous medical documentation (if any).
  • Physical examination (inspection, palpation, auscultation, tension measurement and ECG).
  • advice and recommendation for a further therapeutic plan (if there is a need) and suggestion of possible additional diagnosis (ultrasound imaging, CT …).

Physical examination includes: Inspection – observation (for example, the skin of the arms and legs in order to seek changes that can be due to long-term diabetes), palpation – touching (for example, the thyroid glands in order to detect changes in size or the presence of nodes) and auscultation (listening) Stethoscope is listening to the heart, lungs, bowel movements and large blood vessels.

You need to bring all your previous medical records (if any) with you and do all the laboratory analyzes that your endocrinologist has ordered you to do.

If you experience any of the following disorders, there may be a need to perform an examination with an internal endocrinologist:

  • tiredness, skin changes
  • growth disorder (slow growth or accelerated growth of certain parts of the body)
  • weight loss, rapid heart rate, pronounced sweating, anxiety
  • constipation, dry skin, depressive behavior,
  • excess hunger, excessive thirst, frequent urination.

WHAT IS ULTRASOUND EXAMINATION OF THYROID GLAND?

Ultrasound examination of the thyroid gland is a non-invasive diagnostic method which, with the help of ultrasonic waves, provides data on the size, structure and projection of the thyroid gland. The review lasts 15-20 minutes.

INDICATIONS / WHY IT IS DONE?

  • When examining stomach (dyspnoea), Hashimoto thyroiditis, other inflammation of the thyroid gland (infectious or autoimmune).
  • In order to detect and test all benign and malignant tumors of the thyroid gland.
  • For the purpose of emptying the glands on the thyroid gland and cystic changes.
  • To assist in the performance of thyroid gland biopsy.

HOW IT IS PERFORMED?

The review lasts 15-20 minutes. The patient is on the bed for examination, after which the doctor puts a special gel on the surface of the ultrasound probe. The probe is a small plastic device that sends and receives ultrasound waves and is placed on the patient’s neck. Gel has the role of improving the conductivity of ultrasonic waves and eliminating air between the skin and the probe.

POTENTIAL RISKS

Ultrasound imaging of the thyroid gland is a completely safe and painless method that does not carry any risk.

PREPARATION

No need to prepare for recording.

Oral Glucose Tolerance Test (OGTT)

A sugar test (glucose) or a glucose tolerance test is a test that evaluates the response of the organism to oral glucose. It represents the measurement of glucose concentration in serial samples before and after glucose consumption. It takes 2-3 hours for the test to be performed.

INDICATIONS / WHY IT IS DONE?

  • In order to detect disturbances in sugar metabolism (glucose intolerance, diabetes).
  • For the purpose of early detection (screening) of diabetes mellitus.
  • In order to detect diabetes in pregnancy (gestational diabetes).

HOW IT IS PERFORMED?

The glucose load test takes place in several stages. When you arrive at Tesla Medical a member of our medical team will take your venous blood sample (the glucose concentration in this sample is the concentration of glucose after starvation).

OGTT test (in order to detect glucose metabolism disorders)

  • The OGTT test is performed in the morning. Eight hours before the test, do not eat and drink anything.
  • The first blood sample is taken (on an empty stomach). At the same time, a urinal sample is taken for analysis (on glucose and ketone bodies – positive result is a contraindication for performing the test).
  • After that, you will drink 300 ml of aqueous solution in which 75 grams of glucose is dissolved (children are given 1.5 grams of glucose per kg body weight, but maximum 75 grams).
  • During the performance of the test you need to rest, you must not eat anything or smoke. You can only drink water. The blood for analysis is taken again after 120 minutes and the blood glucose concentration is measured, and the concentration of sugar in the urine is measured at the beginning and at the end of the test. We will do our best to make the time you spend at Tesla Medical during the performance of the test as pleasant as possible.

Screening (early detection) of gestational diabetes

  • The test runs between the 24th and 28th week of pregnancy (for pregnant women with low risk for diabetes appearance). If there is a need, the test is done earlier.
  • During the performance of the test, you should calm down, during this 3 hours you must not eat or smoke. You can only drink water. The blood for analysis is taken again after 60, 120, and 180 minutes, and the blood glucose concentration is measured, and the concentration of sugar in the urine is measured at the beginning and at the end of the test. We will do our best to make the time you spend at Bel Medic during the performance of the test as pleasant as possible.
  • Risk factors for gestational diabetes can be: gestational diabetes in previous pregnancy, family history of diabetes, obesity, metabolic syndrome or polycystic ovarian syndrome.
  • This test can be performed in pregnancy before the 24th week if the blood sugar level in routine measurement is increased.

PREPARATION

  • Three days before the test, you should normally eat, without any restriction in diet (you must eat at least 150g of carbohydrates per day).
  • The test is performed in the early morning hours. You must not eat, drink or smoke, 8-12 hours before performing the test. You are allowed to drink water. You must not be exposed to physical effort.
  • Tell your doctor about all the medicines you take in regular therapy. You should temporarily stop taking your medication that affects the metabolism of glucose (Gluformin, Metformin, Glucophage …) in consultation with your doctor.

AFTER TESTING

After the test you can return to your usual daily activities.

WHAT IS FINE NEEDLE ASPIRATION BIOPSY?

Needle biopsy of the thyroid gland is a procedure that takes a small part of the thyroid tissue to be examined under a microscope and sets the final diagnosis of the disease or changes to this gland. The procedure lasts about 30 minutes.

INDICATIONS / WHY IT IS DONE?

  • Used to examine the origin of the “nodes” on the thyroid gland.
  • It represents an important method in distinguishing benign from malignant changes on the thyroid gland.

HOW IT IS PERFORMED?

  • For this procedure, a doctor uses a fine needle and an ultrasound device. Your doctor will ask you not to move, not to talk, not to swallow saliva or cough during the procedure.
  • The ultrasound apparatus allows the physician to better understand the site on the thyroid gland from which he will take a sample of the tissue. The needle doctor enters the tissue of the thyroid gland, takes a small part of the tissue, draws the needle and sends the material to the laboratory. The pathologist looks at the material under the microscope and sets the final diagnosis.

POTENTIAL RISKS

  • Complications of performing this procedure are rare (because the needle is extremely thin).
  • It usually happens that there is swelling, redness / bruising, and the pain on the site from which the sample is taken (these interruptions cease after a few days).
  • If after the procedure comes the swelling of the whole neck, a change in the voice, severe pain, difficulty breathing, you should immediately contact the medical team of Tesla Medical.
  • Very rarely there is bleeding (severe bleeding is extremely rare).

PREPARATION

  • When scheduling this procedure, it is necessary to specify what medicines you take in regular therapy.
  • In consultation with your doctor, you should temporarily discontinue the use of anti-clotting medications (Aspirin, Plavix, Clopidix, Farin, Sincum, Sintra, Pradaxa, Xarelto, Eliquis).
  • It is necessary to complete a complete blood picture and blood clotting tests before performing the procedure.
  • Bring your previous medical records (if any).