Before the patient takes part in an Endoscopic Digestive Tract Study, the following indications must be taken into account.

• If you take medicines that contain aspirin or iron, you should stop taking them one week before the procedure.
• The patient should buy four capsules or tablets of Dulcolax (5 mg) and two sachets of Klean-Prep.
• If the patient is diagnosed with heart disease (heart failure), kidney failure or liver disease (cirrhosis), please let us know in advance to adjust the preparation.

In order for the samples obtained in the Clinical Laboratory to be reliable, the recommendations for each examination must be followed rigorously. It is important that you inform the treating doctor about your medications, allergies, previous tests and any other aspect that may influence the procedure to be performed

Blood glucose and/or insulin curves, pre and post O'Sullivans

• The patient should have 4 hours to rest in the laboratory, 2 hours for pre and post glycemia, and 1 hour for the O'Sullivan test.
• Be completely fasting on the day of the test.
• Do not smoke before or during the test, it interferes with the results.
• The night before, the patient should eat only until 7:00 p.m.
• The patient must present himself the following day at 7:00 a.m. in the laboratory for the accomplishment of the examination.

Lipid profile

• Do not significantly change your lifestyle before taking blood (diet and exercise).
• The patient should refrain from drinking alcohol two or three days before the test.
• Fasting for 12 hours, the last meal of the previous day should not be high in fat.
• Evaluate the patient's clinical conditions (presence of acute illnesses or medications that modify lipids).
• Myocardial infarction decreases lipids, so it is recommended to measure them in the first hours or six weeks after the event.

Hormone levels

• Report to the lab on an empty stomach preferably.
• Remember the date of the last period.
• If the medical order requires it, take into account the day it is requested

Prolactin cortisol

• Come to the laboratory with a minimum fast of eight hours, two hours after getting up, and without having made any physical effort.
• Avoid stress situations.
• For the prolactin pool, stay in the lab for at least 50 minutes.
• Have a 24-hour sexual abstinence before the test.

The cortisol test should be performed at 8 a.m. sharp; the patient should arrive at least 10 minutes earlier. Stress or physical exercise will significantly alter the test.

Prostate-specific and free antigen

The blood sample should be taken before a prostate biopsy, prostate massage, prostatectomy, or eight days after these procedures are performed.

• Have sexual abstinence for three days before the test.

Hormone levels and therapeutic drugs

• For medications such as tacrolimus and cyclosporine (pre), the sample should be taken 15 minutes before ingesting the medication. For post-cyclosporine, the sample is taken two hours after ingesting the medication.
• Inform the laboratory of the names and doses of the medications you are taking.
• If you are taking hormones, the last dose should be taken the day before the sample is taken.
• When the patient is using therapeutic drugs, the sample should be taken one hour before the next dose and/or when requested by the treating doctor.
• In the case of TSH control patients with permanent medication, it does not influence the result if the consumption of the medication is not interrupted.

Urine partial culture

Please note that proper collection will allow us to provide useful results to your doctor. If you are taking antibiotics, the sample should be obtained, whenever possible, before starting the administration.

• Give the container with the urine, firmly closed, to the staff attending to it within one hour of the sample being collected.
• Collect the first morning's urine as follows: discard the first part of the urination, collect the second part of the urination directly into the container, and discard the last part.
• Wash your genital area thoroughly with soap and water before collecting the sample in the sterile container provided by the laboratory or purchased from a pharmacy.
• When you have finished, tighten the cover of the container and clean up any urine that has splashed out. Check that your name is correctly written on the container.

24-hour urine collection

Start picking her up preferably in the morning hours. In the case of patients with severe complications, it is important to be clear about the start time for collection.

• If the container has any kind of liquid (preservative and/or preservative) DO NOT discard it, it is a preservative for the sample, handle it with caution.
• Store ALL urine discharged for 24 hours, including the first morning urine of the next day, in the container provided.
• Discard the first morning urine to leave the bladder completely empty.
• Keep the sample in a cool place or refrigeration.
• Fluid intake should be normal.
• Take the sample to the laboratory as soon as possible for processing.
• When you have finished, close the container cover and clean up any remaining urine that has splashed out. Check that your name is correctly written on the container.

Stool samples coprological, coproscopic and serial coprological occult blood in stool

• Collect the spontaneously emitted sample in a clean dry container provided by the laboratory.
• The sample should not be contaminated with the urine.
• If you have had a barium radiographic study, allow three days to collect the sample.
• Deliver the sample to the laboratory in less than two hours from the time of collection.
• Parasites have different life cycles. In the presence of a negative coprological test and the suspicion of parasitosis, the ideal test is this one.
• Collect the sample as indicated above, on three different or consecutive days.
• NEVER split a single stool into three.
• Follow the same recommendations above for the coprologic / coproscopic sample.

During the three days prior to the test, your diet should not include: red meat, sausages, lentils, cabbage, turnips, radishes, broccoli, cauliflower, apples, grapes, bananas, tea, coffee, medications such as aspirin, vitamin C supplements, and alcohol.

Testing in the area of genomics and metabolism (gene sequencing, chromosomal array, exomes, karyotypes)

• These tests do not require fasting, they can be taken at any time of the day.
• The patient must submit a copy of the medical history to be attached to the test referral.
• This is because it is required to analyze the report in the clinical context of each patient.
• Also, inform the name of the treating doctor in case it is necessary to contact him/her.

First trimester screening (papp-a and hcgb biochemical tests)

• This test should be taken between 10 and 13.5 weeks of gestation; ideally in the 12th week (ultrasound weeks of gestation).
• It is preferable to take it on an empty stomach, but if it is not available, it can be taken at any time of the day.
• Ultrasound data from the 12th week of gestation are required.
• If your doctor indicated to take the test in a period of less than 10 weeks or more than 13.5 weeks, the biochemical tests will be performed but it will not be possible to perform the risk calculation, as it may be outside the stipulated time.

Tests in the area of flow cytometry (peripheral blood cytometry study)

• This laboratory test does not require prior fasting, so it can be taken at any time of day, always following the specifications of the treating hematologist/specialist.
• It is preferable to present a copy of the medical history, which should be attached to the test referral order, since each sample is processed according to the information provided by the treating specialist.

Dobutamine stress echocardiogram

• The patient should discontinue, if possible, medications such as β-Blockers (metoprolol, propanolol, atenolol, carvedilol, nebivolol, bisoprolol) and Calcium Antagonists (verapamil, diltiazem, dilatrend) for at least 24 hours before the procedure. Medications can only be stopped by a doctor's order.
• Present medical history, chest x-ray and electrocardiogram if possible. If the patient is hospitalized, the IPS must send his medical history.
• Do not consume alcohol or smoke the day before the procedure.
• Do not exercise the day of the procedure.
• The person must fast for at least three hours before the scheduled time. The person must bring an adult companion.
• Fasting for diabetic patients will not exceed two hours. Breakfast must be light and not contain lactic products.
• Women must present themselves without makeup, without nail polish and in comfortable two-piece clothing.

It is very important to know the name of the medicines that the patient is taking and to present the updated formula or list them.

Stress echocardiogram with exercise

• The patient must fast a minimum of three hours before the scheduled time and must be accompanied by an adult. Diabetic patients may not exceed two hours in the fasting, for them their breakfast must be light and not contain dairy products.
• Women must come to the procedure without makeup, without nail polish, and in comfortable two-piece clothing that allows them to exercise comfortably. Men and boys should also present themselves in comfortable clothing.
• Stop taking medications such as β-Blockers (metoprolol, propanolol, atenolol, carvedilol, nebivolol, bisoprolol) and Calcium Antagonists (verapamil, diltiazem, dilatrend) at least 24 hours before the procedure. This can be waived with a doctor's order.
• Present medical history, chest x-ray and electrocardiogram if possible. If the patient is hospitalized, the IPS should send the medical history.
• Do not consume alcohol or smoke the day before the procedure.
• Do not exercise the day of the procedure.

It is very important to know the name of the medicines that the patient is taking and to present the updated formula or list them.

Transesophageal Echocardiogram

• Fasting for a minimum of three hours (prior to the scheduled time), and be accompanied by an adult. Please note that diabetic patients may not fast for more than two hours. Breakfast must be light and not contain milk; confirm that it has been according to the established time.
• Women should appear without makeup or nail polish and in comfortable two-piece clothing that allows them to exercise. Men and boys should also present themselves in comfortable clothing.
• IMPORTANT: Know the name of the medications you are taking and submit the updated formula or list them.
• Discontinue, if possible, medications such as β-Blockers (metoprolol, propanolol, atenolol, carvedilol, nebivolol, bisoprolol) and Calcium Antagonists (verapamil, diltiazem, dilatrend) for at least 24 hours prior to the procedure, except on doctor's orders.
• Present, if possible, medical history, chest x-ray and electrocardiogram. If the patient is hospitalized, the IPS should send the medical history.
• Do not drink alcohol or smoke the day before the procedure.
• Do not exercise on the day of the procedure.

IMPORTANT: Know the name of the medications you are taking and submit the updated formula or list them.

24-hour Electrocardiogram Holter

• The patient will prepare his skin at home. He/she must clean and hygiene his/her body in the shower and then not apply any type of lotion, gel, cream, perfume or powder.
• The person will have to dress with two pieces. The blouse or T-shirt should be wide, preferably with buttons on the front.
• You must present a copy of the medical order and/or medical history with the indication of holter.
• The patient must present a recent electrocardiogram, if available.
• This procedure does not require fasting.

It is very important to know the name of the medicines that the patient is taking and to present the updated formula or list them.

Tilting Table and Autonomic Function Tests

• The patient must fast for at least 8 hours.
• He must present, if possible, the medical history, updated electrocardiogram, electroencephalogram and/or neurological studies if he has them, and carotid doppler if he is older than 60.
• You should not stop taking any medication, even on the day of the exam.
• If the patient is hospitalized in another institution, the IPS must send the clinical history and all the results of the exams.
• Minors must be accompanied by their parents or a responsible adult.

Renal duplex

For Duplex of abdominal aorta, mesenteric arteries, iliac, portal vein, cava and transplanted kidney must

• Show up with an adult.
• Take a medical history if you are hospitalized or if you have one.
• Present yourself in comfortable two-piece clothing.
• Show up fasting.
• Do not smoke the day before the exam or the day of the procedure.

Preparation of the day before

Liquid diet:

• Breakfast: fat-free broth and strained (no onions or garlic), low-sugar and milk-free juice, tea infusion or low-sugar aromatic water.
• Lunch: fat-free beef or chicken broth, low-sugar and milk-free papaya juice
• Dinner: same as lunch menu

You must use 2 sachets of KLEAN PREP:

• Dilute 1 sachet in water and take it at 5:00 pm.
• Dilute the second sachet in water and take it at 6:00 pm.

If you feel hungry between meals, you are allowed to drink aromatic water, black tea or fruit juice without milk and low in sugar. You should not drink milk, soda, or drinks that produce gas.

Patients under the age of 15 should not take KLEAN PREP, but should follow the liquid diet.

Arterial and/or venous duplexes of upper and lower limbs, carotid, vertebral, jugular and scrotal

• This examination doesn't need to be fasting.
• No smoking at least one hour before the procedure.
• Be accompanied by an adult.
• The patient must take a medical history if he or she is hospitalized or has one.
• Present yourself with comfortable two-piece clothing.
• If you have ulcers in your lower limbs, cover them with a gauze or with the material used in healing.
• If the procedure is of the testicular area, the patient should present shaved.

Penis Duplex

• The test does not require fasting.
• You must be accompanied by an adult.
• The patient should take a medical history if he or she is hospitalized or has one.
• Shave the genital area (penis and testicles).
• Buy Caveryect (Prostaglandin E 1) 10 or 20 mg and keep it refrigerated to take it to the procedure.

Arterial plethysmography of lower and upper limbs with measurement of segmental pressures and arterial indices (ankle - arm / arm - wrist)

• This test doesn't need fasting.
• Women should appear in comfortable two-piece clothing.
• Present, if possible, the medical history. If the patient is hospitalized, the IPS should send the medical history.
• Do not consume alcohol or black drinks the day before the procedure.
• Do not smoke for at least one hour before the procedure.
• Do not exercise at least 2 hours before the procedure.
• You should have approximately 2 hours for the examination, which is the maximum duration of the procedure.

Flow-mediated vasodilation

• Do not exercise on the day of the procedure.
• Do not smoke for at least 6 hours before the procedure.
• Stop taking vasoactive medicines such as nitrates and nitrites.
• The patient must fast for 8 hours.
• Do not consume drinks that contain caffeine, fat, or vitamin C for at least 6 hours before the procedure.

Videotelemetry

• Children under the age of 15 should sleep only 5 hours, which means going to bed late at night and waking up early in the morning. People over 15 years old, on the other hand, must sleep very well.
• Suspend the medication 24 hours before the exam, as recommended by the treating doctor.
• The night before the procedure, the patient must wash his hair 2 or 3 times with only shampoo, take into account not to apply conditioner, rinse, lacquer, gel or oils.
• Minors must be accompanied by an adult relative, responsible and aware of their clinical situation.

Polysomnography with or without c-pap

• The night before the procedure, the patient should wash his hair 2 or 3 times with only shampoo, take into account not to apply conditioner, rinse, hairspray, gel or oils.
• Wear comfortable two-piece clothing for the procedure.
• The patient must be accompanied by a responsible adult, who will stay in the same room.
• The patient must not have discontinued any medication.
• The day before the procedure, you should NOT take any sleeping medication, alcohol, or drinks containing caffeine.

Electroencephalogram

• The day before the procedure, the patient should NOT take any sleeping medication, alcohol, or drinks containing caffeine.
• The patient should not have stopped taking any medications, except if medically indicated.
• The night before the procedure, the patient should wash his/her hair 2 or 3 times with only shampoo. Keep in mind not to apply conditioner, rinse, hairspray, gel or oils.
• Children under 10 years old must sleep from 12:00 am to 4:00 am and come to the procedure with a minimum of 4 hours of fasting.
• The patient must be accompanied by a responsible adult.

Digestive Endoscopies

• Present medical history and chest x-ray if possible. If the patient is hospitalized, the IPS must send the medical history.
• Do not consume alcohol the day before the procedure.
• The patient must fast for 8 hours and be accompanied by an adult.
• Women should present themselves without makeup, without nail polish and in comfortable two-piece clothing.

Colonoscopies

• Women should appear without makeup, without nail polish and in comfortable two-piece clothing.
• Present a medical history and chest x-ray if possible. If the patient is hospitalized, the IPS should send the medical history.
• Do not consume alcohol the day before the procedure.
• Suspend anticoagulant medications such as aspirin, ibuprofen, naproxen, for 5 days before the exam, unless the treating physician ordered you to continue with them.
• Stop taking iron, if allowed by your treating doctor, to help visualize the inside of the intestine.

The specialist doctor will give the patient instructions to prepare 2 or 3 days before the exam. These may be:

• Application of evacuation enemas and taking of laxatives.
• Consume solid food up to two days before the procedure.
• You may consume gelatin until the day before the procedure.
• You should drink and feed plenty of clear liquids: coffee or tea without milk, moisturizing sports drinks, fruit juices in water, water, and fat-free meat and chicken broths.

Fibrobronchoscopy

• The patient must fast for 8 hours and be accompanied by an adult.
• Women should present themselves without makeup, without nail polish and in comfortable two-piece clothing.
• Present if possible the medical history and chest X-ray and CT scan. If the patient is hospitalized, the IPS must send the medical history.
• Anticoagulant medications such as aspirin, ibuprofen, naproxen should be discontinued 24 hours before the exam, unless the treating doctor orders their continuation.
• Do not drink alcohol the day before the procedure.

Percutaneous trans-parietal closed pleural needle biopsy

• The patient must fast for 8 hours and be accompanied by an adult.
• Anticoagulant medications such as aspirin, warfarin, etc. should be discontinued. 4 days before the test, or 24 hours before if you are given heparin
• The patient should not have discontinued any medications that are for the treatment of high blood pressure and/or diabetes, except if there is a doctor's order for their discontinuation.
• Inform if the patient is pregnant.

Thoracentesis

• You must fast for 8 hours and be accompanied by an adult.
• Anticoagulant medications such as aspirin, warfarin, etc. should be discontinued. 4 days before the test, or 24 hours before if you are given heparin
• The patient should not stop taking any medications that are for the treatment of high blood pressure and/or diabetes, except if there is a doctor's order for their discontinuation.
• Inform if the patient is pregnant.

It is important that you keep in mind the following recommendations for each exam, otherwise the contrast sought with each one may not be effective.

Creatinine study

• The patient should present his most recent creatinine test, no later than one month after the test. Your treating doctor, who orders the CT scan, should give you the order for the creatinine.
• If you are taking Metformin or Glucophage (diabetic patients), you must stop on the day of the exam and restart them 48 hours later, this with the consent of your treating doctor.
• Inform your history of allergies or if you have previously been given intravenous contrast for any other type of exam (CT, urography, catheterization, angiography.)
• You must fast for at least 6 hours.
• If you take any medication, you should not stop taking it (for example, for hypertension, hypothyroidism, etc.).
• If your contrast study is in the morning hours, you may only eat until 10:00 p.m. the night before.
• If you have previous studies such as ultrasounds, CT scans, X-rays or MRIs, please present them at the time of your exam.

Nephroprotection Study

• You must submit your recent creatinine test no later than 1 month after the test. Your treating doctor, who orders the CT scan, should give you the order for the creatinine.
• If you are taking Metformin or Glucophage (diabetic patients), you must suspend it on the day of the exam and restart it 48 hours later, with the consent of the treating physician.
• Report your history of allergies or if you have previously been given intravenous contrast for any other type of test (CT, Urography, Catheterization, Angiography).
• The patient must fast for at least 6 hours.
• If you take any medication, you should not stop taking it ( for example for Hypertension, hypothyroidism).
• If your contrast study is in the morning hours, you can only eat until 10:00 p.m. the night before.
• If your contrast study is in the afternoon, try to eat a light breakfast at 7:00 a.m.
• If you have previous studies such as ultrasounds, CT scans, X-rays or MRIs, please present them at the time of your exam.
• If a patient has a borderline or elevated creatinine (greater than 1.3 but less than 1.8 mg/dl), a prior nephroprotection study may be considered. This is done to reduce the risk of renal failure. The case should be discussed with the radiologist in charge to program the nephroprotection protocol and order the patient to take control creatinine 2 days after the CT scan. If the creatinine is greater than 1.8, intravenous contrast should not be given under any circumstances, unless the patient is on dialysis.

Allergy Study

• You must submit your recent creatinine test no later than 1 month after the test. Your treating doctor, who orders the CT scan, should give you the order for the creatinine.
• If you are taking Metformin or Glucophage (diabetic patients), it must be suspended on the day of the exam and restarted 48 hours later, with the consent of the treating doctor.
• Report your history of allergies or if you have previously been given intravenous contrast for any other type of test (CT, Urography, Catheterization, Angiography).
• You must fast for at least 6 hours.
• If you take any medication, you should not stop taking it (for hypertension, hypothyroidism, etc.)
• If your contrast study is in the morning hours, you can only eat until 10:00 p.m. the night before.
• If your contrast study is in the afternoon, try to eat a light breakfast at 7:00 a.m.
• If you have previous studies such as ultrasounds, CT scans, X-rays or MRIs, please present them at the time of your exam.
• You should take: 3 tablets of Prednisone (one daily), 6 tablets of Ranitidine ( take one every 12 hours) and 3 tablets of Loratadine (take one every night).
• In case of CT of the abdomen, only take the oral contrast.
• Any patient who is to be given intravenous contrast (CT) should be asked about their history of allergies, whether they have been given intravenous contrast previously for any other tests (CT, urography, catheterization, angiography, etc.). If allergy is confirmed, premeditation should be done before the test.