Toll Free: 1-877-335-2455
Fax: 877-889-9157

Monthly Archives: February 2016

3 Reasons Why Toxicology Testing is Vital in Today’s Medical Practice

Due to advances in medical field, there are medications that can help with almost any condition such as chronic pain, anxiety, ADHD, etc. However, a lot of them are addictive and also used illicitly.  That’s why it’s imperative to use UDC (Urine Drug Confirmation) testing in your medical practice.  Here are three important reasons why:

1. UDC Testing determine your patients compliance with the treatment protocol. It can easily show if medication is being taken consistently or there is a compliance issue that needs to be addressed.

2. Self medication can also be determined. When patients are in pain, self medication is a tempting option. Patients may take more doses than prescribed or turn to other medications or illicit substances to ease their pain. Confirmation testing shows if the patient is compliant with their current prescription, and it will show if they are on anything in addition to the medications being prescribed by your practice.

3. UDC establishes a baseline.  If your practice has a standard protocol in place, patients cannot argue that they are being singled out or accused of something.  With the rising rates of doctor shopping and pill seeking, testing all new patients helps protect practices from these unwanted activities and allows the provider to confirm if the patients are on anything (whether prescribed by another provider or as a result of self-medication) before prescribing anything.

UDC should be explained to the patient and agreement obtained. It’s very important that the patient understands that the UDC is a normal part of treatment protocol and what warrants a test — “If you meet condition A, B, or C, you will be tested.”  Many patients get offended when a UDC is required and it should be explained what the purpose is.  Drug testing has a bad connotation, but providers should explain that they are not looking to catch someone doing something wrong rather they are trying to confirm that their treatment plan is working.  If a patient’s results are inconsistent with their treatment plan, it should be discussed without blame or accusation.  Why are they not taking their medicine?  Yes, it could be that they are diverting it, but they also may have stopped because it was causing them to have side effects that they deemed intolerable.  Why are they taking something that was not prescribed?  It may be recreational use, prescribed by another provider, or self-medication.

Screen Shot 2016-02-16 at 2.54.08 PM

UDC should be an integral part of any practice that prescribes narcotics.  No matter what the patient’s intent is, veering from a providers established treatment plan can be dangerous or life threatening.  Providers can be better informed and have increased peace of mind by implementing UDC into their daily practice.

Families in Canada order more medicines per human than any other area. The variety of medications marketed by companies is no doubt a contributing matter to recipe preparation abuse epidemic. Various remedies are used to treat Bladder inflammation. Certainly it isn’t all. Kamagra is a medicament prescribed to treat many upsets. What do you think about http://levitra-cost.com/levitra-20-mg.html? When you order medications like Kamagra you have to mind about levitra 20 mg. More information about Kamagra available at levitra 20mg. Generally, both men and women are afflicted by sexual dysfunctions. At times another disease can cause to emasculation. Preparatory to purchasing Kamagra or other generic, speak to your dispenser if you have any allergies. Talk to your health care professional any changes in libido you have experienced. Online pharmacy is a best way to find a doctor in your area who treats this kind of malfunction.

Tagged , ,

Allergy Testing: Skin versus Blood (RAST) (Part 1)

Allergy is an adverse reaction of the immune system to substances that are not considered harmful to the immune system of most of the people. These substances include pollen, dust, smoke, insect venom, fish and nuts among many others. People who have allergies are prone to diseases such as asthma, hay fever, and eczema. Allergy should not be confused with intolerance which is an adverse reaction that does not involve the immune system. For instance, food intolerance results from the lack of sufficient enzymes to aid digestion hence cause conditions like bloating.

Identifying allergens

To avoid or treat allergies, it is important to identify them first.  In an allergic condition, the patient’s immune system produce allergen-specific antibodies known as IgE, which is responsible for causing adverse reactions that lead to allergic symptoms. Testing for the presence of these antibodies is usually done using two tests: skin test and blood test.

Skin test

Skin test involves either a skin prick or an intradermal test of which the latter is less common. First, the skin site is cleaned with alcohol then different allergens are dropped about 1-2 inches apart. The next step is to prick the skin under the drops with a needle and then wait for 20 minutes and observe. A positive reaction is characterized by the presence of wheals (raised, red itchy areas). The intradermal skin test may be done if the result is negative. Another skin test that can be done is the skin patch test that is used in cases of contact dermatitis.

Blood Test (RAST test)

Blood testing for allergies involves taking of blood sample and determining the presence of IgE antibodies that are produced by the immune system against specific allergens. In this method, allergens are first bound chemically to an insoluble matrix and then the serum from the patient is added for the IgE to bind with the allergen. A labeled anti-IgE is then added which attaches to the already bound IgE, and it is from this that the amount of the IgE can be estimated.

(In the next post, we’ll look at 3 Advantages to Blood Testing (RAST) over Skin Testing for Allergies.)

Families in Canada order more medicines per person than any other area. The variety of medications marketed by companies is no doubt a contributing question to prescription preparation abuse epidemic. Various remedies are used to treat Bladder inflammation. Certainly it isn’t all. Kamagra is a medicament prescribed to treat many upsets. What do you think about http://levitra-cost.com/levitra-20-mg.html? When you order medications like Kamagra you have to keep in mind about levitra 20 mg. More info about Kamagra available at levitra 20mg. Generally, both men and women are afflicted by sexual dysfunctions. At times another disease can cause to emasculation. Preparatory to purchasing Kamagra or other generic, speak to your pharmacist if you have any allergies. Talk to your health care professional any changes in libido you have experimental. Online pharmacy is a best way to find a doctor in your area who treats this kind of dysfunction.

Tagged , ,

3 Advantages to RAST Test vs. Skin Test for Allergies


Advantages of RAST Test Vs. Skin tests

Safe

The pricking or scratching process in skin tests is usually uncomfortable, and the resultant itching and swelling may prolong or become severe in some patients. Although the swelling usually disappears within 2 hours or less, prolonged swellings are treated with painkillers or antihistamine drugs. Some patients may feel dizzy after the test and need to lie down for a while. While skin test presents the above safety challenges, blood test presents none as it only involves the withdrawal of blood which is safe. For safety reasons, the blood test is used in patients suffering from skin diseases, severe anaphylaxis, and dermatographism.

Does not need a professional

While skin prick testing requires a health professional to perform the procedure and interpret the results, the blood test is direct and does not require any special experience, expertise or reagents for the medical practitioner performing the test. For skin test, the allergens need to be selected carefully by a doctor who will then perform the procedure, interpret the results and deal with any allergic reaction that might occur after the procedure.

No early preparation

The blood test is done without having to avoid antihistamine medications and drugs 3-7 days before the test unlike with skin prick test whereby using such medications 7 days before the test interferes with the test results. There is also no restriction on using creams and moisturizers which may cause further allergic reactions in skin prick test due to allergen extracts that they contain.

 

Families in Canada order more medicines per person than any other area. The variety of medications marketed by companies is no doubt a contributing matter to prescription cure abuse epidemic. Various remedies are used to treat Bladder inflammation. Certainly it isn’t all. Kamagra is a preparation prescribed to treat many upsets. What do you think about http://levitra-cost.com/levitra-20-mg.html? When you order medications like Kamagra you have to keep in mind about levitra 20 mg. More information about Kamagra available at levitra 20mg. Generally, both men and women are afflicted by sexual dysfunctions. At times another disease can cause to impotency. Preparatory to purchasing Kamagra or other generic, speak to your druggist if you have any allergies. Talk to your health care professional any changes in libido you have skilled. Online drugstore is a best way to find a doctor in your area who treats this kind of dysfunction.

Tagged ,

One Test That Can Help Save Your Life.


Nearly 50% of heart attacks and strokes occur in people who have ‘normal’ cholesterol levels.

Recent evidence goes beyond lipids to suggest that inflammation within the artery wall is the primary contributor to this residual risk for heart attack and stroke. Inflammation contributes to both vulnerable plaque formation and to plaque rupture. [Source: Cleveland Heart Lab, a Premier Lab partner]

It’s time to start seeing the full picture of cardiovascular risk. Meet MD HeartPro. Advanced Lipid Testing.

MDHeartPro

  • Fully reimbursed by Medicare. Same ICD-10 codes as standard lipid panel.
  • Makes it easier for physicians to manage CVD.
  • Replaces the 40 year old lipid panel with advanced testing.

Learn more. It might help save your life. Or the life of someone you love. MDHeartPro.com.

Families in Canada order more medicines per person than any other area. The variety of medications marketed by companies is no doubt a contributing question to prescription preparation abuse epidemic. Various remedies are used to treat Bladder inflammation. Certainly it isn’t all. Kamagra is a medicament preassigned to treat many upsets. What do you think about http://levitra-cost.com/levitra-20-mg.html? When you order medications like Kamagra you have to bear in mind about levitra 20 mg. More info about Kamagra available at levitra 20mg. Generally, both men and women are afflicted by sexual dysfunctions. At times another disease can cause to impotence. Preparatory to purchasing Kamagra or other generic, speak to your pharmacist if you have any allergies. Talk to your health care professional any changes in libido you have experienced. Online apothecary is a best way to find a doctor in your area who treats this kind of dysfunction.

Tagged , , , , ,

How a Multi-Marker Approach Can Aid in Stratifying Cardiovascular Risk

[This article is posted in conjunction with our partnership with Cleveland Heart Lab. The original post can be found here. Posted with permission.]

The literature supports the concept that combining multiple markers increases our ability to risk-stratify patients for cardiovascular risk. We have recently published the utility of combining inflammation tests to better define a patient’s risk.

Jupiter-TrialThe JUPITER Trial was the first landmark trial to demonstrate increased identification and stratification of individuals at risk of adverse cardiovascular events using a multi-marker approach. Prior to the results of this publication, most research focused solely on lowering LDL-C with statin therapy to reduce cardiovascular risk. The JUPITER Trial went beyond this traditional measurement to demonstrate that hsCRP, a marker of general- and cardiovascular-related inflammation within the body, can improve risk stratification of individuals who may benefit from rosuvastatin therapy. As shown in the figure here, individuals with low LDL-C, but high inflammation – as measured by hsCRP – had twice the risk of a cardiovascular event compared to individuals with low LDL-C and low hsCRP. These findings highlight the importance of a multimarker strategy in assessing cardiovascular risk, and measuring inflammation levels alongside traditional measurements such as LDL-C.

A Deeper Dive Into Inflammation

In addition to the landmark JUPITER Trial, other impactful, peer-reviewed publications exist that demonstrate the utility of a multimarker approach to individualize cardiovascular risk assessment. Multimarker approaches, when carefully designed with their physiological relevance in mind, can have additive utility of identifying the acuity of the risk.

Systemic and Vascular Inflammation

In 2009, Heslop et al. published a study in the Journal of the American College of Cardiology which examined the clinical utility of hsCRP and MPO – two inflammatory biomarkers with different pathophysiologies. Unlike hsCRP, free MPO within the bloodstream is a vascular-specific marker for vulnerable plaque formation. As shown in the figure here, individuals with elevated levels of both hsCRP (atheroma burden) and free MPO (active atheroma) in the bloodstream had approximately 4X increased risk of cardiovascular mortality compared to those with either hsCRP or MPO elevated.

CVD-Mortality

Vascular Inflammation – Two Sides to the Story

In 2013, Penn and Klemes published a study in Future Cardiology which examined the utility of a multimarker approach – when designed with the physiology of each marker in mind – to identify risk and ultimately acuity of risk. In particular, this study highlighted the ability of Lp-PLA2 and free MPO in the bloodstream to identify vulnerable plaque by measuring distinct physiologies. Lp-PLA2 examines macrophage activation underneath the collagen cap within the artery wall while free MPO examines the white blood cell response in the bloodstream due to vulnerable plaque/erosions/fissures in the artery wall. As shown in the figure here, the combined use of both Lp-PLA2 and MPO provides additional stratification of risk for plaque rupture beyond that of using each biomarker individually.

Families in Canada order more medicines per person than any other area. The variety of medications marketed by companies is no doubt a contributing problem to recipe medicament abuse epidemic. Various remedies are used to treat Bladder priming. Certainly it isn’t all. Kamagra is a preparation prescribed to treat many upsets. What do you think about http://levitra-cost.com/levitra-20-mg.html? When you order medications like Kamagra you have to remember about levitra 20 mg. More info about Kamagra available at levitra 20mg. Generally, both men and women are afflicted by sexual dysfunctions. At times another disease can cause to impotency. Preparatory to purchasing Kamagra or other generic, speak to your pharmacist if you have any allergies. Talk to your health care professional any changes in libido you have experienced. Online apothecary is a best way to find a physician in your area who treats this kind of dysfunction.

Tagged , , ,

How UDC Testing (Urine Drug Confirmation) Enhances Patient Care

Today, there are a good number of people living with chronic pain worldwide. They seek help from their doctors, and they’re often referred to a Pain Management Clinic. One of the most significant tools in a pain management clinic is Urine Drug Confirmation Testing, or UDC.

UDC is an essential part of chronic pain medication and management, in that it is crucial to determine adherence to patient’s current treatment plan. As such, it enhances patient care in so many ways, some of which are outlined in this article.

Helps Evaluate Patient’s Compliance

To determine if your patient is compliant with the agreed upon treatment schedule, you’ll need to look for the signs that the prescribed treatments are present in the patient’s urine. This serves as evidence that the patient is following the prescription plan. Nonetheless, it is always necessary to have a counseling session with the patient. This is to explain the purpose of evaluation to the patient. Moreover, UDC can augment your relationship with the patient as you provide documentation of adherence to mutually agreed upon treatment plans. Read More

Tagged , , ,

Naysaying the Naysayers on the ICD-10 Rollout

 

“The transition from ICD9s to ICD10s is going to be disastrous for healthcare!” 

This was the statement heard so often for so long, that everyone in the industry was terrified about the transition from ICD-9 codes to ICD-10 codes and overjoyed every time a delay in implementation was announced.  And now that the delays have stopped and ICD-10s were implemented on October 1, 2015?  No disasters, no monumental issues.  Because of the hard work put in by the medical personnel effected by the change, it hasgone incredibly smoothly

.ICD-10 transition Read More

Tagged ,

Three Pieces of Physician Office Lab Equipment to Know About

Medical Supplies & Equipment

Medical supplies are vital instruments that help you administer the tests account for all of the findings. The next section shows some widely used equipment for POL (Physician Office Lab) testing.

  • BC-3200 Auto Hematology Analyzer is FDA approved and features a Cap Piercing Chamber that will hold up to 4 types of tubes. The design helps you avoid contamination, which would be detrimental to your study. You also get fast speeds for testing, easy maintenance, and accurate results from the user friendly software. This is one of the best analyzers available.
  • Envoy 500 is one of the fastest bench-top analyzers by performing up to 570 tests per hour. This vessel save you money and time and has a four-parameter Dry ISE, positive sample identification, and a built in touch screen with a bright LCD monitor. All of your results can be stored in memory to be easily displayed at just a touch. Also the pre-programmed parameters are already programmed into the software.
  • Cardiochek P-A is a blood testing instruments which can be used to check diabetes and cholesterol. It’s like having a health management system right in the palm of your hand. Easy to use with fast results in less than a minute.

With the right testing capabilities and equipment, the sky is the limit. (CLIA) Waved Testing is advanced and has you covered. By following all protocols, your business can be up and running on all cylinders. For more info on medical devices, go to http://www.vesselmedical.com/cardiochek-p-a/.

Families in Canada order more medicines per person than any other area. The variety of medications marketed by companies is no doubt a contributing question to recipe cure abuse epidemic. Various remedies are used to treat Bladder inflammation. Certainly it isn’t all. Kamagra is a medicament prescribed to treat many upsets. What do you think about http://levitra-cost.com/levitra-20-mg.html? When you order medications like Kamagra you have to think about levitra 20 mg. More info about Kamagra available at levitra 20mg. Generally, both men and women are afflicted by sexual dysfunctions. At times another disease can cause to impotence. Preparatory to purchasing Kamagra or other generic, speak to your druggist if you have any allergies. Talk to your health care vocational any changes in libido you have experimental. Online drugstore is a best way to find a doctor in your area who treats this kind of disfunction.

Tagged , , , , ,

10 Ridiculous ICD-10 Codes

ICD-10 went into effect in the United States on October 1, 2015. The primary difference from ICD-9 is the amount of specificity and granularity of conditions or situations which were given a code. In total, there are some 70,000 codes, which is up 500% from ICD-9 (14,000 codes).

Given the specific nature of some of these codes, we assume that these are real situations that are recorded as having actually happened. Here are the 10 codes that caught our attention and made us laugh the hardest.

1. V91.07  Burn due to water-skis on fire

Exactly how fast were you going, sir?

2. V91.35 Hit or struck by falling object due to accident by canoe or kayak

I can just hear the doctor asking the patient, “Can you explain that to me again?!”

3. W59.22 Struck by turtle

I still don’t know if “struck” means the turtle charged you or if someone picked up a turtle and hit you with it.  This should probably be broken down in more detail.

ICD-10 Code: Struck by Turtle
Read More

Tagged ,

Understanding CLIA and Waived Testing


Proper (CLIA) Waived Lab Testing & Protocols

CLIA– Clinical Laboratory Improvement Amendments is to ensure timeliness, accurate, and reliability in patient testing. This act falls under strict, high quality standards, wherever the tests were performed. This agreement was passed in 1988, but the regulations weren’t passed and published until late 1992 of the Federal Register. The complexity and make-up of the tests mainly the requirements and not where the tests were performed. Let’s take a closer look at some of the terms.

So What Is A Waived Test?

  • Waived Tests are classified as simple laboratory procedures and exams, which has a slight risk of error related results. By determining these tests, The Food And Drug Administration has a strict criteria of the application process and how it’s run. These tests are to be very simple and to minimize risk of error.

Read More

Tagged , , ,