Physicians Office Resource - September 2018

Physicians office Resource

2018 - Issue 9

â„¢

Resources for You, Your Patients, & Your Practice

Aids in diagnosis

Reimbursable

MEMORY LOSS BIOMARKERS TO AID DIAGNOSIS IN PRIMARY CARE PRACTICES Pages 2 & 16.

Used in office

also in this issue First FDA-Approved Hand Held Ultrasound Device Unprecedented Affordability, Portability, and Ease of Use

Take Our Research Survey Pg 4

Evaluating Memory Loss in Primary Care - A New Approach Increase Laboratory Accuracy with Direct HbA1c Testing

Pg 16

Pg 34

Get your finger on the pulse of the U.S. Healthcare System and entered for a chance to win an iPad Mini!

Pg 21

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2018 - Issue 9

PHYSICIANS office RESOURCE

Physicians office Resource

™

Published by Medical Education Resources, LLC

Publisher Aaron R. Medaris amedaris@ physiciansofficeresource.com CEO Andrew C. Nimmo acnimmo@ physiciansofficeresource.com President John D. Pasquale jpasquale@pharmaconnect.com Business Manager Marci J. Hills mhills@ physiciansofficeresource.com

MDescapes: Luxury Destinations & Deals for Physicians

Account Manager Brandi L. Brower

Four Seasons

Editorial Board Michael Paquin, FHIMSS Barry Craig, MLT (NCA), CLC

#5100

Staff Writer Dylan J. Chadwick

ProductSpotlight

Creative Director Production Manager SEO Specialist Keith A. Katsikas Jr

Memory Loss Biomarkers to Aid in Diagnosis in Primary Care Practices

Copyright ©2018

To continue your free subscription of Physicians Office Resource magazine, please complete the Business Reply Card at the center of this magazine and drop in any USPS mailbox.

From Evoke Neuroscience

The eVox® System is an FDA 510(k) cleared medical device to aid primary and specialty care physicians in diagnosis of memory loss and other cognitive disorders. eVox® measures memory loss biomarkers that may aid in detecting memory loss sooner, identifying the root cause of memory loss, and performing a differential diagnosis. eVox® procedures are performed in-office and are reimbursable by Medicare and commercial payers.

If you are a manufacturer of medical products or provide services to medical professionals and would like to advertise your products or services to the nation’s top physicians doing in-office testing, call 801-380-6094 or visit: POR.io for more information.

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Learn more about this product by entering #5100 at POR.io ! ! ! ! !

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IN THIS ISSUE First FDA-Approved Hand Held Ultrasound Device...

POR spoke with Healcerion Founder and CEO, Dr. Ryu, to learn more about the SONON 300L, a groundbreaking ultrasound...

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Evaluating Memory Loss in Primary Care...

When an individual begins to show signs of memory loss, a physician’s greatest challenge is often discovering the underlying cause of...

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Increase Laboratory Accuracy with HbA1c Testing Diabetes is a global epidemic affecting in the region of 271 million people according to the International Diabetes....

34

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2018 - Issue 9

PHYSICIANS office RESOURCE

FIRST FDA-APPROVED HAND HELD ULTRASOUND DEVICE UNPRECEDENTED AFFORDABILITY, PORTABILITY, AND EASE-OF-USE

By Dr. Benjamin Jeongwon Ryu, Healcerion Founder and CEO POR spoke with Healcerion Founder and CEO, Dr. Ryu, to learn more about the SONON 300L, a groundbreaking ultrasound device for Primary Care Physicians

POR: Please describe the difference of using a handheld diagnostic ultrasound device rather than a portable ultrasound system or a floor-based system.

POR: What have been previous barriers to more providers in the US using diagnostic ultrasound? Why has adoption been relatively low?

Dr. Ryu: Ultrasounds are typically classified into three fields: diagnostic, interventional/therapeutic, and screening. Traditional, floor-based ultrasound applications have been focused on diagnostic ultrasound applications such as finding liver tumors and evaluating cardiac dysfunction via a well-trained specialist.

Providing a handheld ultrasound for PCPs that can be used in screening and diagnostic applications such as trauma scanning can support and expedite the PCP's work in evaluating the need to refer the patient to secondary or tertiary care. It can also assist in interventional procedures such as guided injections and simple surgical procedures. SONON fills a previous void for PCPs to improve the efficiency of these procedures while also extending their range of diagnosis. No longer does the PCP need to rely on simply physical diagnosis and tools: the expanded range and increased offerings that SONON provides can also lead to direct financial benefits for PCPs. Additionally, SONON's ultracompact,

Dr. Ryu: Ultrasound devices are not affordable for most primary care practitioners (PCPs). Most high-end floorbased ultrasound systems have price points over $250,000, which is at or above the average annual income of PCPs in the US; even lower-end systems can cost upwards of $25,000.

Therefore, it may take years to break even after investing in a traditional ultrasound system, which creates a heavy cost burden for PCPs. In addition, if space is limited, traditional floor-based ultrasounds or even first-generation portable ultrasound units take up considerable square footage in a room and have typically required outlets to plug-in the units while using them, making space a potential limiting factor as well.

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wireless design and affordability mean the device requires minimal space and resources to operate. With its direct mobile device connectivity, SONON is an innovative offering that provides accurate and timely diagnostics, confidence and peace of mind for both PCPs and patients.

“ There is a misconception that effective ultrasound usage requires extensive expertise and specialized training. SONON has been developed for the most common clinical and primary care applications.”

POR: What are the most common, nonobstetric, uses/applications by PCPs with a SONON device?

Dr. Ryu: SONON is designed for most common, everyday diagnostic and screening applications in primary care. It is appropriate for pain management and scanning applications include musculoskeletal, tissue inflammation, vascular, and general abdominal scanning.

SONON also assists in procedures like mass removals, guided injections and fluid aspirations, which can be performed by the PCP to save time and money for the patient.

POR: Ultrasounds typically require extensive training and certification to operate. Is this the case for the SONON device?

Dr. Ryu: There is a misconception that effective ultrasound usage requires extensive expertise and specialized training. SONON has been developed for the most common clinical and primary care applications. The device and related mobile app are designed to be fast and easy to learn. SONON devices can be set up in minutes and within a couple hours a new user can feel comfortable scanning for ultrasound applications that they previously thought were out of reach.

POR: What are benefits of PCPs utilizing handheld ultrasound

Dr. Benjamin Jeongwon Ryu

imaging, rather than referring a patient to a radiologist or other specialist?

Dr. Ryu: With SONON, PCPs are now able to refer patients to the proper specialists with confidence and clear evidence from the ultrasound images, unlike previous physical-only diagnosis.

This leads to better care and efficiency at the secondary and tertiary levels as only patients who truly require this level of care are referred with a clearer diagnostic understanding. Improving diagnostic capabilities and building an evidencedbased rapport between PCP and patient improves patient care and outcomes. A doctor can easily share images with the patient in real-time, enhancing transparency and trust.

POR: How can SONON improve the efficacy and efficiency of patient care at the PCP level? (In other words, what advantages do PCPs using SONON have over others, and how can SONON reduce diagnosis time to allow doctors to treat more patients?)

Dr. Ryu: With SONON, diagnostic and screening time is reduced, and the increased efficiency and clearer information provided to secondary and tertiary care from the PCP leads to a shorter overall process from early diagnosis to final diagnosis. Additionally, the overuse of conventional ultrasound devices is alleviated as PCPs can grow their diagnostic and imaging capabilities, providing more value for the patient and expanding the PCP's offerings and value provided to the patient.

POR: Among the current offerings of handheld diagnostic ultrasound devices, what is most unique about the SONON device?

Dr. Ryu: SONON’s compact, wireless design allows PCPs to scan with one hand and not worry about being near a power source or getting tangled in wires or cords. This single-hand usage provides maximum flexibility for PCPs as they can use the other hand to guide a stethoscope, adjust the interface on the mobile device display, and more.

Read this and other articles at www.PhysiciansOfficeNews.com 5

Accurate, Actionable Results from the Leader in Point-of-Care Lipid Testing

#5101

From Abbott

PHYSICIANS office RESOURCE

2018 - Issue 9

PRODUCTFOCUS

The CLIA-waived Alere Cholestech LDX™ Analyzer is engineered for confidence, providing accurate, actionable, and readily accessible results that have set the standard in point-of-care lipid profile, cholesterol, and glucose testing. Results are easy to obtain.

Fingerstick sampling and a small sample size (40μL) makes results less painful and time consuming.

View Brochures, Videos, & More at: POR.io Enter Number 5101 in the Search Area

CLIA Waived Molecular Diagnostic Testing

#5102

From Cepheid

Cepheid’s GeneXpert Xpress® brings standardized molecular testing to any healthcare setting. Employing the highly accurate and easy to use lab in a cartridge technology in every GeneXpert system, the GeneXpert Xpress® is a true on-demand walkaway testing system with a simple test workflow that complements existing laboratory quality and regulatory compliance standards.

Two or four-module configurations save valuable bench space and reduce the need for multiple testing platforms.

View Brochures, Videos & More at: POR.io Enter Number: 5102 in the Search Area

#5103

First Ever CLIA Waived Hematology Analyzer From Sysmex

Faster test results, clinical decisions and greater practice efficiency are coming to physicians’ offices with the first CLIA-waived CBC analyzer. Hematology diagnostics leader Sysmex is bringing more lab testing to the point of care. One of the most common blood tests can be conducted reliably and accurately on-site, in as few as three minutes. The device’s ease of use and innovative technology means in-house staff can operate it in just a few easy steps, without lengthy certification and training. The new Sysmex XW-100 will improve health care efficiency and patient care.

View Brochures, Videos, & More at: POR.io Enter Number 5103 in the Search Area 6

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INNOVATIVE INTEGRATION ACROSS THE CARE CONTINUUM

CBC testing solutions for physician office labs

#5104

#5105

#5106

FREE SERVICE*

XN-L SERIES

Service included at no additional charge with purchase of analyzer. * Promotion available for a limited time on the XN-330 and XN-430 models.

Terms and conditions apply.

Contact your Distribution Representative for additional information and promotions.

www.sysmex.com/us © 2018 Sysmex America Inc.

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#5107

SPOTCHEM™ EZ Chemistry Analyzer From Jant Pharmacal

SPOTCHEM™ EZ chemistry analyzer is a small bench top chemistry analyzer that utilizes dry chemistry technology to test whole blood. Results are available on the SPOTCHEM™ printer or downloaded via LIS. SPOTCHEM™ is ideally suited for small laboratories and physician offices that desire an easy-to-use analyzer with a small footprint. Maximum throughput is 48 tests per hour. Test menu includes 21 tests and 3 panels. Tests whole blood, serum or plasma with rapid results within 4 – 15 minutes.

Extensive CLIA-waived menu, includes lipid panel, creatinine, AST, ALT, glucose, and 2 chemistry panels. Automatic calibration.

PHYSICIANS office RESOURCE

2018 - Issue 9

PRODUCTFOCUS

View Brochures, Videos, & More at: POR.io Enter Number 5107 in the Search Area

Histofreezer® Portable Cryosurgical System From OraSure - Histofreezer

Histofreezer® Portable Cryosurgical System offers medical professionals an easy and effective method to treat nine different types of skin lesions, including common, plantar and genital warts and other common benign skin lesions. Medical professionals in primary care, internal medicine, podiatry, ob/gyn and dermatology areas of care have either added Histofreezer® to their practice offering or replaced more invasive and less tolerated procedures with Histofreezer®.

#5108

View Brochures, Videos & More at: POR.io Enter Number 5108 in the Search Area

#5109

OraQuick ADVANCE® Rapid HIV-1/2 Antibody Test From Orasure

The OraQuick ADVANCE® Rapid HIV-1/2 Antibody Test is an FDA-approved point of care screening test for use with oral fluid, fingerstick or venous whole blood and plasma. The test delivers lab accurate results within 20 minutes with less than 2 minutes of hands on time. This simple test is ideal for testing programs in both clinical and non-clinical settings, as well as outreach events.

View Brochures, Videos & More at: POR.io Enter Number 5109 in the Search Area

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Flu, RSV, Strep.

Be Ready. #5110

With confirmatory molecular results,

Cepheid’s CLIA Waived test menu delivers peace of mind to you and your patients.

Xpert® Xpress Flu/RSV • One sample. One Cartridge. Three results • Qualitative, molecular detection and differentiation of influenza A, influenza B and RSV • No confirmation required for negative results

Xpert® Xpress Flu

Xpert® Xpress Strep A

• Qualitative, molecular detection and differentiation of influenza A and B

• Accurate, real-time PCR molecular testing

• Sample types include nasal swab and nasopharyngeal swab

• Internal QC in each cartridge

• No confirmation required for negative results

for Group A Strep

• No confirmation required for negative results*

For more information, call (888) 256-6990.

For in vitro diagnostic use. * No culture confirmation required for negative results unless clinical symptoms persist, or there is an outbreak of acute rheumatic fever (ARF).

904 Caribbean Drive | Sunnyvale, CA 94089 USA |

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+1.888.336.2743 |

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9

2018 - Issue 9

PRODUCTFOCUS #5111

BD Veritor™ Plus System From BD

PHYSICIANS office RESOURCE

Influenza A/B results in under 11 minutes so treatment can begin immediately. Our BD Veritor™ line of immunoassay products, the BD Veritor™ Plus System and the BD Veritor™ System give healthcare providers and laboratorians in near patient settings the objective, lab-quality tests results at the point of care within minutes. This assay system eliminates the subjectivity of visual interpretations of tests results and replaces it with an objective digital result.

View Brochures, Videos & More at: POR.io Enter Number 5111 in the Search Area #5112

CLIA-Waived Comprehensive Metabolic Panel From Abbott Point of Care

The Piccolo Xpress™ point-of-care chemistry analyzer delivers comprehensive CLIA waived diagnostics to Physician Offices. In 3 easy steps, the Piccolo provides lab-accurate results in minutes from a menu of 29 general chemistry tests, including lipids, liver, kidney, metabolic and other specialty functions. By using only 100 microliters of whole blood, serum or plasma - physicians can make confident treatment decisions faster, thereby increasing the efficiency, throughput and capacity of their practice, while also increasing revenue and ensuring patient satisfaction.

View Brochures, Videos & More at: POR.io Enter Number 5112 in the Search Area

#5113

Brewer’s Flex™ Access Exam Table From Brewer

Step up to power table performance for less with Brewer’s Flex™ Access Exam Table. Industry-leading 700-lb. patient weight capacity, unique safety features and unmatched ergonomic patient access maximize your clinical efficiency and ROI. A streamlined footprint and optional upgrades like safety grab bars, stirrups, and passthrough work surface provide ultimate flexibility for your practice.

View Brochures, Videos, & More at: POR.io Enter Number 5113 in the Search Area

10

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Micros ES 60 Hematology System CBC with 3-part diff

Is it viral or bacterial?

Urgent or routine?

Take the guess work out of your day with point-of-care testing!

Advanced technology in a small footprint HORIBA Part # 5360600241

#5114 Pentra 60C+ Hematology System CBC with 5-part diff

Compact 5-part diff system HORIBA Part # 5300001398

#5115 Pentra C400 Chemistry Analyzer

Compact benchtop offering routine to special testing

Why invest in laboratory testing? #5116

HORIBA Part # 5300001388

Because HORIBA’s hematology and chemistry analyzers: • Provide fast and accurate results allowing you to deliver more decisive patient care • Increase office efficiency by reducing call-backs to patients with test results • Increase patient satisfaction by eliminating wait time for results and repeat office visits

Get Connected!

The LiteDM Data Management System: • Provides an affordable way to connect up to four analyzers • Eliminates transcription errors by consolidating results to one report • Streamlines operations by connecting directly to EMR systems

PROMOTION*

Lite

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Easy • Patient Data Management

Contact us at: 888-280-1401 email us at: medical-marketing.US@horiba.com

Purchase* a HORIBA Micros 60 hematology analyzer with LiteDM and receive the following: • Two LiteDM connections at no additional charge AND • A six month extension on analyzer service OR • A two-year program agreement * Promotion ends December 31, 2018

Contact your HORIBA Medical Representative for more information • www.horiba.com/us/en/medical/

11

2018 - Issue 9

PRODUCTFOCUS

#5117

The Doctors Guide to Eliminating Debt

PHYSICIANS office RESOURCE

From Dr. Cory S. Fawcett

The Doctors Guide to Eliminating Debt can show you how to pay off debt faster than you imagined—including your house. Too many doctors are carrying perpetual debt and giving away a large chunk of each paycheck as interest to the bank. Don’t give away your future to the bank, you earned it, you keep it. Get your cure for Debtabetic Neuropathy and Alzheimer’s Debtmentia before it’s too late.

View Brochures, Videos & More at: POR.io Enter Number 5117 in the Search Area

#5118

Single, Integrated POC Testing Solution From Abbott Point of Care

The fully automated i-STAT System offers a broad menu of tests for diagnostic and treatment indicators related to disease state management and clinical practice guidelines. Using just 2 or 3 drops of blood, the system provides time-sensitive tests at the patient’s side in just minutes.

View Brochures, Videos, & More at: POR.io Enter Number 5118 in the Search Area

#5119

CELL-DYN Emerald Hematology Analyzer From Abbott

CELL-DYN Emerald is a 3-part differential hematology analyzer that offers high performance in an affordable, compact design that provides reliable and accurate patient results every time. As a smaller operating laboratory, you need a solution that offers reliable results. CELL-DYN Emerald provides results in under 65 seconds.

CELL-DYN Emerald’s small size, simple touch screen software and reliability offer an easy-to-use, truly compact table/bench top instrument for easy performance in your laboratory.

View Brochures, Videos & More at: POR.io Enter Number 5119 in the Search Area

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R E A G E N T S #5120

SIZE MATTERS: THE TRUE WEIGHT OF RISK IN LIPID PROFILING LDL CHOLESTEROL = 110mg/dL LOWER RISK

HIGHER RISK

HEALTHY INDIVIDUAL sdLDL-C 20 mg/dL

CAD PATIENT sdLDL-C 70 mg/dL

Small-dense LDL Cholesterol (sdLDL-C), a subtype of LDL cholesterol, can more readily permeate the inner arterial wall making sdLDL-C particularly atherogenic. Research indicates that individuals with a predominance of sdLDL-C have a three-fold increased risk of myocardial infarction. Until recently, the primary methods of assessing a patients sdLDL-C were based on the laborious and time consuming ultracentrifugation and electrophoresis method. The Randox sdLDL-C assay utilizes the quantitative “Denka Seiken” method which facilitates faster patient diagnosis and treatment plan implementation, for use on a wide range of biochemistry analyzers.

Rapid analysis

Applications available

Liquid ready-touse format

Excellent correlation

Direct, automated test

+1 304 728 2890 | www.randox.com/sdldl-cholesterol | reagents@randox.com Randox Laboratories-US, Ltd. 515 Industrial Boulevard, Kearneysville, West Virginia, 25430

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2018 - Issue 9

PRODUCTFOCUS

PHYSICIANS office RESOURCE

The Brewer Basic Exam Table From Brewer

#5121

Full featured, entry-level exam table design. The Brewer Basic Exam Table features a pneumatic cylinder, seamless upholstery, and the largest storage capacity available. We invite you to compare features, price, warranty and you will find the Brewer Basic Exam Table is clearly the best entry level exam table available.

View Brochures, Videos, & More at: POR.io Enter Number 5121 in the Search Area

#5122

Sysmex XN-L™ Series Automated Hematology Analyzers From Sysmex

Now lower volume customers can enjoy the same capabilities in CBC testing as larger hospitals and reference labs. Enhanced clinical value is standard and optional licenses for reticulocyte or body fluid testing are available. The XN-L analyzers are the first to feature BeyondCareSMÂ Quality Monitor, an innovative, web-based QC and calibration management program.

View Brochures, Videos & More at: POR.io Enter Number 5122 in the Search Area

#5123

AAFP-PT is the Right Choice for Proficiency Testing From AAFP

AAFP-Proficiency Testing (AAFP-PT) is a full-service proficiency testing program designed to assist physician office laboratories, clinics, and small hospitals maintain laboratory excellence and regulatory compliance. AAFPPT provides an easy to maintain program with only three shipments per year, technical support by experienced laboratorians, electronic reporting, and P.A.C.E continuing education credits. Rely on AAFP-PT to help you assure the accuracy of lab results, a critical component of quality patient care.

View Brochures, Videos & More at: POR.io Enter Number 5123 in the Search Area

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Bionet CardioCare 2000: $1,255.00 Schiller AT-2 Plus: $2,275.00* *add Spirometry: $1,000.00 Burdick ELI 250c: $2,998.00 Welch Allyn CP150 w/ Interp: $3,186.00

#5124

#5125

#5127

#5126

#5129 #5128

#5130

#5131

Coaxial Ophth, Fiber Optic Oto, Speucla Dispenser, Aneroid BP, Wall Transformer & Wall Board without Thermometer: $850.00 with Thermometer: $1,117.00

#5133 #5132

#5134

#5135

#5136 15

2018 - Issue 9

PHYSICIANS office RESOURCE

EVALUATING MEMORY LOSS IN PRIMARY CARE A NEW APPROACH

By Morgan Ingemanson, PhD, Medical Affairs Manager, Evoke Neuroscience How Do You Evaluate Memory Loss?

When an individual begins to show signs of memory loss, a physician’s greatest challenge is often discovering the underlying cause of symptoms. Behavioral evaluations (including self-report questionnaires such as MoCA and MMSE, effort-based computerized testing, and psychological evaluations) and laboratory tests (such as APOE genotyping and biochemical labs such as blood, urine, and CSF analysis) can be useful in developing a diagnosis in cases of advanced symptom presentation1. But how useful are these tools in assessing cases of early memory loss? Are they capable of detecting dementia early, before disease advancement, so that the physician has the opportunity to implement a successful treatment intervention?

Unfortunately, gold standard assessments often struggle with discovering early stage memory loss. The diagnosis of Alzheimer’s disease (AD) is delayed on average 2-3 years after symptom onset2,3, at a point in which prognosis is poor. Ample clinical research has repeatedly demonstrated that brain changes associated with AD may begin 20 or more years before symptoms appear4. If implemented during this pre-symptomatic

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stage, lifestyle interventions including diet, exercise, cognitive training and monitoring vascular risk can improve or maintain cognitive functioning and potentially course-correct patients headed down the road to dementia5. Sadly, the tools most often used by physicians to evaluate memory loss are unable to detect this early stage of memory loss.

Moreover, many individuals have dementia-like symptoms without the progressive brain changes of Alzheimer’s disease (AD) or other degenerative brain diseases. Especially in early stages, memory loss related to dementia can be difficult to distinguish from cognitive decline caused by depression, thyroid problems, medication side effects, certain vitamin deficiencies, and even normal healthy aging6. Indeed, up to one in five patients diagnosed with probable AD during their lifetime did not have AD pathology at autopsy7.

How is it possible that current gold standard tools lack the sensitivity and objectivity needed to develop timely and accurate diagnoses for patients experiencing memory loss? It is because memory loss is a brain problem. Symptom screeners and effort-based computerized testing base conclusions off of

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behavior, not off of how the brain is functioning. Likewise, laboratory tests do not directly assess the main organ of interest. The impairment of memory, language, problem-solving, and other cognitive skills that characterize dementia occurs because neurons in the brain are damaged, destroyed, or dysfunctional.

Shouldn’t the highest standard of care for memory loss patients include a direct and objective assessment of the brain itself ?

Brain-Based Biomarkers.

Biomarkers are measurable characteristics of a biological function or response that can be objectively measured and evaluated to investigate processes in health and disease. Given that an objective brain assessment is critical in pinpointing the cause of memory loss, a number of neuroimaging diagnostic biomarkers have been identified for clinical use. These include amyloid deposition as measured by PET scan and cerebral atrophy as measured

by MRI8. Unfortunately, in the case of Alzheimer’s disease, these biomarkers begin to present once the disease has already begun to progress (Figure 1). Only once clinical symptoms are evident do various regions of the brain demonstrate atrophy detectible by volumetric MRI4. Moreover, from a practical perspective, these imaging techniques are expensive and/or invasive and therefore remain unavailable to the patients’ first line of contact – the primary care physician.

Electroencephalography, or EEG, involves the measurement of neural oscillations in the brain (i.e., brainwaves), and has long been established as a robust and valuable tool for investigating changes in neural functional.

As opposed to techniques that measure brain structure like MRI and CT, EEG evaluates the electrical activity of the brain to reveal how the brain functions. These electrical changes can be measured during a resting state, reflecting spontaneous neural activity, and in “event-related potentials” (ERP), which reflect brain processing speed of environmental stimuli.

Due to the un-intrusive, non-invasive, and inexpensive nature of EEG, it is a widely used tool for investigating brain function and neurophysiological health or disease in

humans. Additionally, and of particular pertinence, a number of hallmark alterations have been noted in the EEG and ERPs of patients with dementia9.

Up to 20 years prior to the onset of symptoms, there is a window within Alzheimer’s disease progression wherein tau pathology and early amyloid pathology cause impairments in brain function prior to extensive neurodegeneration (Figure 1). Although CSF changes in Aβ and tau are absent at this stage, and functional impairments are not great enough to result in clinical symptoms, clinical research has demonstrated that EEG is capable of detecting biomarkers of impaired brain function. These include spectral “slowing” as measured by quantitative EEG (qEEG), which presents as a relative increase in low frequency brainwaves, and slowed brain processing speed, as indicated by a delay in the P300b component of the ERP waveform9. It is hypothesized that the most effective treatments for AD will be

functional neuroimaging may be necessary to substantiate the diagnosis of MCI and the subsequent risk of developing AD10 (Figure 2).

With the understanding that the highest standard of care for patients with memory loss includes brain electrophysiology evaluations, comes the need for tools that provide objective memory-related measures that guide and inform physicians in their provision of more targeted therapies.

Ideally, such tools would be available in the primary care office, as this is often the first point of care for patients experiencing symptoms of memory loss. However, traditional EEG devices have remained unavailable to most doctors because of expense and complex, time-consuming data interpretation. Historically, only neurologists and expert EEG technical staff have had the resources and training to derive clinical significance from EEG data.

Moreover, the biomarkers useful in detecting pre-clinical dementia are measured via ERP and quantitative EEG (qEEG) testing, which require sophisticated data processing and comparisons with normative reference values. ERP and qEEG biomarkers provide enhanced objectivity and sensitivity over conventional visual inspection of EEG, yet primary care and specialty physicians alike have not had access to normative database comparisons that permit this type of quantitative analysis.

Figure 1. Depiction initiated during this early pre-symptomatic of the main changes across the stage of the disease, when any damage progression of Alzheimer’s disease and may be reversed4. Thus, the ability for a the sequence of associated biomarkers . primary care physician to collect EEG A) Tau and amyloid pathology begin. B) data and measure these memory loss The shaded region indicates a window in biomarkers would profoundly improve which tau and amyloid pathology cause their ability to make the correct diagnosis functional impairments that are not great and to also provide the prognosis of how enough to result in clinical symptoms. to treat the cause.

CSF changes in Aβ and tau are absent but functional biomarkers as measured EEG & ERP for the Primary Care Physician. by EEG and ERP are present. This early Leading research agrees that utilizing pre-symptomatic stage is the time during traditional clinical evaluation and which the most effective treatments will biochemical labs together with other be initiated and any damage may be supportive diagnostic techniques such as reversed. C) Clinical symptoms become 17 4

2018 - Issue 9

PRODUCTFOCUS #5137

PHYSICIANS office RESOURCE

OraQuick® HCV Rapid Antibody Test From OraSure

The OraQuick® HCV Rapid Antibody Test is the FIRST and ONLY FDAapproved, point of care test for the detection of HCV antibodies. This CLIAwaived platform delivers an accurate diagnosis in 20 minutes. The test can be completed in 3 simple steps from fingerstick or venous whole blood with less than 2 minutes of hands on time. It is ideal for testing programs in both clinical and non-clinical settings, as well as outreach events.

View Brochures, Videos & More at: POR.io Enter Number 5137 in the Search Area

#5138

From Routine To Specific Tests, Perform Them All On A Single System From HORIBA Medical

The Pentra C400 is an extremely compact Clinical Chemistry benchtop analyzer. From routine to specific tests, it can perform them all on a single system. It can run up to 420 tests per hour with ISE module. Its automation and continuous loading provides enhanced productivity in a user-friendly environment.

View Brochures, Videos, & More at: POR.io Enter Number 5138 in the Search Area #5139

Now It’s More Than Just A Blood Test From Sysmex

With its simplified operation, the Sysmex XP-300™ is ideal for clinics and physician office labs. It provides a CBC with 17 different parameters, including a 3-part WBC Differential. The XP-300+M combines the accuracy and reliability of a Sysmex CBC with the agility of Medicus Middleware. Features include EMR connectivity, instrument interfaces and a QC module.

View Brochures, Videos & More at: POR.io Enter Number 5139 in the Search Area

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CONTINUEDFROMPAGE17 apparent. D) Clinical symptoms are progressive and severe. Various brain regions demonstrate atrophy as measured by volumetric MRI. Advances in data processing and analytics have led to a golden age of electrophysiology assessments.

Companies like Evoke Neuroscience (www.evokeneuroscience.com) have created low-cost, easy to use systems designed specifically to suit the needs of primary care physicians. In the case of Evoke Neuroscience’s eVox® System, primary care physicians, and neurologists now have access to these important biomarkers for memory loss to aid their diagnosis. A simple solution of integrated EEG hardware and software allows objective evaluations of brain function that can be performed by office staff. By providing these memory loss biomarkers, the eVox® System supports doctors in objectively assessing patients and may aid in recognizing preclinical dementia conditions, identifying the root cause of memory loss, and performing a differential diagnosis.

Figure 2. The highest standard of care for patients with memory loss includes assessments of brain electrophysiology, biochemical labs, and effort-based screeners.

References 1. National Institute of Health: National Institute on Aging.

Diagnosing dementia. Available at: https://www.nia.nih.gov/health/ diagnosing-dementia.

2. Boise L, et al. Am J Alzheimers Dis. 1999;14:20-26.

3. Balasa M, et al.

Neurology. 2011;76(20):1720-1725.

4. Walsh C, et al. Neurosci Biobehav Rev. 2017;73:340-58.

5. Ngandu T, et al. Lancet. 2015; 385(9984):2255-63.

6. Alzheimer’s Association. Alzheimer’s Dement. 2018;14(3):367-429 7. Beach TG, et al. J Neuropathol Exp Neurol. 2012;71(4):266-273.

8. McKhann GM, at al. Alzheimer’s Dement. 2011;7(3):263-9.

9. Horvath A, et al. Front Biosci.

2018;23:183-220.

10. Ladeira RB, et al. CLINICS. 2009;64(10):967-73.

Read the rest of this and other articles at www.PhysiciansOfficeNews.com

MicroLab Spirometer Easy to Use, Affordable, Complete Spirometry The MicroLab spirometer with integral printer and touch screen color display offers easy to use, complete spirometry in an affordable, portable package. ! Touch screen color display ! Choice of child incentives #5140

! ATS/ERS standards compliant ! On-screen test quality prompts

#4975

! Confirming diagnostic interpretation ! Post bronchodilator comparison ! Fast, quiet internal printer ! Low cost disposables ! SPCS PC software optional

www.mdspiro.com Micro Direct, Inc.

803 Webster St., Lewiston, ME

800-588-3381

Fax 207-786-7280

Email sales@mdspiro.com 19

#5141

Accutest pH® Phenaphthazine Paper From Jant Pharmacal

Test papers give instant, easy-to-read results, with clear, bright matches at 0.5 intervals from pH 4.5 to 7.5. Color charts are lab-tested for precision accuracy. Made in the U.S.A. with state-of-the-art materials. An FDA-listed medical test product, used in hospitals and doctor’s offices around the world. Economical – approximately 100 tests/roll. Widely used in hospitals and doctors’ offices to detect the presence of amniotic fluid in vaginal secretions during late-term pregnancy, a sign of premature amniotic sac rupture.

PHYSICIANS office RESOURCE

2018 - Issue 9

PRODUCTFOCUS

View Brochures, Videos, & More at: POR.io Enter Number 5141 in the Search Area

#5142

Make Laboratory Compliance and Inspection Easier From My Inspection

Make laboratory compliance and inspections easier by changing how you document, save and retrieve all information necessary to meet CLIA and accreditation regulations. With two unique electronic tools My Compliance Manual and MyInspection™ Software, the guesswork and tedious task of interpreting and documenting policy, procedure, forms, charts and logs is over. Your lab will be compliant, have less paper, and be inspection ready.

View Brochures, Videos & More at: POR.io Enter Number 5142 in the Search Area

#5143

The Doctors Guide to Smart Career Alternatives and Retirement From Dr. Cory S. Fawcett

The Doctors Guide to Smart Career Alternatives and Retirement will show you ways to redesign your career in healthcare to find that balance of work and enjoyment that’s been missing. Many physicians are ready to give up their healthcare career altogether. It doesn’t have to end that way. There are ways to improve the things you don’t like. We will all eventually leave medicine, when we do, this guide will make it smoother.

View Brochures, Videos & More at: POR.io Enter Number 5143 in the Search Area 20

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Get Your Finger on the Pulse of the US Healthcare System

Join Physicians Office Resource as we conduct our first in a series of focus group surveys, designed to give a voice to providers. With your help we can better understand the current state of, and what’s trending in, physician offices, laboratories, and healthcare facilities across America. Thousands of clinicians, laboratorians, nurses and caregivers coming together to improve office and laboratory proficiency, profitability, and patient care.

As a Thank You, we will report the results from this and future surveys in Physicians Office Resource magazine. Moreover, we will enter you in our periodic drawing for a FREE Apple iPad, which you may gift to someone or keep for yourself. The more surveys completed, and the more questions you answer in each, the more chances you will have to win.

www.survey.por.io

21

2018 - Issue 9

#5144

PRODUCTFOCUS Silaris™ Influenza A&B Test From Sekisui Diagnostics

A molecular test utilizing polymerase chain reaction (PCR) technology providing accurate results for early diagnosis and proper management of influenza.

PHYSICIANS office RESOURCE

Accurate √ Molecular Results √ State-of-the art microfluidic cassette technology √ PCR test using proprietary OscAR™ Technology

Affordable √ Single Test Diagnosis √ Controls in every kit √ Molecular reimbursement (CPT Code 87502) Simple √ Easy to Use √ Compact portable dock with no calibration required √ Room temperature storage

View Brochures, Videos & More at: POR.io Enter Number 5144 in the Search Area

#5145

CLIA-waived OSOM® iFOB From Sekisui Diagnostics

The CLIA-waived OSOM® iFOB test gives the physician and the patient a simpler, more compliant colon cancer screening option that is highly accurate and specific to human hemoglobin. With the ability of a convenient take home kit, patients can collect in the privacy of their own home with no dietary or drug restrictions in just one sample increasing the physician compliance for yearly screening.

View Brochures, Videos & More at: POR.io Enter Number 5145 in the Search Area #5146

Micros ES60 From HORIBA Medical

The Micros ES60 is an easy to use tabletop hematology analyzer. It combines the reliability of the current Micros 60 with the latest Linux based operating system utilizing a large color touch screen user interface. The Micros ES60’s Zero Maintenance concept provides unparalleled user convenience monitoring all aspects of instrument operations and provides real time status updates for the user.

View Brochures, Videos, & More at: POR.io Enter Number 5146 in the Search Area

22

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#5147

23

THE PERFECT Caribbean escape

LIVE LARGE & PROSPER 40% Off Villa Experience Visit FourSeasons.com/Nevis or Call 869-469-6238 Learn more about this resort and take the virtual tour at www.MyMDescapes.com

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LINK YOUR LAB! - Waived Labs From Medicus Laboratory Information Systems

Solutions that meet your laboratory needs:

PHYSICIANS office RESOURCE

2018 - Issue 9

PRODUCTFOCUS

#5148

• Affordably connect lab results to EMR • No more paper results • Stop transcription and scanning errors • Results in patient electronic chart in minutes

View Brochures, Videos & More at: POR.io Enter Number: 5148 in the Search Area

#5149

The Brewer Century Series Stool From Brewer

Has a pneumatic height adjustment, 16" wide, 4" thick polyfoam seat cushion, and five-leg 23" brushed aluminum accent base. Optional adjustable 18" chrome footing. Optional adjustable contoured backrest with black plastic shroud.

View Brochures, Videos & More at: POR.io Enter Number 5149 in the Search Area

#5150

Rad-97™ Pulse CO-Oximeter® From Masimo

Pulse with Integrated Noninvasive Blood Pressure (NIBP) in a Standalone Bedside Device > Upgradable rainbow SET™ Measurements allows for continuous monitoring of multiple additional parameters > Customizable display allows for quick assessment of patient status > Configurable patient profile settings for a variety of patient populations > Connectivity Solutions for electronic charting of patient data Rad-97™

CO-Oximeter®

View Brochures, Videos, & More at: POR.io Enter Number 5150 in the Search Area 26

www.PhysiciansOfficeResource.com

#5153

#5151

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Exam Tables

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Pediatric Tables

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Power Tables

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Cabinets and Stools

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#5171

Fully Automated Quantitive Immunoassay Analyzer From Sekisui

PHYSICIANS office RESOURCE

2018 - Issue 9

PRODUCTFOCUS

The FastPack® IP System is a fully automated quantitative immunoassay analyzer designed for use in the Physician Office laboratory. Utilizing sophisticated chemiluminescence technology, the FastPack® IP System provides the capability to produce complex immunoassay results in 12 minutes or less with a push of a button. Menu includes Vitamin D, Testosterone, TSH, Free T4 PSA and hCG.

View Brochures, Videos & More at: POR.io Enter Number 5171 in the Search Area

#5172

Highly Accurate Networked PC-based Spirometry From Vitalograph

Vitalograph introduces the new Spirotrac V software coupled with the rugged, accurate Pneumotrac spirometer. This accurate, robust and linear Fleisch pneumotach produces over 50 spirometry parameters, automatically stores all test data, calibration data and clinical audit trail data in a secure network capable SQL Server database. An intuitive user interface enhances the routine workflow in most practices, allowing quick patient throughput. Challenge testing, cough testing and slow vital capacity testing with lung age estimation are all standard features. Beyond spirometry, the Spirotrac V also becomes a platform for a PC-based diagnostic workstation, incorporating a Bluetooth ECG, USB Pulse Oximetry, 6 minute walk test, Bluetooth Weight Scale for COPD / CHF assessment, and automated Blood Pressure measurements.

View Brochures, Videos, & More at: POR.io Enter Number 5172 in the Search Area

#5173

Pentra XLR From HORIBA Medical

For laboratories that need a highly reliable hematology analyzer with gold standard technology, the Pentra XLR provides the highest quality of results while delivering process efficiencies with auto-validation, auto rerun, and auto dilutions in a small, compact system. For laboratories that require reticulocytes for better patient care, the Pentra XLR provides a high quality and automated reticulocyte panel, available on a highly reliable hematology analyzer from HORIBA Medical in a cost effective manner.

View Brochures, Videos & More at: POR.io Enter Number 5173 in the Search Area 28

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2018 - Issue 9

PRODUCTFOCUS #5176

Portable, Single Click Operation Spirometer From MicroDirect

PHYSICIANS office RESOURCE

The Micro Direct SpiroUSB many features include single click operation of all main functions, full ATS/ERS test quality checks, real time Flow/Volume and Volume/Time traces, a choice of child incentive displays, choice of predicted values, estimated lung age, pre/post bronchodilator comparisons and can be used on multiple PC’s with dongle software protection key. The child incentive display and ATS quality checks ensure maximal results every time. Use with a laptop for true portability.

View Brochures, Videos & More at: POR.io Enter Number 5176 in the Search Area

Ramp® 200 Cardiac Test System

#5177

From Jant Pharmacal

RAMP® 200 Cardiac Diagnostic System tests for NT-proBNP*, Troponin I, CK-MB and Myoglobin. Compact, high throughput, multi-port laboratory reader (18-36 tests/hour with 3 test modules). Run multiple tests on the same or different patients simultaneously. Enhanced data management and connectivity.

Self-diagnostic and internal quality control checks. Single Port RAMP reader is also available. Results in 15 minutes. *Entresto, a new drug for HF, disrupts BNP levels, however NT-proBNP “remains a useful cardiac biomarker to assess therapeutic effect and prognosis in patients treated with the drug.” References available. Entresto is a TM of Novartis AG.

View Brochures, Videos & More at: POR.io Enter Number 5177 in the Search Area #5178

The RX imola From Randox

A fully automated, random access analyzer with STAT sampling functionality; boosting productivity and saving time when it matters most. Developed for medium-high throughput laboratories, the RX imola provides comprehensive testing with the world-class RX series test menu, including specific proteins, lipids, therapeutic drugs, drugs of abuse, antioxidants and diabetes testing. The RX imola: A cost-effective system that delivers consistent high quality results with a small footprint.

View Brochures, Videos & More at: POR.io Enter Number 5178 in the Search Area 30

www.PhysiciansOfficeResource.com

#5179

#5180

#5181

#5182

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31

#5184

Self-contained Diagnostic Workstation From Vitalograph

Vitalograph introduces the Compact Expert diagnostic workstation.

The device is a full touch-screen based medical workstation, which comes equipped with Vitalograph’s flagship Pneumotrac spirometer.

This accurate, robust and linear Fleisch pneumotach produces over 50 spirometry parameters, automatically stores all test data, calibration data and clinical audit trail data in a secure network capable SQL Server database. An intuitive user interface enhances the routine workflow in most practices, allowing quick patient throughput. Beyond spirometry, it is a desktop testing station for ECG, Pulse Oximetry, Weight , COPD assessment, and Blood Pressure measurements.

PHYSICIANS office RESOURCE

2018 - Issue 9

PRODUCTFOCUS

View Brochures, Videos & More at: POR.io Enter Number 5184 in the Search Area #5185

Hematology Testing Made Easy From Sysmex

Designed for labs testing up to 25 samples per day, the Sysmex pocH-100i™ has the smallest footprint of any analyzer on the market. The instrument requires only 15µL of whole blood for reporting of 17 clinical parameters, including a 3-part WBC Differential. It is ideal for urgent care, physician office lab, small clinic, or any outpatient setting where a point of care CBC is needed.

View Brochures, Videos & More at: POR.io Enter Number 5185 in the Search Area

#5186

Ultra hCG Combo Test From Sekisui Diagnostics

The OSOM® Ultra hCG Combo test is a simple immunoassay for the qualitative detection of human chorionic gonadotropin (hCG) in serum or urine for the early confirmation of pregnancy.

Internal studies have confirmed that the OSOM® Ultra hCG Combo test does not have a false negative result from hCG variants providing physicians with an higher level of confidence.

View Brochures, Videos & More at: POR.io Enter Number 5186 in the Search Area

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Medicus Laboratory Information Systems

MEDICUSLIS.COM

LINK YOUR LAB TO EMR Medicus LIS offers flexible, affordable and easy-to-use systems to help manage and send complete and accurate patient lab results to EMR. We have the LIS solution that meets your requirements without redundant features in your EMR. #5187

Waived Labs Now you can afford to connect point of care testing to EMR. Eliminate transcription errors and complete the patient’s electronic record.

Moderately Complex Labs Handle all your patient and quality results accurately and efficiently. Whether you have a complete multidiscipline lab or a few lab instruments, you can choose the system that fits your needs.

Toxicology Labs If you have EIA and/or LCMS requirements, our toxicology system is designed to make patient lab results simple to interpret and report.

Contact us to learn more about our products.
 Call: 888.643.8081 Email: info@medicuslis.com 33

2018 - Issue 9

PHYSICIANS office RESOURCE

INCREASE LABORATORY ACCURACY WITH DIRECT HBA1C TESTING

By MICHAEL MULLIGAN Randox Laboratories Ltd Diabetes is a global epidemic affecting in the region of 271 million people according to the International Diabetes Federation. Worryingly this figure is on the rise with forecasts suggesting diabetes will affect up to 552 million people globally by 2030. Such a dramatic increase highlights the fundamental need for better disease management. When we look at the worldwide prevalence of diabetes, the USA is one of the most prominent countries affected.

Diabetes represents a significant burden to healthcare systems due to the many serious complications that can result from poor diabetes management. The longer an individual has diabetes, the greater the risk of developing diabetes related complications.

Common complications include cardiovascular disease (CVD), nerve damage and kidney damage; including end-stage kidney disease which can require dialysis or a kidney transplant.

Numerous clinical studies, including the Diabetes Control and Complications Trial, have shown that diabetes-related complications may be reduced by the long-term monitoring and tight control of blood glucose levels. With the rising figures and growing list of complications associated with the disease, diabetes remains one of the leading causes of death in the world and the seventh leading cause of death in the US. 34

Biomarkers for diabetes management and control HbA1c, also known as hemoglobin A1c or glycated hemoglobin, is an important blood test used to determine how well diabetes is being controlled. It develops when hemoglobin, a protein within the red blood cells that carries oxygen throughout the body, joins with glucose in the blood, becoming ‘glycated’. The concentration of HbA1c in the blood of diabetic patients increases with rising blood glucose levels and is representative of the mean blood glucose level over the preceding six to eight weeks. HbA1c can therefore be described as a long-term indicator of diabetic control unlike blood glucose which is only a short-term indicator of diabetic control. It is recommended that HbA1c levels are monitored every three to four months. In patients who have recently changed their therapy or in those who have gestational diabetes it may be beneficial to measure HbA1c levels more frequently, at two to four week intervals.[2] By measuring glycated hemoglobin (HbA1c), clinicians are able to gain an overall picture of average blood sugar levels over a period of weeks/months. For individuals living with diabetes this is important as the higher the level of HbA1c, the greater the risk of developing diabetes-related complications. [1] www.PhysiciansOfficeResource.com

HbA1c measurement in the clinical laboratory Recent advances relating to how HbA1c is measured in the clinical laboratory means it is now possible to measure HbA1c directly using a routine biochemistry analyzer, ultimately resulting in significant benefits and increased efficiency for laboratory professionals.

Perhaps the most significant benefit of direct HbA1c testing is the fact all sample pretreatment steps are conveniently performed onboard the analyzer. Onboard pretreatment not only reduces preparation time but reduces the potential for error whilst ensuring accurate patient testing by eliminating the need for operator interaction. Although HbA1c assays have been available on chemistry analyzers for some time, with traditional assays the operator is required to incubate the patient sample and denaturant offline. This very manual process requires the operator to pipette, mix and incubate accurately, as such there is a significant risk of error which often results in inconsistencies which can ultimately affect the patient result. The ability analyze patient samples immediately allows for a faster result turnaround.

In addition to a reduction in preparation time, laboratories will also benefit from further time savings and faster recovery times as there is no longer a requirement for any offline or manual calculations when using a Direct HbA1c method.

Additional time and cost savings can be achieved using a high throughput clinical chemistry analyzer which will allow the operator to run a full diabetes panel alongside the direct HbA1c test rather than using a dedicated HbA1c analyzer solely for one test.

Further efficiencies are made possible with the introduction of a direct HbA1c assay. Implementation of a direct Hba1c assay will remove the need to also measure Total Hemoglobin, as a result the assay requires a single calibration

“ Perhaps the most significant benefit of direct HbA1c testing is, all sample pretreatment steps are conveniently performed onboard the analyzer. Onboard pretreatment not only reduces preparation time but reduces the potential for error whilst ensuring accurate patient testing by eliminating the need for operator interaction.”

MICHAEL MULLIGAN, Randox

only and a single assay leading to significant cost and time savings.

Randox Direct HbA1c Assay on the RX series Clinical Chemistry Analyzers The RX series range of clinical chemistry analyzers from Randox now offer direct HbA1c testing capabilities allowing users to consolidate testing with an extensive dedicated test menu of over 110 validated Randox Reagents. The RX daytona plus offers a throughput of 270 photometric tests per hour with an optional ISE unit maximizing throughput to 450 tests per hour, the RX imola offers a combined throughput of 560 tests per hour, with the latest edition of the RX series range, the RX modena offering a maximum throughput of 1200 tests per hour including ISE. The RX series range of clinical chemistry analyzers offer many time and cost saving measures for your laboratory, for more information on these, please visit: www.randox.com/clinicalchemistry-analysers or contact us today by emailing: therxseries@randox.com.

References 1. Diabetes – What is HbA1c? [Online] Available at (www.diabetes.co.uk/what-is-hba1c.html) [Accessed: 30th January 2018] 2. Randox – HbA1c [Online] Available at: (www.randox.com/hba1c/) [Accessed: 30th January 2018] 3. Cohen P.M. Perspective: measurement of Circulating Glycated Protein to Monitor Intermediate – Term Changes in Glycaemic Control Eur J Clin Chem. Clin. Biochem.

1992:30 (12): 851 – 859.

4. The Diabetes Control of complications Trial Research on the Development and Progression of Long – Term Complicity of Insulin – Dependent Diabetes Mellitus. The New England Journal of Medicine 1993:329 (14): 977 – 986.

5. Mayer T.K. and Freedman Z.R.: Protein glycosylation in diabetes mellitus: A review of laboratory measurements and of their clinical utility. Clin. Chem. Acta 127: 147 – 184 (1983).

6. Baynes J.W., Bunn H.F., Goldstein D.E. et al: National Diabetes Group: Report of the expert committee on glucosylated hemoglobin.

Diabetes Care 7: 602 – 606 (1984).

7. Koenig R.J., Petersen C.M., Kilo C et al: Hemoglobin A1c as an indicator of the degree of glucose intolerance in diabetes.

Diabetes 25: 230 – 232 (1976).

8. Nathan D.M., Singer D.E., Hurxthal K. and Goodson J.D.: The clinical information value of the glycosylated hemoglobin assay. NE J Med 310: 341 – 346 (1984).

9. McCarren M: DCCT and its works: Intensive therapy reduces the risk of diabetic eye, kidney, and nerve disease. Diabetes Forecast 49 – 51 (September 1993).

10. Larsen M.L., Horder M, and Mogensen E.F.: Effect of long-term monitoring of glycosylated hemoglobin levels in insulin-dependent diabetes mellitus. NE J Med. 323: 1021 – 1025 (1990).

11. Nathan D.M.: Hemoglobin A1c – Infatuation or the real thing? NE J Med. 323: 1062 – 1063 (1990).

Read this and more articles plus references at www.PhysiciansOfficeNews.com 35

2018 - Issue 9

PRODUCTFOCUS #5188

Pronto® Pulse CO-Oximeter®

PHYSICIANS office RESOURCE

From Masimo

Pronto® Pulse CO-Oximeter® with rainbow® Technology for Noninvasive Spot-Checking of Total Hemoglobin (SpHb®) and SpO2 in a Handheld device.

Featuring Masimo SET® Measure-through Motion and Low Perfusion™ Pulse Oximetry Technology: > Helps clinicians monitor more than 100 million patients a year1 > Used by the top 10 U.S. hospitals listed in the 2017-18 U.S. News and World Report Best Hospitals Honor Roll2 1 Estimate: Masimo data on file. 2 http://health.usnews.com/healthcare/best-hospitals/articles/best-hospitals-honor-roll-and-overview

View Brochures, Videos, & More at: POR.io Enter Number 5188 in the Search Area

Lightweight Handheld Spirometer From Vitalograph

Vitalograph’s In2itive combines the benefits of full spirometry, data integration and mobility in a small lightweight handheld spirometer.

The In2itive features flow measurement with the robust, industry leading accuracy of the Fleisch pneumotach. The spirometer can store over 10,000 patients in memory, archive to a MicroSD memory card or synchronize seamlessly with the new Spirotrac V spirometry software. Printing is accomplished by quickly downloading to the included Vitalograph Reports software or via an optional accessory print cradle directly to standard office printers. The In2uitive has a color touchscreen featuring audible graphic incentives. Portability is enhanced with full day rechargeable battery life. A unique aspect of the product is a convertible flow head, which can either be mounted directly on the top of the device or separated to allow it to be held by the patient while the technician holds the device.

#5189

View Brochures, Videos & More at: POR.io Enter Number 5189 in the Search Area

#5190

The RX daytona+ From Randox

A bench-top, fully automated, random-access chemistry analyzer, providing routine and specialized testing with emergency STAT sampling functionality. Demonstrating unparalleled versatility, the RX daytona+ combines robust hardware and intuitive software with the world-class RX series test menu, including specific proteins, lipids, therapeutic drugs, drugs of abuse, antioxidants and diabetes testing. The RX daytona+ ensures unrivalled precision, reliability and accuracy for results you can trust.

View Brochures, Videos & More at: POR.io Enter Number 5190 in the Search Area 36

www.PhysiciansOfficeResource.com

AMH Total βhCG (5th IS) DHEA-S Sensitive Estradiol Unconjugated Estriol hFSH

hLH

Inhibin A Progesterone Prolactin SHBG Testosterone

A COMPREHENSIVE MENU TO ANSWER LIFE’S REPRODUCTIVE CONCERNS Two new reproductive assays provide you with more options for testing.

Our comprehensive menu of reproductive immunoassays helps to support healthcare for men, women and children. Our newest reproductive health assays, Access AMH and Access Sensitive Estradiol, support global fertility assessment and hormone monitoring.

› Access AMH, the only automated AMH assay to use a human recombinant antigen, delivers consistent and dependable results for assessing ovarian reserve

› Access Sensitive Estradiol assay has the broadest measuring range, surpassing IVF guidelines for hyper-response, in addition to offering pediatric reference ranges

› Access 2 immunoassay system, a powerful and reliable benchtop analyzer, features a space-saving design and user-friendly features

Learn more at beckmancoulter.com/reproductive

#5191 © 2018 Beckman Coulter, Inc. All rights reserved. Beckman Coulter, the stylized logo and the Beckman Coulter product and service marks mentioned herein are trademarks or registered trademarks of Beckman Coulter, Inc. in the United States and other countries.

For more information, visit www.beckmancoulter.com/contact.

AD-103964 For distribution only in the following region(s): U.S.

37

#5192

Drugs of Abuse Testing and Routine Chemistry Panels on a Single Analyzer From Carolina Liquid Chemistries

PHYSICIANS office RESOURCE

2018 - Issue 9

PRODUCTFOCUS

Carolina Liquid Chemistries Corp. announces the successful launch of Medica Corporation’s high-speed benchtop analyzer, the EasyRA®.

The updated analyzer now operates at a photometric rate of up to 240 tests per hour or up to 480 tests per hour with ISE. The EasyRA urine drug screening and general chemistry reagents are CLIA categorized as moderately complex. This all-in-one system allows clinical laboratories to screen for drugs of abuse in urine while also allowing healthcare providers to assess routine chemistry panels on a single analyzer.

View Brochures, Videos & More at: POR.io Enter Number 5192 in the Search Area

#5193

The NanoEnTek FREND Immunoassay System From NanoEnTek

The NanoEnTek FREND Immunoassay System provides Vitamin D, TSH, fT4, PSA, and Testosterone results in minutes with a nocost placement program. Complete all 5 tests in less than 20 minutes for same visit patient consultation. PSA and TSH results are available in 3 minutes or less. Imagine having a new source of revenue with improved practice efficiency and patient satisfaction. Thoughtfully designed, with your practice in mind.

View Brochures, Videos & More at: POR.io Enter Number 5193 in the Search Area

#5194

EZ 2-Part Reagent Vitamin D From Carolina Liquid Chemistries

Carolina Liquid Chemistries Corp., also known as The Reagent Company, has recently added to their menu the EZ Vitamin D assay. The EZ Vitamin D Assay is the first and only 2-part, latex enhanced immunoturbidimetric assay for use on automated chemistry analyzers. It is FDA Cleared, recognizes both 25-OH Vitamin D2 and D3 equally, and is a 20part (R1 and R2) liquid ready to use reagent with no sample pretreatment required.

View Brochures, Videos & More at: POR.io Enter Number 5194 in the Search Area 38

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#5196

39

DON’T GIVE HEART DISEASE A CHANCE.

IDENTIFY CARDIOVASCULAR AND DIABETES RISKS IN ONLY 5 MINUTES The Alere Cholestech LDX® System provides lipid profile with glucose results from a small finger stick sample. n

Lab-accurate, rapid and easy to use

n

CLIA-Waived—no special training required

n

Reimbursed by Medicare and most private payers

Actionable results create immediate coachable moments with patients. See why Alere Cholestech LDX® is the #1 choice

#5197

of finger stick lipid testing by physicians.

TO LEARN MORE, VISIT LDX.POR.IO. © 2018. All rights reserved. Alere Cholestech LDX is a trademark of the Abbott group of companies. Any photos displayed are for illustrative purposes only.

Any 40person depicted in such photos is a model. CVD141562 10004216 09/18 www.PhysiciansOfficeResource.com