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WHO:

Dr. Gish is a Hepatologist specializing in all forms of liver disease, liver cancer and liver transplant. Dr. Gish has partnered with TeleMed2U to provide telemedicine consultative services for patients with liver disease.

WHAT:

TeleMed2U is a telemedicine-based multi-specialty clinical practice increasing access to specialist providers providing, “healthcare anywhere and everywhere.” The telemedicine consultation will be conducted through our HIPAA and HITECH compliant platform. Connectivity testing will be done in advance to ensure you can connect via our telemedicine platform. Following the consultation, a clinical note will be provided including a summary of your liver consultation with Dr. Gish and his consultative recommendations.

COST:

Payment will be processed through an online secure transaction portal. The fees for consultative services are:

Initial 60 minute consultation per patient: $500.00
Follow Up 30 minute consultation per patient: $300.00

NEXT STEPS:

If you’d like to continue, please click Next to complete the form and we will contact you to schedule connectivity testing. During the test you will have the opportunity to determine the method of providing medical records, discuss appointment availability as well as discuss any additional questions that you have. If you are a healthcare facility interested in services, please complete the form and we can discuss the options that are right for you and your patients.

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You should be aware of the general risks of transmitting information over the Internet, which may not use encryption. You should therefore not share any personal medical information that you would wish to be held confidential in a physician/patient or similar clinical relationship.

The information contained on this website is not intended, should not substitute for, or be used instead of, a clinical or therapeutic relationship with a health care professional who is fully familiar with the specifics of your case. The information on this site may assist you in your personal, general research but none of it constitutes the practice of medicine or any other health care profession.

Nothing in this site is intended as a recommendation or endorsement of any specific tests, products, procedures, healthcare provider, opinions, or other information that may be mentioned in this site. Any reliance on any information provided by the website personnel, others appearing on the site at the invitation of the website and/or other visitors to the site is solely at the user's risk.

E-mail correspondence with Dr. Robert G. Gish Consultants, LLC or any of its employees, or agents, does not create a physician/patient relationship between us or cause Dr. Gish to create or retain any medical records about you, monitor your care, or communicate with your own health care provider.

Always seek the advice of your physician or other qualified health care provider with any questions you have regarding your medical care. If you suspect that you may have a medical condition, or are seeking medical advice or treatment, we recommend that you consult a qualified health professional as soon as possible.

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Elevated Alpha- Fetoprotein

Dec 3, 2019

Elevated Alpha - Fetoprotein / Differential Diagnosis - Hepatocellular Carcinoma and Other Disorders

KEYWORDS

Hepatocellular carcinoma
Alpha-fetoprotein
Chronic hepatitis C virus infection
Chronic hepatitis B virus infection
Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein
Des-gamma-carboxy prothrombin

KEY POINTS

The incidence of cirrhosis-related hepatocellular carcinoma (HCC) is rising in the United
States, with the associated disease burden expected to grow through 2020.
Surveillance with alpha-fetoprotein (AFP) in combination with abdominal ultrasonography every 6 months was once widely recommended for HCC surveillance.
Increased AFP is seen in chronic liver disease without HCC, nonhepatic malignancies, and normal pregnancy; thus, AFP levels must be interpreted within the context of the clinical presentation.
Results of cross-sectional HCC screening studies show the benefit of diagnosing additional cases of HCC with AFP, but highlight the lack of cost-effectiveness owing to the increased false-positive results.
US Food and Drug Administration guidelines for HCC risk assessment include using Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3) with des-gammacarboxy prothrombin (DCP), or the combination of AFP-L3 with AFP and DCP.

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