Blood Tests for Colitis and Crohn's Disease: an Introduction

Blood tests for colitis and Crohn's disease are a relatively new and exciting development that have added significantly to the screening, diagnosis and management of ulcerative colitis and Crohn's disease. Differentiating the two may allow better predictions regarding responses to medical treatments, decisions regarding surgery options and the risks of various complications. Antibodies to various proteins including Baker's or Brewer's yeast (saccharomyces cerevisiae) and bacteria like Escherichia. coli (E. coli) are present in the blood of many people with Crohn's disease but rarely in normal people. Antibodies to a normal cell component, a nuclear protein, is present in most people with ulcerative colitis, a few people with Crohn's whose colitis behaves more like ulcerative colitis than Crohn's, and rarely in normal people.

Antibody tests or serologic markers are blood tests looking for markers of diseases. The serologic markers or antibody tests for ulcerative colitis and Crohn's disease are pANCA and ASCA, OmpC, and CBir1 Flagelin respectively. The latter three blood tests for Crohn's are only available through one laboratory, Prometheus Laboratories, Inc.

Ulcerative colitis is a chronic inflammatory bowel disease (IBD) of unknown cause that only involves the colon. It affects the superficial lining of the colon and rarely causes bowel obstruction (blockage) or perforation (rupture) but frequently causes severe bloody diarrhea, blood in the stool, weight loss, abdominal pain, as well as joint aches or arthritis, skin rashes, eye irritation and occasionally a severe liver disorder known as primary sclerosing cholangitis that can lead to cirrhosis and liver cancer. Ulcerative colitis can be cured by complete removal of the colon but not Crohn's disease.

Blood Tests for Colitis and Crohn's Disease: an Introduction

Crohn's disease can also cause colitis but usually also affects the very end of the small intestine called the ileum (ileitis or regional enteritis). When Crohn's affects only the colon it may be difficult to distinguish it from ulcerative colitis though Crohn's tends to affect the colon in a patchy manner whereas ulcerative colitis is continuous. Crohn's can affect the gastrointestinal tract anywhere from the mouth to the anus and is not curable by removing the colon. It is also frequently associated with bowel strictures (constrictions) causing obstruction that may require surgery. It also may be associated with fistula that are abnormal connections of the intestine to other organs and the skin or it can result in abscesses or perforation requiring surgery It is important to distinguish Crohn's disease from ulcerative colitis since medical treatments and surgical approaches may differ and the types of complications that can occur can be much different.

Traditionally, the diagnosis of ulcerative colitis and Crohn's disease is highly accurate by the appearance of the colon on colonoscopy or x-rays that confirm the presence or absence of involvement of other parts of the intestinal tract. Diagnosis is confirmed by a typical pattern of inflammation of the intestine lining as seen under the microscope on tissue obtained by biopsy during colonoscopy. However, before blood tests were available about 10% of people with IBD were diagnosed as having an indeterminate colitis because the biopsies could not distinguish between the ulcerative colitis and Crohn's disease.

The blood tests currently available are pANCA, anti-ASCA, anti-OmpC, and anti-CBir1 flagelin antibodies. pANCA is the peripheral anti-nuclear antibody. It is an abnormal antibody to nuclear protein of cells and is highly sensitive and specific for ulcerative colitis. The pANCA anbibody has been further divided into subsets by Prometheus Laboratories Inc. Neutrophil-specific pANCA ELISA (NSNA) is positive in the majority of people with ulcerative colitis (UC) and a small subset of people with Crohn's disease that have disease characteristics more like UC. Immunofluorescent cellular staining of neutrophils (NSNA IFA) and enzyme Dnase testing (NSNA DNase sensitivity) is also done as part of the Prometheus IBD Serology 7. The latter test when present in high levels is significantly associated with development of inflammation of the rectal pouch (pouchitis) created when someone has their entire colon removed for ulcerative colitis that does not respond to medical treatment.

ASCA is anti-saccharomyces cerevisiae antibody. Saccharomyces cerevisiae is Brewer's or Baker's yeast. Crohn's patients have a high prevalence of abnormal antibodies to this yeast. Some have suggested that another yeast, Candida albicans, somehow plays a role in this abnormal response. A few people with celiac disease have this antibody present in their blood in the absence of signs of Crohn's disease. OmpC is the abbreviation for an antibody that develops in many Crohn's patients to the outer membrane porin protein of the bacteria E. coli though that bacteria is not thought to be the cause of Crohn's disease. Just recently Prometheus Laboratories added antibody testing for a specific protein on bacteria that constitutes the flagelin or hair like structure on certain bacteria enabling movement and attachment of bacteria in the intestine called CBir1 flagelin.

Future blood tests may include antibodies against certain sugar (mannose) residues in the cell wall of the yeast saccharomyces cerevisiae. Anti-laminaribioside and anti-chitobioside antibodies were recently reported to be present in Crohn's patients who were anti-ASCA negative possibly further strengthening the ability to distinguish them from people with ulcerative colitis. This is also interesting because of suspicions and the lay public interest in the role of sugars or glycans and yeast in IBD. In particular the reports in lay literature of success of carbohydrate specific diet in IBD.

If you have a diagnosis of ulcerative colitis or Crohn's disease these blood tests may be very helpful in your treatment. If you have unexplained abdominal pain, diarrhea, or blood in your stools then these tests should be considered. If you have a diagnosis of irritable bowel syndrome, these tests may exclude ulcerative colitis and Crohn's disease. Since as many as 10% of people with ulcerative colitis and Crohn's disease may also have celiac disease, celiac blood tests should also be considered. Lactose intolerance is also common in IBD, IBS and celiac disease.

Future helpful information on colitis, Crohn's disease, celiac disease, food allergies, food intolerance, food sensitivity, eosinophilic esophagitis and irritable bowel syndrome will be available from Dr. Scot Lewey, the food allergy expert-the food doc at http://www.thefooddoc.com. Information on colitis and Crohn's disease can also be obtained from the Crohn's and Colitis Foundation of America (CCFA, http://www.ccfa.org). Dr. Scot Lewey is a member of the medical advisory panel for the Rocky Mountain Chapter of CCFA. For more information about Prometheus Laboratories Inc. see http://www.prometheuslabs.com. A more detailed explanation of the blood tests can be found in a separate article by the food doc and references below.

Abreu MT et.al. Use of Serologic Tests in Crohn's Disease. Clinical Gastroenterology and Hepatology. Vol.4, No. 3. 2001

Dotan I et.al. Antibodies Against Laminaribioside and Chitiobioside Are Novel Serologic Markers in Crohn's Disease. Gastroenterology. Vol.131, No. 2. 2006

Mei, L et.al. Familial Expression of Anti-Escherichia coli Outer Membrane Porin C in Relatives of Patients with Crohn's Disease. Gastroenterology. Vol. 130, No. 4 2006

Stadaert-Vitse et.al. Candida albicans Is an Immunogen for Anti-Saccharomyces cerevisiae Antibody Markers of Crohn's Disease. Gastroenterology. Vol 130, No. 6. 2006

Targan, SR et.al. Antibodies to Cbir1 Flagelin Define a Unique Response That Is Associated Independently Crohn's Disease. Gastroenterology. Vol.128, No.7. 2005

Copyright The Food Doc, LLC, 2006. All Rights Reserved. http://www.thefooddoc.com

Blood Tests for Colitis and Crohn's Disease: an Introduction
Check For The New Release in Health, Fitness & Dieting Category of Books NOW!
Check What Are The Top Cooking Books in Last 90 Days Best Cheap Deal!
Check For Cookbooks Best Sellers 2012 Discount OFFER!
Check for Top 100 Most Popular Books People Are Buying Daily Price Update!
Check For 100 New Release & BestSeller Books For Your Collection

Dr. Scot Lewey, the food doc, is a practicing stomach and intestine specialist (gastroenterologist) who is an expert in colitis, Crohn's disease, food allergy, food intolerance, gluten sensitivity, celiac disease, irritable bowel syndrome and eosinophilic esophagitis. He has a website http://www.thefooddoc.com under development to help people with these conditions get expert doctor information, free symptom assessment online and the use of an online food diet symptom diary.

watches cell phone Discount Everlast Protex 3 Evergel Training Gloves Cheap Rugged Ridge 53703 52 Soft Top With

S.M.A.R.T. Goals

(excerpted from the Jim Rohn One-Year Success Plan)

Jim Rohn's Second Pillar of Success: Goal-Setting, Part Three - S.M.A.R.T. Goals

Hi, Jim Rohn here. As you know, we are focused on the Second Pillar of Success this month - Goal-Setting.

S.M.A.R.T. Goals

We have introduced the four main components of Goal-Setting:

1. Evaluation and Reflection.

The only way we can reasonably decide what we want in the future and how we will get there, is to first know where we are right now and secondly, what our level of satisfaction is for where we are in life. As we focus this month on goal-setting, our first order of business and our topic two weeks ago was evaluation and reflection.

2. Dreams and Goals.

What are your dreams and goals? Not related to the past or what you think you can get, but what you want. Have you ever really sat down and thought through your life values and decided what you really want? This isn't something that someone else says you should have or what culture tells us successful people do or have. These are the dreams and goals that are born out of your own heart and mind. These are the goals that are unique to you and come from who you were created to be and gifted to become. Last week we showed you exactly how to find out what you want from life.

3. S.M.A.R.T. Goals.

S.M.A.R.T. means Specific, Measurable, Attainable, Realistic, and Time-sensitive.

Specific: Don't be vague. Exactly what do you want?

Measurable: Quantify your goal. How will you know if you've achieved it or not?

Attainable: Be honest with yourself about what you can reasonably accomplish at this point in your life - along with taking into consideration your current responsibilities.

Realistic: It's got to be do-able, real and practical.

Time: Associate a timeframe with each goal. When should you complete the goal?

We will spend time this week looking at how to apply the S.M.A.R.T. test to your goals to make sure they are as powerful as they can be!

4. Accountability.

Think of the word "accountable." It means to "give an account." When someone knows what your goals are, they help hold you accountable. Whether it is someone else going through this program with you (have you thought about inviting a friend to join you on this one-year journey?) or just someone you can give the basic idea to, having a person who can hold you accountable will give you another added boost to getting your goals! Next week we will show you how to set up an accountability partner.

This week we will be discussing point 3 - S.M.A.R.T. Goals.

S.M.A.R.T. means Specific, Measurable, Attainable, Realistic, and Time-sensitive.

I really like this acronym S.M.A.R.T., because we want to be smart when we set our goals. We want to intelligently decide what our goals will be so that we can actually accomplish them. We want to set the goals that our heart conceives, that our mind believes and that our bodies will carry out. Let's take a closer look at each of the components of S.M.A.R.T. goals:

Specific: Goals are no place to waffle. They are no place to be vague. Ambiguous goals produce ambiguous results. Incomplete goals produce incomplete futures.

When we are specific, we harness the power of our dreams and set forces into action that empower us to achieve our goals. We then know exactly what it is we are shooting for. There is no question. As we establish our priorities and manage our time, we do so for a specific goal to achieve the results we expect. There is no wondering or guessing. The future is locked into our minds and we see it - specifically - and that is powerful! Never underestimate just how important it is to have very specific, concrete goals. They act as magnets that draw you toward them! A S.M.A.R.T. goal is specific.

Measurable: Always set goals that are measurable. I would say "specifically measurable" to take into account our principle of being specific as well. Our goals should be such that we know when we are advancing and by how much. Whether it is by hours, pounds, dollars or whatever, we should be able to see exactly how we are measuring up as we proceed through the journey of life using our goals. Could you imagine if you didn't measure your goals? You would never know which way you were going or even if you were going anywhere! A S.M.A.R.T. goal is measurable.

Attainable: One of the detrimental things that many people do - and they do it with good intentions - is to set goals that are so high they are unattainable. Yes, it is very important to set big goals that cause your heart to soar with excitement, but it is also imperative to make sure that they are attainable. In the next section we talk about being realistic. So what does it mean to be attainable? An attainable goal is one that is both realistic but also attainable in a shorter period of time than what you have to work with. Now when I say attainable, I don't mean easy. Our goals should be set so they are just out of our reach; so they will challenge us to grow as we reach forward to achieve them. After the next paragraph, I will give you an example of a goal that is both attainable and realistic. A S.M.A.R.T. goal is attainable.

Realistic: The root word of realistic is "real." A goal has to be something that we can reasonably make "real" or a "reality" in our lives. There are some goals that simply are not realistic. You have to be able to say, even if it is a tremendously stretching goal, that yes, indeed, it is entirely realistic -- that you could make it. You may even have to say that it will take x, y, and z to do it, but if those happen, then it can be done. This is in no way to say it shouldn't be a big goal, but it must be realistic. This is to a great degree, up to the individual. For one person a goal may be realistic, but for another unrealistic. I would encourage you to be very honest with yourself as you do your planning and evaluation. Perhaps it would be good to get a friend to help you (as long as that friend is by nature an optimist and not a pessimist). This can go a long way toward helping you know what is realistic. A S.M.A.R.T. goal is realistic.

Example of Attainable and Realistic: Knowing that perhaps you could use a bit of help differentiating attainable and realistic, here is an example: You are overweight and have 150 pounds to lose to get to your proper weight. Is that goal attainable? Yes, considering that you also make it realistic. For example, it isn't realistic to think you can do it in 5 months. 18-24 months would be realistic (with hard work). Thus, losing 150 pounds in 2 years is both attainable and realistic, while losing 150 pounds in 5 months is neither attainable nor realistic.

Time: Every goal should have a timeframe attached to it. I think that life itself is much more productive for us as humans because there is a timeframe connected to it. Could you imagine how much procrastination there would be on earth if people never died? We would never get "around to it." We could always put it off. One of the powerful aspects of a great goal is that it has an end, a time in which you are shooting to accomplish it. You start working on it because you know there is an end. As time goes by you work because you don't want to get behind. As it approaches, you work diligently because you want to meet the deadline. You may even have to break down a big goal into different measured parts time frames. That is okay. Set smaller goals and work them out in their own time. A S.M.A.R.T. goal has a timeline.

Be sure to spend some reflection time this week to make sure your goals fit the S.M.A.R.T. parameters. Go through the reflection questions below and the action points associated with them. Doing so will put a real engine in your goals and make them charged with power to help you accomplish your dreams.

Until next week, let's do something remarkable!

Jim Rohn

S.M.A.R.T. Goals
Check For The New Release in Health, Fitness & Dieting Category of Books NOW!
Check What Are The Top Cooking Books in Last 90 Days Best Cheap Deal!
Check For Cookbooks Best Sellers 2012 Discount OFFER!
Check for Top 100 Most Popular Books People Are Buying Daily Price Update!
Check For 100 New Release & BestSeller Books For Your Collection

Reproduced with permission from Jim Rohn's Weekly E-zine. Copyright 2005 Jim Rohn International. All rights reserved worldwide. To subscribe to Jim Rohn's Weekly E-zine, go to [http://Jim-Rohn.InspiresYOU.com]

watch mobile phone Purchase Alps Mountaineering Red Tail 4900 Cubic Inch Cheap Rugged Ridge 53703 52 Soft Top With Cheap Tiffany Office Furniture Tif1010Pcantflk Presentation Stand

UB04 Form - What is a UB04 Form, Where Do I Get One, and How Do I Fill it Out?

Do you need to get a UB04 form completed for an insurance company?  What is a UB04 form?  Where do you find one?  And how do you fill it out?  We run across these questions often in the world of medical billing.  Most medical health insurance claims are filed on CMS 1500 forms (sometimes called HCFA forms).  These are more common to most people.   Many billers don't know when to use the CMS forms and when to use the UB 04 forms.

The UB04 claim form is used by facilities rather than physicians for their health insurance billing.  Hospitals, rehabilitation centers, ambulatory surgery centers, clinics, etc need to bill their services on the UB04 form in order to get paid.  Physician billing is done on the CMS 1500 claim forms. 

Every once in awhile we get a call from a person who is trying to get an insurance claim paid and they are told by the insurance company that they must file the claim on a UB04 claim form.  These people don't have a clue what this form is or how to complete it.  They may have had to admit a loved one into a drug and alcohol rehab facility and now find that the facility doesn't participate with their insurance plan.  These facilities often don't file UB04 forms and can not help the family get reimbursed by the insurance company.

UB04 Form - What is a UB04 Form, Where Do I Get One, and How Do I Fill it Out?

Many times the family has paid up front for the services of the facility and are now trying to get the insurance company to reimburse them.  The insurance policy may pay out of network but the claim must be filed correctly on a UB04 form.  Often times people are trying to collect many thousands of dollars on the claim.  Required fields on the UBO4 form include rev codes, value codes and type of bill.  What do you put in these fields?   These forms can be very confusing.  Where do you get the correct information to complete the forms?  And which fields are required on the form?  If the facility does not have a UB04 form to fill out, where do you get one? 

Unfortunately the answers are not easy.  The Rev codes represent the procedure codes.  The type of bill is a three digit number that represents the type of facility, the bill classification and the frequency of the bill.  The value codes are required fields only in certain situations.  It is very difficult to complete these forms correctly without previous experience or proper training.  Another catch is that the forms were changed in May 2007 to allow for use of the NPI number.  You must understand NPI numbers completely to determine where you should be entering an individual NPI number or a group NPI number.  And when you try to find UB04 forms for sale, you find they are available in boxes of 2500.

If you find yourself needing to file a claim on a UB04 form and don't know what you are doing, make sure you look into it fully.  Claims are often denied time after time for information being incomplete or incorrect.  If your claim is for a lot of money, you may not want to wait months for payment.

Copyright November 2008 - Alice Scott

UB04 Form - What is a UB04 Form, Where Do I Get One, and How Do I Fill it Out?
Check For The New Release in Health, Fitness & Dieting Category of Books NOW!
Check What Are The Top Cooking Books in Last 90 Days Best Cheap Deal!
Check For Cookbooks Best Sellers 2012 Discount OFFER!
Check for Top 100 Most Popular Books People Are Buying Daily Price Update!
Check For 100 New Release & BestSeller Books For Your Collection

Alice Scott and Michele Redmond own and operate a Medical Billing Service. They offer information on completing UB04 forms and getting rehab claims paid on their website. They've written several books on medical billing and starting a medical billing business. They also offer a forum where you can find the answer to many billing questions or leave your own question.

watch mobile phone Cheap Tiffany Office Furniture Tif1010Pcantflk Presentation Stand

It's Easier to Finance a $5,000,000 Apartment Building Than a Single Family Investment Property

Funding has dried up for residential investment property (1-4 family), but it's plentiful for large multi family projects.

1. Funds are available for large multi family properties, but not for residential investment homes.

President Obama said during his Economic Recovery Act Speech, "there is no money available for you speculators" and he meant it. Try to get a loan for a residential (1-4 family) non-owner occupied property and see the results for yourself. There are no more stated income loans available for residential investors. If you have been in the residential investment game for a while, you already know it, if you are just starting out; you will experience this problem on your first residential investment deal. Its cash, hard money at 12% and a 65% LTV or you're done.

It's Easier to Finance a ,000,000 Apartment Building Than a Single Family Investment Property

The good news is that government backed funds are plentiful for larger, multi-family properties. This presents tremendous opportunities for those who know how to access the funding sources.

2. You don't have to personally qualify for the loan the properties qualify.

Imagine that! Anyone who has ever attempted to purchase a residential investment property (1-4 family) has encountered the issue of personally qualifying. Sure the rents may cover part or the entire mortgage, but the lender only considers a percentage of that income toward your ability to pay the new mortgage. You need, tax returns, financial statements, proof of funds for down payment, etc. Not only that, but of course your FICO score becomes a big factor. Get through all of this and every time you buy another residential property your FICO score drops and you are viewed as more of a risk to the lenders. The more successful you become in this arena, the harder it gets......

With commercial financing, the properties qualify for the loan, not you. The loan is not reported to the credit bureau's. The more successful you become, the easier it gets.....

3. Most loans on large multi family properties are fully assumable.

Ever try to assume a residential loan without having to qualify for it? Not happening, at least not since the early 80's when FHA and VA loans went from "fully assumable" to "qualifying assumable". It's the same as having to secure a new purchase money mortgage, so unless the interest rate is very attractive, it's never done. The first home I ever purchased was a little bungalow for ,000. It was 1980, I was 20 years old and didn't qualify for a 0 limit MasterCard, but I assumed a ,000 VA loan, no questions asked. The same criteria hold true to this date for large multi family projects, but very few know about it.

The financing on many large multi family buildings are fully assumable. Remember, the properties qualify not the buyer. You can buy 100 + unit apartment complexes without qualifying, no verification of funds, no credit report, no tax returns, just knowledge.

4. You ARE NOT personally obligated to repay the loan.

Try getting a residential mortgage and tell the lender that you don't want to personally guarantee the loan. Not happening! We are accustomed to all loans carrying personal guarantees. It's incorporated into every residential mortgage, by every lender in the country. Of course they want recourse if you default, they get the property and then have the right to a default judgment for any balance that may be due after they liquidate the property. Residential loans carry "FULL RECOURSE" to the mortgagee.

Larger commercial loans are "NON RECOURSE" to the borrower. The property and its ability to generate cash flow is the lenders security, not you personally.

5. Multi Family Properties are built to CASH FLOW, single family homes are not.

Single family homes are designed, built and price for owner occupants, not for cash flow. Study the numbers on almost any single family home and you will discover that after you pay the mortgage, taxes. Insurance, utilities, maintenance, etc, you will lose money every month. Single family homes are terrible for cash flow despite what the residential guru's on TV tell you.

Multi family properties are designed, built and priced to do one thing and one thing only, "make money". Lenders lend based on the fact that there are sufficient funds to cover the debt obligations, not on what your credit score is, or what the house down the block sold for or what your personal income was last year, etc.....

6. Professionals manage the property- No tenants and toilets to deal with.

With residential investment property YOU generally have to manage it. The property has negative cash flow to begin with; there probably is no budget to hire a management company to run it. You go from watching the guru on TV sitting by the pool telling you how great your new lifestyle is going to be once you buy a couple of homes, to fielding leaking roof calls and clogged drain problems on Saturday nights.

With the larger properties a professional management company handles all of that for you. It's budgeted in just like taxes and maintenance. The lenders require a professional management contract be in place at closing. They handle all the problems; they are staffed for it and deal with repairs, collecting rents, renting vacant units, etc. They send the funds to you. You never have to deal with a single tenant, yet you reap the rewards. Now you have a lifestyle.

There are many more reasons to move from residential to large multi family including dramatically increasing the property's value by simple rent increases, etc. I encourage anyone investing in residential property to take a good look at moving up to larger properties. It's easier than you think when you acquire the knowledge.

Copyright (c) 2009 Joe Florentine

It's Easier to Finance a ,000,000 Apartment Building Than a Single Family Investment Property
Check For The New Release in Health, Fitness & Dieting Category of Books NOW!
Check What Are The Top Cooking Books in Last 90 Days Best Cheap Deal!
Check For Cookbooks Best Sellers 2012 Discount OFFER!
Check for Top 100 Most Popular Books People Are Buying Daily Price Update!
Check For 100 New Release & BestSeller Books For Your Collection

Joe Florentine is a licensed Realtor, award winning builder and developer with 25 years experience in residential investing. Joe recently moved from residential investing to financing and acquiring large multi family projects with great success. He highly recommends Durante Parks' Learn Commercial Financing training program to gain the same knowledge to finance and acquire large multi family projects. Free video to learn more.

watch mobile phone Order Tablespoon Waldorf 7 Micron Silverplated Set Of Discount Everlast Protex 3 Evergel Training Gloves