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Transforming Lives

Priority on prevention

Annual checkup:

As a result of recent health care reform legislation, most health insurance plans allow you to receive certain eligible preventative care services without co-payments or other cost sharing when these services are provided by an in-network provider.
This means that certain eligible preventative services, including screenings, checkups and counseling, are covered with no out-of-pocket cost if you:
  • See an in-network health care professional; and
  • Receive only preventative care services during your visit.

Preventive Services Covered Under the Affordable Care Act

If you have a new health insurance plan or insurance policy beginning on or after September 23, 2010, the following preventive services must be covered without your having to pay a copayment or co-insurance or meet your deductible. This applies only when these services are delivered by a network provider.

16 Covered Preventive Services for Adults

  • Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked
  • Alcohol Misuse screening and counseling
  • Aspirin use for men and women of certain ages
  • Blood Pressure screening for all adults
  • Cholesterol screening for adults of certain ages or at higher risk
  • Colorectal Cancer screening for adults over 50
  • Depression screening for adults
  • Type 2 Diabetes screening for adults with high blood pressure
  • Diet counseling for adults at higher risk for chronic disease
  • HIV screening for all adults at higher risk
  • Immunization vaccines for adults–doses, recommended ages, and recommended populations vary:
    • Hepatitis A
    • Hepatitis B
    • Herpes Zoster
    • Human Papillomavirus
    • Influenza (Flu Shot)
    • Measles, Mumps, Rubella
    • Meningococcal
    • Pneumococcal
    • Tetanus, Diphtheria, Pertussis
    • Varicella
  • Obesity screening and counseling for all adults
  • Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
  • Tobacco Use screening for all adults and cessation interventions for tobacco users
  • Syphilis screening for all adults at higher risk
 

22 Covered Preventive Services for Women, Including Pregnant Women

The eight new prevention-related health services marked with an asterisk ( * ) must be covered with no cost-sharing in plan years starting on or after August 1, 2012.

  • Anemia screening on a routine basis for pregnant women
  • Bacteriuria urinary tract or other infection screening for pregnant women
  • BRCA counseling about genetic testing for women at higher risk
  • Breast Cancer Mammography screenings every 1 to 2 years for women over 40
  • Breast Cancer Chemoprevention counseling for women at higher risk
  • Breastfeeding comprehensive support and counseling from trained providers, as well as access to breastfeeding supplies, for pregnant and nursing women*
  • Cervical Cancer screening for sexually active women
  • Chlamydia Infection screening for younger women and other women at higher risk
  • Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, not including abortifacient drugs*
  • Domestic and interpersonal violence screening and counseling for all women*
  • Folic Acid supplements for women who may become pregnant
  • Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes*
  • Gonorrhea screening for all women at higher risk
  • Hepatitis B screening for pregnant women at their first prenatal visit
  • Human Immunodeficiency Virus (HIV) screening and counseling for sexually active women*
  • Human Papillomavirus (HPV) DNA Test: high risk HPV DNA testing every three years for women with normal cytology results who are 30 or older*
  • Osteoporosis screening for women over age 60 depending on risk factors
  • Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
  • Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
  • Sexually Transmitted Infections (STI) counseling for sexually active women*
  • Syphilis screening for all pregnant women or other women at increased risk
  • Well-woman visits to obtain recommended preventive services*

(Effective August 1, 2012)

 
Dr. Litvinova does not believe that preventative care services covered by recent Health Care Reform give the full information about person’s health and can result in missing possibility to early diagnose and prevent potentially serious and complex medical conditions. For this reason Dr. Litvinova performs additional tests and screenings to ensure that these conditions are prevented, diagnosed and treated at very early stages. These tests include:
  • Vitamin level screening
  • Thyroid panel screening
  • STD screening for sexually active patients
  • Hepatitis screening
  • Complete Urinalysis
  • ECG
  • Glaucoma screening
  • Hearing tests
  • Broncho evaluation test
  • Ankle-Brachial Index (ABI) test
Dr. Litvinova believes that these services are giving the much better picture of the patient health, and would help early diagnose, address and prevent many chronic conditions including, but not limited to:
  • Chronic fatigue
  • Frequent headaches
  • Glaucoma
  • Hashimoto disease
  • Hepatitis
  • Heart problems
  • Hearing loss
  • Blood circulation and blood vessels problems
  • Sexually transmitted diseases
For your annual checkup, please fast for at least 8 hours prior to being seen by the Dr. Litvinova and her staff.

Infectious diseases consultation and treatment

Do you recognize the potential danger of various infections? 

Our goal is to provide you with consultations, preventive measures, diagnosis and treatment of infectious diseases, including sexually transmitted diseases (STD’s), Hepatitis A/B/C and HIV. 

Please read the following information carefully and immediately consult our specialist if you discover any potential of infection presence.

Sexually Transmitted Diseases

STD’s often do not cause visible symptoms. Nevertheless, you do need medical consultation if you have recently discovered abnormal vaginal dischargebumps and sores, burning or itching in the vaginal area, burning or pain during urinationpain during sex, pain in the pelvic or abdominal region, or abnormal discharge from the penis.

HIV

Early symptoms of HIV infection can include fatigue, fever, headache, rash, sore throat, and swollen lymph glands. Anyhow, the only sure way to tell if you have HIV is to get yourself tested. Our services for patients with HIV include evaluation of the stage of infection, diagnosis and prophylaxis of opportunistic infections, ascertaining need for anti-retroviral therapy, and clinical follow-up. 

Hepatitis A, B and C

Hepatitis is an acute infectious disease of the liver, caused by a virus. Hepatitis A does not become chronic, Hepatitis B is unlikely to become chronic, while Hepatitis C is very likely to become chronic and cause long-term health problems. The common symptoms of Hepatits are dark urine, fatigue, jaundice, low appetite, scarring of the liver and stomach pain. We provide diagnosis and treatment of any type of Hepatitis.

Travel medicine and Vaccination

Are you going to take care of your health before making a trip?

It is believed that tickets, passport and visa issues are the first priority for travelling. We are sure that it is your health what has to be put first.

In our globalized world, about 1 million people travel internationally every day. In many developing and tropical countries, vaccine-preventable diseases like cholera, dengue, malaria, and typhoid still are a significant threat. The favourite holiday destinations like Tanzania, Egypt, Laos and Cambodia are evaluated as high-risk countries where infections may cause serious health problems and result in an international evacuation. Even large rapidly developing countries like Argentina, Russia or Indonesia provide high quality health care only in major cities while the rest of country lacks medical assistance.

Even if you do not go abroad, prevention of infection-related diseases is surely important for daily life at home as well.

Vaccination helps to avoid health risks resulting from travelling to tropical and developing countries or from the local vaccine-preventable diseases. We provide vaccinations and medicine services to travellers heading overseas, as well as seasonal and routine immunizations.

Our travel medicine services include personalised health risk assessment, tailored to your destination, and vaccinations for going to any country in the world. If you are visiting BrazilChinaIndiaKenyaPeruSouth AfricaThailand or Vietnam we do recommend you to consider vaccination.

We offer a complete range of vaccinations to prevent risk of chickenpoxcholera, diphtheria, fluhepatitismalaria,meningitis, poliomyelitis, rabies, typhoid, yellow fever, etc.

Protect yourself now by timely vaccination!

Bioidentical Hormone Replacement Therapy (BHRT)

What is Bioidentical Hormone Replacement Therapy (BHRT)?

Hormones are chemical messengers that control important physiological processes.  Sooner or later all people experience a significant drop in hormone levels. This hormonal deficiency is often linked with women’s menopause and men’s andropause. BHRT helps hormones remain at an optimal level, replacing hormonal deficiencies with the use of hormones that have a molecular structure identical to the hormones that are produced in the human body. Unlike synthetic hormones, bioidentical hormones are believed to be accepted more effectively and do not cause side effects experienced with conventional HRT. You probably need BHRT if you are older than 25 and are experiencing any of these symptoms:

  • Chronic fatigue
  • Concentration problems
  • Enlarged Prostate
  • Erectile disfunction
  • Hot flashes
  • Insomnia
  • Irregular periods
  • Male pattern baldness
  • Mood swings
  • Vaginal dryness

Our approach to BHRT

Upon making a precise assessment of your hormone levels, we provide an individual therapy based on your personal needs and symptoms and closely monitor your health during treatment. We also recommend specific diet, vitamins and herbs to augment BHRT. To prevent the risk for cancer associated with hormone replacement we use the lowest hormones dosage for the shortest time needed.

Bioidentical Estrogen Replacement Therapy for Women

There is a stage in a woman’s life like menopause when her estrogen level drops and, finally, her periods stop permanently. The most common menopause symptoms are:

  • Chronic fatigue
  • Hot flashes
  • Insomnia
  • Irregular periods
  • Mood swings
  • Night sweats
  • Osteoporosis
  • Reduced libido
  • Urinary incontinence
  • Vaginal dryness

BHRT proved to be an effective way to restore estrogen level, which improves both health and appearance. Why is estrogen replacement effective to treat symptoms of menopause?

There is a certain type of estrogen, estradiol, which affects many important health abilities. In many studies, it has been shown to be important for arteries, blood coagulation, bones, cognitive and memory functions, energy production, fine motor coordination, hair, heart, integrity of the vaginal wall, serotonin provision and skin.

The popular forms of biodentical estrogen products are pills, patches, vaginal rings, gels or sprays.

Bioidentical Testosterone Replacement Therapy for Men

For men, BHRT is a beneficial way to treat symptoms of andropause. In andropause there is deficiency of testosterone. The most common andropause symptoms are:

  • Depression
  • Erectile dysfunction
  • Loss of energy and concentration
  • Low libido
  • Mood swings

The popular biodentical testosterone products are creams and gels, injectable testosterone, troches, and implantable pellets. As transdermal testosterone can be accidentally transferred to other people through the clothes, or by intimacy, testosterone injections, pellets and troches are better options for men who are married, or have small children. Besides, with implanted pellets, you will be free from regular use of creams, troches and injections.

Side effects

Men and women have experienced increased aggressiveness, acne, irritability, breast tenderness, spotting, cramping, bloating and itching initially with BHRT, but these symptoms are generally resolved as the body adjusts to treatment.

The male-specific side effects can be gynecomastia, hair loss, impotence, belly fat gain, liver cyst and low libido. These issues have to be prevented by appropriate medications and diet.

Fertility Issues

Infertility

Infertility is a unique medical condition because it involves a couple, rather than a single individual. It is defined as failure of a couple to conceive after 12 months of regular intercourse without use of contraception in women less than 35 years of age; and after six months of regular intercourse without use of contraception in women 35 years and older.

CAUSES OF INFERTILITY — The World Health Organization (WHO) task force on Diagnosis and Treatment of Infertility performed a study of 8500 infertile couples and utilized standard diagnostic criteria to determine the medical conditions contributing to infertility. In developed countries, female factor infertility was reported in 37 percent of infertile couples, male factor infertility in 8 percent, and both male and female factor infertility in 35 percent. Five percent of couples had unexplained infertility and 15 percent became pregnant during the study. This study illustrates that infertility should not be assumed to result primarily from disorders in the female partner.

Some causes of infertility are easily identifiable, such as azoospermia (no sperm cells in the ejaculate), longstanding amenorrhea, or bilateral tubal obstruction. However, the situation is less clear in most couples: the sperm may be reduced in number, but are not absent; there may be oligomenorrhea with some ovulatory cycles; the woman may have partial tubal obstruction; or a menstrual history may suggest intermittent ovulation. It is often difficult to weigh or prioritize these findings when counseling infertile couples or planning treatment programs.

Adding to the complexity of the situation, there are few data regarding the predictive validity of these tests despite their widespread use. Thus, short of the absolute infertility factors mentioned (eg, azoospermia or bilateral tubal obstruction), an abnormal test result cannot be said to be the cause of infertility in a particular couple.

The uncertain causal relationship between an abnormality on infertility testing and the actual cause of infertility makes it difficult to estimate the relative frequency of the causes of infertility. Nevertheless, it is instructive to estimate the frequency with which various factors are found in association with infertility as a rough proxy for their relative importance. One population-based study reported the following results [14]:

  • Male factor (hypogonadism, post-testicular defects, seminiferous tubule dysfunction) — 26 percent
  • Ovulatory dysfunction — 21 percent
  • Tubal damage — 14 percent
  • Endometriosis — 6 percent
  • Coital problems — 6 percent
  • Cervical factor — 3 percent
  • Unexplained — 28 percent

Both partners of an infertile couple should be evaluated for factors that could be impairing fertility. The infertility specialist then uses this information to counsel the couple about the possible etiologies of their infertility and to offer a treatment plan targeted to their specific needs.

It is important to remember that the couple may have multiple factors contributing to their infertility; therefore, a complete initial diagnostic evaluation should be performed to detect the most common causes of infertility, if present. When applicable, evaluation of both partners is performed concurrently [1].

The recognition, evaluation, and treatment of infertility are stressful for most couples [2]. The clinician should not ignore the couple’s emotional state, which may include depression, anger, anxiety, and marital discord. Information should be supportive and informative.