J Mitch Twining MD

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J Mitch Twining MD

General Practitioners

Arthritis
In this webinar, Ara H. Dikranian, MD and rheumatologist, discusses the clinical significance of diagnostic antibodies and the importance of evaluating not just for specificity, but also for common overlapping conditions. With Quest ANA cascade testing coupled with rheumatoid arthritis (RA) biomarkers, discover how our testing can screen for the more common autoimmune conditions and increase specificity for early RA. Watch webinar

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AKA: Twining J Mitch
Categories: Physicians & Surgeons, Mental Health Services, Physicians & Surgeons, Allergy & Immunology, Physicians & Surgeons, Dermatology, Physicians & Surgeons, Endocrinology, Diabetes & Metabolism, Physicians & Surgeons, Family Medicine & General Practice, Physicians & Surgeons, Gynecologic Oncology, Physicians & Surgeons, Infectious Diseases, Physicians & Surgeons, Internal Medicine, Physicians & Surgeons, Nephrology (Kidneys), Physicians & Surgeons, Neurology, Physicians & Surgeons, Oncology, Physicians & Surgeons, Pediatrics, Physicians & Surgeons, Psychiatry, Physicians & Surgeons, Rheumatology (Arthritis), Skin Care, Stress Management & Prevention

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Phone: (843) 692-0968

Address: 909 Medical Cir, Myrtle Beach, SC 29572

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J Mitch Twining MD

General Practitioners

Arthritis
In this webinar, Ara H. Dikranian, MD and rheumatologist, discusses the clinical significance of diagnostic antibodies and the importance of evaluating not just for specificity, but also for common overlapping conditions. With Quest ANA cascade testing coupled with rheumatoid arthritis (RA) biomarkers, discover how our testing can screen for the more common autoimmune conditions and increase specificity for early RA. Watch webinar
Rheumatology
Our dedicated team of trained rheumatology account executives is exclusively focused on supporting you and your staff to help make test selection and reporting of complex results seamless for you and your patients.
Pediatric Care
America Academy of Pediatrics. Statement of endorsement: Genetic and metabolic testing on children with global developmental delay. Pediatrics. 2012;129(3):e825-e825. doi:10.1542/peds.2011-3485
Primary Care
The problem of autoimmune disease is widespread and becoming more prevalent, affecting an estimated 24 million Americans in the US, many of them undiagnosed.<sup>1</sup> Complicating matters, many autoimmune diseases present with similar yet nonspecific symptoms that in some cases can flare and remit.</p>\r\n<p>As an industry leader in diagnostic testing, Quest Diagnostics is proud to support primary care physicians, and other specialty care providers with innovative autoimmune tests and panels that can help facilitate earlier detection and treatment of autoimmune diseases.<br>\r\n</p>\r\n<p>We offer over 150 specialty tests and panels backed by clinical evidence, aligned with guidelines from leading health organizations, and performed with state-of-the-art automation to reduce subjectivity and help you confidently guide clinical decisions. Quest Diagnostics brings reliable insights, convenience, and technology together so you can take action toward better health for your patients.</p>\r\n"}}" id="text-1a7d198cdc" class="cmp-text">
Infectious Diseases
The pandemic exposed the challenges and opportunities in enabling <a href=\"/content/corporate/us/en/healthcare-professionals/about-our-tests/infectious-diseases/covid-19.html\" title=\"faster and more effective diagnostics\" target=\"_self\">faster and more effective diagnostics</a> for infectious diseases. While vaccines have helped to significantly mitigate the transmission of COVID-19, new variants have proven to be particularly problematic among unvaccinated individuals and high-risk communities.</p>\r\n<p>As these and other barriers take shape during the return to work, school, life, and healthcare, the need for comprehensive, flexible, and adaptive testing programs is evident. While COVID-19 has taken priority, the lessons learned from the pandemic also bring new insights for prevention, diagnosis, and management of future epidemics.</p>\r\n"}}" id="text-1fdb444ce6" class="cmp-text">

Internal Medicine
Nephrology
Chronic kidney disease (CKD) affects 37 million people in the US, but most of them are undiagnosed: 9 in 10 adults with CKD don’t know they have it.<sup>1</sup> These missed diagnoses drive hospitalizations and costs,<sup>2</sup> and risk bad outcomes.<br>\r\n</p>\r\n<p>Quest Diagnostics provides the complete testing and expert guidance you need to diagnose CKD, manage progression, establish follow-ups, and initiate nephrology referrals. With combined insights from eGFR, uACR, and other panels, you can feel empowered to get a complete picture of your patient’s kidney health.</p>\r\n"}}" id="text-749a79dcea" class="cmp-text">
Cervical Cancer
In 2020, researchers at Quest and UPMC published new evidence that the HPV screening test is significantly less likely to detect cervical cancer and precancer than is cotesting, a method that combines HPV and Pap testing using the same specimen.
Cancer Care
Quest Advanced Oncology offers a powerful and comprehensive portfolio of testing that spans the full continuum of cancer care. Quest delivers the resources you need to help make advanced cancer diagnostics more accessible, actionable, and affordable.</p>\r\n"}}" id="text-feed0d3fac" class="cmp-text">

Neurology
We offer a complete portfolio inclusive of molecular, biochemical, neuroimmunological, cytogenetic, and pharmacogenomic testing for the diagnosis of neurological conditions. Our broad menu of over 400 neurology tests, powered by 15 distinct methodologies, provides transformative answers that can end your patient’s diagnostic journey.</p>\r\n"}}" id="text-ee78ba0d3b" class="cmp-text">
Autism
If you suspect a developmental concern in a pediatric patient, swift detection matters. Research shows that early interventions for ASD and developmental delay can greatly improve a child’s development. For these populations, we offer AAP guidelines-based chromosomal microarray analysis (CMA),<sup>3</sup> which has the highest diagnostic yield of any single test for children currently available to clinicians. </p>\r\n<ul>\r\n<li>View our <a href=\"/content/dam/corporate/restricted/documents/hcp/about-our-tests/neurological-disorders/CMA%20Brochure.pdf\" target=\"_self\" title=\"CMA brochure\">CMA brochure</a></li>\r\n<li>Access our <a title=\"CMA prior authorization form\" href=\"/content/dam/legacy/magnolia/documents/clarisure/cma-preauth-fillable/CMA-PreAuth-Fillable.pdf\" target=\"_self\">CMA prior authorization form</a></li>\r\n</ul>\r\n"}}" id="text-4184f6c092" class="cmp-text">
Multiple Sclerosis
Neuroimmunological diseases are complex. Testing for them shouldn’t be. We make advanced neuroimmunology testing more accessible and actionable. Our neuroimmunology portfolio includes testing for myasthenia gravis, paraneoplastic syndromes, autoimmune encephalitis, neuromyelitis optica, peripheral neuropathy, and multiple sclerosis. Our expansive test menu includes over 40 antibodies and utilizes gold-standard methodologies, such as CBA, RIA, and line blot.<sup>5</sup></p>\r\n"}}" id="text-ca961ef54f" class="cmp-text">
Epilepsy
Quest provides a comprehensive test menu of neurological diagnostic testing, including tests used for epilepsy, dementia, paraneoplastic disorders, multiple sclerosis, and myasthenia gravis.

Stress Management
® Program utilizes clinical educators that use the test results to customize each patient’s education about nutrition, exercise, stress management, and therapy adherence, pursuant to each clinician’s treatment plan. Through our combination of lipid testing technology, esoteric testing capability, and patient support services, we provide clinicians and patients with a viable disease management offering for cardiovascular disease prevention.
Psychiatry
7 Taquet M, Geddes JR, Husain M, et al. 6-month neurological and psychiatric outcomes in 236,379 survivors of COVID-19: a retrospective cohort study using electronic health records. Lancet Psychiatry. 2021;8(5):416-427. doi:10.1016/S2215-0366(21)00084-5
Behavioral Health
Drug misuse often occurs unintentionally in any population, which is why we offer a broad array of drug testing for your diverse needs. Whether you are seeking to start a drug monitoring program or to supplement an existing program with additional testing, we offer urine and oral fluid drug testing to meet the needs of healthcare providers, pain specialists, behavioral health specialists, and health systems.<br>\r\n</p>\r\n<p>Our reputation in clinical laboratory diagnostics is built on an unparalleled commitment to service, coupled with our industry-leading, comprehensive drug testing portfolio, including an extensive menu for prescription drugs used in the treatment of anxiety, depression, and substance use disorders; for other controlled medications; and for substances of abuse.</p>\r\n<p>With state-of-the-art technologies, fast turnaround time, easy-to-interpret results and more than 650 on-staff toxicology and medical experts, Quest Diagnostics helps you protect your patients and your practice by helping you make more informed decisions.<br>\r\n</p>\r\n"}}" id="text-e10bbd7ed5" class="cmp-text">

Endocrinologist

Diabetes Care
Fox CS, Sullivan L, D’Agostino R, et al. The significant effect of diabetes duration on coronary heart disease mortality. Diabetes Care. 2004;27(3):704-708. doi:10.2337/diacare.27.3.704
Endocrinology
Hypothyroidism
Powering better outcomes for your patients with memory loss</p>\r\n<p>Quest and uMETHOD are redefining what’s possible for dementia and Alzheimer's patients.</p>\r\n<p>At Quest, we know that some memory loss occurs as we get older, but dementia and Alzheimer’s disease are not a normal part of aging. While dementia is the #1 health concern of many retired people,<sup>4</sup> only 1 in 7 of those 65 years or older are screened for memory loss.<sup>5</sup></p>\r\n<p>Quest is committed to bringing 2 powerful solutions together–uMETHOD's groundbreaking AI-based technology and our advanced lab testing–to help you analyze your patient’s risk factors and create a personalized care plan that can make a real difference.</p>\r\n<ul>\r\n<li><b>Pharmacological and supplementation-based treatment</b> for conditions such as insulin resistance, hypothyroidism, and nutritional deficiencies, etc</li>\r\n<li><b>Improved lifestyle habits</b> including exercise, sleep, stress reduction, and diet</li>\r\n<li><b>Medication management</b> to quickly reduce brain fog and resolve interactions</li>\r\n</ul>\r\n"}}" id="text-4415e89fd1" class="cmp-text">
Thyroid
Below is a list of limited coverage policies for certain tests or test groups. Click on the link to ﬁnd your patient's Blue Cross Blue Shield home plan coverage limitations and indications within the BCBS policy.</p>\r\n<p><b>Alabama</b></p>\r\n<ul>\r\n<li><a href=\"https://al-policies.exploremyplan.com/portal/web/medical-policies/-/mp-732?inheritRedirect=true&redirect=https%3A%2F%2Fal-policies.exploremyplan.com%2Fportal%2Fweb%2Fal-policies%2Fhome%3Fp_p_id%3Dcom_liferay_portal_search_web_portlet_SearchPortlet%26p_p_lifecycle%3D0%26p_p_state%3Dmaximized%26p_p_mode%3Dview%26_com_liferay_portal_search_web_portlet_SearchPortlet_redirect%3Dhttps%253A%252F%252Fal-policies.exploremyplan.com%252Fportal%252Fweb%252Fal-policies%252Fhome%253Fp_p_id%26_com_liferay_portal_search_web_portlet_SearchPortlet_mvcPath%3D%252Fsearch.jsp%26_com_liferay_portal_search_web_portlet_SearchPortlet_keywords%3Dvitamin%2Bd%26_com_liferay_portal_search_web_portlet_SearchPortlet_formDate%3D1611689149126%26_com_liferay_portal_search_web_portlet_SearchPortlet_scope%3Dthis-site\" title=\"go to vitamin D testing page for alabama on Blue Cross Blue Shield site\">Vitamin D</a></li>\r\n</ul>\r\n<p><b>Arkansas</b></p>\r\n<ul>\r\n<li><a href=\"https://secure.arkansasbluecross.com/members/report.aspx?policyNumber=2018006\" title=\"go to vitamin D testing page for arkansas on Blue Cross Blue Shield site\">Vitamin D</a></li>\r\n</ul>\r\n<p><b>North Carolina</b></p>\r\n<ul>\r\n<li><a href=\"https://www.bluecrossnc.com/sites/default/files/document/attachment/services/public/pdfs/medicalpolicy/vitamin_b12_and_methylmalonic_acid_testing.pdf#search=82607,\" title=\"Vitamin B12 and Methylmalonic Acid Testing\">Vitamin B12 and Methylmalonic Acid Testing</a></li>\r\n<li><a href=\"https://www.bluecrossnc.com/sites/default/files/document/attachment/services/public/pdfs/medicalpolicy/vitamin_d_testing.pdf#search=82306,\" title=\"go to vitamin D testing page for north carolina on Blue Cross Blue Shield site\">Vitamin D</a></li>\r\n</ul>\r\n<p><b>South Carolina</b></p>\r\n<ul>\r\n<li><a href=\"https://www.southcarolinablues.com/web/public/brands/medicalpolicy/external/external-policies/vitamin-b12-and-methylmalonic-acid-testing/\" title=\"Vitamin B and Methylmalonic\" target=\"_blank\">Vitamin B and Methylmalonic</a></li>\r\n<li><a href=\"https://www.southcarolinablues.com/web/public/brands/medicalpolicy/external/external-policies/vitamin-d-testing/\" title=\"Vitamin D Testing\" target=\"_blank\">Vitamin D Testing</a></li>\r\n<li><a href=\"https://www.southcarolinablues.com/web/public/brands/medicalpolicy/external/external-policies/thyroid-disease-testing/\" title=\"Thyroid Disease Testing\" target=\"_blank\">Thyroid Disease Testing</a></li>\r\n</ul>\r\n"}}" id="text-0d12e8121e" class="cmp-text">

Skin Cancer
<b>Supporting excellence in cancer care through precision medicine solutions</b></p>\r\n<p>Quest Diagnostics offers decision-support tools to help physicians develop a treatment plan for navigating the standard of care and clinical trial options, and beyond. We offer disease-specific panels for prognosis and treatment decisions, as well as a comprehensive guideline-driven 49-gene panel, to make treatment decisions based on the mutations found in the individual’s tumor sample. Our solid tumor solutions include such cancer types as:</p>\r\n<p>⦁ Breast<br>\r\n⦁ Cervical<br>\r\n⦁ GI, Colorectal<br>\r\n⦁ Lung<br>\r\n⦁ Melanoma<br>\r\n⦁ Prostate<br>\r\n⦁ Thyroid</p>\r\n"}}" id="text-29d2272e84" class="cmp-text">
Psoriasis
<br>\r\nPsoriatic arthritis (PsA) occurs in about 10% to 20% of people with psoriasis.<sup>9</sup> While PsA is similar to RA, it is more serious, because it extends to the joints, ligaments, and tendons.</p>\r\n<p>Evaluation of a patient for psoriatic arthritis may include a personal and family history and a physical exam. Helpful laboratory tests include<sup>10</sup>:</p>\r\n<ul>\r\n<li>Rheumatoid factor and cyclic citrullinated peptide antibody to rule out RA</li>\r\n<li>C-reactive protein and/or erythrocyte sedimentation rate to document inflammation</li>\r\n<li>Hemoglobin or CBC to test for anemia</li>\r\n</ul>\r\n<p><b>A marker of erosive arthritis in psoriasis: the 14-3-3η protein</b><br>\r\n</p>\r\n<p>Patients with psoriasis have normal 14-3-3η levels, as do psoriasis patients with nonerosive arthritis. However, patients with erosive psoriatic arthritis may have elevated 14-3-3η. As a result, elevations in 14-3-3η in followed psoriasis patients may herald onset of erosive disease.<sup>11 </sup>Quest incorporates a longitudinal view of the patient’s 14-3-3η test results for ease of monitoring.</p>\r\n<p><b>Psoriatic arthritis tests<i>:<br>\r\n </i></b></p>\r\n"}}" id="text-af70160104" class="cmp-text">

Allergies
Allergies affect tens of millions of adults and children in the United States. According to the CDC, over 19 million adults and over 5 million children in the US suffer from seasonal allergies (hay fever), and over 4.5 million children have food allergies.<sup>1</sup></p>\r\n<p>Allergy testing can help your patient know what exposures to avoid, and just as important, what exposures are safe. The ImmunoCAP IgE blood test from Quest Diagnostics makes it possible to easily identify allergen-specific triggers, for improved patient management and outcomes.</p>\r\n"}}" id="text-89e8094b46" class="cmp-text">

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