Can an emergency room remove a cyst. What is the difference between a cyst and an abscess. When should you seek emergency care for skin infections. How are skin abscesses treated in the ER.

Understanding Skin Infections and Abscesses

Skin infections and abscesses are common medical conditions that can cause discomfort and, in some cases, require immediate medical attention. To better understand these issues, let’s explore their causes, symptoms, and when to seek professional help.

What is a Skin Abscess?

A skin abscess is a localized collection of pus that forms in response to an infection or the presence of foreign material under the skin. It typically appears as a swollen, painful area on the skin’s surface and can develop due to various factors, including:

• Bacterial infections
• Inflammation of sweat glands or hair follicles
• A weakened immune system
• Chronic medical conditions

The body’s immune system creates a capsule or cavity to contain the infection and prevent it from spreading. As the abscess progresses, the inside liquefies, forming pus composed of dead cells, bacteria, proteins, and other debris.

Cyst vs. Abscess: Key Differences

While cysts and abscesses may appear similar, there are crucial differences between the two:

• Cysts are typically non-infected, fluid-filled sacs
• Abscesses are infected and contain pus
• Cysts can become infected and develop into abscesses

Are antibiotics effective for treating both cysts and abscesses? Antibiotics are often used to treat cysts, but abscesses require more than just antibiotic treatment. An abscess must be opened and drained to heal properly.

Risk Factors for Skin Abscess Development

Several factors can increase the likelihood of developing skin abscesses or experiencing recurrent infections. These include:

1. Diabetes
2. Chemotherapy treatment
3. Chronic steroid therapy
4. Autoimmune conditions like lupus
5. Cancer
6. Kidney failure requiring dialysis
7. Sickle cell anemia
8. HIV/AIDS
9. Inflammatory bowel diseases (Crohn’s disease, ulcerative colitis)
10. Peripheral vascular disease
11. Severe burns or trauma
12. Intravenous drug use
13. Alcoholism
14. Skin injections (tattoos, medical procedures, or prescription drugs)

Do certain medical conditions make you more susceptible to skin abscesses? Yes, individuals with weakened immune systems, chronic diseases, or those undergoing specific medical treatments are at a higher risk of developing skin abscesses.

When to Seek Medical Care for Skin Infections

While some skin abscesses may heal on their own, certain situations require professional medical evaluation to prevent complications. Consider seeking medical care if:

• The infected area is larger than 1 cm (1/2 inch) across
• The sore continues to enlarge and become more painful
• You have an underlying medical condition (e.g., cancer, HIV/AIDS, diabetes)
• You’re undergoing immunosuppressive therapy
• The abscess is located in sensitive areas (buttock crease, near rectal or groin area)
• There’s a visible foreign body within the wound
• You have a fever of 100.4째F (38째C) or higher
• You’re pregnant
• The sore heals but then returns

Is it necessary to visit a doctor for every skin abscess? Not always. Many skin abscesses will rupture and drain on their own without complications. However, if you experience any of the above symptoms or have concerns, it’s best to consult a healthcare professional.

Emergency Care for Skin Infections and Abscesses

In some cases, skin infections and abscesses may require immediate medical attention. Visit the emergency room if you experience:

• A fever of 102째F (38.9째C) or higher
• Fever accompanied by vomiting, especially if you have a chronic disease or are on immunosuppressive medications
• A visible red streak on the skin extending from the abscess
• A facial abscess larger than 1 cm (1/2 inch) across
• Black or dead skin around the abscess
• Severe pain unresponsive to over-the-counter pain medications
• Weakness, dizziness, trouble walking, or loss of use of a limb or body part
• Persistent bleeding from the infected area

Why is it crucial to seek emergency care for severe skin infections? Prompt treatment can prevent the spread of infection to the bloodstream and deeper tissues, which can lead to more serious complications if left untreated.

Treatment Options for Skin Abscesses in the Emergency Room

When you visit the emergency room for a skin abscess, the medical team will assess your condition and determine the most appropriate treatment. Common procedures include:

Incision and Drainage

For many abscesses, the primary treatment is incision and drainage. This procedure involves:

1. Cleaning the affected area
2. Administering local anesthesia
3. Making a small incision in the abscess
4. Draining the pus and infected material
5. Cleaning the wound cavity
6. Packing the wound (if necessary)
7. Applying a sterile dressing

Does incision and drainage hurt? The procedure is typically performed under local anesthesia, which minimizes pain during the process. You may experience some discomfort afterward, but this can usually be managed with over-the-counter pain medications.

Antibiotic Therapy

In some cases, the healthcare provider may prescribe antibiotics in addition to performing incision and drainage. This is particularly common for:

• Large or severe abscesses
• Infections in sensitive areas
• Patients with weakened immune systems
• Cases where the infection has spread beyond the initial site

Are antibiotics always necessary for treating skin abscesses? Not always. Many uncomplicated abscesses can be effectively treated with incision and drainage alone. However, your healthcare provider will determine if antibiotics are needed based on your specific situation.

Aftercare and Follow-up for Treated Skin Abscesses

Proper aftercare is crucial for ensuring proper healing and preventing recurrence of skin abscesses. Follow these guidelines after treatment:

1. Keep the wound clean and dry
2. Change dressings as instructed by your healthcare provider
3. Take any prescribed antibiotics as directed
4. Watch for signs of infection or worsening symptoms
5. Attend follow-up appointments as scheduled
6. Avoid picking or squeezing the treated area

How long does it take for a treated abscess to heal? Healing time can vary depending on the size and severity of the abscess, as well as your overall health. Most abscesses begin to improve within a few days of treatment, but complete healing may take several weeks.

Preventing Skin Infections and Abscesses

While it’s not always possible to prevent skin infections and abscesses, there are steps you can take to reduce your risk:

• Practice good hygiene, including regular handwashing
• Keep cuts, scrapes, and other wounds clean and covered
• Avoid sharing personal items like razors or towels
• Maintain a healthy lifestyle to support your immune system
• Manage underlying health conditions effectively
• Seek prompt medical attention for minor skin infections

Can lifestyle changes help prevent recurring skin abscesses? Yes, maintaining good overall health, practicing proper hygiene, and managing underlying medical conditions can significantly reduce your risk of developing recurrent skin infections and abscesses.

When to Choose an Emergency Room for Skin Infection Treatment

While many skin infections can be treated in an outpatient setting, there are times when visiting an emergency room is the best course of action. Consider seeking emergency care if:

• You have severe pain or swelling
• The infection is spreading rapidly
• You have a high fever or other systemic symptoms
• The abscess is located in a sensitive or dangerous area
• You have a weakened immune system or underlying health conditions
• Home remedies or over-the-counter treatments haven’t improved the condition

Why choose an emergency room over an urgent care center for skin infections? Emergency rooms are equipped to handle more severe cases and can provide a higher level of care, including surgical interventions if necessary. They also have access to a wider range of diagnostic tools and specialists.

Benefits of Specialized Emergency Care Facilities

Some emergency care facilities, such as Frontline ER mentioned in the original text, offer specialized care for skin infections and abscesses. These facilities may provide:

• 24/7 availability
• Shorter wait times compared to traditional hospital emergency rooms
• Board-certified emergency physicians
• State-of-the-art equipment and facilities
• Comprehensive care for a wide range of emergency conditions

How do specialized emergency care facilities differ from traditional hospital emergency rooms? Specialized facilities often provide more personalized care with shorter wait times while maintaining the same level of expertise and equipment as hospital emergency departments.

Understanding the Long-term Impact of Skin Infections

While most skin infections and abscesses can be effectively treated, it’s important to understand their potential long-term impacts:

Scarring

Depending on the size and severity of the abscess, scarring may occur after treatment. This is particularly common with larger abscesses or those that required extensive incision and drainage.

Recurrence

Some individuals may be prone to recurrent skin infections and abscesses, especially if they have underlying risk factors or medical conditions.

Systemic Infections

In rare cases, untreated or severe skin infections can lead to systemic infections, affecting other parts of the body or entering the bloodstream.

Psychological Impact

Chronic or recurrent skin infections can have psychological effects, including anxiety, depression, or self-esteem issues, particularly if they result in visible scarring.

Can the long-term effects of skin infections be minimized? Yes, by seeking prompt medical attention, following proper treatment protocols, and addressing any underlying risk factors, you can significantly reduce the likelihood of long-term complications from skin infections and abscesses.

Advances in Skin Infection Treatment

Medical research continues to improve our understanding and treatment of skin infections and abscesses. Some recent advancements include:

Antimicrobial Resistance Management

With the rise of antibiotic-resistant bacteria, healthcare providers are developing new strategies to treat infections effectively while minimizing the risk of resistance.

Improved Drainage Techniques

New tools and techniques for draining abscesses can lead to more effective treatment with less scarring and faster healing times.

Targeted Antibiotic Therapy

Advanced diagnostic techniques allow for more precise identification of infectious agents, enabling healthcare providers to prescribe the most effective antibiotics for each specific case.

Immunomodulatory Treatments

For individuals prone to recurrent infections, researchers are exploring treatments that can boost or modulate the immune system to prevent future occurrences.

How are these advancements improving patient outcomes? These innovations are leading to more effective treatments, reduced complication rates, and improved long-term prognoses for patients with skin infections and abscesses.

In conclusion, understanding skin infections and abscesses, knowing when to seek medical care, and following proper treatment and prevention strategies are crucial for maintaining skin health. By staying informed and taking prompt action when needed, you can effectively manage these conditions and minimize their impact on your overall well-being.

Going To An Emergency Room For Skin Infections And Abscesses

Going To An Emergency Room For Skin Infections And Abscesses 

Skin abscess develops as a response to infection or presence of another foreign material under your skin. The abscess will be characterized by a collection of pus in the affected area, especially on the skin surface. Abscesses can also be formed due to inflammations surrounding the sweat glands or the hair follicles. 

Another common cause of skin abscess is a weakened immune system. This can be due to medications or a chronic disease. This happens because the ability of the body to fight infections is reduced. Here are a few risk factors that can cause the development of one or more abscess or even cause recurrent abscesses.

• Diabetes
• Chemotherapy
• Chronic steroid therapy
• Lupus
• Cancer
• Dialysis for kidney failure
• Sickle cell anemia
• HIV/AIDS
• Crohns disease
• Peripheral vascular disease
• Severe burns or trauma
• Intravenous IV drug use
• Ulcerative colitis
• Alcoholism
• Skin injections due to tattoos, medical procedures, or prescription drugs

The infectious or foreign material in your body is the one that triggers an inflammatory response that leads the body immune system to form a capsule or cavity to contain the infection and prevent it spreading to other body areas. The inside of the abscess liquefies and what results is pus that is made of dead cells, bacteria, proteins, and other debris. The area will start to expand and you will feel some tension and observe inflammation on the overlying skin.

An abscess can be found on any part of your organs including liver, kidney, teeth, neck, face, and intra-abdominal area among others.

Many people confuse an abscess with a cyst. While both will be filled by fluids and will have a lumpy appearance, the abscess will be infected while a cyst is not infected. Nevertheless, a cyst can become infected and become an abscess.

Medical Care For Skin Abscess And Other Skin Infections

Antibiotics are often used to cure a cyst but an abscess will require more than antibiotics. The abscess must open up and drain to heal.

A skin abscess will often rupture and drain on its own without any complications. This is a good thing because once the pus is released the abscess will most likely heal on its own. However, in some instances, you will need to visit a doctor for an evaluation to prevent complications that might be caused by the spread of the infection. Consult a doctor in case of the symptoms below.

• If the infected part is bigger than 1 cm or bigger than ½ inch across
• The sore does not heal but continues to enlarge and becomes more painful
• You have an underlying medical problem such as cancer, HIV/AIDS, sickle cell disease, diabetes, and other medical conditions mentioned above.
• If you are on steroid therapy, chemotherapy or other drugs that suppress your immunity
• If the patient is an IV drug user
• If the abscess is found on the buttock crease, near the rectal or groin area
• If there is a foreign body visible within the wound
• If you have a fever of 100.4 F or higher
• In case, the patient is pregnant
• If the sore heals but then returns.

When Should I Seek Emergency Care?

If the abscess does not heal on its own, a health care provider might need to lance and drain it for it to heal. Other abscesses will require surgical drainage procedures performed in the emergency room.

If the abscess is left without care and proper incision and drainage, it will worsen. The infection can spread to the bloodstream and even to deeper tissues. Once the infection spreads, the patient will suffer from fever, vomiting, and nausea. They will also notice increased pain and redness in the area of infection.

Visit the ER if you notice the symptoms below:

• If the patient has a fever of 102 F or higher
• If the fever is accompanied by vomiting and more so if the person has a chronic disease or is on steroids, chemotherapy or other immune-suppressing medications
• There is a visible red streak on the skin from the abscess, which signifies the spreading of the infection
• If the patient is suffering from a facial abscess that is larger than 1 cm or larger than 1.2 inch across
• In case, the person has a black or dead skin around the abscess
• Severe pain that does not respond to over the counter pain medications
• Weakness, dizziness, trouble walking or loss of use of the limb or another body part
• Persistent bleeding from the infected area

Why Visit Frontline ER

If you are concerned about any abscess or skin infection in your body, visit Frontline ER. We are located in Richmond and Dallas Texas. Our board-certified doctors have emergency care experience and they will look at your condition and offer the best care. Open 24/7 we function just like a hospital emergency room only that we have no waiting time.

We also offer care in the most caring and friendly manner. If you are worried about emergency care cost, do not be. We accept commercial insurance and we offer private payment arrangements to ensure you do not miss the care you need.

What is a Cyst & How an Urgent Care Can Help

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What is a Cyst & How an Urgent Care Can Help

Cysts can be quite common, affecting all age groups and almost 20% of all adults in the US at some point in time. Occurring in all shapes, sizes, and severity. Cysts are generally easily treatable and in this article, you will learn how you can leverage your local Urgent Care to quickly treat and address cysts.

What is a Cyst?

A cyst is a small pocket of tissue filled with air, fluid, or other substances. They can develop in any part of the body and may be caused by genetics, inflammation, infection, or other issues. Cysts are usually round, dome-shaped lumps that can move easily under the skin and range in size from very small to several inches across.

How Can You Recognize a Cyst?

Cysts can vary in appearance depending on their type and cause. Generally, they are round or oval-shaped bumps that are firm to the touch. They may be yellow or white and have a dark plug through which you might be able to squeeze out the pus. If you notice any unusual lumps on your body, it’s important to seek medical attention right away so that your doctor can diagnose the cause and recommend treatment if necessary.

Why Do People Get Cysts?

The exact cause of cysts varies depending on their type and location. Some cysts form as a result of infection, while others may be caused by genetics or inflammation. In some cases, cysts may form due to blockages in the body’s natural drainage system, such as the lymphatic system or sweat glands.

What Is Inside A Cyst?

The contents of a cyst depend on its type and cause, but generally, they contain air, fluid, or other substances such as pus or blood. Sebaceous cysts typically contain sebum (an oily substance produced by sebaceous glands) while ovarian cysts often contain hormones such as estrogen and progesterone.

Is A Cyst Serious?

In most cases, cysts are not serious and do not require treatment unless they become infected or cause pain or discomfort. Oftentimes cysts are nothing more than cosmetic, or annoying inconveniences. However, in some cases, they may indicate a more serious underlying medical condition, and it is important to seek medical attention if you suspect you have a cyst, or if the cyst is growing in size, is painful, or has any other unusual symptoms.

Does A Cyst Go Away On Its Own?

In some cases, a cyst may go away without treatment, but this depends on its type and cause. If it does not go away on its own, then it may need to be surgically removed depending on its size and location. Your doctor will be able to advise you on the best course of action for treating your particular type of cyst. Other treatment options for a cyst include:

• Antibiotics
• Steroid injections
• Laser treatments
• Cryotherapy

At an urgent care center, you can expect to conveniently take advantage of some steroid injections, antibiotics, and drainage.

What To Know About Cysts:

It’s important to know what kind of cyst you have before attempting any kind of treatment, as different types require different treatments. It’s also important to seek medical advice if you notice any unusual lumps on your body so that your doctor can diagnose the cause and recommend appropriate treatment if necessary.

What Are the Types Of Cysts?

There are many different types of cysts including sebaceous (oil) cysts, epidermoid (skin) cysts, ovarian (hormonal)cysts, dermoid (hair follicle), pilar (sweat gland)cyts , ganglion (joint capsule)cyts , bursal (fluid filled sacs near joints), pancreatic pseudocysts, renal pseudocysts, hepatic pseudocysts, splenic pseudocysts, thyroid nodules/cysts.

You can tell these types apart by size, shape, location, and what they’re filled with. It is important to get a diagnosis from your doctor before pursuing any form of treatment, as some cysts can be serious or indicate an underlying medical condition.

Why Do Cysts And Pseudocysts Form?

Cysts form when cells divide abnormally due to genetic mutations, while pseudocysts form when fluids build up in an area due to blockages in natural drainage systems like lymph nodes or sweat glands. These can be especially dangerous if left untreated, as they can lead to infection and inflammation.

How Are Cysts Treated?

Treatment for a cyst depends on its type and severity but generally involves draining them with a needle followed by antibiotics for infections; surgical removal for larger ones; hormone therapy for ovarian cysts; radiation therapy for cancerous ones; topical creams for skin-related ones; physical therapy for joint related ones; etc.

Can Cysts be Prevented?

In most cases no but some lifestyle changes such as avoiding smoking/alcohol/drugs/unprotected sex/poor hygiene practices may help reduce risk factors associated with certain types of cystic conditions.

University Urgent Care offers a variety of cyst treatments, including drainage and antibiotics for infections, hormone therapy for ovarian cysts, radiation therapy for cancerous ones, topical creams for skin-related ones, and more. If you think you may have a cyst or other lump that requires medical attention, contact University Urgent Care today to

When Should You Seek Help For A Cyst?

At University Urgent Care, we are well-equipped to provide quick, convenient, and affordable care for cysts. We know you want care now! That’s why we accept walk-ins and same-day appointments. Skip the wait and the hassle and get care when you need it!

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Removal of a cyst of the neck – surgery free of charge according to compulsory medical insurance

Median cyst of the neck is a benign neoplasm, which, nevertheless, needs to be removed. Whether it is possible to get rid of the cyst without surgical intervention, what will happen in the absence of treatment and how the operation goes, we found out from the maxillofacial surgeon.

Expert: Ara Sargisovich Khandzratsyan, Head of the Department of Maxillofacial Surgery, City Clinical Hospital named after. F.I. Inozemtseva, maxillofacial surgeon, Ph.D.

Where does a cyst appear on the neck?

This is a congenital pathology that begins in the womb. At 6-7 weeks of development, a gap is formed in the embryo between the root of the tongue and the thyroid gland. Within a few weeks, the hole should close, but sometimes it doesn’t. In the future, fluid accumulates in this “space” and a cyst forms.

Most neck cysts are discovered and removed during childhood, but sometimes the pathology goes unnoticed. Over the years, the cyst can grow and become visible even to the naked eye.

How do you know if you have a median neck cyst?

The person usually finds out about it when the cyst becomes inflamed. The following symptoms occur:

• – pain when swallowing
• – soreness in the region of the tongue
• – Foreign body sensation when swallowing
• – temperature increase
• – swelling in the anterior region of the neck

Another sign is cyst mobility. Place your fingers on the bump and swallow: if it moves, it’s probably a cyst. The fact is that it is connected with the hyoid bone and, when swallowed, moves with it.

Sometimes it is just a swelling in some place, in the middle of the neck or slightly on the side. There may be no pain, but the person is concerned about the aesthetic component: the cyst sticks out and forms a tubercle on the neck.

Removal of a median neck cyst

A cyst can be removed as soon as it is found, whether it is inflamed or not. There are no conservative treatment options, only surgery.

How long the cyst will last without inflammation is unknown. If inflammation joins, it will fester and you will have to intervene quickly: puncture, open, remove.

The most dangerous complication is suppuration of the cyst and the occurrence of non-healing fistulas. Before that, it is better not to bring it up and do the operation as soon as you find out about the pathology.

Surgery to remove a median cyst in the neck is called a cystectomy. It is performed by maxillofacial surgeons. Cystectomy is performed under “general” (endotracheal) anesthesia. An incision is made at the level of the hyoid bone, at the very top of the neck. So that in the future the scar is not visible, the surgeon cuts the skin along the crease of the neck. Further, the cyst and the hyoid bone are isolated with special devices. The latter is resected, and then the cyst is removed. You can watch the video of the operation in our YouTube video.

One day the patient is observed in the hospital, you can eat a few hours after the operation. The next day, the person is discharged home.

Is cystectomy performed free of charge under the CHI policy?

Yes, the operation is available under the CHI program. Moscow hospitals are ready to accept even residents of other regions.

Sources:

[1] Clinical guidelines. Cysts of the maxillofacial region and neck. LLC “Society of specialists in the field of maxillofacial surgery”. — M., 2020.

[2] G. A. Gadzhimirzaev, A. Kh. A., Asiyatilov G.A., Magomedova Kh.M., Shakhbanov A.K. Congenital cysts and fistulas of the neck // Bulletin of Otorhinolaryngology. 2016. No. 81(5). pp. 27‑29.

The material was prepared jointly with the expert: A. S. Khandzratsyan,
Maxillofacial Surgeon, Candidate of Medical Sciences,
Head of the Department of Maxillofacial Surgery,
F.I. Inozemtseva.

Source: information project
“Moscow – the capital of health”

Ovarian cyst laparoscopy | Articles by EMC doctors about diseases, diagnosis and treatment

Laparoscopy is a minimally invasive technique that allows you to perform surgery through 4-5 small (5-10 mm) incisions. Thanks to a special video camera that is inserted into the abdominal cavity, the surgeon sees an enlarged image on the monitor screen. This makes it possible to carry out the operation as accurately as possible and save the organ with virtually no blood loss.

Laparoscopy for ovarian pathology is prescribed in cases of detection of cysts and neoplasms up to 10 cm in size. The volume of intervention is determined by the doctor during the operation based on a histological examination, which is carried out within 20 minutes after removal of the formation. All this time the patient is in the operating room. We inform you in advance that if a malignant tumor is detected, the volume of surgical intervention may be increased.

Tissue trauma during laparoscopy is very low, so there are practically no traces left on the body, and rehabilitation takes a little time. The patient is discharged from the hospital, usually the next day.

In the clinic of gynecology and oncogynecology of the European Medical Center, the diagnosis of ovarian formations and laparoscopic operations are performed by qualified gynecologists and oncogynecologists with international experience. You can get advice from us within the framework of the Second Opinion in Operative Gynecology and Oncogynecology program.

Advantages of laparoscopy in ovarian pathology

• Minimal damage to healthy tissue.
• Aesthetic appearance after surgery.
• Quick recovery and return to normal life.

Types of ovarian laparoscopy

There are three main types of laparoscopy for ovarian pathology. The choice depends on the nature, size and location of the cyst or tumor.

The resection maximizes the preservation of healthy ovarian tissue. During the operation, the surgeon makes an incision in the ovary membrane, highlights and removes the cyst.

Cyst enucleation is a method of extracting a mass in a special plastic container. This prevents rupture of the cyst in the abdominal cavity and the potential spread of the tumor process. The principle of the method is to localize the cyst, place it in a special container and remove it without damaging the ovarian tissue.

Ovariectomy is an operation in which the ovary is removed along with the cyst. It is prescribed, as a rule, for large or suspicious formations. The surgeon removes the ovary and fallopian tube, bandages and removes them in a special container.

Indications for laparoscopy in ovarian pathology

• Diagnosis (type of cyst or other formation).
• Ruptured ovarian cyst with bleeding (emergency).
• Adnexal torsion.

Contraindications for laparoscopy in ovarian pathology

There are few contraindications to laparoscopy. Most often, this is an acute blood loss in the abdominal cavity with hemodynamic instability, when not a minute can be lost. The main contraindications for laparoscopy are also considered:

• common oncological process;
• the inability to remove the tumor without a rupture in the abdominal cavity;

• acute infectious diseases during planned interventions (the operation is simply postponed until complete recovery).

Rehabilitation and pregnancy planning

After the operation, the patient is transferred to the hospital in 2 hours, where she is under the supervision of gynecologists for another day. After that, she is usually discharged home. Almost immediately, she can return to her usual way of life. The final rehabilitation ends in about 2-3 weeks. It is recommended to resume sexual life no earlier than the second or third week of the postoperative period.

Laparoscopy for ovarian pathology does not disrupt the ovulation process, so the ability to conceive is preserved, and the woman can plan a pregnancy. The timing of planning depends on the type of pathology of the appendages, which is determined by histology. If laparoscopy was performed for polycystic disease, then pregnancy can be planned in the next six months. In the absence of a desired pregnancy within a year of regular sexual life, a woman is advised to consult.

Why do they trust us?

• Preoperative examination as soon as possible on the basis of one medical center.
• Organ-preserving treatment for benign, borderline and some malignant gynecological diseases.
• Personalized approach – each patient has the opportunity to contact the attending physician by e-mail, receive comments on the results of the tests.