Thursday, February 08, 2007

Adhesion Medical Headlines ARD vark Blog

Company Agrees to Stop Making Endoscope Cleaners Until Compliance Problems Are Resolved

Blue Cross And Blue Shield Association Opposes Reduction In Reimbursements To Medicare MA Plans

AmeriHealth Expands Disease Management Program To Benefit Members With Crohn's Disease

2006 Procedural Survey Shows 3% Increase In Men Seeking Cosmetic Surgery

MRI Contrast Agent Linked To Complication In Renal Patients

Consumer Group Petitions FDA To Ban Some Contraceptive Pills

Operative Hysteroscopy For Intrauterine Adhesions Video

Operative Hysteroscopy For Intrauterine Adhesions Video The operative hysteroscopy for intrauterine adhesions video shows the procedure also known as adhesiolysis for treating Ashermann's syndrome. The surgeon is Dr Anjali Malpani.
The video first shows the uterine cavity as the the surgeon sees it on the video screen. This cavity is small and distorted because of the adhesion, due to a scar on the inside wall of the uterus. The adhesion divided the cavity into two parts. The surgeon cuts through the adhesion with a hysteroscopic cutting knife, which uses electricity. The goal is not only to resect the adhesion but to eliminate the scar itself.
Once the resection was done, the video shows how the uterine cavity opened up and normalized the uterus. This woman will undergo further IVF treatment, but now her chances of conceiving are greatly increased, since the uterus is almost normal now.
Click here to see UTube Video

Wednesday, February 07, 2007

Adhesion ARD Medical Headlines ARDvark Blog

Consumer Group Petitions FDA To Ban Some Contraceptive Pills
US consumer group Public Citizen is petitioning the Food and Drug Administration (FDA) to ban certain types of contraceptive pills...[read article]

Patients Should Take Steps To Prevent Medical Errors, Experts Say

Bacteria Fighter Goes Where Antibiotics Can't

Alliance Pharmaceutical Corp. Completes The Manufacture Of Oxygent (TM) For Clinical Trials

Baxter Receives Clearance From U.S. FDA For Ipump Pain Management System 510(k)

IVF Success May Be Increased With Use Of Ultrasound

Vitamin D Appears Effective In Reducing Colorectal Cancer Incidence

Senate Committee Investigation Finds Pharmaceutical Companies Improperly Used Exception In Medicaid Drug Rebate Program

Sexual History Should Be An Integral Component Of Medical Assessment

Pilot Study Shows Withdrawal Drug Offers Symptom Relief To Crohn's Sufferers

Study sounds alarm on surgery drug

By Carla K. Johnson
Associated Press
CHICAGO – A drug widely used to prevent excessive bleeding during heart surgery appears to raise the risk of dying in the five years afterward by nearly 50 percent, an international study found.
The researchers said replacing the drug – aprotinin, sold by Bayer AG under the brand name Trasylol – with other, cheaper medications for a year would prevent 10,000 deaths worldwide over the next five years.
The findings were more bad news for Trasylol: The same scientists found the drug raised the risk of kidney failure, heart attacks and strokes in a study published last year. Most of the deaths in the new study were related to those problems.
Bayer said in a statement that the findings are unreliable because Trasylol tends to be used in more complex operations and the researchers’ statistical analysis did not fully account for the complexity of the surgery cases.
Nevertheless, the drug company said it will “work with regulatory agencies and external experts in the field to further evaluate the findings.”
Read More

Assessment of the efficacy of absorbable adhesion barriers on dissection in esophagus operations.

Yilmaz O,
Genc A,
Taneli F,
Demireli P,
Deliaga H,
Taneli C.
Celal Bayar University, Medical Faculty, Department of Pediatric Surgery, 45010 Manisa, Turkey.
OBJECTIVE: During childhood, recent repeated operations for esophagus are normally conducted if long gap esophageal atresia exists. During multistaged extrathoracic esophageal elongation procedure, the dissection of the esophagus poses severe problems due to adhesion. However, Gore-Tex membrane may simplify esophagus dissection. The most popular adhesion barriers used today are sodium hyaluronate (Seprafilm((R)); Genzyme Corp., Cambridge, MA) and oxidized regenerated cellulose (Interceed((R)); Johnson&Johnson Medical Inc., New Brunswick, NJ). The purpose of this study is to investigate the efficacy of adhesion barriers on esophagus dissection. METHODS: In the study, 21 Wistar albino adult male rats were worked on. The rats were randomly divided into three groups, each including seven rats. About 1cm-segment of the esophagus, located just behind the trachea, was dissected from the surrounding tissues through blunt dissection. Rats in group 1 were wrapped with Seprafilm((R)), and in group 2 with Interceed((R)). But the rats in group 3 underwent only esophagus dissection. Three weeks later, during esophagus dissection, adhesion scoring was performed and esophagus was divided into two parts: one for the assessment of hydroxyproline level, and the other for histological examination. RESULTS: When the adhesion scores of the three groups were compared, there was not a significant difference between the groups (p=0.75). In terms of tissue hydroxyproline levels, mean scores of hydroxyproline revealed no significant difference between the three groups (p=0.19). When the histopathological results were examined, esophagus looked normal and no connective tissues were seen around esophagus. CONCLUSION: Seprafilm((R)) and Interceed((R)) had no effect on esophagus dissection. Although Seprafilm((R)) had the best mean score, this was statistically insignificant. Gore-Tex might play a better role than Interceed((R)) in preventing adhesion formation; however, it is still not certain whether adhesion barrier should be used in such organs as esophagus having no serosa.
PMID: 17161874 [PubMed - in process]

Lichen Sclerosis:

A Guide for Teens
Lichen sclerosis is a skin condition that usually affects the vulva area (the outside parts of the female genitalia) and the anal area in young girls, adolescents, and adults. Similar to other skin conditions, there are treatments available to help the symptoms.

What is lichen sclerosis and what does it look like?
Lichen sclerosis (LS) is a skin condition that makes the vulva look white, slightly shiny, and smooth. The skin's surface becomes thin and delicate so that it tears easily. This can cause bleeding under the skin. In severe cases of lichen sclerosis of the genital area, scarring can occur. This causes the inner lips of the vulva to get smaller. The clitoris can become covered in scar tissue.

What causes lichen sclerosis?
We do not know the exact cause of lichen sclerosis. Scientists have different theories to try to explain the cause. Some scientists think that an overactive immune system may play a role in causing the disease. Some people may also develop lichen sclerosis due to their genes or to changes in hormones. Since lichen sclerosis is not caused by an infection, it cannot be spread and is not contagious.

What are the symptoms of lichen sclerosis?
Symptoms of lichen sclerosis may be different from one person to another and can be mild to severe. Girls and young women who have this disease may experience some or all of the following symptoms in the vulvar area:
mild to severe itching in the vulvar area
skin that appears fragile, pale, and/or white
bruised skin with broken blood vessels or "blood blisters"
small tears or fissures in the skin
scar tissue covering the labia or clitoris
bleeding or tearing of skin when having bowel movements
How is lichen sclerosis diagnosed?
Lichen sclerosis can be a difficult diagnosis to make. It is not unusual for someone to see more than one doctor before the disease is finally diagnosed. This can be very frustrating for you if the treatment you are receiving isn't working. Most of the time, doctors who see a lot of patients with lichen sclerosis can often make the diagnosis just by looking at the skin, but still may need to do a biopsy. If you are in the early stages of lichen sclerosis, the doctor may have to do a biopsy (removal and examination of a small sample of affected skin) to identify the cause of your symptoms.

Will I need treatment?
Even if you do not have symptoms such as itching or pain, it is important for you to receive medical treatment for lichen sclerosis. Treatment to genital skin is necessary to try to prevent scarring of the vulva. Without treatment, there can be scarring that causes parts of the vulva to narrow and cause problems with passing urine or pain with sexual activity. Severe scarring can cause the opening to the vagina to narrow. Intercourse may be painful if the vagina narrows too much.

Are there medicines to treat lichen sclerosis?
Yes. Medications are available to help with the symptoms of lichen sclerosis. They are only available by a prescription from your doctor. If you have lichen sclerosis, your doctor will most likely prescribe a strong topical corticosteriod, which is a type of ointment that reduces swelling and itching on your skin. This medicine also decreases the body's immune response. Your doctor will probably tell you to apply this drug every day so that your skin can return to its normal surface and strength. The amount of time it takes for this to happen is different from patient to patient. It is important to realize that the treatment may not undo the scarring that may have already occurred.
Read More

Constipation And Bowel Obstruction

Constipation And Bowel Obstruction
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Tuesday, February 06, 2007

Adhesion Related Disorder Medical Headlines ARD Adhesions

Texas Governor Perry Stands Firm On HPV Vaccination Mandate For Schoolgirls
Texa Governor Rick Perry stands firm against the opposition to his executive order to vaccinate schoolgirls against HPV, making Texas the first state to mandate the vaccination. He said he is for "protecting life"...[read article]

Abdominal Surgical Procedures Without Skin Incisions

MIT 'microsieve' Could Aid Study Of Diseases

NHS Inpatient And Outpatient Waiting Times Figures - December 2006, UK

Chronic pelvic pain

Chronic pelvic pain (CPP) is characterized by pain in the lower abdomen and pelvic area that has been present for at least six months. Sometimes the pain may travel downward into the legs or around to the lower back. The pain may be felt all of the time or it may come and go, perhaps recurring or intensifying each month with your menstrual period.
In either case, the pain is felt internally, not externally as in another common pain disorder in women called vulvodynia. In vulvodynia (or burning vulva syndrome), the external genital area stings, itches, becomes irritated or hurts when any kind of pressure, from tight clothing to intercourse, is experienced. Chronic pelvic pain and vulvodynia sometimes occur together.
Women with CPP have one or more of the following symptoms:

Abnormal menstrual periods
painful periods (dysmenorrhea)
prolonged periods
heavy periods
premenstrual spotting
severe cramps
constant or intermittent pelvic pain
low backache for several days before period, subsiding once period starts
pain during intercourse (rarely, some vaginal bleeding after intercourse)
pain on urination and/or during bowel movements (rarely, blood in urine or stool)
rectal itching or burning
vaginismus -- difficulty initiating sexual intercourse

The course of CPP is unpredictable and different in every woman. Symptoms may stay constant, disappear without treatment or suddenly increase. They usually decrease during pregnancy and improve after menopause.
The severity of pain is also unpredictable. It may range -- even in the same woman -- from mild and tolerable to so severe it interferes with your normal activities. Your physical or mental state can also cause the level of pain to fluctuate. So can fatigue, stress and depression. Moderate to severe pain generally requires medical or surgical treatment, although such therapies are sometimes unsuccessful at relieving pain entirely.
Unrelieved, unrelenting pelvic pain may affect your sense of well being, as well as your work, recreation and personal relationships. You may begin to limit your physical activities and show signs of depression (including sleep problems, eating disorders and constipation); and your sex life and role in the family may change.
When pelvic pain leads to such emotional and behavioral changes, the International Pelvic Pain Society (IPPS) calls the condition "chronic pelvic pain syndrome" and says that the "pain itself has become the disease." In other words, the pain is more of a problem than the original cause. In fact, a medical examination may find nothing physically wrong with the area that hurts. Nonetheless, the nerve signals in that area continue to fire off pain messages to the brain, and you continue to hurt.
Causes and Risk Factors
There are two kinds of pain. Acute pain typically occurs with an injury, illness or infection. A warning signal that something is wrong, it lasts only as long as it takes for the injured tissue to recover. In contrast, chronic pain lasts long after recovery from the initial injury or infection, and is often associated with a chronic disorder or underlying condition.
The most common cause of pelvic pain is endometriosis, in which pieces of the lining of the uterus attach to other organs or structures within the abdomen and grow outside the uterus. In practices specializing in the treatment of endometriosis, 70 percent or more of patients with CPP are diagnosed with endometriosis. And in three major studies conducted since 1989, 71 to 83 percent of patients with chronic pelvic pain had endometriosis, either alone or in combination with one or more other disorders. Two of those disorders are adhesions (scar tissue resulting from previous abdominal or pelvic surgery) and fibroids (clumps of tissue that grow inside, in the wall of, or on the surface of the uterus).
The second most common cause of CPP is pelvic inflammatory disease (PID). PID is one of the most common gynecologic conditions, usually related to a sexually transmitted disease. As many as 30 percent of women with PID develop CPP [However, we don't know exactly why PID so often leads to CPP.
Other causes of CPP are diagnosed more frequently by other kinds of specialists. They include diseases of the urinary tract or bowel as well as hernias, slipped discs, drug abuse, fibromyalgia, and psychological problems. (See the Diagnosis section at this Web site for a more complete discussion of all causes.)
In fact, many women with CPP collect a different diagnosis from each specialist they see. What is going on here? It is likely that CPP represents a general abnormality in the way the nervous system processes pain signals from the pelvic nerves, producing pain that involves the genital organs, the bladder, the intestine, pelvic and hip muscles, and the wall of the abdomen, as well as pain involving the back and legs.
Despite the number of possible causes, up to 61 percent of women with chronic pelvic pain receive no diagnosis. These are often the women who make the rounds of various specialists seeking relief, only to be told the pain is "all in their heads." They may also be subjected to multiple tests or even unnecessary surgery. These women may feel that the pain is somehow their fault, when, in fact, the lack of a diagnosis represents the limitations of medical science.
Simply put, there is no simple answer to the question, "What causes chronic pelvic pain?" and no "typical patient." Still, a woman with pelvic pain is more likely to:

have been sexually or physically abused
be married rather than single or divorced
be in her early 30s
be white rather than from another racial group
have a history of drug and alcohol abuse
have sexual dysfunction
have a mother or sister with chronic pelvic pain
have history of pelvic inflammatory disease (PID)
have had abdominal or pelvic surgery or radiation therapy
have previous or current diagnosis of depression
have a structural abnormality of the uterus, cervix or vagina.

Some of these, like family history, surgery and PID, are obvious risk factors; others (drug abuse, depression) may be risk factors or result from having chronic pain.
The Impact of Chronic Pelvic Pain
According to the IPPS, up to 15 percent of 18- to 50-year-old American women have chronic pelvic pain. It is also one of the most common reasons American women see a physician, accounting for 10 percent of gynecologic office visits, up to 40 percent of laparoscopies, and 12 to 16 percent of hysterectomies in the U.S. Total treatment costs may run as high as $2.8 billion annually.
The cost to the patient is also enormous. Studies and surveys show that a quarter of affected women are incapacitated by pain two to three days each month. More than twice that many are forced to curtail their normal activities one or two days each month. Nine of 10 women with chronic pelvic pain have pain during intercourse. More than half say they have significant emotional changes, many reporting they feel "downhearted and blue" at least some of the time. For many, the pain and underlying conditions lead to fertility problems, just at the age when they want children.

Intestinal ischemia

Like your other organs, the organs in your digestive system need a constant supply of oxygen-rich blood to function properly. A diminished blood flow to your small intestine or colon is referred to as intestinal ischemia (is-KE-me-uh).
Intestinal ischemia can cause pain and make it difficult for your intestines to do their job. In severe cases, loss of blood flow to the intestines can lead to damaged or dead intestinal tissue, not unlike what happens to the heart during a heart attack.
Intestinal ischemia may develop suddenly (acute intestinal ischemia), often as a result of a blood clot blocking the flow of blood to or from the intestines, or it may develop gradually over time (chronic intestinal ischemia), due to a variety of causes.
Undetected and untreated, intestinal ischemia may be fatal. This condition, though uncommon, is serious and often requires immediate medical care. Depending on the cause of your intestinal ischemia, treatment options may include medications, surgery or a procedure to open your arteries.

NEXT: Signs and symptoms

Monday, February 05, 2007

Adhesion Medical Healines ARDvark Blog

Particles In Polluted Air Increase Risk Of Cardiovascular Disease Among Postmenopausal Women, Study Says

Coffee: Is It Good Or Bad For You?

Help To Change Unhealthy Habits

Managing Early-Onset Menopause

Psychological Effects Of Heart Surgery Examined

Electronic Nurses

Tarceva : European Approval For Pancreatic Cancer Treatment

Scientists Should Adopt Codes Of Ethics, Scientist-bioethicist Says

Enhancing Medical Imaging With Nano-Magnets

Emergency Departments Test Chest Pain Patients Differently, Based On Race, Gender And Insurance

Strong Link Found Between Muscle Damage In Childbirth, Fallen Bladder

Take Fatigue Seriously Says Researcher

Grafts Against Cancer

Appointment Of The Chair Of The NHS Litigation Authority

HPV Vaccine Mandates Risky And Expensive

Morals Do Not Conquer All In Decision Making

House Likely To Pass $463.5B FY 2007 Omnibus Appropriations Bill With Increased Funds For Health Programs

Project PCOS is Revolutionizing How We View PCOS

Download this press release as an Adobe PDF document.
On February 1, Project PCOS will unveiled a brand new website and campaign designed to bring PCOS (Polycystic Ovary Syndrome) education, support and resources to the PCOS patient, professionals treating PCOS and the public.
Philadelphia, PA (PRWeb) February 2, 2007 -- Realizing there was a strong need for women and girls to be able to connect and find reliable resources about PCOS, Ashley Tabeling began development of Project PCOS in late 2006. Collaborating with leaders of the PCOS Community, including Linda Harvey of PCOS Today Magazine;Tarra Hartl, a long time PCOS Advocate and co-founder of PCOS Living; Tammy Dolak, a PCOS community advocate; Cynthia Johns, a PCOS advocate and RN and Branden Simbeck, an IT specialist and PCOS Advocate, Tabeling and her partners are creating a new experience that will revolutionize the way PCOS information, professionals treating PCOS, and the PCOS community come together.Up to 10% of women and girls worldwide have polycystic ovary syndrome (PCOS), and it is estimated more than half go undiagnosed. The syndrome is a complex hormonal disorder for which there is no cure. If left untreated, PCOS can be a precursor to many life threatening conditions including type II diabetes, hypertension, endometrial cancer, cardiovascular disease, stroke, and kidney problems.Dennis Gage, M.D., medical advisor for Project PCOS, states that the syndome is frequently mislabeled and the consequences to women and girls with PCOS is that the serious complications of metabolic syndrome, cardiovascular disease, and diabetes can be missed and undiagnosed. Therefore there is a need for a centralized resource and database to make all persons aware of potential consequences of the syndrome.This new site and campaign will be able to offer a site to provide patients with avenues for one-on-one communication with professionals treating PCOS. Through online chats, forums, educational programs, featured newsletters, directories, links, podcasts, downloadable filesand much more, women with PCOS will be able to find everything they need in one place, free of charge.Among the leading experts and personalities taking part in shaping this innovative site are: Dr. Charles Glueck (Director, Jewish Cholesterol Center); Dr. Dennis Gage (author: "The Thinderella Syndrome"); Julie Lenz (PCOS coach); Dr. Katherine Sherif (co-director, PCOS Center at Drexel); Monika Woolsey ("After the Diet"); Kelly Bliss (; Drs. Deborah and Spencer Ward; Hansi Halloway (Ms. Plus Sized NC 2004); Tulin Reid (founder, PCOS Living and plus-size model); Dr. Shahab Minassian (Director Drexel Fertility), Dr. Samuel Thatcher (Author:"PCOS The Hidden Epidemic") and the great -granddaughter of Dr. Irving Stein (Stein-Leventhal Syndrome).The Project PCOS site will go live Feb. 1, and can be accessed through For more information about Project PCOS, to partner as a medical professional, or to volunteer, please contact Project PCOS via email. Executive Director LindaHarvey can be reached via email or via (785) 410-5160. You may also contact Director of Operations, Ashley Tabeling by email.
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Petition for PCOS (Polycystic Ovary Syndrome) is Quickly Gaining Signatures and Notice
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What Ails Castro?

Written by Dr. TimPublished February 04, 2007
Fidel Castro, borrowing a line from Mark Twain, would like you to know that reports of his demise are greatly exaggerated. Fidel Alejandro Castro Ruz, the 80-year-old dictator of the island nation of Cuba, transferred power to his younger brother on July 31 after "intestinal surgery" and has been recovering ever since.
The city of Miami is planning a mega-party to celebrate his death, but many of Castro's most bitter critics have been down this road too many times before and say they won't believe it until they can spit on his corpse. It's not surprising that it is not known what his illness is, or that there are conflicting stories about it, given the web of secrecy, fabrications and double talk that has swarmed around Castro since the inception of the revolution that eventually toppled the Batista regime. But based on what little is known, and using a little surgical detective work, we can get a pretty good idea of what happened. The first report out of Cuba was a statement from the government that said Castro had undergone surgery for stress-related gastrointestinal bleeding. His condition was reported as serious, but his return was to be expected in a few weeks. According to the official statement, Castro said his intense schedule "promoted in me a sharp intestinal crisis with sustained bleeding that obligated me to undergo a complicated surgical procedure." But during the next several days, when he didn't appear in public, rumors began to swarm: Was it cancer? Was he dying? The Bush administration, always last to know what's going on in the world, said it was caught off-guard by the reports of Castro's illness and had no idea what his condition was. As the speculation whirlwind reached tornado strength, the Cuban government released four photos of the recovering Castro, including one in which he is seated in a chair, holding up the August 12th edition of the state-run newspaper Granma and dressed in a red, white, and blue Addidas jumpsuit. The irony of the Communist leader dressed in a workout suit with the same color scheme as the American Flag and advertising a US corporation was lost on most Americans, as all attention focused on whether the photos were real or photo shopped. But Venezuelan President Hugo Chavez stopped over for a visit and had some photos taken with Castro, convincing the world that Castro was indeed alive, if not well. Additional state visits followed, with more pictures, an October video with Castro again reading from the current edition of the paper to prove it was not file footage, and lots of speculation.The statements of any of the politicians who have visited or spoken with Castro can be discounted outright, as they are not physicians, and all have their own axe to grind. The first report of reasonable veracity about Castro's condition came from Spanish surgeon Jose Luis Garcia Sobredo, the Chief of Surgery of Madrid's Hospital Gregorio Maranon, who responded to a "humanitarian request" from the Cuban government. He confirmed that Castro did not have cancer and was recovering. Subsequent reports leaked out of Maranon gave further details: Castro was suffering from an infection of his large intestine and had undergone at least three failed operations to repair damage from complications of diverticulitis. And here at last the story begins to make sense. The diagnosis of diverticulitis is likely to be true, not only because of the reports, but also because they match his age, history, and survival this far into this illness. To start with, examine all the major candidates for bleeding intestinal illness: diverticulitis, vascular problems, cancer, pre-cancerous lesions, inflammatory bowel disease, hemorrhoids. Vascular problems, a large group of problems having in common compromised blood flow to the colon, can be excluded because they have very different presentation and course of action than has been seen with Castro, and are almost exclusively treated with medical treatment rather than surgical treatment. Inflammatory bowel disease, including Crohn's disease and ulcerative colitis, are chronic diseases that present long before the ninth decade of life. Hemorrhoids and pre-cancerous lesions (polyps) are easily treated and would not require a 6-month recovery, even in someone Castro's age.
For colon cancer to have been the cause of his illness, given the known symptoms and lengthy recovery, it would have to have been at least Stage III colorectal cancer, but the treatment of Stage III and Stage IV colorectal cancer (meaning that it is a large tumor that had spread at least to the lymph nodes and possibly to surrounding organs) includes chemotherapy, and there has been no hint of Castro having undergone chemo. Also, chemotherapy or not, survivability of Stage III or IV is poor, which could explain his failing health, but does not match with the repeated surgeries. What remains from our differential diagnosis is diverticulitis. Diverticulosis is a condition of the large bowel in which little outpouchings develop over the course of a lifetime. Think of a long skinny balloon, and along the balloon there are weak spots where the balloon pooches out. Changing -osis (presence of a condition) to -itis (presence of inflammation) means that an infection has set up shop in the outpouchings. This diagnosis agrees with his symptoms, his condition (as much as has been released by the Cuban government) and his history. Brazilian journalist Claudi Furiati, author of History Will Absolve Me, Castro's authorized biography, reported that Castro suffered from diverticulitis 20 years ago. Again, this agrees with the course of the disease, which develops later in life and can recur at any time.

Friday, February 02, 2007

Adhesions Medical Headlines ARDvark Blog

NIH Director Zerhouni Assumes Greater Budget Authority Over Research Under New Law
A "little-noticed" bill signed by President Bush this month, which grants NIH Director Elias Zerhouni greater budget authority over the institute's research, has prompted concern among patient advocacy groups who fear their research will be compromised, the Wall Street Journal reports...[read article]

Procter & Gamble Pharmaceuticals Commemorates 15 Years Of Trusted Leadership With Asacol(R) (Mesalamine) Delayed-Release Tablets

Sigma-Aldrich Enhances Internet-Based Bioactive Nutrient Explorer To Improve Customer Access To Nutrition Research Information

Damage To Muscle During Vaginal Deliveries Connected With Pelvic Organ Prolapse Later In Life

New York Times Examines Reaction To Potential First U.S. Uterus Transplant

More U.S., French Couples Traveling Abroad For Cheaper Fertility Treatment

Functioning On Automatic Pilot

A Snapshot Of Primary Care Visits

Study Finds Flaws In Cancer Clinical Trials

Federal Appeals Court To Rehear In March Case Involving Terminally Ill Patients' Access To Experimental Treatments

Patients Debate What To Do With Embryos After Fertility Treatments, USA Today Reports

Adhesion Related Disorder

Thursday, February 01, 2007

Adhesions Medical Headlines

Air Pollution Linked to Increased Cardiovascular Events and Death in Postmenopausal Women

Temple University Hospital Investigates Treatment For Cervical Dysplasia - A Potential Advance In Preventing Cervical Cancer

Chronic Pain Up Almost 40 Percent Among U.S. Workers In Past Decade

Ranbaxy Gains FDA Approval To Market Amoxicillin And Clavulanate Potassium For Oral Suspension USP

US Parents And Doctors Concerned About The Haste To Vaccinate Pre-teen Girls Against Cervical Cancer

Neurological Illness Affects Millions Of Americans

Drug Ads On TV May Infuence Americans To Overmedicate

Important Mechanism Identified In The Formation Of Blood Vessels

Industry Critics Say Health Insurance Companies Overuse Practice Of Retroactively Canceling Private Insurance Policies

An Estimated Quarter Of Uninsured U.S. Residents Are Eligible But Not Enrolled In Public Health Insurance Programs

Despite Numerous Studies, Final Verdict Still Not In On St. John's Wort And Depression

Top 10 Things You Should Know About Antidepressants

Septic Shock Patients Offered New Hope

Some Health Insurance Agents Might Be Violating Medicare Rules By Aggressively Marketing Fee-for-Service Plans

First Not-for-Profit Pharmacy Opens In Cincinnati

Couple Awarded $1.5m After Prempro Caused Breast Cancer

Class 1 Recall: Bard® Composix® Kugel® Mesh Patch - Expansion

Date Recall Initiated:
December 22, 2005
*This recall notice was updated on January 24, 2007, to include additional product codes and lot numbers recalled by the manufacturer since the first list was issued (see previous announcements). The expanded list below includes all recalled product codes and lot numbers.*
Product Code
Lot Numbers Recalled
Date Recalled
Bard® Composix® Kugel® Extra Large Oval, 8.7” x 10.7”
All Lot Numbers
December 2005 and January 2006
Bard® Composix® Kugel® Extra Large Oval, 10.8” x 13.7”
All Lot Numbers
December 2005 and January 2006
Bard® Composix® Kugel® Extra Large Oval, 7.7” x 9.7”
All Lot Numbers
December 2005 and January 2006
Bard® Composix® Kugel® Oval, 6.3” x 12.3”
All Lot Numbers
March, 24, 2006
Bard® Composix® Kugel® Large Oval, 5.4” x 7.0”
All Lot Numbers
January 10, 2007
Bard® Composix® Kugel® Large Circle, 4.5”
All Lot Numbers
January 10, 2007
The Bard®Composix® Kugel® Mesh Patch is used to repair ventral (incisional) hernias caused by thinning or stretching of scar tissue that forms after surgery. The patch is placed behind the hernia defect through a small incision. The patch is then held open by a “memory recoil ring” that allows the patch to be folded for insertion and later spring open and lay flat once it is in place.
Recalling Firm:
Davol, Inc., Sub. C.R. Bard, Inc.100 Sockanossett CrossroadCranston, RI 02920
Reason for Recall:
The "memory recoil ring" that opens the Bard®Composix® Kugel® Mesh Patch can break under the stress of placement of the large sized products in the intra-abdominal (inside the belly area) space. This can lead to bowel perforations (rupture) and/or chronic (recurring) intestinal fistulae (abnormal connections or passageways between the intestines and other organs).
Public Contact:
Robin DragoVP Regulatory & Clinical AffairsDavol, Inc., Sub. C.R. Bard, Inc.100 Sockanossett CrossroadCranston, RI 02920401-463-7000
FDA District:
New England
FDA Comments:
Surgeons and hospitals should stop using the recalled product and return unused units to the company.
Patients who have who have been implanted with one of the recalled devices should seek medical attention immediately if they experience symptoms that could be associated with ring breakage such as unexplained or persistent abdominal pain, fever, tenderness at the implant site or other unusual symptoms.
It should be noted that product codes 0010202 and 0010204 were involved in both recall expansions. The lots produced prior to January 2004 were recalled during the March 2006 expansion. Since the March expansion Davol received 4 confirmed complaints of recoil ring breakage from product code 0010202. There were no complaints for product code 0010204.
On January 10, 2007, Davol, Inc. (a subsidiary of C.R. Bard) sent letters to health care professionals and distributors notifying them of the most recent expansion of this recall to include all numbers of Bard® Composix® Kugel® Large Oval and Large CircleMesh Patches for product codes 0010202 and 0010204. Davol has also decided to withdraw from the market all remaining 0010202 and 0010204 products, manufactured from January, 2004 through October, 2006, which has the same component design as the manufacturing lots being recalled.
Davol notified U.S. customers of the initial recall by letter on 12/27/05 via Federal Express. On March 24, 2006, Bard issued letters to hospitals and health care professionals alerting them to the additional recalled products. The letters included updated Instructions for Use (“IFU”) clarifying the proper insertion technique and Supplemental Patient Management Information. Copies of current product IFUs to be used for both Open Placement and Laparoscopic Placement for the Large Bard®Composix® Kugel® Mesh Patches are available from Davol Customer Service by calling 1-800-531-4124.
An upgraded product design for both product codes is available for replacement. Product codes and lot numbers that contain the re-designed product can easily be identified on the case or unit package with the label stating “Redesigned for improved ring integrity.” If this label is affixed to your case stock and/or individual packages, this product is not affected by this market withdrawal and need not be returned to Davol.
For more information, customers can contact Davol Customer Service at 1-800-531-4124. Physicians may contact Bard’s Medical Services and Support Department at 1-800-562-0027 or to speak with the Bard Medical Director, call 1-908-277-8306. A copy of the company’s press release regarding this recall expansion can be found on the Davol website.
Updated January 31, 2006

Long-term results of hysteroscopic myomectomy in 235 patients.

Polena V,
Mergui JL,
Perrot N,
Poncelet C,
Barranger E,
Uzan S.
Service de gynecologie-obstetrique, Hopital Tenon, 4 rue de la Chine, 75020 Paris, France.
OBJECTIVE: To assess the efficacy of transcervical resection of submucous fibroids according to type and size. MATERIALS AND METHODS: Retrospective follow-up of 235 women with submucous fibroids at outpatient hysteroscopy who underwent a hysteroscopic transcervical resection. The main indications were the abnormal uterine bleeding and fertility problems. Thirty-seven percent of patients had an associated endometrial ablation and 32% had a polyp resection. Fifty-one percent of women were menopausal. In cases of incomplete resection a repeat procedure was offered. RESULTS: Intra-operative complications were rare (2.6%) and there was no major complication. Eighty-four percent of cases were followed-up. The median follow-up was 40 months (range 18-66 months). The procedure was classed as a success in 94.4% of patients. Among the cases that were classed as a failure, four patients had a repeated hysteroscopic procedure, three patients had a subsequent hysterectomy and four patients presented with abnormal uterine bleeding at follow-up. CONCLUSION: The hysteroscopic transcervical resection of submucous fibroids is a safe and highly effective long-term therapy for carefully selected women presenting with abnormal uterine bleeding and fertility problems. It produces satisfactory long-term results with few complications.
PMID: 16530319 [PubMed - in process]
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Peritoneal Adhesions and Intestinal Obstructions in Patients with Familial Mediterranean Fever-Are They More Frequent?

Berkun Y,
Ben-Chetrit E,
Klar A,
Ben-Chetrit E.
Department of Pediatrics, Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel.
OBJECTIVE: Familial Mediterranean fever (FMF) is characterized by recurrent episodes of peritonitis. A controversy exists as to whether intestinal obstruction due to peritoneal adhesions is more common among FMF patients compared with healthy controls. The aim of the study was to estimate the rate of spontaneous or postsurgical small-bowel obstruction (SBO) in FMF patients. METHODS: We reviewed the charts of 560 FMF patients followed in our clinic for the occurrence of spontaneous SBO. We also assessed the occurrence of postappendectomy intestinal obstruction among 89 FMF patients compared with 417 individuals without FMF who underwent an appendectomy without other abdominal surgery in the same medical center. RESULTS: Ten of 471 FMF patients (2.1%) developed spontaneous SBO, 8 of whom required laparotomy and adhesiolysis. Six of 89 FMF patients (6.7%) who underwent appendectomy developed SBO. None of the non-FMF patients developed SBO. CONCLUSIONS: Our retrospective study showed that FMF patients are at a higher risk than healthy individuals for developing SBO either spontaneously or as a postsurgical complication. Physicians should be alert to this possible complication when FMF patients arrive at the emergency room.
PMID: 17240429 [PubMed - as supplied by publisher]
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Peripheral opioids for functional GI disease: a reappraisal.

Lembo A.
Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
Opioids have been used medicinally and recreationally for thousands of years. The clinical use of opioids for gastrointestinal conditions has been limited by central nervous system side effects. A new generation of peripheral opioid receptor ligands free of central nervous system side effects is being developed. Clinical trials with the peripherally acting mu opioid receptor antagonists' alvimopan and N-methylnaltrexone show promise for improving postoperative ileus- and opioid-induced constipation. Likewise, preliminary studies with the peripherally acting kappa opioid agonist fedotozine showed promise in the treatment of irritable bowel syndrome (IBS) and functional dyspepsia. Further studies are on hold presumably due to lack of efficacy in subsequent studies. However, clinical studies are underway for newer kappa opioid agonists such as asimadoline and ADL 10-0101. Copyright 2006 S. Karger AG, Basel.
PMID: 16699267 [PubMed - indexed for MEDLINE]
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Polycystic Ovarian Syndrome Diet Tips

Information on Healthy Eating and Successful Weight Loss when you suffer with PCOS.
PCOS sufferers have a slower metabolic rate than non-sufferers. This is now a fact confirmed by many Consultants, doctors and health experts. Because of this, a high percentage of sufferers struggle to lose weight. The figures are 20% of PCOS sufferers do not struggle with their weight, whilst 80% do. The tips that follow have worked for PCOS sufferers that have come to me as clients; they can work for you.
Late evening, make up a glass of boiling water, add a thin slice of lemon to the water. Cover and leave to cool overnight. As soon as you wake-up, drink the water. This will hydrate your system after a night's sleep. The lemon water will also detox the system, is excellent if you have stubborn bowels and the lemon, being nature's natural cleanser will help with any skin problems.
Eating small and often is much healthier for PCOS sufferers. Having six small meals each day, is much better than three larger meals.
Most PCOS sufferers are 'carbohydrate sensitive', which means that, because of your PCOS, your body cannot cope with starchy, sugary or high-carbohydrate food. If you eat this type of food, it can make you crave more, hence the reason that PCOS sufferers go on a 'binge'. Your are best keeping to a low-fat, low-sugar, low-carbohydrate, protein diet, with a balance of fresh fruit and vegetables and lots of nibbles. Personal diets can be prepared if you wish.
Try to avoid eating standard bread, as most PCOS sufferers can be yeast sensitive. You are better eating soda or rye bread, which does not contain yeast. You could also use yeast-free crispbreads as an alternative.
Organic vegetables and fruit are better than 'normal' vegetables and fruit.. The reason is that as a PCOS sufferers you are very sensitive to chemicals because of your hormone or chemical imbalance. Food that contains chemicals is best avoided. If you are unable to buy or cannot obtain organic fruit and vegetables, please try the following tip:- Wash all fruit and vegetables in a solution of one part cider-vinegar to twelve parts water, then rinse in filtered water to remove the vinegar odour. This can help to remove a good percentage of the pesticides and chemicals that are sprayed onto food whilst growing.
Please try to avoid processed or prepacked foods, that contain preservatives and colourings. Again, for the reason mentioned above, it is healthier to have fresh foods, whenever possible.
Do not fall into the 'low-fat' trap. A considerable number of low-fat products are very high in sugar and will certainly not help your slimming or healthy eating programme.
Try to drink lots of fresh, filtered water. It will detox the system and can reduce fluid retention problems. NEVER drink from plastic containers or cans. They contain chemicals and your chemical imbalance will be heightened.
NEVER eat meals that have been microwaved in their plastic containers. Again, please remember, you have a chemical imbalance and introducing more chemicals will slow up your healthy eating plan. Remove the food from the plastic container, place in a glass container before you microwave. This will be much healthier.
Try to eat plenty of cucumber and peppers, as 'nibbles'. They contain lots of vitamins and will help you to enjoy a healthy diet plan.
If you have been taking Metformin for over twelve months, this medication can, in some PCOS sufferers deplete the body of B Vitamins, which are essential for good health. You need to replace these vitamins by eating lots of 'what we call' BURNS. Burns are tiny pieces of protein food, which are eaten in tiny amounts every 15 minutes. Not only will they improve the Vitamin B level in the body, but will help the struggling PCOS slimmer to shed unwanted pounds.
Some PCOS sufferers have serious fertility problems. Please remember that, if you are overweight and you want to conceive a baby, consultants now agree that losing weight healthily, with a well-balanced diet, that provides all the vitamins that you need, will improve your chances of conceiving. Figures show that just losing 24 lbs, if you are seriously overweight, can improve your chances of conceiving very considerably.
Take plenty of exercise. It does not have to be strenuous. Walking, swimming and doing the exercises on this website will make a big difference. Always exercise on an empty stomach (after your lemon water) for the best results. Exercising after food when you have PCOS can turn the foods that you have eaten into sugars. This is because of your insulin and hormone imbalance. Better to exercise, gently, on an empty stomach. Five minutes a day is all that is needed, initially.
Regularly changing the food you eat will improve your weight loss and stop you getting bored. Having a different breakfast, lunch, evening meal and supper each day, will help. Eating a mid morning and mid afternoon snack will improve your health and weight loss. Going for long periods of time without food will result in your sugar-level dropping and you can get cravings for sweet foods.
PCOS sufferers who are overweight need a personal diet working out to suit their metabolism and these diets need to be changed regularly. Counselling and support from experts who know about the symptoms of PCOS are also vital. More advice can be given on individual diets if you email our experts.
Deep breathing exercises are also very important to PCOS sufferers. Taking deep breaths, by inhaling to the count of five, holding for two seconds, and then exhaling to the count of three, will not only expand your lungs, but can improve your circulation, sending oxygen to the brain and making you feel fitter and healthier. Trying these breathing exercises every morning before you get out of bed, will give you a good start to the day. You can also try the exercises if you find difficulty sleeping. Our PCOS sufferers assure us, that they really do work.
At all costs avoid sugar. Please remember that, you can have an insulin problem when you suffer with PCOS, and eating sugar can aggravate the problem. It is much better to use the 'sugar - free' alternatives. If you want some ideas or recipes, please email our experts for help, and we can send you our recipe books.
More tips will be added as we expand the website, but please remember that, we have been studying PCOS and all related problems and symptoms for some considerable time now. If you need an answer to a particular problem, please email. We will do all we can to help.