Friday, February 29, 2008

Adhesions News ARDvark Blog

Baxter Recalls All Heparin Vial Products
Written by Catharine Paddock, PhD
Baxter International Inc announced yesterday, Thursday 28th February, that it was recalling all remaining multi-dose and single-dose heparin sodium and HEP -LOCK heparin flush products now that alternative suppliers are able to meet national demand for them...[read article]
Peer-Reviewed Science Must Be The Source For Policy Decisions Regarding Drug Harm-Reduction

Possible Target To Treat Deadly Bloodstream Infections Found By Researchers

The Critically Ill May Be Harmed By Intensive Insulin Therapy

State-To-State Differences In Quality Of Care Revealed By New Child Health Data

Regulatory Agencies In Argentina And Brazil On The Specific Characteristics For Clinical Trial Development In Each Country

AMA Denounces Erosion Of Insurer Competition, USA

New National Poll: Majority Of American Voters Oppose Bush Administration's Proposed Cuts To Medicare

Clostridium Difficile Deaths Up In England And Wales

Antibiotic Resistant E. Coli Could Soon Become Prevalent, Similar To MRSA

Democratic Governors Call On Congress To Block Bush Administration Rules That Would Make It Harder For States To Expand SCHIP

Democratic Presidential Candidates Clinton, Obama Discuss Plans To Expand Health Coverage During Ohio Debate

Health Insurers Work To Address Issues Involving Retroactively Canceled Policies

AdvaMed Offers Qualified Support For Bill To Require Disclosure Of Payments From Medical Device Companies To Physicians

Medicaid Changes; Should Be Suspended Until Change In Administration, Senate Budget Chair Says

Potential Drug Targets Found In Scripps Study Of Sepsis In Mice

MIT Student Invents Knock-Out Punch For Antibiotic Resistance

Recovery Of Bowel Function After Gastrointestinal Surgery Aided By Chewing Gum

Blue Shield Of California Foundation Selects APIC In Initiative To Fight Healthcare-Associated Infections

Royal College Issues Guidance On The Management Of Premenstrual Syndrome, UK

Thalidomide Shows Promise For Treatment Of Recurrent Ovarian Cancer

ECRI Institute Salutes Patient Safety Week With Free Content On Disclosure Of Unanticipated Outcomes

Does Artificial Intelligence Help Clinicians To Recognize Atrophic Gastritis With Thyroid Disease?

Network To Study Health Care Disparities Affecting Minorities Launched By UCLA

NCCN Updates Ovarian Cancer Guidelines

Mayo Clinic Finds Capsule Endoscopy Can Detect Intestinal Damage Caused By Celiac Disease

Polycystic Ovary Syndrome PCOS

PCOD is a female hormonal imbalance where maturing eggs fail to be expelled from the ovary, creating an ovary filled with immature follicles. The cysts then contribute to the hormonal imbalance, which causes more cysts and enlarged ovaries. Polycystic ovary disease is characterized by anovulation (no formation of egg) irrespective of periods (regular or irregular or absent) and hyperandrogenism (elevated serum testosterone and androgen). Also women with PCOD who conceive have a higher rate of early foetal loss than women without PCOD.
PCOD women have fewer chances to conceive, compared to normal women who ovulate every month. Normal women get 12chances in a year to conceive. But PCOD women hardly get 3-4 chances due to delayed periods.
Relative causes of PCOD
PCOD does run in families. Several genes contribute to the pathogenesis of PCOD. Many of these genes are related to insulin resistance with elevated fasting blood insulin levels. The high levels of androgenic hormones interfere with the pituitary ovarian axis, leading to increased LH levels, anovulation, amenorrhea and infertility.
Young diabetic women treated with insulin are at special risk of PCOD. The amount of insulin injected by insulin-dependent or insulin-requiring diabetics is far in excess of what the body produces naturally.
Obesity is a common part of PCOD and many of these women are also insulin-resistant. When a woman is insulin-resistant, her fat cell does not respond normally to the insulin in the blood stream. Weight gain in itself can result from high serum insulin levels.
Symptoms of PCOD
The most common symptoms of PCOD are
Irregular and infrequent menstrual periods or no menstrual periods at all;
Infrequent or no ovulation with increased serum levels of male hormones - testosterone;
Inability to get pregnant within one year of unprotected sexual intercourse;
Weight gain or obesity;
Diabetes, over-production of insulin with abnormal lipid levels and high blood pressure;
Excess growth of hair on the face, chest, stomach in male pattern (hirsutism) and male-pattern baldness or thinning of hair;Acne, oily skin or dandruff;
Patches of thickened and dark brown or black skin on the neck, groin, underarms, or skin folds;
Skin tags, or tiny excess flaps of skin in the armpits or neck area;
Male fat storage patterns - abdominal storage rather than standard female pattern on thighs, hips and waist; and Mid-cycle pain indicating painful ovulation - due to the enlargement and blockage of the surface of the ovaries;
Consequences of PCOD
Hyperinsulinemia in PCOD has also been associated with high blood pressure and increased clot formation and appears to be a major risk factor for the development of heart disease, stroke and type-II diabetes
Women with irregular cycles need to have other conditions ruled out, such as anorexia, stress or exercise-induced problems with the menstrual cycle, other hormonal problems such as thyroid disease or medication problems.
The general consequences of PCOD are:Menstrual irregularities - Constant oestrogen production stimulates growth of the uterine lining which usually induces very heavy uterine bleeding. The bleeding episodes may occur after long gaps of time (oligomenorrhea) or, for some women, not at all (amenorrhea). Irregular periods are a nuisance and suggest some hormonal disorder or risk of endometrial thickening.
Impaired Fertility- Another consequence of incomplete follicular development is a lack of regular ovulation. Irregular ovulation usually means that pregnancy is more difficult to achieve. Similarly, if ovulation is not taking place, it is not possible to conceive.
Miscarriage - While miscarriage seems an unfortunate chance event for most couples, it is clear that women with PCOD may be at increased risk of early foetal loss. The hormonal environment in PCOD may interfere with egg development within the follicle and disrupt embryo implantation within the uterus.
Hair and skin problems - Androgen (male hormone) is a byproduct of the ovaries. In PCOD, the production of androgen, such as testosterone, is excessive, which causes abnormally increased hair growth and contributes to acne formation. The assessment of excessive hair growth (or hirsutism) may be difficult.
Obesity - About 50 per cent of women with PCOD are obese. Obesity tends to enhance abnormal estrogen and androgen production in this disorder, which only magnifies the problems of irregular bleeding and excessive hair growth.
More important, the long-term effects of unopposed oestrogen place women with the syndrome at considerable risk for endometrial cancer or breast cancer.
Diagnosis of PCOD - The signs of PCOD are ovaries slightly enlarged and may contain 10 or more small cysts located at the periphery of the ovary, which have led to polycystic ovaries. The size of these cysts is generally less than 8 mm and can usually be detected by ultrasound examination. Pelvic and physical examination, ultra sound scanning, blood tests to measure hormone, insulin and cholesterol levels will also help. Height and weight will be noted along with any increase in facial or body hair or loss of scalp hair, acne and discoloration of the skin under the arms, breasts and in the groin. Elevated androgen levels or testosterone confirms the diagnosis.
General treatment for PCOD
Mostly patients take treatment for cosmetic ailments like obesity, unwanted hair growth or acne. They will not mind the underlying delayed and heavy periods which is to be treated first. Medical treatment should be given to correct irregular menstruation, eradicate excessive hair growth or achieve pregnancy.
Because there is no cure for PCOD in Allopathy, it concentrates on ways of management to prevent further problems. The treatment can be as:
Medication: To induce a menstrual period and restore normal cycles, birth control pills are used. It regulates menstruation, reduces androgen levels and helps to clear acne. The method of treatment depends on the severity of the symptoms and whether the patient is trying to get pregnant or not. If not trying to conceive, then they are treated with hormones, including the birth control pill. If trying to become pregnant, fertility drugs and other treatments are necessary.
Getting normal can be tried:
1) Eating a balanced diet low in carbohydrates and maintaining a healthy weight can help lessen the symptoms of PCOD.2) Regular exercise helps weight loss and also helps the body in reducing blood glucose levels. Aerobic activities such as walking, jogging or swimming are advised. With reduction of weight and reduction in insulin resistance, regular periods will mostly resume. It is not always possible to promise a woman who has achieved ideal body weight and who continues with exercise that she may have regular ovulation.3) For reducing excess body and facial hair, bleaching, removal by waxing or a hair removal cream can be used. For permanent facial hair removal, electrolysis is done.
Treatment of PCOD for the infertile patient will usually focus on ovulation inducting. They induce ovulation with fertility drugs. Sometimes fertility drugs may induce risk of multiple pregnancies.
Surgery: Doctors used to perform ovarian surgery called wedge re-section to help patients with PCOD to ovulate. A recent treatment option uses laparoscopy to treat patients with PCOD. During operative laparoscopy, a laser is used to drill multiple holes through the thickened ovarian capsule. When wedge re-section or drilling is used, there is risk of inducing adhesions around the ovary. As a result of these, surgeries are used as the last resort.
Related
Naomi Campbell fine after cyst operationThe Sun, UK - Feb 27, 2008
Polycystic Ovary Syndrome (PCOS) – where there are several cysts – is a more serious condition associated with hormonal abnormalities. ...

Wednesday, February 27, 2008

Adhesions news ARDvark Blog

America Will Be Spending One Fifth Of GDP On Healthcare By 2017

EndoGastric Solutions(TM) Announces Results Of EsophyX(TM) Multi-Center GERD Study

Bacterial 'Battle For Survival' Leads To New Antibiotic - Holds Promise For Treating Stomach Ulcers

Causes Of, Risk Factors For Pelvic Floor Injury To Be Determined By OHSU Researcher, Funded By NIH Award

News From The Journal Of Neuroscience

Botox Examined By U Of C Researchers In New Study

ITrials Launches New Technology To Identify Clinical Trial Risks Before Significant Recruiting Investments Are Made

Kohl To Examine Medical Device Industry Practice Of Providing Payments To Surgeons, USA

Tips For Troublesome Medications, From The Harvard Heart Letter

Baby Boomers Confused About Medicare, According To Recent NAIC Survey

Researchers Identify And Shut Down Protein That Fuels Ovarian Cancer

Researchers Engineer First System Of Human Nerve Cell Tissue

Risks Of CVD For COX 2 Inhibitors Lower Than Previously Reported

Prophylactic nasogastric decompression after abdominal surgery

Nelson R, Edwards S, Tse B
Summary
Nasogastric decompression used routinely after abdominal surgery does not speed recovery.This systematic review of 33 trials showed that routine use of nasogastric tube decompression after abdominal operations, rather than speeding recovery, may slow recovery down and increase the risk of some postoperative complications. On the other hand routine use may decrease the risk of wound infection and subsequent ventral hernia.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2008 Issue 1, Copyright © 2008 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).This record should be cited as: Nelson R, Edwards S, Tse B. Prophylactic nasogastric decompression after abdominal surgery. Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No.: CD004929. DOI: 10.1002/14651858.CD004929.pub3
This version first published online: January 24. 2005Date of last subtantive update: April 17. 2007
Abstract
Background
Routine use of nasogastric tubes after abdominal operations is intended to hasten the return of bowel function, prevent pulmonary complications, diminish the risk of anastomotic leakage, increase patient comfort and shorten hospital stay.
Objectives
To investigate the efficacy of routine nasogastric decompression after abdominal surgery in achieving each of the above goals.
Search strategy
Search terms were nasogastric, tubes, randomised, using MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (Central), and references of included studies, from 1966 through 2006.
Selection criteria
Patients having abdominal operations of any type, emergency or elective, who were randomised prior tot he completion of the operation to receive a nasogastric tube and keep it in place until intestinal function had returned, versus those receiving either no tube or early tube removal, in surgery, in recovery or within 24 hours of surgery. Excluded will be randomised studies involving laparoscopic abdominal surgery and patient groups having gastric decompression through gastrostomy.
Data collection and analysis
Data were abstracted onto a form that assessed study eligibility, as defined above, quality related to randomizations, allocation concealment, study size and dropouts, interventions, including timing and duration of intubation, outcomes that included time to flatus, pulmonary complications, wound infection, anastomotic leak, length of stay, death, nausea, vomit ting, tube reinsertion, subsequent ventral hernia.
Main results
33 studies fulfilled eligibility criteria, encompassing 5240 patients, 2628 randomised to routine tube use, and 2612 randomised to selective or No Tube use. Patients not having routine tube use had an earlier return of bowel function (p<0.00001), a decrease in pulmonary complications (p=0.01) and an insignificant trend toward increase in risk of wound infection (p=0.22) and ventral hernia (0.09). Anastomotic leak was no different between groups (p=0.70). Vomit ting seemed to favour routine tube use, but with increased patient discomfort. Length of stay was shorter when no tube was used but the heterogeneity encountered in these analyses make rigorous conclusion difficult to draw for this outcome. No adverse events specifically related to tube insertion (direct tube trauma) were reported. Other outcomes were reported with insufficient frequency to be informative.
Authors' conclusions
Routine nasogastric decompression does not accomplish any of its intended goals and so should be abandoned in favour of selective use of the nasogastric tube.
Surgery Archive

Cardiovascular Sciences, Inc. Consolidates Progress and Forges Ahead

SOURCE: Cardiovascular Sciences
Feb 19, 2008 08:18 ET

ORLANDO, FL--(Marketwire - February 19, 2008) - Cardiovascular Sciences, Inc. (PINKSHEETS: CVSC) was established a few years ago to investigate and develop novel medical technologies to meet unmet and only partially addressed clinical needs. Areas of endeavor have required technologies as wide ranging as cell engineering to clot resistant coatings to tissue grafts to guided radiofrequency ablators and more. But what gradually became evident to the Company's technical team as they considered a variety of factors such as the size and growth of the ultimate market, the shortfalls of available products for this need, and the resources and time required to develop a likely technology to marketability, there was one clinical need that trumped the other areas. That is the need to prevent adhesions and adhesion related complications that often follow various surgeries and traumas. The cost of these complications constitutes a $6+ billion global market.
The adhesion process is part of normal healing and is what allows the edges of a cut on the skin to knit together and heal. But when two adjacent tissues that are not normally attached are stressed as happens in most surgeries, the surfaces can scar together and contract, causing problems ranging from minor discomfort to joint limitation to life threatening obstruction and intestinal perforation. The key to preventing this is to use a material to separate the surfaces for several days that then degrades and reabsorbs after the healing has reached the point after which adhesions are unlikely to occur.
Focusing on this need has allowed the team to consolidate its resources and efforts in the most productive area. A new president with market development experience was brought in, Mr. Eric O. Edelmann, who remains as a consultant. Larry Hooper, a physician, was moved into the top spot as CEO, directed and coordinated the team's research at the University of Central Florida. Along with this, the Company was admitted into UCF's award winning Technology Incubator program where it has garnered much praise as evidenced by Gordon Hogan, the incubator's Business Development Executive, "It is exciting to watch Cardiovascular Sciences leverage their existing management strengths with the scientific and technological strengths of UCF. This convergence can easily result in dramatic changes in the prevention of surgical adhesions." Carol Ann Dykes, the incubator's Technology Site Manager is similarly enthused. "It's been exciting to watch this committed and passionate team pull it together and march toward what promises to be an exciting and successful future."
"Rightly or wrongly," explains the company's CEO, "the company did spend considerable effort chasing and investigating a wide range of technologies." But Dr. Hooper hastens to add, "But if not for that, we would not have found, developed and understood the value of the technology we now have. And by intently focusing in this area, the range of indications and other possible uses of the second generation material we have produced continue to blossom well beyond what we first envisioned."
The recent funding event announced with Seven Palm Investments, LLC now allows the company to intensify its efforts and move into high gear with its R & D. This next year should see an increasing frequency of announcements as the Company continues to develop an even wider variety of applications for its products, and commences expanded in vitro and animal trials as it relentlessly pursues the course to marketing its proprietary technology.
About Cardiovascular Sciences
Cardiovascular Sciences, Inc. is an advanced medical device company which is developing a novel technology platform to address the problem of post-surgical and post-traumatic adhesions. Adhesions and the complications of adhesions are a significant problem worldwide for a wide range of specialists, including general surgeons, cardiothoracic surgeons, orthopedic, plastic, and ophthalmologic and otolaryngology specialists to name just some of them. In addition, the veterinary field has a tremendous need for a product that can prevent similar problems in a wide variety of animals.
The Company's unique materials and processes promise a more cost-effective and decidedly more efficient and capable means to deal with a problem that has been so devastating to so many. Current sponsored research at the University of Central Florida (UCF) and previously at other institutions indicate that The Company is on the right path and progressing well.
In addition to the anti-adhesion technology, The Company owns technology in a variety of other areas, including thrombo-resistant coatings, enhanced intra-arterial balloon pumping catheters, cell engineered vascular tissues, and a method for improved recovery of the heart following cardioplegia. This yields a diversified portfolio with projects in various stages of development. www.cvsciences.org
Forward-looking statements in this release are made pursuant to the Safe Harbor Provisions of the Private Securities Litigation Reform Act of 1995. These forward-looking statements are subject to certain risks, and uncertainties and actual results could differ from those discussed. This material is information only and is not an offer or solicitation to buy or sell the securities.

Pelvic inflammatory disease

Pelvic inflammatory disease (or disorder) (PID) is a generic term for inflammation of the female uterus, fallopian tubes, and/or ovaries as it progresses to scar formation with adhesions to nearby tissues and organs. This may lead to tissue necrosis with/or without abscess formation. Pus can be released into the peritoneum. Two thirds of patients with laparoscopic evidence of previous PID were not aware they had had PID.[1] PID is often associated with sexually transmitted diseases, as it is a common result of such infections. PID is a vague term and can refer to viral, fungal, parasitic, though most often bacterial infections. PID should be classified by affected organs, the stage of the infection, and the organism(s) causing it. Although an STD is often the cause, other routes are possible, including lymphatic, postpartum, postabortal (either miscarriage or abortion) or intrauterine device (IUD) related, and hematogenous spread.

Epidemiology
In the United States, more than one million women are affected by PID each year, and the rate is highest with teenagers. Over 100,000 women become infertile in the US each year from PID.[2] N. gonorrhoea is isolated in only 40-60% of women with acute salpingitis.[3] C. trachomatis was estimated by current obgyn 9th ed to be the cause in about 60% of cases of salpingitis, which may lead to PID. It is unsure how much is due to a single organism and how much is due to multiple organisms; many other pathogens that are in normal vaginal flora become involved in PID. 10% of women in one study had asymptomatic Chlamydia trachomatis infection and 65% had asymptomatic infection with Neisseria gonorrhoeae.[3] It was noted in one study that 10-40% of untreated women with N. gonorrhoea develop PID and 20-40% of women infected with C. trachomitis developed PID.[1] PID is the leading cause of infertility. "A single episode of PID results in infertility in 13% of women."[1] This rate of infertility increases with each infection.

Diagnosis
There may be no actual symptoms of PID. If there are symptoms then fever, cervical motion tenderness, lower abdominal pain, new or different discharge, painful intercourse, or irregular menstrual bleeding may be noted. It is important to note that PID can occur and cause serious harm without causing any noticeable symptoms. Laparoscopic identification is helpful in diagnosing tubal disease, 65-90% positive predictive value in patients with presumed PID.[3] Regular Sexually transmitted disease (STD) testing is important for prevention. Treatment is usually started empirically because of the terrible complications. Definitive criteria include: histopathologic evidence of endometritis, thickened filled fallopian tubes, or laparoscopic findings. Gram-stain/smear becomes important in identification of rare and possibly more serious organisms.[1]

Differential diagnosis
Appendicitis, ectopic pregnancy, septic abortion, hemorrhagic or ruptured ovarian cysts or tumors, twisted ovarian cyst, degeneration of a myoma, and acute enteritis must be considered. Pelvic inflammatory disease is more likely to occur when there is a history of pelvic inflammatory disease, recent sexual contact, recent onset of menses, or an IUD in place or if the partner has a sexually transmitted disease.
Acute pelvic inflammatory disease is highly unlikely when recent intercourse has not taken place or an IUD is not being used. A sensitive serum pregnancy test should be obtained to rule out ectopic pregnancy. Culdocentesis will differentiate hemoperitoneum (ruptured ectopic pregnancy or hemorrhagic cyst) from pelvic sepsis (salpingitis, ruptured pelvic abscess, or ruptured appendix).
Pelvic and vaginal ultrasounds are helpful in the differential diagnosis of ectopic pregnancy of over six weeks. Laparoscopy is often utilized to diagnose pelvic inflammatory disease, and it is imperative if the diagnosis is not certain or if the patient has not responded to antibiotic therapy after 48 hours.
No single test has adequate sensitivity and specificity to diagnose pelvic inflammatory disease. A large mulitsite U.S. study found that cervical motion tenderness as a minimum clinical criterion increases the sensitivity of the CDC diagnostic criteria from 83% to 95%. However, even the modified 2002 CDC criteria does not identify women with subclinical disease.[4]

Prognosis
Although the PID infection itself may be cured, effects of the infection may be permanent. This makes early identification by someone who can prescribe appropriate curative treatment so important in the prevention of damage to the reproductive system. Since early gonococcal infection may be asymptomatic, regular screening of individuals at risk for common agents (history of multiple partners, history of any unprotected sex, or people with symptoms) or because of certain procedures (post pelvic operation, postpartum, miscarriage or abortion). Prevention is also very important in maintaining viable reproduction capabilities.
If the initial infection is mostly in the lower tract, after treatment the person may have few difficulties. If the infection is in the fallopian tubes or ovaries, more serious complications are more likely to occur.

Complications
PID can cause scarring inside the reproductive organs, which can later cause serious complications, including chronic pelvic pain, infertility (difficulty becoming pregnant), ectopic pregnancy (the leading cause of pregnancy-related deaths in adult females), and other dangerous complications of pregnancy. Multiple infections and infections that are treated later are more likely to result in complications.
Infertile women may wish to see a specialist, because there may be a possibility in restoring fertility after scarring. Traditionally tuboplastic surgery was the main approach to correct tubal obstruction or adhesion formation, however success rates tended to be very limited. In vitro fertilization (IVF) was developed to bypass tubal problems and has become the main treatment for patients who want to become pregnant.

Treatment
Treatment depends on the cause and generally involves use of antibiotic therapy. If the patient has not improved within two to three days after beginning treatment with the antibiotics, they should return to the hospital for further treatment. Drugs should also be given orally and/or intravaneously to the patient while in the hospital to begin treatment immediately to increase the effectiveness of antibiotic treatment. Hospitalization may be necessary if Tubo-ovarian abscess, very ill, immunodeficient, pregnancy, incompetence, or because this or something else life threatening can not be ruled out. Treating partners for STD's is a very important part of treatment and prevention. Anyone with PID and partners of patients with PID since six months prior to diagnosis should be treated to prevent reinfection. Psychotherapy is highly recommended to women diagnosed with PID as the fear of redeveloping the disease after being cured may exist. It is important for a patient to communicate any issues and/or uncertainties they may have to a doctor, especially a specialist such as a gynecologist, and in doing so, to seek follow-up care.
A systematic review of the literature related to PID treatment was performed prior to the 2006 CDC sexually transmitted diseases treatment guidelines. Strong evidence suggests that neither site nor route of antibiotic administration affects the short or long-term major outcome of women with mild or moderate disease. Data on women with severe disease was inadequate to influence the results of the study. [5]

Prevention
Risk reduction against sexually transmitted diseases through abstinence or barrier methods such as condoms, see human sexual behavior for other listings.
Going to the doctor immediately if symptoms of PID, sexually transmitted diseases appear, or after learning that a current or former sex partner has, or might have had a sexually transmitted disease.
Getting regular gynecological (pelvic) exams with STD testing to screen for symptomless PID.[6]
Discussing sexual history with a trusted physician in order to get properly screened for sexually transmitted diseases.
Regularly scheduling STD testing with a physician and discussing which tests will be performed that session.
Getting a STD history from your current partner and insisting they be tested and treated before intercourse.
Understanding when a partner says that they have been STD tested they usually mean chlamydia and gonorrhea in the US, but that those are not all of the sexually transmissible diseases.
Treating partners to prevent reinfection or spreading the infection to other people.

Other diseases that can lead to or be involved in PID
Salpingitis, any infection of the fallopian tubes.
Tubo-ovarian abscess an abscess of the fallopian tube or ovary.
Endometritis
Pelvic peritonitis
The Dalkon Shield (withdrawn from the market in 1975 for this reason)
Bacterial Vaginosis

References
^ a b c d Loscalzo, Joseph; Andreoli, Thomas E.; Cecil, Russell L.; Carpenter, Charles A.; Griggs, Robert C. (2001). Cecil essentials of medicine. Philadelphia: W.B. Saunders. ISBN 0-7216-8179-4.
^ STD Facts - Pelvic inflammatory disease (PID). Retrieved on 2007-11-23.
^ a b c Lauren Nathan; DeCherney, Alan H.; Pernoll, Martin L. (2003). Current obstetric & gynecologic diagnosis & treatment. New York: Lange Medical Books/McGraw-Hill. ISBN 0-8385-1401-4.
^ Blenning CE, Muench J, Judkins DZ, Roberts KT (2007). "Clinical inquiries. Which tests are most useful for diagnosing PID?". J Fam Pract 56 (3): 216–20. PMID 17343812. 
^ Walker CK, Wiesenfeld HC (2007). "Antibiotic therapy for acute pelvic inflammatory disease: the 2006 Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines". Clin. Infect. Dis. 44 Suppl 3: S111–22. doi:10.1086/511424. PMID 17342664. 
^ Smith KJ, Cook RL, Roberts MS (2007). "Time from sexually transmitted infection acquisition to pelvic inflammatory disease development: influence on the cost-effectiveness of different screening intervals". Value Health 10 (5): 358–66. doi:10.1111/j.1524-4733.2007.00189.x. PMID 17888100. 

External links
NIH/Medline
CDC
Pelvic Inflammatory Disease (PID; Salpingitis, Endometritis)

EndoTimes: Pelvic Pain? Solve the Mystery

EndoTimes: Pelvic Pain? Solve the Mystery

Tuesday, February 26, 2008

Fentanyl patches recalled over leakage risk

20-Feb-2008 - Concerns have been building across North America about the safety of transdermal patches for delivering the highly potent narcotic analgesic fentanyl.
Both brand-name and generic companies selling fentanyl patches have recalled some of their products voluntarily due to the risk of a potentially life-threatening manufacturing defect.The problems emerged last week when PriCara, a division of Ortho-McNeil-Janssen Pharmaceuticals, said all lots of 25 microgram/hour (mcg/hr) Duragesic (fentanyl transdermal system) CII patches sold by PriCara in the US, as well as all 25 mcg/hr fentanyl patches sold as an authorised generic by Sandoz in the same market, were being recalled voluntarily "as a precaution" from wholesalers and pharmacies. The action was taken in co-operation with the US Food and Drug Administration (FDA). The patches involved all had expiry dates of December 2009 or earlier and were all manufactured by Alza, the drug delivery specialist that, like PriCara, is part of the Johnson & Johnson group. All 25 mcg fentanyl patches manufactured by Alza and sold in Canada - by both Janssen-Ortho as Duragesic and by Ranbaxy as Ran Fentanyl Transdermal System patches, under an October 2006 licensing and supply agreement between Janssen-Ortho and Ranbaxy Pharmaceuticals Canada - were also taken off the market. The Canadian regulatory authority, Health Canada, issued a public health advisory warning against use of the affected patches.As PriCara explained, the patches concerned "may have a cut along one side of the drug reservoir". That meant there was a possibility the fentanyl gel could be released from the gel reservoir into the pouch in which the patch is packaged, "exposing patients or caregivers to fentanyl gel". As the company pointed out, fentanyl is a powerful opioid compound classified under Schedule II of the US Controlled Substances Act. Exposure to fentanyl gel "may lead to serious adverse events, including respiratory depression and possible overdose, which may be fatal", it warned. Nor would patches with a cut edge that had leaked gel provide effective pain relief, PriCara noted. This is not the first time Johnson & Johnson has run into difficulties with Duragesic. There have been a number of recalls of the patch since it was originally approved in the US in August 1990, although PriCara spokesman Greg Panico said these involved different manufacturing issues from those behind the current recall.
Read More:
http://www.in-pharmatechnologist.com/news/ng.asp?n=83383-actavis-johnson-johnson-fentanyl-duragesic

Adhesions News ARDvark Blog

Who Benefits From Antidepressants? US Health Inequities

Silica Smart Bombs Deliver Knock Out To Bacteria

New Study Suggests Young Adults More Approving Of Cosmetic Surgery

Flu Season At Its Peak: Experts Have Tips For Staying Healthy

Jhpiego Honors Women Around The World - International Women's Day, March 8, 2008

New Consortium Announces Significant Grant Funding Of Anaemia Product Programme, UK

Indiana U Study May Alter Approach To Psychiatric Treatment

Insights Into Drug Toxicity Revealed By New Chemical Tool Kit That Manipulates Mitochondria

Attorney General Martha Coakley Reaches Settlement With Drug Second Manufacturer In Oral Contraceptive Lawsuit, Massachesetts

Center For Assisted Reproduction Is First In Southwest To Offer Pioneering Test Of A Woman's Biological Clock

Baltimore Sun Examines Concerns About Overuse Of CT Scan

CMS Proposes Medicaid Changes That Would Give States 'Unprecedented Flexibility'

More Surgery Problems For Obese Children

Hyaluronan Treatment Of Interstitial Cystitis/Painful Bladder Syndrome

Before A CT Scan, Many Should Take Drug To Protect Kidneys

Clinical Trials: Anti adhesion agent

From http://clinicaltrials.gov/

Found 27 studies with search of:
Anti adhesion agent


1
Recruiting
Pilot Study Evaluating the Safety and Potential Trends in Efficacy of Adhexil
Condition:
Bilateral Ovarian Disease
Intervention:
Biological: Anti adhesion agent
2
Completed
Efficacy and Safety Study of Anti-Adhesion Product in the Prevention of Intraperitoneal Adhesions
Condition:
Intraperitoneal Adhesions
Intervention:
Biological: Anti-Adhesion Product
3
Active, not recruiting
The Effects of Cranberry Juice on Bacterial Adhesion
Conditions:
Bacterial Vaginosis; Oxaluria
Intervention:
Procedure: cranberry juice
4
Active, not recruiting
Allogeneic Bone Marrow Transplantation in Patients With Primary Immunodeficiencies
Conditions:
Immunologic Deficiency Syndromes; Chediak-Higashi Syndrome; Common Variable Immunodeficiency; Graft Versus Host Disease; X-Linked Lymphoproliferative Syndrome; Familial Erythrophagocytic Lymphohistiocytosis; Hemophagocytic Lymphohistiocytosis; X-Linked Agammaglobulinemia; Wiskott-Aldrich Syndrome; Chronic Granulomatous Disease; X-Linked Hyper IgM Syndrome; Severe Combined Immunodeficiency; Leukocyte Adhesion Deficiency Syndrome; Virus-Associated Hemophagocytic Syndrome
Interventions:
Drug: anti-thymocyte globulin; Drug: busulfan; Drug: cyclophosphamide; Drug: cyclosporine; Drug: etoposide; Drug: methotrexate; Drug: methylprednisolone; Drug: prednisone; Procedure: Allogeneic Bone Marrow Transplantation
5
Active, not recruiting
The Effect of Beta-Blockers and Aspirin on Hemostasis and Endothelial Function After Acute Mental Stress
Conditions:
Arteriosclerosis; Stress, Psychological
Intervention:
Drug: inderal (drug), acetylsalicylic acid (drug)
6
Completed
Evaluation of Adhesion and Dermal Tolerability of EMSAM
Condition:
Healthy
Interventions:
Drug: EMSAM (Selegiline Transdermal System) 6mg/24Hr; Drug: EMSAM (Selegiline Transdermal System) 9mg/24Hr; Drug: EMSAM (Selegiline Transdermal System) 12mg/24hr
7
Recruiting
Efalizumab to Treat Uveitis
Conditions:
Uveitis; Intraocular Inflammatory Diseases
Intervention:
Drug: Raptiva (efalizumab)
8
Completed
Interferon Gamma to Treat Leukocyte Adhesion Deficiency Type I
Condition:
Leukocyte Adhesion Deficiency Syndrome
Intervention:
Drug: Interferon gamma
9
Not yet recruiting
Oxidative Stress Lowering Effect of Simvastatin and Atorvastatin.
Conditions:
Diabetes Mellitus; Hypertension
Interventions:
Drug: atrorvastatin 10mg; Drug: simvastatin 40mg
10
Recruiting
Raptiva to Treat Sjogren's Syndrome
Condition:
Sjogren's Syndrome
Intervention:
Drug: Raptiva
11
Recruiting
Impact of Pitavastatin in Hypercholesterolemic Patients With Metabolic Syndrome
Conditions:
Metabolic Syndrome; Oxidative Stress; Inflammation
Intervention:
Drug: pitavastatin
12
Completed
Vascular and Metabolic Effects of Hormone Therapy Combined With L-Arginine in Postmenopausal Women
Conditions:
Hypercholesterolemia; Postmenopause
Interventions:
Drug: L-arginine; Drug: Estrogen
13
Completed
A Pharmacokinetic Study of Genistein, a Tyrosine Kinase Inhibitor
Condition:
Cancer
Intervention:
Drug: Genistein
14
Recruiting
Donor Stem Cell Transplantation for Congenital Immunodeficiencies
Conditions:
MUD Transplant; AlloPBSC; Congenital Immunodeficiencies; HLA Matched Transplant; BMT
Interventions:
Drug: Busulfan; Drug: Campath-1 H; Drug: Sirolimus; Procedure: BMT; Procedure: Apheresis; Procedure: Total Body Irradiation; Procedure: GCSF Injections
15
Suspended
Phase III Randomized Trial of Thalidomide/Dexamethasone vs VAD.
Condition:
Multiple Myeloma
Interventions:
Drug: thalidomide; Drug: dexamethasone; Drug: vincristine; Drug: doxorubicin; Drug: zoledronic acid
16
Recruiting
Dexamethasone to Treat Acute Chest Syndrome in People With Sickle Cell Disease
Condition:
Anemia, Sickle Cell
Interventions:
Drug: Dexamethasone; Drug: Placebo
17
Not yet recruiting
Rosiglitazone and Metformin: Outcomes Trial in Nondiabetic Patients With Stable Coronary Syndromes (Romance) Pilot Study
Condition:
Coronary Artery Disease
Intervention:
Drug: rosiglitazone/metformin
18
Recruiting
A Pilot Study of the Mechanism of Synergism Between FP and Salmeterol in Preventing COPD Exacerbations
Condition:
Pulmonary Disease, Chronic Obstructive
Intervention:
Drug: fluticasone and salmeterol
19
Recruiting
Study of the Inflammatory Activity in Diabetic Patients With Stable Angina Treated With Simvastatin and Ezetimibe
Conditions:
Diabetes; Stable Angina
Intervention:
Drug: simvastatin or ezetimibe/simvastatin, 6 weeks
20
Recruiting
Study of the Arachidonate 5-Lipoxygenase Enzyme in Affecting the Risk for Coronary Heart Disease
Condition:
Coronary Heart Disease
Intervention:
Drug: montelukast
21
Completed
GALLEX 4 - Long-Term Extension Study to Evaluate Tesaglitazar Therapy in Patients With Type 2 Diabetes
Condition:
Type 2 Diabetes
Intervention:
Drug: Tesaglitazar
22
Completed
Efficacy and Safety Study of Miconazole Lauriad to Treat Oropharyngeal Candidiasis in HIV Patients
Condition:
HIV Infections
Intervention:
Drug: miconazole Lauriad
23
Active, not recruiting
Non-Traditional Cardiovascular Risk Factors and Atherosclerosis in Type 2 Diabetes
Condition:
Type 2 Diabetes Mellitus
Interventions:
Drug: Insulin; Drug: Glimepiride; Drug: Rosiglitazone; Drug: Metformin
24
Terminated
N-Acetylcysteine and Arginine Administration in Diabetic Patients
Conditions:
Type 2 Diabetes Mellitus; Hypertension
Interventions:
Drug: Arginine; Drug: Acetylcysteine; Drug: Placebo
25
Completed
GALLANT 7 Tesaglitazar Add-on to Sulphonylurea
Condition:
Type 2 Diabetes
Interventions:
Drug: Tesaglitazar 0.5 or 1 mg; Drug: Glibenclamide 2.5, 5, 10 or 15 mg
26
Completed
GALLANT 4 Tesaglitazar vs. Glibenclamide
Condition:
Type 2 Diabetes
Interventions:
Drug: Tesaglitazar; Drug: Glibenclamide
27
Recruiting
A Safety Study of Two Intratumour Doses of Coxsackievirus Type A21 in Melanoma Patients.
Condition:
Stage IV Melanoma
Intervention:
Drug: Coxsackievirus A21

Clinical Trials: Anti adhesion agent

From http://ClinicalTrials.gov

Found 27 studies with search of:
Anti adhesion agent

1
Recruiting
Pilot Study Evaluating the Safety and Potential Trends in Efficacy of Adhexil
Condition:
Bilateral Ovarian Disease
Intervention:
Biological: Anti adhesion agent
2
Completed
Efficacy and Safety Study of Anti-Adhesion Product in the Prevention of Intraperitoneal Adhesions
Condition:
Intraperitoneal Adhesions
Intervention:
Biological: Anti-Adhesion Product
3
Active, not recruiting
The Effects of Cranberry Juice on Bacterial Adhesion
Conditions:
Bacterial Vaginosis; Oxaluria
Intervention:
Procedure: cranberry juice
4
Active, not recruiting
Allogeneic Bone Marrow Transplantation in Patients With Primary Immunodeficiencies
Conditions:
Immunologic Deficiency Syndromes; Chediak-Higashi Syndrome; Common Variable Immunodeficiency; Graft Versus Host Disease; X-Linked Lymphoproliferative Syndrome; Familial Erythrophagocytic Lymphohistiocytosis; Hemophagocytic Lymphohistiocytosis; X-Linked Agammaglobulinemia; Wiskott-Aldrich Syndrome; Chronic Granulomatous Disease; X-Linked Hyper IgM Syndrome; Severe Combined Immunodeficiency; Leukocyte Adhesion Deficiency Syndrome; Virus-Associated Hemophagocytic Syndrome
Interventions:
Drug: anti-thymocyte globulin; Drug: busulfan; Drug: cyclophosphamide; Drug: cyclosporine; Drug: etoposide; Drug: methotrexate; Drug: methylprednisolone; Drug: prednisone; Procedure: Allogeneic Bone Marrow Transplantation
5
Active, not recruiting
The Effect of Beta-Blockers and Aspirin on Hemostasis and Endothelial Function After Acute Mental Stress
Conditions:
Arteriosclerosis; Stress, Psychological
Intervention:
Drug: inderal (drug), acetylsalicylic acid (drug)
6
Completed
Evaluation of Adhesion and Dermal Tolerability of EMSAM
Condition:
Healthy
Interventions:
Drug: EMSAM (Selegiline Transdermal System) 6mg/24Hr; Drug: EMSAM (Selegiline Transdermal System) 9mg/24Hr; Drug: EMSAM (Selegiline Transdermal System) 12mg/24hr
7
Recruiting
Efalizumab to Treat Uveitis
Conditions:
Uveitis; Intraocular Inflammatory Diseases
Intervention:
Drug: Raptiva (efalizumab)
8
Completed
Interferon Gamma to Treat Leukocyte Adhesion Deficiency Type I
Condition:
Leukocyte Adhesion Deficiency Syndrome
Intervention:
Drug: Interferon gamma
9
Not yet recruiting
Oxidative Stress Lowering Effect of Simvastatin and Atorvastatin.
Conditions:
Diabetes Mellitus; Hypertension
Interventions:
Drug: atrorvastatin 10mg; Drug: simvastatin 40mg
10
Recruiting
Raptiva to Treat Sjogren's Syndrome
Condition:
Sjogren's Syndrome
Intervention:
Drug: Raptiva
11
Recruiting
Impact of Pitavastatin in Hypercholesterolemic Patients With Metabolic Syndrome
Conditions:
Metabolic Syndrome; Oxidative Stress; Inflammation
Intervention:
Drug: pitavastatin
12
Completed
Vascular and Metabolic Effects of Hormone Therapy Combined With L-Arginine in Postmenopausal Women
Conditions:
Hypercholesterolemia; Postmenopause
Interventions:
Drug: L-arginine; Drug: Estrogen
13
Completed
A Pharmacokinetic Study of Genistein, a Tyrosine Kinase Inhibitor
Condition:
Cancer
Intervention:
Drug: Genistein
14
Recruiting
Donor Stem Cell Transplantation for Congenital Immunodeficiencies
Conditions:
MUD Transplant; AlloPBSC; Congenital Immunodeficiencies; HLA Matched Transplant; BMT
Interventions:
Drug: Busulfan; Drug: Campath-1 H; Drug: Sirolimus; Procedure: BMT; Procedure: Apheresis; Procedure: Total Body Irradiation; Procedure: GCSF Injections
15
Suspended
Phase III Randomized Trial of Thalidomide/Dexamethasone vs VAD.
Condition:
Multiple Myeloma
Interventions:
Drug: thalidomide; Drug: dexamethasone; Drug: vincristine; Drug: doxorubicin; Drug: zoledronic acid
16
Recruiting
Dexamethasone to Treat Acute Chest Syndrome in People With Sickle Cell Disease
Condition:
Anemia, Sickle Cell
Interventions:
Drug: Dexamethasone; Drug: Placebo
17
Not yet recruiting
Rosiglitazone and Metformin: Outcomes Trial in Nondiabetic Patients With Stable Coronary Syndromes (Romance) Pilot Study
Condition:
Coronary Artery Disease
Intervention:
Drug: rosiglitazone/metformin
18
Recruiting
A Pilot Study of the Mechanism of Synergism Between FP and Salmeterol in Preventing COPD Exacerbations
Condition:
Pulmonary Disease, Chronic Obstructive
Intervention:
Drug: fluticasone and salmeterol
19
Recruiting
Study of the Inflammatory Activity in Diabetic Patients With Stable Angina Treated With Simvastatin and Ezetimibe
Conditions:
Diabetes; Stable Angina
Intervention:
Drug: simvastatin or ezetimibe/simvastatin, 6 weeks
20
Recruiting
Study of the Arachidonate 5-Lipoxygenase Enzyme in Affecting the Risk for Coronary Heart Disease
Condition:
Coronary Heart Disease
Intervention:
Drug: montelukast
21
Completed
GALLEX 4 - Long-Term Extension Study to Evaluate Tesaglitazar Therapy in Patients With Type 2 Diabetes
Condition:
Type 2 Diabetes
Intervention:
Drug: Tesaglitazar
22
Completed
Efficacy and Safety Study of Miconazole Lauriad to Treat Oropharyngeal Candidiasis in HIV Patients
Condition:
HIV Infections
Intervention:
Drug: miconazole Lauriad
23
Active, not recruiting
Non-Traditional Cardiovascular Risk Factors and Atherosclerosis in Type 2 Diabetes
Condition:
Type 2 Diabetes Mellitus
Interventions:
Drug: Insulin; Drug: Glimepiride; Drug: Rosiglitazone; Drug: Metformin
24
Terminated
N-Acetylcysteine and Arginine Administration in Diabetic Patients
Conditions:
Type 2 Diabetes Mellitus; Hypertension
Interventions:
Drug: Arginine; Drug: Acetylcysteine; Drug: Placebo
25
Completed
GALLANT 7 Tesaglitazar Add-on to Sulphonylurea
Condition:
Type 2 Diabetes
Interventions:
Drug: Tesaglitazar 0.5 or 1 mg; Drug: Glibenclamide 2.5, 5, 10 or 15 mg
26
Completed
GALLANT 4 Tesaglitazar vs. Glibenclamide
Condition:
Type 2 Diabetes
Interventions:
Drug: Tesaglitazar; Drug: Glibenclamide
27
Recruiting
A Safety Study of Two Intratumour Doses of Coxsackievirus Type A21 in Melanoma Patients.
Condition:
Stage IV Melanoma
Intervention:
Drug: Coxsackievirus A21

Walkerville custodian battles rare cancer

By Craig Pearson,
Windsor Star
Published: Friday, February 22, 2008
He'd have a better chance of being hit by lightning - and maybe he'd choose that over the rare and ravenous tumor now eating his insides - but Scott Wilson refuses to consider himself unlucky.
"It hasn't changed me in any way," the affable 29-year-old father of two said Monday. "I'm not going to let this take me down. I have a family to take care of."
Just before Christmas, Wilson started feeling nauseous. A few days later he felt a lump in his abdomen. By the time he had the diagnosis confirmed in late January, the cancerous tumor had wound around his intestines - and began spreading, showing up in diagnostic images as nearby specks.
"It's wrapped around my bowels right now, so there's no possible way they can do surgery," Wilson said. "It's a very rapid aggressive cancer. It's spreading."
Wilson travelled to a specialist in Toronto, who confirmed that he had something called a desmoplastic small round cell tumor, a soft-tissue sarcoma.
Soft-tissue sarcomas represent less than one per cent of all cancers, while the desmoplastic variety are even rarer, usually attacking boys or young men.
"My doctor told me there were only six people in Canada who have this," said Wilson, adding that his doctor also told him the condition is incurable but can be treated. "I would have a better chance of winning a lottery twice than getting what I have now."
Desmoplastic tumors show high recurrence rates and can be fatal.
The news, which Wilson said initially angered him, comes at a difficult time for his family.
"It was really hard," said Wilson's wife Tonya, 27, an American who met Scott through an Internet chat room about five years ago and moved to Canada a year ago. "We're just starting our family. What are we gong to do? What's going to happen? I don't want my husband taken away."
The couple have a one-year daughter, Aubrey, and Tonya's eight-year-old son, Conner.
Besides his inspiring attitude, Wilson has something else going for him: an extended family at Walkerville Collegiate high school, where he works as an afternoon custodian.
Wilson began 30 weeks of chemotherapy on Monday - in hope the tumor can be shrunk enough to be operated on - and has thus been feeling nauseous and tired.
But fellow custodians, faculty and students have rallied behind him.
They have raised more than $1,000 through bake sales and hot-lunch programs, to help the Wilsons cover travel and lodging expenses in the coming months. And the Walkerville crowd will hold a fundraiser for him tonight at the Fogolar Furlan - complete with sports memorabilia, since Wilson's a sports fan, and Elvis impersonators, because he loves The King.
Wilson said he looks forward to getting together with his school community, since he cannot work - nor continue to help coach the school badminton team - while undergoing chemotherapy.
"We miss him. He's family," said fellow custodian Rick Hancrar. "It's quiet around here. Kids are asking me about him every day."
Wilson said he now appreciates his family that much more, not to mention his Walkerville Collegiate friends.
"I can't say thank you enough times to tell them how much it means to me what they're doing," Wilson said with a smile. "There aren't enough thank-yous. There aren't enough hugs for me to give."
Helping hand
A fund-raiser for Walkerville Collegiate custodian Scott Wilson, recently diagnosed with a rare desmoplastic tumor, will be held tonight at the Fogolar Furlan Club. Tickets are $15. For more information or to donate, call 252-6514.
Desmoplasia 101
Desmoplasia refers to the formation of adhesions, or scar tissue. Desmoplastic small round cell tumors are classified as soft-tissue sarcoma. Because it is so rare and spreads so quickly, the disease is often misdiagnosed, and primarily occurs as multiple masses in the abdomen.
Source: Wikipedia

Pfizer pulls TV ads with heart expert Jarvik

By Lisa Richwine Mon Feb 25, 8:35 PM ET

WASHINGTON (Reuters) - Pfizer Inc said on Monday it was pulling television advertisements for its Lipitor cholesterol drug featuring Dr. Robert Jarvik, inventor of the Jarvik artificial heart, because they created "misimpressions."

The ads involving Jarvik had come under scrutiny from a U.S. House of Representative committee as part of an investigation into celebrity endorsements of prescription medicines.

Democratic lawmakers had voiced concern that Jarvik's qualifications were misrepresented in widely seen TV commercials touting the blockbuster drug. They said Jarvik seemed to be dispensing medical advice even though he is not a practicing physician.
Read More

Clinic targets disease in children

Clinic targets disease in children
By KAWANZA NEWSONknewson@journalsentinel.com
Posted: Feb. 17, 2008
New parents often spend the first year of their child's life anticipating milestones such as smiling, babbling and rolling over onto their tummies.
But for Jennifer and Jeff Roubik, those moments never came.
Instead, their son lay listless. His skin was tinted gray as his kidney function rapidly deteriorated from a genetic disorder called autosomal recessive polycystic kidney disease.
At 3 months, Gabriel had one kidney removed. A month later, he lost his second kidney and began dialysis.
Each day, his parents wondered if their son would make it to his first birthday.
"Those thoughts kept coming in," said Jeff, 37, of Elkhorn. "He also had heart problems because his blood pressure was out of control. Things were not pretty."
Though researchers still don't understand what causes most pediatric kidney disorders, the opening of a nephrology clinic and lab at the Children's Research Institute affiliated with Children's Hospital in Wauwatosa will soon provide some answers.
Using a $4.6 million grant from the National Institutes of Health, a group of Medical College of Wisconsin researchers will design studies to better understand the basic molecular and cellular mechanisms associated with pediatric kidney disease so they can develop therapies to prevent and treat the condition.
This work will then be quickly translated into clinical trials using childhood kidney disease patients.
"This is a very exciting time," said Ellis D. Avner, director of the Children's Research Institute and associate dean of research at the Medical College.
Read More

Monday, February 25, 2008

Adhesions News ARDvark Blog

Fear Of Genetic Discrimination Fuelling Fall In DNA Testing

Alvine Pharmaceuticals Obtains Patents For Celiac Disease Therapies

Phase II Results For Yale's Early Stage Ovarian Cancer Blood Test 99% Accurate

Repros' IND For The Commencement Of Phase III Studies Of Proellex(R) In The Treatment Of Anemia Associated With Uterine Fibroids Is Now Effective

SonoSite Expands M-Turbo Product Line With New M-OB/GYN Office Ultrasound Tool

A Novel HMSH2 Gene Mutation In Colorectal Cancer Patients?

A Strange Case Of Upper Obstructive Syndrome

Inflammatory Bowel Disease May Mimic Gynecological Disorders In Its Clinical Presentation

Congressional Democrats To Draft Bill To Overturn Supreme Court Decision On Medical Devices

Former Kansas AG Kline Petitions Judge For Planned Parenthood Clinic Records

Technology To Defeat Bacterial Infections Shows Positive Results

Beyond The Abstract - Uroplakin III-Delta4 Messenger RNA As A Promising Marker To Identify Nonulcerative Interstitial Cystitis

MIT creates gecko-inspired bandage

Elizabeth Dougherty,
Harvard-MIT Division of Health Sciences and TechnologyFebruary 18, 2008
MIT researchers and colleagues have created a waterproof adhesive bandage inspired by gecko lizards that may soon join sutures and staples as a basic operating room tool for patching up surgical wounds or internal injuries.
Drawing on some of the principles that make gecko feet unique, the surface of the bandage has the same kind of nanoscale hills and valleys that allow the lizards to cling to walls and ceilings. Layered over this landscape is a thin coating of glue that helps the bandage stick in wet environments, such as to heart, bladder or lung tissue. And because the bandage is biodegradable, it dissolves over time and does not have to be removed.
The team is led by MIT Institute Professor Robert Langer and Jeff Karp, an instructor of medicine at Brigham and Women's Hospital and Harvard Medical School. Both are also faculty members at the Harvard-MIT Division of Health Sciences and Technology (HST).
The work is described in the Feb. 11 online issue of the Proceedings of the National Academy of Sciences.
"There is a big need for a tape-based medical adhesive," said Karp. For instance, a surgical adhesive tape made from this new material could wrap around and reseal the intestine after the removal of a diseased segment or after a gastric bypass procedure. It could also patch a hole caused by an ulcer. Because it can be folded and unfolded, it has a potential application in minimally invasive surgical procedures that are particularly difficult to suture because they are performed through a very small incision.
Gecko-like dry adhesives have been around since about 2001 but there have been significant challenges to adapt this technology for medical applications given the strict design criteria required. For use in the body, they must be adapted to stick in a wet environment and be constructed from materials customized for medical applications. Such materials must be biocompatible, meaning they do not cause inflammation; biodegradable, meaning they dissolve over time without producing toxins; and elastic, so that they can conform to and stretch with the body's tissues.
The MIT researchers met these requirements by building their medical adhesive with a "biorubber" invented by Karp, Langer and others. Using micropatterning technology--the same technology used to create computer chips--the researchers shaped the biorubber into different hill and valley profiles at nanoscale dimensions. After testing them on intestinal tissue taken from pigs, they selected the stickiest profile, one with pillars spaced just wide enough to grip and interlock with the underlying tissue.
Karp then added a very thin layer of a sugar-based glue, to create a strong bond even to a wet surface. The resulting bandage "is something we never expect to remove," said Karp. Because of that difference, he continued, "we're not mimicking the gecko"--which has sticky feet but can still lift them up to walk--"we are inspired by the gecko to create a patterned interface to enhance the surface area of contact and thus the overall strength of adhesion."
When tested against the intestinal tissue samples from pigs, the nanopatterned adhesive bonds were twice as strong as unpatterned adhesives. In tests of the new adhesive in living rats, the glue-coated nanopatterned adhesive showed over a 100 percent increase in adhesive strength compared to the same material without the glue. Moreover, the rats showed only a mild inflammatory response to the adhesive, a minor reaction that does not need to be overcome for clinical use.
Among other advantages, the adhesive could be infused with drugs designed to release as the biorubber degrades. Further, the elasticity and degradation rate of the biorubber are tunable, as is the pillared landscape. This means that the new adhesives can be customized to have the right elasticity, resilience and grip for different medical applications.
"This is an exciting example of how nanostructures can be controlled, and in so doing, used to create a new family of adhesives," said Langer.
Other MIT authors of the paper are co-first authors Alborz Mahdavi, a former MIT lab technician now at the California Institute of Technology; Lino Ferreira, a former MIT postdoctoral fellow now at the University of Coimbra, Portugal; Jason W. Nichol and Edwin P. Chan, HST postdoctoral fellows; David J.D. Carter and Jeff Borenstein of Draper Laboratory; HST doctoral student Chris Bettinger; and MIT graduate students Siamrut Patanavanich, Loice Chignozha, Eli B. Joseph, Alex Galakatos and Seungpyo Hong, all from the Department of Chemical Engineering. Additional authors are from Massachusetts General Hospital and the University of Basel, Switzerland.
The work was funded by the National Institutes of Health, the Materials Research Science and Engineering Center (MRSEC) program of the National Science Foundation, and the MIT-Portugal program.
http://web.mit.edu/newsoffice/2008/adhesive-0218.html

Rogue doctor removes woman's ovaries without her knowledge

A Wanganui woman had her ovaries removed without her knowledge by a rogue doctor.
Her case, and the doctor, has been investigated as part of a Health and Disability Commissioner report to be made public on Tuesday. The Wanganui District Health Board (DHB) is expected to be severely criticised.
Fredericka Himmel is terrified of ever going under the knife again. The Wanganui grandmother is still haunted by the work of Dr Roman Hasil.
She says Hasil diagnosed massive adhesions on her ovaries. After he resigned from Wanganui Hospital, his notes were later used by other surgeons and the ovaries were removed. But, examined later, they showed no sign of any other problems.
The gynaecologist - now Australian based - is at the centre of a Health and Disability Commissioner's report to be released publicly on Tuesday..
It is expected to target weaknesses in the Wanganui DHB's hiring process, Hasil's supervision and the way complaints were handled.
Himmel is not the only Wanganui patient to have her ovaries removed unnecessarily.
John Rowan QC confirmed to 3 News a young woman had hers removed by Dr Hasil. But it was not discussed before surgery and Hasil never told her after she woke. She found out months later.
Rowan is organising legal action against the Wanganui DHB over the incident.
Rowan told 3 News he believes more women will come forward after the report is released. Just what legal action will be taken will not be decided until he has read the findings. But he hopes the board will respond in a sensible way.
The DHB will not talk public until the report is released.
Click here for video

Wednesday, February 13, 2008

METHYLENE BLUE

http://www.drugs.com/cons/methylene-blue.html

METHYLENE BLUE (Systemic)
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Some commonly used brand names are:
In the U.S.—
Urolene Blue
Generic name product may be available in the U.S. and Canada.
Other commonly used names are aniline violet , methylthionine chloride , and tetramethylthionine chloride .

Category
Antimethemoglobinemic
Diagnostic aid, tissue dye

Description
Methylene (METH-i-leen) blue is used to treat a condition called methemoglobinemia. This condition occurs when the blood cannot deliver oxygen where it is needed in the body. Methylene blue is also used as a dye to stain certain parts of the body before or during surgery.
Oral
Tablets (U.S.)
Parenteral
Injection (U.S. and Canada)

Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For methylene blue, the following should be considered:
Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to methylene blue. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy—Studies on effects in pregnancy have not been done in either humans or animals.
Breast-feeding—It is not known whether methylene blue passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.
Children—Babies are especially sensitive to the effects of methylene blue. This may increase the chance of side effects during treatment.
Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing the use of methylene blue in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.
Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Other medical problems—The presence of other medical problems may affect the use of methylene blue. Make sure you tell your doctor if you have any other medical problems, especially:
Glucose-6-phosphate dehydrogenase (G6PD) deficiency—Methylene blue may cause anemia or make methemoglobinemia worse
Kidney disease—In patients with kidney disease methylene blue may accumulate in the body; smaller doses of this medicine may be needed
Methemoglobinemia to treat cyanide toxicity—Methylene blue may make cyanide toxicity worse by increasing the amount of cyanide in the blood

Proper Use of This Medicine
For patients taking the tablet form of this medicine:
Take tablets after meals with a full glass (8 ounces) of water.
Take this medicine only as directed . Do not take more of it and do not take it more often than recommended on the label unless directed by your doctor. To do so may increase the chance of side effects.
Dosing—The dose of methylene blue will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of methylene blue. If your dose is different, do not change it unless your doctor tells you to do so.
For oral dosage form (tablets):
For methemoglobinemia:
Adults and children—100 to 300 milligrams (mg) a day.
For injection dosage form:
For methemoglobinemia:
Adults and children—Dose is based on body weight or size and must be determined by your doctor. The dose is usually 1 to 2 mg per kilogram (kg) (0.45 to 0.9 mg per pound) of body weight, or 25 to 50 mg per square meter of body surface area, injected into a vein over a period of five minutes. A second dose may be given after one hour, if needed.
Missed dose—If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage—To store this medicine:
Keep out of the reach of children.
Store away from heat and direct light.
Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
Keep the medicine from freezing. Do not refrigerate.
Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine
Before you have any medical tests, tell the doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.

Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Symptoms of overdose
Anxiety; back pain; bluish fingernails, lips, or skin; chest pain; chills; confusion; difficulty in breathing; dizziness; headache; leg pain; nausea and vomiting; severe sweating; stomach pain; trembling; unusual tiredness or weakness
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
More common
Greenish blue to blue discoloration of urine and stools
Less common
Diarrhea; nausea and vomiting; painful urination or increased need to urinate (with tablet form)

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
Developed: 05/27/1994

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http://www.rxlist.com/cgi/generic/methyleneblue_cp.htm

Methylene Blue

Methylene Blue is Phenothiazin-5-ium, 3,7-bis (dimethylamino)-,chloride, trihydrate. It will produce two opposite actions on hemoglobin. Low concentrations will convert methemoglobin to hemoglobin. High concentrations convert the ferrous iron of reduced hemoglobin to ferric iron which results in the formation of methemoglobin.

Methylene Blue must be injected intravenously very slowly over a period of several minutes to prevent local high concentration of the compound from producing additional methemoglobin.
Do not exceed recommended dosage.
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Both of these links contain extensive information on the substance in question with SprayGel Adhesion Barrier.

Tuesday, February 12, 2008

Scarring gel in spotlight

By JANINE RANKIN - Manawatu Standard
Tuesday, 12 February 2008
The one in five Palmerston North women and girls who suffer from endometriosis need not be alarmed at reports that a product used in surgical treatment could make their condition worse.
The surgical spray gel at the centre of a Wellington gynaecologist's concerns that it causes internal scarring isn't widely used in Palmerston North.
MidCentral Health and private specialist Digby Ngan Kee says he doesn't use the product and isn't aware of any other surgeons locally who use it.
"It is a very expensive product, and there is no good evidence that it is effective," he said.
Wellington gynaecologist Hanifa Koya says she's stopped using the gel since she's had endometriosis patients returning for repeat surgery after its use, to repair the sort of scarring the product was supposed to prevent.
Endometriosis New Zealand chief executive Deborah Bush, who originally set up the national support group in Palmerston North, said she didn't believe women should be alarmed.
The evidence that the gel actually caused scarring over and above the damage done by endometriosis was anecdotal rather than scientific, she said.
"It's a horrible disease, and we don't know what causes it. Surgeons can excise the disease, but that doesn't mean a woman won't develop more adhesions."
In women with endometriosis the tissue that developed in the uterus each month also formed in other parts of the abdomen causing pain, scarring, and often damaging fertility.
Ms Bush said although some surgeons were reporting an increased rate of women coming back for repeat surgery, there was no good evidence the scarring was a result of the gel rather than a result of surgery or the disease.
Dr Ngan Kee said the numbers of women returning for surgery were still too small to give an accurate view. Women struggling with endometriosis will be able to attend a seminar at Palmerston North Hospital next month when Ms Bush, a gynaecologist, and an authority on nutrition and fertility will talk about latest treatments and self-help options