J Diabetes Complications. 2011 Jan-Feb;25(1):39-43. Epub 2009 Oct 13.
Effect of bovine amniotic fluid on intra-abdominal adhesion in diabetic male rats.
Abbasian B, Kazemini H, Esmaeili A, Adibi S.
SourceFaculty of Veterinary Medicine, Shahrekord Azad University, Shahrekord, Iran.
Abstract
BACKGROUND: Postsurgical adhesion formation is a significant clinical problem within every surgical specialty. In type I diabetic patients, the problem is more severe and wound healing is slow. A wide variety of treatments have been proposed to deal with the problems that adhesion causes. One of the modalities that have not been studied extensively yet is the use of amniotic fluid. The purpose of the present study was to evaluate the clinical value of bovine amniotic fluid (BAF) efficacy in the treatment of postsurgical adhesion formation in diabetic male rats.
MATERIALS AND METHODS: Fifty male Wistar rats in five groups were used for our study, with animal identification being facilitated by a microchip implant system. Diabetes was induced in all groups except for the control group by intraperitoneal alloxan injection (120 mg/kg). Based upon blood glucose concentration, rats received either one third of the required insulin (two groups) or all the required insulin (remaining groups). After 2 weeks, a laparotomy was performed on each rat and adhesions were scaled. Bovine amniotic fluid was then applied to two groups, and, as a control, sterilized water was applied to the other groups. After 2 weeks, a laparotomy was again performed on each rat and adhesion was rescored.
RESULTS AND CONCLUSION: Significant reductions (P<.05) in adhesions were seen with BAF only in those diabetic rats that had received the required insulin. The results of our study suggest that BAF could be effective in the treatment of adhesion formation during diabetes.
Copyright © 2011 Elsevier Inc. All rights reserved.
PMID:19828333[PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/19828333
Showing posts with label adhesionsinfo. Show all posts
Showing posts with label adhesionsinfo. Show all posts
Thursday, November 17, 2011
Tuesday, November 01, 2011
Companies pitch ideas to angel investors at MedVentures
Bill Hethcock
Staff Writer - Dallas Business Journal
Email Dallas Business Journal by Bill Hethcock, Staff Writer
Date: Thursday, October 6, 2011, 3:00pm CDT - Last Modified: Thursday, October 6, 2011, 3:02pm CDT
I spent the morning at the MedVentures conference in Frisco, hosted by the North Texas Enterprise Center.
The conference is where companies with ideas and plans for medical instruments and devices, diagnostic equipment and other health-related products make their pitch for advice and, more importantly, money from venture capital and angel investors to get their businesses off the ground.
Interesting products in development by some of the presenting companies include:
• Coltrix Biomedical, a Fort Worth-based preclinical-stage company whose mission is to deliver collagen-based medical devices that improve surgical outcomes, has a product called Collapatch. It's a membrane that prevents the formation of adhesions, an internal form of scarring, after surgery. These adhesions result in 300,000 readmissions annually to U.S. hospitals at a cost of $1.3 billion.
• Plano-based Neuro Resource Group .Neuro Resource Group Latest from The Business Journals Emerging Tech Fund faces possible cutsDataInfoCom granted .6M from ETFDataInfoCom granted .6M from ETF Follow this company .'s InterX is a non-invasive solution for acute and chronic pain. Clinical trials have demonstrated InterX significantly reduces pain and decreases the intake of opioids and other pain medication.
• Arcos Inc., based in Houston, has developed decision-support software to battle sepsis, a severe illness in which the bloodstream is overwhelmed by bacteria. In one test, the "Sepsis Toolkit" enabled one hospital to lower its severe sepsis mortality from 34 percent to 14 percent.
Bill covers health care, law, education and nonprofits.
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.Related:Banking & Financial Services, Health Care, Technology, Frisco
http://www.bizjournals.com/dallas/blog/2011/10/companies-pitch-ideas-to-angel.html
..
Staff Writer - Dallas Business Journal
Email Dallas Business Journal by Bill Hethcock, Staff Writer
Date: Thursday, October 6, 2011, 3:00pm CDT - Last Modified: Thursday, October 6, 2011, 3:02pm CDT
I spent the morning at the MedVentures conference in Frisco, hosted by the North Texas Enterprise Center.
The conference is where companies with ideas and plans for medical instruments and devices, diagnostic equipment and other health-related products make their pitch for advice and, more importantly, money from venture capital and angel investors to get their businesses off the ground.
Interesting products in development by some of the presenting companies include:
• Coltrix Biomedical, a Fort Worth-based preclinical-stage company whose mission is to deliver collagen-based medical devices that improve surgical outcomes, has a product called Collapatch. It's a membrane that prevents the formation of adhesions, an internal form of scarring, after surgery. These adhesions result in 300,000 readmissions annually to U.S. hospitals at a cost of $1.3 billion.
• Plano-based Neuro Resource Group .Neuro Resource Group Latest from The Business Journals Emerging Tech Fund faces possible cutsDataInfoCom granted .6M from ETFDataInfoCom granted .6M from ETF Follow this company .'s InterX is a non-invasive solution for acute and chronic pain. Clinical trials have demonstrated InterX significantly reduces pain and decreases the intake of opioids and other pain medication.
• Arcos Inc., based in Houston, has developed decision-support software to battle sepsis, a severe illness in which the bloodstream is overwhelmed by bacteria. In one test, the "Sepsis Toolkit" enabled one hospital to lower its severe sepsis mortality from 34 percent to 14 percent.
Bill covers health care, law, education and nonprofits.
See all your followed company news on your personalized dashboard.
To access the full benefits of bizWatch and receive a weekly email with aggregated news on all the companies you are following, please provide your email address below.
. Sign Up Now .
You must have a bizjournals account to follow a company.
Please Log In or Register.
.Related:Banking & Financial Services, Health Care, Technology, Frisco
http://www.bizjournals.com/dallas/blog/2011/10/companies-pitch-ideas-to-angel.html
..
Saturday, October 08, 2011
Differential mRNA expression of TACR1 after ischemic peritoneal trauma: a pilot animal study.
Arch Gynecol Obstet. 2011 Aug 12. [Epub ahead of print]
Differential mRNA expression of TACR1 after ischemic peritoneal trauma: a pilot animal study.
Kraemer B, Wallwiener M, Wallwiener CW, Juhasz-Boess I, Hartkopf A, Wallwiener D, Rajab TK.
SourceUniversity Hospital for Women, University of Tuebingen, Calwerstr. 7/1, 72076, Tuebingen, Germany, Bernhard.Kraemer@med.uni-tuebingen.de.
Abstract
PURPOSE: Experimental trial in an in vivo animal model in the laboratory facilities of a university department of obstetrics and gynecology and a microarray facility using seventeen female Wistar rats to investigate the regional expression level of TACR1 at specific locations in the peritoneum in a rodent animal model of post-operative adhesions.
METHODS: Peritoneal adhesions were induced by the placement of three unilateral ischemic lesions. A time course experiment was performed to identify when adhesions form in this model to determine the optimal time for tissue harvesting. To this effect, second look analysis for adhesion scoring occurred after day 1, 3 and 5. Eighteen tissue samples from the adhesiogenic lesions and the contralateral non-adhesiogenic peritoneum were harvested from n = 3 animals at day 3 for quantitative real-time PCR analysis.
RESULTS: After 1 day, no adhesions were macroscopically detectable. After 3 days, adhesions were detectable which could be separated easily by gravity. After 5 days, all animals had formed adhesions and strong traction was required for adhesiolysis. The adhesions always formed to the ischemic part of the lesions. Quantitative PCR analysis after 3 days demonstrated down-regulation of TACR1 mRNA in the adhesiogenic peritoneum of the lesions compared to non-adhesiogenic peritoneum on the contralateral side. This difference was statistically highly significant (p < 0.01).
CONCLUSIONS: In the ischemic lesion model of adhesiogenesis, TACR1 is differentially expressed between adhesiogenic peritoneum and non-adhesiogenic peritoneum at the time-point of adhesion formation.
PMID:21837425[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21837425
Differential mRNA expression of TACR1 after ischemic peritoneal trauma: a pilot animal study.
Kraemer B, Wallwiener M, Wallwiener CW, Juhasz-Boess I, Hartkopf A, Wallwiener D, Rajab TK.
SourceUniversity Hospital for Women, University of Tuebingen, Calwerstr. 7/1, 72076, Tuebingen, Germany, Bernhard.Kraemer@med.uni-tuebingen.de.
Abstract
PURPOSE: Experimental trial in an in vivo animal model in the laboratory facilities of a university department of obstetrics and gynecology and a microarray facility using seventeen female Wistar rats to investigate the regional expression level of TACR1 at specific locations in the peritoneum in a rodent animal model of post-operative adhesions.
METHODS: Peritoneal adhesions were induced by the placement of three unilateral ischemic lesions. A time course experiment was performed to identify when adhesions form in this model to determine the optimal time for tissue harvesting. To this effect, second look analysis for adhesion scoring occurred after day 1, 3 and 5. Eighteen tissue samples from the adhesiogenic lesions and the contralateral non-adhesiogenic peritoneum were harvested from n = 3 animals at day 3 for quantitative real-time PCR analysis.
RESULTS: After 1 day, no adhesions were macroscopically detectable. After 3 days, adhesions were detectable which could be separated easily by gravity. After 5 days, all animals had formed adhesions and strong traction was required for adhesiolysis. The adhesions always formed to the ischemic part of the lesions. Quantitative PCR analysis after 3 days demonstrated down-regulation of TACR1 mRNA in the adhesiogenic peritoneum of the lesions compared to non-adhesiogenic peritoneum on the contralateral side. This difference was statistically highly significant (p < 0.01).
CONCLUSIONS: In the ischemic lesion model of adhesiogenesis, TACR1 is differentially expressed between adhesiogenic peritoneum and non-adhesiogenic peritoneum at the time-point of adhesion formation.
PMID:21837425[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21837425
Sunday, October 02, 2011
Abdominal pain
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
ConsiderationsAlmost everyone experiences pain in the abdomen at one time or another. Most of the time, it is not caused by a serious medical problem.
There are many organs in the abdomen. Pain in the abdomen can originate from any one of them, including:
•Organs related to digestion -- the end of the esophagus, stomach, small and large intestines, liver, gallbladder, and pancreas
•The aorta -- a large blood vessel that runs straight down the inside of the abdomen
•The appendix -- an organ in the lower right abdomen that no longer serves much function
•The kidneys -- two bean-shaped organs that lie deep within the abdominal cavity
•The spleen -- an organ involved in blood maintenance and infection control
However, the pain may start from somewhere else -- like your chest or pelvic area. You may also have a generalized infection, such as the flu or strep throat, that affects many parts of your body.
The intensity of the pain does not always reflect the seriousness of the condition causing the pain. Severe abdominal pain can be from mild conditions, such as gas or the cramping of viral gastroenteritis. On the other hand, relatively mild pain or no pain may be present with life-threatening conditions, such as cancer of the colon or early appendicitis.
Other ways of describing pain in your abdomen include:
•Pain may be generalized, meaning that it is present in more than half of your belly. This is more typical for a stomach virus, indigestion, or gas. If the pain becomes more severe, it may be caused by a blockage of the intestines.
•Pain that is localized is found in only one area of your belly. This type of pain is more likely to be a sign of a problem in one of your organs, such as the appendix, gallbladder, or stomach (ulcers).
•Cramp-like pain is usually not serious, and is more likely to be due to gas and bloating. It is often followed by diarrhea. More worrisome signs include pain that occurs more often, lasts longer (more than 24 hours), or has a fever with it.
•Colicky pain is pain that comes in waves, usually starts and ends suddenly, and is often severe. Kidney stones and gallstones are common causes of this type of belly pain.
CausesMany different conditions can cause abdominal pain. The key is to know when you must seek medical care right away. In many cases you can simply wait, use home care remedies, and call your doctor at a later time only if the symptoms persist.
Possible causes include:
•Appendicitis (inflammation of the appendix)
•Bowel blockage or obstruction
•Cholecystitis (inflammation of the gallbladder) with or without gallstones
•Chronic constipation
•Dissecting abdominal aortic aneurysm
•Diverticulitis
•Food allergy
•Food poisoning (salmonella, shigella) or viral gastroenteritis (stomach flu)
•Heartburn, indigestion, or gastroesophageal reflux
•Inflammatory bowel disease (Crohn's disease or ulcerative colitis)
•Intussusception -- while uncommon, this is a serious possible cause of pain in an infant who may be bringing the knees to the chest and crying
•Irritable bowel syndrome
•Ischemic bowel
•Kidney stones
•Lactose intolerance
•Mesenteric insufficiency or infarction (lack of enough blood supply to the gut, sometimes resulting in the failure or death of part of the bowel or intestines)
•Pancreatitis (inflammation of the pancreas)
•Tumors or cancers
•Ulcers
•Urinary tract infections
When an inflamed organ (such as the appendix) in the abdomen ruptures or leaks fluid, the pain is not only excruciating, but the abdomen becomes stiff and very tender to the touch. There is also a fever. This occurs as peritonitis (inflammation and infection of the lining of the abdominal cavity) develops and spreads from the site of the rupture. This is a medical emergency.
In infants, prolonged unexplained crying (often called "colic") may be caused by abdominal pain that may end with the passage of gas or stool. Colic is often worse in the evening. Cuddling and rocking the child may bring some relief.
Abdominal pain that occurs during menstruation may be from menstrual cramps or it may indicate a problem in a reproductive organ. This includes conditions such as endometriosis (when tissue from the uterus is displaced to somewhere else like the pelvic wall or ovaries), or pelvic inflammatory disease (PID) (infection of the reproductive organs, usually from a sexually transmitted disease). An ectopic pregnancy, or a pregnancy outside the normal location in the uterus, may mimic menstrual cramping and bleeding. However, symptoms are usually more intense than those usually experienced during a menstrual period.
Abdominal pain may actually be caused by an organ in the chest, like the lungs (for example, pneumonia) or the heart (like a heart attack). Or, it may stem from a muscle strain in the abdominal muscles.
Cancers of the colon and other gastrointestinal areas are serious but uncommon causes of abdominal pain.
Other more unusual causes of abdominal pain include a type of emotional upset called somatization disorder, reflected as physical discomfort (including recurrent abdominal pain). Strep throat in children can cause abdominal pain.
Sickle cell disease crisis may cause abdominal pain. It sometimes may be mistaken for the pain of appendicitis or conditions of other abdominal organs.
Shingles (an infection of the nerves associated with a skin rash, which is caused by the chicken pox virus) may cause pain in the abdomen. However, because the rash comes several days after the start of the pain, it can be mistaken for appendicitis or other conditions of the abdominal organs.
Home CareFor mild pains:
•Sip water or other clear fluids.
•Avoid solid food for the first few hours. If you have been vomiting, wait 6 hours. Then eat small amounts of mild foods such as rice, applesauce, or crackers. Avoid dairy products.
•If the pain is high up in your abdomen and occurs after meals, antacids may provide some relief, especially if you feel heartburn or indigestion. Avoid citrus, high-fat foods, fried or greasy foods, tomato products, caffeine, alcohol, and carbonated beverages. You may also try H2 blockers (Tagamet, Pepcid, or Zantac) available over the counter. If any of these medicines worsen your pain, CALL your doctor right away.
•AVOID aspirin, ibuprofen or other anti-inflammatory medications, and narcotic pain medications unless your health care provider prescribes them. If you know that your pain is not related to your liver, you can try acetaminophen (Tylenol).
When to Contact a Medical ProfessionalSeek immediate medical help or call your local emergency number (such as 911) if you:
•Are currently being treated for cancer
•Are unable to pass stool, especially if you are also vomiting
•Are vomiting blood or have blood in your stool (especially if maroon or dark, tarry black)
•Have chest, neck, or shoulder pain
•Have sudden, sharp abdominal pain
•Have pain in, or between, your shoulder blades with nausea
•Your belly is rigid, hard, and tender to touch
•You are pregnant or could be pregnant
•You have had a recent injury to your abdomen
•You are having difficulty breathing
Call your doctor if you have:
•Abdominal discomfort that lasts 1 week or longer
•Abdominal pain that does not improve in 24 - 48 hours, or is becoming more severe and frequent
•Bloating that persists for more than 2 days
•Burning sensation when you urinate or frequent urination
•Diarrhea for more than 5 days, or if your infant or child has diarrhea for more than 2 days or vomiting for more than 12 hours -- call right away if a baby younger than 3 months has diarrhea or vomiting
•Fever (over 100°F for adults or 100.4°F for children) with your pain
•Prolonged poor appetite
•Unexplained weight loss
What to Expect at Your Office VisitFrom your medical history and physical examination, your doctor will try to determine the cause of your abdominal pain. Knowing the location of pain and its time pattern will help, as will the presence of other symptoms like fever, fatigue, general ill feeling, nausea, vomiting, or changes in stool.
During the physical examination, the doctor will test to see if the pain is localized to a single area (point tenderness) or whether it is diffuse. He or she will be checking to see if the pain is related to inflammation of the peritoneum (called peritonitis). If the health care provider finds evidence of peritonitis, the abdominal pain may be classified as an "acute abdomen," which may require surgery right away.
Your doctor may ask the following questions about your abdominal pain:
•Is the pain all over (diffuse or generalized) or in a specific location?
•What part of the abdomen is affected? Lower or upper? Right, left, or middle? Around the navel?
•Is the pain severe, sharp or cramping, persistent or constant, periodic and changing intensity over minutes?
•Does the pain awaken you at night?
•Have you had similar pain in the past? How long has each episode lasted?
•How often do you have the pain? Is it constant or does it come and go?
•Does it occur within minutes following meals? Within 2 to 3 hours after meals?
•Is it getting increasingly more severe?
•Does it occur during menstruation (dysmenorrhea)?
•Does the pain go into your back, middle of the back, below the right shoulder blade, or your groin, buttocks, or legs?
•Does the pain get worse after lying on the back?
•Does the pain get worse after eating or drinking? After eating greasy foods, milk products, or alcohol?
•Does the pain get worse after stress? After straining efforts?
•Does the pain get better after eating or a bowel movement?
•Does the pain get better after milk or antacids?
•What medications are you taking?
•Have you had a recent injury?
•Are you pregnant?
•What other symptoms are occurring at the same time?
Diagnostic tests that may be performed include:
•Barium enema
•CT scan
•Colonoscopy or sigmoidoscopy (direct viewing of the lower bowel)
•Blood, urine, and stool tests
•Endoscopy of upper GI (gastrointestinal) tract (EGD)
•Ultrasound of the abdomen
•Upper GI and small bowel series
•X-rays of the abdomen
PreventionFor prevention of many types of abdominal pain:
•Avoid fatty or greasy foods.
•Drink plenty of water each day.
•Eat small meals more frequently.
•Exercise regularly.
•Limit foods that produce gas.
•Make sure that your meals are well-balanced and high in fiber. Eat plenty of fruits and vegetables.
For prevention of symptoms from heartburn or gastroesophageal reflux disease:
•After eating, stay upright for at least 30 minutes.
•Elevate the head of your bed.
•Finish eating at least 2 hours before you go to bed.
•Lose weight if you need to.
•Quit smoking.
Alternative NamesStomach pain; Pain - abdomen; Belly ache; Abdominal cramps
ReferencesEbell MH. Diagnosis of appendicitis: part 1. History and physical examination. Am Fam Physician. 2008;77:828-830.
Bundy DG, Byerley JS, Liles EA, Perrin EM, Katznelson J, Rice HE. Does this child have appendicitis? JAMA. 2007;25:438-451.
Ohge H. Levitt MD. Intestinal Gas. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: WB Saunders; 2006: Chap. 10.
Postier RG, Squires RA. Acute abdomen. In: Townsend CM Jr., Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007: chap 45.
Bengiamin RN, Budhram GR, King KE, Wightman JM. Abdominal pain. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 21.
Update Date: 10/7/2009Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm
ConsiderationsAlmost everyone experiences pain in the abdomen at one time or another. Most of the time, it is not caused by a serious medical problem.
There are many organs in the abdomen. Pain in the abdomen can originate from any one of them, including:
•Organs related to digestion -- the end of the esophagus, stomach, small and large intestines, liver, gallbladder, and pancreas
•The aorta -- a large blood vessel that runs straight down the inside of the abdomen
•The appendix -- an organ in the lower right abdomen that no longer serves much function
•The kidneys -- two bean-shaped organs that lie deep within the abdominal cavity
•The spleen -- an organ involved in blood maintenance and infection control
However, the pain may start from somewhere else -- like your chest or pelvic area. You may also have a generalized infection, such as the flu or strep throat, that affects many parts of your body.
The intensity of the pain does not always reflect the seriousness of the condition causing the pain. Severe abdominal pain can be from mild conditions, such as gas or the cramping of viral gastroenteritis. On the other hand, relatively mild pain or no pain may be present with life-threatening conditions, such as cancer of the colon or early appendicitis.
Other ways of describing pain in your abdomen include:
•Pain may be generalized, meaning that it is present in more than half of your belly. This is more typical for a stomach virus, indigestion, or gas. If the pain becomes more severe, it may be caused by a blockage of the intestines.
•Pain that is localized is found in only one area of your belly. This type of pain is more likely to be a sign of a problem in one of your organs, such as the appendix, gallbladder, or stomach (ulcers).
•Cramp-like pain is usually not serious, and is more likely to be due to gas and bloating. It is often followed by diarrhea. More worrisome signs include pain that occurs more often, lasts longer (more than 24 hours), or has a fever with it.
•Colicky pain is pain that comes in waves, usually starts and ends suddenly, and is often severe. Kidney stones and gallstones are common causes of this type of belly pain.
CausesMany different conditions can cause abdominal pain. The key is to know when you must seek medical care right away. In many cases you can simply wait, use home care remedies, and call your doctor at a later time only if the symptoms persist.
Possible causes include:
•Appendicitis (inflammation of the appendix)
•Bowel blockage or obstruction
•Cholecystitis (inflammation of the gallbladder) with or without gallstones
•Chronic constipation
•Dissecting abdominal aortic aneurysm
•Diverticulitis
•Food allergy
•Food poisoning (salmonella, shigella) or viral gastroenteritis (stomach flu)
•Heartburn, indigestion, or gastroesophageal reflux
•Inflammatory bowel disease (Crohn's disease or ulcerative colitis)
•Intussusception -- while uncommon, this is a serious possible cause of pain in an infant who may be bringing the knees to the chest and crying
•Irritable bowel syndrome
•Ischemic bowel
•Kidney stones
•Lactose intolerance
•Mesenteric insufficiency or infarction (lack of enough blood supply to the gut, sometimes resulting in the failure or death of part of the bowel or intestines)
•Pancreatitis (inflammation of the pancreas)
•Tumors or cancers
•Ulcers
•Urinary tract infections
When an inflamed organ (such as the appendix) in the abdomen ruptures or leaks fluid, the pain is not only excruciating, but the abdomen becomes stiff and very tender to the touch. There is also a fever. This occurs as peritonitis (inflammation and infection of the lining of the abdominal cavity) develops and spreads from the site of the rupture. This is a medical emergency.
In infants, prolonged unexplained crying (often called "colic") may be caused by abdominal pain that may end with the passage of gas or stool. Colic is often worse in the evening. Cuddling and rocking the child may bring some relief.
Abdominal pain that occurs during menstruation may be from menstrual cramps or it may indicate a problem in a reproductive organ. This includes conditions such as endometriosis (when tissue from the uterus is displaced to somewhere else like the pelvic wall or ovaries), or pelvic inflammatory disease (PID) (infection of the reproductive organs, usually from a sexually transmitted disease). An ectopic pregnancy, or a pregnancy outside the normal location in the uterus, may mimic menstrual cramping and bleeding. However, symptoms are usually more intense than those usually experienced during a menstrual period.
Abdominal pain may actually be caused by an organ in the chest, like the lungs (for example, pneumonia) or the heart (like a heart attack). Or, it may stem from a muscle strain in the abdominal muscles.
Cancers of the colon and other gastrointestinal areas are serious but uncommon causes of abdominal pain.
Other more unusual causes of abdominal pain include a type of emotional upset called somatization disorder, reflected as physical discomfort (including recurrent abdominal pain). Strep throat in children can cause abdominal pain.
Sickle cell disease crisis may cause abdominal pain. It sometimes may be mistaken for the pain of appendicitis or conditions of other abdominal organs.
Shingles (an infection of the nerves associated with a skin rash, which is caused by the chicken pox virus) may cause pain in the abdomen. However, because the rash comes several days after the start of the pain, it can be mistaken for appendicitis or other conditions of the abdominal organs.
Home CareFor mild pains:
•Sip water or other clear fluids.
•Avoid solid food for the first few hours. If you have been vomiting, wait 6 hours. Then eat small amounts of mild foods such as rice, applesauce, or crackers. Avoid dairy products.
•If the pain is high up in your abdomen and occurs after meals, antacids may provide some relief, especially if you feel heartburn or indigestion. Avoid citrus, high-fat foods, fried or greasy foods, tomato products, caffeine, alcohol, and carbonated beverages. You may also try H2 blockers (Tagamet, Pepcid, or Zantac) available over the counter. If any of these medicines worsen your pain, CALL your doctor right away.
•AVOID aspirin, ibuprofen or other anti-inflammatory medications, and narcotic pain medications unless your health care provider prescribes them. If you know that your pain is not related to your liver, you can try acetaminophen (Tylenol).
When to Contact a Medical ProfessionalSeek immediate medical help or call your local emergency number (such as 911) if you:
•Are currently being treated for cancer
•Are unable to pass stool, especially if you are also vomiting
•Are vomiting blood or have blood in your stool (especially if maroon or dark, tarry black)
•Have chest, neck, or shoulder pain
•Have sudden, sharp abdominal pain
•Have pain in, or between, your shoulder blades with nausea
•Your belly is rigid, hard, and tender to touch
•You are pregnant or could be pregnant
•You have had a recent injury to your abdomen
•You are having difficulty breathing
Call your doctor if you have:
•Abdominal discomfort that lasts 1 week or longer
•Abdominal pain that does not improve in 24 - 48 hours, or is becoming more severe and frequent
•Bloating that persists for more than 2 days
•Burning sensation when you urinate or frequent urination
•Diarrhea for more than 5 days, or if your infant or child has diarrhea for more than 2 days or vomiting for more than 12 hours -- call right away if a baby younger than 3 months has diarrhea or vomiting
•Fever (over 100°F for adults or 100.4°F for children) with your pain
•Prolonged poor appetite
•Unexplained weight loss
What to Expect at Your Office VisitFrom your medical history and physical examination, your doctor will try to determine the cause of your abdominal pain. Knowing the location of pain and its time pattern will help, as will the presence of other symptoms like fever, fatigue, general ill feeling, nausea, vomiting, or changes in stool.
During the physical examination, the doctor will test to see if the pain is localized to a single area (point tenderness) or whether it is diffuse. He or she will be checking to see if the pain is related to inflammation of the peritoneum (called peritonitis). If the health care provider finds evidence of peritonitis, the abdominal pain may be classified as an "acute abdomen," which may require surgery right away.
Your doctor may ask the following questions about your abdominal pain:
•Is the pain all over (diffuse or generalized) or in a specific location?
•What part of the abdomen is affected? Lower or upper? Right, left, or middle? Around the navel?
•Is the pain severe, sharp or cramping, persistent or constant, periodic and changing intensity over minutes?
•Does the pain awaken you at night?
•Have you had similar pain in the past? How long has each episode lasted?
•How often do you have the pain? Is it constant or does it come and go?
•Does it occur within minutes following meals? Within 2 to 3 hours after meals?
•Is it getting increasingly more severe?
•Does it occur during menstruation (dysmenorrhea)?
•Does the pain go into your back, middle of the back, below the right shoulder blade, or your groin, buttocks, or legs?
•Does the pain get worse after lying on the back?
•Does the pain get worse after eating or drinking? After eating greasy foods, milk products, or alcohol?
•Does the pain get worse after stress? After straining efforts?
•Does the pain get better after eating or a bowel movement?
•Does the pain get better after milk or antacids?
•What medications are you taking?
•Have you had a recent injury?
•Are you pregnant?
•What other symptoms are occurring at the same time?
Diagnostic tests that may be performed include:
•Barium enema
•CT scan
•Colonoscopy or sigmoidoscopy (direct viewing of the lower bowel)
•Blood, urine, and stool tests
•Endoscopy of upper GI (gastrointestinal) tract (EGD)
•Ultrasound of the abdomen
•Upper GI and small bowel series
•X-rays of the abdomen
PreventionFor prevention of many types of abdominal pain:
•Avoid fatty or greasy foods.
•Drink plenty of water each day.
•Eat small meals more frequently.
•Exercise regularly.
•Limit foods that produce gas.
•Make sure that your meals are well-balanced and high in fiber. Eat plenty of fruits and vegetables.
For prevention of symptoms from heartburn or gastroesophageal reflux disease:
•After eating, stay upright for at least 30 minutes.
•Elevate the head of your bed.
•Finish eating at least 2 hours before you go to bed.
•Lose weight if you need to.
•Quit smoking.
Alternative NamesStomach pain; Pain - abdomen; Belly ache; Abdominal cramps
ReferencesEbell MH. Diagnosis of appendicitis: part 1. History and physical examination. Am Fam Physician. 2008;77:828-830.
Bundy DG, Byerley JS, Liles EA, Perrin EM, Katznelson J, Rice HE. Does this child have appendicitis? JAMA. 2007;25:438-451.
Ohge H. Levitt MD. Intestinal Gas. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: WB Saunders; 2006: Chap. 10.
Postier RG, Squires RA. Acute abdomen. In: Townsend CM Jr., Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007: chap 45.
Bengiamin RN, Budhram GR, King KE, Wightman JM. Abdominal pain. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 21.
Update Date: 10/7/2009Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm
Thursday, September 08, 2011
Adhesion Awareness Giveaway Offers Over $9,700 in Prizes
By Djordje Jurinac on Aug 30, 2011
Virtually all people have adhesions (internal scars). If you scrape your knee, have a fall, undergo surgery or develop an infection, adhesions form to surround the injured area. As the body heals, adhesions often remain at the site of the trauma, surgery, infection or inflammation.
Unfortunately, they can spread to nearby organs, muscles, or nerves, causing unexplained pain or dysfunction. Small but powerful adhesions can act like nylon ropes or straight-jackets, and can cause a myriad of health problems.
Adhesions are often an underlying cause of chronic pain, female infertility, endometriosis pain, and bowel obstructions. Because they are invisible on most diagnostic tests, such as x-rays, CT and MRI scans, they often go undiagnosed by physicians and health care professionals.
Clear Passage Physical Therapy has developed and researched non-invasive treatments for adhesions for over twenty years. Their non-surgical, hands-on therapy (Wurn Technique) uses techniques that feel like a deep massage, to release adhesions that bind structures within the body. In published studies, most patients reported significant pain relief, and a return of function.
In honor of Adhesion Related Disorder (ARD) Awareness Month this September, Clear Passage will donate over $9,700 in treatment and lodging, to three prize winners. Patients who suffer from an ARD can enter this giveaway on the Clear Passage website or on their Facebook page.
The grand prize winner will receive 20 hours of free treatment at Clear Passage’s national headquarters in Gainesville, FL and five days of lodging at a lovely Florida waterfront cottage (a $6,100 value). The second prize winner will receive 10 hours of free treatment (a $2,600 value), and the third prize winner will receive 20 percent off a 20 hour treatment program (a $1,040 value).
“Diagnosing adhesions can be confusing, because they often cross body systems,” says Clear Passage National Director Belinda Wurn, PT. “Many people go from specialist to specialist, sometimes for years, simply searching for a diagnosis. Their problems increase when they learn that the surgery to remove adhesions can often create more adhesions.”
“We are pleased to offer a non-surgical alternative to patients” she said. “It’s very gratifying to give adhesion sufferers back their lives.”
About Clear Passage Physical Therapy
Clear Passage Physical Therapy is a network of high quality physical therapy clinics specializing in hands-on treatment of adhesions, chronic pain, infertility, endometriosis, and bowel obstruction.
http://eyugoslavia.com/featured/30/adhesion-awareness-giveaway-offers-over-9700-in-prizes-2223748/
Virtually all people have adhesions (internal scars). If you scrape your knee, have a fall, undergo surgery or develop an infection, adhesions form to surround the injured area. As the body heals, adhesions often remain at the site of the trauma, surgery, infection or inflammation.
Unfortunately, they can spread to nearby organs, muscles, or nerves, causing unexplained pain or dysfunction. Small but powerful adhesions can act like nylon ropes or straight-jackets, and can cause a myriad of health problems.
Adhesions are often an underlying cause of chronic pain, female infertility, endometriosis pain, and bowel obstructions. Because they are invisible on most diagnostic tests, such as x-rays, CT and MRI scans, they often go undiagnosed by physicians and health care professionals.
Clear Passage Physical Therapy has developed and researched non-invasive treatments for adhesions for over twenty years. Their non-surgical, hands-on therapy (Wurn Technique) uses techniques that feel like a deep massage, to release adhesions that bind structures within the body. In published studies, most patients reported significant pain relief, and a return of function.
In honor of Adhesion Related Disorder (ARD) Awareness Month this September, Clear Passage will donate over $9,700 in treatment and lodging, to three prize winners. Patients who suffer from an ARD can enter this giveaway on the Clear Passage website or on their Facebook page.
The grand prize winner will receive 20 hours of free treatment at Clear Passage’s national headquarters in Gainesville, FL and five days of lodging at a lovely Florida waterfront cottage (a $6,100 value). The second prize winner will receive 10 hours of free treatment (a $2,600 value), and the third prize winner will receive 20 percent off a 20 hour treatment program (a $1,040 value).
“Diagnosing adhesions can be confusing, because they often cross body systems,” says Clear Passage National Director Belinda Wurn, PT. “Many people go from specialist to specialist, sometimes for years, simply searching for a diagnosis. Their problems increase when they learn that the surgery to remove adhesions can often create more adhesions.”
“We are pleased to offer a non-surgical alternative to patients” she said. “It’s very gratifying to give adhesion sufferers back their lives.”
About Clear Passage Physical Therapy
Clear Passage Physical Therapy is a network of high quality physical therapy clinics specializing in hands-on treatment of adhesions, chronic pain, infertility, endometriosis, and bowel obstruction.
http://eyugoslavia.com/featured/30/adhesion-awareness-giveaway-offers-over-9700-in-prizes-2223748/
Friday, August 19, 2011
September is Adhesion Related Disorder Awareness Month
September is Adhesion Related Disorder Awareness Month.
Find out about ARD
before you have any surgery.
that are not normally connected. Adhesions form as a result of trauma due to surgery,
infection, disease or other injury. Adhesions can distort and disturb body functions and
cause pain, intestinal obstruction and infertility, giving rise to a complex of problems,
collectively termed "Adhesion Related Disorder (ARD)" - Dr. David Wiseman, founder
International Adhesion Society.....
The rate of adhesion formation after surgery is surprising given the relative lack of knowledge about ADHESIONS among doctors and patients alike. From autopsies on victims of traffic accidents, Weibel and Majno (1973) found that 67% of patients who had undergone surgery had adhesions. This number increased to 81% and 93% for patients with major and multiple procedures respectively. Similarly, Menzies and Ellis (1990) found that 93% of patients who had undergone at least one previous abdominal operation had adhesions, compared with only 10.4% of patients who had never had a previous abdominal operation. Furthermore, 1% of all laparoscopies developed obstruction due to adhesions within one year of surgery with 3% leading to obstruction at some time after surgery. Of all cases of small bowel obstruction, 60-70% of cases involve adhesions (Ellis, 1997).
Lastly, following surgical treatment of adhesions causing intestinal obstruction, obstruction due to adhesionreformation occurred in 11 to 21% of cases (Menzies, 1993).
Between 55 and 100% of patients undergoing pelvic reconstructive surgery will form adhesions.
Recent analysis of the latest US health statisticsby the International Adhesions Society (IAS)
(http://www.adhesions.org/) reveals that over 2200 people died in 2001 with a diagnosis of intestinal obstruction due to adhesions. This number has been consistent for five consecutive years with between 2100 and almost 2500 deaths per annum. Women account for a 60% majority of these deaths.
obstruction, with an average length of hospitalization of 9.8 days. With an average charge of some $32,000, this represents a cost to the economy of $2.15 Billion.
About two-thirds of these costs were borne by Medicare and Medicaid.
But this is just the tip of the iceberg. When other inpatient diagnoses of peritoneal and pelvic adhesions are added, the cost easily exceeds $5 billion, and that is before out-patient costs and loss of work are considered. Nearly 30% of the hospital discharges for adhesion-related obstruction occurred in the 45-64 age range, and 53% occurred in the 65+ age range. The most deaths (1196) occurred in the 45-64 age range, but as a percentage of the hospitalizations, the greatest risk of death (10%) occurred after age 85.
To our knowledge this is the first report to document the number of deaths related to adhesions, and serves to highlight the extent of an under-appreciated problem. Others have previously reported that a patient undergoing pelvic or abdominal surgery will be readmitted twice in the next 10 years for a problem related to adhesions, or for a procedure that could become complicated by adhesions. Given the extent and severity of ARD it is surprising that few people have heard of the condition. In a recent survey conducted by the IAS, patients reported that they were told about adhesions in only 25% of procedures they underwent. This number dropped to only
10% when procedures not known to involve adhesion surgery were considered.
The IAS strongly urges all patients to ask their doctors about ARD before undergoing surgery. The IAS also urges hospital and public health officials to ensure that adhesions are discussed as part of the informed consent procedures. By engaging in this discussion doctors will want to consider options for reducing the risks to the patient of post-operative adhesions. This will benefit not only patients, also the doctors who are faced with the sequelae of ARD.
For more information please contact:
Dr. David Wiseman, Founder, International Adhesions Society
6757 Arapaho Road, Suite 711-238, Dallas, TX 75248
972- 931- 5596
david.wiseman@adhesions.org
The rate of adhesion formation after surgery is surprising given the relative lack of knowledge about ADHESIONS among doctors and patients alike. From autopsies on victims of traffic accidents, Weibel and Majno (1973) found that 67% of patients who had undergone surgery had adhesions. This number increased to 81% and 93% for patients with major and multiple procedures respectively. Similarly, Menzies and Ellis (1990) found that 93% of patients who had undergone at least one previous abdominal operation had adhesions, compared with only 10.4% of patients who had never had a previous abdominal operation. Furthermore, 1% of all laparoscopies developed obstruction due to adhesions within one year of surgery with 3% leading to obstruction at some time after surgery. Of all cases of small bowel obstruction, 60-70% of cases involve adhesions (Ellis, 1997).
Lastly, following surgical treatment of adhesions causing intestinal obstruction, obstruction due to adhesionreformation occurred in 11 to 21% of cases (Menzies, 1993).
Between 55 and 100% of patients undergoing pelvic reconstructive surgery will form adhesions.
Recent analysis of the latest US health statisticsby the International Adhesions Society (IAS)
(www.adhesions.org) reveals that over 2200 people died in 2001 with a diagnosis of intestinal obstruction due to adhesions. This number has been consistent for five consecutive years with between 2100 and almost 2500 deaths per annum. Women account for a 60% majority of these deaths.
In 2001 there were over in-patient 67,000 discharges with a primary diagnosis of adhesion-related
obstruction, with an average length of hospitalization of 9.8 days. With an average charge of some $32,000, this represents a cost to the economy of $2.15 Billion.
About two-thirds of these costs were borne by Medicare and Medicaid.
But this is just the tip of the iceberg. When other inpatient diagnoses of peritoneal and pelvic adhesions are added, the cost easily exceeds $5 billion, and that is before out-patient costs and loss of work are considered.
Nearly 30% of the hospital discharges for adhesion-related obstruction occurred in the 45-64 age range, and 53% occurred in the 65+ age range. The most deaths (1196) occurred in the 45-64 age range, but as a percentage of the hospitalizations, the greatest risk of death (10%) occurred after age 85.
To our knowledge this is the first report to document the number of deaths related to adhesions, and serves to highlight the extent of an under-appreciated problem. Others have previously reported that a patient undergoing pelvic or abdominal surgery will be readmitted twice in the next 10 years for a problem related to adhesions, or for a procedure that could become complicated by adhesions.
Given the extent and severity of ARD it is surprising that few people have heard of the condition. In a recent survey conducted by the IAS, patients reported that they were told about adhesions in only 25% of procedures they underwent. This number dropped to only
10% when procedures not known to involve adhesion surgery were considered.
The IAS strongly urges all patients to ask their doctors about ARD before undergoing surgery. The IAS also urges hospital and public health officials to ensure that adhesions are discussed as part of the informed consent procedures. By engaging in this discussion doctors will want to consider options for reducing the risks to the patient of post-operative adhesions. This will benefit not only patients, also the doctors who are faced with the sequelae of ARD.
For more information please contact:
Dr. David Wiseman, Founder, International Adhesions Society
6757 Arapaho Road, Suite 711-238, Dallas, TX 75248
972- 931- 5596
david.wiseman@adhesions.org
Saturday, June 18, 2011
The inpatient burden of abdominal and gynecological adhesiolysis in the US
Adhesions are fibrous bands of scar tissue, often a result of surgery, that form between internal organs and tissues, joining them together abnormally. Postoperative adhesions frequently occur following abdominal surgery, and are associated with a large economic burden.
This study examines the inpatient burden of adhesiolysis in the United States (i.e ., number and rate of events, cost, length of stay [LOS]).
Methods: Hospital discharge data for patients with primary and secondary adhesiolysis were analyzed using the 2005 Healthcare Cost and Utilization Project's Nationwide Inpatient Sample. Procedures were aggregated by body system.
Results: We identified 351,777 adhesiolysis-related hospitalizations: 23.2% for primary and 76.8% for secondary adhesiolysis.
The average LOS was 7.8 days for primary adhesiolysis. We found that 967,332 days of care were attributed to adhesiolysis-related procedures, with inpatient expenditures totaling $2.3 billion ($1.4 billion for primary adhesiolysis; $926 million for secondary adhesiolysis).
Hospitalizations for adhesiolysis increased steadily by age and were higher for women. Of secondary adhesiolysis procedures, 46.3% involved the female reproductive tract, resulting in 57,005 additional days of care and $220 million in attributable costs.
Conclusions: Adhesiolysis remain an important surgical problem in the United States.
Hospitalization for this condition leads to high direct surgical costs, which should be of interest to providers and payers.
Author: Vanja SikiricaBela BapatSean CandrilliKeith DavisMalcolm WilsonAlan Johns
Credits/Source: BMC Surgery 2011, 11:13
Wednesday, June 15, 2011
Ceftriaxone Injection
Ceftriaxone Injection(sef try ax' one)
Last Revision: March 16, 2011.
Why is this medication prescribed?
Ceftriaxone injection is used to treat certain infections caused by bacteria such as gonorrhea (a sexually transmitted disease), pelvic inflammatory disease (infection of the female reproductive organs that may cause infertility), meningitis (infection of the membranes that surround the brain and spinal cord), and infections of the lungs, ears, skin, urinary tract, blood, bones, joints, and abdomen. Ceftriaxone injection is also sometimes given before certain types of surgery to prevent infections that may develop after the operation. Ceftriaxone injection is in a class of medications called cephalosporin antibiotics. It works by killing bacteria. Antibiotics will not work for colds, flu, or other viral infections.
How should this medicine be used?
Ceftriaxone injection comes as a liquid to be injected intravenously (into a vein) or intramuscularly (into a muscle). It is sometimes given as a single dose and sometimes given once or twice a day for 4-14 days, depending on the type of infection being treated. You may receive ceftriaxone injection in a hospital or doctor's office, or you may administer the medication at home. If you are using ceftriaxone injection at home, use it at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use ceftriaxone injection exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
You should begin to feel better during the first few days of your treatment with ceftriaxone injection. If your symptoms do not improve or get worse, call your doctor.
If you will be using more than one dose of ceftriaxone injection, use the medication until you finish the prescription, even if you feel better. If you stop using ceftriaxone injection too soon or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.
Other uses for this medicine
Ceftriaxone injection is also sometimes used to treat endocarditis (infection of the heart lining and valves), chancroid (genital sores caused by bacteria), Lyme disease (an infection that is transmitted by tick bites that may cause problems with the heart, joints, and nervous system), relapsing fever (an infection that is transmitted by tick bites that causes repeated episodes of fever), shigella (an infection that causes severe diarrhea), typhoid fever (a serious infection that is common in developing countries), salmonella (an infection that causes severe diarrhea), and Whipple's disease (a rare infection that causes serious problems with digestion). Ceftriaxone injection is also sometimes used to prevent infection in people who have been sexually assaulted or who have been bitten by humans or animals. Talk to your doctor about the risks of using this medication for your condition.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before using ceftriaxone injection,
•tell your doctor and pharmacist if you are allergic to ceftriaxone injection, other cephalosporin or penicillin antibiotics, or any other medications.
•tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any intravenous medications or feedings that contain calcium such as total parenteral nutrition (TPN, a liquid feeding that is given intravenously to people who cannot eat or digest food).
•tell your doctor if you have or have ever had problems with your digestive system, especially colitis (inflammation of the large intestine), malnutrition (you do not eat or cannot digest the nutrients needed for good health), or kidney or liver disease.
•tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using ceftriaxone injection, call your doctor.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do if I forget a dose?
Use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.
What side effects can this medication cause?
Ceftriaxone injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
pain, tenderness, hardness, or warmth in the place where ceftriaxone was injected
headache
dizziness
sweating
flushing
diarrhea
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
rash
bloody, watery stools
fever
stomach cramps
stomach pain or bloating
nausea and vomiting
heartburn
chest pain
Ceftriaxone injection may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
What storage conditions are needed for this medicine?
If you will be injecting ceftriaxone injection at home, your health care provider will tell you where you should store it and how long you may keep it. Follow these directions carefully. Be sure to store ceftriaxone in the container it came in and out of reach of children. Throw away any medication that is outdated or no longer needed. Talk to your health care provider about the proper disposal of your medication.
In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to ceftriaxone.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
American Society of Health-System Pharmacists, Disclaimer
AHFS® Consumer Medication Information. © Copyright, 2011. The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.
The following brand names are from RxNorm, a standardized nomenclature for clinical drugs produced by the National Library of Medicine:
Brand names
•Rocephin
Last Revision: March 16, 2011.
Why is this medication prescribed?
Ceftriaxone injection is used to treat certain infections caused by bacteria such as gonorrhea (a sexually transmitted disease), pelvic inflammatory disease (infection of the female reproductive organs that may cause infertility), meningitis (infection of the membranes that surround the brain and spinal cord), and infections of the lungs, ears, skin, urinary tract, blood, bones, joints, and abdomen. Ceftriaxone injection is also sometimes given before certain types of surgery to prevent infections that may develop after the operation. Ceftriaxone injection is in a class of medications called cephalosporin antibiotics. It works by killing bacteria. Antibiotics will not work for colds, flu, or other viral infections.
How should this medicine be used?
Ceftriaxone injection comes as a liquid to be injected intravenously (into a vein) or intramuscularly (into a muscle). It is sometimes given as a single dose and sometimes given once or twice a day for 4-14 days, depending on the type of infection being treated. You may receive ceftriaxone injection in a hospital or doctor's office, or you may administer the medication at home. If you are using ceftriaxone injection at home, use it at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use ceftriaxone injection exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
You should begin to feel better during the first few days of your treatment with ceftriaxone injection. If your symptoms do not improve or get worse, call your doctor.
If you will be using more than one dose of ceftriaxone injection, use the medication until you finish the prescription, even if you feel better. If you stop using ceftriaxone injection too soon or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.
Other uses for this medicine
Ceftriaxone injection is also sometimes used to treat endocarditis (infection of the heart lining and valves), chancroid (genital sores caused by bacteria), Lyme disease (an infection that is transmitted by tick bites that may cause problems with the heart, joints, and nervous system), relapsing fever (an infection that is transmitted by tick bites that causes repeated episodes of fever), shigella (an infection that causes severe diarrhea), typhoid fever (a serious infection that is common in developing countries), salmonella (an infection that causes severe diarrhea), and Whipple's disease (a rare infection that causes serious problems with digestion). Ceftriaxone injection is also sometimes used to prevent infection in people who have been sexually assaulted or who have been bitten by humans or animals. Talk to your doctor about the risks of using this medication for your condition.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before using ceftriaxone injection,
•tell your doctor and pharmacist if you are allergic to ceftriaxone injection, other cephalosporin or penicillin antibiotics, or any other medications.
•tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any intravenous medications or feedings that contain calcium such as total parenteral nutrition (TPN, a liquid feeding that is given intravenously to people who cannot eat or digest food).
•tell your doctor if you have or have ever had problems with your digestive system, especially colitis (inflammation of the large intestine), malnutrition (you do not eat or cannot digest the nutrients needed for good health), or kidney or liver disease.
•tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using ceftriaxone injection, call your doctor.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do if I forget a dose?
Use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.
What side effects can this medication cause?
Ceftriaxone injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
pain, tenderness, hardness, or warmth in the place where ceftriaxone was injected
headache
dizziness
sweating
flushing
diarrhea
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
rash
bloody, watery stools
fever
stomach cramps
stomach pain or bloating
nausea and vomiting
heartburn
chest pain
Ceftriaxone injection may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
What storage conditions are needed for this medicine?
If you will be injecting ceftriaxone injection at home, your health care provider will tell you where you should store it and how long you may keep it. Follow these directions carefully. Be sure to store ceftriaxone in the container it came in and out of reach of children. Throw away any medication that is outdated or no longer needed. Talk to your health care provider about the proper disposal of your medication.
In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to ceftriaxone.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
American Society of Health-System Pharmacists, Disclaimer
AHFS® Consumer Medication Information. © Copyright, 2011. The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.
The following brand names are from RxNorm, a standardized nomenclature for clinical drugs produced by the National Library of Medicine:
Brand names
•Rocephin
Friday, June 03, 2011
Adhesiolysis in Repeat Caesarean Delivery Common, Costly
Medscape Medical News from the:
American Congress of Obstetricians and Gynecologists (ACOG) 59th Annual Clinical Meeting
May 20, 2011 (Washington, DC) — Adhesions from previous Caesarean deliveries severe enough to require adhesiolysis during repeat Caesarean delivery have clinical and economic implications, according to a retrospective review of a large database with discharge data from 60 hospitals in the United States. The data were reported here at the American Congress of Obstetricians and Gynecologists 59th Annual Clinical Meeting.
The matched cohort study found that for patients who required adhesiolysis, the cost per patient was $300 more, operative length was longer, hospital stay was longer, and postoperative complications were more frequent.
Read the rest: http://www.medscape.com/viewarticle/743097
Monday, May 23, 2011
Adhesiolysis in Repeat Caesarean Delivery Common, Costly
Adhesiolysis in Repeat Caesarean Delivery Common, Costly
Alice Goodman
May 20, 2011 (Washington, DC) — Adhesions from previous Caesarean deliveries severe enough to require adhesiolysis during repeat Caesarean delivery have clinical and economic implications, according to a retrospective review of a large database with discharge data from 60 hospitals in the United States. The data were reported here at the American Congress of Obstetricians and Gynecologists 59th Annual Clinical Meeting.
The matched cohort study found that for patients who required adhesiolysis, the cost per patient was $300 more, operative length was longer, hospital stay was longer, and postoperative complications were more frequent.
"Adhesions are a significant complication of surgery. C-sections are increasingly common in the United States, and anywhere from 30% to 50% of patients have adhesions," explained Michael Broder, MD, from the University of California at Los Angeles School of Medicine. He estimated that treating complications of adhesions related to Caesarean deliveries that are severe enough for adhesiolysis costs $25 million to $30 million per year.
Read The Rest
Alice Goodman
May 20, 2011 (Washington, DC) — Adhesions from previous Caesarean deliveries severe enough to require adhesiolysis during repeat Caesarean delivery have clinical and economic implications, according to a retrospective review of a large database with discharge data from 60 hospitals in the United States. The data were reported here at the American Congress of Obstetricians and Gynecologists 59th Annual Clinical Meeting.
The matched cohort study found that for patients who required adhesiolysis, the cost per patient was $300 more, operative length was longer, hospital stay was longer, and postoperative complications were more frequent.
"Adhesions are a significant complication of surgery. C-sections are increasingly common in the United States, and anywhere from 30% to 50% of patients have adhesions," explained Michael Broder, MD, from the University of California at Los Angeles School of Medicine. He estimated that treating complications of adhesions related to Caesarean deliveries that are severe enough for adhesiolysis costs $25 million to $30 million per year.
Read The Rest
Friday, May 13, 2011
SprayShield EU Post Market Study Terminated
Sorry everyone...
SprayShield EU Post Market Study
This study has been terminated.
http://clinicaltrials.gov/ct2/show/NCT01002287
First Received on October 26, 2009. Last Updated on May 4, 2010 History of Changes
Sponsor: Confluent Surgical
Information provided by: Confluent Surgical
ClinicalTrials.gov Identifier: NCT01002287
Purpose
This will be a prospective, multi-center, randomized, single blind study to collect and evaluate post-market clinical data on the SprayShield Adhesion Barrier System as an adjuvant to good surgical technique for the reduction of postoperative adhesion formation following major open abdominal surgery.
Condition Intervention Phase
Ulcerative Colitis
Familial Polyposis
Device: SprayShield Adhesion Barrier System
Procedure: Good Surgical Technique Alone
Phase IV
Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Subject)
Primary Purpose: Prevention
Official Title: An Evaluation of the SprayShield Adhesion Barrier System in Reducing Post-Operative Adhesion Formation Following Major Open Abdominal Surgery
Resource links provided by NLM:
Genetics Home Reference related topics: Crohn disease familial adenomatous polyposis Help Me Understand Genetics
MedlinePlus related topics: Adhesions Ulcerative Colitis
U.S. FDA Resources
Further study details as provided by Confluent Surgical:
Primary Outcome Measures:
•To evaluate the incidence of adhesions, defined as the proportion of subjects presenting at the follow-up surgery (10-12 weeks) with one or more adhesions to the midline incision, regardless of extent and/or severity. [ Time Frame: 10-12 Weeks post Initial Surgery for J-Pouch ] [ Designated as safety issue: No ]
Estimated Enrollment: 30
Study Start Date: October 2009
Estimated Study Completion Date: May 2011
Estimated Primary Completion Date: October 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
SprayShield Adhesion Barrier: Experimental
SprayShield Adhesion Barrier + Good Surgical Technique
Intervention: Device: SprayShield Adhesion Barrier System Device: SprayShield Adhesion Barrier System
Adhesion Barrier Device Plus Good Surgical Technique
Control: No Intervention
Good Surgical Technique Alone
Intervention: Procedure: Good Surgical Technique Alone Procedure: Good Surgical Technique Alone
Good Surgical Technique Alone
Eligibility
Ages Eligible for Study: 18 Years and older
Genders Eligible for Study: Both
Accepts Healthy Volunteers: No
Criteria
Inclusion Criteria:
•Diagnosis of ulcerative colitis or familial polyposis and require two-stage surgery for treatment of either of these disorders will be eligible
Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01002287
Locations
United States, Massachusetts
Confluent Surgical
Waltham, Massachusetts, United States, 02451
Sponsors and Collaborators
Confluent Surgical
More Information
No publications provided
Responsible Party: Confluent Surgical ( Jennifer Doyle/Director, Clinical Affairs )
ClinicalTrials.gov Identifier: NCT01002287 History of Changes
Other Study ID Numbers: ABD-08-001
Study First Received: October 26, 2009
Last Updated: May 4, 2010
Health Authority: Czech Republic: Ethics Committee; Poland: Ministry of Health
Additional relevant MeSH terms:
Colitis
Colitis, Ulcerative
Adenomatous Polyposis Coli
Ulcer
Gastroenteritis
Gastrointestinal Diseases
Digestive System Diseases
Colonic Diseases
Intestinal Diseases
Inflammatory Bowel Diseases
Adenomatous Polyps
Adenoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Colonic Neoplasms
Neoplastic Syndromes, Hereditary
Intestinal Polyposis
Genetic Diseases, Inborn
Pathologic Processes
ClinicalTrials.gov processed this record on May 12, 2011
Pity
SprayShield EU Post Market Study
This study has been terminated.
http://clinicaltrials.gov/ct2/show/NCT01002287
First Received on October 26, 2009. Last Updated on May 4, 2010 History of Changes
Sponsor: Confluent Surgical
Information provided by: Confluent Surgical
ClinicalTrials.gov Identifier: NCT01002287
Purpose
This will be a prospective, multi-center, randomized, single blind study to collect and evaluate post-market clinical data on the SprayShield Adhesion Barrier System as an adjuvant to good surgical technique for the reduction of postoperative adhesion formation following major open abdominal surgery.
Condition Intervention Phase
Ulcerative Colitis
Familial Polyposis
Device: SprayShield Adhesion Barrier System
Procedure: Good Surgical Technique Alone
Phase IV
Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Subject)
Primary Purpose: Prevention
Official Title: An Evaluation of the SprayShield Adhesion Barrier System in Reducing Post-Operative Adhesion Formation Following Major Open Abdominal Surgery
Resource links provided by NLM:
Genetics Home Reference related topics: Crohn disease familial adenomatous polyposis Help Me Understand Genetics
MedlinePlus related topics: Adhesions Ulcerative Colitis
U.S. FDA Resources
Further study details as provided by Confluent Surgical:
Primary Outcome Measures:
•To evaluate the incidence of adhesions, defined as the proportion of subjects presenting at the follow-up surgery (10-12 weeks) with one or more adhesions to the midline incision, regardless of extent and/or severity. [ Time Frame: 10-12 Weeks post Initial Surgery for J-Pouch ] [ Designated as safety issue: No ]
Estimated Enrollment: 30
Study Start Date: October 2009
Estimated Study Completion Date: May 2011
Estimated Primary Completion Date: October 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
SprayShield Adhesion Barrier: Experimental
SprayShield Adhesion Barrier + Good Surgical Technique
Intervention: Device: SprayShield Adhesion Barrier System Device: SprayShield Adhesion Barrier System
Adhesion Barrier Device Plus Good Surgical Technique
Control: No Intervention
Good Surgical Technique Alone
Intervention: Procedure: Good Surgical Technique Alone Procedure: Good Surgical Technique Alone
Good Surgical Technique Alone
Eligibility
Ages Eligible for Study: 18 Years and older
Genders Eligible for Study: Both
Accepts Healthy Volunteers: No
Criteria
Inclusion Criteria:
•Diagnosis of ulcerative colitis or familial polyposis and require two-stage surgery for treatment of either of these disorders will be eligible
Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01002287
Locations
United States, Massachusetts
Confluent Surgical
Waltham, Massachusetts, United States, 02451
Sponsors and Collaborators
Confluent Surgical
More Information
No publications provided
Responsible Party: Confluent Surgical ( Jennifer Doyle/Director, Clinical Affairs )
ClinicalTrials.gov Identifier: NCT01002287 History of Changes
Other Study ID Numbers: ABD-08-001
Study First Received: October 26, 2009
Last Updated: May 4, 2010
Health Authority: Czech Republic: Ethics Committee; Poland: Ministry of Health
Additional relevant MeSH terms:
Colitis
Colitis, Ulcerative
Adenomatous Polyposis Coli
Ulcer
Gastroenteritis
Gastrointestinal Diseases
Digestive System Diseases
Colonic Diseases
Intestinal Diseases
Inflammatory Bowel Diseases
Adenomatous Polyps
Adenoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Colonic Neoplasms
Neoplastic Syndromes, Hereditary
Intestinal Polyposis
Genetic Diseases, Inborn
Pathologic Processes
ClinicalTrials.gov processed this record on May 12, 2011
Pity
Sunday, May 08, 2011
Marilyn Monroe suffered with Adhesions!
Marilyn's Autopsy
Coroner Thomas Noguchi conducted the operation. He was assisted by Eddy Day. Noguchi's findings were as follows.
External examination: The unembalmed body is that of a 36-year-old well-developed, well-nourished Caucasian female weighing 117 pounds and measuring 65-1/2 inches in length. The scalp is covered with bleached blond hair. The eyes are blue. The fixed lividitv is noted in the face, neck, chest, upper portions of arms and the right side of the abdomen. The faint lividity which disappears upon pressure is noted in the back and posterior aspect of the arms and legs. A slight ecchymotic area is noted in the left hip and left side of lower back. The breast shows no significant lesion. There is a horizontal 3-inch long surgical scar in the right upper quadrant of the abdomen. A suprapubic surgical scar measuring 5 inches in length is noted. The conjunctivae are markedly congested; however, no ecehymosis or petechiae are noted. The nose shows no evidence of fracture. The external auditory canals are not remarkable:. No evidence of trauma is noted in the scalp, forehead, cheeks, lips or chin. The neck shows no evidence of trauma. Examination of the hands and nails shows no defects. The lower extremities show no evidence of trauma.
Body cavity: The usual Y-shaped incision is made to open the thoracic and abdominal cavities. The pleural and abdominal cavities contain no excess of fluid or blood. The mediastinum shows no shifting or widening. The diaphragm is within normal limits. The lower edge of the liver is within the costal margin. The organs are in normal position and relationship.
Cardiovascular system: The heart weighs 300 grams. The pericardial cavity contains no excess of fluid. The epicardium and pericardium are smooth and glistening. The left ventricular wall measures 1.1 cm. and the right 0.2 cm. The papillary muscles are not hypertrophic. The chordae tendineac are not thickened or shortened. The valves have the usual number of leaflets which are thin and pliable. The tricuspid valve measures 10 cm., the pulmonary valve 6.5 cm., mitral valve 9.5 cm. and aortic valve 7 cm in circumference. There is no septal defect. The foramen ovale is closed. The coronary arteries arise from their usual location and are distributed in normal fashion. Multiple sections of the anterior descending branch of the left coronary artery with a 5 mm. interial demonstrate a patent lumen throughout. The circumflex branch and the right coronary artery also demonstrate a patent lumen. The pulmonary artery contains no thrombus. The aorta has a bright yellow smooth intima.
Respiratory system: The right lung weighs 465 grams and the left 420 grams. Both lungs are moderately congested with some edema. The surface is dark and red with mottling. The posterior portion of the lungs show severe congestion. The tracheobronchial tree contains no aspirated material or blood. Multiple sections of the lungs show congestion and edematous fluid exuding from the cut surface. No consolidation or suppuration is noted. The mucosa of the larynx is grayish white.
Liver and biliary system: The liver weighs 1890 grams. The surface is dark brown and smooth. There are marked adhesions through the omentum and abdominal wall in the lower portion of the liver as the gallbladder has been removed. The common duct is widely patent. No calculus or obstructive material is found. Multiple sections of the liver show slight accentuation of the lobular pattern; however, no hemorrhage or tumor is found.
Hemic and lymphatic system: The spleen weighs 190 grams. The surface is dark red and smooth. Section shows dark red homogeneous firm cut surface. The Malpighian bodies are not clearly identified. There is no evidence of lymphadenopathy. The bone marrow is dark red in color. Endocrine system: The adrenal glands have the usual architectural cortex and medulla. The thyroid glands are of normal size, color and consistency. Urinary system: The kidneys together weigh 350 grams. Their capsules can be stripped without difficulty. Dissection shows a moderately congested parenchyma. The cortical surface is smooth. The pelves and ureters are not dilated or stenosed. The urinary bladder contains approximately 150 cc. of clear straw-colored fluid. The mucosa is not altered.
Genital system: The external genitalia shows no gross abnormality. Distribution of the pubic hair is of female pattern. The uterus is of the usual size. Multiple sections of the uterus show the usual thickness of the uterine wall without tumor nodules. The endometrium is grayish yellow, measuring up to 0.2 cm in thickness. No polyp or tumor is found. The cervix is clear, showing no nabothian cysts. The tubes are intact. The right ovary demonstrates recent corpus luteum haemorrhagicum. The left ovary shows corpora lutea and albicantia. A vaginal smear is taken. Digestive system: The esophagus has a longitudinal folding mucosa. The stomach is almost completely empty. The contents is brownish mucoid fluid. The volume is estimated to be no more than 20 cc. No residue of the pills is noted. A smear made from the gastric contents and examined under the polarized microscope shows no refractile crystals. The mucosa shows marked congestion and submucosal petechial hemorrhage diffusely. The duodenum shows no ulcer. The contents of the duodenum is also examined under polarized microscope and shows no refractile crystals. The remainder of the small intestine shows no gross abnormality. The appendix is absent. The colon shows marked congestion and purplish discoloration. The pancreas has a tan lobular architecture. Multiple sections shows a patent duct.
Skeletomuscular system: The clavicle, ribs, vertebrae and pelvic bones show fracture lines. All bones of the extremities are examined by palpation showing no evidence of fracture.
Head and central nervous system: The brain weighs 1440 grams. Upon reflection of the scalp there is no evidence of contusion or hemorrhage. The temporal muscles are intact. Upon removal of the dura mater the cerebrospinal fluid is clear. The superficial vessels are slightly congested. The convolutions of the brain are not flattened. the contour of the brain is not distorted. No blood is found in the epidural, subdural or subarachnoid spaces. Multiple sections of the brain show the usual symmetrical ventricles and basal ganglia. Examination of the cerebellum and brain stem shows no gross abnormality. Following removal of the dura mater from the base of the skull and calvarium no skull fracture is demonstrated.
Liver temperature taken at 10:30 A.M. registered 89 F
Specimen: Unembalmed blood is taken for alcohol and barbiturate examination. Liver, kidney, stomach and contents, urine and intestine are saved for further toxicological study. A vaginal smear is made.
T NOGUCHI, M.D. DEPUTY MEDICAL EXAMINER 8-13-62
http://marilynmonroepages.com/autopsy.html
Coroner Thomas Noguchi conducted the operation. He was assisted by Eddy Day. Noguchi's findings were as follows.
External examination: The unembalmed body is that of a 36-year-old well-developed, well-nourished Caucasian female weighing 117 pounds and measuring 65-1/2 inches in length. The scalp is covered with bleached blond hair. The eyes are blue. The fixed lividitv is noted in the face, neck, chest, upper portions of arms and the right side of the abdomen. The faint lividity which disappears upon pressure is noted in the back and posterior aspect of the arms and legs. A slight ecchymotic area is noted in the left hip and left side of lower back. The breast shows no significant lesion. There is a horizontal 3-inch long surgical scar in the right upper quadrant of the abdomen. A suprapubic surgical scar measuring 5 inches in length is noted. The conjunctivae are markedly congested; however, no ecehymosis or petechiae are noted. The nose shows no evidence of fracture. The external auditory canals are not remarkable:. No evidence of trauma is noted in the scalp, forehead, cheeks, lips or chin. The neck shows no evidence of trauma. Examination of the hands and nails shows no defects. The lower extremities show no evidence of trauma.
Body cavity: The usual Y-shaped incision is made to open the thoracic and abdominal cavities. The pleural and abdominal cavities contain no excess of fluid or blood. The mediastinum shows no shifting or widening. The diaphragm is within normal limits. The lower edge of the liver is within the costal margin. The organs are in normal position and relationship.
Cardiovascular system: The heart weighs 300 grams. The pericardial cavity contains no excess of fluid. The epicardium and pericardium are smooth and glistening. The left ventricular wall measures 1.1 cm. and the right 0.2 cm. The papillary muscles are not hypertrophic. The chordae tendineac are not thickened or shortened. The valves have the usual number of leaflets which are thin and pliable. The tricuspid valve measures 10 cm., the pulmonary valve 6.5 cm., mitral valve 9.5 cm. and aortic valve 7 cm in circumference. There is no septal defect. The foramen ovale is closed. The coronary arteries arise from their usual location and are distributed in normal fashion. Multiple sections of the anterior descending branch of the left coronary artery with a 5 mm. interial demonstrate a patent lumen throughout. The circumflex branch and the right coronary artery also demonstrate a patent lumen. The pulmonary artery contains no thrombus. The aorta has a bright yellow smooth intima.
Respiratory system: The right lung weighs 465 grams and the left 420 grams. Both lungs are moderately congested with some edema. The surface is dark and red with mottling. The posterior portion of the lungs show severe congestion. The tracheobronchial tree contains no aspirated material or blood. Multiple sections of the lungs show congestion and edematous fluid exuding from the cut surface. No consolidation or suppuration is noted. The mucosa of the larynx is grayish white.
Liver and biliary system: The liver weighs 1890 grams. The surface is dark brown and smooth. There are marked adhesions through the omentum and abdominal wall in the lower portion of the liver as the gallbladder has been removed. The common duct is widely patent. No calculus or obstructive material is found. Multiple sections of the liver show slight accentuation of the lobular pattern; however, no hemorrhage or tumor is found.
Hemic and lymphatic system: The spleen weighs 190 grams. The surface is dark red and smooth. Section shows dark red homogeneous firm cut surface. The Malpighian bodies are not clearly identified. There is no evidence of lymphadenopathy. The bone marrow is dark red in color. Endocrine system: The adrenal glands have the usual architectural cortex and medulla. The thyroid glands are of normal size, color and consistency. Urinary system: The kidneys together weigh 350 grams. Their capsules can be stripped without difficulty. Dissection shows a moderately congested parenchyma. The cortical surface is smooth. The pelves and ureters are not dilated or stenosed. The urinary bladder contains approximately 150 cc. of clear straw-colored fluid. The mucosa is not altered.
Genital system: The external genitalia shows no gross abnormality. Distribution of the pubic hair is of female pattern. The uterus is of the usual size. Multiple sections of the uterus show the usual thickness of the uterine wall without tumor nodules. The endometrium is grayish yellow, measuring up to 0.2 cm in thickness. No polyp or tumor is found. The cervix is clear, showing no nabothian cysts. The tubes are intact. The right ovary demonstrates recent corpus luteum haemorrhagicum. The left ovary shows corpora lutea and albicantia. A vaginal smear is taken. Digestive system: The esophagus has a longitudinal folding mucosa. The stomach is almost completely empty. The contents is brownish mucoid fluid. The volume is estimated to be no more than 20 cc. No residue of the pills is noted. A smear made from the gastric contents and examined under the polarized microscope shows no refractile crystals. The mucosa shows marked congestion and submucosal petechial hemorrhage diffusely. The duodenum shows no ulcer. The contents of the duodenum is also examined under polarized microscope and shows no refractile crystals. The remainder of the small intestine shows no gross abnormality. The appendix is absent. The colon shows marked congestion and purplish discoloration. The pancreas has a tan lobular architecture. Multiple sections shows a patent duct.
Skeletomuscular system: The clavicle, ribs, vertebrae and pelvic bones show fracture lines. All bones of the extremities are examined by palpation showing no evidence of fracture.
Head and central nervous system: The brain weighs 1440 grams. Upon reflection of the scalp there is no evidence of contusion or hemorrhage. The temporal muscles are intact. Upon removal of the dura mater the cerebrospinal fluid is clear. The superficial vessels are slightly congested. The convolutions of the brain are not flattened. the contour of the brain is not distorted. No blood is found in the epidural, subdural or subarachnoid spaces. Multiple sections of the brain show the usual symmetrical ventricles and basal ganglia. Examination of the cerebellum and brain stem shows no gross abnormality. Following removal of the dura mater from the base of the skull and calvarium no skull fracture is demonstrated.
Liver temperature taken at 10:30 A.M. registered 89 F
Specimen: Unembalmed blood is taken for alcohol and barbiturate examination. Liver, kidney, stomach and contents, urine and intestine are saved for further toxicological study. A vaginal smear is made.
T NOGUCHI, M.D. DEPUTY MEDICAL EXAMINER 8-13-62
http://marilynmonroepages.com/autopsy.html
Friday, May 06, 2011
A reliable way to predict intraabdominal adhesions at repeat cesarean delivery: scar characteristics
NASUH U. DOGAN1, SEVAL A. HAKTANKACMAZ1, SELEN DOGAN2, OZLENEN OZKAN3, HATICE CELIK1, OZLEM G. ERYILMAZ1, MELIKE DOGANAY1, CAVIDAN GULERMAN1Article first published online: 16 MAR 2011Keywords: Intraabdominal adhesion; repeat cesarean delivery; hypertrophic scar
DOI: 10.1111/j.1600-0412.2011.01080.x
© 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2011 Nordic Federation of Societies of Obstetrics and Gynecology
Abstract
Objective. To evaluate association between scar characteristics and intraabdominal adhesions at repeat cesarean delivery. Design. A prospective, cross-sectional study. Setting. Tertiary Government Maternity Training Hospital in Ankara, Turkey. Population. 295 pregnant women with at least one prior cesarean delivery. Methods. All women were at least 36 weeks pregnant. Appearance of previous cesarean delivery scars was categorized into three groups – flat, depressed and elevated. Pigmentation status was also noted (non-pigmented or pigmented). Main Outcome Measures. Intraoperatively detected adhesions, evaluated and classified into three groups (no adhesion, filmy adhesion and dense adhesion groups) by a modified Nair's classification. Results. Elevated scars had significantly more dense adhesion formation than depressed ones (31.4 vs. 12.7%, p=0.02). No difference was found for dense adhesions when depressed and flat scars were compared (12.7 vs. 6.8%, p=0.124). Of flat scars, 93.2% were free of dense adhesions. Pigmented scars had more dense adhesions than non-pigmented (26.6 vs. 9.3%, p<0.01). Using logistic regression analysis scar length, scar width and appearance of scar (flat or non-flat) were directly related to adhesion formation. Conclusion. There is an association between scar type and adhesions, particularly for hypertrophic scars and dense adhesions.
DOI: 10.1111/j.1600-0412.2011.01080.x
© 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2011 Nordic Federation of Societies of Obstetrics and Gynecology
Abstract
Objective. To evaluate association between scar characteristics and intraabdominal adhesions at repeat cesarean delivery. Design. A prospective, cross-sectional study. Setting. Tertiary Government Maternity Training Hospital in Ankara, Turkey. Population. 295 pregnant women with at least one prior cesarean delivery. Methods. All women were at least 36 weeks pregnant. Appearance of previous cesarean delivery scars was categorized into three groups – flat, depressed and elevated. Pigmentation status was also noted (non-pigmented or pigmented). Main Outcome Measures. Intraoperatively detected adhesions, evaluated and classified into three groups (no adhesion, filmy adhesion and dense adhesion groups) by a modified Nair's classification. Results. Elevated scars had significantly more dense adhesion formation than depressed ones (31.4 vs. 12.7%, p=0.02). No difference was found for dense adhesions when depressed and flat scars were compared (12.7 vs. 6.8%, p=0.124). Of flat scars, 93.2% were free of dense adhesions. Pigmented scars had more dense adhesions than non-pigmented (26.6 vs. 9.3%, p<0.01). Using logistic regression analysis scar length, scar width and appearance of scar (flat or non-flat) were directly related to adhesion formation. Conclusion. There is an association between scar type and adhesions, particularly for hypertrophic scars and dense adhesions.
Wednesday, May 04, 2011
What is adhesions related disorder (ARD)?
What is adhesions related disorder (ARD)?
Adhesion related disorder is a complex of symptoms related to adhesions.
Patient’s primary complaint is usually chronic abdominal pain.
Their symptoms can be primarily in one area of the abdomen but are often generalized, vague, crampy and difficult to define.
The symptoms of ARD could include:
Chronic pain
Infertility
Bowel obstruction
Gastro-esophageal reflux disease, (GERD)
Urinary Bladder dysfunction
Pain and difficulty having a bowel movement
Pain on movement such as: Walking, sitting or laying in certain positions.
Loss of Nutrients due to poor eating habits or loss of appetite.
Loss of employment due to lost work days
Loss of family and social life
Emotional Disorders such as: Depression, Thoughts of Suicide, Hopelessness
Other intestinal problems can accompany the pain.
Constipation or obstruction is sometimes encountered.
Alternating constipation with diarrhea from partial obstruction can also be seen.
Symptoms may also be related to the gynecologic orders in women as this disorder frequently affects women.
Changes in the menstrual cycle, infertility, and pain with sexual intercourse can be encountered.
Other symptoms, not directly related to the adhesions, can also be encountered.
Since ARD generally results in chronic problems, anxiety and depression can result.
Strained relationships can occur especially when the disorder affects sexual function.
Difficulty with conception can result.
This further adds to the anxiety and problems with self esteem experienced by women who suffer with this disorder.
Difficulty eating can result in poor nutrition, weakening suffers overall medical condition and can also lead to a decrease in immune function leading to many other illnesses.
Since many of the symptoms related to ARD are vague and wide spread and often include emotional factors, they are often difficult to diagnose.
Symptoms of ARD will often be attributed to other abnormalities.
Patient will often carry multiple diagnoses including chronic fatigue syndrome, endometriosis, irritable bowel syndrome, fibromyalgia, depression, anxiety, along with a whole host of other possible syndromes.
While multiple disorders can certainly exist in one patient, the confusion over which abnormality is truly causing the symptoms adds to the frustration of ARD. This, unfortunately, adds to the discomfort experienced by those who suffer with adhesions.
Undiagnosed chronic pain causes so much physical and emotional pain for victims of adhesion related disorder – and fills their lives with so much indecision.
In time the effects of ARD will begin to affect the lives of their families, their relationships and their jobs. This inordinate control by ARD has the power to erode and change our lives – and not necessarily for the better!
Adhesion related disorder is a complex of symptoms related to adhesions.
Patient’s primary complaint is usually chronic abdominal pain.
Their symptoms can be primarily in one area of the abdomen but are often generalized, vague, crampy and difficult to define.
The symptoms of ARD could include:
Chronic pain
Infertility
Bowel obstruction
Gastro-esophageal reflux disease, (GERD)
Urinary Bladder dysfunction
Pain and difficulty having a bowel movement
Pain on movement such as: Walking, sitting or laying in certain positions.
Loss of Nutrients due to poor eating habits or loss of appetite.
Loss of employment due to lost work days
Loss of family and social life
Emotional Disorders such as: Depression, Thoughts of Suicide, Hopelessness
Other intestinal problems can accompany the pain.
Constipation or obstruction is sometimes encountered.
Alternating constipation with diarrhea from partial obstruction can also be seen.
Symptoms may also be related to the gynecologic orders in women as this disorder frequently affects women.
Changes in the menstrual cycle, infertility, and pain with sexual intercourse can be encountered.
Other symptoms, not directly related to the adhesions, can also be encountered.
Since ARD generally results in chronic problems, anxiety and depression can result.
Strained relationships can occur especially when the disorder affects sexual function.
Difficulty with conception can result.
This further adds to the anxiety and problems with self esteem experienced by women who suffer with this disorder.
Difficulty eating can result in poor nutrition, weakening suffers overall medical condition and can also lead to a decrease in immune function leading to many other illnesses.
Since many of the symptoms related to ARD are vague and wide spread and often include emotional factors, they are often difficult to diagnose.
Symptoms of ARD will often be attributed to other abnormalities.
Patient will often carry multiple diagnoses including chronic fatigue syndrome, endometriosis, irritable bowel syndrome, fibromyalgia, depression, anxiety, along with a whole host of other possible syndromes.
While multiple disorders can certainly exist in one patient, the confusion over which abnormality is truly causing the symptoms adds to the frustration of ARD. This, unfortunately, adds to the discomfort experienced by those who suffer with adhesions.
Undiagnosed chronic pain causes so much physical and emotional pain for victims of adhesion related disorder – and fills their lives with so much indecision.
In time the effects of ARD will begin to affect the lives of their families, their relationships and their jobs. This inordinate control by ARD has the power to erode and change our lives – and not necessarily for the better!
Tuesday, April 26, 2011
Study Details Causes of High Maternal Death Rates
This is just an expert from the full article.....please click here to read the full article
By Sharon Johnson
WeNews senior correspondent
Tuesday, April 26, 2011
In the United States 1 out of every 7 maternal deaths occurs six weeks after delivery, so some deaths might have been prevented if the woman received more follow-up care.
"On the other hand, some women may have received too many interventions," Bingham said. "Surgical interventions may have reached a level of overuse in the United States. Although there has been a 50 percent increase in the number of Cesarean sections since the 1990s, we have not seen any data to show that this leads to improvements in outcomes for the mother or baby. C-sections carry all the risks of abdominal surgery, such as infection and hemorrhage and life-long complications, such as adhesions."
The city's report found that 79 percent of all mothers who died from pregnancy-related causes gave birth via C-section. Although the report did not break the C-section data down by race or ethnicity, it did note that C-sections were the most common method of delivery among women who died from hemorrhage, infections and embolism.
By Sharon Johnson
WeNews senior correspondent
Tuesday, April 26, 2011
In the United States 1 out of every 7 maternal deaths occurs six weeks after delivery, so some deaths might have been prevented if the woman received more follow-up care.
"On the other hand, some women may have received too many interventions," Bingham said. "Surgical interventions may have reached a level of overuse in the United States. Although there has been a 50 percent increase in the number of Cesarean sections since the 1990s, we have not seen any data to show that this leads to improvements in outcomes for the mother or baby. C-sections carry all the risks of abdominal surgery, such as infection and hemorrhage and life-long complications, such as adhesions."
The city's report found that 79 percent of all mothers who died from pregnancy-related causes gave birth via C-section. Although the report did not break the C-section data down by race or ethnicity, it did note that C-sections were the most common method of delivery among women who died from hemorrhage, infections and embolism.
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