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Tuesday, December 17, 2013
Monday, December 16, 2013
Current Status of Adhesions Clinical Trails from clinicaltrails.gov
RankStatusStudy
1 Completed Closure of Peritoneum at Cesarean Section and Postoperative Adhesion
Conditions: Cesarean Section; Adhesions
Intervention: Procedure: Closure of the peritoneum at cs
2 Completed Efficacy and Safety Study of Anti-Adhesion Product in the Prevention of Intraperitoneal Adhesions
Condition: Intraperitoneal Adhesions
Intervention: Biological: Anti-Adhesion Product
3 Active, not recruiting Seprafilm® Adhesion Barrier and Cesarean Delivery
Conditions: Adhesions; Cesarean Section; Delivery, Obstetric
Interventions: Device: modified sodium hyaluronic acid and carboxymethylcellulose (Seprafilm Adhesion Barrier); Device: Placebo
4 Not yet recruiting Adhesions After Open Versus Laparoscopic Resection of Colorectal Malignancies Detected During Liver Resection
Condition: Adhesions
Intervention: Procedure: Liver resection
5 Completed Safety and Efficacy Study of a Hydrogel, Applied Following Removal of Myomas During Gynecologic Surgery, Administered for the Prevention/Reduction of Postoperative Adhesion Formation
Condition: Myoma
Interventions: Other: Adhibit Adhesion Prevention Gel; Other: Standard of Care Comparator
6 Terminated
Has Results DuraGen Plus® Adhesion Barrier for Use in Spinal Surgery
Conditions: Spinal Injuries; Adhesions
Intervention: Device: DuraGen Plus Adhesion Barrier Matrix
7 Terminated Seprafilm® for Prevention of Adhesions at Repeat Cesarean
Condition: Adhesion Formation After Primary Cesarean Delivery
Interventions: Device: Seprafilm®; Other: Control
8 Terminated Efficacy of Sprayable PEG Barrier in Gynecologic Laparoscopy
Conditions: Postoperative Adhesion; Peritoneal Adhesion, Nos
Interventions: Device: Spraygel; Device: Control
9 Not yet recruiting A Trial to Reduce Adhesions Following a Primary Cesarean Section
Condition: Tissue Adhesions
Intervention: Device: Seprafilm
10 Completed Efficacity Assessment of PREVADH® in Adhesion Prevention in Gynaecologic Surgery
Conditions: Uterine Fibroids; Fertility Disorders
Interventions: Other: Ringer lactate solution; Device: Prevadh film
11 Completed Evaluation of Bioresorbable Sheet to Prevent Intra-Abdominal Adhesions in Colorectal Surgeries
Condition: Adhesions
Intervention: Device: Polylactic Acid Sheet
12 Recruiting Intravitreal Gas for Vitreomacular Adhesion
Condition: Vitreomacular Adhesion
Intervention: Procedure: Intravitreal Injection of sulfahexafluoride gas
13 Recruiting Comparative Effectiveness Multicenter Trial for Adhesion Characteristics of Ventral Hernia Repair Mesh
Conditions: Ventral Hernia; Adhesions
Intervention: Procedure: Clinically-Indicated Abdominal Re-Exploration Surgery
14 Suspended Evaluation of Adhexil Safety and Efficacy in Prevention and/or Reduction of Adhesions in Gynecological Surgery
Conditions: Ovarian Cysts; Endometriosis; Adhesions
Intervention: Biological: ADHEXIL
15 Terminated Evaluation of the Safety and Effectiveness of Sepraspray™ in Reducing Post-surgical Adhesions
Condition: Abdominal Adhesions
Intervention: Device: Sepraspray
16 Not yet recruiting A Trial to Assess the Effect and Safety of the C-Qur™ Film
Condition: Postoperative Adhesions
Intervention: Device: C-Qur
17 Completed Collagenase in the Treatment of Zone II Flexor Tendon Adhesions in the Hand
Condition: Adhesion of Flexor Tendon of Hand
Interventions: Drug: Collagenase; Drug: Collagenase injection
18 Recruiting The Role of 2-octyl Cyanoacrylate in Prevention of Recurrent Adhesions After Circumcision
Conditions: Phimosis; Adhesions
Interventions: Procedure: application of 2-octyl cyanoacrylate skin adhesive in addition to stitches; Procedure: standard stitches only
19 Terminated SprayShield EU Post Market Study
Conditions: Ulcerative Colitis; Familial Polyposis
Interventions: Device: SprayShield Adhesion Barrier System; Procedure: Good Surgical Technique Alone
20 Recruiting Effects of CoSeal on Bleeding & Adhesions in Pediatric Heart Surgery
Conditions: Congenital Heart Defect; Surgery-Induced Tissue Adhesions; Hemorrhage
Intervention: Device: CoSeal Surgical Spray Group
21 Completed
Safety and Efficacy Study of Intravitreal Ocriplasmin in Subjects With AMD With Focal Vitreomacular Adhesion
Conditions:
Exudative Age-Related Macular Degeneration; Focal Vitreomacular Adhesion
Interventions:
Drug: Ocriplasmin; Drug: Sham injection
22 Terminated Pregabalin for Abdominal Pain From Adhesions
Conditions: Abdominal Pain; Surgical Adhesions
Intervention: Drug: Pregabalin
23 Completed A-Part® Gel as Adhesion Prophylaxis After Major Abdominal Surgery Versus a Non-treated Group
Conditions: Adhesions; Abdominal Cavity
Intervention: Device: A-Part® Gel
24 Active, not recruiting Assessment of the Manageability and Safety of ADBLOCK Adhesion Barrier System in Laparoscopic Gynaecological Surgery
Condition: UTERINE MYOMAS
Intervention: Device: ADBLOCK
25 Completed Has Results
Post Market Study for an Adhesion Barrier Following Laparoscopic Myomectomy
Conditions: Fibroid; Myoma; Leiomyoma
Intervention: Device: SprayShield™
26 Completed Resorbable Barrier for the Prevention of Abdominal and Peri-hepatic Adhesion Formation
Condition: Colorectal Cancer
Interventions: Procedure: - use of resorbable membrane Seprafilm; Procedure: without resorbable barrier (seprafilm)
27 Recruiting Seprafilm Slurry in the Prevention of Uterine Scarring in Patients Undergoing Hysteroscopic Myomectomy
Condition: Intrauterine Adhesions
Interventions: Device: Seprafilm; Device: Sterile Saline Solution
28 Completed Adhesion Formation Following Laparoscopic and Open Colorectal Surgery
Condition: Adhesions
Intervention: Procedure: Laparoscopy
29 Completed Has Results
Trial of Microplasmin Intravitreal Injection for Non-surgical Treatment of Focal Vitreomacular Adhesion. The MIVI-TRUST (TG-MV-006) Trial.
Condition: Vitreomacular Adhesion
Interventions: Drug: 125 µg Ocriplasmin; Drug: Placebo
30 Completed Interferon Gamma to Treat Leukocyte Adhesion Deficiency Type I
Condition: Leukocyte Adhesion Deficiency Syndrome
Intervention: Drug: Interferon gamma
31 Completed Has Results
Trial of Microplasmin Intravitreal Injection for Non-Surgical Treatment of Focal Vitreomacular Adhesion. The MIVI-TRUST (TG-MV-007) Trial.
Condition: Vitreomacular Adhesion
Interventions: Drug: Ocriplasmin 125µg; Drug: Placebo
32 Recruiting a Study to Evaluate Adhesion Risk in Fertility Patients' Status Post Laparoscopic Myomectomy.
Conditions: Uterine Fibroids; Infertility
Intervention: Device: surgery utilizing V-Loc suture
33 Completed Efficiency of Intercoat (Oxiplex/AP Gel)in Decreasing Intrauterine Adhesions
Condition: Asherman Syndrome
Interventions: Drug: Oxiplex/AP gel; Drug: Normal Saline
34 Completed Safety Study of Polylactide-Caprolactone-Trimethylenecarbonate Copolymer for Post-Operative Adhesion Prophylaxis
Condition: Adhesions
Interventions: Device: polylactide-caprolactone-trimethylenecarbonate copolymer; Device: Icodextrin 4%
35 Completed Stem Cell Transplantation to Treat Leukocyte Adhesion Deficiency
Condition: Leukocyte-Adhesion Deficiency Syndrome
Intervention: Procedure: modified stem cell transplant
36 Completed Safety and Efficacy Study of Microplasmin in for Non-Surgical Treatment of Focal Vitreomacular Adhesion
Condition: Focal Vitreomacular Adhesion
Intervention: Drug: Microplasmin
37 Completed Efficacy and Safety of the Investigational Device, SurgiShield Anti-Adhesion Barrier Gel
Condition: Wound Healing
Intervention: Device: 5ml surgishield
38 Recruiting A Phase III Study of A01016 in Subjects With Symptomatic Vitreomacular Adhesion
Condition: Vitreomacular Adhesion
Interventions: Drug: A01016; Drug: Sham injection
39 Recruiting Propanolol and Red Cell Adhesion Non-asthmatic Children Sickle Cell Disease
Condition: Sickle Cell Disease
Intervention: Drug: propranolol
40 Recruiting Adhesion of Connective Tissue Around Laser-treated Abutments for Dental Implants - Clinical Trial in Humans
Condition: Periimplantitis
Intervention: Procedure: Dental implant placement with a final pro
Sunday, December 15, 2013
Intestinal obstructions
Intestinal obstruction is a partial or complete blockage of the bowel that prevents the contents of the intestine from passing through.
Causes, incidence, and risk factors
Obstruction of the bowel may due to:
- A mechanical cause, which means something is in the way
- Ileus, a condition in which the bowel doesn't work correctly but there is no structural problem
Paralytic ileus, also called pseudo-obstruction, is one of the major causes of intestinal obstruction in infants and children. Causes of paralytic ileus may include:
- Bacteria or viruses that cause intestinal infections (gastroenteritis)
- Chemical, electrolyte, or mineral imbalances (such as decreased potassium levels)
- Complications of abdominal surgery
- Decreased blood supply to the intestines (mesenteric ischemia)
- Infections inside the abdomen, such as appendicitis
- Kidney or lung disease
- Use of certain medications, especially narcotics
Mechanical causes of intestinal obstruction may include:
- Adhesions or scar tissue that forms after surgery
- Foreign bodies (eaten materials that block the intestines)
- Gallstones (rare)
- Hernias
- Impacted stool
- Intussusception (telescoping of one segment of bowel into another)
- Tumors blocking the intestines
- Volvulus (twisted intestine)
Symptoms
- Abdominal swelling (distention)
- Abdominal fullness, gas
- Abdominal pain and cramping
- Breath odor
- Constipation
- Diarrhea
- Inability to pass gas
- Vomiting
Signs and tests
During a physical exam, the health care provider may find bloating, tenderness, or hernias in the abdomen.
Tests that show obstruction include:
- Abdominal CT scan
- Abdominal x-ray
- Barium enema
- Upper GI and small bowel series
Treatment
Treatment involves placing a tube through the nose into the stomach or intestine to help relieve abdominal swelling (distention) and vomiting. Volvulus of the large bowel may be treated by passing a tube into the rectum.
Surgery may be needed to relieve the obstruction if the tube does not relieve the symptoms, or if there are signs of tissue death.
Expectations (prognosis)
The outcome depends on the cause of the blockage. Most of the time the cause is easily treated.
Complications
Complications may include or may lead to:
- Electrolyte (blood chemical and mineral) imbalances
- Dehydration
- Hole (perforation) in the intestine
- Infection
- Jaundice (yellowing of the skin and eyes)
If the obstruction blocks the blood supply to the intestine, it may cause infection and tissue death (gangrene). Risks for tissue death are related to the cause of the blockage and how long it has been present. Hernias, volvulus, and intussusception carry a higher gangrene risk.
In a newborn, paralytic ileus that destroys the bowel wall (necrotizing enterocolitis) is life-threatening and may lead to blood and lung infections.
Calling your health care provider
Call your health care provider if you:
- Cannot pass stool or gas
- Have a swollen abdomen (distention) that does not go away
- Keep vomiting
Prevention
Prevention depends on the cause. Treating conditions, such as tumors and hernias, that can lead to obstruction may reduce your risk of getting an obstruction.
Some causes of obstruction cannot be prevented.
References
- McKenzie S, Evers BM. Small intestine. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. St. Louis, Mo: WB Saunders; 2012:chap 50.
- Fry RD, Mahmoud N, Maron DJ, Bleier JIS. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. St. Louis, Mo: WB Saunders; 2012:chap 52.
- Turnage RH, Heldmann M. Intestinal obstruction. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 119.
- Review Date: 7/25/2012.Reviewed by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington; and Joshua Kunin, MD, Consulting Colorectal Surgeon, Zichron Yaakov, Israel. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
Friday, December 13, 2013
Thursday, December 05, 2013
Potential for scar tissue treatment
Posted: Tuesday, November 12, 2013 10:23 am | Updated: 10:31 am, Tue Nov 12, 2013.
Researchers from Scotland have identified a specific molecule responsible for turning regular tissue into scar tissue.
Using mice bred with the disease fibrosis, researchers from the University of Edinburgh developed a drug which blocked a molecule called alpha v integrin. Mice treated with the drug were protected from liver and lung fibrosis. The discovery could help patients with damaged organs avoid the long wait on organ transplant lists.
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