Great article in Trials, on why regulators should stop withholding trial info from doctors and patients

October 18th, 2012 by Ben Goldacre in bad science, big pharma | 5 Comments »

One thing in Bad Pharma has shocked readers more than anything else: the way that vitally important information about trials is withheld from doctors and patients, not just by drug companies, but also by government bodies such NICE and the European Medicines Agency (the body that approves and regulates medicines for the UK).

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Great site BAD SCIENCE http://www.badscience.net/

The same goes for an adhesiolysis

Dr Koh USA

Charles H. Koh

MD, FRCOG, FACOG
Gynecology and Reproductive Medicine

Email Dr. Koh!

Dr. Koh specializes in advanced laparoscopic surgery and has created many innovations and techniques to further the field. He lectures and performs demonstration surgeries around the world at international meetings and courses. He holds patents for a laparoscopic hysterectomy technique "Simplifying Total Laparoscopic Hysterectomy" (U.S. patent #5520698, May 28, 1996) and a device for aiding the operation "KOH Colpotomizer Pneumo occluder" "Vaginal Extender for Colpotomy" (U.S. Patent #5643285, July 1, 1997). Dr. Koh also designed the "KOH Ultramicro Instruments) used for laparoscopic microsurgery which remain the only set of instruments for that purpose in the world today. This has allowed tubal reversal to be performed laparoscopically and its use has been adopted in pediatric laparoscopy, general surgery, and vascular surgery.

Medical Education & PostGraduate Training:

• University of Singapore
  Bachelor of Medicine and Bachelor of Surgery, 1967
  Residencies in OB/GYN, Surgery, Pediatrics & Public Health, 1967-1971
• Hammersmith Hospital, University of London, University of New Castle, England
  Residency in OB/GYN, 1971-1974
• Board Certified in England and U.S.A.
• Fellow, Society of Reproductive Surgeons

PostGraduate Teaching (Full-Time Faculty Appointments)

• Senior Registrar, Department of Obstetrics & Gynecology
  Hammersmith Hospital, London, 1975-1976
• Tutor and Lecturer, Royal Postgraduate Medical School, University of London, 1974-1975
• Assistant Professor, Department of Obstetrics & Gynecology, Medical College of Wisconsin, 1977-1979

Academic/Staff Appointments:

• Attending Staff
  
  USA - Columbia Hospital, St. Mary's Hospital, Milwaukee, WI
  Singapore - Mount Alvernia Hospital, Queen Elizabeth Hospital
  Hong Kong - Hong Kong Adventist Hospital, Sanatorium Hospital
• Associate Clinical Professor-Department of Obstetrics and Gynecology, Medical College of Wisconsin
• Co-Director - Milwaukee Institute of Minimally Invasive Surgery
• Member of Society of Reproductive Surgeons
• American Society for Reproductive Medicine
• Fellow of the Royal College of Obstetrics and Gynecology
• Fellow of the American College of Obstetrics and Gynecology

Advisorships

• Advisory Committee/Board Editorial - Medical Video Productions Editorial Board
• Journal of AAGL Advisor
• Gynecologic Endoscopy Editorial Board
• International Society for Gynecologic Endoscopists Board Member 1998-2000

Pain Scale

Preliminary study with SprayShield™ Adhesion Barrier System in the prevention of abdominal adhesions

Preliminary study with SprayShield™ Adhesion Barrier System in the prevention of abdominal adhesions

Go to:

Abstract

Introduction

Peritoneal adhesions, the fibrotic bands that form between the surfaces in the peritoneal cavity following surgery, still pose a difficult clinical challenge.

Aim

To evaluate the SprayShield™ Adhesion Barrier System (PEG ester amine solution and a buffer solution) in reducing post-operative adhesion formation.

Material and methods

This was a prospective, multi-center, randomized, single blind study. A total of 11 subjects diagnosed with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) were randomized: 8 to the SprayShield™ arm and 3 to the control arm. SprayShield™ was applied on the viscera directly under the midline peritoneal incision and at the site of ileostomy. During the follow-up surgery, the incidence, extent, and severity of post-operative adhesion formation were evaluated, as well as the time required to mobilize the ileal loop.

Results

In patients who received SprayShield™ the time required to mobilize the ileal loop at the ileostomy closure was slightly shorter and the incidence and severity of adhesions were somewhat lower vs. control subjects (NS).

Conclusions

SprayShield™ was found to be easy to use, safe, and quick to apply, and performed well in adherence and conformity. The incidence and severity of adhesions were lower for SprayShield™ subjects vs. control subjects, but due to the limited number of patients there are not enough data to confirm the effectiveness of the SprayShield™ Adhesion Barrier System in prevention of adhesions.

Keywords: 

Wideochir Inne Tech Malo Inwazyjne. Dec 2013; 8(4): 301–309.

Published online May 6, 2013. doi:  10.5114/wiitm.2011.34884

PMCID: PMC3908634

Preliminary study with SprayShield™ Adhesion Barrier System in the prevention of abdominal adhesions

Tomasz Banasiewicz,¹ Karolina Horbacka,² Jacek Karoń,² Stanisław Malinger,¹ Frantisek Antos,³ Sławomir Rudzki,⁴Zdenek Kala,⁵ Zoran Stojcev,⁶ Jyrki Kössi,⁷ and Piotr Krokowicz²

Author information ► Article notes ► Copyright and License information ►

Copyright © 2013 Sekcja Wideochirurgii TChP

This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction

Peritoneal adhesions, the fibrotic bands that form between the surfaces in the peritoneal cavity following surgery, still pose a difficult clinical challenge.

Aim

To evaluate the SprayShield™ Adhesion Barrier System (PEG ester amine solution and a buffer solution) in reducing post-operative adhesion formation.

Material and methods

This was a prospective, multi-center, randomized, single blind study. A total of 11 subjects diagnosed with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) were randomized: 8 to the SprayShield™ arm and 3 to the control arm. SprayShield™ was applied on the viscera directly under the midline peritoneal incision and at the site of ileostomy. During the follow-up surgery, the incidence, extent, and severity of post-operative adhesion formation were evaluated, as well as the time required to mobilize the ileal loop.

Results

In patients who received SprayShield™ the time required to mobilize the ileal loop at the ileostomy closure was slightly shorter and the incidence and severity of adhesions were somewhat lower vs. control subjects (NS).

Conclusions

SprayShield™ was found to be easy to use, safe, and quick to apply, and performed well in adherence and conformity. The incidence and severity of adhesions were lower for SprayShield™ subjects vs. control subjects, but due to the limited number of patients there are not enough data to confirm the effectiveness of the SprayShield™ Adhesion Barrier System in prevention of adhesions.

Keywords: adhesions, adhesion prevention, laparotomy, ileostomy

Read the full article here  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3908634/

Go to:

Abstract

Introduction

Peritoneal adhesions, the fibrotic bands that form between the surfaces in the peritoneal cavity following surgery, still pose a difficult clinical challenge.

Aim

To evaluate the SprayShield™ Adhesion Barrier System (PEG ester amine solution and a buffer solution) in reducing post-operative adhesion formation.

Material and methods

This was a prospective, multi-center, randomized, single blind study. A total of 11 subjects diagnosed with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) were randomized: 8 to the SprayShield™ arm and 3 to the control arm. SprayShield™ was applied on the viscera directly under the midline peritoneal incision and at the site of ileostomy. During the follow-up surgery, the incidence, extent, and severity of post-operative adhesion formation were evaluated, as well as the time required to mobilize the ileal loop.

Results

In patients who received SprayShield™ the time required to mobilize the ileal loop at the ileostomy closure was slightly shorter and the incidence and severity of adhesions were somewhat lower vs. control subjects (NS).

Conclusions

SprayShield™ was found to be easy to use, safe, and quick to apply, and performed well in adherence and conformity. The incidence and severity of adhesions were lower for SprayShield™ subjects vs. control subjects, but due to the limited number of patients there are not enough data to confirm the effectiveness of the SprayShield™ Adhesion Barrier System in prevention of adhesions.

Keywords: 

Dr Mario Malzoni Italy

Dott. Mario Malzoni 
Head physician of the  Department of Advanced Gynaecological Endoscopy 
Nursing Home - Avellino 
Dott. Mario Malzoni, born in Avellino on June 06 1969 

STUDIES: 
High School Diploma  “Liceo Scientifico” at the  "PS Mancini " high school in Avellino in 1987; 
He graduated on 29/07/93 in Medicine at the University of Naples (Federico II) with 110 cum laude. 
Specialization in Obstetrics and Gynecology at the University of Naples (50/50) in October 1997;
6 month internship at the Division of Advanced Laparoscopic Surgery at Columbia University (New York).

PROFESSIONAL EXPERIENCE:. 
Head of the Gynecologic Endoscopy Division at the Casa di Cura Malzoni of Avellino. (CIP Laparoscopic LT03899 IP hysteroscopy L100101) 

Consultant of endoscopic surgery at: 
1.Casa di Cura Villa Del Rosario Rome 
2.Casa di Cura Ruesch Napoli 
3.Casa di Cura "Malzoni" Spa Agropoli;

Read the rest of his impressive Vitae here http://www.endoscopicamalzoni.it/index.php?option=com_content&task=view&id=193&Itemid=280&lang=english

The best for baby and you ~ VBAC after C-Section

If you had a prior c- section please ask your OB," What will you do if adhesions are encountered ? "     
You deserve an answer to that question and it should be incorporated into your "Informed Consent".
Please read the article below about VBAC. It may be an option despite your prior c-section and with your Adhesion Related Disorder.                        

The best for baby and you

Yaowaluk Rapeepattana, MD
Samitivej Sukhumvit Hospital April 1, 2014 1:00 am

Many women who have delivered a child by Caesarean believe they are fated to deliver any more babies they may have the surgical rather than the natural way.

While many do opt for a C section, whether or not or medical advice, vaginal birth after caesarean or VBAC as it's known for short, allows a woman to give birth safely and comfortably, even if an earlier pregnancy resulted in a C-section. The American College of Obstetricians and Gynaecologists recommends that all doctors offer VBAC to expectant mothers. 

Anyone who wants a natural birth is an ideal candidate for VBAC though it should be noted that it's not entirely without risk: there is a 1 per cent or lower risk of uterine rupture.

To assess the risks associated with VBAC, it is helpful to determine why a previous pregnancy might have resulted in a C-section. For example, if the abnormal position of the baby or the abnormal location of the placenta necessitated the first caesarean, VBAC would be a low risk process the next time. However, if a C-section was required because of the mother's small pelvis or the baby's large size, vaginal birth could be complicated for subsequent pregnancies as well. Risks associated with VBAC increase if a woman has had uterine surgery, more than one C-section, or if her baby is bigger than her pelvis. If the interval between pregnancies is less than a year, risks increase substantially; some doctors are unwilling to recommend VBAC to such patients.     
Click link to finish the article
http://www.nationmultimedia.com/life/The-best-for-baby-and-you-30230557.html