FDA warns obesity doctor over implants
WASHINGTON - A Los Angeles-area doctor who lent his name to a type of stomach-shrinking surgery failed to obtain the full informed consent of 175 patients implanted with an experimental medical device, according to a federal warning letter released Tuesday.
FDA proposes report cards on new drugs
Military creates mental health hotline
Glaxo distorted Paxil drug test data: BBC
100 Percent Juices Found As Beneficial To Health As Fruits And Vegetables
Louisiana Plan To Cover Uninsured Could Cost Less Than Previously Estimated
MedInsight(SM) Announces Clinical Trial Results Of Low-dose Naltrexone; Potential Breakthrough For Crohn's Disease Patients
World's First Users Meeting On Endoluminal Surgery Unites Leading Digestive Surgeons And Gastroenterologists Throughout Europe
Top Hospitals Have 28 Percent Lower Mortality Rate, Annual Study Finds
Wednesday, January 31, 2007
Sound waves saved me from losing my womb
Last updated at 23:22pm on 29th January 2007A pioneering sound wave technique has helped one woman to get rid of her fibroids and also prevented her from losing her womb. Paula Green, 32, started having excruciating period pains ten years ago
My problems started ten years ago, when every month I started having excruciating period pains, and the flow became really heavy.
Sometimes it was embarrassing and life was lived according to my monthly cycle.
I couldn't go to the gym or out to a party if it was my time of the month.
I also suffered from water retention and mood swings, like the worst case of PMT every month.
After six months I went to see my GP.
I had started to bleed between periods, too, and was worried that I might have cancer.
There was also a hard, visible lump in my abdomen which stuck out.
My GP referred me to a specialist, who did an ultrasound scan that confirmed large fibroids — muscular growths of tissue in the wall of the uterus — up to 4in (10cm) and dozens of small ones the size of marbles.
I was told that I could have an operation to remove them, but did not want to go through major surgery.
Read More
My problems started ten years ago, when every month I started having excruciating period pains, and the flow became really heavy.
Sometimes it was embarrassing and life was lived according to my monthly cycle.
I couldn't go to the gym or out to a party if it was my time of the month.
I also suffered from water retention and mood swings, like the worst case of PMT every month.
After six months I went to see my GP.
I had started to bleed between periods, too, and was worried that I might have cancer.
There was also a hard, visible lump in my abdomen which stuck out.
My GP referred me to a specialist, who did an ultrasound scan that confirmed large fibroids — muscular growths of tissue in the wall of the uterus — up to 4in (10cm) and dozens of small ones the size of marbles.
I was told that I could have an operation to remove them, but did not want to go through major surgery.
Read More
Nutritional Management of SBS
Nutritional strategies and regimens are important components of the treatment and ongoing management of SBS. These regimens vary depending on the severity of the condition and the ability of the remaining intestine to absorb nutrients. In some people, oral nutrition may simply be restricted and supplemented, depending on individual nutritional needs. There are other people in whom the length and condition of the bowel are insufficient to provide the body with the nutrients it requires through oral feeding. This results in the need for intravenous nutrition, usually through a catheter inserted in a large vein that has been surgically adapted for this purpose (TPN, or total parenteral nutrition). It is obvious that the type of nutritional regimen being used will have a considerable effect on quality of life. Since many social activities center around meals and eating and drinking, people whose ability to ingest food has been impaired often feel uncomfortable and self-conscious in these situations. Other areas of life potentially affected by these nutritional requirements are working outside the home, outings for such activities as shopping or going to the movies, independence, and relationships with family and friends.
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Laparoscopic Adhesiolysis
by Ceana H. Nezhat, MD, Daniel S. Seidman, MD Farr R. Nezhat, MD, Camran R. Nezhat MD
SURGICAL ANATOMY AND TECHNIQUES
Laparoscopy is an effective tool for the evaluation of patients with chronic pain. Laparoscopic adhesiolysis is associated with significant relief of chronic abdominal pain in more than 80% of patients. Laparoscopic adhesiolysis was also found to be more effective than microsurgical adhesiolysis for infertility. Although complications due to adhesiolysis are rare, there is understandable concern about blunt, sharp, or thermal injury to the bowel. Adhesions are frequently involved between two organs and most often involve the bowel. The possibility of injury during abdominal entry with a Veress needle or trocar exists in patients with or without a previous history of laparotomy.(Figure 1, Figure 2a, Figure 2b) To adequately perform laparoscopic adhesiolysis, three or four abdominal punctures are required - the infraumbilical incision for the operative laparoscope and two to three lower, lateral punctures for introduction of ancillary instruments. Successful insertion depends on adequate skin incision, the trocar’s working condition, proper orientation, and control over the instrument’s force and depth of insertion. Small diameter (<3 mm in diameter) laparoscopy as an alternative to open laparoscopy can be utilized for initial abdominal entry in patients at risk for adhesions. Through the lateral trocar, on the side of the assistant, an atraumatic grasping forceps is inserted to hold the adhesion or involved organ, stretch it, and identify its boundaries and avascular planes. The opposite trocar, on the side of the surgeon, is used for microscissors or the suction-irrigator probe. Dense adhesions are severed first, followed by thin and filmy adhesions. This approach allows for progressive exposure of the pelvic structures. Once the intestines are freed from the adjacent structures, they can be pushed cephalad. In the pelvis, adherent ovaries are freed from the pelvic sidewall, broad ligament, tubes, and uterus. Once the ovaries are lifted from the cul-de-sac and mobilized, all peritubal adhesions are removed. Any bleeding that cannot be controlled with the laser is desiccated using the bipolar or unipolar electrocoagulator to maintain a clear field.
PREVENTION
Adhesion formation is a serious concern following pelvic surgery. Adhesion formation at the vaginal cuff and pelvic sidewall usually involves bowel and omentum. This may result in pelvic pain, dyspareunia, small bowel obstruction, and residual ovary syndrome when salpingo-oophorectomy is not performed. Adhesions were identified as the primary cause of chronic pelvic pain in 13-26% of females. Painful coitus is frequently reduced after lysis of pelvic adhesions. In many surveys of postoperative bowel obstruction, abdominal surgery is the leading cause of adhesion formation.
Read the rest
SURGICAL ANATOMY AND TECHNIQUES
Laparoscopy is an effective tool for the evaluation of patients with chronic pain. Laparoscopic adhesiolysis is associated with significant relief of chronic abdominal pain in more than 80% of patients. Laparoscopic adhesiolysis was also found to be more effective than microsurgical adhesiolysis for infertility. Although complications due to adhesiolysis are rare, there is understandable concern about blunt, sharp, or thermal injury to the bowel. Adhesions are frequently involved between two organs and most often involve the bowel. The possibility of injury during abdominal entry with a Veress needle or trocar exists in patients with or without a previous history of laparotomy.(Figure 1, Figure 2a, Figure 2b) To adequately perform laparoscopic adhesiolysis, three or four abdominal punctures are required - the infraumbilical incision for the operative laparoscope and two to three lower, lateral punctures for introduction of ancillary instruments. Successful insertion depends on adequate skin incision, the trocar’s working condition, proper orientation, and control over the instrument’s force and depth of insertion. Small diameter (<3 mm in diameter) laparoscopy as an alternative to open laparoscopy can be utilized for initial abdominal entry in patients at risk for adhesions. Through the lateral trocar, on the side of the assistant, an atraumatic grasping forceps is inserted to hold the adhesion or involved organ, stretch it, and identify its boundaries and avascular planes. The opposite trocar, on the side of the surgeon, is used for microscissors or the suction-irrigator probe. Dense adhesions are severed first, followed by thin and filmy adhesions. This approach allows for progressive exposure of the pelvic structures. Once the intestines are freed from the adjacent structures, they can be pushed cephalad. In the pelvis, adherent ovaries are freed from the pelvic sidewall, broad ligament, tubes, and uterus. Once the ovaries are lifted from the cul-de-sac and mobilized, all peritubal adhesions are removed. Any bleeding that cannot be controlled with the laser is desiccated using the bipolar or unipolar electrocoagulator to maintain a clear field.
PREVENTION
Adhesion formation is a serious concern following pelvic surgery. Adhesion formation at the vaginal cuff and pelvic sidewall usually involves bowel and omentum. This may result in pelvic pain, dyspareunia, small bowel obstruction, and residual ovary syndrome when salpingo-oophorectomy is not performed. Adhesions were identified as the primary cause of chronic pelvic pain in 13-26% of females. Painful coitus is frequently reduced after lysis of pelvic adhesions. In many surveys of postoperative bowel obstruction, abdominal surgery is the leading cause of adhesion formation.
Read the rest
Tuesday, January 30, 2007
Adhesions Headlines ARDvark Blog
Role Of Appetite Hormone MCH In Insulin Production Uncovered By Joslin-led Study
A new Joslin Diabetes Center-led study has shown conclusively that a neuropeptide, melanin concentrating hormone (MCH), found in the brain and known for its role in increasing appetite in people, plays a role in the growth of insulin-producing beta cells and the secretion of insulin...
UK Still Has Long Way To Go In War On Killer Hospital Bugs
Medicare Beneficiaries Under 'Observation' At Hospitals Often Receive Large Prescription Drug Bills
Empi Announces FDA Clearance Of Select(TM) TENS Device
New Interactive Website Features Data From Clostridium Difficile-Associated Disease (CDAD) Surveillance Project
Threshold Pharmaceuticals Initiates Phase 2 Clinical Trial Evaluating Glufosfamide In Patients With Platinum-Resistant Ovarian Cancer
Better Strategies For Osteoporosis Prevention And Therapy
Ikerlan-IK4 And Gaiker-IK4 Patent Device For Rapid Diagnosis Of Infectious Diseases And Cancer
Need For Exploratory Surgery Avoided As MDCT Accurately Locates Bowel Perforation
Less-Invasive Uterine Fibroid Treatment As Effective As Hysterectomy, Myomectomy, Study Says
Panel Recommends That FDA Not Create Specific Effectiveness Standard For Oral Contraceptive Approvals
Getting SAD Is More Than Having The Blues
Lawmakers Consider Including Association Health Plan Amendment To Minimum Wage Legislation
Light At Night Is Dangerous To Health
Newer Class Of Antidepressants Similar In Effectiveness, Side Effects Differ
Advances In Optics For Biotechnology, Medicine And Surgery
MRI Contrast Agent Linked To Rare Disease
Surgical Trauma In Back Surgery Lowered By Pretreating Spinal Cord With Local Anesthetic
Back Pain: When To Opt For Surgery, From The Harvard Health Letter
New Review May Ease Worries Of People With Disabling Anxiety Disorder
2 Minutes Conversation prevents RX - Wrong-Site Surgery
CDC To Hire Ombudsman To Address Low Morale Among Employees
About One-Fifth Of Women In India Experience Menopause By Age 41, Study Says
A new Joslin Diabetes Center-led study has shown conclusively that a neuropeptide, melanin concentrating hormone (MCH), found in the brain and known for its role in increasing appetite in people, plays a role in the growth of insulin-producing beta cells and the secretion of insulin...
UK Still Has Long Way To Go In War On Killer Hospital Bugs
Medicare Beneficiaries Under 'Observation' At Hospitals Often Receive Large Prescription Drug Bills
Empi Announces FDA Clearance Of Select(TM) TENS Device
New Interactive Website Features Data From Clostridium Difficile-Associated Disease (CDAD) Surveillance Project
Threshold Pharmaceuticals Initiates Phase 2 Clinical Trial Evaluating Glufosfamide In Patients With Platinum-Resistant Ovarian Cancer
Better Strategies For Osteoporosis Prevention And Therapy
Ikerlan-IK4 And Gaiker-IK4 Patent Device For Rapid Diagnosis Of Infectious Diseases And Cancer
Need For Exploratory Surgery Avoided As MDCT Accurately Locates Bowel Perforation
Less-Invasive Uterine Fibroid Treatment As Effective As Hysterectomy, Myomectomy, Study Says
Panel Recommends That FDA Not Create Specific Effectiveness Standard For Oral Contraceptive Approvals
Getting SAD Is More Than Having The Blues
Lawmakers Consider Including Association Health Plan Amendment To Minimum Wage Legislation
Light At Night Is Dangerous To Health
Newer Class Of Antidepressants Similar In Effectiveness, Side Effects Differ
Advances In Optics For Biotechnology, Medicine And Surgery
MRI Contrast Agent Linked To Rare Disease
Surgical Trauma In Back Surgery Lowered By Pretreating Spinal Cord With Local Anesthetic
Back Pain: When To Opt For Surgery, From The Harvard Health Letter
New Review May Ease Worries Of People With Disabling Anxiety Disorder
2 Minutes Conversation prevents RX - Wrong-Site Surgery
CDC To Hire Ombudsman To Address Low Morale Among Employees
About One-Fifth Of Women In India Experience Menopause By Age 41, Study Says
Use of fibrin glue (Tissucol((R))) in laparoscopic repair of abdominal wall defects: preliminary experience.
Olmi S,
Scaini A,
Erba L,
Croce E.
Department of General Surgery, Centre for Laparoscopic and Minimally Invasive Surgery, Ospedale San Gerardo, Monza, Italy, stefanoolmi@tiscali.it.
INTRODUCTION: The aim of this study was to establish the efficacy and tolerability of human fibrin glue (Tissucol((R))) for the nontraumatic fixation of a composite prosthesis (Parietex((R))) in the laparoscopic repair of small to medium-sized incisional hernias and primary defects of the abdominal wall. MATERIALS AND METHODS: From October 2003 to October 2005, 40 patients underwent laparoscopic repair at the hands of one surgeon with expertise in laparoscopic surgery; all meshes were implanted in an intraperitoneal position. Follow-up visits were scheduled for 7 days and 1, 6, and 12 months. These included assessments for pain and postoperative complications. RESULTS: Forty patients (24 females, 16 males) with a mean age of 50 years (range, 26-65 years) and a mean Body Mass Index (BMI) of 27 (range 25 to 30) were included in the study. Sixteen patients had incisional hernias, and 24 had primary defects. The size of the defects varied from 2 to 7 cm. Adhesiolysis was necessary in 92.5% of cases (25/40). There were no intraoperative complications or conversions. After a mean follow-up of 16 months (range, 3-24 months), no postoperative complications were observed. The mean surgical intervention time was 36 min (range, 12-40 min), with an average hospitalization time of 1 day. CONCLUSIONS: The use of fibrin glue in the present study provided stable and uniform fixation of the prosthesis and minimized intraoperative and postoperative complications. Consequently, laparoscopic treatment of small to medium-sized abdominal defects using this approach is our therapeutic option of choice.
PMID: 17177079 [PubMed - as supplied by publisher]
Scaini A,
Erba L,
Croce E.
Department of General Surgery, Centre for Laparoscopic and Minimally Invasive Surgery, Ospedale San Gerardo, Monza, Italy, stefanoolmi@tiscali.it.
INTRODUCTION: The aim of this study was to establish the efficacy and tolerability of human fibrin glue (Tissucol((R))) for the nontraumatic fixation of a composite prosthesis (Parietex((R))) in the laparoscopic repair of small to medium-sized incisional hernias and primary defects of the abdominal wall. MATERIALS AND METHODS: From October 2003 to October 2005, 40 patients underwent laparoscopic repair at the hands of one surgeon with expertise in laparoscopic surgery; all meshes were implanted in an intraperitoneal position. Follow-up visits were scheduled for 7 days and 1, 6, and 12 months. These included assessments for pain and postoperative complications. RESULTS: Forty patients (24 females, 16 males) with a mean age of 50 years (range, 26-65 years) and a mean Body Mass Index (BMI) of 27 (range 25 to 30) were included in the study. Sixteen patients had incisional hernias, and 24 had primary defects. The size of the defects varied from 2 to 7 cm. Adhesiolysis was necessary in 92.5% of cases (25/40). There were no intraoperative complications or conversions. After a mean follow-up of 16 months (range, 3-24 months), no postoperative complications were observed. The mean surgical intervention time was 36 min (range, 12-40 min), with an average hospitalization time of 1 day. CONCLUSIONS: The use of fibrin glue in the present study provided stable and uniform fixation of the prosthesis and minimized intraoperative and postoperative complications. Consequently, laparoscopic treatment of small to medium-sized abdominal defects using this approach is our therapeutic option of choice.
PMID: 17177079 [PubMed - as supplied by publisher]
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