Endometriosis ~ Abdominal Pain ~ Endo ~ Scar Tissue ~ Adhesions ~ Infertility ~ Hysterectomy

Saturday, December 30, 2006

IVM ~ New IVF 'is a stunning success'

By Martin Beckford
Last Updated: 1:27am GMT 30/12/2006

A revolutionary fertility treatment is being developed that could provide a safer and cheaper alternative to conventional techniques, it was disclosed yesterday.
The new treatment, known as invitro maturation (IVM), is said by doctors to have had "stunning" results and helped more than 1,000 couples to have babies already.

It involves removing immature eggs from a woman's ovaries and maturing them in laboratories before fertilising them with a man's sperm, rather than using hormone drugs to stimulate the release of mature eggs.
Prof Svend Lindenberg, of the Nordica Fertility Centre in Copenhagen, told a London fertility conference that IVM was about to revolutionise fertility treatment. "We have achieved stunning results and demonstrated that it is possible to take an egg and fertilise it without having to use the heavy-duty drug approach."
So far only a handful of centres worldwide, none of them in the UK, have used IVM.

Environmental and host-associated risk factors in endometriosis and deep endometriotic nodules: A matched case-control study.

Environ Res. 2007 Jan;103(1):121-9. Epub 2006 Jun 15.

Heilier JF,
Donnez J,
Nackers F,
Rousseau R,
Verougstraete V,
Rosenkranz K,
Donnez O,
Grandjean F,
Lison D,
Tonglet R.
Industrial Toxicology and Occupational Medicine Unit, Universite catholique de Louvain, 30.54 Clos Chapelle aux Champs B-1200 Brussels, Belgium.
Peritoneal endometriosis (PE) and deep endometriotic nodules (DEN) are gynecological diseases recently shown to be associated with elevated serum concentrations of organochlorines. The objective of the present study was to compare risk factors associated with both forms of the disease, with a particular attention to potential sources of organochlorine exposure. This matched case-control study with prospective recruitment included 88 triads (PE-DEN-control). All women were face-to-face interviewed with a standardized questionnaire, and serum dioxin and polychlorinated biphenyl measurements were available for 58 of them. Alcohol consumption (odds ratio (OR): 5.82 [confidence interval at 95% (95%CI) 1.20-28.3]) in DEN and low physical activity at work for DEN (OR: 4.58 [95%CI 1.80-11.62]) and PE (OR: 5.61 [95%CI 1.90-16.60]) were traced as significant risk factors. Organochlorine-related factors (use of tampons, occupational or environmental exposure) were not related to the disease. The current consumption of foodstuffs that were more likely to contribute to organochlorine body burden did not differ among the groups. Only some of these fatty foodstuffs (marine fish, pig meat) were traced by multiple regression analysis as significant determinants of organochlorine body burden, explaining only a small fraction (20%) of the interindividual variation of organochlorine body burden. We conclude that PE and DEN share similar patterns of risk or protective factors.
PMID: 16781705 [PubMed - in process]

Increased dioxin-like compounds in the serum of women with peritoneal endometriosis and deep endometriotic (adenomyotic) nodules. [Fertil Steril. 2005] PMID: 16084869
Organochlorine exposure and the risk of endometriosis. [Fertil Steril. 1998] PMID: 9496332
NTP Toxicology and Carcinogenesis Studies of 2,3,4,7,8-Pentachlorodibenzofuran (PeCDF) (CAS No. 57117-31-4) in Female Harlan Sprague-Dawley Rats (Gavage Studies). [Natl Toxicol Program Tech Rep Ser. 2006] PMID: 17160103
Serum dioxin-like compounds and aromatase (CYP19) expression in endometriotic tissues. [Toxicol Lett. 2006] PMID: 17112691
NTP technical report on the toxicology and carcinogenesis studies of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) (CAS No. 1746-01-6) in female Harlan Sprague-Dawley rats (Gavage Studies). [Natl Toxicol Program Tech Rep Ser. 2006] PMID: 16835633

You Don't Have to Live With Excessive Menstrual Bleeding

FRIDAY, Dec. 29 (HealthDay News) -- About 10 million American women struggle each year with a debilitating but little discussed health condition -- menorrhagia.
It's more commonly known as excessive menstrual bleeding, and it can result in fatigue, anemia, missed work days, restricted physical activity and embarrassment when accidents occur.
While "excessive" is relative, in general, menorrhagia refers to the need to go through more than three or four sanitary pads a day or to change tampons every hour or two, said Elizabeth Battaglino Cahill, a registered nurse and executive vice president of the National Women's Health Resource Center, an independent health information source for women in Red Bank, N.J.
In a survey of 600 women conducted by the center in 2005, researchers found that nearly 60 percent of women with the condition hadn't bothered to discuss it with a doctor, even though it was having an adverse effect on their lives and can be treated with a number of approaches.
When women do approach their doctor or another health-care provider about menorrhagia, Cahill said, there can still be more problems. "A lot of physicians are not explaining a lot of the treatment options," she said.
Read More:

Thursday, December 28, 2006

Endometriosis Differential Diagnosis and Prevention

True complications of endometriosis are few. Implants over the bowel or ureters may cause obstruction and silent impairment of renal function. The erosive nature of the lesions in advanced aggressive disease can cause a myriad of symptoms, depending on the tissue damaged. Endometriomas can cause ovarian torsion or can rupture and spill their irritating contents into the peritoneal cavity, resulting in a chemical peritonitis. Excision of endometriosis causing catamenial seizures or pneumothorax may be necessary.

Differential Diagnosis
The varied presentations of endometriosis mandate that it be considered in the differential diagnosis of virtually all pelvic disease. In particular, the pain, infertility, and adhesions associated with endometriosis must be distinguished from similar symptoms accompanying pelvic inflammatory disease and pelvic tumors.
Usually this will require operative evaluation. A patient with a persistent adnexal mass greater than 5 cm should never be presumed to have an endometrioma even if endometriosis has been diagnosed previously. Such masses require surgical diagnosis.

Prevention of endometriosis is not currently possible. Traditionally, women with relatives affected by endometriosis - or in whom the diagnosis has recently been made - are advised not to postpone childbearing. The merits of this advice have not been proved. A more thorough understanding of the pathophysiology of endometriosis is required before preventative strategies can be devised.


Wednesday, December 27, 2006

Endometriosis Clinical Trials

17 studies were found.
Not yet recruiting
The Immune Base of EndometriosisCondition: Endometriosis
Effects of Endometriosis on Bone Mineral DensityCondition: Endometriosis
Pelvic Pain in Women With EndometriosisConditions: Endometriosis; Pelvic Pain; Healthy; Tubal Ligation
Medical Treatment of Endometriosis-Associated Pelvic PainConditions: Endometriosis; Pelvic Pain
Effect of Rosiglitazone on Peritoneal Cytokines in Women With EndometriosisCondition: Endometriosis
Use of Rosiglitazone in the Treatment of EndometriosisCondition: Endometriosis
A Multinational, Randomized, Double-Blind, Placebo‑Controlled, Parallel Group Study to Investigate the Efficacy, Safety and Duration of Effect of a Single Administration of Various Doses of Cetrorelix SR in Subjects With Histologically Confirmed EndometriosisCondition: Endometriosis
Evaluation of DR-2001 for the Management of Endometriosis-Related Pelvic PainCondition: Endometriosis
Use of Arimidex and Zoladex as Pretreatment to IVF in Women With Ovarian EndometriosisCondition: Endometriosis
Evaluation of Endometrial Stromal Cell Apoptosis in AdenomyosisCondition: Endometriosis
Progestin Treatment for Endometrial Stromal Cells in AdenomyosisCondition: Endometriosis
Acupuncture for Women's Health ConditionsConditions: Ovarian Neoplasms; Endometriosis; Pelvic Pain; Uterine Neoplasms
'SPRING'-Study: "Subfertility Guidelines: Patient Related Implementation in the Netherlands Among Gynaecologists"Conditions: Male Infertility; Female Infertility; Ovarian Hyperstimulation Syndrome; Premature Ovarian Failure; Endometriosis
Health-Related QoL Among Women Receiving Hysterectomy in NTUHConditions: Leiomyoma; Adenomyosis
Uterine Artery Embolization for Symptomatic FibroidsConditions: Uterine Fibroids; Menorrhagia; Adenomyosis
Treatment of Uterine Fibroids With the Selective Progesterone Receptor Modulator CDB-2914Conditions: Leiomyomata; Uterine Leiomyomata; Fibroids
Not yet recruiting
PTEN and IGFBP-3 Correlation in Ovarian Carcinoma InvasionCondition: Ovarian Cancer


2 dairies to end use of artificial hormones

Hope to compete with organic milk
By Bruce Mohl, Globe Staff September 25, 2006
The region's biggest dairies are rushing to rid their bottled milk of artificial growth hormones in a bid to draw back customers who have switched to organic milk.
Dean Foods, which operates the Garelick plant in Franklin, and H.P. Hood, which operates a plant in Agawam, are demanding that regional farmer cooperatives supply them with milk from cows that haven't been injected with synthetic hormones that boost milk production.
Over the next few weeks, jugs of Hood and Garelick milk with labels pledging ``no artificial growth hormones" should start filling supermarket shelves -- a strategy the dairies hope will satisfy the chief concern of consumers going organic and do so at less than half the retail price of organic milk.
``The phenomenal success of organic milk, with growth rates of 20 percent or more, is driving our demand for milk from cows not treated with artificial growth hormones," said John Kaneb, the chief executive of Chelsea-based Hood.
Under federal standards, organic milk is from cows not treated with synthetic hormones or antibiotics; these cows are fed only organically grown food and have access to pastures.
By halting the use of synthetic hormones, which are marketed under the brand name Posilac by Monsanto Corp. of St. Louis, Hood and Dean are bringing their milk one step closer to the organic standard. Their milk is also screened for antibiotics.
Smaller dairies have previously marketed conventional milk produced without synthetic hormones, but the changes taking place now in southern New England represent the first large-scale conversion in the country. If more dairies jump on board, it could be a tipping point in the long-running debate about the safety of using synthetic hormones to spur milk production.
``Even though conventional milk is completely safe and POSILAC is completely safe, some people don't feel comfortable with it," said Marguerite Copel, a spokeswoman for Dallas-based Dean Foods. POSILAC is a trademarked bovine protein product marketed by Monsanto .
Copel said Dean intends to see how consumers react to its new Garelick milk before expanding its hormone-free operations. Dean operates 100 dairy plants nationwide; eight will now be operating with milk from artificial-hormone-free cows.
Whole Foods Markets sells organic milk and a store-brand milk produced from cows not treated with POSILAC. At the chain's Boston store near Symphony Hall, most consumers yesterday were opting for the less expensive store-brand milk.
Read More http://www.boston.com/ae/food/articles/2006/09/25/2_dairies_to_end_use_of_artificial_hormones?mode=PF

Tuesday, December 26, 2006


Surgical Treatment
Only surgery can properly diagnose and stage the disease.Endometriosis in its early stages can be treated at the time of laparoscopic (surgical) diagnosis. During laparoscopy, a thin viewing tube (called a laparoscope) is passed through a small incision in the abdomen. A second incision may be made on the lower abdomen to provide an additional opening for surgical instruments.Using the laparoscope, the surgeon inspects the outside of the uterus, ovaries, fallopian tubes and nearby organs. The laparoscope can also be fitted with surgical devices for taking tissue samples or removing scar tissue.Endometrial lesions (implants of endometrial tissue outside of the endometrium) can be cut away (excised) or burned away using a high-energy heat source, such as a laser (ablation). Treatment with laparoscopy is more difficult with advanced disease that involves large areas of the rectum or larger lesions.An endometrioma is a mass of tissue (noncancerous cyst or tumor) that contains shreds of endometrial tissue. Endometriomas most frequently occur in the ovary, in a part of the peritoneum (sac around the internal organs) between the rectum and uterus, the wall (septum) between the rectum and vagina, and the outside of the uterus.Several surgical treatments are available for endometriomas:
Simple puncture - This procedure is completed by draining the fluid from the cyst. Endometriomas have been shown to recur in about 50 percent of the patients treated with simple puncture. However, a more aggressive surgical approach, such as cutting away the mass, can cause extensive adhesions (scar tissue) that may prevent the ovary from releasing an egg.
Ablation - To drain the cyst and remove its base with laser or electrosurgery. However, heat can also damage the ovary.
Cutting away of the cyst wall - This is the procedure of choice to decrease recurrence of disease. This procedure can also damage the outer layer of the ovary that contains the eggs.
Draining, drug therapy, and surgery - Endometriomas can also be drained, treated with medication, and later removed by surgery. Endometriomas recur in 8 percent of the patients treated with this procedure. Results from several different prospective studies have reported pregnancy rates of 50 percent over 3 years. There are no randomized clinical trials comparing these different treatment methods. The most challenging surgery by laparoscopy or by laparotomy (traditional abdominal surgery, which requires a large incision) is the management of advanced endometriosis within the pelvic cavity and the rectum and vagina. Several studies have reported pregnancy rates over 2 years of 50 to 60 percent of cases treated with surgery. According to several reports, endometriosis may recur in 20 percent of the cases.Please see "Intestinal Endometriosis" by Dr. David Redwine.Adhesions are fibrous bands connecting structures that normally are separate. Adhesions develop as a response of normal tissue to some type of injury or trauma (as in surgery). In most cases, patients who undergo surgery for endometriosis will form new adhesions at the site of the surgery. Adhesion formation may cause infertility by impairing the function of the ovaries and fallopian tubes. Adhesions also may cause pelvic pain and small bowel obstruction.There are some newer preventive treatments that can be used during surgery to help prevent adhesions from forming. These include rinsing the pelvic cavity with special solutions and placing a piece of protective material (such as Interceed) into the pelvic area to serve as a barrier. The barrier keeps the surfaces from rubbing together after surgery, which can lead to adhesion formation. The barrier dissolves and is absorbed when it is no longer needed.In some cases, a woman will have to undergo additional surgery to remove adhesions formed from previous surgery. Fortunately, the advancement of laparoscopic surgery and the development of these new preventive treatments can reduce the chances of adhesion formation.Please see "A Patients Guide to Adhesions and Related Pain" by Dr. David M. Wiseman.

Wednesday, December 20, 2006

Happy Holidays

Happy ( Insert Celebration Here)
form all our bloggers!
Wishing all a renewed sence of hope and faith for the new year

Friday, December 15, 2006

New Plain-English Guide Dispels the Many Myths Surrounding Endometriosis

DUBLIN, Ireland--(BUSINESS WIRE)--Research and Markets (http://www.researchandmarkets.com/reports/c46808) has announced the addition of Endometriosis For Dummies to their offering.
Get the empowering info that puts you in control
Endometriosis is painful disorder of the female reproductive system - a condition thats also linked to increased risks of infertility and autoimmune disease. This plain-English guide dispels the many myths that still swirl around endometriosis. It describes the disease and how it affects the body, pinpoints symptoms and warning signs, and tells how to understand a diagnosis. Offering reliable, reassuring guidance, it explains the latest drug, hormone, surgical, and alternative treatments and provides guidelines for healthy nutrition as well as advice on coping with the emotional and physical challenges of living with endometriosis.
Take charge and take comfort in knowing how to live well with endometriosis
Diagnosing and living with endometriosis isn’t easy, but this disease doesn’t have to rule your life. This book helps you find out and recognize typical symptoms. Plus, you’ll get up-to-date info on traditional and alternative treatments — ranging from medications and surgeries to acupuncture and massages. The authors provide plenty of compassionate advice on dealing with the pain and emotional issues, so you can enjoy life.
Discover how to
Evaluate treatment options
Enhance your chances of getting pregnant
Manage the pain
Make lifestyle changes to minimize symptoms
Deal with the emotional and financial challenges
Author information
Dr. Joseph W. Krotec from Philadelphia, Pennsylvania, has practiced general gynecology, reproductive endocrinology, and gynecologic surgery specializing in endoscopic surgery. He has instructed peers, residents, and students for more than 25 years and has been Chair of Obstetrics and Gynecology, Chief of Gynecology, and Director of Endoscopic Surgery at various institutions. Dr. Krotec recently won the Milton Goldrath, M.D. Award for excellence in teaching.
Sharon Perkins is an RN with 20 years of experience in maternal child health. She currently works for retinal specialists. Sharon has five children, two daughters-in-law, one son-in-law, and two perfect grandchildren. Oh, and a retired husband. This is her fourth For Dummies book.
Part I: Endometriosis: What It Is and Isn’t.
Chapter 1: The Lowdown on Endometriosis: A Quick Run-Through. .
Chapter 2: Suspecting Endometriosis: Defining the Symptoms. .
Chapter 3: Endometriosis: A Quick Review of Biology. .
Chapter 4: Determining What Causes Endometriosis. .
Part II: Digging Deeper into Endometriosis
Chapter 5: Understanding Your Menstrual Cycle (And Its Relationship to Endometriosis). .
Chapter 6: Looking Closer at How Endometriosis Also Affects Other Body Parts. .
Chapter 7: Endometriosis and Infertility: Having a Baby (Or Trying To). .
Chapter 8: Finding the Right Doctor. .
Chapter 9: Do You Have Endometriosis? Your Initial Exam and Diagnosis. .
Part III: Treating Endometriosis.
Chapter 10: Relying on (Prescription) Drugs to Treat Endometriosis. .
Chapter 11: Contemplating Surgery to Improve Your Endometriosis. .
Chapter 12: Considering Alternative Therapies and Remedies to Relieve the Pain. .
Chapter 13: Managing the Chronic Physical Pain. .
Chapter 14: All Things Teens: Diagnosing, Treating, and Coping with Endometriosis. .
Part IV: Living with Endometriosis.
Chapter 15: Coping with Endometriosis and Your Emotions. .
Chapter 16: Changing Your Lifestyle When You Have Endometriosis. .
Chapter 17: Just for Friends and Family: Help and Support. .
Part V: The Part of Tens.
Chapter 18: Ten Myths about Endometriosis. .
Chapter 19: Ten (Or So) Trends in the Future of Endometriosis. .
Chapter 20: Ten Strategies to Help with the Pain. .
Part VI: Appendix
Appendix A: Glossary.
Appendix B: Resources and Support.
For more information visit http://www.researchandmarkets.com/reports/c46808

Early ovarian cancer not detectable

Ask Dr. H Mitchell Hecht
Q: I received an e-mail that is circulating around, imploring women to insist on an annual CA-125 blood test for the detection of ovarian cancer. The e-mail said it’s kind of like the female equivalent of the PSA test men get for detecting early prostate cancer. Is this true?
A: It was a well-intentioned but inaccurate e-mail warning. Currently, there are no commercially available screening tests for detecting early ovarian cancer. The CA-125 blood test measures a protein released from ovarian cells, but it is neither sensitive enough to pick up an early cancer (studies show it can only detect early cancer 20-57 percent of the time) nor specific enough (it can be falsely elevated because of endometriosis, pelvic infection, uterine fibroids, liver disease, pancreatitis and even ovulation) to be clinically useful as a screening test.
The only approved use of the CA-125 blood test is in women with known ovarian cancer to monitor treatment response or recurrence.
For women of high risk, gynecologists may still order a CA-125 test along with a transvaginal ultrasound at the time of their gynecological exam. Always pay attention to persistent vague abdominal symptoms of bloating that have not been explained by irritable bowel syndrome or constipation. If colonoscopy and X-rays don’t explain your symptoms, be sure your doctor scans your ovaries and abdomen.
Good news: There may be a screening test for ovarian cancer within the next few years from Correlogic Systems — the OvaCheck blood test ( www.correlogic.com) is under review by the FDA.
Q: I have suffered with low back pain since I injured it eight months ago while lifting heavy furniture. I’ve been diagnosed with an L4/L5 herniated disc by MRI. I’ve had several months of physical therapy and am still in pain. A neurosurgeon who reviewed my MRI isn’t sure that surgery will help me. Wouldn’t you think that surgery is my best option?
A: I can’t really comment specifically on your disc herniation, but I can tell you that back surgery isn’t necessarily the best option for a herniated lumbar disc. That may come as a surprise, but a number of studies comparing surgical treatment with non-surgical treatment don’t show a strong superiority of one treatment approach over the other when it comes to either lumbar disc herniation or spinal stenosis.
Symptoms related to low back disc herniation can regress over time in the absence of surgery. Physical therapy, home exercises, epidural injections and pain medication are effective treatment modalities for a number of people.

Doctors: Period Pain Could Be More Than Cramps

POSTED: 2:35 pm EST December 11, 2006
UPDATED: 2:50 pm EST December 11, 2006
BALTIMORE -- More than just cramps could be causing menstrual pains. A condition called endometriosis could be the root of the problem, and doctors said that if left untreated, it could lead to infertility.
Mercy Medical Center Dr. Christine Vergara said about half of adolescents with chronic pelvic pain have endometriosis.
"The patients that have cramping so bad are missing school or missing sports activities. They're not able to participate in their normal sports activities (and they're having) pain that's not relieved by simple pain medications -- over-the-counter medications, like ibuprofen. Those are the patients that you become a lot more worried that they have endometriosis," Vergara said.
According to doctors, endometriosis happens when tissue similar to the endometrial lining of the uterus grows in other parts of the pelvic cavity, including the outside of the uterus, the ovaries or fallopian tubes.
During a woman's monthly cycle, the tissue sheds and can cause pain and other problems.
"With endometriosis in particular, it can be progressive. So, if you can identify it and treat it (when you are) younger, then you're much less likely to have a lot of problems with huge cysts, with infertility, with adhesions, and problems that are just more difficult to deal with (as you get older)," Vergara said.
Doctors said daughters of women with the disease are more likely to get endometriosis.

Is Your Lipstick Safe?

By Anuja Mendiratta, Ms. MagazinePosted on December 11, 2006, Printed on December 15, 2006 /
That lipstick or nail polish you may be wearing -- are they a danger to your health? How about your deodorant, toothpaste, body lotion, soap?
Seemingly innocuous personal-care products contain a host of largely unregulated chemicals and toxic ingredients. Some of those chemicals -- phthalates, formaldehyde, petroleum, parabens, benzene and lead -- have been variously linked to breast cancer, endometriosis, reproductive disorders, birth defects and developmental disabilities in children.
Women and girls should be particularly concerned, as our bodies are uniquely susceptible to certain environmental chemicals. Women have a greater percentage of fat in comparison to men, so fat-soluble chemicals such as parabens and toluene tend to be more readily absorbed and fatty breast tissue can be a long-term storage site for some of the more persistent toxic chemicals. Hormones also play a role: Synthetic chemicals such as alkylphenols (found in some detergents) and bisphenol A (found in hard plastics) can mimic natural estrogens in the body -- and excess estrogen can play a role in the development of breast cancer. Childbearing women may also pass toxins to fetuses in utero or to newborns when breastfeeding.
But U.S. consumers are left in the dark about vital safety information: Cosmetic companies are not required to label many of their products' ingredients, and the Food and Drug Administration does not mandate premarket safety testing of those ingredients.
And that's why the California Safe Cosmetics Act is such a landmark achievement.
Signed into law by Gov. Arnold Schwarzenegger last October and taking effect in 2007, it requires manufacturers to disclose product ingredients found on state or federal lists of chemicals that cause cancer or birth defects. The law further authorizes the state to investigate the health impacts of chemicals in cosmetics, and requires manufacturers to supply health-related information about their ingredients. Finally, the act enables the state to regulate products in order to assure the safety of salon workers.
California is the first state in the nation to pass such legislation, thus serving as a model for the other 49. "This is an important disclosure bill, and an important victory for women's health," says Jeanne Rizzo of the Breast Cancer Fund. "California has set the stage for states to assert regulatory authority around toxic chemicals in cosmetics, which the federal government has thus far refused to lead on."
Adds California state Sen. Carole Migden, who championed the legislation, "It is beyond belief that consumers are not being told whether or not they are putting carcinogens on their skin, in their hair or on their face. [The law] represents a triumph of grassroots efforts over money and power. Even in the face of a multinationally funded lobbying machine, common sense and the public good prevailed."
While many known toxic components have been banned in Europe from use in personal care products, similar ingredients remain legal in products marketed to the American public. Currently, the FDA does not review the ingredients in cosmetic and beauty-care products, but instead relies on self-regulation by the cosmetic industry's own Cosmetic Ingredient Review (CIR) panel. According to the watchdog Environmental Working Group, only 11 percent of the 10,500-plus ingredients that the FDA has documented in personal-care products have been assessed for safety by the CIR panel.
In response to the lack of government oversight, an international Campaign for Safe Cosmetics was initiated in 2002 to pressure the personal-care industry to phase out known toxic ingredients and replace them with safer alternatives. Manufacturers have been encouraged to sign the "Compact for Safe Cosmetics," and to date more than 300 have done so, including The Body Shop, Burt's Bees and Aubrey Organics.
Migden authored the California Safe Cosmetics Act (S.B. 484) in 2004, with co-sponsorship by Breast Cancer Action, Breast Cancer Fund and the National Environmental Trust. They joined with other public-health, environmental, consumer, Asian Pacific Islander, teen and faith-based groups in a yearlong organizing and lobbying campaign -- which met aggressive opposition from the Cosmetic, Toiletry and Fragrance Association. The industry group spent more than $600,000 trying to defeat the bill, even going so far as to host a website to capture searchers looking for the Campaign for Safe Cosmetics. In contradiction to a growing body of science, the website claims that the personal-care products sold in California are the safest in the world.
Julia Liou, of Oakland-based Asian Health Services, advocated particularly for provisions in the bill designed to protect the safety of nail-salon and cosmetology workers. "We realize that Asian nail-salon workers and owners are not fully aware of the long-term health risks facing their sector," says Liou. Currently, of the more than 83,500 manicurists in California, 80 percent are of Vietnamese descent, more than half of whom are of reproductive age.
Nail-salon and cosmetology workers handle solvents, chemical solutions and glues on a daily basis, yet little research has been conducted on the chronic health effects of such exposures. There is also a dearth of culturally and linguistically appropriate educational materials to build awareness about environmental exposures and help workers and salon owners implement safety precautions.
Most of the Vietnamese salon workers earn less than $15,700 a year, speak limited English and lack health coverage. Their voices went largely unheard in the safe-cosmetics debate, and some salon owners actually came out against the bill -- "based on misinformation and fear about how it might impact small immigrant-owned businesses," says Liou. "So it is important for us to work with salon workers and owners in a way that empowers them to be leaders and advocates themselves." In an effort to do so, the California Healthy Nail Salons Collaborative was formed, and now advocates for greater work- place safety, protective policies, research and community education.
The passage of the California Safe Cosmetics Act sets the stage for further advocacy around cosmetic safety, occupational exposures and chemical policy reform. Those who fought to pass it are now working to ensure its adequate funding and enforcement, and hope to see it replicated in other states.
For more information, visit: Campaign for Safe Cosmetics; California Health Nail Salons Collaborative, jliou@ahschc.org; Skin Deep, a database of the Environmental Working Group providing a safety assessment of personal-care product ingredients. To access the California Safe Cosmetics Act: www.leginfo.ca.gov/bilinfo.html.
Anuja Mendiratta is a senior program officer with the Women's Foundation of California and on the steering committee of the California Health Nail Salons Collaborative; she is also a freelance writer.

Monday, December 11, 2006

World Endometriosis Research Foundation Established

Press Release:
The American Society for Reproductive Medicine (ASRM), the European Society for Human Reproduction and Embryology (ESHRE) and the World Endometriosis Society (WES) are proud to announce the first global endometriosis project initiated jointly by these three professional organisations: the establishment of the World Endometriosis Research Foundation.The World Endometriosis Research Foundation is the first global charitable organisation with an aim to foster research into endometriosis to improve knowledge and treatment(s) of this enigmatic disease.The Foundation will achieve its aim of fostering research by providing a platform to attract sufficient funding from a variety of sources to:
Facilitate and carry out large scale international multi-centre trials involving sufficient patient numbers to provide results of statistical significance;
Support specific research projects investigating disease mechanisms.
An early deliverable will be the establishment of a global epidemiological research registry.Says founding trustee Professor Robert Schenken: “The ASRM, ESHRE and WES have recognised the lack of large scale international clinical trials in endometriosis, the lack of overall funding for research into the disease and, not least, the potential overlap of effort from country to country when centres work in isolation and can’t share data. This collaboration will allow us to share vital resources within the endometriosis community and work towards improving our knowledge about prevention, early diagnosis and treatment”.The Foundation is a registered charity in the United Kingdom, but will operate globally. Its board has representatives from all three founding organisations, with the first board comprising:
Professor Robert Shaw (United Kingdom) – president Professor Linda Giudice (USA) – vice-presidentProfessor G David Adamson (USA)Professor Thomas D’Hooghe (Belgium)Dr Stephen Kennedy (United Kingdom)Professor Robert Schenken (USA)Dr Martyn Stafford-Bell (Australia)Professor Carlos Sueldo (Argentina)
The board has appointed Ms Lone Hummelshoj as the Foundation’s Chief Executive.It is possible to make donations to endometriosis research via the Foundation’s website: www.endometriosisfoundation.org

Melissa's Tragedy

Karen's daughter, Melissa , is not well.
Not for some time now.
Don't believe us again. Call her, ( not her mom and hopefully when her mom is NOT around!)

Steward Melissa
melissasgb@yahoo.com +1 (817) 341-3000
Adhesiolysis via gasless laparoscopy with SprayGel, AdhesionsDate: 10.04.2003
Steward, Karen (Mother of Melissa)
+1 (817) 341 3000
Gasless laparoscopic adhesiolysis

( Careful, they have the same phone number)

Her procedure failed. She is back in pain. For some time now.

Her mom talks for her and writes for her.
Such a beautiful young woman ( not a child) locked in an ivory tower built by her own mother.

Many went to Dr Kruschinski to have adhesions lysed from their battle with Endometriosis.
Melissa too.
Unless the lesions are excised, they will continue to release agonists into the abdomen or where ever the lesions are located.
More adhesions.
Now with a beautiful young son to care for.

It's not PID nor is it polycystic ovaries......the common culprits according to Kru when prior patients return for repeat surgeries.

I wonder if her surgical report looks allot like mine.....more on the positioning of the abdo-lift and very little explanation as to what happen during the actual surgery. Only pictures and no video. Does your operative report look like mine?


Still only one person has ever asked for a copy of the videos of my PA surgery. Hundreds of long standing lesions and nodules. Never mentioned nor photographed. Adhesions so old they had calcified and had to be chipped away.

Kru knew it, knew he would be getting an extra 10 grand from the Stewarts when Melissa presented again.
Melissa is also the first Kru reported to have an adhesion (s?) at her second look. He had to because he knew she would be sick again soon enough.

Poor Melissa.
How can she get out of this nightmare?

Karen - "I am "obsessed" with one thing: Sharing with other sufferers the joy of having finally found a surgeon who could help my daughter!!!!!"

Has Karen sent many of you off to Germany with the infamous story of her daughter? The recipient of a miraculous cure from the ravages of endo and adhesions?
Do you think the possible motivation Karen had was to keep this surgeon financially solvent so her daughter could return their for more surgery....even when all was going to hell in a hand basket for Endogyn because of Kruschinski's obvious lies and outrageous behaviors?

Karen has been pretty outrageous herself, don't you think ? Murderers?
Kind of Munchauseny??
Not letting Melissa speak for herself, why?.... is Karen bucking for some mom of the year award?

What IHRT hopes is Melissa can turn to her dad. His poor daughter more than likely has endometriosis still and the adhesions from before along with new adhesions caused by the devil endo and her recent surgeries.How could this poor girl ever approach her mother if she is still ill and not willing to return for a surgery with Kru.Karen has created a less than conducive atmosphere for that.IHRT hopes that Mr. Karen will be able to help their daughter as Karen herself seems to have lost all objectivity.
Melissa can't turn to "knowledge is power" Helen. Connie? All these folks seem to hang on way too long and IHRT opines they wish to stay near and dear to Kruschinski as they are not as well as they claim to be.

Just like I once did. Cept I would never knowingly send up a sacrifice for my own benefit. Even if it meant I died.
The needs of the many outweighed the needs of the one.

Another brave soul laid her life on the line so the truth could be told.
Another website to warn patients of Dr. Kruschinski

Other IHRT members all have similar op reports. Sigh.

Melissa, honest to God, if any of us here at Ihrt can help you. We are here.
Please know there is hope and there is help still out there but proceed with caution.

Kruschinski is done and not an option for anyone anymore. Face it and dig in and do your homework again.
Time to move on and pray the lessons we learned observing this surgical monster are well heeded!
Time for peace and healing to begin.

I had to remove the email from this comment but thought I'd bring it up to the top

1 Comment Close this window

Anonymous said...
My heart aches for all who were scammed by Kru and think they are hopeless because he said so! My heart rejoices for those who got some improvements! For them, it WAS pure luck and soon enough they will realize that to be true!!I see the young beautiful face of Melissa Steward and her little guy, Tim, and I know her pain and suffering! I cry when reading about her, I cry now as I speak to her!My message to her is this: Melissa, do not give up....you CAN still be helped, but not by Kru as you know when your mother tried to get you back there last summer, he was already washed up! YOUR mother knew that, and you knew that too! Your mother kept up a ruse....and to save her face, not to save her daughter as she claims!Stand up for yourself, Melissa, do not let her convince you that your hopeless.....it is Kru speaking, and it is NOT true! Your NOT a child as your mother keeps calling you, your a grown women, and you have a wonderful father who will help you!With a mother convincing her that her problems are hopeless to correct, even for Kru, then why was Karen bashing American surgeons so much? It is apparent that NO one has helped Melissa, and most of all, her own mother.Karen never had ARD, she has no clue of the real horror's of it, the pain, the hopelessness, and more so these past three years!Karen's focus was NOT on her daughters need, but instead on her obsession with her daughters Ob/gyn, anyone can see this is true!Even her own daughter could not come out and ask her mother for help, as if she did, it would be perceived as being AGAINST Kru, and for Karen, that is a no-no!Melissa, leave your mom at home and go to Dr. Mathias Korell in Germany! PLEASE!Take your Dad with you, as he knows what is going on and HIS heart is breaking! GO TO KORELL as you can still get better then you are!Turn to Robin Massengil:( email removed by IHRT but Robin can be found helping on the IAS).coShe will help you and your father! Tell your father to truct his friend, she will also help him, he knows who I mean...go to your father now, Mellisa!
December 10, 2006 10:44 AM

La Asociación de Endometriosis

La Asociación de Endometriosis (EA) es una organización sin ánimo de lucro y auto-ayuda fundada por mujeres para mujeres.
La EA existe para proporcioner educación, y apoyo a mujeres y adolescents con endometriosis, educar al publico y a la comunidad médica acerca de la endometriosis, y realizar investigaciónes relacionadas con la endometriosis.La Endometriosis Association Oficinas Internacionales8585 N. 76th PlaceMilwaukee, WI 53223 USATel: (414) 355-2200/ Fax: (414) 355-6065Norte América (800) 992-3636

Podcast: Endometriosis and Pelvic Pain

From OBGYN.Net
Endometriosis and Pelvic Pain
Andrew S. Cook, MD

Click here to view

Endometrial Hyperplasia

What is Endometrial Hyperplasia?
Endometrial Hyperplasia occurs when the uterine lining (endometrium) grows too thick as a result of estrogen stimulation. Women with irregular menstrual cycles who don't ovulate are more likely to have this condition.
Endometrial Hyperplasia is a non-cancerous condition.
Symptoms of Endometrial Hyperplasia?
The most common symptoms are:
vaginal discharge
abdominal pain
bleeding between menstrual periods
heavy or prolonged menstrual periods
Risks for developing Endometrial Hyperplasia?
Women who are at risk for developing endometrial hyperplasia:
Experiencing menopause
Skip menstrual periods or have no periods at all
Have diabetes
Have polycystic ovary syndrome
If your doctor thinks you have endometrial hyperplasia, he will take a small sample of your endometrium and analyze it.
Can Endometrial Hyperplasia be Treated?
Yes. In most cases, endometrial hyperplasia can be treated with medication. The most common form of medication is a hormone progesterone.
If progesterone is not successful at treating endometrial hyperplasia, your doctor may suggest other medication or surgery.

Emma Bunton wants kids

- and what she wants she gets- After medical problems, she may have a bit of bother
Emma Bunton is considering adopting - if she can't have children of her own.The former Spice Girl wants to start a family with her long-term boyfriend Jade Jones but is worried she won't be able to conceive because of medical problems. In 2000, Emma had to have pre-cancerous cells removed from her cervix. Shortly after, she discovered she had endometriosis, a condition which causes the lining of the womb to come away and makes it difficult for thesufferer to fall pregnant.

Friday, December 08, 2006

Progesterone receptor polymorphism +331G/A is associated with a decreased risk of deep infiltrating endometriosis

K.J.A.F. van Kaam 1 *, A. Romano 1, J.P. Schouten 1, G.A.J. Dunselman 1, and P.G. Groothuis 1
1 Research Institute GROW, University of Maastricht; Department of Obstetrics and Gynaecology, University Hospital Maastricht, Maastricht, The Netherlands
* To whom correspondence should be addressed.K.J.A.F. van Kaam, E-mail: kvk@sgyn.azm.nl

BACKGROUND: Alterations in the progesterone receptor (PR) are considered a risk factor for the development of endometriosis. In this study, the frequencies of the PROGINS and +331G/A polymorphisms of the PR gene were determined in deep infiltrating endometriosis and correlated with the expression of the PR protein. METHODS AND RESULTS: The frequencies of the PR polymorphisms were determined in women with deep infiltrating endometriosis (n = 72), women with adenomyosis in the uterine wall (n = 40), gynaecological patients without symptomatic endometriosis (n = 102) and healthy females (n = 93). Detection of +331G/A and PROGINS polymorphisms was performed using PCR-restriction fragment length polymorphism (RFLP) analysis. Expression of PR-A and PR-B protein was assessed with immunohistochemistry. The allelic frequency of the polymorphic allele +331A was lower in women with endometriosis (P < 0.01) and adenomyosis (P < 0.02) compared with healthy females. The frequency of the PROGINS polymorphism did not differ between the groups. The mean staining index (SI) for PR-B in endometriotic epithelium was higher in the presence of the +331A polymorphic allele (n = 2) (P < 0.001) compared with +331G/G individuals (n = 61). The PROGINS polymorphism did not affect the SI for PR-A and PR-B. CONCLUSIONS: The presence of the PR gene polymorphic allele +331A is associated with a reduced risk of deep infiltrating endometriosis and adeno-myosis compared with healthy population controls. The PROGINS polymorphism does not seem to modify the risk of deep infiltrating endometriosis.Keywords: +331G/A/endometriosis/progesterone receptor/PROGINS.


Premature Menopause

Apart from the natural menopause transition (perimenopause to postmenopause) which most women will experience, some may face one of the following challenges:
Premature Ovarian Failure (POF)
Surgical Menopause
Medical Menopause
The average age for women to reach natural menopause, the cessation of periods, is about 50. Some women, however, go through menopause in their 40s and some, as early as their 20s and 30s. For most women, the diagnosis of Premature Menopause (also known as Premature Ovarian Failure) is a shattering experience. Many younger women who are diagnosed with POF have not had the chance to make a decision about having children and find that opportunity denied to them.
If you've found an absence of support and information on this subject in your community, here are some helpful online resources.
A UK-based Premature Menopause support group called The Daisy Network has some excellent resources. It is a very interactive site, structured to include What is Premature Menopause, Health Risks, Infertility, and contacts with other online support.
The most comprehensive site is Premature Ovarian Failure Support Group. It is well organized and includes a Newsletter, Listserv, Chat Room and Doctor's Answer Line which has 3 resident doctors to field questions. There is an annual membership fee which includes benefits such as assistance in creating a local POF Support Group, a confidential Share List with names and addresses of women diagnosed with POF who are interested in talk with other women, a newsletter and more.
Conceiving Concepts explores the correlation between Premature Ovarian Failure (POF) and hypothyroid condition as well as a possible new connection between POF and diabetes.

Menopause happens most dramatically as the result of surgical intervention, namely a hysterectomy and bilateral oophorectomy where both ovaries are removed. Sometimes this is called TAH/BSO, or total abdominal hysterectomy with bilateral salpingo-oophorectomy. Salpingo refers to the fallopian tubes which connect the ovaries to the uterus. In the case of a hysterectomy, where only the uterus is removed and the ovaries maintained, there will be some confusion about when menopause occurs because of the absence of a period.
When the uterus is removed (hysterectomy) and the ovaries remain, menstrual periods stop but other menopausal symptoms (if any) usually occur at the same age that they would naturally. However, some women who have a hysterectomy may experience menopausal symptoms at a younger age.
There are many decisions to make when faced with surgical menopause. You can never have enough information about the process. You can't just take your doctor's word! Become proactive…this is your body. Listed below are a few points of information that should help your transition into this process:
The younger the woman going through surgical menopause, the more problems she will likely encounter.
It is crucial that every young woman scheduled for a hysterectomy have a complete hormonal blood work-up. That way there is a baseline to go by when determining hormonal needs. You can look back at those tests and see what the levels were when you felt normal and try to achieve those levels again with the right hormones.
Plan on your care after the hysterectomy. As a young woman it is important to find a "specialist " in hormonal therapy; someone who is up to date and keeps up to date with the newest medicine and side effects from surgical menopause. This doctor has to be someone you can trust, who provides good information and is open minded and will see you as a partner in your healthcare.
Research, research, and more research! The long-term affects of surgical menopause at a younger age has not really been determined. We are just now finding out how it relates to heart disease, osteoporosis and general health.
Not every woman will experience these symptoms, but it is a proven fact that if you are in surgical menopause, then you will experience most of these symptoms in a more severe fashion than women going through menopause naturally.
Hot Flashes
Thyroid dysfunction
Night sweats
Bladder infections
Increased appetite
Weight gain
Hair Loss
Vaginal dryness
Painful intercourse
Suicidal thoughts
Decreased sexual desire

HERS FOUNDATION (Hysterectomy Educational Resources & Services)422 Bryn Mawr Avenue Bala Cynwyd, PA 19004 Email: info@hersfoundation.com
To request a free information packet: Tel (610) 667-7757To arrange a telephone appointment with a counselor: FAX (610) 667-8096
Sans Uteri Hysterectomy Forum, communication between hysterectomized women and women considering surgery. This site has many segments including a private mailing list of women who have had hysterectomies. Other features of the site are described in their FAQ.
Alternatives to Hysterectomy is designed for women who have been told they need a hysterectomy and are searching for alternative treatment. This site is under the direction of Michael E. Toaff, M.D.
Alternatives in Gynecology is the site of Paul D. Indman, M.D., FACOG. Topics explored at this site are common gynecological problems and procedures that should be considered when contemplating hysterectomy.
A Woman's Guide to Overcoming Endometriosis from IVF.com - complete and thorough resource about endometriosis
EarlyMenopause.com offers information and support for women who are experiencing early menopause—whether it's happened naturally or due to premature ovarian failure; surgery (hysterectomy and oophorectomy), cancer treatments (such as chemotherapy or radiation), autoimmune disorders, and more.
Hystersisters, a woman-to-woman support website for hysterectomy recovery. This group offers resources and kindness so that visitors can discover options and make decisions for themselves.

Intervention can occur which produces a medical menopause. Often women who are treated for cancer with chemotherapy go into temporary or permanent menopause.
Anticancer drugs can damage the ovaries and reduce the amount of hormones they produce. As a result, some women find that their menstrual periods become irregular or stop completely while they are having chemotherapy. The hormonal effects of treatment may cause menopause-like symptoms such as hot flashes and itching, and burning or dryness of vaginal tissues.
Damage to the ovaries may result in infertility, the inability to become pregnant. In some cases, the infertility is a temporary condition; in other cases, it may be permanent. Whether infertility occurs, and how long it lasts, depends on many factors, including the type of drug, the dosage given, and the woman's age.
The above information is summarized from The National Cancer Institute web site. It has been extracted from a segment entitled "Coping With Side Effects".
Cancer Care, Inc. This is a national non-profit organization whose mission is to provide free professional help to people with all cancers through counseling, education, information and referral and direct financial assistance. This page covers breast cancer.
It is not the intention of Project AWARE to offer in-depth information on cancer treatment, but only to provide direction to information as it relates to cancer and its effect on women's reproductive health

Polymorphisms in exons 1B and 1C of the type I interleukin-1 receptor gene in patients with endometriosis.

D'Amora P, Sato H, Girao MJ, Silva ID, Schor E.Molecular Gynecology Laboratory, Gynecology Department, Federal University of Sao Paulo, Escola Paulista de Medicina, Sao Paulo, Brazil. paulo.toco@epm.brTo study possible correlation between the prevalence of polymorphisms in the type I interleukin-1 receptor gene and pelvic endometriosis. Genotypes of 223 women were analyzed: 109 women with surgically and histologically confirmed endometriosis and 114 healthy women. Distributions of two single-base polymorphisms of the human interleukin-1 receptor type I (IL-1RI) gene were evaluated: PstI, due to a C-->T transition in exon 1B and BsrBI a C-->A transition at position 52 in exon 1C. Polymorphisms were detected by polymerase chain reaction (PCR) followed by restriction fragment length polymorphism analysis (RFLP) resolved on 3% agarose gels stained with ethidium bromide. Genotypes for PstI polymorphisms did not differ significantly among control and endometriosis (P = 0.058). However, in relation to BsrBI polymorphism, protective risk was observed for the development of endometriosis [OR 0.39-IC 95% (0.2-0.9)]. BsrBI heterozygote genotype (C/A) showed protective effect against endometriosis development.PMID: 16911713 [PubMed - indexed for MEDLINE]

Yeast Infections The dangers of self-diagnosis

Many women think they recognize the symptoms of a yeast infection—itching or stinging and discharge—yet research shows that only about one-third of those who buy over-the-counter (OTC) therapies for a yeast infection actually have one. [1]
Even women who have had a yeast infection confirmed by a doctor in the past have difficulty recognizing a new episode. [2] That's why it's important not to self-diagnose and self-treat. Making an appointment with a clinician for an examination and a test is the most effective strategy.
According to a multicenter study, only about 19 percent of women buying OTC yeast therapies actually have a diagnosis of bacterial vaginosis (a bacterial infection). Roughly 21 percent have vaginitis (a general vaginal irritation with various causes), almost 14 percent have no identifiable abnormality, 10.5 percent have other diagnoses, and a little over 2 percent have trichomonas vaginitis (a sexually transmitted infection). [3]
Although the symptoms of itching and discharge may be similar for all of these conditions, the treatments are not. In fact, treating for the wrong thing can often make the patient worse.
A vaginal yeast infection, also known as vulvovaginal candidiasis (VVC), is characterized by the overgrowth of a naturally occurring vaginal yeast – most commonly Candida albicans. Women are more susceptible to this in their reproductive years and at times of hormonal change, especially prior to menstruation or during pregnancy. Women who are immune-compromised—for example, those with AIDS or diabetes—are also more prone to contracting VVC. Further, women who use broad-spectrum antibiotics or corticosteroids have a high risk of developing VVC. [4]

About 75 percent of women will have at least one case of VVC in their lives, and that between 40 percent and 45 percent will have two or more. [5]
Recurrent VVC, usually defined as four or more episodes each year, affects less than 5 percent of all women with yeast vaginitis. [6] Contrary to popular opinion, recurrent VVC is not caused by an unusual or drug-resistant strain of yeast. In more than 90 percent of cases it is caused by the same yeast that causes initial episodes of VVC – Candida albicans.
Getting the right diagnosis
Physicians who diagnose a yeast infection without properly identifying the offending organism run the same risks of misdiagnosis as patients who self-treat. Their first tool should be pH paper that measures the acidity of the vagina. Surprisingly, this is vastly underutilized.
If a patient has a normal vaginal pH (less than 4.5), this essentially rules out bacterial vaginosis as the cause of her symptoms and suggests VVC. After that, simple microscopy can often clinch the diagnosis of VVC, but, unfortunately, this is underused, as well.
Research shows that almost 90 percent of physicians seeing women for vaginal complaints don't measure vaginal pH. Further, 40 percent fail to use a microscope to determine if yeast is present. [7] This means that many cases of vaginal itching and discharge are misdiagnosed and inappropriately treated.
Although recognizing organisms under the microscope can initially be challenging, getting familiar with the appearance of healthy vaginal flora can help when it comes to recognizing abnormalities.
Normal flora is characterized by rod-shaped lactobacilli and normal epithelial cells, with clear spaces between the cells, and no evidence of any other vaginal pathogens. In contrast, Candida albicans is characterized by fungal hyphae. The presence of budding yeast forms suggests non-albicans strains.
One of the stumbling blocks in diagnosing VVC comes when a patient presenting with symptoms has negative results under the microscope. This patient is a good candidate for a yeast culture. Despite negative microscopy, the yeast can show up when cultured in a lab. [8]
It is a common practice for many physicians to do a quick microscope evaluation, and if they fail to see yeast, they then treat for a bacterial infection. Some patients, however, may have a yeast infection that shows up only on a culture. They may be very sensitive to extremely small amounts of yeast in the vagina.
Antimicrobial treatment strategy would be inappropriate for women with yeast infections because it kills the friendly lactobacilli bacteria, which are fighting the yeast – thus making the patient's condition worse.
Women with recurrent symptoms have probably developed a hypersensitivity or allergy to yeast, and, therefore, cannot tolerate even small amounts of yeast in their vaginas. [9] They might also be harboring one of the more resistant Candida strains, which should be identified by culture.
The optimal treatment for patients with recurrent Candida albicans VVC remains unknown, but the accepted approach is to first attack it aggressively, and then to keep it under control with maintenance therapy.
Bear in mind that none of today's VVC therapies actually kill yeast, they simply inhibit it. The agents used to treat yeast are fungistatic and not fungicidal. These agents are not like antibiotics that kill bacteria. Thus, many women still remain culture-positive for vaginal yeast even though their symptoms have been resolved by a full course of treatment with an antifungal agent.
Candida albicans responds equally well to either the OTC preparations such as miconazole cream and suppositories (Monistat), or prescription medications such as oral fluconazole (Diflucan), or terconazole suppositories (Terazol). I prefer the oral therapy - because topical therapy can interfere with the accuracy of microscopy.
The Centers for Disease Control and Prevention (CDC) recommends 10-14 days of azole (antiyeast medications, cream or oral) therapy followed by a 6-month maintenance regimen for recurrent Candida albicans VVC. [10] I treat with oral fluconazole 200mg (Diflucan) every 3 days until the patient is asymptomatic, followed by a maintenance regimen involving once weekly dosing initially, gradually tapering to one dose every 2 weeks, and then every 3 weeks, as long as the patient remains asymptomatic. The treatment for resistant strains involves less commonly used oral antifungals than Diflucan.
Optimally, the patient should re-dose only once a month, just before her menstrual period when most patients tend to have a flare-up of symptoms.
For patients who have a non-albicans VVC, the CDC recommends treatment with either a longer azole (antifungal) therapy, boric acid suppositories (600mg daily for 14 days), or topical flucytosine (4 percent for 14 days). [11]
Although it is comforting for physician and patient to have both a diagnosis and a treatment for these symptoms, it is important to remember that many patients with vaginal itching and discharge have no identifiable disease. They may have allergies or irritations from feminine hygiene products, douches, or vaginal deodorants and should be encouraged to simply "wait it out" until their symptoms subside.
If these patients are inappropriately treated with either topical antifungal or antimicrobial agents, they often end up with complications of vulvar sensitivity and vestibulitis – something that can also be a problem in women who have had prolonged, untreated VVC.
This problem generally resolves itself once the yeast infection is eliminated or the irritant therapy is discontinued. Thus, it is very important that a proper diagnosis is made and the right treatment is started in women with yeast infections or bacterial vaginosis.
Recurrent use of over-the-counter creams and/or the wrong treatment over a period of time has the risk of leading to a hypersensitivity to yeast or a general vulvar sensitivity and vulvodynia, a burning and irritation of the vulva.
For more information about genital Candidasis, Vulvovaginal Candidiasis vaginal yeast infections (VVC), contact the CDC's Division of Bacterial and Mycotic Diseases.

Thursday, December 07, 2006

Endometriosis is an endocrine and immune disease that affects an estimated 89 million women and girls around the world, regardless of ethnic or social origin. The incidence of allergies, asthma, and chemical sensitivities in women with endometriosis is higher than in the general population. Women with endometriosis are also at higher risk for autoimmune diseases and certain types of cancers.The connection with chemical toxinsDioxin is a toxic byproduct of industrial and consumer processes that involve chlorine or incineration of chlorine-containing substances, such as PVC (polyvinyl chloride, commonly known as “vinyl”) plastics. The main sources of dioxins are medical waste incineration, municipal waste incineration, chemical and plastic manufacturing, some pesticides, and pulp and paper bleaching. PVC disposable medical devices, such as IV bags and tubing, are a major concern because they become medical waste, which is often incinerated. Dioxins formed during incineration are released into the air and travel via air currents, contaminating fields and crops. Cattle and other livestock eat the crops and the dioxin enters their tissue. Humans then eat the contaminated animal products.In the early 1990s, the Endometriosis Association found that 79% of a group of monkeys developed endometriosis after exposure to dioxin in their food during a research study over ten years earlier. The severity of endometriosis found in the monkeys was directly related to the amount of TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin – the most toxic dioxin) to which they had been exposed . Monkeys that were fed dioxin in amounts as small as five parts per trillion developed endometriosis. In addition, the dioxin-exposed monkeys showed immune abnormalities similar to those observed in women with endometriosis .As explained in books including Our Stolen Future, Dying from Dioxin, and The Endometriosis Sourcebook, scientists have come to the realization that certain chemical compounds, such as dioxin, have profound immunological and reproductive impacts at exposures far below the level known to cause cancer. These chemicals are known as endocrine disruptors and can mimic hormones and interfere with many physiological processes . Scientists are still researching the mechanisms that are used, but they already know that these man-made chemicals persist in the body for years. PCBs (polychlorinated biphenyls) are a group of dioxin-like chemicals that were used in industry until they were banned in the 1970s. Some PCBs persist in the environment for more than one hundred years. According to Endometriosis Association research, certain PCBs appear to be linked with TCDD in endometriosis in the monkeys. The severity of endometriosis correlated with the blood levels of a particular PCB .Based on animal studies and observation of wildlife, impaired fertility is a result of exposure to endocrine disruptors. Infertility affects approximately 40% of women with endometriosis. The Endometriosis Association’s research registry provides data showing that endometriosis is starting at a younger age and is more severe than in the past. Could this be the result of a rising “body burden” level of dioxins and other endocrine disruptors?It is imperative that we stop dioxin exposure now. These toxins are affecting our health and are threatening the health of future generations. Let’s join together and take action now! For more information on what you can do, contact the Environmental Coordinator at support@EndometriosisAssn.org.
Rier,S.E. et al. (1993). “Endometriosis in Rhesus Monkeys (Macaca Mulatta) Following Chronic Exposure to 2,3,7,8,-tetrachlorodibenzo-p-dioxin.” Fundamental and Applied Toxicology, Vol.21, pp.433-441.
Rier, S.E. et al. (2000). “Increased Tumor Necrosis Factor-a Production by Peripheral Blood Leukocytes from TCDD-Exposed Rhesus Monkeys.” Toxicological Sciences, Vol. 60, pp. 327-337.
Colborn, Theo et al. (1997). Our Stolen Future. Penguin Books USA Inc.
Rier, S.E. et al. (2001). “Serum Levels of TCDD and Dioxin-like Chemicals in Rhesus Monkeys Chronically Exposed to Dioxin: Correlation of Increased Serum PCB Levels with Endometriosis.” Toxicological Sciences, Vol. 59, No. 1, pp. 147-159

Special ES&T Issue Examines Effects Of Emerging Contaminants On People, Planet

Main Category: Genetics NewsArticle Date: 03 Dec 2006 - 23:00pm (PST) email this article printer friendly view or write opinions
Article Also Appears In
Water - Air Quality / Agriculture

Useful Article? Not so long ago, the notion that particles 80,000 times thinner than a human hair could somehow self-assemble and cause harmful effects in the water, air and perhaps even cells seemed far-fetched. But today the quest to understand nanoparticles and other emerging contaminants and discover ways to cope with them is one of the hottest and most critical areas in chemistry research. More than 40 scientific papers on an array of these potentially problematic compounds - including pharmaceuticals, disinfectant by-products and fluorochemicals - are highlighted in the Dec. 1 issue of the American Chemical Society journal, Environmental Science & Technology. These articles examine what chemists and engineers are learning about emerging contaminants as well as what can be done to remediate those already in the environment and prevent others from getting there. "(This) special issue not only publishes new knowledge on chemicals and organisms of recent interest, but it also suggests some newly realized effects on humans and the ecology of our planet," says Editor-in-Chief Jerald Schnoor, Ph.D. "It packs years of research into one broad reference on the fate, transport and effects of contaminants in water, air, soil and even our bodies today." Here are a few selected highlights from the issue, including a look at how buckyballs can damage DNA and how trees could help curb the spread of NDMA into groundwater. Buckyball clumps damage human DNA Buckyballs that clump together in water can induce DNA damage in human lymphocytes, according to Volodymyr Tarabara, Ph.D., and his colleagues at Michigan State University and India's Industrial Toxicology Research Centre. The study, believed to be the first of its kind, raises new concerns about the potential risk these nanoparticles pose to human health and the environment, the researchers say. A buckyball is a spherical fullerene - a soccer ball-shaped molecule comprised of 60 carbon atoms. Buckyballs have been touted for their potential applications in everything from drug delivery to energy transmission. But recent studies have shown that when buckyballs combine into nano-sized clumps known as nC60, they can promote cellular damage. This new study goes a step further, demonstrating "a strong correlation between the presence of nC60 and DNA damage" to human lymphocytes, the researchers conclude. The study is the first to assess the genotoxicity of nC60 mixed into water. Water is a likely pathway for future human exposure to buckyballs and other nanoparticles, Tarabara says. PBDEs accumulate in Great Lake trout at extraordinary rate PBDE ( polybrominated diphenyl ether) flame retardants amass in the top predator fish in the Great Lakes to the same extent as PCBs, a potentially harmful group of compounds banned 30 years ago, according to Deborah Swackhamer, Ph.D., and colleagues at the University of Minnesota. The study is the first to measure PBDEs in water and the extent that these compounds bioaccumulate in an aquatic food chain. The researchers concluded certain PBDE levels found in lake trout were 10 million times higher than in the surrounding water. Swackhamer estimates that a person eating one lake trout fillet would consume more PBDEs than from a lifetime of drinking Lake Michigan water. The finding could help explain why human PBDE levels in North American are higher than elsewhere in the world, she said. Toxicology testing suggests that, like PCBs (polybrominated biphenyls), PBDEs may be harmful to humans. Noble metal catalysts, trees remove NDMA from ground water A pair of new remediation techniques could help eliminate NDMA (N-nitrosodimethylamine) from ground and drinking water. NDMA, which is classified as a probable human carcinogen by the Environmental Protection Agency, often forms when water is disinfected with chlorine and especially chloramine. NDMA is difficult to remove from water using conventional methods, but in a laboratory study, Martin Reinhard, Ph.D., and his colleagues at Stanford University and the University of Illinois, Urbana-Champaign, used noble metal catalysts, such as palladium, to destroy NDMA under ambient conditions. When the technology is further developed, the researchers say NDMA concentrations could possibly be reduced to a few parts per trillion. The new process, they note, potentially could be used to treat a broad spectrum of contaminants. NDMA also can be formed by oxidation of UDMH (1, 1-dimethylhydrazine), a compound used in rocket fuel production. As a result, NDMA and a co-contaminant, perchlorate, which also is used in rocket fuel and munitions, often infiltrate ground water near aerospace facilities. However, Valentine Nzengung, Ph.D., and colleagues at the University of Georgia found that pre-rooted trees, such as willows and poplars that soak up tremendous amounts of water, effectively removed up to 94 percent of the NDMA in 50 days and 100 percent of the perchlorate in 70 days, at concentration ranges found in most ground water. The study is the first to suggest a cost-effective way to use plants and trees to manage the spread of groundwater contaminated with NDMA or NDMA and perchlorate, Nzengung says. Carbon nanotube byproducts could impact key food source for shrimp, fish Byproducts produced during the manufacture of single-walled carbon nanotubes appear to have a disruptive effect on copepods, a group of small crustaceans, which are a critical food source for shrimp, crabs and fish in coastal rivers and estuaries, according to Thomas Chandler, Ph.D., and colleagues at the University of South Carolina. Copepods exposed to these impurities, called fluorescent nanocarbon byproducts, took longer to reach maturity, had more reproductive problems and had higher mortality rates than copepods that weren't exposed to these compounds. Single-walled carbon nanotubes, which are about 80,000 times thinner than a human hair and are used in electronic equipment and sporting goods, had no adverse effects on copepods in this study. The findings suggest that nanoscale manufacturing byproducts could upset coastal food chains if released into rivers and estuaries, the researchers say. These byproducts, they add, should be monitored or possibly regulated in the future. ### A podcast featuring guest editors Jennifer Field of Oregon State University, Joan Rose of Michigan State University, and Annette Johnson of the Swiss Federal Institute of Aquatic Science and Technology is available at: http://pubs.acs.org/subscribe/journals/esthag/40/i23/html/120106feature_intro_mp3.html The American Chemical Society - the world's largest scientific society - is a nonprofit organization chartered by the U.S. Congress and a global leader in providing access to chemistry-related research through its multiple databases, peer-reviewed journals and scientific conferences. Its main offices are in Washington, D.C., and Columbus, Ohio. Contact: Michael Bernstein American Chemical Society

Leading Reproductive Endocrinologist Suggests 15 Simple Ways to Prevent Infertility

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Dr. Sweet, a board certified practitioner in both the specialty of Obstetrics & Gynecology and the subspecialty of Reproductive Endocrinology & Infertility offers 15 ways you can combat infertility.
(PRWeb) December 6, 2006 -- Each year more than 7.3 million people in the United States are affected by infertility, yet there are many simple ways to prevent infertility from affecting you. Dr. Sweet, a board certified practitioner in both the specialty of Obstetrics & Gynecology and the subspecialty of Reproductive Endocrinology & Infertility offers 15 ways you can combat infertility:
1. Adopt stress busters
Some stress is normal but extremes of stress or inappropriate response to stress may affect fertility. By eating inadequately or in excess, your general medical condition may deteriorate making conception more difficult. By coping with stress through smoking and alcohol, additional damage to your fertility may occur.
2. Avoid Sexually Transmitted Diseases
Either through abstinence or condoms, one should always attempt to avoid sexually transmitted diseases including HIV/AIDS, gonorrhea, chlamydia, syphilis, herpes and venereal warts.
3. Avoid substance abuse
Nearly all forms of substance abuse can affect sperm production, egg release and embryo development. These substances include recreational drugs, alcohol and cigarettes.
4. Check your family tree
If you know that a close relative (parent or sibling) had diseases such as endometriosis, polycystic ovarian syndrome (PCOS), early menopause and hypothyroidism, you may be at an increased risk for some of these same diseases. While not usually inherited like the color of hair and eyes, many families have predispositions for specific diseases and these diseases may affect fertility.
5. Freeze sperm, eggs, ovarian and testicular tissue
If there is going to be a significant delay in reproduction or if a patient may be at risk for loss of their eggs or sperm (i.e., chemotherapy and/or surgery), the freezing of sperm and eggs (considered investigational) may want to be considered. There may be some circumstances where it may be wise to consider freezing testicular and ovarian tissue although these procedures are experimental.
6. Get vaccinated
Diseases such as Mumps can affect sperm production. Many diseases (i.e., German Measles) are dangerous during pregnancy.
7. Have children sooner
Women are at greater risk for more sexual partners should marriage and childbearing be delayed. As women age, gynecologic conditions such as endometriosis and uterine polyps/fibroids become more common. Women become dramatically less fertile as they age, especially in the late 30's and 40's. Men's sperm production does also deteriorate with age.
8. If you are having problems, seek help quickly
The definition of infertility is the inability to conceive after one year of unprotected intercourse. If this time has passed, seek the assistance of your OB/GYN. If over the age of 35, consider seeking the assistance of a Board Certified Reproductive Endocrinologist since time is running out.
9. If you have had surgery or infections, seek assistance sooner
If a woman has had ovarian surgery in the past or any sexually transmitted diseases, consider seeking evaluation sooner. Men who have had infections of the prostate, testicles/nearby structures and men, who have injured their testicles to the point of bruising or swelling, may be at risk for sperm problems.
10. Maintain your ideal body weight
Weight-related fertility factors are certainly known. Obesity, pre-diabetes and diabetes can affect ejaculation, sperm production, ovulation, miscarriage rates and increase fetal malformation rates. A balanced diet is important for numerous health concerns including fertility.
11. Some forms of hormonal contraception may prevent disease
Hormonal contraception seems to reduce the incidence of some sexually transmitted diseases. In addition, the hormonal contraception may protect from endometriosis, endometrial polyps and the formation of endometrial cancer.
12. Stay active
It is very important part of a balanced lifestyle to stay active and healthy. Sedentary lifestyles lead to weight problems, which can potentially impact fertility.
13. Stay healthy
While too numerous to list, many significant medical problems, especially those that are not under strict control, may damage your fertility potential over time. One classic example is diabetes. Stay as healthy as you can and treat existing medical problems effectively. Remember that delivery is like a mini-marathon and if you are out of shape, it may be a difficult run, at best.
14. Take a look at your meds
Calcium channel blockers used for high blood pressure and medications used to treat arthritis may affect fertility potential. Many medications are not recommended during pregnancy while others may be taken without concern to current & future fertility issues. Seek consultation with your physician for additional information. Cancer treatment (i.e., chemotherapy, surgery and/or radiation treated) may result in sterility.
15. Think quantity not quality
Couples, who have frequent intercourse, up to five times per week, seem to get pregnant the fastest. Relations every 36 and 48 hours bracketing around ovulation is probably ideal. Sexual position does not play a role in fertility.

Wednesday, December 06, 2006

A loss no one sees

Ectopic pregnancies present real danger, risks for women of all ages
By DIONNE GLEATON, T&D Staff WriterMonday, December 04, 2006
Orangeburg resident Elizabeth Mobley already had four healthy children, but the severely sharp, intense pains and deep heavy pressure in her pelvic region indicated her fifth pregnancy was in serious trouble.A late menstrual period, slight mood changes, tighter jeans and an increased appetite were early signs that she could be pregnant, but she wanted to wait another week or two before getting tested.The pains, however, would ease off but continue through the night. Soon, she could barely get up out of a chair and eventually doubled over in pain and couldn't move at all. Her brother carried her over to her couch while her mother called the ambulance.Blood samples were taken, pain medication was given and a pelvic exam was performed at the hospital within an hour, confirming Mobley's pregnancy. The emergency room doctor initially diagnosed that a bladder infection was causing the pelvic pain, but he was wrong. There was obviously a problem with the pregnancy.
Mobley went on to lose her baby from what an ultrasound revealed as one of the leading causes of early pregnancy-related death -- an ectopic pregnancy."During my ultrasound, the screen showed that my uterus was not carrying a baby. Instead, it showed a large amount of fluid in my pelvis. My left Fallopian tube had burst, which was causing me to bleed internally. I needed surgery immediately," Mobley said."Within two hours of my arrival at the hospital, I found out that I was pregnant and then I wasn't. I was in surgery having my obliterated left Fallopian tube removed."What is an ectopic pregnancy?The word ectopic means "out of place.""It's a pregnancy outside of the uterus," said Dr. David Gillespie, an obstetrician who has been practicing in Orangeburg for 19 years. "Most of the time when we think about it, we think about it being in the Fallopian tubes. That's the vast majority of them, more than 95 percent, but it can also happen in the abdomen, ovaries and inside on the cervix.""Ectopic pregnancies are not all that uncommon. Most pregnancies will proceed well and end up in a child. It's a wonderful and happy occasion, but there are times when this does not happen," Gillespie said.He said if an ultrasound is unable to detect any abnormalities after a doctor suspects an ectopic pregnancy, patients may be given a quantitative hCG test which measures levels of the hormone human chorionic gonadotropin, which is produced by the placenta. If they are lower than expected for a woman's particular stage of pregnancy, doctors are one step closer to diagnosing ectopic pregnancy."The doctor stressed that I can still conceive another child, that my right Fallopian tube is fully operational," Mobley said. "Apparently, I had some form of infection that caused injury to my left one. I was about eight weeks pregnant and the baby had grown too large for the tube, bursting it.""The tube was not made to carry a pregnancy," Gillespie said. "As the pregnancy expands, it's like a balloon. The tube gets more and more tense and ruptures, and there will be bleeding inside the abdomen. Blood gets up in the liver and the diaphragm, which has nerves that come from the neck. Because blood is irritating the diaphragm, you'll feel pain in your neck and back. A woman can also feel weak, dizzy and faint,"Vaginal spotting or bleeding and lower back pain are among the other symptoms suggesting an ectopic pregnancy, according to the Web site www.kidshealth.org.Risk factorsA woman is at risk for an ectopic pregnancy if she has had a prior infection in the tubes (including a previous ectopic pregnancy or pelvic inflammatory disease); has had prior tubal surgery; smokes; is between ages 35 and 44); has had infertility problems and has had or has sexually transmitted diseases "which we're seeing a lot of in youth and kids in school." Gillespie said.Endometriosis, which occurs when cells from the uterus lining detach and grow elsewhere in the body can cause blockages, as can scar tissue from previous abdominal or Fallopian surgery."We're seeing it more often. In the past, women would come in, and we didn't have antibiotics," Gillespie said. "The tube completely closed, and the women never could get pregnant. What's happening now is either we're inadequately treating it because people are not coming in soon enough, or they're not taking all their antibiotics. Perhaps there's been a misdiagnosis when there's pain the abdomen, which can come from anywhere."Treatment"If we catch it early enough, there's some medication. One is a drug used for cancer therapy because it basically attacks rapidly growing cells. A pregnancy is a rapidly growing cell, ... so that is an option," said Gillespie.Another treatment for ectopic pregnancy is surgery involving a large incision across the pelvic area to remove the abnormal pregnancy.A less invasive laparoscopic surgery option is also available. "You take a little periscope about the size of a pencil and make an incision through the navel," Gillespie says. "Through that, you look inside and see what's going on."An ectopic pregnancy is then removed; any damaged organs are repaired and removed.Mobley realizes she could have died and is grateful to be alive, but is still sad about the loss of her baby."My doctor told me he was really glad I came on in to the hospital; ectopic pregnancy is the number one cause for maternity deaths," Mobley said. "I'm saddened for my loss. Now my emotions and my body are readjusting again to being without a baby.""It's a difficult transition. I'm exhausted. I'm healing, but my heart still hurts. Losing a baby is heart- and soul-shattering. The hurt never changes,' said Mobley, who was comforted by a letter her fiancee wrote with his and all of their children's initials on it."It's an emotional time. Once that pregnancy is lost, a lot of people say, 'No big deal," Gillespie said. "It happened early, and you can get pregnant again.' That's not the best thing to tell somebody with any type of miscarriage. It's heartbreaking," Gillespie said."If you miss your period and are having pain or a little spotting, you need to go ahead and see your doctor right away," he said. "Don't wait. In the reproductive years, even if you're using birth control, if you have a missed period and have attempted pregnancy, or if you're having issues with bleeding and cramping, you need to go ahead and be seen."T&D Staff Writer Dionne Gleaton can be reached by e-mail at dgleaton@timesanddemcrat.com or by phone at 803-533-5534. Discuss this and other stories online at TheTandD.com.