EndoTimes

New test for endometriosis

2012-01-24T05:42:00.000-05:00

New test for endometriosis
BY KATE HAGAN
20 Jan, 2012 04:00 AM
An ultrasound is just as effective as an invasive surgical procedure in diagnosing the female reproductive disorder endometriosis, a Melbourne specialist has found, in a development that could lead to more women being treated for the painful condition.
Sofie Piessens found the new technique was more than 90 per cent effective at diagnosing endometriosis, in an analysis of 100 patients she saw between 2009 and last year.

She presented her findings at the annual scientific meeting of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists last month.

About 15 per cent of women have endometriosis, which can cause severe pain and damage reproductive organs, leading to infertility in up to 50 per cent of cases.

Dr Piessens said the disorder, in which the cells lining the uterus migrate to the abdomen, was usually diagnosed with a laparoscopy, an operation to inspect the pelvic organs.

''Some people will have painful periods but not endometriosis, so to do a laparoscopy on everyone who has painful periods was quite invasive,'' she said.

''A lot of women are told the pain is normal and they have to put up with it, so there can be a significant delay in diagnosis and the endometriosis can become quite severe.''

Dr Piessens, a gynaecologist who specialises in ultrasound, said doctors had previously believed that ultrasounds could not detect endometriosis.

''Now groups around the world have published data to say if you just look backwards, behind the uterus, you can diagnosis a high proportion of women who have that really bad form of endometriosis,'' she said.

''With a normal vaginal ultrasound we look right ahead at the uterus, we turn it to the side to look at the ovaries, and I would like people to just look behind the uterus as well to look for endometriosis.

''It's something people need to become aware of and my feeling is, if there is demand from referring doctors, then imaging people will lift their game and look harder.''
Dr Piessens said the result was a speedier diagnosis which provided a template for surgeons performing complex surgery to remove the lesions.

She said the ultrasound could also be used to monitor the effect of hormone medication in shrinking the lesions, potentially avoiding surgery.

One of the patients who has benefited from the new diagnostic technique is Alana Vaughan, 29, who suffered for years with painful periods.

She said her symptoms ''returned with a vengeance'' when she stopped taking the contraceptive pill a few years ago, before she was referred to Dr Piessens who diagnosed her endometriosis. After extensive surgery to remove it, Ms Vaughan said she was now thrilled to be pregnant with twins.

http://www.canberratimes.com.au/news/national/national/general/new-test-for-endometriosis/2426662.aspx?storypage=0

ARDvark Blog Journal of Adhesion Related Disorder: U.S. to Force Drug Firms to Report Money Paid to Doctors

2012-01-22T07:24:00.000-05:00

ARDvark Blog Journal of Adhesion Related Disorder: U.S. to Force Drug Firms to Report Money Paid to Doctors

Adhesion Related Disorder International Human Rights Team IHRT: Beware of the Abdo-lift....

2012-01-19T12:32:00.000-05:00

ARDvark Blog Journal of Adhesion Related Disorder: Adhesion related Disorder ~ Adhesion Products Adhesion Reduction Agents

2012-01-17T06:27:00.000-05:00

ARDvark Blog Journal of Adhesion Related Disorder: Adhesion related Disorder ~ Adhesion Products Adhesion Reduction Agents

Hope For Adhesion Pain Sufferers: Asherman’s Syndrome – could it be why you’re struggling to have a baby?

2012-01-12T08:15:00.000-05:00

Hope For Adhesion Pain Sufferers: Asherman’s Syndrome – could it be why you’re struggling to have a baby?

Gynaecologist analyses women’s biggest sexual problems

2012-01-12T08:12:00.000-05:00

Gynaecologist analyses women’s biggest sexual problems
On January 2, 2012 · In Health | 4:10 pm..
Abuja – Unlike men’s main sexual complaint — erectile dysfunction, women’s biggest sexual problem is caused by a combination of mental and physical factors, a doctor has analysed.

Dr Ekpi Philips, a Consultant Gynaecologist, said that common causes for a loss of sexual desire and drive in women could be interpersonal relationship issues, socio-cultural influences and peer pressure.

Others include partner performance problems, lack of emotional satisfaction with the relationship, the birth of a child and becoming a caregiver for a loved one.

“Medical problems such as mental illnesses, depression, or medical conditions such as endometriosis, fibroids, and thyroid disorders impact on a woman’s sexual drive both mentally and physically.

“Age, medications, certain antidepressants, blood pressure lowering drugs, and oral contraceptives can lower sexual drive.’’

Philips said that testosterone could also affect sexual drive in both men and women.

Testosterone is a hormone made by the body and helps to stimulate and maintain sexual function, maintain bone strength, among others.

“Testosterone levels peak in women’s mid-20s and then steadily decline until menopause, and drop dramatically,’’ he said.

Philips noted that lower sexual drive sets in when a woman experiences a significant decrease in interest in sex and it is having an effect on her.

According to him, sexual desire is more than just an issue of low libido or sex drive.

“Sexual drive is the biological component of desire which is reflected as spontaneous sexual interest including sexual thoughts, erotic fantasies, and daydreams.

“ It’s about your body signaling that it wants to be sexual.

“Whether or not there is any intention to act on it, we all have a certain level of drive.”

He explained that a woman carrying financial burdens of the home could lose interest in sex.

“For a growing number of women, declining hormones, job stress, relationship issues, and other problems are taking their toll in the bedroom.

“When a woman go to work and comes back late, think of bills to pay, prepares the children and think of the attitudes of the husband, such woman can never pick interest in sex’’.

Philips also explained that a woman who is ill and probably on medication, could have low sex drive.

He stated that relationships between the husband must be cordial for both parties to enjoy sex.

He added that loss of sexual desire, known in medical terms as hypoactive sexual desire disorder (HSDD), is the most common form of sexual dysfunction among women of all ages.

“These are not likely to be cured by merely using a pill’’.

He said that since the loss of sexual desire in women was caused by a combination of factors, it required more than an approach to fix the problem.

He advised that putting the desire back in women’s sex lives would require putting her on sex therapy and relationship counseling.

“Changing medications or altering the dose, addressing underlying medical conditions of the woman and the use of vaginal estrogens, testosterone therapy, could help.’’

According to Philips, many gynaecologists recommend off-label uses of testosterone therapy for women with low sexual desire to restore testosterone to normal levels.

“In postmenopausal women, vaginal dryness may be treated with vaginal estrogen creams although no hormone or drug has been approved to treat sexual problems in women,’’ Philips added

http://www.vanguardngr.com/2012/01/gynaecologist-analyses-women%E2%80%99s-biggest-sexual-problems/

Baylor scientists receive $1.35 million from Ovarian Cancer Research Fund

2012-01-11T04:57:00.000-05:00

Baylor scientists receive $1.35 million from Ovarian Cancer Research Fund

HOUSTON -- (January 9, 2012) -- Two Baylor College of Medicine researchers have received three-year grants totaling $1.35 million from the Ovarian Cancer Research Fund for studies directed toward earlier detection of ovarian cancer.

Ovarian cancer is the ninth most common cause of cancer among U.S. women and the fifth most common cause of cancer deaths in women. An estimated 22,000 will be diagnosed with the disorder this year and more than 15,000 will die of it.

"Investigating ARID1A
Over the next three years, Hawkins will research why some women with endometriosis (the growth of cells that usually line the uterus outside that organ, often on the ovary) go on to develop a kind of ovarian cancer known as endometrioid or clear cell ovarian cancer.

"Additionally, women with endometriosis-associated ovarian cancer have a better prognosis than women without endometriosis," she said.

She will look at a gene called ARID1A that may play a role in the transformation from endometriosis cells to ovarian cancer cells. How ARID1A plays a role in the formation of tumors is not yet understood, and Hawkins plans to study both benign and malignant human tissue to find mutations in ARID1A. She will work in cell cultures to determine if ARID1A leads to increased growth of cancer cells because of interaction with other cancer genes. She will create a mouse model to mimic the low levels of ARID1A and see how early tumors form as well as to study potential therapies."
Click here to read entire article: http://www.bcm.edu/news/item.cfm?newsID=5022

Health insurance rescission case upheld by California appellate court - Lexology

2012-01-11T04:47:00.000-05:00

Health insurance rescission case upheld by California appellate court - Lexology

New Risks for Women with Endometriosis

2012-01-10T06:30:00.000-05:00

New Risks for Women with Endometriosis
By Heidi Anne Duerr, MPH | January 3, 2012

Endometriosis affects as many as 6% of the general population. While some women with endometriosis remain asymptomatic, many women experience dysmenorrhea, dyspareunia, non-cyclical pelvic pain, and subfertility. Now, new research indicates that patients with endometriosis are also more likely to develop inflammatory bowel disease.
Read the rest here: http://hcp.obgyn.net/endometriosis/content/article/1760982/2012566

Adhesion Related Disorder International Human Rights Team IHRT: Has wanna be adhesion activist/author Karen Steward made you feel...

2012-01-10T06:24:00.000-05:00

Endometriosis Linked to IBD

2012-01-02T07:17:00.000-05:00

Endometriosis puts women at risk for Crohns Ulcerative Colitis
By: Lindsay Patterson

Reviewed By: Joseph V. Madia, MD

(dailyRx)Endometriosis is a common reproductive disorder that affects women during their childbearing years. It is often connected with infertility, and now, it's also been linked to inflammatory bowel disease.

New research has found that women with endometriosis are at least twice as likely to develop inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis.

Click here to read the rest: http://www.dailyrx.com/news-article/endometriosis-puts-women-risk-crohns-ulcerative-colitis-16651.html

3rd Annual Blossom Ball-Susan Sarandon - Video Gallery - Endometriosis Foundation of America

2011-12-23T05:37:00.000-05:00

3rd Annual Blossom Ball-Susan Sarandon - Video Gallery - Endometriosis Foundation of America

Breaking News! Adhesions easily visualised with simple Barium Swallow!

2011-12-21T06:53:00.002-05:00

Breaking News!

Adhesions easily visualised with simple

"NONE INVASIVE "

CONTRAST X-RAY BARIUM SWALLOW!

When taking the test, you drink a preparation containing Barium sulfate . The x-ray tracks the chalky like liquid as it makes it way through your digestive system, (inside the organs).....however it also showed what was on the OUTSIDE of the organs of the digestive track, (in the peritoneal cavity within the abdominal cavity!)

The "Contrast Barium Swallow" abdominal x-ray diagnostic was never meant to show anything else, it showed ADHESIONS attaching internal organs in the lower digestive track to the peritoneum and to other organs.

It can also show the "mis-alignment" of intestines from being pulled out of the normal alignment by adhesion attachments!

This diagnostic can also detect bowel obstructions or bowel impactions---and all of this without so much as a surgeons knife!

MORE TO COME
on this magnificent discovery in the world of
ARD!

Maybe 2012 WILL be a year of good for

"Adhesion Related Disorder"
victims!

!!!! Visible Adhesions !!!!!

"MERRY CHRISTMAS"
"HAppy Holidays"
or rather
"THank-God"

!! DEMAND THIS DIAGNOSTIC !!

The "X-Ray Barium Swallow" diagnostic test is NOT used to detect adhesions, or any other "pathological anomalies," OUTSIDE of the organs of the digestive track!

The "X-Ray Barium Swallow" is a diagnostic tool used to solely detect "pathological anomalies, obstructions and/or diseases," WITHIN the organs of the digestive track!

You MUST insist that your attending physician order this diagnostic test if you have had a previous adhesiolysis, or many of them for that matter, and are currently experiencing abdominal/pelvic pain that YOU think is associated with adhesions, or ARD!

Have it ordered for "Pain," as you see listed below!

DO NOT ALLOW YOURSELF

to be denied this diagnostic!

Barium Swallow IntroductionA barium swallow is a test that may be used to determine the cause of painful swallowing, difficulty with swallowing, abdominal pain, bloodstained vomit, or unexplained weight loss.

Barium sulfate is a metallic compound that shows up on x-ray and is used to help see abnormalities in the esophagus and stomach. When taking the test, you drink a preparation containing this solution. The x-rays track its path through your digestive system.

•These problems can be detected with a barium swallow: ◦Narrowing or irritation of the esophagus (the muscular tube between the back of the throat and the stomach)

◦Disorders of swallowing

◦Hiatal hernia (an internal defect that causes the stomach to slide partially into the chest)

◦Abnormally enlarged veins in the esophagus that cause bleeding

◦Ulcers

◦Tumors

◦Polyps (growths that are usually not cancerous, but could be precancerous)

Barium Swallow - Test Results

ALWAYS INSIST YOU RECEIVE A COPY OF THE TEST , BUT MOST IMPORTANT IS THAT YOU SECURE A VISUAL COPY OF THE FILMS OF THE X-RAY ITSELF AS IT IS IN THESE THAT YOU WILL SEE ADHESIONS IF THEY ARE VISIBLE!!!!

The "normal" pathology results your Dr. looks for and will jabber about are listed below here, just listen them out, then make sure you get a visual or the test for yourself! It is imperative that YOU look for your own results and IF adhesions can be seen in these films, you will recognize them!

Usual Test Results:
Ask your doctor for the results of your barium swallow test. You may have to wait a few days until the radiologist (a specialist in x-ray examinations) looks at the x-rays and gives your doctor the final results. Your doctor will recommend a plan of action to you based on the results.

•The x-rays will show the digestive wave (peristalsis) through the length of the esophagus. When barium reaches the end of the esophagus, the barium enters the stomach.
•The barium swallow may reveal problems in the pharynx (the back of the throat), the esophagus, or the stomach. The problems could be narrowing, tumors, polyps, ulcers (erosions), or disorders in moving food through the system. It can also show a hiatal hernia, diverticula (pouches opening along the esophagus), or varices (enlarged veins).

•If the barium swallow test shows any area of concern, your doctor may plan what other tests, procedures, treatments, or medications you may need. The treatment for problems discovered during a barium swallow vary depending on the condition. http://www.emedicinehealth.com/barium_swallow/article_em.htm

A picture is worth a 1000 word...so see for yourselves!

In 2009 a known adhesion sufferer had a GI Barium Swallow for "Chronic Abdominal Pain."

This female suffered "Adhesion Related Disorder" and had undergone multiple surgeries in which abdominal adhesion's were present and lysed in each of her each surgeries. Relief was always fleeting and the pain always returned after each surgery.

When this test was taken in 2009 she was told everything is fine and the test revealed nothing, and it was absolutely right, as long as he made his determination based on what the test was meant to show! She had NO abnormal internal organ pathology showing in this Barium Swallow! The docs said she was just fine and sent her on her way.

She had Cat scans, MRI's every test in the book, you name it and the financial toll was enormous...... and all the doctors said she was fine. They could find nothing wrong and yet she suffered so.
A subsequent surgery was scheduled and records and imagery were sent to the new surgeon.

During pre op...reviews of all the tests...these images below caught the surgeon eye!
The surgeon palpitated each area where adhesions were being visualised on these simple

"Contrast Barium Swallow X-Ray Films."
As an ARD patient advocate watched, knowing what was being seen on the screen in front of them showing what could only be "ADHESIONS," the Dr. asked the patient, "Does it hurt there? Does it hurt here?"

Each time the ARD patient confirmed her pain was exactly where the surgeon indicated it might be in her abdomen. The surgeon then told his surgery team that he wanted these films up on a screen in the operating room during the procedure!

You bet he did!

An IHRT patient advocate was scrubbed up and in the OR with the surgeon.....as you will see below, everywhere the wispy white tendrils appeared...is where he lysed adhesion! He used the images below as a guide to lysing the patients adhesions during the entire surgery. He confirmed this for us all!

After surgery, the patient, the surgeon and IHRT advocate were in somewhat of disbelief at what they had just witnessed, and they knew that these images had guided the way...the surgeon confirmed for us that indeed...this simple test reveled adhesions exquisitely!

We feel that this may finally be the end of expensive testing for adhesion patients....the statement that adhesions rarely if ever show up in any type of imaging is now a myth.
No more "Let's have a surgical look, see" to search for the always elusive adhesions.
Use these images to advocate for yourself. Ask for this simple non invasive, inexpensive test!!!!
It is not in your head....it is right there in black and white for all the world to see.
Removing personal information from these images has been difficult but this most generous adhesion sufferer has had that as her only request.
There are more images still to be placed in this posting and each image will be summarised as to what you are looking at anatomically so please check back! Approx a dozen more images from the same series coming soon!

Surgery done by Dr Pagels
We place his information here for your convenience but urge you to exercise due diligence when deciding which surgeon is right for you!
Dr. Pagels is now Chief of Gynecology at St.Josef Krankenhaus Moers. He was chief of Gynecology at Klinikum Duisburg, when this surgery was done.

This is his address: Herr Dr. Med. Jens Pagels
St. Josef Krankenhaus Moers
Asberger Str. 4
47441 Moers
Germany
Telephone Number: +49 (0) 2841 1072430
His email address is: gyn.pagels@st-josef-moer

This news is so wonderful we wanted to get it to you as soon as possible!
We wish all who suffer from adhesions all the best this holiday season and we present you a gift from an anonymous adhesion sufferer.

A simple " Contrast Barium Swallow X-Ray!"

"MERRY CHRISTMAS"
"Happy Holidays"

This first image below ...what do you see in the one o'clock position?

Do YOU think you are correct!
( NO, that is not a fetus, it is a twisted bowel!)

Simple remedies for menstrual cramps

2011-12-14T06:29:00.000-05:00

Simple remedies for menstrual cramps
GYNOISSUES

By DONNA HUSSEY-WHYTE All Woman writer husseyd@jamaicaobserver.com

Monday, December 12, 2011

SOME women endure cramps so bad each month, that they are forced to stop regular activities for a day or two.

Severe cramping can be caused by a number of things, like disease in the reproductive organs; endometriosis; pelvic inflammatory disease; narrowing of the cervix; or fibroids or growths on the inner wall of the uterus.

But whatever the cause, the recommended remedies are the same.

Gynaecologist and obstetrician at the University Hospital of the West Indies, Professor Horace Fletcher, said young women don't need to suffer horrible pain that keeps them away from work and school.

He suggested:

1. The best way to treat severe menstrual cramps is to take oral contraceptives. This kind of pain responds to contraceptive pills taken in the normal way — once daily for 21 days. The woman should be first evaluated by her doctor to make sure there are no contraindications.

2. Mild cramps respond to normal painkillers like Paracetamol, Panadol, Tylenol, or any of the non- steroidal anti-inflammatory drugs like aspirin or ibuprofen. All of these have some side effects.

3. Antispasmodics like Baralgin or Buscopan can work as well, usually in conjunction with the treatments above.

4. A hot water bottle or heating pad compress against the stomach helps.

Other remedies you could try are:

1. Drink herbal teas like chamomile, mint, raspberry and blackberry, which may help soothe tense muscles and anxious moods.

2. Exercise. Regular workouts decrease the severity of cramps. It is therefore recommended that you start exercising the week leading up to the start of your period.

3. Empty your bladder as soon as you have the urge to urinate.

Read more: http://www.jamaicaobserver.com/magazines/allwoman/Simple-remedies-for-menstrual-cramps_10343747#ixzz1gVWgRTKT

Study Links Ovary Removal in Younger Women to Bone Thinning and Arthritis

2011-12-09T05:45:00.000-05:00

Released: 12/6/2011 8:45 AM EST
Embargo expired: 12/8/2011 11:30 AM EST
Source: Johns Hopkins Medicine

Note to Reporters: The authors of this study will present their data during a press conference at the CTRC-AACR San Antonio Breast Cancer Symposium on Thursday, Dec. 8 at 11:30 AM, ET. The dial-in phone number for the press conference is (888) 647-7462.

Newswise — Having both ovaries removed before age 45 is strongly associated with low-bone mineral density and arthritis in later years, according to a new study by Johns Hopkins oncologists and epidemiologists. The analysis covered several thousand women who took part in a U.S. government-sponsored, multiyear national health study, and excluded women whose ovaries were removed due to cancer.

“This is one of the largest national studies, to my knowledge, that highlights the difference in bone-mineral density in women who have their ovaries removed at a young age. Our results suggest that such women should be monitored closely for osteoporosis,” says Kala Visvanathan, M.D., M.H.S., associate professor of oncology and epidemiology in the Johns Hopkins Bloomberg School of Public Health and Kimmel Cancer Center. Results of the study are expected to be presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 6-10.

The investigators were interested in studying the long-term effects of ovary removal, known as oophorectomy, on bone health since the procedure is recommended to reduce ovarian and breast cancer risk in women at high risk for these diseases. Oophorectomy also is a common procedure in women who undergo hysterectomy, or womb removal. In the U.S., about 600,000 1 women per year undergo a hysterectomy, or womb removal, and about half of these women also have both ovaries removed. Hysterectomy is commonly performed in middle-aged women to treat symptoms of pain or bleeding caused by conditions, such as fibroids, endometriosis, or uterine prolapsed, or cysts. Women having hysterectomies for these benign conditions may also have their ovaries removed at the same time, believing that it will reduce cancer risk, according to Visvanathan.

Regardless of the reason for such surgery, however, the procedure has adverse effects, the Hopkins researchers say. Levels of estrogens and related hormones that are normally produced by the ovaries fall steeply after oophorectomy, bringing on menopause abruptly in women who are not yet postmenopausal. Estrogens help protect the body from aging and age-related disease, and physicians and epidemiologists over the past two decades have linked their premature loss to increased risks of parkinsonism, dementia, arthritis, and the brittle-bone condition known as osteoporosis.

For the study, Anne Marie McCarthy, a Ph.D. candidate at Hopkins’ Bloomberg School of Public Health, and Visvanathan used existing information from a health research database, called the third National Health and Nutrition Examination Survey (NHANES III). The information was gathered as part of a U.S.-sponsored epidemiological study conducted during 1988-94, and, among other health measures, it includes data from standard, X-ray-based measure of bone-mineral density in the hip and spine for thousands of women. “Using the NHANES III data, we set out to measure bone mineral density in women who’d had a bilateral oophorectomy compared with women with intact ovaries,” says McCarthy.

Of the data on 34,000 Americans aged two months and older included in the NHANES III study, McCarthy focused on more than 3,700 women aged 40 and over with no history of cancer. Most had intact ovaries; of the 560 women who had oophorectomy, about half had surgery before age 45.

McCarthy found that women who had both ovaries removed before age 45 had on average three percent lower bone mineral density than women with intact ovaries.

McCarthy examined arthritis risk, too, and found that 48 percent of women who had oophorectomies before age 45 reported an arthritis diagnosis, compared with only 32 percent for those with intact ovaries.

When McCarthy excluded women who had taken hormone replacement therapy (HRT), which normally counters the effects of lost ovarian hormones, these added risks became even higher. “Women who had had a bilateral oophorectomy before age 45 and didn’t take HRT were about twice as likely to get arthritis and three times as likely to have low-bone mineral density, compared with those with intact ovaries,” she says.

The NHANES III data represent snapshots of subjects’ health, and do not conclusively establish that oophorectomy causes lower bone mineral density, according to the researchers. But the Hopkins researchers’ analysis is consistent with previous studies, they say, and strongly suggests that oophorectomy can accelerate age-related conditions, such as osteoporosis – and thus shouldn’t be done without a clear medical reason. “The key factor may be the abrupt removal of ovarian hormones, in contrast with natural menopause in which there is a gradual decline, but that’s something we need to study further,” says Visvanathan.

Women with cancer and other medical conditions that necessitate oophorectomy, and women with specific genetic mutations that bring extremely high ovarian cancer risk, should still get their ovaries removed, she adds. “But they should be monitored closely for early signs of low-bone mineral density, so that osteoporosis can be prevented with the appropriate treatments.”

The research was funded by the Breast Cancer Research Foundation.

On the Web:
http://www.hopkinskimmelcancercenter.org/

CTRC-AACR San Antonio Breast Cancer Symposium: http://www.sabcs.org/

Reference:
1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585770

http://www.newswise.com/articles/johns-hopkins-study-links-ovary-removal-in-younger-women-to-bone-thinning-and-arthritis

Protagen Collaborates in Endometriosis Biomarker Project

2011-12-08T06:53:00.000-05:00

Protagen Collaborates in Endometriosis Biomarker Project
Protagen AG
Protagen AG, a specialist for in-vitro diagnostics, has announced that it is to collaborate with Bayer HealthCare Pharmaceuticals on the clinical validation of Endometriosis biomarkers. The project will build on the results of the Endometriosis biomarker discovery study performed last year.

Endometriosis is a gynaecological condition which occurs in roughly 5-10% of women worldwide. It occurs when uterine cells grow outside of the uterine cavity, often on the ovaries. The debilitating condition can cause recurrent pelvic pain of varying severity, constipation, fatigue and infertility issues in sufferers.

Protagen has successfully developed the proprietary UNIarray® technology platform for the development of novel, non-invasive diagnostic tests based on auto-antibody signatures in human blood.

The ‘gold standard’ diagnostic test for endometriosis is currently laparoscopy, a visual inspection of the abdominal organs followed by surgical removal and examination of lesions. The collaborative project to be undertaken by Protagen AG and Bayer Healthcare Pharmaceutical, is aimed at employing the UNIarray® technology for the predictive diagnosis of Endometriosis.

“With the targeted advancement of the UNIarray® technology platform, Protagen has developed into a preferred partner for drug development companies”, states Dr. Peter Schulz-Knappe, CSO and Executive Vice President Diagnostics at Protagen, “now we can directly support our collaboration partners in pharma and biotech in all clinical Phases I-IV with the development of therapy specific diagnostic assays. Besides Endometriosis, our technology is applied in autoimmune diseases like Multiple Sclerosis, chronic inflammatory diseases and cancer. Cooperation partners are, amongst others, Bayer, Biogen-Idec und SuppreMol”.

In order to understand the biochemical and molecular biological processes of Endometriosis, new technologies like UNIarray® are becoming increasingly important. Improving the predictive diagnosis of Endometriosis should help to improve patient’s quality of life.

Rise in Dangerous Type of Ovarian Cancer

2011-12-03T08:01:00.000-05:00

Poon Chian Hui - Straits Times Indonesia | November 18, 2011

More women in Singapore are coming down with an aggressive form of ovarian cancer whose symptoms are vague and survival rate low.

In 1988, 5.2 percent of all ovarian cancers were of the type called clear cell carcinoma. In 2007, the figure went up to 13.4 percent.

Less than 40 percent of women who get it survive, even when the cancer is detected early, said Associate Professor Tay Sun Kuie of the Singapore General Hospital (SGH).

In contrast, other types of ovarian cancer have a survival rate of as high as 70 percent when discovered early.

Prof Tay led a study which looked at the profiles of 256 ovarian cancer patients seen at SGH from 2004 to 2009, and examined national trends based on data from the Singapore Cancer Registry from 1988.

Ovarian cancer is the fifth most common among women in Singapore after breast, colorectal, lung and uterus, and nearly 300 are diagnosed with it every year.

It affects one out of 18 female cancer patients, and some 40 percent of cases occur in those aged 55 and above. The clear cell type usually crops up earlier, in those aged 40 onwards.

The symptoms for clear cell carcinoma are vague, but it has been found to occur in women who have painful and irregular periods and who are mysteriously losing weight or their appetite.

The study also found that women who were never pregnant are 14 percent more likely to get this aggressive cancer, compared with ovarian cancer patients who had at least one child.

There is also a link to endometriosis, a disorder where the womb lining responsible for menstruation is found outside the womb, leading to severe menstrual cramps, chronic pain in the pelvic region and infertility.

Patients who have the clear cell type are nearly five times more likely to have endometriosis than those with other types of ovarian cancer.

Clear cell carcinoma is the most lethal of all ovarian cancers. Even with surgery and chemotherapy, up to 80 percent of sufferers fail to improve, even if they were diagnosed at an early stage.

Prof Tay, a senior consultant in obstetrics and gynaecology, said the cancer cells have special genes that makes them more resistant to chemotherapy drugs. "Giving the cancer cells medicine is like giving them water - it doesn't kill them," he said.

SGH decided to research clear cell carcinoma because the cancerous cysts resemble ordinary ones in ultrasound and computed tomography (CT) scans.

Cysts in the ovaries are common and normally harmless.

"The cyst looks just like an empty fish bowl," said Prof Tay. "It can confuse doctors... because of the seemingly harmless appearance."

This was the case for a patient known only as Madam Lim in the study, which was first presented at the Singapore International Congress of Obstetrics and Gynaecology in August.

The 41-year-old manager, who was married but never pregnant, had a history of endometriosis.

When her pain flared up again, she underwent ultrasound and CT scans which revealed a large cyst measuring 15cm in diameter.

During the operation to remove it, doctors realized she actually had clear cell ovarian cancer.

Her condition is currently stable after treatment.

As doctors "cannot possibly take out every cyst in all women", Prof Tay hoped the study would help doctors in better diagnosing this cancer by pointing out, for example, the link with endometriosis.

He said women who experience an unexplained loss of appetite and worsening symptoms of endometriosis may want to seek medical advice early.

"This doesn't mean that one should be alarmist, but women ought to be more aware of changes in their body," he said.

Reprinted courtesy of Straits Times Indonesia. To subscribe to Straits Times Indonesia and/or the Jakarta Globe call 021 2553 5055.

http://www.thejakartaglobe.com/international/rise-in-dangerous-type-of-ovarian-cancer/479337#Scene_1

Endometriosis Has Major Effect on Lives of Women

2011-12-02T06:35:00.000-05:00

Notice of Decision for Pr VISANNE® Canada

2011-11-30T06:49:00.000-05:00

Notice of Decision for PrVISANNE®Help on accessing alternative formats, such as Portable Document Format (PDF), Microsoft Word and PowerPoint (PPT) files, can be obtained in the alternate format help section.

(PDF Version - 23 K)
Contact: Bureau of Metabolism, Oncology and Reproductive Sciences

Date issued: November 7, 2011

On October 12, 2011, Health Canada issued a Notice of Compliance to Bayer Inc. for the drug product, Visanne.

Visanne contains the medicinal ingredient dienogest which is a progestin.

Visanne is indicated for the management of pelvic pain associated with endometriosis. The efficacy of Visanne has not been tested beyond 15 months.

Endometriosis is a gynaecological disease where endometrial tissue is found outside the uterine cavity, most commonly on the ovaries and the peritoneal surface. This tissue can cause inflammation and adhesions which result in chronic pelvic pain and often infertility. The cause of endometriosis remains unknown. Visanne reduces the endogenous production of estradiol and thereby suppresses the trophic effects of estradiol on both the eutopic and ectopic endometrium. When given continously, Visanne leads to a hyperprogestogenic and moderately hypoestrogenic endocrine environment causing initial decidualization of endometrial tissue. In addition to the estradiol-mediated effects Visanne also has direct antiproliferative, immunologic and antiangiogenic effects that contribute to the reduction of pelvic pain associated with endometriosis.

The market authorization was based on quality, non-clinical, and clinical information submitted. The efficacy and safety of Visanne were demonstrated primarily in three multicentre Phase III studies. All three studies enrolled patients with a confirmed diagnosis of endometriosis with various stages of disease severity. Assessment of pelvic pain associated with endometriosis was determined by using a visual analog scale (0-100 mm, where 0 mm represents no pain and 100 mm represents severe pain). The first study was a double-blind placebo-controlled study where 102 patients were treated orally (PO) with a Visanne 2 mg tablet once daily (OD) compared to 96 patients who were treated with a placebo, over a 12 week period. The second study was an open-label extension to the placebo-controlled study. The extension study included 168 women; 87 previously treated with Visanne (2 mg, PO, OD) and 81 previously treated with placebo. All 168 women received Visanne (2 mg, PO, OD) for an additional 52 weeks to assess the long-term efficacy of Visanne treatment. The third study compared Visanne (2 mg, PO, OD) to 3.75 mg leuprolide acetate administered intramuscularly every four weeks, where 120 patients received Visanne treatment and 128 patients received leuprolide acetate, for a 24-week treatment period. Results from all three studies demonstrated that treatment with Visanne produced clinically significant reductions in pelvic pain compared to baseline values. In the placebo-controlled study, following 12 weeks of treatment with Visanne, the mean reduction of pelvic pain compared to baseline was 27.4 ± 22.9 mm. The open-label extension study showed continued improvement in pelvic pain for up to 15 months. In the third active comparator study, Visanne demonstrated efficacy similar to leuprolide acetate in reducing pelvic pain associated with endometriosis. In all clinical studies, Visanne was generally well-tolerated.

Visanne (2 mg, dienogest) is provided in tablet form. The recommended dose of Visanne is one oral tablet per day, preferably taken at the same time each day, with some liquid as needed. Visanne tablets are intended for continuous administration regardless of any vaginal bleeding. Dosing guidelines are available in the Product Monograph.

Visanne is contraindicated in women with any of the conditions listed below, which are partially derived from information on other progestin-only preparations. Should any of the conditions appear during the use of Visanne, treatment must be discontinued immediately.

•Known or suspected pregnancy;
•Lactation;
•Active venous thromboembolic disorder;
•Arterial and cardiovascular disease, past or present [for example (e.g.) myocardial infarction, cerebrovascular accident, ischaemic heart disease];
•Diabetes mellitus with vascular involvement;
•Presence or history of severe hepatic disease as long as liver function values have not returned to normal;
•Presence or history of liver tumours (benign or malignant);
•Known or suspected sex hormone-dependent malignancies;
•Undiagnosed abnormal vaginal bleeding;
•Any ocular lesion arising from ophthalmic vascular disease, such as partial or complete loss of vision or defect in visual fields;
•Current or history of migraine with focal aura;
•Hypersensitivity to dienogest or to any ingredient in the formulation or component of the container.
Visanne should be administered under the conditions stated in the Product Monograph taking into consideration the potential risks associated with the administration of this drug product. Detailed conditions for the use of Visanne are described in the Product Monograph.

Based on the Health Canada review of data on quality, safety, and efficacy, Health Canada considers that the benefit/risk profile of Visanne is favourable for the indication stated above.

© 2011, Bayer Inc.
®VISANNE is a trademark used under license by Bayer Inc.

Notices of Decision (NDs) are produced in accordance with the Summary Basis of Decision (SBD) initiative. All NDs will be reproduced within the corresponding SBD, normally available within 5 months of product authorization.

http://www.hc-sc.gc.ca/dhp-mps/prodpharma/sbd-smd/drug-med/nd_ad_2011_visanne_132174-eng.php

Visanne® is the first oral treatment approved in more than 10 years for Canadian women with endometriosis

2011-11-30T06:45:00.000-05:00

MORE FINANCIALS November 29, 2011 7:00 AM - General
Save Visanne® is the first oral treatment approved in more than 10 years for Canadian women with endometriosis~ Provides women with the first approved long-term, oral treatment option to relieve debilitating pelvic pain from endometriosis ~

TORONTO, Nov. 29, 2011 /CNW/ - There is now relief for Canadian women living with the pelvic pain associated with endometriosis. The symptoms of endometriosis, including severe menstrual cramps, painful intercourse, painful urination or bowel movements, and lower back or abdominal pain, take a toll on a woman's emotional health and overall quality of life. Bayer HealthCare announced that Visanne® (2 mg dienogest tablets) was approved by Health Canada for the management of pelvic pain associated with endometriosis. It is the first long-term, oral, progestin-only regimen specifically developed for women with endometriosis in more than 10 years.1

"Once diagnosed, endometriosis patients must use a treatment on a daily basis to cope with the immense pain of the disease," said Dr. Sony Singh, Director of Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, University of Ottawa. "Visanne is an important management option for patients with the disease, as it is proven to relieve the chronic, debilitating pelvic pain caused by endometriosis including menstrual pain and pain during sexual intercourse. This is the first new treatment in more than a decade to help these women, which is encouraging."

Visanne® has been shown to provide effective pain relief in women with endometriosis, as clinical studies of up to 15 months duration, have proven that Visanne® is effective at relieving pelvic pain.2 Visanne® contains a novel progestin called dienogest, which suppresses the effects of estradiol on endometrial tissue and effectively reduces pelvic pain.3

The Impact of Endometriosis
Endometriosis is the growth of tissue, similar to the kind that lines the uterus every month, elsewhere in the abdomen. This excess tissue responds to the monthly menstrual cycle and when the tissue breaks down, it can lead to inflammation, causing pain. Common sites for endometrial growth are the ovaries, on the uterus and behind the uterus.4 The condition affects approximately 5 - 10 per cent of women of reproductive age.5 Pain associated with endometriosis can be excruciating and debilitating and is often the most difficult symptom for women with the disease.6

The disease can greatly impact a woman's social, professional and personal life, and women with endometriosis often experience a higher incidence of depression and emotional distress due to the uncertainty of diagnosis, unpredictability of symptoms and living a normal life.7

Recognize the Symptoms
Despite the high prevalence of endometriosis, there is a lack of general disease awareness and few women recognize the symptoms - thus causing a significant delay in diagnosis. Studies show it takes an average of three years from the time a woman has her first symptom to the time she discusses it with her doctor.8 It frequently takes up to 12 years for a woman to get a confirmed diagnosis from the first time she seeks help for her symptoms.9

"It is very common for women to live for several years with the severe pelvic pain of endometriosis before receiving an official diagnosis. This often means a delay in disease management consequently, negatively impacting their professional, social and psychological life," said Jan Silverman, The Endometriosis Network of Toronto (TENT). "It's important for women to learn about the symptoms of endometriosis, rather than just thinking pelvic pain is 'normal.' Women need to know that endometriosis is real and the pain can be treated, so it's important for them to speak with their doctors. The availability of a new treatment is good news and a step in the right direction."

The Facts on Visanne®
Visanne® (2 mg dienogest tablets) is indicated for the management of pelvic pain associated with endometriosis. Clinical trials regarding the efficacy of Visanne® have lasted up to 15 months.10

In clinical trials, Visanne® was generally well tolerated. The most frequent side effects reported were headache, breast discomfort including breast engorgement and breast pain. Undesirable effects, such as irregular bleeding, are more common during the first months of treatment with Visanne® and subside with continued treatment.2 Patients are encouraged to talk to their healthcare provider to see if Visanne® is right for them.

To learn more about endometriosis, visit www.endometriosisinfo.ca. For more information on endometriosis support groups from TENT, visit the group's Facebook page: http://www.facebook.com/group.php?v=info&ref=mf&gid=301016744454
.

About Bayer Inc.
Bayer Inc. (Bayer) is a Canadian subsidiary of Bayer AG, an international research-based group with core businesses in health care, crop science and innovative materials. Headquartered in Toronto, Ontario, Bayer Inc. operates the Bayer Group's HealthCare and MaterialScience businesses in Canada. Bayer CropScience Inc., headquartered in Calgary, Alberta operates as a separate legal entity in Canada. Together, the companies play a vital role in improving the quality of life for Canadians - producing products that fight diseases, protecting crops and animals, and developing high-performance materials for applications in numerous areas of daily life. Canadian Bayer facilities include the Toronto headquarters and offices in Montréal and Calgary.

Bayer Inc. has approximately 800 employees across Canada and had sales of $827 million CDN in 2010. Globally, the Bayer Group had sales of over 35 billion Euro in 2010. Bayer Inc. invested approximately $36 million CDN in research and development in 2010. Worldwide, the Bayer Group spent the equivalent of over 3.1 billion Euro in 2010 in R&D. For more information, go to www.bayer.ca.

Forward-Looking Statements
This news release may contain forward-looking statements based on current assumptions and forecasts made by Bayer Group or subgroup management. Various known and unknown risks, uncertainties and other factors could lead to material differences between the actual future results, financial situation, development or performance of the company and the estimates given here. These factors include those discussed in Bayer's public reports which are available on the Bayer website at http://www.bayer.com/
. The company assumes no liability whatsoever to update these forward-looking statements or to conform them to future events or developments.

References:
--------------------------------------------------------------------------------

1 Lupron Depot Canadian Product Monograph. http://www.abbott.ca/static/content/document/LUPRON-DEPOT-ENDO-PM-23MAR10.pdf.
May 20, 2011.

2 Visanne Product Monograph. 2011. Page 21.

3 Visanne Product Monograph. 2011. Page 14.

4 SOGC.ca. What is Endometriosis? Available at http://www.sogc.org/health/health-endometriosis_e.asp
. Accessed November 1, 2011.

5 Endometriosis. Infertility Awareness Association of Canada. Available at: http://www.iaac.ca/content/endometriosis-1
. Accessed October 31, 2011.

6 Hummelshoj L. Medical needs in endometriosis. Gynaecology Forum 2010;15(2):5-7.

7 Kennedy S, Bergqvist A, Chapron C, D'Hooghe T, Dunselman G, Greb R, Hummelshoj L, Prentice A, Saridogan. ESHRE guideline on the diagnosis and management of endometriosis. Human Reproduction 2005;20(10):2698-2704. Also available online at: http://guidelines.endometriosis.org/.

8 Diagnosis: http://www.womenshealthmatters.com/centres/pelvic_health/endometriosis/diagnosis/index.html . Accessed November 1, 2011.

9 SOGC Diagnosis and Management Guidelines. Available at: http://www.sogc.org/guidelines/documents/gui244CPG1007E.pdf. Accessed November 1, 2011.

10 Visanne Product Monograph. 2011. Page 3.

For further information:
For more information or to arrange an interview, please contact:

Laine Jaremey Tiana DiMichele
GCI Group (Canada) Bayer Inc.
416-486-7224 416-240-5466
laine.jaremey@gcicanada.com

http://www.newswire.ca/en/story/886139/visanne-is-the-first-oral-treatment-approved-in-more-than-10-years-for-canadian-women-with-endometriosis

Endometriosis

2011-11-26T07:55:00.000-05:00

This patient education video explains endometriosis. Endometriosis is a common medical condition that affects women. The program covers anatomy, symptoms, causes, diagnosis, and treatment options.

Taking birth-control pills — but not for birth control

2011-11-21T05:44:00.000-05:00

By Jennifer LaRue Huget
Oral contraceptives are quite the multi-taskers these days.

A new report finds that of the 11.2 million women ages 15 to 44 who use oral contraceptives, 86 percent do so primarily to prevent pregnancy, while the remaining 14 percent — 1.5 million women — take them solely for other reasons. Those reasons include easing menstrual cramps or pain, regulating menstrual cycles, relieving symptoms of endometriosis and controlling acne. The report further found that more than three quarters of a million women who take the pill report never having had sex.

The report was written and published by the nonprofit Guttmacher Institute (which works to “advance sexual and reproductive health and rights,” according to its Web site) and drawn from data collected through the federal National Survey of Family Growth.

The report could help clarify, or further muddy, the controversy over whether the federal government should require insurance companies to cover the cost of birth control, including oral contraceptives.

By Jennifer LaRue Huget | 07:00 AM ET, 11/18/2011

http://www.washingtonpost.com/blogs/the-checkup/post/taking-birth-control-pills--but-not-for-birth-control/2010/12/20/gIQAbKieVN_blog.html

'Top Chef' Host Padma Lakshmi On Dealing With Her Chronic Pain From Endometriosis

2011-11-20T11:10:00.000-05:00

Padma Lakshmi, an author, model and Emmy-nominated host of Bravo's "Top Chef," suffered chronic pain every month for 23 years before she was finally diagnosed with endometriosis at age 36.

"I even had regular exams, and I had an ovarian cyst removed. They said everything would be better, but it didn't, and that was the tip of the iceberg," Lakshmi, now 41, said in an interview with HuffPost. "If I had been diagnosed at 20, or 25, the quality of my life would have been drastically different."

Endometriosis is actually quite common, affecting 8.5 million women in North America, though many are not diagnosed until their mid-20s, according to the Endometriosis Foundation of America, a non-profit organization Lakshmi co-founded with her doctor, Dr. Tamer Seckin, MD, to educate girls and young women about the condition. Just last month, the foundation held a conference to teach nurses about endometriosis, as they are often the first to see potential signs of the condition.

Undiagnosed and untreated, endometriosis causes abnormally painful cramping, bloating and nausea, and can even lead to infertility, according to the Mayo Clinic. It's often confused for ovarian cysts, pelvic inflammatory disease and irritable bowel syndrome. There is no cure for the condition, which occurs when the endometrium (the tissue that lines the inner part of the uterus) grows outside of the uterus, most commonly on the ovaries, bowel or the tissue that lines the pelvis, according to the Mayo Clinic. Depending on the pain, painkillers, hormone therapy, surgery and even hysterectomy are options for treating the condition.

Risk factors for the condition include having a shorter-than-normal menstrual cycle, having never given birth and having a family history (a mom, aunt or sisters) of the disease, the Mayo Clinic reported.

Lakshmi's in the family history camp. Her mother had undiagnosed endometriosis, and so when Lakshmi grew up experiencing the severe pain every month, she thought "it was just my lot in life."

Click here to read the rest: http://www.huffingtonpost.com/2011/11/15/padma-lakshmi-endometriosis-chronic-pain_n_1094003.htm l

Endometriosis slowly emerges as a debilitating Disease for Women

2011-11-17T12:24:00.000-05:00

Endometriosis slowly emerges as a debilitating Disease for Women
PDF | Print | E-mail

Written by Cleophas Mutinda

Imagine a pain in your abdomen so excruciating that you are unable to get out of bed for several days every month. That is horrible enough, but when it continues 12 times a year for more than 27 years, majority of people would agree it is cruel.

Most women with endometriosis will recognise this shocking scenario as not imaginary, but very real. They know the misery of pelvic pain and have poignant stories of how endometriosis has devastated their lives with terrible suffering. Many women feel angry or despondent about being robbed off a normal life during teenage, adulthood and even sometime a ruined motherhood.

Endometriosis is a gynaecological condition, which occurs when, cells like the ones (endometrial cells) lining inside of the uterus (womb) grow outside, usually on the surfaces of organs in pelvic and abdominal areas. It can be found within the peritoneal cavity, on the ovaries and the bowels or bladder. In extremely rare cases, endometriosis can be found in lungs or other parts of the body. Endometriosis can affect any menstruating woman, from time of her first period to menopause, regardless of race, ethnicity or socio-economic status. Endometriosis rarely persists after menopause. The disorder, for which there is no absolute cure, affects over 70 million women and girls worldwide. Often stigmatized as simply “painful periods,” Endometriosis is a puzzling and widely misunderstood illness.

It is not known exactly what causes endometriosis. But over the years several theories have been advanced to explain the probable cause of the disease although none can fully explain the various clinical manifestations of the disease. A theory proposed by John Sampson in the 1920s, suggests that endometriosis may result from something called “retrograde menstrual flow”, in which some of the tissue that a woman sheds during her period flows back through the tubes and grows in the pelvic cavity. While studies show that retrograde menstrual flow is a universal phenomenon among women of reproductive age, the theory fall short of explaining why the tissues survive in some women, but fail in others. Another theory proposed by Iwanoff in 1898, claims that, the transformation of what we call coelomic epithelium into endometrial-like tissue may be a cause of endometriosis. This theory has been supported by experimental data. The induction theory, proposes that an endogenous factor can induce peritoneal cells to develop into endometrial tissue. This theory has been supported by experiments in rabbits.

Lymphatic or vascular hypothesis suggests that endometrial fragments may be transported through blood vessels or the lymphatic system to other parts of the body. This theory speculates how endometriosis ends up in distant sites, such as the lung, brain, or the skin. A genetic linkage has been adduced which claims that, this disease could be inherited, or result from genetic errors, making some women more prone to develop the condition than others.

Studies show that the risk of endometriosis is seven times greater if the disease has affected a first-degree relative. This theory has been supported by experiments in mouse model but has not been verified either in women. Immunological etiology (cause) has also been conjured since studies report that many women with endometriosis exhibit immunological abnormalities. It is speculated that the immune system may fail to clear the menstrual debris in the pelvic cavity, allowing the endometrial cells to implant and develop into endometriosis.

Also most scientists agree that endometriosis is exacerbated by oestrogen; a hormone involved in the thickening of the endometrium and appears to promote the growth of disease implants. Some studies have pointed out environmental factors like toxins may contribute to the development of endometriosis, though this theory has not been confirmed and remains controversial.

The most common symptoms of endometriosis are abdominal pain and infertility. Some studies have reported that endometriosis may occur in 30%-40% of women with infertility and the incidence of endometriosis in women with pelvic pain may be higher than 50%.

Endometriosis associated pain may include but not limited to extremely painful (disabling) menstrual cramps, chronic pelvic pain (which includes lower back pain and pelvic pain), pain during or after sex, painful bowel movements or painful urination during menstrual periods, heavy menstrual periods and bleeding between periods. The amount of pain a women feels is sometimes not linked to degree of endometriosis. Some women have no pain even though their disease is extensive, while others have severe chronic pelvic pain even though they have only few affected areas.

The relation between endometriosis and pain is still shrouded in the mist of intricate puzzle and ignorance. Many women with endometriosis feel pain during their periods. Normally, a woman’s menstrual cycle involves her endometrial tissue to build up, breaks down into blood and tissue debris, and is shed as her menstrual flow or period. This cycle of growth and shedding happens every month under normal condition. Endometriosis grows outside the uterus and also goes through a similar cycle, build-up, breakdown and bleed every month. The problem is the tissue is in the wrong place and can’t leave the body the way a woman’s period normally does. Studies show that as part of this process, endometriosis may spur the production of substances that may irritate the nearby tissue, as well as provoke the release of chemicals that cause or mediate pain. Over time, endometriosis areas can grow and become nodules or bumps on the surface of pelvic organs, or become cysts (fluid-filled sacs) in the ovaries and may cause the organs in the pelvic area to adhere together.

Endometriosis is more than just simple "killer" cramps. Women and girls around the world continue to suffer in silence with a disease that can be potentially devastating to every aspect of their lives. It can be so painful as to render a woman or teenager unable to care for herself or her family, attend work, school, or social functions, or go about her normal routine. Endometriosis has a negative impact on the individual quality of life, affecting both physical and emotional well-being. A study by the American Endometriosis Association, demonstrated that 81% of the endometriosis patients in USA were unable to work, including household chores, because of pelvic pain. Approximately 27% were incapacitated for 3 or more days and 87% complained of fatigue or low energy. These figures are indicators of enormous suffering, in addition to the healthcare costs incurred. The need to develop intervention strategies is eminent, a published poll reveals women have to wait an average of 11.7 years in US and 8 years in UK to get a correct diagnosis after the initial onset of symptoms and a patient will seek the counsel of five or more physicians before her pain is adequately addressed and diagnosed. Once diagnosed, it is not unusual for a patient to undergo repeat surgeries and embark on many different medical therapies in an attempt to treat her symptoms. Endometriosis is a bit puzzling. We do not know why it causes such extreme symptoms in some women, while less in others. The treatment options can sometimes be unsuccessful. Sadly, endometriosis is associated with menstruation, sex, infertility, and pain (taboos in many societies), thus it is a disease that is not well known, understood, or accepted in the general public. This is frustrating for those who suffer from endometriosis, and for those who care for someone with the disease.

There is no non-invasive test to diagnose endometriosis. In fact, the only gold standard diagnosis of endometriosis is a surgical procedure known as laparoscopy and confirm histologically by taking a biopsy of the suspicious tissue.

However, this is an expensive, minimally invasive procedure. Furthermore, a specialised surgeon is needed for adequate assessment of the pelvis, for recognition of the various types and appearances of the disease. If the patients decline surgery, this makes diagnosis a challenge, and therefore an experienced gynaecologist should be able to recognise symptoms suggestive of endometriosis. The fact that there is no non-invasive diagnostic test for endometriosis is frustrating for clinicians as well as for women with the disease and underscores the need for search of better diagnostic tools.

Since the cause of endometriosis remains unknown, a treatment that fully cures the disease is yet to be developed. Choosing a holistic, treatment option comes down to the individual woman's needs, depending on symptoms, age, and reproductive desires.

Pain is the most common symptom in many women with endometriosis, mainly managed by painkillers, which may vary from simple analgesics to non-steroidal anti-inflammatory drugs. Most researchers agree that endometriosis is exacerbated by oestrogen. Subsequently, hormonal treatments for endometriosis attempt to reverse oestrogen production in a woman's body and thereby alleviate symptoms. However, hormonal therapies have varying degrees of side effects, and unfortunately, whatever pain relief is achieved tends to be only temporary for many women. Most gynaecologists agree that laparoscopic surgery is the only way to diagnose and treat endometriosis. Laparoscopy involves a small cut or incision in the abdomen, inflating the abdomen with harmless gas, and then inserts a viewing instrument with help of light (Laparoscope) into the abdomen. The success of surgery depends largely on the skills of the surgeon and the thoroughness of the surgery. The aim is to remove all endometriosis lesions, cysts, and adhesions. Today, most endometriosis surgery is being done through the laparoscopy, although a full abdominal incision called a laparotomy may still be required in rare cases for extensive disease or bowel resections.

Although the prevalence of endometriosis is well documented in women living in the developed world, studies among African women are still limited. The current myth is that endometriosis rarely affects women of African origin. However, among African-American women in the USA, studies have shown endometriosis is one of the common indications for major gynaecological surgery and hysterectomy, and is associated with a high hospital costs. Although genetically, African-American and African women from the African continent are not necessarily identical given the known genetic admixture among the African-American population. Lack of awareness of endometriosis as a potentially disabling disease and poor access to state-of art diagnostic and therapeutic facilities has contributed to the meagre data on prevalence of the disease in the African population. There is need to initiate awareness campaign of endometriosis to reach all women in Africa. Also to highlight the general lack of information, facilitate endometriosis research efforts and draw attention to the impact and implications of the disease to healthcare systems in our country and the continent in general.

The writer is a Senior Scientist with special interest in endometriosis and ovarian cancer research

http://www.africasciencenews.org/en/index.php/health/63-health/194-endometriosis-slowly-emerges-as-a-life-threatening-disease-for-women

sharing my experience with the robotic laparoscopy and endometriosis

2011-11-12T06:36:00.000-05:00

http://www.youtube.com/watch?v=lTCMy4k9qrE&feature=related

Oxytocin receptor expression in smooth muscle cells of peritoneal endometriotic lesions and ovarian endometriotic cysts.

2011-11-10T18:09:00.000-05:00

Oxytocin receptor expression in smooth muscle cells of peritoneal endometriotic lesions and ovarian endometriotic cysts.
Authors
Mechsner S, Bartley J, Loddenkemper C, et al.
Institution
Endometriosis Research Center Berlin, Department of Gynecology, Charité, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.

Source
Fertil Steril 2005 Apr.:1220-31.
Abstract
To investigate the expression of oxytocin receptor (OTR) in peritoneal and ovarian endometriotic lesions.Retrospective nonrandomized study.University hospital endometriosis research center.Premenopausal women with histologically confirmed endometriosis were selected. Peritoneal endometriotic lesions (n = 120); ovarian endometriotic cysts (n = 40); peritoneal biopsies, distant from the endometriotic lesion (n = 55); and unaffected peritoneal biopsies from patients without endometriosis (n = 11) were obtained. Hysterectomy specimens from patients without endometriosis and/or adenomyosis were used for controls (n = 10).Histopathological examination of peritoneal and ovarian specimens for OTR expression and identification of smooth muscle cells by immunohistochemistry staining with antibodies against OTR and smooth muscle actin. In addition, Western blot analysis, double-immunofluorescence, and in vitro studies with primary cell cultures have been performed.Comparison of the immunoreactive score of the OTR and smooth muscle actin expression with the smooth muscle content in peritoneum with and without endometriosis.In the epithelial cells of endometriotic lesions, we could demonstrate a high OTR expression. The stromal cells were OTR negative with the exception of some single cells. By using a monoclonal anti-smooth muscle actin antibody, these cells could be identified as intrastromal OTR-positive smooth muscle cells. The peritoneum of women with endometriosis shows a significantly higher smooth muscle content than the peritoneum of women without endometriosis. There were no significant differences between the smooth muscle content of active or inactive lesions and the stage of disease.Oxytocin receptor is expressed in smooth muscle cells and epithelial cells of peritoneal endometriotic lesions and ovarian endometriotic cysts. The inhibition of OTR by specific inhibitors might be a useful approach for the treatment of endometriosis-associated pain.

Mesh
Adult
Blotting, Western
Endometrium
Female
Fluorescent Antibody Technique
Humans
Metaplasia
Middle Aged
Myocytes, Smooth Muscle
Myometrium
Ovarian Cysts
Peritoneum
Receptors, Oxytocin

Language
eng

Pub Type(s)
Journal Article Research Support, Non-U.S. Gov't

PubMed ID
15831296
http://www.unboundmedicine.com/anesthesia/ub/citation/15831296/Oxytocin_receptor_expression_in_smooth_muscle_cells_of_peritoneal_endometriotic_lesions_and_ovarian_endometriotic_cysts_

Does laparoscopic management of deep infiltrating endometriosis improve quality of life? A prospective study.

2011-11-09T06:22:00.000-05:00

Deep infiltrating endometriosis (DIE) can affect importantly patients'quality of life (QOL). The aim of this study is to evaluate the impact of the laparoscopic management of DIE on QOL after six months from treatment.MethodS: It is a prospective cohort study.

In a tertiary care university hospital, between April 2008 and December 2009, 100 patients underwent laparoscopic management of DIE and completed preoperatively and 6-months postoperatively a QOL questionnaire, the short form 36 (SF-36).Quality of life was measured through the SF-36 scores. Intra-operative details of disease site, number of lesions, type of intervention, period of hospital stay and peri-operative complications were noted.

Results: : Six months postoperatively all the women had a significant improvement in every scale of the SF-36 (p<0,0005). Among patients with intestinal DIE, significant differences in postoperative scores of SF-36 were not detected between patients submitted to nodule shaving and segmental resection (p>0.05). There were no significant differences in the SF-36 scores at 6 months from surgery between patients who received postoperative medical treatment and patients who did not (p>0.05).

Conclusions: : Laparoscopic excision of DIE lesions significantly improves general health and psycho-emotional status at six months from surgery without differences between patients submitted to intestinal segmental resection or intestinal nodule shaving.

Author: Mohamed MabroukGiulia MontanariManuela GuerriniGioia VillaSerena SolfriniClaudia VicenziGiuseppe MignemiLetizia ZannoniClarissa Frasca'Nadine Di DonatoChiara FacchiniSimona Del FornoElisa GeraciGiulia FerriniDiego RaimondoStefania AlvisiGiulia Gio

http://7thspace.com/headlines/399070/does_laparoscopic_management_of_deep_infiltrating_endometriosis_improve_quality_of_life_a_prospective_study.html

One in ten women ~ Endometriosis

2011-11-05T06:24:00.000-04:00

Endometriosis from Endometriosis.org on Vimeo.

Massachusetts Adopts Groundbreaking Endometriosis Resolution

2011-11-04T08:34:00.000-04:00

http://www.prweb.com/releases/2005/11/prweb306562.htm
Representative Elizabeth A. Poirier (R) introduces Endometriosis Awareness to Massachusetts with the resolution below urging increased awareness of endometriosis.
Email PDF Print .(PRWEB) November 5, 2005

Massachusetts House of Representatives

Urging Increased Awareness of Endometriosis

Whereas, Endometriosis is a painful, reproductive and immunological disease which is a leading cause of female infertility, chronic pelvic pain, and gynecological surgery, and accounts for nearly half the 600,000 hysterectomies performed annually, and endometriosis is more prevalent than Alzheimer's disease, Parkinson's disease and even Breast Cancer, that places significant costs for the individual, and the Commonwealth in medical bills and lost productivity; and

Whereas, Endometriosis can negatively affect a woman or teen's ability to work, attend school, social functions or care for herself and her family, and can frequently be misdiagnosed due to lack of awareness and understanding of the symptoms ; and

Whereas, Endometriosis symptoms include pelvic pain with or without menstruation, infertility, miscarriage, ectopic pregnancy, pain associated with sexual intercourse, gastrointestinal difficulties, fatigue, chronic pain, allergies and other immune system-related dysfunction and associations to diseases including multiple sclerosis, lupus, and fibromyalgia, and endometriosis can lead to painful internal scar tissue know as adhesions, resulting in a complex set of symptoms called Adhesion Related Disorder; and

Whereas, studies have also shown an elevated risk of certain cancers and autoimmune disorders in women with endometriosis and rarely, even malignant changes within the disease itself, thus researchers remain unsure as to the specific cause of endometriosis and there is no definitive cure, and current treatments are often accompanied by significantly negative side effects; and

Whereas, in recognition of the disabling effects endometriosis as a significant disabling disease in women, it is incumbent upon the citizens of the Commonwealth of Massachusetts to support the courageous individuals living and coping with this painful condition; therefore be it

Resolved, That the Massachusetts House of Representatives moves to promote Endometriosis Awareness Month every March and to encourage awareness of the Endometriosis Research Center, The Endometriosis Association, and The International Adhesion Society; and be it

Resolved, That a copy of these resolutions be forwarded by the clerk of the House of Representatives to the Endometriosis Association.

House of Representatives, adopted October 31, 2005

http://www.endometriosisassn.org/
http://www.endocenter.org/
http://www.adhesions.org/
http://endotimes.blogspot.com/

Our deepest gratitude to Representative Elizabeth A. Poirier for her continuing dedication to women's issues in the Commonwealth.

Teen finds relief from debilitating endometriosis

2011-11-04T06:38:00.000-04:00

BY CYNTHIA BILLHARTZ GREGORIAN • cbillhartz@post-dispatch.com > 314-340-8114 STLtoday.com |

Read more: http://www.stltoday.com/lifestyles/health-med-fit/fitness/article_aea7c10e-1f4f-5f7b-8353-1761f10c6d9e.html#ixzz1cjQpZ7fu
Endometriosis is a common disease by most standards. Between 6 percent and 10 percent of women of child-bearing age have the condition, which results when cells from the lining of the uterus grow in other parts of the body.

Yet many women, like Emily Ingargiola, endure intense and prolonged pain and the possibility of infertility because they're misdiagnosed or inadequately treated, says Dr. Patrick Yeung. He intends to change that.

In August, Yeung, one of a handful of OB-GYNs nationwide who call themselves "excisionists," joined SLUCare and formed the Center for Endometriosis at St. Mary's Health Center. Before that, he'd been practicing at Duke University, where he founded a similar center.

The main mission of the clinic, Yeung said, is to take seriously the women who come to him seeking pain relief. In those who prove to have endometriosis, he'll use a CO2 laser to excise it. All of it. No matter how big or small or where it is.

Most doctors only recognize some lesions as endometriosis and won't touch it on certain organs.

The center at St. Mary's also will study the value of excising endometriosis with CO2 lasers compared to more traditional removal methods such as cauterization and ablation, Yeung said. And it will become home to an endometrial tissue bank for further study.

Ingargiola, 19, of High Ridge, became Yeung's first patient shortly after he set up shop in St. Louis.

By then, she and her mother, Nancy Ingargiola, a registered nurse who has worked in obstetrics and gynecology, had grown frustrated with a medical system that initially refused to believe Emily had a problem.

Ingargiola's troubles started shortly after she reached puberty at age 14. At first she had extreme pain but just during menstruation.

Then she started urinating and defecating blood. Her periods were so heavy that she'd use a tampon and maxi-pad simultaneously and bleed through both. The pain started lasting all month, often leaving her doubled over, unable to go to school.

At first, she said, her doctors told her pain was normal. That she was being whiny. Then they said she had irritable bowel syndrome, most likely from stress.

She spent an entire month during her junior year of high school in the hospital. "It's really traumatic to have something going on in your body and having a lot of pain and having doctors not believe you and say that you're crazy," Emily Ingargiola said. "Not being listened to was the hardest part for me."

Finally, in March 2010, doctors at the Mayo Clinic suggested that maybe she had endometriosis. An ultrasound in St. Louis indicated that was likely. When hormone suppressants didn't work, doctors performed laparoscopic surgery and found severe endometriosis on her bladder, bowels, ureter, ovaries and pelvic lining. They ablated it twice. Ablation vaporizes endometrial lesions by either freezing, heating, microwaving or sending electrical currents through them.

It didn't work. The pain and endometriosis returned within weeks.

By this time, Ingargiola was enrolled at Bellarmine University in Louisville, Ky. Out of desperation, she began getting Lupron injections, which suppressed the endometriosis and induced menopause. The side effects were almost as bad as the pain.

"I turned into a different person," Ingargiola said. "I was getting hot flashes, I was completely unable to remember things or focus on school, and I had horrible mood swings."

She had been on Lupron for three months when her mother attended a medical conference and heard about Yeung.

Emily Ingargiola had the laparoscopic CO2 laser excision surgery Aug. 23.

THE TEXTBOOK PATIENT

Ingargiola is the type of patient Yeung hopes to help.

Many OB-GYNs have accepted that recurrences of pain and endometriosis after ablation and cauterization are normal, particularly in teenagers, he said.

But excisionists like Yeung who train at the Center for Endometriosis Care in Atlanta don't accept that.

They're taught to recognize subtle forms of the disease, including the slightest of spots, which other OB-GYNs either miss or dismiss as something else. Then they use a CO2 laser to cut out every last bit of it.

Most OB-GYNs only cauterize or ablate tissue on the surface of organs.

"You might be getting just the tip of the iceberg," Yeung said. "We know endometriosis can invade, and you can't tell which lesions are invading. I and others believe that excision, which is cutting out the entire implant down to healthy tissue, is the only way to 100 percent treat it."

Read more: http://www.stltoday.com/lifestyles/health-med-fit/fitness/article_aea7c10e-1f4f-5f7b-8353-1761f10c6d9e.html#ixzz1cjQa2nB i

Part 2 - Darcy Spears News Report on Lupron Depot - (KTVN, Las Vegas)

2011-11-03T08:44:00.000-04:00

ARDvark Blog Journal of Adhesion Related Disorder: Adhesion-Prevention Strategy in C-Sections: Focus on Risk Reduction

2011-10-26T05:59:00.000-04:00

ARDvark Blog Journal of Adhesion Related Disorder: Adhesion-Prevention Strategy in C-Sections: Focus on Risk Reduction

Endometriosis slowly emerges as a debilitating Disease for Women

2011-10-26T05:57:00.000-04:00

Endometriosis slowly emerges as a debilitating Disease for Women

Written by Cleophas Mutinda
Imagine a pain in your abdomen so excruciating that you are unable to get out of bed for several days every month. That is horrible enough, but when it continues 12 times a year for more than 27 years, majority of people would agree it is cruel.

Most women with endometriosis will recognise this shocking scenario as not imaginary, but very real. They know the misery of pelvic pain and have poignant stories of how endometriosis has devastated their lives with terrible suffering. Many women feel angry or despondent about being robbed off a normal life during teenage, adulthood and even sometime a ruined motherhood.

Endometriosis is a gynaecological condition, which occurs when, cells like the ones (endometrial cells) lining inside of the uterus (womb) grow outside, usually on the surfaces of organs in pelvic and abdominal areas. It can be found within the peritoneal cavity, on the ovaries and the bowels or bladder. In extremely rare cases, endometriosis can be found in lungs or other parts of the body. Endometriosis can affect any menstruating woman, from time of her first period to menopause, regardless of race, ethnicity or socio-economic status. Endometriosis rarely persists after menopause. The disorder, for which there is no absolute cure, affects over 70 million women and girls worldwide. Often stigmatized as simply “painful periods,” Endometriosis is a puzzling and widely misunderstood illness.

It is not known exactly what causes endometriosis. But over the years several theories have been advanced to explain the probable cause of the disease although none can fully explain the various clinical manifestations of the disease. A theory proposed by John Sampson in the 1920s, suggests that endometriosis may result from something called “retrograde menstrual flow”, in which some of the tissue that a woman sheds during her period flows back through the tubes and grows in the pelvic cavity. While studies show that retrograde menstrual flow is a universal phenomenon among women of reproductive age, the theory fall short of explaining why the tissues survive in some women, but fail in others. Another theory proposed by Iwanoff in 1898, claims that, the transformation of what we call coelomic epithelium into endometrial-like tissue may be a cause of endometriosis. This theory has been supported by experimental data. The induction theory, proposes that an endogenous factor can induce peritoneal cells to develop into endometrial tissue. This theory has been supported by experiments in rabbits.

Lymphatic or vascular hypothesis suggests that endometrial fragments may be transported through blood vessels or the lymphatic system to other parts of the body. This theory speculates how endometriosis ends up in distant sites, such as the lung, brain, or the skin. A genetic linkage has been adduced which claims that, this disease could be inherited, or result from genetic errors, making some women more prone to develop the condition than others.

Studies show that the risk of endometriosis is seven times greater if the disease has affected a first-degree relative. This theory has been supported by experiments in mouse model but has not been verified either in women. Immunological etiology (cause) has also been conjured since studies report that many women with endometriosis exhibit immunological abnormalities. It is speculated that the immune system may fail to clear the menstrual debris in the pelvic cavity, allowing the endometrial cells to implant and develop into endometriosis.

Also most scientists agree that endometriosis is exacerbated by oestrogen; a hormone involved in the thickening of the endometrium and appears to promote the growth of disease implants. Some studies have pointed out environmental factors like toxins may contribute to the development of endometriosis, though this theory has not been confirmed and remains controversial.

The most common symptoms of endometriosis are abdominal pain and infertility. Some studies have reported that endometriosis may occur in 30%-40% of women with infertility and the incidence of endometriosis in women with pelvic pain may be higher than 50%.

Endometriosis associated pain may include but not limited to extremely painful (disabling) menstrual cramps, chronic pelvic pain (which includes lower back pain and pelvic pain), pain during or after sex, painful bowel movements or painful urination during menstrual periods, heavy menstrual periods and bleeding between periods. The amount of pain a women feels is sometimes not linked to degree of endometriosis. Some women have no pain even though their disease is extensive, while others have severe chronic pelvic pain even though they have only few affected areas.

The relation between endometriosis and pain is still shrouded in the mist of intricate puzzle and ignorance. Many women with endometriosis feel pain during their periods. Normally, a woman’s menstrual cycle involves her endometrial tissue to build up, breaks down into blood and tissue debris, and is shed as her menstrual flow or period. This cycle of growth and shedding happens every month under normal condition. Endometriosis grows outside the uterus and also goes through a similar cycle, build-up, breakdown and bleed every month. The problem is the tissue is in the wrong place and can’t leave the body the way a woman’s period normally does. Studies show that as part of this process, endometriosis may spur the production of substances that may irritate the nearby tissue, as well as provoke the release of chemicals that cause or mediate pain. Over time, endometriosis areas can grow and become nodules or bumps on the surface of pelvic organs, or become cysts (fluid-filled sacs) in the ovaries and may cause the organs in the pelvic area to adhere together.

Endometriosis is more than just simple "killer" cramps. Women and girls around the world continue to suffer in silence with a disease that can be potentially devastating to every aspect of their lives. It can be so painful as to render a woman or teenager unable to care for herself or her family, attend work, school, or social functions, or go about her normal routine. Endometriosis has a negative impact on the individual quality of life, affecting both physical and emotional well-being. A study by the American Endometriosis Association, demonstrated that 81% of the endometriosis patients in USA were unable to work, including household chores, because of pelvic pain. Approximately 27% were incapacitated for 3 or more days and 87% complained of fatigue or low energy. These figures are indicators of enormous suffering, in addition to the healthcare costs incurred. The need to develop intervention strategies is eminent, a published poll reveals women have to wait an average of 11.7 years in US and 8 years in UK to get a correct diagnosis after the initial onset of symptoms and a patient will seek the counsel of five or more physicians before her pain is adequately addressed and diagnosed. Once diagnosed, it is not unusual for a patient to undergo repeat surgeries and embark on many different medical therapies in an attempt to treat her symptoms. Endometriosis is a bit puzzling. We do not know why it causes such extreme symptoms in some women, while less in others. The treatment options can sometimes be unsuccessful. Sadly, endometriosis is associated with menstruation, sex, infertility, and pain (taboos in many societies), thus it is a disease that is not well known, understood, or accepted in the general public. This is frustrating for those who suffer from endometriosis, and for those who care for someone with the disease.

There is no non-invasive test to diagnose endometriosis. In fact, the only gold standard diagnosis of endometriosis is a surgical procedure known as laparoscopy and confirm histologically by taking a biopsy of the suspicious tissue.

However, this is an expensive, minimally invasive procedure. Furthermore, a specialised surgeon is needed for adequate assessment of the pelvis, for recognition of the various types and appearances of the disease. If the patients decline surgery, this makes diagnosis a challenge, and therefore an experienced gynaecologist should be able to recognise symptoms suggestive of endometriosis. The fact that there is no non-invasive diagnostic test for endometriosis is frustrating for clinicians as well as for women with the disease and underscores the need for search of better diagnostic tools.

Since the cause of endometriosis remains unknown, a treatment that fully cures the disease is yet to be developed. Choosing a holistic, treatment option comes down to the individual woman's needs, depending on symptoms, age, and reproductive desires.

Pain is the most common symptom in many women with endometriosis, mainly managed by painkillers, which may vary from simple analgesics to non-steroidal anti-inflammatory drugs. Most researchers agree that endometriosis is exacerbated by oestrogen. Subsequently, hormonal treatments for endometriosis attempt to reverse oestrogen production in a woman's body and thereby alleviate symptoms. However, hormonal therapies have varying degrees of side effects, and unfortunately, whatever pain relief is achieved tends to be only temporary for many women. Most gynaecologists agree that laparoscopic surgery is the only way to diagnose and treat endometriosis. Laparoscopy involves a small cut or incision in the abdomen, inflating the abdomen with harmless gas, and then inserts a viewing instrument with help of light (Laparoscope) into the abdomen. The success of surgery depends largely on the skills of the surgeon and the thoroughness of the surgery. The aim is to remove all endometriosis lesions, cysts, and adhesions. Today, most endometriosis surgery is being done through the laparoscopy, although a full abdominal incision called a laparotomy may still be required in rare cases for extensive disease or bowel resections.

Although the prevalence of endometriosis is well documented in women living in the developed world, studies among African women are still limited. The current myth is that endometriosis rarely affects women of African origin. However, among African-American women in the USA, studies have shown endometriosis is one of the common indications for major gynaecological surgery and hysterectomy, and is associated with a high hospital costs. Although genetically, African-American and African women from the African continent are not necessarily identical given the known genetic admixture among the African-American population. Lack of awareness of endometriosis as a potentially disabling disease and poor access to state-of art diagnostic and therapeutic facilities has contributed to the meagre data on prevalence of the disease in the African population. There is need to initiate awareness campaign of endometriosis to reach all women in Africa. Also to highlight the general lack of information, facilitate endometriosis research efforts and draw attention to the impact and implications of the disease to healthcare systems in our country and the continent in general.

The writer is a Senior Scientist with special interest in endometriosis and ovarian cancer research

http://www.africasciencenews.org/en/index.php/health/63-health/194-endometriosis-slowly-emerges-as-a-life-threatening-disease-for-women

Putting the pieces together: endometriosis blogs, cognitive authority, and collaborative information behavior

2011-10-24T05:07:00.000-04:00

J Med Libr Assoc. 2011 April; 99(2): 127–134.
doi: 10.3163/1536-5050.99.2.004 PMCID: PMC3066582

Copyright © 2011, Authors.
Putting the pieces together: endometriosis blogs, cognitive authority, and collaborative information behavior*
Diane M Neal, PhD
Assistant Professor ; Email: dneal2@uwo.caPamela J McKenzie, PhD
Associate Professor and Assistant Dean Research; Faculty of Information and Media Studies, The University of Western Ontario, North Campus Building, Room 240, London, ON, Canada N6A 5B7 ; Email: pmckenzi@uwo.caReceived June 2010; Accepted October 2010.
Readers may use articles without permission of copyright owners, as long as the author and MLA are acknowledged and the use is educational and not for profit. Other Sections▼
AbstractINTRODUCTIONMETHODSRESULTSDISCUSSIONCONCLUSIONSREFERENCESAbstractObjective:
A discourse analysis was conducted of peer-written blogs about the chronic illness endometriosis to understand how bloggers present information sources and make cases for and against the authority of those sources.Methods:
Eleven blogs that were authored by endometriosis patients and focused exclusively or primarily on the authors' experiences with endometriosis were selected. After selecting segments in which the bloggers invoked forms of knowledge and sources of evidence, the text was discursively analyzed to reveal how bloggers establish and dispute the authority of the sources they invoke.Results:
When discussing and refuting authority, the bloggers invoked many sources of evidence, including experiential, peer-provided, biomedical, and intuitive ones. Additionally, they made and disputed claims of cognitive authority via two interpretive repertoires: a concern about the role and interests of the pharmaceutical industry and an understanding of endometriosis as extremely idiosyncratic. Affective authority of information sources was also identified, which presented as social context, situational similarity, or aesthetic or spiritual factors.Conclusions:
Endometriosis patients may find informational value in blogs, especially for affective support and epistemic experience. Traditional notions of authority might need to be revised for the online environment. Guidelines for evaluating the authority of consumer health information, informed by established readers' advisory practices, are suggested. Other Sections▼
AbstractINTRODUCTIONMETHODSRESULTSDISCUSSIONCONCLUSIONSREFERENCES Highlights
•Endometriosis patients who blog about the illness may determine authority of information sources through both cognitive and affective methods.
Implications
•Because patients with chronic illnesses might have different authority criteria than medical librarians do, it could be useful to carefully incorporate electronic patient discussion forums, medical blogs written by laypeople, and other nontraditionally authoritative resources into consumer health information selection policies. Standard biomedical resources are certainly important to recommend to consumers, but they do not convey the complete picture of a chronic illness and its related experience.
•Patients with chronic illnesses and caregivers can benefit from sources such as blogs and online discussion lists that provide social and emotional support as well as accounts of “lived experience.”
•An understanding of the patient's potential epistemological community can make the librarian's recommendations more appropriate for the individual user.
Other Sections▼
AbstractINTRODUCTIONMETHODSRESULTSDISCUSSIONCONCLUSIONSREFERENCESINTRODUCTIONChronic illness is a context in which people may do a great deal of “information work” [1]. Chronic illnesses are often broad in scope and effect, difficult to diagnose, complex, ever changing, and not amenable to conventional treatments. They often have significant physical, emotional, and social repercussions, and their management requires work by the ill person and those around the ill person, much of which may require considerable time and energy, be mentally and emotionally demanding, and occur beyond doctors' offices [1].A major barrier to information access expressed by people with chronic illnesses is the difficulty of finding information relevant to their situations [1, 2]. Chronic illness is an important impetus for collaborative information behavior [3, 4]: As do information seekers in other contexts, people with chronic illnesses tend first to seek help or information from people like themselves [5]. Acquaintances with the same disease can provide socially appropriate opportunities to expose a seeker to disease-relevant information and support [6]. The desire for support underlies the creation of resources, services, and groups in which peers physically or virtually “come together to provide emotional and other support through sharing their personal lived experience as well as exchanging other resources” [7]. Participants in health-oriented support groups [8, 9] and online resources such as discussion forums and peer-authored blogs [10] report receiving both informational and emotional support. Illness blogs have many of the advantages of face-to-face peer sources without the stigma of approaching a peer with a personal question [6].Peer sources may also offer a highly valued and particularly relevant kind of information based on “wisdom and know-how gained through reflection upon personal lived experience” [11] rather than on professional knowledge. Experiential knowledge “consists of the statements, stories or narratives reflecting some aspect of an individual's experience that she or he values and trusts as knowledge. To an uninvolved observer, much experiential knowledge may sound like or appear to be small talk or everyday conversation” [11].The significance of experiential knowledge for people with chronic illnesses poses particular challenges for information professionals, who are schooled in selecting traditionally authoritative resources and employing evidence-based techniques for evaluating health information sources. Selection criteria for a health sciences journal include, among other things, its perceived “scholarly” status, its publisher, the affiliations of the journal's authors and editors, and its impact factor [12]. Health sciences monograph selection tools consist of resources such as core lists, vendors, and book reviews in medical journals [13]. Guidelines for consumer health information collection development focus on patient education literature written by health professionals, as well as by patient advocacy and professional organizations. Consumer-oriented library materials might also include general medical reference books [14]. These and other standard evaluation criteria assume that the most authoritative resources are authored by health care professionals and researchers. However, people with chronic illnesses may use authority criteria that are completely distinct from those that information professionals use [15]. For example, while a blog describing the author's experience with a chronic disease is unlikely to meet librarians' traditional standards for authority, it might be considered very authoritative by someone who is learning to cope emotionally with a new diagnosis [16].Library and information science (LIS) researchers have long been interested in the ways that individuals and communities evaluate the authority of information sources. The concept of cognitive authority has offered a useful framework for explaining an individual's situated judgments about the authority of information sources [17]. Cognitive authority is a particularly important concept for understanding users' evaluations of web resources [18]. It has been defined by Rieh, following Wilson [17], as “the extent to which users think that the information is useful, good, current, and accurate. Cognitive authority is operationalized as to the extent to which users think that they can trust the information” [18]. More recently, LIS researchers have adopted new approaches to the study of authority that consider not the cognitive processes by which an individual makes decisions about an information source, but the social practices whereby a community collaboratively negotiates what counts as an authoritative information source [19–,21]. Depression patients were found to rely on a wide range of resources, while using personal, experiential knowledge as confirmation of treatment effectiveness [20]. A study of the ways that members of a chronic illness community collectively filter, interpret, evaluate, and synthesize as they share can provide insight into the ways that authority is developed and challenged in that community [4]. Studies such as this can provide practitioners with new ways of thinking about the criteria they use when evaluating or recommending peer sources for chronic illness.This article analyzes the ways that peer bloggers with endometriosis present information sources and make cases for and against their authority. Endometriosis is an enigmatic chronic disease that causes uterine tissue implantation in areas other than the uterus. Highly underdiagnosed, it may affect up to 25% of reproductive-age women. Symptoms vary widely, but the most frequent complaint is pelvic pain, and endometriosis is a cause of common infertility. The broad spectrum of presentation and symptoms, as well as the absence of satisfactory treatments, leaves patients largely at a loss for information that they perceive as reliable [22]. For these reasons, Whelan characterizes women with endometriosis who work together to find answers as an “epistemological community” [23]. This analysis will show how bloggers' justification strategies draw on understandings that members of their specific epistemological community commonly hold.Blogs authored by people with chronic illness are of particular interest to LIS researchers, because they provide naturalistic sources of data about the blogger's illness-related information work [2], including selection, justification, evaluation, and interpretation of information identified by the blogger from other sources. Comments and links on blogs provide evidence of what Talja and Hansen call a “community of sharing” [4], a group of people who develop shared understandings and create knowledge structures that may in turn be used by others. Blogs allow both members and nonmembers of epistemic cultures to interact in dialogue and to participate in the culture [24]. They therefore offer the possibility of extending the face-to-face social networks that Veinot [6] has shown to mediate information validation. LIS researchers have begun to study social and community aspects of health- and illness-related information work [6, 25–,27]. Important findings about the readers of illness blogs have been identified [10]. However, there has so far been little consideration of what the blogs themselves can tell librarians and researchers about how people living with chronic illness evaluate information sources.
Read More : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3066582/

New Concepts in Diagnosis and Treatment Summarized from ISGE 8th Annual Congress

2011-10-24T04:52:00.000-04:00

By Ted L. Anderson, M.D., Ph.D.
October 24, 2011
"What is the hardest of all to do? To see with our eyes what our eyes lay before us. (Paraphrased, with apologies from Goethe) That essentially is the message of the innovative efforts of Ms. Deborah Bush, Chairperson of the New Zealand Endometriosis Foundation. She has developed an interactive Menstrual Health and Endometriosis Education Program that has been presented to over 40,000 young women (ages 15-24), educators and clinicians. There has been an overwhelmingly positive response as this population gained better knowledge of what is "normal" and how to recognize the symptoms of endometriosis. Of note, anecdotal reports show this program has resulted in increased referrals to gynecologists and increased early diagnosis and treatment. Hopefully, such early intervention will mitigate the long-term sequellae of adhesions, pain and infertility. On the other hand, it is too often that we dismiss endometriosis as a source of pelvic and rectal pain, especially in young women and after hysterectomy and salpingo-oophorectomy.

However, infiltrative endometriosis involving the apical vaginal wall, the anterior rectal wall and the soft tissues of the cul-de-sac are not uncommon. This is the advice from Dr. Ray Garry and his colleagues from WEL Foundation, South Cleveland Hospital, Middleborough, UK. Using his techniques of radical laparoscopic excision, he excises the tissue bounded by the uterosacral ligaments laterally, the anterior rectal wall posteriorly and the posterior cervix. Then he removes the tissue en bloc. This technique offers relief from dysmenorrhea, dyspareunia, rectal pain and general pelvic pain in over 80% of his patients as measured by a standardized questionnaire. They have not examined the potential added benefit of hormonal suppressive therapy pre or post-operatively. Despite excellent results in this difficult patient population, this group continues to follow long-term success, as will we, with great interest."

The patient with pelvic pain continues to be one of the greatest therapeutic challenges to gynaecologists. There have been few developments in recent years that will impact treatment success in these patients, as we will likely see with conscious laparoscopy and pain mapping. This was illustrated beautifully in an excellent workshop on pelvic pain, moderated by Dr. Christopher Sutton (The Guilford Nuffield Hospital, Surrey, UK). Our concepts of pain aetiologies were challenged by Dr. FM. Howard (Rochester General Hospital, NY, USA), who provided evidence that endometriosis lesions accounted for only 1/3 of pain described by patients during conscious pain mapping, with adhesions accounting for another 1/3. This group called into question the routine use of postoperative GnRH agonists in this patient population. Dr. John Steege (University of North Carolina, USA), demonstrated the power of pain mapping by showing a procedure without sound in a post-hysterectomy patient with adhesions involving the pelvic sidewall and vaginal cuff, as well as an ovarian remnant. After an audience poll of operative options, he replayed the tape with audio feedback from the patient during the procedure. Much to our surprise, this experience changed the opinion of appropriate operative intervention in a substantial number of participants. Dr. Lawrence Demco (University of Calgary, Canada), illustrated his techniques of pain mapping through multiple video clips. Interestingly, many patients described pain with touching of peritoneal surfaces up to 2.5 cm away from visible endometriotic lesions. Additionally, he demonstrated that the pain perceived by the patient frequently does not correlate with the position of lesions or pain elicited during mapping. For example, touching visible endometriosis on the left pelvic sidewall often correlated with right-sided pelvic pain experienced by the patient. Using these techniques to guide subsequent operative interventions, he has described greater than 80% of patients remain pain free at 6 months follow-up. Dr. Sutton presented his prospective randomized double-blinded study that demonstrated the efficacy of operative treatment for stage I-III endometriosis compared with no treatment. Not surprisingly, there was increasing benefit of surgical treatment with advancing endometriosis stage. Additionally, he presented the results of a study showing no additional benefit of LUNA when endometriosis is ablated surgically. Certainly the message we can learn from this workshop will continue to guide our ability to understand and treat pelvic pain.

http://hcp.obgyn.net/pelvic-pain/content/article/1760982/1975952

ARDvark Blog Journal of Adhesion Related Disorder: Asherman's Syndrome

2011-10-20T05:51:00.000-04:00

ARDvark Blog Journal of Adhesion Related Disorder: Asherman's Syndrome

Ovarian cyst

2011-10-14T05:08:00.000-04:00

An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. Any ovarian follicle that is larger than about two centimeters is termed an ovarian cyst. An ovarian cyst can be as small as a pea, or larger than an orange.

Most ovarian cysts are functional in nature and harmless (benign).[1] In the US, ovarian cysts are found in nearly all premenopausal women, and in up to 14.8% of postmenopausal women.[citation needed]

Ovarian cysts affect women of all ages. They occur most often, however, during a woman's childbearing years.

Some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to remove cysts larger than 5 centimeters in diameter.

Classification[edit] Non-functional cystsThere are several other conditions affecting the ovary that are described as types of cysts, but are not usually grouped with the functional cysts. (Some of these are more commonly or more properly known by other names.) These include:

Dermoid cyst
Chocolate cyst of ovary: An endometrioma, endometrioid cyst, endometrial cyst, or chocolate cyst is caused by endometriosis, and formed when a tiny patch of endometrial tissue (the mucous membrane that makes up the inner layer of the uterine wall) bleeds, sloughs off, becomes transplanted, and grows and enlarges inside the ovaries.
A polycystic-appearing ovary is diagnosed based on its enlarged size — usually twice normal —with small cysts present around the outside of the ovary. It can be found in "normal" women, and in women with endocrine disorders. An ultrasound is used to view the ovary in diagnosing the condition. Polycystic-appearing ovary is different from the polycystic ovarian syndrome, which includes other symptoms in addition to the presence of ovarian cysts.
Ovarian serous cystadenoma
Ovarian mucinous cystadenoma
[edit] Signs and symptomsSome or all of the following symptoms[2] [3] [4] [5] [6] may be present, though it is possible not to experience any symptoms:

Dull aching, or severe, sudden, and sharp pain or discomfort in the lower abdomen (one or both sides), pelvis, vagina, lower back, or thighs; pain may be constant or intermittent—this is the most common symptom
Fullness, heaviness, pressure, swelling, or bloating in the abdomen
Breast tenderness
Pain during or shortly after beginning or end of menstrual period.
Irregular periods, or abnormal uterine bleeding or spotting
Change in frequency or ease of urination (such as inability to fully empty the bladder), or difficulty with bowel movements due to pressure on adjacent pelvic anatomy
Weight gain
Nausea or vomiting
Fatigue
Infertility
Increased level of hair growth
Increased facial hair or body hair
Headaches
Strange pains in ribs, which feel muscular
Bloating
Strange nodules that feel like bruises under the layer of skin
[edit] Diagnosis
A 2cm left ovarian cyst as seen on ultrasound
An Axial CT demonstrating a large hemorrhagic ovarian cyst. The cyst is delineated by the yellow bars with blood seen anteriorly.
A CT scan showing a 8.5 cm cyst in a 29 year old female.Ovarian cysts are usually diagnosed by either ultrasound or CT scan.

[edit] TreatmentAbout 95% of ovarian cysts are benign, meaning they are not cancerous.[7]

Treatment for cysts depends on the size of the cyst and symptoms.

Pain caused by ovarian cysts may be treated with:

pain relievers, including acetaminophen/paracetamol (Tylenol), nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil), or narcotic pain medicine (by prescription) may help reduce pelvic pain.[8] NSAIDs usually work best when taken at the first signs of the pain.
a warm bath, or heating pad, or hot water bottle applied to the lower abdomen near the ovaries can relax tense muscles and relieve cramping, lessen discomfort, and stimulate circulation and healing in the ovaries.[9] Bags of ice covered with towels can be used alternately as cold treatments to increase local circulation.[10]
combined methods of hormonal contraception such as the combined oral contraceptive pill – the hormones in the pills may regulate the menstrual cycle, prevent the formation of follicles that can turn into cysts, and possibly shrink an existing cyst. (American College of Obstetricians and Gynecologists, 1999c; Mayo Clinic, 2002e)[8]
Also, limiting strenuous activity may reduce the risk of cyst rupture or torsion.

Cysts that persist beyond two or three menstrual cycles, or occur in post-menopausal women, may indicate more serious disease and should be investigated through ultrasonography and laparoscopy, especially in cases where family members have had ovarian cancer. Such cysts may require surgical biopsy. Additionally, a blood test may be taken before surgery to check for elevated CA-125, a tumor marker, which is often found in increased levels in ovarian cancer, although it can also be elevated by other conditions resulting in a large number of false positives.[11]

For more serious cases where cysts are large and persisting, doctors may suggest surgery. Some surgeries can be performed to successfully remove the cyst(s) without hurting the ovaries, while others may require removal of one or both ovaries.[12][13]

[edit] References1.^ "Ovarian Cysts Causes, Symptoms, Diagnosis, and Treatment". eMedicineHealth.com. http://www.emedicinehealth.com/ovarian_cysts/article_em.htm .
2.^ "Ovarian cysts: Symptoms". MayoClinic.com. http://www.mayoclinic.com/health/ovarian-cysts/DS00129/DSECTION=2 .
3.^ [1]
4.^ "Ovarian Cysts Causes, Symptoms, Diagnosis, and Treatment". eMedicineHealth.com . http://www.emedicinehealth.com/ovarian_cysts/page3_em.htm .
5.^ "Ovarian Cysts – Symptoms, Treatment and Prevention". HealthScout. http://www.healthscout.com/ency/1/725/main.html#SymptomsofOvarianCysts .
6.^ "Ovarian Cysts". http://www.medicineonline.com/topics/O/2/Ovarian-Cysts.html .
7.^ http://www.nhs.uk/Conditions/Ovarian-cyst/Pages/Symptoms.aspx
8.^ a b "Ovarian Cysts Treatment & Monitoring". Medicine Online. http://www.medicineonline.com/topics/O/2/Ovarian-Cysts/info/Treatment-&-Monitoring.html .
9.^ [2]
10.^ [3]
11.^ MedlinePlus Encyclopedia CA-125
12.^ "HealthHints: Gynecologic Health (January/February, 2003)". Texas AgriLife Extension Service: HealthHints. http://fcs.tamu.edu/health/health_education_rural_outreach/Health_Hints/2003/jan-feb/gynecologic_health.php .
13.^ http://ovariancystinfo.weebly.com/ Cyst on Ovary
[edit] External links"Ovarian cyst Introduction". Health encyclopaedia – NHS Direct. http://www.nhs.uk/conditions/Ovarian-cyst/Pages/Introduction.aspx. Retrieved 3 May 2011.
David B. Redwine, MD. "Endometriosis Persisting after Removal of the Uterus, Ovaries and Fallopian Tubes, Removing Disease, Not Organs, Key to Long-Term Relief". http://www.endometriosistreatment.org/html/reprint7.html . Retrieved 23 February 2009.
"Hemorrhagic Ovarian Cyst". http://www.hemorrhagicovariancyst.com/.

"Corpus Luteum Cyst". http://donorivf.org/articles/corpus-luteum-cyst/.

"Ovarian cyst symptoms". http://www.ovariancystreatment.com/category/ovarian-cyst-symptoms/.
http://en.wikipedia.org/wiki/Ovarian_cyst

Chronic pain series helps public to see the 'invisible'

2011-10-13T04:19:00.000-04:00

Chronic pain series helps public to see the 'invisible'

Re: Chronic pain series, Oct. 1-5

The series typified the reality of people who live with chronic pain. I am thankful for those pieces of journalism. Most of the public still doesn't understand what chronic pain sufferers live with.

My daughter suffers from a number of "invisible" yet crippling disabilities including endometriosis. She is an attractive, engaging, committed and hard-working 26-year-old forced to rely on opiates to get through her day.

Some days she can't get out of bed. Some days her entire body feels like it's been beaten. Some days the pain is "manageable."

Some days she can't function because she has had to take too many opiates to squelch the pain.

People would never guess she is sick because she looks so "beautiful." And every day she needs to justify her illness to someone because it isn't something you can see.

Her good fortune is that she has the support, strength and courage to carry on. Through her family, a few friends and excellent health care professionals she has advocates who do understand.

Chronic pain can be a life sentence - lack of knowledge about it doesn't have to be.

Shirley Ross

Vancouver

Read more: http://www.vancouversun.com/health/Chronic+pain+series+helps+public+invisible/5536855/story.html#ixzz1aeDpkw1L

Abdominal pain may be sign of endometriosis

2011-10-12T04:54:00.000-04:00

By Christi Myers

HOUSTON (KTRK) -- Women who experience unexplained abdominal pain could be facing endometriosis. The condition can be difficult to diagnose, so here's what women need to look for when it comes to that.

"The nurse and the doctor both looked at me and looked at my stomach and said, 'You look like you're seven months pregnant' and I'm like, 'I know and I'm not pregnant,'" Janet Strickland said.

Strickland was frustrated by her swollen abdomen and the pain she was having. She spent thousands of dollars on tests but got no answers.

"Everyone of those six doctors had told me there's nothing wrong with me," she said.

The doctors were wrong. After four years janet finally got an answer. Fertility Specialists of Houston Dr R.K. Mangal found severe endometriosis, which occurs when the menstrual flow goes back into the body, coating organs like glue.

"It spreads out to the pelvis, into the bowel cavity; we've seen it in lungs, we've seen it in patients with the diaphragm, so anywhere in the abdominal cavity which makes sense," Dr. Mangal said.

Endometriosis can start with painful menstrual cramps, pain during sex, bladder pain, colon pain, and infertility and more. Treatment often starts with the birth control pill to reduces the flow, and laser surgery to remove endometriosis from internal organs.

"I might have been with another doctor and they might have just wanted to do a total hysterectomy because I had it all over," Strickland said.

Instead Dr. Mangal was able to remove it but it took two surgeries to do it, and despite damage that remains, children are still possible.

"I think Janet has a good chance of having a baby," Dr. Mangal said.

But the surgeries, the tests and the pain could have been avoided had one of the first six doctors found it earlier.

Many women only discover they have endometriosis when they have infertility problems. Experts say by catching it early, women can often avoid infertility issues.

What you don't know can hurt you: Knowledge is Power in a Doctor/Patient Relationship

2011-10-10T08:16:00.001-04:00

Meet Jennifer Lewis, a long time endo sufferer and advocate for victims of endometriosis.

What you don't know can hurt you: Knowledge is Power in a Doctor/Patient Relationship
By Jennifer Lewis | October 7, 2011

I was intimidated from the get-go. I was a 23 year old woman going on her fourth Laparoscopy for endometriosis. I had been experiencing severe pain and abnormal bleeding with and w/o my periods since I was fifteen, diagnosed with endometriosis at eighteen and already had three surgical laparoscopies to remove the endometial growths. This time the doctor wanted to try a different technique called a LUNA or uterine ablation. This procedure severs the ligaments in the uterus thus reducing pain created by cramping during menstruation. By this time I was having varying degrees of bleeding throughout the month as well as pain that did not correlate with my periods. I thought, "what the heck, maybe the fourth times’ a charm". I didn’t research the fact that LUNA’s are only of considerable benefit to women with pain DIRECTLY associated with their periods. At the time of the surgery I was in pain 75% of the time, and it was NOT only related to what by now had become unbearable menstruation. By the time I was 25 I had two more similar surgeries to relieve pain and abnormal bleeding caused by the regrowth of the endometrial tissue. I inquired on more than one occasion about a hysterectomy but was told by the heroes in white coats that I was either too young, I would regret it, menopause at my age would be ghastly, maybe I should seek therapy and learn to "live" with the pain"(that was a good one!) or that I should, as one of my FORMER GYN’s put it, "Swallow the pain medication and Buck Up". Essentially, I let my doctor be the ringmaster of the circus inside my body. I was intimidated by the number of degrees on his walls and the various snapshots of smiling new mothers and newborns; all having had complete faith in this physician to lead them down the path to a better life. Why should I think any different? I mean, who am I, Jennifer, to question a man who spent half his life learning how to practice medicine? But my gut and my instinct were pulling me in another direction; a direction that saved my life.

Only after seven surgical procedures, years on addictive narcotic medications, high doses of mind altering hormones, ER visits, catheterizations and mental anguish did I learn how to learn about being a patient. After experiencing fear and abandonment along with complete lack of faith in both the field of medicine and the doctors who practice it did I begin my true healing. Essentially, I became my own health advocate, and it changed my life.

Knowledge is power, plain and simple. Whether you are stricken with a life threatening illness or dealing with a persistent problem that affects the quality of your life you must take your health and any problems associated with it and ATTACK it with knowledge. In being your own advocate, it is essential that you approach your provider with sense of self and dignity; a competent individual who is aware of her own body. Your own research on and about the issue at hand is vital as well as your own personal ammunition; use it! As much as your physician would like to be, she/he may not be current on all of the cutting edge research and experimental trials that you may be eligible for. Go to the local University or college and research the medical section. The local hospital will also have up to date periodicals and medical journals that may contain useful information. In doing your own research, you become better able to understand your options. Only then can you make an informed consent on the treatment best suited for you. Utilize your provider as you would a consultant. This will enable a mutually effective exchange and your doctor will not only respect your interest in your own healthcare but respond to it.

It took me ten years of chasing white coats until I sat still enough to see my pattern. Be it intimidation, laziness or apathy, I had no regard for my most precious gift, my health. This is a society where we are inherently trained to entrust our healthcare in the hands of doctors. Asking for a second opinion, questioning a test result or inquiring about or expressing concerns over medications you may be taking can be difficult at best. When I was faced with the option of having my seventh surgery I began to really sit and think about my body, my goals (realistic) of the outcome of the surgery as well as the quality of my life. I was not comfortable speaking freely and easily with my current provider so I changed doctors. Instead of walking in her office uninformed, I confidently presented her with a list of questions I had, similar case studies and outcomes of the treatments and my realistic goals. I was able to weigh the pros and the cons intelligently and make an informed decision based on both my research and her professional experience. Less than two weeks later I had a total hysterectomy, something I had wanted and inquired about many times before only to be told that I could not possibly know for certain that was what I wanted because I was too young, too disillusioned or just too naïve about the consequences. Only after ten years did I find restitution in having the total hysterectomy and the ironic thing is that I was fought all that time by the doctors who proclaimed they wanted to help me. I got better when I finally decided to help myself.

Questions to ask your doctor include:

What are the benefits of doing this?
What are the risks involved?
What are my other options?
What should I do first?
What are the probable outcomes of each of these options?
What are the probable outcomes if I decide NOT to do this?
How many times have you performed/administered this drug before and what were the outcomes?

Remember, this is your body, your healthcare and your decision. Every woman has the potential to be her own powerhouse when it comes to her body, seize the opportunity or someone in a white coat will.

Jennifer Lewis
Author, Endometriosis: One Womans Journey
Freelance writer

http://hcp.obgyn.net/hysterectomy/content/article/1760982/1965908

Adhesion Related Disorder International Human Rights Team IHRT: Press Release: Cochrane Collaboration statement on access to clinical trial data

2011-10-08T09:06:00.000-04:00

Endometriosis.

2011-10-08T06:47:00.000-04:00

Niger J Med. 2011 Apr-Jun;20(2):191-9.
Endometriosis.
Okeke TC, Ikeako LC, Ezenyeaku CC.
SourceDepartment of Obstetrics & Gynaecology University of Nigeria Teaching Hospital, Enugu, Nigeria. Ubabikctochukwu@iyahoo.comendometriosis

Abstract
BACKGROUND: Endometriosis is a common mysterious and fascinating gynaecological condition with diverse clinical manifestations, highly variable and unpredictable clinical course with decreased quality of life. Despite extensive research, endometriosis is fraught with controversies.

METHODS: Review of pertinent literature on endometriosis, selected references, internet services through gynaecological search which have been critical in the understanding of this puzzling gynaecologic condition were included in the review.

RESULTS: Endometriosis most commonly afflict women in there late 20s and 30s. The classic symptom complex include dysmenorrhoea, dyspareunia, menorrhagia and infertility. About 30% of the patients are asymptomatic. The incidence of infertility amongst women suffering from endometriosis ranges from 30%-40%. The factors implicated in causing endometriosis-associated infertility are multiple and its management is shrouded in controversy, complex and imperfectly understood.

CONCLUSION: Inspite of diverse clinical manifestations, variable and unpredictable clinical course, there is a chance to improve pregnancy rates with improvement in assisted reproductive technology.

PMID:21970227[PubMed - in process]
http://www.ncbi.nlm.nih.gov/pubmed/21970227

Adhesion Info: Diagnostic Laparoscopy and Adhesiolysis: Does It Help with Complex Abdominal and Pelvic Pain Syndrome (CAPPS) in General Surgery?

2011-10-07T09:38:00.000-04:00

Adhesion Info: Diagnostic Laparoscopy and Adhesiolysis: Does It Help with Complex Abdominal and Pelvic Pain Syndrome (CAPPS) in General Surgery?

Neurocrine Wins $20M from Abbott Related to Elagolix for Endometriosis

2011-10-06T05:38:00.000-04:00

Neurocrine Biosciences received a $20 million milestone payment from Abbott following a pre-Phase III meeting with FDA on the companies' treatment of endometriosis-related pain called elagolix. That brings the total milestone payments paid by Abbott in the third quarter of this year up to $30 million.

Last month Neurocrine received a $10 million milestone fee after Abbott started a Phase II trial to evaluate elagolix in the treatment of uterine fibroids. The firms' partnership, valued at $575 million, covers elagolix for endometriosis and all next-generation gonadotropin-releasing hormone (GnRH) antagonists for a variety of women’s and men’s health conditions.

Under the exclusive, worldwide collaboration, inked in June 2010, Abbott is responsible for all development, marketing, and commercialization costs and will be entitled to an undisclosed percentage of worldwide sales of GnRH compounds. Abbott made an up-front payment of $75 million.

Neurocrine could receive additional milestone payments of about $500 million from Abbott toward achievement of certain development, regulatory, and commercial milestones; funding for certain internal collaboration expenses; plus royalty payments on any future product sales.

http://www.genengnews.com/gen-news-highlights/neurocrine-wins-20m-from-abbott-related-to-elagolix-for-endometriosis/81245782/

http://www.genengnews.com/gen-news-highlights/neurocrine-wins-20m-from-abbott-related-to-elagolix-for-endometriosis/81245782/

Endometriosis Therapeutics- Pipeline Assessment and Market Forecasts to 2018

2011-10-05T05:20:00.000-04:00

NEW YORK, Sept. 28, 2011 /PRNewswire/ -- Reportlinker.com announces that a new market research report is available in its catalogue:

Endometriosis Therapeutics- Pipeline Assessment and Market Forecasts to 2018

http://www.reportlinker.com/p0648874/Endometriosis-Therapeutics--Pipeline-Assessment-and-Market-Forecasts-to-2018.html#utm_source=prnewswire&utm_medium=pr&utm_campaign=NoCategory

Endometriosis Therapeutics- Pipeline Assessment and Market Forecasts to 2018

Summary

GlobalData, the industry analysis specialist, has released its new report, "Endometriosis Therapeutics- Pipeline Assessment and Market Forecasts to 2018". The report is an essential source of information and analysis on the global endometriosis therapeutics market and identifies the key trends shaping and driving it. The report also provides insights on the prevalent competitive landscape and the emerging players expected to significantly alter the market positioning of the current market leaders. Most importantly, the report provides valuable insights on the pipeline products within the global endometriosis therapeutics sector. This report is built using data and information sourced from proprietary databases, primary and secondary research and in-house analysis by GlobalData's team of industry experts.

GlobalData estimates that the global endometriosis therapeutics market was valued at $785m in 2010 and will grow at a Compound Annual Growth Rate (CAGR) of 5.9% to reach $1,239m by 2018. This steady growth is primarily attributed to the recently launched product, Visanne (dienogest) and the expected launch of the pipeline product, Elagolix (NBI-56418) in 2015 in the US and Europe. Organizations, such as the Endometriosis Special Interest Group (EndoSIG), through their work are creating awareness about the disease among the general public. This increasing awareness and the resultant higher treatment seeking rates for the disease are also expectecd to contribute to the growth of the market. The current market is underserved due to the lack of specific as well as non-invasive diagnostic techniques, alongside low disease awareness and the poor safety and moderate efficacy profiles of the current marketed therapies. There is a high unmet need which is largely driven by the unavailability of products with adequate efficacy and safety profiles.

Scope

The report provides information on the key drivers and challenges of the endometriosis therapeutics market. Its scope includes -

- Annualized seven key markets (US, France, Germany, Italy, Spain, UK and Japan) endometriosis therapeutics market revenues data from 2005 to 2010, forecast for eight years to 2018.

- Pipeline analysis data providing a split across the different phases, mechanisms of action being developed and emerging trends. Pipeline candidates fall under major therapeutic classes of GnRH agonists, GnRH antagonists, Aromatase inhibitors and others.

- Analysis of the current and future competition in the global endometriosis therapeutics market. Key market players covered are Nobelpharma, Novartis AG and Neurocrine Biosciences/Abbott.

- Insightful review of the key industry drivers, restraints and challenges. Each trend is independently researched to provide a qualitative analysis of its implications.

- Key topics covered include strategic competitor assessment, market characterization, unmet needs and the implications for the endometriosis therapeutics market.

- Analysis of key recent licensing and partnership agreements in the endometriosis therapeutics market.

Reasons to buy

The report will enhance your decision making capability. It will allow you to -

- Develop and design your in-licensing and out-licensing strategies through a review of pipeline products and technologies and by identifying the companies with the most robust pipeline.

- Develop business strategies by understanding the trends shaping and driving the global endometriosis therapeutics market.

- Drive revenues by understanding the key trends, innovative products and technologies, market segments and companies likely to impact on the global endometriosis therapeutics market in the future.

- Formulate effective sales and marketing strategies by understanding the competitive landscape and by analyzing the performance of various competitors.

- Identify emerging players with potentially strong product portfolios and create effective counter-strategies to gain a competitive advantage.

- Organize your sales and marketing efforts by identifying the market categories and segments that present maximum opportunities for consolidations, investments and strategic partnerships.

- What's the next big thing in the global endometriosis therapeutics market landscape? – Identify, understand and capitalize.

To order this report:

: Endometriosis Therapeutics- Pipeline Assessment and Market Forecasts to 2018

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Nicolas Bombourg
Reportlinker
Email: nbo@reportlinker.com
US: (805)652-2626
Intl: +1 805-652-2626

SOURCE Reportlinker

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Adhesion Related Disorder International Human Rights Team IHRT: CONFLUENT SPRAYSHIELD MAUDE Adverse Event Report

2011-10-04T15:30:00.000-04:00

ARDvark Blog Journal of Adhesion Related Disorder: Abdominal/Pelvic Pain Can Occur After Surgery.

2011-10-04T08:33:00.000-04:00

ARDvark Blog Journal of Adhesion Related Disorder: Abdominal/Pelvic Pain Can Occur After Surgery.

Endometriosis can Reach Your Bowel and Bladder

2011-10-04T07:52:00.000-04:00

Endometriosis can Reach Your Bowel and Bladder
By Deborah Ross
Having endometriosis is tricky business. For many women, it’s something you have to “look forward to” every month. Sometimes friends and family don’t understand the pain you are enduring with your cycle. And sometimes endometriosis is causing abnormalities in your reproductive area, pelvis and gut that you can’t even feel.

As defined by the American Congress of Obstetricians and Gynecologists, endometriosis occurs when the tissue that normally lines the uterus and gets shed during menstrual cycles for some reason is found growing outside the uterus, usually on the ovaries, fallopian tubes or other pelvic structures. In many cases that endometrium -- the lining -- can cause problems such as chronic abdominal pain, pressure or fullness in the pelvis, debilitating menstrual cramps, pain with intercourse and, sadly, infertility, according to ACOG.

Endometriosis can be an issue not only in a woman’s reproductive area, but also in the bowel and bladder. That’s because the displaced tissue responds to changes in hormones and can break down and bleed each month just as if it were in the uterus. Scar tissue, or adhesions, can form, sometimes binding organs together with painful results.

So, for many women having endometriosis, it’s not just the discomfort of a menstrual cycle but also pain that extends outward toward the digestive system. During a menstrual period, there can be diarrhea, constipation, bloating, nausea, aches in the lower back, and pain during bowel movements and urination.

More than 5 million American women have endometriosis, with it most often hitting women in their 30s and 40s, according to a fact sheet from womenshealth.gov.

The fact sheet also noted that sometimes women can have endometrial growths in a number of areas outside the uterus yet feel no pain. On the other hand, some women with endometriosis have only a few abnormal growths and still feel severe pain.

Researchers are looking at associations between endometriosis and a number of conditions, including allergies, autoimmune diseases, chronic fatigue syndrome, certain cancers and yeast infections.

Read More:

http://www.empowher.com/endometriosis/content/endometriosis-can-reach-your-bowel-and-bladder

ARDvark Blog Journal of Adhesion Related Disorder: The inpatient burden of abdominal and gynecological adhesiolysis in the US

2011-10-04T07:44:00.000-04:00

ARDvark Blog Journal of Adhesion Related Disorder: The inpatient burden of abdominal and gynecological adhesiolysis in the US

Endometriosis: sharing resources and pooling knowledge

2011-10-03T05:52:00.000-04:00

By Lone Hummelshøj Managing Editor, EndoZone.org | October 2, 2011

Dysmenorrhoea, infertility, bowel problems, nausea, dyspareunia, vomiting, fatigue and chronic pelvic pain are all symptoms associated with endometriosis. They are also topics that are taboo in today’s society. These are not issues that we can discuss over Sunday lunch with our nearest and dearest, nor at a family party, and often not even with our friends. These are not issues with which any of us would necessarily wish to be associated, but an estimated 89 million women and girls need to deal with these symptoms — and so do their physicians.

Both of these groups have unmet needs. Effective treatment options is one of them; the other is information about current knowledge and resources that will enable them to put together an individualised treatment plan tailored to the personal circumstances of the woman in question: be it to tackle pain, to resolve subfertility, or both.

Competing for time and being able to provide timely information is one of the challenges of the 21st century. The Internet enables a new way of thinking and a new way of interacting with each other.

The expert patient
According to the International Alliance of Patients’ Organisations, ‘All patients, no matter their condition, background or nationality, have a fundamental and legitimate human right of access to all kinds of information about their health, medical conditions and the availability of treatments including knowledge of the best available management for their disease’[1].

The era of the educated consumer has arrived. For women, a growing desire for information parallels a wish to take more responsibility for their health and be more involved in their treatment decisions. Patients accept less and less that health care professionals should unilaterally make these decisions for them. However, whilst women may be experts at having endometriosis, they are not experts at treating the disease. They need access to information about their options and expect health care professionals to act increasingly as facilitators or partners (Table I).
Click here to read more: http://hcp.obgyn.net/hysterectomy/content/article/1760982/1960967

ARDvark Blog Journal of Adhesion Related Disorder: Adhesion-Related Complications Are Common, But Rarely Discussed in Preoperative Consent: A Multicenter Study

2011-09-29T05:38:00.000-04:00

ARDvark Blog Journal of Adhesion Related Disorder: Adhesion-Related Complications Are Common, But Rarely Discussed in Preoperative Consent: A Multicenter Study

ARDvark Blog Journal of Adhesion Related Disorder: Abdominal/Pelvic Pain Can Occur After Surgery.

2011-09-27T05:21:00.000-04:00

ARDvark Blog Journal of Adhesion Related Disorder: Abdominal/Pelvic Pain Can Occur After Surgery.

Endometri-what? THE Female Trouble

2011-09-27T05:11:00.000-04:00

By Jenn | Published: September 8, 2011

As I flipped through the 2011 Philly Fringe catalogue this summer, Cathy Quigley’s show Female Trouble almost didn’t catch my eye. To me, Female Trouble is a 1974 John Waters movie, a Charm City roller girls team or a reference that is bound to be offensive when it comes out of the mouth of a man (sorry, men). Ironically, this Female Trouble is the Fringe show I am most looking forward to seeing during the Festival this year because, as I found out, it’s the one I can relate to the most.

There are fifteen female performers, ranging in age from 18 to 50, in Cathy’s production, a multimedia performance about endometriosis. Endometri-what? (That, coincidently is the working title of my book about the disease.) This disease affects 10-15% of all women and is one of the top causes of infertility in women in this country. Normally, a women’s uterus will collect and grow tissue to prep itself for a baby and if said woman doesn’t become pregnant, it will release the endometrial lining that has formed. (This is her period.) When a woman has endometriosis, that endometrial tissue not only attaches itself to the uterus walls but also outside the uterus. Most commonly, it will create cysts on the ovaries but in more extreme cases, it can attach to other organs like the bowels, the intestines, even the lungs. The inflammation of the tissue not only affects the way the organ works but also creates a great deal of pain and fatigue in the woman suffering from endometriosis. Forty percent of all women who have endometriosis are infertile.

“This is a show about the patient,” Cathy told me when we spoke. “And while it focuses on endometriosis, it is about women’s health in general. My goal is to teach women to become their own activists when it comes to their health.”

After the jump: The challenges of diagnoses, and the intersection of drama, culture, and fertility.

Cathy doesn’t have to convince me. My endometriosis knowledge is not because of pre-interview research. I was diagnosed at age twenty one and since then, I’ve had two surgeries and even on days where I’m sure, to you, I look fine, I’m probably not. Endometriosis is not fatal but the pain is life altering. While learning how to decrease my own external symptoms of the disease, I saw nine doctors in six weeks. This is not uncommon, as Cathy confirmed.

“When I was in my twenties,” Cathy told me. “I suffered a lot of bizarre medical issues. My period was irregular and painful. I had a lot of stomach pain.” After two years of uncomfortable tests and probing by doctors, a nurse practitioner asked Cathy if she had ever heard of endometriosis.

“Ten to fifteen of women have this disease,” Cathy said. “And yet, it took two years for a medical professional to mention it [to me].”

Cathy became obsessed, something she and I have in common even though she doesn’t suffer from the disease. Laposcopic surgery showed she didn’t have the disease but she did have a ruptured cyst on her ovary. Once a surgeon cleaned that up and Cathy changed her diet, she felt much better. This is an illness that few doctors know about, and that has no cure. While wome speculate on the causes — and I find that those speculations come more from patients than from doctors -– there is no concrete explanation of where it comes from. 176,000,000 women suffer from this disease and yet, it has an average nine-year diagnosis rate: it takes nine years from the time a woman tells her doctor she has the symptoms of it to the time where a medical professional actually diagnoses her as having the disease.

Cathy and I talked about how endometriosis is a “silent” disease. It doesn’t have 5K races or marathons. It doesn’t have a designated ribbon. Mention it and women might have heard of it, or know someone who has it, but few can tell you exactly what it is or how it works.

While I believe that, among other things, that little is known because our society is so uncomfortable with talking about sex (one of the most common symptoms of endometriosis is painful sex for the woman with the disease), Cathy also thinks women’s relationship with fertility has a lot to do with it.

Cathy became interested in fertility while working on Female Troubles, the first version of which was her senior project at Montclair State University.

“In Western Culture,” Cathy says, “Women are obsessed with having a child. From a very young age, females are conditioned to have children. We are given dolls when we are kids and we are told to babysit when we are in high school. It is not always an easy thing to conceive a child and women don’t talk about that. It’s almost a taboo. But women are obsessed with it. You can see a Viagra commercial every time you turn on the television.” But no one is trying to sell you a drug to prevent your female parts from disintegrating during the next commercial break.

Her view on fertility is only one of Cathy’s sentiments that won me over. It is also something I can relate to. As an artist myself, I know that there are ways to create or give birth in today’s world that have nothing to do with giving birth to and raising a child however; as a victim of the disease (endometrial lesions were so heavy that they caused my fallopian tubes to fold over on themselves), infertility will always make me feel biologically broken.

“My hope is to be able to tour this piece to colleges and other spots where I can raise awareness about the disease,” Cathy said. “I’m not an ignorant person. I am educated and knowledgeable but until I dug deep into the research, I hadn’t even heard of the disease. With this piece, I want to raise awareness, explore why doctors know very little about women’s health and create an open dialogue to discuss these ideas.”

Female Trouble runs at 8:00 pm on Saturday, September 10 at 8:00 pm and at 2:00 pm on Sunday, September 11 at the Painted Art Bride Center, 230 Vine Street. $14.

–Jennifer Leah Peck
http://blog.livearts-fringe.org/2011/09/08/endometri-what-the-female-trouble

Early-Stage Endometriosis Diagnosis Possible With New Test

2011-09-26T06:49:00.000-04:00

Main Category: Women's Health / Gynecology
Article Date: 22 Sep 2011 - 2:00 PDT
A new test has been developed by surgeons and scientists based at Southampton's teaching hospitals, that could transform they way early-stage endometriosis is diagnosed.

In an investigation funded by the Infertility Research Trust, Miss Ying Cheong, a consultant gynecologist and co-funder of the Complete Fertility Center in Southampton, together with Dr. Tracey Newman, an academic at the University of Southampton's faculty of medicine, used small particles marked with fluorescent markers to bring to light areas of affected tissue.

Endometriosis, a female health disorder that occurs when small pieces of the uterus grow on to different organs such as the ovaries and fallopian tubes, that can cause heavy bleeding, stomach and back pain as well as infertility, can take up to seven to surface. In the UK, approximately 2 million women are affected by this condition, several of whom are diagnosed between 25 and 40 years of age.
Click here to read the rest of the article: http://www.medicalnewstoday.com/articles/234802.php

ARDvark Blog Journal of Adhesion Related Disorder: Adhesions, Adhesions-Related Disorder or CAPPS – a way to think about the problem from the patient’s perspective.

2011-09-26T06:17:00.000-04:00

ARDvark Blog Journal of Adhesion Related Disorder: Adhesions, Adhesions-Related Disorder or CAPPS – a way to think about the problem from the patient’s perspective.

2011-09-26T05:42:00.000-04:00

ARDvark Blog Journal of Adhesion Related Disorder: Adhesions, Adhesions-Related Disorder or CAPPS – a way to think about the problem from the patient’s perspective.

ARDvark Blog Journal of Adhesion Related Disorder: ¿Cuál es el desorden relacionado las adherencias (ARD)?

2011-09-24T09:26:00.000-04:00

ARDvark Blog Journal of Adhesion Related Disorder: ¿Cuál es el desorden relacionado las adherencias (ARD)?

Surgical encounters in Endometriosis

2011-09-24T07:13:00.000-04:00

From Ad-Lap surgical group
http://www.adlap.com/endoNodules.htm

Nodules, Cul-de-sac disease, endometriomas, Extensive endometriosis means bulky deep fibrotic endometriosis deposits that can often be palpated preoperatively as tender pelvic nodules. These nodules consist of endometriosis glands and stroma surrounded by fibromuscular tissue that has accumulated over many years in response to cyclic monthly activation of the endometriosis. They represent a longstanding chronic inflammatory response.

Cul-de-sac Obliteration
In the female without previous hysterectomy, the anterior peritoneal reflection on the rectum (rectouterine pouch or pouch of Douglas) folds at an average distance of 4 cm from the anal verge. The rectovaginal fascial septum separates the rectum from the vagina.

In 1921, Sampson defined cul-de-sac obliteration as “extensive adhesions in the cul-de-sac obliterating its lower portion and uniting the cervix or the lower portion of the uterus to the rectum; with adenoma of the endometrial type invading the cervical and the uterine tissues and probably also (but to a lesser degree) the anterior wall of the rectum.” (7) Cul-de-sac obliteration secondary to endometriosis implies the presence of retrocervical deep fibrotic endometriosis beneath the peritoneum. This endometriosis is located on or in the anterior rectum, posterior vagina, posterior cervix (the cervical vaginal angle between the upper vagina and the cervix), the rectovaginal septum, or the uterosacral ligaments; often one area predominates.

Partial cul-de-sac obliteration (PCDSO) means that deep fibrotic endometriosis is severe enough to alter the course of the rectum, fusing it to a portion of posterior vagina. With complete cul-de-sac obliteration (CCDSO), fibrotic endometriosis and/or adhesions involve the entire cul-de-sac between the cervicovaginal junction (and sometimes above) and the rectum.

At laparoscopy, careful inspection of the cul-de-sac is necessary to evaluate the extent of upward tenting of the rectum. To determine if cul-de-sac obliteration is partial or complete, a sponge on a ring forceps is inserted into the posterior vaginal fornix (and a rectal probe in the rectum). The normal cul-de-sac will show a portion of vaginal wall between the cervix and rectum as a distinct and separate bulge. The utero-sacral ligaments will be of normal calibre and lateral. Partial cul-de-sac obliteration occurs when rectal tenting is visible but a protrusion from the sponge in the posterior vaginal fornix is noted between the rectum and the inverted “U” of the uterosacral ligaments. Complete cul-de-sac obliteration is diagnosed when the outline of the sponge in the posterior fornix cannot be visualised initially through the laparoscope: the rectum or fibrotic endometriosis nodules completely obscure the identification of the deep cul-de-sac.

Partial and complete cul-de-sac obliteration are the same disease, requiring the same surgical dissection. Both indicate that deep fibrotic endometriosis is present on the anterior rectum and the posterior vagina, areas from which it can be completely excised. Yet the American Society of Reproductive Medicine Classification makes partial obliteration Stage 1 and complete cul-de-sac obliteration Stage 4; go figure it!

Endometriomas
Preoperatively, transvaginal sonography is done to evaluate the ovaries in cases involving a pelvic mass, retrocervical nodules, or fibroids, and a CA 125 assay is obtained if persistent enlargement is documented. Ultrasound findings of a round shaped adnexal mass with thick wall and homogeneous, low-level echo pattern is highly suggestive of endometrioma. Another pattern has irregular margins with septations and an anechoic appearance. Intravenous pyelograms (IVP) are rarely necessary preoperatively, as ureteral dilation is readily evident at laparoscopic examination. An IVP is ordered postoperatively if abdominal pain persists after surgery on or near the ureter. Presently, there is no indication for CT scan or MRI prior to laparoscopic ovarian surgery.

In all cases careful inspection of the abdomen and pelvis is done. The ovaries are evaluated for visual evidence of malignancy. Washings are taken if indicated. Endometriomas are drained by mobilizing them from the pelvic sidewall.

Enlarged ovaries containing cysts are either free in the peritoneal cavity or attached to the pelvic sidewall, uterosacral ligament, or cul-de-sac. If attached to these structures, the cyst is frequently an endometrioma. An aquadissector is used to mobilize the ovaries by lifting them from the pelvic sidewall. Often this maneuver will result in drainage of chocolate-like hemosiderin filled fluid from the undersurface of the ovary. After this occurs, the ovary is completely mobilized from the pelvic sidewall to its hilum using aquadissection and careful blunt dissection to reduce pelvic sidewall peritoneal damage. If no endometrioma is readily identified, and the patient has “unexplained infertility” or pre- or postmenstrual spotting, a knife electrode connected to monopolar cutting current (70 W) is used to incise and drain areas on the ovary with superficial endometriosis and cysts suspicious for endometrioma. The clinical distinction between an endometrioma (pathology to be excised) and a corpus luteum cyst (normal, vascular tissue best left alone) may be difficult, and conservative discretion is advised to avoid the trauma and risk of removing normal tissue. An endometrioma has a thick white fibrotic capsule while a corpus luteum cyst capsule is yellow.

If an endometrioma is discovered by either of these two methods, the cyst cavity is rinsed with lactated Ringer’s solution and then excised using 5 mm biopsy forceps, grasping forceps, and sometimes scissors (Semm, Mettler 1980)(Reich, McGlynn 1986). Experience has proven that drainage is not enough. Ovarian endometriomas up to 15 cm are excised. The cyst wall is most firmly attached to the ovarian cortex in the area of cyst rupture during mobilization, i.e., the portion that was adhered to the pelvic sidewall or uterosacral ligament, and not to the portion near the ovarian hilum. To help create an initial plane between normal ovarian cortex and endometrioma cyst wall, cutting current (70 W) through a knife electrode tip is applied at the cyst wall-cortex junction to develop a dissection plane in this firmly attached area. This step is particularly useful near the utero-ovarian ligament as rough avulsion can lead to excessive bleeding. The laparoscope is brought close to the area of dissection, magnifying it to identify the cyst wall clearly. This incision is extended through the visible 360o opening if possible. The cutting current will destroy endometriosis at the ovarian cortex-endometrioma junction while making a divot of separation between the two structures. Thereafter, biopsy or grasping forceps are placed to stabilize the ovarian cortex and endometrioma cyst wall while traction is exerted on the endometrioma cyst wall to peel it from inside the ovary. If the cyst wall is felt to be incompletely excised, the cyst cavity can be desiccated or fulgurated to destroy any remaining endometrioma. Otherwise, the endometrioma may recur. Excision can be done with minimal bleeding from the cyst wall bed and the ovarian wall edges usually reapproximate quite well, though occasionally extracorporeal suturing is required, especially after removal of large endometriomas. Hemostasis is checked by underwater examination inside the ovary, and individual bleeders are identified using irrigation through an irrigating channel and coagulated with microbipolar forceps. When removal results in a large, asymmetrical defect, the ovary is suture repaired, usually with one purse-string absorbable suture, applied close to the utero-ovarian ligament in one direction and the infundibulopelvic ligament in the other. Although suturing is not thought to be necessary for reapproximation by many surgeons, anyone who has operated on many of these women realizes that the open ovary is very receptive to small and large bowel; I suspect that those who preach that all ovaries should not be suture repaired are not comfortable with suturing techniques.

In most cases of ovarian endometrioma, endometriosis of the pelvic sidewall and/or uterosacral ligament is present. These lesions should be excised after enucleation of the endometrioma to prevent recurrence. Pelvic sidewall endometriosis peritoneal excision usually requires ureterolysis to free the underlying ureter from the lesion.

Oophorectomy can also be considered for pain or mass arising from ovarian endometrioma in women not desiring future fertility. This is especially indicated for left pelvic pain if the left ovary is enmeshed in rectosigmoid adhesions because they tend to recur.

Before removal, the ovary is released from all pelvic sidewall and bowel adhesions. It is imperative that the surgeon visualize the course of the ureter. The peritoneum above the ureter is opened with sharp scissors. Smooth grasping forceps are then opened parallel and perpendicular to the retroperitoneal structures until the ureter is identified. Scissors can be used to further dissect the ureter throughout its course along the pelvic sidewall.

The uterus is anteverted and displaced to the contralateral side. The fallopian tube is grasped and pulled medially to stretch out the infundibulopelvic ligament containing the ovarian vessels. The anterior and posterior leaves of the broad ligament are opened with scissors lateral and medial to the infundibulopelvic ligament and a free ligature (2-0 Vicryl) passed through the window thus created and tied extracorporeally using the Clarke-Reich knotpusher. This is repeated twice until two proximal ties and one distal one are placed, and the ligament then divided. While applying traction to the cut distal pedicle, the broad ligament is divided to the round ligament just lateral to the uteroovarian artery anastomosis using cutting current through a spoon electrode. Two free ligatures are placed around the uteroovarian ligament, which is then divided.

Alternatively, Kleppinger bipolar forceps are used to compress and desiccate the infundibulopelvic ligament, the broad ligament, the fallopian tube isthmus, and the utero-ovarian ligament with bipolar cutting current (25-35 W). In most cases, 3 contiguous areas are desiccated. Laparoscopic scissors are used to divide the pedicle. (Reich H, 1987)

The free ovary is removed through the umbilicus or cul-de-sac. Large endometriomas are usually sufficiently cystic and pliable that, once separated from the pelvic sidewall, they can be removed through the umbilical incision.

When the ovary is retroperitoneal, embedded in the pelvic sidewall, a lateral approach is advocated. The peritoneum lateral to the ovary and the infundibulopelvic ligament where it crosses the iliac vessels is incised with dissecting scissors and the broad ligament opened by bluntly separating the extraperitoneal areolar tissues. The peritoneal incision is extended to the round ligament, lateral to the infundibulopelvic ligament. The infundibulopelvic ligament is pulled medially with grasping forceps to expose the ureter at the pelvic brim where it crosses the common or external iliac artery. It may be necessary to reflect the ureter off the medial leaf of the broad ligament for a short distance to aid in its identification, although this is not always required. The infundibulopelvic ligament is ligated, divided, and its distal cut end put on traction with traumatic grasping forceps for the rest of the oophorectomy. The medial leaf of the broad ligament with its contained ovary is freed from the pelvic sidewall vessels and areolar tissue. The ureter is peeled off the retroperitoneal ovary for most of its pelvic course until the uteroovarian ligament can be isolated and divided.

--------------------------------------------------------------------------------

References
Cornillie FJ, Oosterlynck D, Lauweryns JM, Koninckx PR. Deeply infiltrating pelvic endometriosis: histology and clinical significance. Fertil.Steril. 1990;53:978-983.

Koninckx PR, Meuleman C, Demeyere S, Lesaffre E, Cornillie FJ. Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil.Steril. 1991;55:759-765.

Koninckx PR, Barlow D, Kennedy S. Implantation versus infiltration: The Sampson versus the endometriotic disease theory. GYNECOLOGIC.AND.OBSTETRIC.INVESTIGATION. 1999;47

Martin DC, Hubert G D, Levy B S. Depth of infiltration of endometriosis. Journal of Gynecologic Surgery, 5:55-60, 1989.

Reich H, McGlynn F: Treatment of ovarian endometriomas using laparoscopic surgical techniques. J of Reprod Med 1986;31:577-84.

Reich H, McGlynn F: Laparoscopic oophorectomy and salpingo-oophorectomy in the treatment of benign tuboovarian disease. J Reprod Med 1986; 31:609.

Reich H: Laparoscopic oophorectomy and salpingo-oophorectomy in the treatment of benign tubo-ovarian disease. Int J Fertil 1987; 32:233-236

Reich H: Laparoscopic oophorectomy without ligature or morcellation. Contemp Ob Gyn 1989;9:34-46

Reich H. New techniques in advanced laparoscopic surgery. In Laparoscopic surgery. Sutton C, ed. Bailliere’s Clinical Obstetrics and Gynecology. WB Saunders, Philadelphia London. 1989;3:655-81.

Semm K, Mettler L: Technical progress in pelvic surgery via operative laparoscopy. Am J Obstet Gynecol 1980; 138:121

Adhesion Related Disorder International Human Rights Team IHRT: Karen Steward writes "Autobiography" Is she confessing her love with Dr. Kruschinski after all?

2011-09-24T07:04:00.000-04:00

ARDvark Blog Journal of Adhesion Related Disorder: From Clinical Trails.Gov

2011-09-23T08:04:00.000-04:00

ARDvark Blog Journal of Adhesion Related Disorder: From Clinical Trails.Gov

ARDvark Blog Journal of Adhesion Related Disorder: “September 23rd is ARD AWARENESS Day!”

2011-09-22T08:03:00.000-04:00

ARDvark Blog Journal of Adhesion Related Disorder: “September 23rd is ARD AWARENESS Day!”

Karen Stewards tries to shut down adhesion web site!

2011-09-21T16:54:00.003-04:00

Karen Steward's attempt to shut down ARD web sites FAILS again!

Year after year Karen Steward "stews" and "obsesses" over ARD web sites that provide beneficial information to persons afflicted with Adhesion Related Disorder.

Her problem? These web sites make it hard for Karen and her cohort, Con Doc. Daniel Kruschinski to profit on the pain of those who are afflicted with ARD!

No ifs, ands or buts about it, in our opinion and experience, this is the reason behind her "attacks"on ARD web sites!

For years Karen has attempted to capitalize on ARD victims with items for sale, and soliciting the sale of a book she wrote about Con Doc Kruschinski, of Germany! Karen paid to have this book published, and it bombed right off the press losing her money spent on it!

Since then Karen seeks any means necessary to recoup her losses, and YES, she will take advantage of vulnerable victims of ARD and have no problem making them victims of her greed as well!

"Steward ARD Merchandise being sold in India by Doc Kru!

Karen has been saying for years that "she, and Doc Kru" were going to shut down the following web site http://www.adhesionrelateddisorder.com/" & "http://www.ihrt.com,/" among other ARD web sites. To date, they have not been successful!

The reasons they have always bombed was that the alleged complaints by them were always found to be invalid! For the past 10 years Karen and Kru have banded together in their attempts to corner the market on ARD, be it ARD web sites or those afflicted with ARD, in their attempts to cash in on ARD!

You will see here in this post in an ARD web site that the web site one of Karen's "competition" is scratched out! Not to proffesional, but hey, neither is Karen or Kru in our opinion!

The good news in Karen Steward making all these petty contacts as seen below, is that every time she does something underhanded and immoral like this, in our opinion, she feeds IHRT enough material showing exactly what type of person SHE is!

Karen is trying to paint others in a bad light, and sell her ARD loot, but all she succeeds in accomplishing is to show what she is made of.

Smells like some "Something Evil" is blowing out of Wetherford, Texas, and it reeks of a stinky Steward!!

Pssssst, some Steward facts: Karen Stewards daughter made more then one trip to Doc. Kru as did many others, some as many as 6 trips, and yes, paying cash to Kru each time!
Karen, if you think this is not a true statement, go read your book, as it says in there Melissa went to Kru more then once for surgery! Perhaps YOUR book is not truthfull????

(We will bring you more "Steward facts" in the future, so stop back if you want the truth!)

ENJOY the 2011 Rants of Karen Steward......

-----Original Message-----
From: abuse@hostway.com [mailto:abuse@hostway.com]
Sent: Wednesday, August 17, 2011 12:43 PM
Subject: (HW#14378200) Defamation of Character Complaint: adhesionrelateddisorder.com

Dear Customer,

We have been made aware of a defamation of character complaint against your web site adhesionrelateddisorder.com. The content in question is hosted at the following location:

http://www.adhesionrelateddisorder.com/BJD-Picture-Trail-pg2.html

Please review the complaint provided below. We request that you voluntarily remove the content or contact the complainant directly to resolve the matter. If you have any questions regarding defamation complaints, please contact legal@hostway.com. Feel free to let us know if you require any further assistance.

Thank you,

Abuse Department

Hostway Corporation

From: karen steward [karensteward@mac.com]

Dear Sirs,

The ip address above is the one found when I check this url:

http://www.adhesionrelateddisorder.com

The name of the person behind this website is Beverly Doucette of

Marinette , Wisconsin. This website is a front used solely for the

purpose of libeling numerous people across the world, myself

included. I, along with several other people, were successful in getting

this site taken down several years ago when Beverly was hosted through Bravenet.

Though the majority of the libel is written at http://www.ihrt.blogspot.com,

the url http://www.adhesionrelateddisorder.com is the

active springboard to the libelous blog.

I have contacted everyone from the FBI, to Beverly 's local police,

Wisconsin 's attorney general, etc. They all tell me to contact her

hosting, as she cannot achieve this evil without an available host.

I do have a case file with the FTC, as the purpose of adhesionrelateddisorder

is to monopolize a market of medicine, specifically, adhesions.

The man safely hidden behind Beverly 's skirt, is David Wiseman of

Dallas , Texas . In the link below, you will see that Beverly is tied to

David Wiseman and is the puppet in his diabolical crime of libeling

many innocent people across the globe.

http://www.adhesionrelateddisorder.com/BJD-Picture-Trail-pg2.html

The purpose of my email is to find out if you can help me in removing

this website from the internet since you are the host.

One man has committed suicide due to Beverly 's

libel against him and his wife. Beverly successfully destroyed his

online retirement internet business by her crude, libelous postings.

Their crime? His wife had gone to Germany for adhesions surgery and

innocently posted on the internet her joy at becoming well. The man,

nor his wife, knew David Wiseman of Beverly Doucette prior to the

attacks upon them. The same holds true for all of us who are

being libeled by these people.

Thanks for any help you can offer,

Karen Steward

Beverly Doucette's response to Hostway...

Subject: RE: (HW#14378200) Defamation of Character Complaint: adhesionrelateddisorder.com

There is no defamation, nor libel or slander in this web site. The entire contents is 100% validated and proven to be true as printed. http://www.adhesionrelateddisorder.com/

Material found in this web site absolutely exposes persons for criminal activity at national and International levels, however, all material within this web site is validated and true as stated. Some of the content is our opinion, and it is stated as just that, “Our opinion.” Mrs. Steward uses the word, “crime” three different times in her email to you, and accuses Beverly Doucette, AND Dr. David Wiseman of criminal acts, of defamation, which in my estimation tells me that she is angry with both of us, and though Dr. Wiseman has never once blogged or placed material in the web site which the complaint is being made against, she includes him in her accusations.

We could go tit for tat for years as to the reasons Mrs. Steward decided to send a complaint to your service, but I am far to busy for that, and not interested in all of this as for years, as she states, she had had a personal vendetta against Dr. Wiseman and myself thinking that she was left behind when we each choose this venue to educate and inform persons with ARD. She wrote a book about ARD, and she has stated before that it will not sell if web sites offer the same material in their web sites, though these web sites were up well before she came on the scene. ( Simple way to validate that is to look at the date of publication of her book and the dates our web sites first appeared in the Internet. She will continue to try to get ever ARD web site off the Internet if she could thus her book might sell. Simple fact.

Prior to placing material on this public web site we involved an attorney to proof material that is controversial, none was shown to be of a nature that would, nor could, prove to be considered libel, slanderous or defaming in nature.

The reason Mrs. Steward has been unsuccessful in having this web site removed after she had it investigated by all those she listed as contacting, is because there is nothing in it that constitutes breaking a law of any sort.

Though you state that you were "made aware of a defamation of character" located in this web site, you do not show where this defamation occurs within the site, nor do I know of any such defamation. If there is a specific portion within this web site that this woman deems is defaming, it would be more advantageous to direct your attention(and mine)to that particular material and location of it in the web site, which if proven to be of an illegal nature, will then be removed by me immediately. If you deem the web site to be improper, contact me with specific reasons for the action, and to give me the chance to rectify any errors. I will also seek legal advice prior to any changes I will allow to be made in the services I paid for. The email sent to you by Mrs. Steward does not contain anything that validates any action against the web site http://www.adhesionrelateddisorder.com by your team.

The material in this web site has at no time caused any person to "kill themselves," and though I am aware of this claim against the web site, upon investigating the person who supposedly killed himself due to my web site in fact had been dealing with depression and severe financial issues, and did not commit suicide, but rather appeared to have had a long term health/psychological issue. The most important thing here is that at no time did I ever mention this person, and had never heard his name prior to Mrs. Steward's accusation. Simply was not a true accusation, and there is nothing in this web site that even mentions this person. Note she does not offer up that name or dates for you to investigate prior to taking any action to remove this web site let alone accept her comments without validating them.

The web site link as seen here is located on many, many links within the Internet, http://www.adhesionrelateddisorder.com not just in this link.

http://www.ihrt.blogspot.com/. If there was any criminal material in the IHRT link, Google would remove the web site, however, none was ever found in the IHRT web site. Google did however remove a web site owned by Mrs. Steward. No matter what Mrs. Steward thinks of the IHRT blog, it has nothing to do with the allegations she is making against my web site and thus cannot be used as a reason to remove my web site..

Any associations I have with anyone does not a defamation make. Nor does having acquaintances' create libel, or slander, or anything else for that matter. It appears that Mrs. Steward doesn't care for my acquaintances, however her dislike of my associations have no bearing on her accusation as submitted to you. (Unless you can show me just cause that person's I associate with is validation of her accusations of defamation, even IF defamation is found to exist within this web site, my acquaintances would absolutely have no bearing on it. Mrs. Steward says” “In the link below, you will see that Beverly is tied to David Wiseman and is the puppet in his diabolical crime of libeling many innocent people across the globe.”

The date of this complaint must be taken into consideration as to why now is Mrs. Steward choosing to bring this to your attention when this web site has been up for a number of years without change. Another interesting caveat here is that Mrs. Steward seems to be confused as to whom she is accusing of the defamation complaint. Is it me, Bevery Doucette, or is it the “diabolical Dr. Wiseman” who she is accusing of the crime of libel? Isn’t Mrs. Steward committing defamation of Dr. Wiseman in her statement regarding him? (The answer is NO, though she is not stating it is her opinion, she is actually making the claim that “David Wiseman is diabolical and involved in the crime of libeling many innocent…etc,” however, unless comments made against another causes them to lose money and reputation in a court of law, there is no defamation. Also, once someone is deceased, they have no rights, thus anything said about them cannot be deemed anything! ( Though at no time has material in this web site defamed a person.) Mrs. Steward is again using the word crime when speaking of this person, "One man has committed suicide due to Beverly 's libel against him and his wife. “ Beverly successfully destroyed his online retirement internet business by her crude, libelous postings. Their crime?”

If there is anything even remotely of a defaming nature in this link, it shall be, or can be, removed, however, I see nothing of that nature in this link. I was at these congress’s not Mrs. Steward, and every word in this link is absolutely fact. As for the pictures, they speak for themselves! I too encourage you to visit the link as submitted by Mrs. Steward as it does validate the validity that the web site is geared to educate and inform persons with ARD how best to “Be Their Own Dr.”
http://www.adhesionrelateddisorder.com/BJD-Picture-Trail-pg2.html

Next “his accusation of “monopolizing a market of medicine, specifically, adhesions”
is very easy to rule out in the http://www.adhesionrelateddisorder.com/BJD-Picture-Trail-pg2.html by visiting Mrs. Stewards web site, which is also an education and information web site for those who are afflicted with ARD. In fact, the ONLY people making money on ARD with the
"www.adhesion relateddisorder.com" web site is Hostways being paid each year to host it!

There exists many, many web sites offering the same material that you will find in the ARD web site and Mrs. Stewards web site. http://www.karensteward.com/
Simply take a look at her web site if you want to see someone trying to corner the market on ARD! And for profit no less!

You will never fund that existing in any of the ARD web sites I am associated with! Absolutely not!

If the following charge were true in this statement by Mrs. Steward, I am certain one of the agencies she contacted would have contacted you with a legal notice to have this link removed from the Internet, and they would not have asked that of you, they would have directed you to do it based on law!

“The man, nor his wife, knew David Wiseman of Beverly Doucette prior to the attacks upon them. The same holds true for all of us who are being libeled by these people.” I am of the opinion that Mrs. Steward file a class action against me using her accusations as stated to you in her email. I am certain that if there is actual defamation in the web site, any literate Atty. Could locate it and manage a class action. I do know that she has made claims of doing this, but like the other contacts, she was informed that no criminal activity is taking place in my web site, and her opinion or the web site nor her dislike of me and others she is accusing, doesn’t make her accusations fact. She needs to prove her accusations, as does your team before taking any actions against it,and an investigation of your team would be of benefit to me as this lady will continue to seek ways to shut other “ARD” websites down , and her agenda is a personal as her book is not selling, from what I hear.

You will not find one single word of defamation, slander or libel in the following link, nor within the contents in any of it. http://www.adhesionrelateddisorder.com/BJD-Picture-Trail-pg2.html

I would expect a thorough investigation from your legal team to show just cause for any changes in your services of hosting the web site AdhesionRelaterDisorder. In the event you do not, or will not, put forth an effort to prove or disprove the allegations made against the web site, I would expect that you considered my explanations as presented here to be fact, thus closing the issue.

The fact of the matter is that I have not edited material to the web site and the web site manager relocated years ago thus rendering it in a state of inactivity and usable by me.

Please indicate to me as to any other action you wish from me regarding this communication in the event I misunderstood your directions.

Thank-you for informing me of this matter,
Beverly Doucette

"Okay then, THIS bombed! What do will Karen do next to corner the ARD market to sell her ARD loot?

We never could figure out the obsession, in our opinion, is between Kru and Karen,

and we still don't!

What could it be between these two after all these years???

"GINGIRL"

Lets get to know Doc Kru a little better now that Karen brings this up again!

SLUMDOG "SUGAR DADDY" Dr. Daniel Kruschinski

The OSCAR goes to......

"SLUMDOG DOCTOR in GERMANY"

In the latest escapades out of Endogyn, IHRT cought SLUMDOG "SUGAR DADDY" Dr. Daniel Kruschinski slumming with his NEW and IMPROVED "DADDY'S GIRL" after meeting her through "XING.com! Here you will see the NEW "Endogyn" infrastructure Con Kru has in India!

Complete with the "Abdolift" exclusive to his surgeries!

Only in IHRT will you find the facts as "Dr. Daniel Kruschinski – Endogyn, Germany" reveals his “perverted” side for all the world to see, and it appears to be without shame!

https://www.xing.com/app/profile?op=contacts&name=Daniel_KruschinskiDr

!!!!!CAUTION…BEWARE… CAUTION…BEWARE…!!!!!

PORNO MATERIAL WILL TAG YOUR PC AT THE ABOVE WEB SITE

(IHRT cautions you that going into these web sites, your PC WILL get porno pop ups, curtsey of Kruchsinski! Even if you use a different email address, the PC going into these web sites WILL get tagged!)

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*** FACES OF A PERVERT ***

DR. DANIEL MARIAN KRUSCHINSKI lives life on the shady side with his new "Daddy's Girl" as he slums with her all over Germany after meeting her in "XING.com"... (Ouch!)

Seems they now run a web site that assists "Young Girls" to meet "Old Men!" (Yuck!)

Looks like the "OLD USED UP" Mistress Micheala Katzer is OUT of a "Sugar Daddy" and the "YOUNG SEXY" Janine Gessner is IN with a new "Sugar Daddy!"

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Meet the "NEW FACE" in Dr. Daniel Kruschinski's life......“Janine Gessner"

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"Hi, DANNY BOY" .........

Janine seems to be saying to her new "Sugar Daddy..
(Wait until she finds out her DOCTOR is really nothing but a bankrupt, lying, washed up, smelly alcoholic, married OLD perverted fart..oh, IHRT forgot that Kruschinski is GAS-LESS, at least Janine has THAT going for her! (LOL! LOL!)

https://www.xing.com/profile/Janina_Gessner

<<<<<<<<>>>>>>>>

B.Z. stellt die speziellsten Flirtseiten im Internet vor Für reife Männer - Frauen, die graue Schläfen lieben, finden hier ihr Objekt der Begierde. Als eines von 2500 Mitgliedern muss man als Lady unter 30, als Mann über 40 Jahre alt sein:

http://www.reif-trifft-jung.de/
Janina Gessner Premium-Mitglied
CRM work Firma:(sichtbar nur für registrierte Mitglieder)
10587 Berlin, Deutschland

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Über michBerliner Zeitung

Dass ältere Herren oft ein Faible für wesentlich jüngere Damen haben, liegt in der Natur der Sache. Viele Promis über 40 "schmücken" sich mit Schönheit und Frische solcher Grazien. ... Auch für den Durchschnittsbürger gibt es Möglichkeiten, ohne Millioneneinkommen und Promibonus mit jüngeren Frauen anzubandeln. Vielen Frauen ist ein erfahrener Partner lieber, da er über eine gewisse Lebenserfahrung verfügt und Sicherheit sowie Geborgenheit symbolisiert. Spezielle Wünsche, besondere Börsen So verwundert es nicht, dass es sogar Kontaktbörsen für diese spezielle Beziehungskonstellation gibt... Eine dieser Börsen ist "Reif-trifft-Jung.de": Über 1000 Damen zwischen 18 und 30 sind hier bereits registriert und schauen sich nach einem erfahrenen Partner von 40 Jahren und älter um. Eine solche Kontaktbörse bietet für eben diese Partnerkonstellationen eine gute Möglichkeit zum Kennenlernen. Denn hier suchen und finden sich junge Frauen und ältere Männer... [Quelle: Hombrero.de v. 8.1.2008]

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Babel Fish Translation….

Ripely young meets The fact that older gentlemen have often a Faible for substantially younger ladies lies in the nature of the thing. Many Promis over 40 " schmücken" itself with beauty and freshness of such Grazien. … Also for the average citizen there are possibilities, without million-incomes and Promibonus with younger Mrs. anzubandeln. Many women is rather an experienced partner, since it symbolizes security as well as security had a certain life experience and. Special desires, special stock exchanges Thus it does not surprise that there are even contact contacts for this special relations constellation… One of these stock exchanges is " Hoar frost meet Jung.de": Over 1000 ladies between 18 and 30 are registered here already and look themselves after an experienced partner of 40 years and older over. Such a contact stock exchange offers a good possibility for evenly these partner constellations to becoming acquainted with. Because and are young women and older men search here…[Quelle: Hombrero.de v. 8.1.2008]

GAME ON KAREN..TAG YOUR IT!

adhesions, ARD, ELM, endogyn, hope for adhesion pain, Karen Steward, kruschinski, Pain, scar tissue

ENDOGYN, abdolift, gasless, abdominal pain, debilitating, hidden disorder, enslaving, ARD awareness, hopelessness, Jill Ronsley

Rectal Endometriosis Causing Colonic Obstruction and Concurrent Endometriosis of the Appendix

2011-09-20T08:37:00.000-04:00

From Journal of Medical Case Reports
Rectal Endometriosis Causing Colonic Obstruction and Concurrent Endometriosis of the Appendix
A Case Report
N Katsikogiannis; AK Tsaroucha; K Dimakis; E Sivridis; CE Simopoulos

Authors and Disclosures

Posted: 09/14/2011; J Med Case Reports. 2011;5(3) © 2011 BioMed Central, Ltd.

Click link below to read more
http://www.medscape.com/viewarticle/748886

Abstract and Introduction

Abstract

Introduction: Endometriosis is a clinical entity which presents with functioning endometrial tissue at sites outside the uterus. Bowel endometriosis is usually asymptomatic, but it may show non-specific symptoms. The presence and/or association of appendiceal endometriosis, concomitant with rectal endometriosis, is possible.

Case presentation: A 36-year-old Greek woman was admitted to the emergency room of our hospital with signs of acute abdomen. On physical examination, our patient had a painful distended abdomen. Digital examination revealed an empty rectum and bowel obstruction was diagnosed. Our patient underwent exploratory laparotomy and rectum stenosis (almost complete obstruction) was observed. The bowel stenosis was resected, and temporary colostomy and appendectomy were performed. The pathology report showed endometriosis of the colon and the appendix, and our patient received medical treatment for endometriosis. Six months after this operation our patient had another surgery for restoration of large bowel continuity. No endometriosis was found. Our patient was doing well at the one-year follow up.

Conclusion: Endometriosis of the bowel is a disease that may cause large bowel obstruction. In women of reproductive age, the surgeon should consider endometriosis as a differential diagnosis in case of various gastrointestinal symptoms.

Introduction

Endometriosis is a clinical entity, which was first described by von Rokitansky Kitansky as the presence of functioning endometrial tissue at sites outside the uterus.[1,2] Endometriosis occurs in 3–10% of the general female population of reproductive age, 40–80% present symptoms such as pelvic pain, infertility, or both.[2,3] Endometriosis rarely involves the small intestine, the appendix, the colon, the lung or other tissues.[4,5]

Bowel endometriosis is usually asymptomatic, but it may show non-specific symptoms, such as abdominal colic-like pain, nausea, vomiting, and general symptoms of intestinal obstruction.[6,7] Circumferential endometriosis of the rectum should be differentially diagnosed from inflammatory or malignant diseases.[5] Endometriosis of the appendix usually presents with abdominal pain.[8] The presence and/or association of appendiceal endometriosis, concomitant with rectal endometriosis, is possible, because endometriosis could occur in more than one anatomical location at the same time.

A PubMed search revealed less than 20 reported cases of large bowel obstruction due to endometriosis in the last 10 years. In none of these reports was the appendix involved. We add here an additional case report. We present a case of rectal endometriosis and bowel obstruction, together with appendiceal endometriosis, diagnosed after surgical treatment in a female patient of reproductive age.

Section 1 of 5

Profiting from Pain: Adhesion Related Disorder ~ Stay safe

2011-09-20T06:54:00.000-04:00

Profiting from Pain: Adhesion Related Disorder ~ Stay safe

Adhesion Related Disorder International Human Rights Team IHRT: Endogyn Update: Attention Dr. Kruschinski Creditors! Cold hard cash and lots of it!

2011-09-20T06:44:00.000-04:00

Adhesion Related Disorder International Human Rights Team IHRT: The truth about Gas less laparoscopy and Dr. Kruschinski

2011-09-20T06:42:00.000-04:00

Profiting from Pain: Karen Steward Profiting from Pain

2011-09-17T10:02:00.001-04:00

Profiting from Pain: Karen Steward Profiting from Pain

2011-09-17T10:02:00.000-04:00

Profiting from Pain: Karen Steward Profiting from Pain

Kruschinski Alert: September is Adhesion Related Disorder Awareness Month

2011-09-17T09:09:00.000-04:00

Kruschinski Alert: September is Adhesion Related Disorder Awareness Month

2011-09-17T06:17:00.000-04:00

Kruschinski Alert: September is Adhesion Related Disorder Awareness Month

Profiting from Pain: September is Adhesion Related Disorder Awareness Month

2011-09-17T06:01:00.000-04:00

Profiting from Pain: September is Adhesion Related Disorder Awareness Month

Endometriosis can Reach Your Bowel and Bladder

2011-09-08T08:19:00.000-04:00

Endometriosis can Reach Your Bowel and Bladder

By Deborah Ross August 31, 2011 - 2:25pm

Having endometriosis is tricky business. For many women, it’s something you have to “look forward to” every month. Sometimes friends and family don’t understand the pain you are enduring with your cycle. And sometimes endometriosis is causing abnormalities in your reproductive area, pelvis and gut that you can’t even feel.

As defined by the American Congress of Obstetricians and Gynecologists, endometriosis occurs when the tissue that normally lines the uterus and gets shed during menstrual cycles for some reason is found growing outside the uterus, usually on the ovaries, fallopian tubes or other pelvic structures. In many cases that endometrium -- the lining -- can cause problems such as chronic abdominal pain, pressure or fullness in the pelvis, debilitating menstrual cramps, pain with intercourse and, sadly, infertility, according to ACOG.

Endometriosis can be an issue not only in a woman’s reproductive area, but also in the bowel and bladder. That’s because the displaced tissue responds to changes in hormones and can break down and bleed each month just as if it were in the uterus. Scar tissue, or adhesions, can form, sometimes binding organs together with painful results.

So, for many women having endometriosis, it’s not just the discomfort of a menstrual cycle but also pain that extends outward toward the digestive system. During a menstrual period, there can be diarrhea, constipation, bloating, nausea, aches in the lower back, and pain during bowel movements and urination.

More than 5 million American women have endometriosis, with it most often hitting women in their 30s and 40s, according to a fact sheet from womenshealth.gov .

The fact sheet also noted that sometimes women can have endometrial growths in a number of areas outside the uterus yet feel no pain. On the other hand, some women with endometriosis have only a few abnormal growths and still feel severe pain.

Researchers are looking at associations between endometriosis and a number of conditions, including allergies, autoimmune diseases, chronic fatigue syndrome, certain cancers and yeast infections.
Read the rest by clicking here: http://www.empowher.com/endometriosis/content/endometriosis-can-reach-your-bowel-and-bladder

Unhappy Camper: Boycott Peters Pond Park Sandwich MA

2011-08-24T11:38:00.000-04:00

Unhappy Camper: Boycott Peters Pond Park Sandwich MA

Combating endometriosis

2011-08-21T11:47:00.000-04:00

A new surgical procedure offers hope and promise

Vasudha Rai

Ashwini K. Trehan, consultant gynaecological surgeon at Spire Elland Hospital and Dewsbury and District Hospital, UK, is giving many with endometriosis a reason to smile.

While pelvic peritoneal excision surgery (basic laparoscopy where parts affected with endometriosis are removed) is effective, it has a 50% recurrence rate and may result in the removal of ovaries. Dr Trehan’s technique is called total pelvic peritoneal excision, where the entire pelvic lining is removed to prevent recurrence.

In a study conducted by Dr Trehan and F. Sanaullah, post-CCT clinical fellow in minimal access surgery, and C. Rooke, clinical audit facilitator, at Dewsbury and District Hospital in 2008, it was found that the new surgery improved the symptoms of endometriosis in 89.6% of women.

The circumstances in which removing the entire pelvic lining may not work is when the disease has spread into the uterus or in spots where endometriosis has reached very deep into the organs.

Dr Trehan says ovarian removal is the main reason for early death in women because it increases the risk of cancer, heart disease and acute menopause.

For more information, visit www.endometriosis-consultant.co.uk

Write to us at businessoflife@livemint.com

http://www.livemint.com/2011/08/08220011/Combating-endometriosis.html?h=B

Unhappy Camper: Peters Pond Park Rip Off Review

2011-08-21T08:16:00.001-04:00

Unhappy Camper: Peters Pond Park Rip Off Review

Unhappy Camper: More Corcerns as Maine deals With Morgan RV Resorts

2011-08-21T08:16:00.000-04:00

Unhappy Camper: More Corcerns as Maine deals With Morgan RV Resorts

Unhappy Camper: Peters Pond Park

2011-08-20T11:23:00.000-04:00

Unhappy Camper: Peters Pond Park

Unhappy Camper Peters Pond Park

2011-08-20T10:12:00.002-04:00

http://peterspondpark.blogspot.com/

Batt Publishes First Scholarly History of Endometriosis

2011-08-19T04:36:00.000-04:00

Published August 9, 2011

More than 150 years have elapsed since endometriosis was discovered and described. Yet, until now, no scholarly history has ever been written about the disease, which affects millions of women worldwide.

This summer Springer Publishing released “A History of Endometriosis” by Ronald E. Batt, MD ’58, PhD, professor in the Department of Gynecology-Obstetrics.

The back cover describes Batt’s task as “daunting” and states that the book “provides a stunning chronological and biographical history of endometriosis.”

An Expert Clinician and Practiced Historian
An expert in infertility and reproductive endocrinology, Batt also is a noted historian of medicine in Buffalo and Western New York.

He is writing a historical essay on the life and research of Kornel Ludwig Terplan, MD, professor of pathology at UB from 1933 to 1960.

In addition, he is researching a new book on the history of endometriosis from World War II to the present.

In the book, Batt provides a detailed account of the progress made in identifying and treating the once enigmatic condition from its discovery in 1860 by Austrian physician Carl Rokitansky through World War II.

http://medicine.buffalo.edu/news_and_events/news.host.html/content/shared/smbs/news/2011/08/batt_book_endometriosis_41.detail.html

New hope for endometriosis sufferers

2011-08-19T04:32:00.001-04:00

By Cheah Ui-Hoon

Women who suffer from endometriosis now have another drug to turn to in their struggle to manage the condition. A new pill, Visanne, has been designed to tackle the problem differently from conventional hormonal medicine. Whereas the latter prevents the ovaries from producing estrogen - and gives women menopausal side effects as a result - the new drug does not block the production of estrogen.

'This new medicine takes a completely different approach. It blocks ovulation, thus lowering the chances of endometriosis, but it does not block estrogen,' explains Thomas Strowitzki, director of the Department of Gynaecological Endocrinology and Reproductive Medicine at the University of Heidelberg, Germany.

Conventional GnRH (Gonadotropin-Releasing Hormone) analogue drugs put women in a menopausal state for the duration of the treatment. They block the pituitary gland, which stops estrogen production, thus relieving the pain associated with endometriosis. Women are put on this treatment for up to a maximum 12-month course.

Side effects from the resulting low levels of estrogen, however, are common, and most women will experience at least one or two symptoms commonly associated with the menopause. These include insomnia, headaches, mood swings, acne, dizziness, depression, decreased libido and vaginal dryness, although they usually disappear soon after conventional GnRH treatment ends.

Endometriosis is a condition in which the cells of the womb lining (the endometrium) are found outside the womb, usually in the pelvis and around the womb, ovaries and fallopian tubes. Unlike endometrial cells that are normally found in the uterus and which are shed during menstruation, those that grow outside the uterus remain in place and are stimulated during each menstrual cycle. Over the long term, this process gives rise to pain and can also result in scars or lesions on the tubes, ovaries, and surrounding structures in the pelvis.

Left undiagnosed or untreated, endometriosis can be a frustrating condition. Painful periods can cause a woman to miss work or school, strain sexual relationships, and affect the overall quality of her life. Besides irregular bleeding, endometriosis can also be a cause of infertility.

Dr Strowitzki says that doctors don't know why 15 per cent of fertile women develop endometriosis. 'To be honest, we don't know the risk factors and we don't know which group of women is at risk. We also don't know how to avoid the disease as it's not like cancer,' he adds.

http://health.asiaone.com/Health/News/Story/A1Story20110802-292226.htm l

New medical FICO score sparks controversy, questions

2011-07-29T08:47:00.000-04:00

Jeremy M. Simon, On Thursday July 28, 2011, 8:00 am EDT

Within the next 12 months, whether you like it or not, about 10 million Americans are expected to be scored -- much like a credit score -- on how likely they are to fill a prescription and take all the pills the doctor ordered, on schedule.

FICO , creator of the widely used credit score that predicts whether you'll borrow responsibly, is now rolling out its new Medication Adherence Score.

FICO based its score on a formula that predicts whether you will take your prescription drugs. FICO says that since correct use of medication is important for patients, medical providers, insurers and pharmaceutical companies, the Medication Adherence Score will help achieve that goal. They predict it will improve therapy effectiveness and reduce health care costs.

The company says those who score low can be targeted for extra reminders and educational efforts, with the goal of making patients more likely to complete their prescribed regimens.

"It's very important to identify those people who may need that additional education and that additional help," says Dave Shellenberger, senior principal consultant in FICO's health care division.

Critics aren't so sure. Since the score uses information on patients' employment, homeownership and living situations, they say that in the current economic environment, the Medication Adherence Score may unfairly target people who have found themselves in challenging financial situations. It could also, they say, open the door for a new way for insurance companies to charge different prices for different scores. This happened in recent years to consumers buying auto insurance: The cost of those policies are now likely based on an auto insurance credit score .

What's in the score?
FICO launched the Medication Adherence Score on June 23, 2011. To create the scoring algorithm, FICO looked at data from a random sample of several million anonymous patients provided by a large pharmacy benefits manager. FICO observed patients who filled (or refilled) their prescriptions and patients who failed to, with the company then identifying those variables that best predicted medication adherence. For the Medication Adherence Score, those variables include age, gender, family size and asset information -- such as the likelihood of car ownership -- data also used by direct marketing companies. FICO says that with only a patient's name and address, it can pull the remainder of the necessary information from publicly available sources.

The scores range from 1 to 500. "The higher the score, the higher the likelihood a patient will be adherent to a drug regimen," FICO's Shellenberger says. FICO says patients who score 400 or higher are likely to take medication as prescribed, while those who score below 200 are at high risk of not taking medication. According to FICO, patients who earn a low score may receive a medication reminder in the form of an email, letter or phone call from their doctor -- tactics that would be too costly to apply across the board.

FICO says those who wouldn't want to receive notices should contact their health care providers and ask about their opt-out policies. High scorers who appear likely to take all their meds probably won't be contacted.

Click here to read the rest!

Rectal endometriosis causing colonic obstruction and concurrent endometriosis of the appendix: a case report

2011-07-28T12:12:00.000-04:00

http://7thspace.com/headlines/389786/rectal_endometriosis_causing_colonic_obstruction_and_concurrent_endometriosis_of_the_appendix_a_case_report.html

Introduction Endometriosis is a clinical entity which presents with functioning endometrial tissue at sites outside the uterus. Bowel endometriosis is usually asymptomatic, but it may show non-specific symptoms.

The presence and/or association of appendiceal endometriosis, concomitant with rectal endometriosis, is possible.Case presentationA 36-year-old Greek woman was admitted to the emergency room of our hospital with signs of acute abdomen. On physical examination, our patient had a painful distended abdomen.

Digital examination revealed an empty rectum and bowel obstruction was diagnosed. Our patient underwent exploratory laparotomy and rectum stenosis (almost complete obstruction) was observed.

The bowel stenosis was resected, and temporary colostomy and appendectomy were performed. The pathology report showed endometriosis of the colon and the appendix, and our patient received medical treatment for endometriosis.

Six months after this operation our patient had another surgery for restoration of large bowel continuity. No endometriosis was found.

Our patient was doing well at the one-year follow up.

Conclusion: Endometriosis of the bowel is a disease that may cause large bowel obstruction. In women of reproductive age, the surgeon should consider endometriosis as a differential diagnosis in case of various gastrointestinal symptoms.

Author: N. KatsikogiannisA. TsarouchaK. DimakisE. SivridisC. Simopoulos

Credits/Source: Journal of Medical Case Reports 2011, 5:320

Endotimes blogger opinion: Yikes, I would never have an open surgery....if they can't do it laparoscoply then they aint good enough!

Aromatase inhibitors in post-menopausal endometriosis

2011-06-30T06:30:00.000-04:00

Postmenopausal endometriosis is a rare clinical condition. The diagnosis and treatment of an endometriotic lesion in postmenopausal women is complicated.

First line treatment choice should be surgical, given that there is a potential risk of malignancy. Medical treatment may be considered as second line or as an alternate first line treatment whenever surgery is contradicted and aims to alter the hormonal pathway leading to endometriosis progress.

Different hormonal regimens have been administered to these patients, with conflicting however results. Aromatase inhibitors (AIs) represent one of the most recently used drugs for postmenopausal endometriosis.

Clinical data for the use of (AIs) in postmenopausal patients is scarce. Up to date only 5 case reports are available regarding the use of these agents in postmenopausal women.

Although definite conclusions may be premature, AIs appear to considerably improve patients'symptoms and reduce endometriotic lesions size. Nonetheless the subsequent induced reduction in estrogen production, leads to certain short-term and long-term adverse effects.

Despite the limited available data, AIs appear to represent a new promising method which may improve symptoms and treat these patients, either as first line treatment, when surgery is contraindicated or as a second line for recurrences following surgical treatment. However, careful monitoring of patients'risk profile and further research regarding long-term effects and side-effects of these agents is essential prior implementing them in everyday clinical practice.

Author: Nikolaos PolyzosHuman FatemiApostolos ZavosGrigoris GrimbizisDimitra KyrouJuan Garcia VelascoPaul DevroeyBasil TarlatzisEvangelos Papanikolaou
Credits/Source: Reproductive Biology and Endocrinology 2011, 9:90

Published on: 2011-06-21

Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please make sure to read our disclaimer prior to contacting 7thSpace Interactive. To contact our editors, visit our online helpdesk. If you wish submit your own press release, click here.

http://7thspace.com/headlines/386793/aromatase_inhibitors_in_post_menopausal_endometriosis.html

DATA FROM DAISY PETAL STUDY WILL BE PRESENTED IN THREE SESSIONS

2011-06-18T06:35:00.000-04:00

SAN DIEGO, June 16, 2011 /PRNewswire/ -- Neurocrine Biosciences, Inc. (NASDAQ: NBIX) today announced that three elagolix presentations have been accepted for the scientific program at 2011 World Congress on Endometriosis, to be held September 4-7, 2011 in Montpellier, France. This important meeting is sponsored by the World Endometriosis Society and occurs every three years, bringing together clinicians and basic scientists from all over the world to share the latest developments in endometriosis.

"We are very pleased to participate in this prestigious scientific event," said Chris O'Brien, MD, Chief Medical Officer at Neurocrine. "This Congress will highlight the marked increase in both the basic science and clinical research related to endometriosis that has occurred in recent years. Endometriosis profoundly impacts the lives of well over one hundred million women worldwide, and global efforts to improve our understanding of the disorder, its symptoms and treatment, are the highlights of this triennial meeting. We are excited to be an integral part of these initiatives and to provide a detailed update on our potential new therapy."

The acceptance of multiple abstracts and datasets from the development program of elagolix for endometriosis at the 2011 World Congress on Endometriosis is as follows:

Data from the recently completed Daisy Petal clinical study of elagolix for the treatment of endometriosis-associated pain will be presented in a speaking session:

•"Elagolix, A Novel Oral GnRH Antagonist, Significantly Reduced Endometriosis-Associated Pelvic Pain: Results For The Placebo-Controlled, Double-Blind Period Of A Randomized Phase 2 Study" on Wednesday, September 7, 2011 at 10:30 am

Data from the recently completed Daisy Petal clinical study of elagolix for the treatment of endometriosis-associated pain will also be presented in two distinct poster sessions:

•"Elagolix, A Novel Oral GnRH Antagonist Improves Quality Of Life In Women With Endometriosis-Associated Pelvic Pain" on Tuesday, September 6, 2011 at 8:00 am
•"Elagolix, A Novel Oral GnRH Antagonist, Maintained Reduction Of Endometriosis-Associated Pelvic Pain During 24 Weeks Of Treatment" on Wednesday, September 7, 2011 at 8:00 am

In addition, data from the extensive work undertaken to improve our understanding of endometriosis symptoms will be presented at the 11th World Congress on Endometriosis in two separate sessions:

•"A Qualitative Evaluation of Disease Severity and Bothersomeness of Symptoms In Patients with Endometriosis" on Tuesday, September 6, 2011 at 8:00 am
•"Perception of Pelvic Pain in Women with Endometriosis: A Focus Group Study" on Wednesday, September 7, 2011 at 11:30 am.

About Neurocrine Biosciences

Neurocrine Biosciences, Inc. is a biopharmaceutical company focused on neurological and endocrine diseases and disorders. Our product candidates address some of the largest pharmaceutical markets in the world, including endometriosis, stress-related disorders, pain, diabetes, insomnia, and other neurological and endocrine-related diseases and disorders. Neurocrine Biosciences, Inc. news releases are available through the Company's website via the internet at http://www.neurocrine.com

In addition to historical facts, this press release may contain forward-looking statements that involve a number of risks and uncertainties. Among the factors that could cause actual results to differ materially from those indicated in the forward-looking statements are risks and uncertainties associated with Neurocrine's business and finances in general, and Company overall. In addition, the Company faces risks and uncertainties with respect to the Company's R & D pipeline including risk that the Company's clinical candidates will not be found to be safe and effective; and the other risks described in the Company's report on Form 10-K for the year ended December 31, 2010 and report on Form 10-Q for the quarter ended March 31, 2011. Neurocrine undertakes no obligation to update the statements contained in this press release after the date hereof.

SOURCE Neurocrine Biosciences, Inc.

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http://www.prnewswire.com/news-releases/neurocrine-biosciences-announces-elagolix-scientific-presentations-at-the-11th-world-congress-on-endometriosis-123989909.html

Team eyes infrared route to diagnose endometriosis

2011-06-03T11:50:00.000-04:00

24 May 2011 | By Andrew Czyzewski

Infrared (IR) spectroscopy could greatly improve the diagnosis of endometriosis, bypassing the need for invasive surgical biopsy, according to a team from from Lancaster University

The team found that tissue from women with the condition carried a distinct IR signature — thus paving the way for routine assessment such as that done for cervical smears.

‘We use spectroscopy as a method of deriving what we call a biochemical cell fingerprint of a tissue sample — and from that we can get an absorption spectrum associated with the functionality of the tissue we’ve looked at,’ project lead Dr Francis Martin of Lancaster told The Engineer.

Read more: http://www.theengineer.co.uk/sectors/medical-and-healthcare/news/team-eyes-infrared-route-to-diagnose-endometriosis/1008781.article#ixzz1OEE8qLKt

Symptoms in teen years may foretell severe endometriosis

2011-05-16T14:05:00.000-04:00

I have a 16 year old daughter.
I suffer with deep infiltrating endo and I believe my mother and my grandmother may have suffered also. They both had hysterectomies at a young age. I had one at age 32.
I am terrified for my daughter as I am sure all parents with Endo are. ~ Chef

Symptoms in teen years may foretell severe endometriosis
By Amy Norton

NEW YORK
Fri Nov 19, 2010 5:31pm EST

NEW YORK (Reuters Health) - In some teenage girls, very painful menstrual periods that interfere with daily life may signal an increased risk of developing the most extensive form of endometriosis, a preliminary study suggests.

In a study of 229 women undergoing surgery for endometriosis, French researchers found that those with the most extensive form -- known as deep infiltrating endometriosis (DIE) -- were more likely to have had particularly painful periods as teenagers.

As a group, they were four times as likely as women with non-DIE endometriosis to have used birth control pills to treat severe menstrual pain before the age of 18. And they were 70 percent more likely to say they'd missed school days because of menstrual symptoms.

The findings, published in the journal Fertility and Sterility, suggest that such problems in adolescence can sometimes predict a later diagnosis of DIE.

In endometriosis, pieces of the tissue that lines the uterus (the endometrium) also grow outside the organ -- often on the ovaries, the fallopian tubes or elsewhere in the pelvis. Like the endometrium, this misplaced tissue changes with each menstrual cycle, thickening and then breaking down and bleeding.

This leads to a buildup of adhesions, or scar tissue, outside the uterus, with symptoms including pelvic pain and heavy, painful menstrual periods. Some women also have difficulty becoming pregnant.

There are three forms of endometriosis: superficial endometriosis, ovarian endometriomas and DIE, with the latter being the most extensive. Women with DIE usually have adhesions in multiple areas of the pelvis, including the vagina, bladder, bowel and the ligaments attaching the uterus to the pelvis.

Endometriosis can be tricky to diagnose, and many girls and women go years before a diagnosis.

The condition may, for instance, be mistaken for other causes of pelvic pain, like ovarian cysts, pelvic inflammatory disease or, depending on the symptoms, irritable bowel syndrome. In addition, while a pelvic exam or ultrasound test are often used to help diagnose endometriosis, the only way to definitively diagnose it is through minimally invasive laparoscopic surgery to take a tissue sample.

Compared with the other forms of endometriosis, DIE appears to have a longer delay to diagnosis.

So for the new study, Dr. Charles Chapron and colleagues at Universite Paris Descartes tried to find out whether women undergoing surgery for endometriosis had any early symptom history that was associated with a greater likelihood of having DIE.

The study included 229 women who had surgery at a single medical center between 2004 and 2009; 43 percent had DIE, while the rest had the less-extensive forms of endometriosis. All of the women were interviewed about their symptom history; their average age at the time of surgery was 32.

Overall, 58 percent of women with DIE had ever been prescribed birth control pills to treat severe menstrual pain, versus 26 percent of women with non-DIE forms. Similarly, 21 percent of women with DIE had their first prescription before the age of 18, compared with 6 percent of those in the non-DIE group.

When it came to missed school days, 38 percent of DIE patients said they'd had absences due to menstrual symptoms, versus one-quarter of women in the non-DIE group.

Women with DIE were also more likely to report a family history of endometriosis; 13 percent did, compared with just under 5 percent of women with non-DIE endometriosis.

The study has a number of limitations, including the fact that it surveyed women at one time point and asked them to recall symptoms from adolescence. A study that followed young women over time to see whether symptoms predicted a later diagnosis of DIE would be more informative.

These findings now set the groundwork for such a long-term study, Chapron told Reuters Health in an email.

But the "crux of the issue," he noted, is whether diagnosing endometriosis earlier will eventually lead to fewer cases of DIE and less need for surgery.

"Today, there is no effective way to prevent the progression of endometriosis to its most severe stage, DIE," Chapron said.

And the current results, he noted, suggest that treating severe menstrual pain with birth control pills does not prevent progression to DIE, as a history of such treatment was linked to the condition. Chapron also pointed out, however, that this does not mean that birth control pills contributed to the development of DIE either.

Still, even though it is not clear whether progression to DIE can be prevented, an earlier diagnosis of endometriosis would at least allow girls and women to know the cause of their symptoms.

According to Chapron and his colleagues, girls and women with severe menstrual pain that does not respond to pain relievers like ibuprofen should see their doctors, and, if appropriate, be evaluated for endometriosis.

Besides painkillers and birth control pills, non-surgical treatments for endometriosis include several types of hormonal medications that inhibit the growth of the endometrial tissue.

SOURCE: link.reuters.com/xam46q Fertility and Sterility, online November 11, 2010

Smilage Dental: Dr Fred Attarzadeh of Smilage Dental Franklin and Framingham MA

2011-05-09T18:39:00.000-04:00

Smilage Dental: Dr Fred Attarzadeh of Smilage Dental Franklin and Framingham MA

ENDURING Endometriosis

2011-05-09T06:35:00.000-04:00

Painful disorder may increase risk of infertility

EILEEN CIPRIANI Times Leader Correspondent

It is among the top three causes of infertility and pelvic pain in women. There is a research center and a foundation in the United States, as well as an international society and yellow ribbon devoted to the disorder. According to the U.S. Department of Health and Human Services more than 5 million women in America alone have been diagnosed. Oscar Award-winning actress Susan Sarandon and “Top Chef” host Padma Lakshmi are among them. In March at the 3rd annual Blossom Ball fundraiser for research in New York, Sarandon and Lakshmi shared their first-hand experiences with the malady -- endometriosis.

Endometriosis is when endometrial cells that normally line the interior of the uterus relocate in other areas of the body. The cells usually become displaced in the pelvic area, but in extremely rare cases they can be found in other parts of the body, says Dr. Jennifer Sue Gell of Geisinger Health System’s Women’s Health Center. Gell is obstetrics-gynecology certified with a practicing specialty in reproductive endocrinology and fertility.

In endometriosis the displaced tissues acts as it normally would during the menstrual cycle. It thickens and bleeds, but because it is unable to exit the body it irritates surrounding tissue causing pain and eventually develops scar tissue and adhesions.

Click link to read the rest
http://www.timesleader.com/features/ENDURING_Endometriosis_05-02-2011.html

Eggsploitation

2011-04-24T09:24:00.001-04:00

04-06-11: Award-winning documentary, 'Eggsploitation', was shown at Boston College Law School. Risks of lupron, and the lack of data-tracking of women who undergo egg donation and IVF, were discussed. 'RESOLVE' (the organization that alleges to "educate, advocate, and support the infertile") had in attendance a Board Member who attempted to discredit 'Eggsploitation' as "biased" and 'not representative of the industry'. 'RESOLVE's' Board Member failed to inform the audience of 'RESOLVE's' conflicts of interest: RESOLVE has a history of receiving hundreds of thousands of dollars from the fertility drug manufacturers, fertility clinics, and fertility doctors.

From: http://www.lupronvictimshub.com/

Global Endometriosis Market to Reach $1.3 Billion by 2017, According to a New Report by Global Industry Analysts, Inc.

2011-04-24T09:20:00.000-04:00

Monday, April 4, 2011

San Jose, CA (Vocus/PRWEB) April 04, 2011

Endometriosis is the most common health problem among women. As per the estimates of World Endometriosis Research Foundation, an estimated 170 million women suffer from endometriosis globally. Endometriosis-related healthcare costs and productivity losses exceed US$4,000 per patient annually. Annual direct and indirect endometriosis-related costs are estimated to cross US$20 to US$25 billion in the US over the coming years. The disease affects reproductive age women more compared to post-menopausal women. Endometriosis affects more than 90 million women of reproductive age globally. The disease represents one of the major causes of female infertility and constitutes for about 30% of infertility cases in women. More than 7.8 million women in the US suffer from endometriosis-related symptoms, which include chronic pelvic pain, dysmenorrhea, and infertility.

Gonadotropin-Releasing Hormone GnRH agonists, Progestins, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), and contraceptives are the major therapeutic options available for the treatment of endometriosis. The present drugs are characterized by safety and efficacy concerns. Huge unmet medical need exists for novel medication with improved safety profile and minimal side effects. Lupron Depot from Abbott Laboratories, Depo-Provera and Synarel from Pfizer, are the major drugs approved for the treatment of endometriosis. Abbott's Lupron (Leuprolide) represents one of the leading drugs for the treatment of endometriosis.

The global endometriosis market is led by the US, as stated by a new market research report on Endometriosis. Europe represents the next largest region, while growth is expected to emanate mainly from the 'Rest of the world' market, which is expected to depict a compounded annualized growth of more than 6.0% during 2009-2017. The future looks promising for endometriosis, with increasing efforts being made in research, and novel treatment emerging in the field of surgical as well as pharmaceutical treatment. In addition, myths are being dispelled regarding the disease, and alternative methods are being readily accepted. Non-invasive diagnostics, including next-generation MRIs, are forecast to become major tools for the diagnosis of endometriosis, although laparoscopy, an invasive surgery, still remains the gold standard for performing disease diagnosis. Genetic and biomolecular diagnostic tests are also being trailed.

Drugs that are expected to drive future market growth include Abarelix, SERMs (Selective Estrogen Receptor Modulators), Extracellular Matrix Modulators, Terbutaline, and RU-486. Abarelix, for instance, is a GnRH antagonist, presently undergoing clinical trials in the US for its use in endometriosis. The emergence of certain other promising innovative drugs, including Repros Therapeutics' Proellex, Neurocrine's Elagolix, and Bayer HealthCare Pharmaceuticals' Visanne (Dienogest) is forecast to have a robust impact on the endometriosis market in future. Elagolix is the first oral non-peptide gonadotropin-releasing hormone (GnRH) antagonist. Meanwhile, Proellex acts by selectively blocking the activity of progesterone, and allows the secretions of tonic hormone by alleviating the negative side effects of GnRHa. Besides pipeline drugs, Angiogenesis therapy is forecast to be one of the key potential treatment options for endometriosis, whether used alone or as an adjunct therapy. Angiogenesis theory holds that endometriosis lesions could be destroyed by cutting off the blood supply.

Major players profiled in the report include Abbott Laboratories, AEterna Zentaris Inc., AstraZeneca Plc., Bayer HealthCare Pharmaceuticals Inc., Eli Lilly and Company, Meditrina Pharmaceuticals Inc., Neurocrine Biosciences Inc., Paladin Labs Inc., Pfizer Inc., Repros Therapeutics Inc., among others.

The research report titled "Endometriosis: A Global Strategic Business Report" announced by Global Industry Analysts Inc., provides a comprehensive review of endometriosis, current market trends, key growth drivers, the available treatment, overview of major drugs, insight into current leading and pipeline drugs, recent product approvals, recent industry activity, and profiles of major/niche global as well as regional market participants. The report provides annual sales estimates and projections for Endometriosis treatment for the years 2009 through 2017 for the following geographic markets - US, Canada, Japan, Europe, and Rest of World. Also, a six-year (2003-2008) historic analysis is provided for additional perspective.

For more details about this comprehensive market research report, please visit - www.strategyr.com/Endometriosis_Market_Report.asp
About Global Industry Analysts, Inc.
Global Industry Analysts, Inc., (GIA) is a reputed publisher of off-the-shelf market research. Founded in 1987, the company is globally recognized as one of the world's largest market research publishers. The company employs over 800 people worldwide and publishes more than 1200 full-scale research reports each year. Additionally, the company also offers thousands of smaller research products including company reports, market trend reports, and industry reports encompassing all major industries worldwide.

Global Industry Analysts, Inc.
Telephone: 408-528-9966
Fax: 408-528-9977
E-mail: press(at)StrategyR(dot)com
Web Site: www.StrategyR.com/
# # #

For the original version on PRWeb visit: www.prweb.com/releases/prwebendometriosis/laproscopy/prweb8257835.htm

http://sfgate.com/cgi-bin/article.cgi?f=/g/a/2011/04/04/prweb8257835.DTL

Global Endometriosis Market to Reach $1.3 Billion by 2017, According to a New Report by Global Industry Analysts, Inc.

2011-04-07T04:34:00.000-04:00

Endometriosis: A Global Strategic Business Report
GIA announces the release of a comprehensive global report on Endometriosis markets. The global market for endometriosis treatment is forecast to reach $1.31 billion by the year 2017. Major factors driving market growth include huge unmet need for novel and effective drugs in the market with improved safety profiles, increasing incidence rates of endometriosis due to environmental factors, rising awareness of the disease, and improved diagnosis. Drugs that are expected to drive future market growth include Abarelix, SERMs (Selective Estrogen Receptor Modulators), Extracellular Matrix Modulators, Terbutaline, and RU-486.

San Jose, CA (Vocus/PRWEB) April 04, 2011

Endometriosis is the most common health problem among women.
As per the estimates of World Endometriosis Research Foundation, an estimated 170 million women suffer from endometriosis globally. Endometriosis-related healthcare costs and productivity losses exceed US$4,000 per patient annually. Annual direct and indirect endometriosis-related costs are estimated to cross US$20 to US$25 billion in the US over the coming years. The disease affects reproductive age women more compared to post-menopausal women. Endometriosis affects more than 90 million women of reproductive age globally. The disease represents one of the major causes of female infertility and constitutes for about 30% of infertility cases in women. More than 7.8 million women in the US suffer from endometriosis-related symptoms, which include chronic pelvic pain, dysmenorrhea, and infertility.

Gonadotropin-Releasing Hormone GnRH agonists, Progestins, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), and contraceptives are the major therapeutic options available for the treatment of endometriosis. The present drugs are characterized by safety and efficacy concerns. Huge unmet medical need exists for novel medication with improved safety profile and minimal side effects. Lupron Depot from Abbott Laboratories, Depo-Provera and Synarel from Pfizer, are the major drugs approved for the treatment of endometriosis. Abbott's Lupron (Leuprolide) represents one of the leading drugs for the treatment of endometriosis.

The global endometriosis market is led by the US, as stated by a new market research report on Endometriosis. Europe represents the next largest region, while growth is expected to emanate mainly from the ‘Rest of the world’ market, which is expected to depict a compounded annualized growth of more than 6.0% during 2009-2017. The future looks promising for endometriosis, with increasing efforts being made in research, and novel treatment emerging in the field of surgical as well as pharmaceutical treatment. In addition, myths are being dispelled regarding the disease, and alternative methods are being readily accepted. Non-invasive diagnostics, including next-generation MRIs, are forecast to become major tools for the diagnosis of endometriosis, although laparoscopy, an invasive surgery, still remains the gold standard for performing disease diagnosis. Genetic and biomolecular diagnostic tests are also being trailed.

Drugs that are expected to drive future market growth include Abarelix, SERMs (Selective Estrogen Receptor Modulators), Extracellular Matrix Modulators, Terbutaline, and RU-486. Abarelix, for instance, is a GnRH antagonist, presently undergoing clinical trials in the US for its use in endometriosis. The emergence of certain other promising innovative drugs, including Repros Therapeutics’ Proellex, Neurocrine’s Elagolix, and Bayer HealthCare Pharmaceuticals’ Visanne (Dienogest) is forecast to have a robust impact on the endometriosis market in future. Elagolix is the first oral non-peptide gonadotropin-releasing hormone (GnRH) antagonist. Meanwhile, Proellex acts by selectively blocking the activity of progesterone, and allows the secretions of tonic hormone by alleviating the negative side effects of GnRHa. Besides pipeline drugs, Angiogenesis therapy is forecast to be one of the key potential treatment options for endometriosis, whether used alone or as an adjunct therapy. Angiogenesis theory holds that endometriosis lesions could be destroyed by cutting off the blood supply.

Major players profiled in the report include Abbott Laboratories, AEterna Zentaris Inc., AstraZeneca Plc., Bayer HealthCare Pharmaceuticals Inc., Eli Lilly and Company, Meditrina Pharmaceuticals Inc., Neurocrine Biosciences Inc., Paladin Labs Inc., Pfizer Inc., Repros Therapeutics Inc., among others.

The research report titled “Endometriosis: A Global Strategic Business Report” announced by Global Industry Analysts Inc., provides a comprehensive review of endometriosis, current market trends, key growth drivers, the available treatment, overview of major drugs, insight into current leading and pipeline drugs, recent product approvals, recent industry activity, and profiles of major/niche global as well as regional market participants. The report provides annual sales estimates and projections for Endometriosis treatment for the years 2009 through 2017 for the following geographic markets - US, Canada, Japan, Europe, and Rest of World. Also, a six-year (2003-2008) historic analysis is provided for additional perspective.

For more details about this comprehensive market research report, please visit – http://www.strategyr.com/Endometriosis_Market_Report.asp

About Global Industry Analysts, Inc.

Global Industry Analysts, Inc., (GIA) is a reputed publisher of off-the-shelf market research. Founded in 1987, the company is globally recognized as one of the world’s largest market research publishers. The company employs over 800 people worldwide and publishes more than 1200 full-scale research reports each year. Additionally, the company also offers thousands of smaller research products including company reports, market trend reports, and industry reports encompassing all major industries worldwide.

Global Industry Analysts, Inc.

Telephone: 408-528-9966

Fax: 408-528-9977

E-mail: press(at)StrategyR(dot)com

Web Site: http://www.StrategyR.com/

If your doctor wants you to take Lupron, please watch this news clip first!

2011-03-29T06:28:00.002-04:00

I took a 6 months course of Lupron when I was 32. All I can seem to remember about this is I wished I had never done it. The side effects were awful. The pain of stage 4 endometriosis and their accompanying adhesions came right back.
I am now 49 with osteoperosis and almost an inch shorter than I was my whole adult life.
One time I presented at ER Mass General....and that witch sneered at me...."why aren't you taking lupron?"
I got off the table and just kept walking.....outta there!

Please....Lupron does not cure endometriosis.

Watch this investigative report before you decide to go this course.

Understanding Endometriosis

2011-03-27T06:55:00.000-04:00

'Top Chef's Padma Lakshmi gets personal about endometriosis

2011-03-26T11:46:00.000-04:00

'I didn’t know how much pain I was in until I wasn’t in pain anymore"

Cause Celeb highlights a celebrity’s work on behalf of a specific cause. This week, we speak with model, actress and television host Padma Lakshmi about her charity, the Endometriosis Foundation of America. Lakshmi herself had the painful disorder, which affects millions of women and adolescent girls in the United States.

Lakshmi joined the organization and relaunched it with Dr. Tamer Seckin in 2009. Lakshmi, host of “Top Chef” on Bravo channel, uses her celebrity to bring awareness to the disease and its symptoms. Endometriosis is an often painful disorder in which tissue that normally lines the inside of the uterus grows outside the uterus.On March 18, the Endometriosis Foundation of America hosted its third annual Blossom Ball to raise funds to combat the debilitating condition. To find out more information about endometriosis and future events, you can visit http://www.endofound.org/.

Click here to read more

FDA Approves BENLYSTA® For Lupus In Breakthrough For Millions Of Sufferers

2011-03-23T09:18:00.003-04:00

Since Lupus has an ancillary tie to endometriosis we report on such issues.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

FDA Approves BENLYSTA® For Lupus In Breakthrough For Millions Of Sufferers-199m ago Medical News Today
The Lupus Research Institute (LRI) and its National Coalition of state and local lupus organizations welcome the U.S. Food and Drug Administration's (FDA) historic approval of BENLYSTA® (belimumab) for systemic lupus erythematosus (lupus), launching the
Click here to read the rest

Adhesion Related Disorder International Human Rights Team IHRT: Preventing Adhesions in Gynaecologic Surgery

2011-03-16T07:14:00.000-04:00

March is Endometriosis Awareness Month!

2011-03-15T11:09:00.001-04:00

Endometriosis from Endometriosis.org on Vimeo.

ARDvark Blog Journal of Adhesion Related Disorder: For Post-Traumatic Stress Disorder In Women, New Biological Pathway Identified

2011-03-10T10:21:00.000-05:00

ARDvark Blog Journal of Adhesion Related Disorder: For Post-Traumatic Stress Disorder In Women, New Biological Pathway Identified