FEBRUARY 18, 2014

A BREAKTHROUGH IN A DISEASE THAT NO ONE LIKES TO TALK ABOUT

POSTED BY AMANDA SCHAFFER

" Over the years, Linda Griffith, a biological engineer at the Massachusetts Institute of Technology, has undergone nine surgeries for endometriosis. In women with the disease, tissue that normally lines the uterus grows elsewhere in the body—for instance, on the ovaries, bladder, or bowel—often causing pain, infertility, or both. In early-stage cases, patients have small lesions, usually accompanied by inflammation; if the disease progresses, scar tissue may cause one organ to stick to another. The bladder might attach to the uterus, or the ovary might attach to the bowel. It’s “like someone poured superglue into the pelvis, and organs that normally are free to move around are, all of a sudden, just stuck,” Keith Isaacson, a gynecologist and surgeon at Newton-Wellesley Hospital, in Massachusetts, said. He operated several times on Griffith, a MacArthur fellowship recipient, and is now her scientific collaborator."

New York Times

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A BREAKTHROUGH IN A DISEASE THAT NO ONE LIKES TO TALK ABOUT

POSTED BY AMANDA SCHAFFER

http://www.newyorker.com/online/blogs/elements/2014/02/a-breakthrough-in-a-disease-that-no-one-likes-to-talk-about.html

"The work also hints at potential new treatments. No new drugs for endometriosis have been approved in decades, and most of the current ones target hormones that can fuel the growth of uterine tissue. “The first line is always a birth-control pill,” said Taylor. This approach seems to work for some women, reducing pain and perhaps stopping the growth of lesions, but not for everyone, and sometimes its effectiveness wanes. Patients also commonly use drugs like ibuprofen, which target inflammation but are not specifically designed to treat endometriosis. The M.I.T. group’s work suggests that it might be possible to reduce inflammation in a more targeted way in some patients with the disease."

What it costs to have endometriosis

J Manag Care Pharm. 2007 Apr;13(3):262-72.

Actuarial analysis of private payer administrative claims data for women with endometriosis.

Mirkin D, Murphy-Barron C, Iwasaki K.

Author information

Abstract

BACKGROUND:

Endometriosis is a painful, chronic disease affecting 5.5 million women and girls in the United States and Canada and millions more worldwide. The usual age range of women diagnosed with endometriosis is 20 to 45 years. Endometriosis has an estimated prevalence of 10% among women of reproductive age, although estimates of prevalence vary greatly. Endometriosis is the most common gynecological cause of chronic pelvic pain, but published information on its associated medical care costs is scarce.

OBJECTIVE:

The aim of this study was to determine (1) the prevalence of endometriosis in the United States, (2) the amount of health care services used by women coded with endometriosis in a commercial medical claims database during 1999 to 2003, and (3) the endometriosis-related costs for 2003, the most recent data available at the time the study was performed.

METHODS:

This study was a retrospective review of administrative data for commercial payers, which included enrollment, eligibility, and claims payment data contained in the Medstat Marketscan database for approximately 4 million commercial insurance members. All claims and membership data were extracted for each woman aged 18 to 55 years who had at least 1 medical or hospital claim with a diagnosis code for endometriosis (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 617.00-617.99) for 1999 through 2003. Claims data from 1999 through 2003 were used to determine prevalence and health care resource utilization (i.e., annual admission rate, annual surgical rate, distribution of endometriosis-related surgeries, and prevalence of comorbid conditions). The cost analysis was based on claims from 2003 only. Cost was defined as the payer-allowed charge, which equals the net payer cost plus member cost share.

RESULTS:

The prevalence of women with medical claims (inpatient and/or outpatient) containing ICD-9-CM codes for endometriosis was 1.1% for the age band of 30 to 39 years and 0.7% over the entire age span of 18 to 55 years. The medical costs per patient per month (PPPM) for women with endometriosis were 63% greater ($706 PPPM) than those of the average woman per member per month ($433) in 2003; inpatient hospital costs accounted for 32% of total direct medical costs. Between 1999 and 2003, these women with endometriosis who were identified by either inpatient and/or outpatient claims had high rates of hospital admission (53% for any reason; 38% for an endometriosis-related reason) and a high annual surgical procedure rate (64%). Additionally, women with endometriosis frequently suffered from comorbid conditions, and these conditions were associated with greater PPPM costs of 15% to 50% for women with an endometriosis diagnosis code, depending on the condition. Interstitial cystitis was associated with 50% greater cost ($1,061 PPPM); depression, 41% ($997 PPPM); migraine, 40% ($988 PPPM); irritable bowel syndrome, 34% ($943 PPPM); chronic fatigue syndrome, 29% ($913 PPPM); abdominal pain, 20% ($846 PPPM); and infertility, 15% ($813 PPPM).

CONCLUSIONS:

Women with endometriosis have a high hospital admission rate and surgical procedure rate and a high incidence of comorbid conditions. Consequently, these women incur total medical costs that are, on average, 63% higher than medical costs for the average woman in a commercially insured group.

PMID:

 

17407392

 

[PubMed - indexed for MEDLINE] 

Fre

I bet you say that to all the girls with Endometriosis...

Fertil Steril. 2013 Jan;99(1):212-8. doi: 10.1016/j.fertnstert.2012.08.039. Epub 2012 Sep 15.

Attractiveness of women with rectovaginal endometriosis: a case-control study.

Vercellini P, Buggio L, Somigliana E, Barbara G, Viganò P, Fedele L.

Source

Clinica Ostetrica e Ginecologica, Istituto Luigi Mangiagalli, Università degli Studi, and Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy. paolo.vercellini@unimi.it

Abstract

OBJECTIVE:

To evaluate physical attractiveness in women with and without endometriosis.

DESIGN:

Case-control study.

SETTING:

Academic hospital.

PATIENT(S):

Three hundred nulliparous women.

INTERVENTION(S):

Assessment of attractiveness by four independent female and male observers.

MAIN OUTCOME MEASURE(S):

A graded attractiveness rating scale.

RESULT(S):

A total of 31 of 100 women in the rectovaginal endometriosis group (cases) were judged as attractive or very attractive, compared with 8 of 100 in the peritoneal and ovarian endometriosis group and 9 of 100 in the group of subjects without endometriosis. A higher proportion of cases first had intercourse before age 18 (53%, 39%, and 30%, respectively). The mean ± SD body mass index in women with rectovaginal endometriosis, in those with other disease forms, and in those without endometriosis was, respectively, 21.0 ± 2.5, 21.3 ± 3.3, and 22.1 ± 3.6. The median (interquartile range) waist-to-hip ratio and breast-to-underbreast ratio were, respectively, 0.75 (0.71-0.81), 0.76 (0.71-0.81), and 0.78 (0.73-0.83), and 1.15 (1.12-1.20), 1.14 (1.10-1.17), and 1.15 (1.11-1.18).

CONCLUSION(S):

Women with rectovaginal endometriosis were judged to be more attractive than those in the two control groups. Moreover, they had a leaner silhouette, larger breasts, and an earlier coitarche.

Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

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1. Women With Endometriosis More Attractive - Endometriosis Study ...

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The Role of DJ-1 in the Pathogenesis of Endometriosis

Some light reading...

PLoS One. 2011; 6(3): e18074.

Published online 2011 March 21. doi:  10.1371/journal.pone.0018074

PMCID: PMC3061880

The Role of DJ-1 in the Pathogenesis of Endometriosis

Priyanka Rai and Sisinthy Shivaji*

Jean-Marc Vanacker, Editor

Author information ► Article notes ► Copyright and License information ►

Abstract

Background

Endometriosis is an estrogen-dependent disease causing pelvic pain and infertility in 10% of reproductive-aged women. Despite a long history of the disease the pathogenesis of endometriosis is poorly understood. It is known that the expression of several proteins is either up or down regulated during endometriosis, but their precise role remains to be determined. DJ-1 is one such protein that is upregulated in eutopic endometrium of women having endometriosis suggesting that DJ-1 may be involved in the pathogenesis of endometriosis

Link to the rest: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3061880/

Thanks to U.S. National Library of Medicine