Showing posts with label endo. Show all posts
Showing posts with label endo. Show all posts
Friday, May 16, 2014
Thursday, April 24, 2014
Genetic Screening For Endometriosis-Associated Ovarian Cancer
April Flowers for redOrbit.com – Your Universe Online
Endometriosis is a chronic inflammatory disease that affects more than 176 million women and girls worldwide, according to the Endometriosis Foundation of America. Despite being one of the most common gynecological disorders, there is no definitive consensus on the cause of endometriosis. To add insult to injury, some women who have endometriosis are also predisposed to ovarian cancer.
A new study from the University of Pittsburgh Cancer Institute (UPCI) and Magee-Womens Research Institute (MWRI) reveals that genetic screening could someday help clinicians to know which women are most at risk.
The research team will present their results on the first comprehensive immune gene profile exploring endometriosis and cancer on Monday at the American Association for Cancer Research (AACR) Annual Meeting 2014.
“A small subset of women with endometriosis go on to develop ovarian cancer, but doctors have no clinical way to predict which women,” said Anda Vlad, MD, PhD, assistant professor of obstetrics, gynecology and reproductive sciences at MWRI. “If further studies show that the genetic pathway we uncovered is indicative of future cancer development, then doctors will know to more closely monitor certain women and perhaps take active preventative measures, such as immune therapy.”
Endometriosis is a painful condition that is often misdiagnosed for years before some form of correct treatment is attempted. As redOrbit reported in February, it is called a disease of theories, because so little is known about how it works, or who it will strike.
“We know there is a genetic component, we know there is an environmental component, and we know there is an inflammatory component. But it’s very difficult to say for individual patients what particular sequence of events led to particular symptoms,” Michael Beste, a postdoc in MIT’s Department of Biological Engineering, said.
It is the genetic component, and its association to cancer, that Vlad and her team are focused on finding.
Vlad and her team screened tissue samples from women with benign endometriosis, women with precancerous lesions and women with endometriosis-associated ovarian cancer. This allowed the researchers to identify the complement pathway, which refers to a series of protein interactions that trigger an amplified immune response, as the most prominent immune pathway that is activated in both endometriosis and endometriosis-associated ovarian cancer.
“If, as our study indicates, a problem with the immune system facilitates cancer growth through chronic activation of the complement pathway, then perhaps we can find ways to change that and more effectively prime immune cells to fight early cancer, while controlling the complement pathway,” said Swati Maruti Suryawanshi, PhD, a post-doctoral research fellow at MWRI.
Source: April Flowers for redOrbit.com - Your Universe Online
Topics: Health Medical Pharma, Endometriosis, Menstrual cycle, Medicine, American Association for Cancer Research, Health, Cancer, ovarian cancer
Read more at http://www.redorbit.com/news/health/1113114048/endometriosis-and-ovarian-cancer-040514/#XMkO89uv8p3qqxHf.99
Thursday, April 17, 2014
Safety and Effect on Quality of Life of Laparoscopic Douglasectomy with Radical Excision for Deeply Infiltrating Endometriosis in the Cul-de-Sac.
J Laparoendosc Adv Surg Tech A. 2014 Mar;24(3):165-70. doi: 10.1089/lap.2013.0270.
Safety and Effect on Quality of Life of Laparoscopic Douglasectomy with Radical Excision for Deeply Infiltrating Endometriosis in the Cul-de-Sac.
Abstract
Abstract Objective: To evaluate the safety and effects on health-related quality of life (HRQOL) of radical excision of deeply infiltrating endometriosis (DIE) in the cul-de-sac. Patients and Methods: This study included 390 patients with pathologically proven DIE in the cul-de-sacwho underwent laparoscopic surgery between January 2000 and December 2011. The preoperative and postoperative visual analog scale (VAS) pain scores and HRQOL data from the 36-item Short Form (SF-36) questionnaire were recorded in 343 patients. Surgical outcomes, complications, and HRQOL were compared between patients who underwent hysterectomy and those who did not. Data were analyzed using the paired t test, Student's t test, and Pearson's correlation analysis. Results: In the group overall, the VAS pain score and all SF-36 scales improved after surgery. In patients who underwent hysterectomy, all SF-36 scales improved except physical functioning, role-physical, general health, and vitality. In patients who did not undergo hysterectomy, all SF-36 scales improved except general health. There were significant associations between gonadotropin-releasing hormone agonist therapy and SF-36 mental health, SF-36 mental component summary, and oral medication use. The VAS pain score and SF-36 body pain score showed the greatest improvement, and the SF-36 general health score showed the least improvement. Patients who underwent hysterectomy had more severe disease and poorer surgical outcomes than those who did not undergo hysterectomy. Conclusions: Laparoscopic radical excision of DIE in the cul-de-sac is safe and significantly improves HRQOL, especially in terms of pain. The severity of endometriosis may affect the degree of improvement in HRQOL scores.
- PMID:
- 24625348
- [PubMed - in process]
Wednesday, April 16, 2014
Researchers to present at the World Congress on Endometriosis in Brazil
Wednesday, April 16, 2014 - 00:48 Updated 4 hours ago
Dr. Nalini Santanam, a professor in the Department of Pharmacology, Physiology and Toxicology, and biomedical sciences doctoral student Kristeena Ray said they are looking forward to participating in the conference, which is being held April 30-May 3.
"Though 10 to 15 percent of young women suffer from endometriosis and almost two-thirds of these women suffer from chronic pain, the exact nature of this disease is not very well understood. My laboratory has a long-standing interest in understanding why some women get endometriosis and have pain," said Santanam. "We are very honored that our abstracts were chosen for presentation at this meeting. The most exciting part was to find out that Kristeena was selected to give an oral presentation and was one of only six investigators selected to receive the Rodolphe Maheux Travel Grant."
Friday, April 11, 2014
Vitamin D and female fertility
Curr Opin Obstet Gynecol. 2014 Apr 8. [Epub ahead of print]
Vitamin D and female fertility.
Abstract
PURPOSE OF REVIEW:
Apart from the well known effects of vitamin D on maintaining calcium homeostasis and promoting bone mineralization, there is some evidence suggesting that vitamin D also modulates human reproductive processes. We will review the most interesting and relevant studies on vitamin D and female fertility published over the past year.
RECENT FINDINGS:
In the past year, several observational studies reported a better in-vitro fertilization outcome in women with sufficient vitamin D levels (≥30 ng/ml), which was mainly attributed to vitamin D effects on the endometrium. One randomized controlled trial found an increased endometrial thickness in women with polycystic ovary syndrome (PCOS) receiving vitamin D during intrauterine insemination cycles. Further, vitamin D supplementation had a beneficial effect on serum lipids in PCOS women. Vitamin D treatment improved endometriosis in a rat model and increased vitamin D intake was related to a decreased risk of incident endometriosis. Vitamin D was also favorably associated with primary dysmenorrhea, uterine leiomyoma, and ovarian reserve in late reproductive aged women.
SUMMARY:
In women undergoing in-vitro fertilization, a sufficient vitamin D level (≥30 ng/ml) should be obtained. Vitamin D supplementation might improve metabolic parameters in women with PCOS. A high vitamin D intake might be protective against endometriosis.
- PMID:
- 24717915
- [PubMed - as supplied by publisher]
MIT bioengineer works to unravel endometriosis
By Carolyn Y. Johnson / Globe Staff
Linda Griffith, a biological engineer at MIT who used a new technique to begin to unravel the molecular cause of endometriosis.
For four years, MIT bioengineer Linda Griffith has been slowly unraveling the biology of endometriosis, a complicated and poorly understood disease that she has silently struggled with her entire life. The condition—in which tissue normally found in the uterus grows elsewhere in the body—is remarkably common. It causes severe pain and infertility and affects up to 10 percent of women, yet relatively little is known about what causes it, how to prevent it, or even how to effectively treat it.
Thursday, April 10, 2014
Endometriosis symptoms and pain written off too often
By ASHLEIGH GLEESON Health
A HUNTER woman who once menstruated through her belly button is sharing her personal story to raise awareness about endometriosis.
Naomi Weatherburn, 46, suffered from painful periods ever since she was a teenager.
But despite the condition being so common – approximately one in 10 women have it – the GPs and gynaecologists she visited told her some level of pain was normal and she would just have to endure it.
It wasn’t until Ms Weatherburn was married and stopped taking the pill because she wanted to get pregnant that she was diagnosed with endometriosis."
Wednesday, April 09, 2014
Author Hilary Mantel: 'It won’t all be novels now — it could be plays' ~ Writes with severe Endometriosis
"Mantel has written about the severe endometriosis that doctors failed to diagnose in her youth; how it caused the loss of her fertility and the doubling of her body weight in less than a year.
Now she says the condition defined her as a writer, indeed made her one. “You really live on the verge of panic because you don’t know what’s going on inside you. And when the pain isn’t there, you know it’s waiting for you. It’s why I became a writer in the first place. I don’t like to let people down and I couldn’t have gone into an office every day.
“Sometimes I’ve travelled [to author events] and gone on stage when any sensible person would have stayed at home. I have sat in car parks thinking, ‘Do I go in and do the talk or do I go to A&E?’"
UPCI/MWRI researchers to present results of immune gene profile exploring endometriosis and cancer
Some women with endometriosis, a chronic inflammatory disease, are predisposed toovarian cancer, and a genetic screening might someday help reveal which women are most at risk, according to a University of Pittsburgh Cancer Institute (UPCI) study, in partnership with Magee-Womens Research Institute (MWRI).
Monday at the American Association for Cancer Research (AACR) Annual Meeting 2014, UPCI and MWRI researchers will present the preliminary results of the first comprehensive immune gene profile exploring endometriosis and cancer.
"A small subset of women with endometriosis go on to develop ovarian cancer, but doctors have no clinical way to predict which women," said senior author Anda Vlad, M.D., Ph.D., assistant professor of obstetrics, gynecology and reproductive sciences at MWRI. "If further studies show that the genetic pathway we uncovered is indicative of future cancer development, then doctors will know to more closely monitor certain women and perhaps take active preventative measures, such as immune therapy."
Monday, April 07, 2014
Monday, March 31, 2014
Eve's Daughters, or, Go With the Flow
In the beginning, there was pain.
My periods began when I was 13-years-old, and I only remember them accompanied with pain. I bled heavily each month for six to eight days. As I got older, I would find myself passed out on my bedroom or bathroom floor from painful cramps. I would pass heavy blood clots, was often lightheaded, and regularly was prescribed iron supplements and over-the-counter medications like ibuprofen. When Alleve came on the market, I was thrilled to try a new pain reliever. They would dull, but never eradicate, the pain. My periods were always preceded with hefty bouts of PMS; I suffered from bloating, fatigue, headaches, skin rashes, and swelling in my knees and fingers.
When I'd report these symptoms to my doctor, he told me that periods can be like that. Some girls have problems, others don't. I just happened to be one of the girls who had a problem period. My mother told me the same thing, adding, "That's what my mother told me. It was like that for me and for other girls I knew growing up, too." As Carol Pearson discusses in her TEDTalk, as Zora Neale Hurston wrote inTheir Eyes Were Watching God ("Black women are the mules of the world"), as Eve was told after she fed into her curiosity and took a bite of that forbidden fruit, I learned -- whether the lesson was intended to be learned this way or not -- that being a girl, becoming a woman, was painful. And I had to live with that pain. I had to learn to handle pain.
And so I did. I went with the flow.
What I didn't know was that I had endometriosis.Endometriosis is a disease that affects 10 percent of women globally. It knows no race, class, or socioeconomic status. Some doctors refer to endometriosis as a benign cancer. Padma Lakshmi, model and co-founder of the Endometriosis Foundation of America, describes the disease as "a web, like a vapor, like weeds in a garden that permeate everything, and stain everything. And metaphorically as well as clinically what you have to go and do, whether it is with laparoscopy or therapy or just understanding and support, is you have to go in there... and get rid of it. Not only getting rid of it in the womb, but getting rid of it in the heart and the mind."
When I'd report these symptoms to my doctor, he told me that periods can be like that. Some girls have problems, others don't. I just happened to be one of the girls who had a problem period. My mother told me the same thing, adding, "That's what my mother told me. It was like that for me and for other girls I knew growing up, too." As Carol Pearson discusses in her TEDTalk, as Zora Neale Hurston wrote inTheir Eyes Were Watching God ("Black women are the mules of the world"), as Eve was told after she fed into her curiosity and took a bite of that forbidden fruit, I learned -- whether the lesson was intended to be learned this way or not -- that being a girl, becoming a woman, was painful. And I had to live with that pain. I had to learn to handle pain.
And so I did. I went with the flow.
What I didn't know was that I had endometriosis.Endometriosis is a disease that affects 10 percent of women globally. It knows no race, class, or socioeconomic status. Some doctors refer to endometriosis as a benign cancer. Padma Lakshmi, model and co-founder of the Endometriosis Foundation of America, describes the disease as "a web, like a vapor, like weeds in a garden that permeate everything, and stain everything. And metaphorically as well as clinically what you have to go and do, whether it is with laparoscopy or therapy or just understanding and support, is you have to go in there... and get rid of it. Not only getting rid of it in the womb, but getting rid of it in the heart and the mind."
Saturday, March 22, 2014
New Guideline: Management of Women With Endometriosis
ESHRE Guideline: Management of Women With Endometriosis
Dunselman GA, Vermeulen N, Becker C, et al
Hum Reprod. 2014;29:400-412
Hum Reprod. 2014;29:400-412
Background
Endometriosis can be diagnosed when endometrial tissue is found in extrauterine locations. It is found in 10%-15% of the general population and in up to one third of the infertile population.[1] There are various theories that attempt to explain its etiology. Some cases can be explained by retrograde menstruation, but metaplasia, hormonal, inflammatory processes, and abnormal cytokine function also seem to play a role.[2]
A wide variety of symptoms may accompany endometriosis. Some women are asymptomatic, whereas others are affected by dysmenorrhea, menorrhagia, dyspareunia, chronic pelvic pain, and urinary and gastrointestinal symptoms. The symptoms typically recur in a cyclic fashion, and an exacerbation can occur around menstruation.
The diagnosis can be suspected on the basis of symptoms but is established when histologic confirmation of endometrial glands and stroma is made from a tissue biopsy sample obtained from an extrauterine location.
Read the rest here: http://www.medscape.com/viewarticle/822100
Wednesday, March 19, 2014
Monday, March 17, 2014
A BREAKTHROUGH IN A DISEASE THAT NO ONE LIKES TO TALK ABOUT
FEBRUARY 18, 2014
A BREAKTHROUGH IN A DISEASE THAT NO ONE LIKES TO TALK ABOUT
Sunday, March 16, 2014
Transvaginal hydrolaparoscopy. as diagnostic tool Endometriosis Adhesions
JSLS. 2012 Jul-Sep;16(3):461-5. doi: 10.4293/108680812X13462882736295.
Transvaginal hydrolaparoscopy.
Abstract
Transvaginal hydrolaparoscopy (THL) is being performed regularly in Europe and China, but rarely in the United States. The reasons may be physicians' unfamiliarity with the procedure and their uneasiness over potential rectal puncturing due to the proximity of the rectum to the vaginal trocar insertion site. THL has the advantage over hysterosalpingography (HSG) in that it allows for direct visualization of the tubal mucosa in addition to determining tubal patency. THL has advantages over traditional laparoscopy in that it does not require an abdominal incision and has the capability of being conducted in an outpatient office setting with local anesthesia. Studies have shown that THL has comparable accuracy to laparoscopy with 96.1% concordance between THL and laparoscopic findings. THL may be combined with chromopertubation and salpingoscopy. In addition to diagnostic purposes, THL may be used for operative intervention including adhesiolysis, endometriosis ablation, and ovarian drilling. Studies from France and China report the occurrence of rectal injury from 0% to1%. Despite the advantages of THL and low reports of rectal injury, THL has not gained popularity in the United States. The purpose of this article is to familiarize gynecologists in the United States with THL.
- PMID:
- 23318074
- [PubMed - indexed for MEDLINE]
- PMCID:
- PMC3535799
Transvaginal endoscopy and small ovarian endometriomas: unravelling the missing link?
Gynecol Surg. 2014;11:3-7. Epub 2013 Oct 17.
Abstract
The incidence of endometriosis in the infertile female is estimated to be between 20 and 50 %. Although the causal relationship between endometriosis and infertility has not been proven, it is generally accepted that the disease impairs reproductive outcome. Indirect imaging techniques and transvaginal laparoscopy now offer the possibility of an early stage diagnosis. Although it remains debated whether the disease is progressive, treatment in an early stage is recommendable as it carries less risk for ovarian damage, hence premature ovarian failure. Under water, inspection with the technique of transvaginal hydrolaparoscopy (THL) accurately shows the invagination of the ovarian cortex as minimal superficial lesions but with the presence of well-differentiated endometrial like tissue at the base, the lateral walls and especially the inner edges of the small endometrioma. An inflammatory environment is responsible for the formation of connecting adhesions with the broad ligament and lateral wall with invasion of endometrial-like tissue and formation of adenomyotic lesions. In around 50 % of the small endometriomas, adhesiolysis is necessary at the site of invagination with opening of the cyst, to free the chocolate content and hereby recognize the underlying endometrioma. The detailed inspection of these early-stage endometriotic lesions at THL reunites the hypothesis of Sampson with the observation of Hughesdon.
KEYWORDS:
Endometrioma, Endoscopy, Hydroflotation, Ovarian endometriosis, Pathogenesis, Surgery, Transvaginal hydrolaparoscopy
- PMID:
- 24611037
- [PubMed]
http://www.ncbi.nlm.nih.gov/pubmed/24611037
Subscribe to:
Posts (Atom)