ARD, CAPPS, Adhesions and Adhesion Related Disorder , Internal Scar Tissue, Hope for those who suffer from Adhesions

Wednesday, April 09, 2014

ARDvark Blog Journal of Adhesion Related Disorder: Adhesion Barrier Not Helpful for Cesarean Delivery ~ Seprafilm

ARDvark Blog Journal of Adhesion Related Disorder: Adhesion Barrier Not Helpful for Cesarean Delivery ~ Seprafilm

New pain killer Zohydro making headlines

Zohydro to be Manufactured by Same Company That Makes Addiction Medicine

The newly approved pure hydrocodone product, Zohydro ER (extended release), will be made by the same company that manufactures Vivitrol, a drug used to treat patients addicted to opioids or alcohol, The New York Times reports.
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Boston Globe ‎- 6 hours ago
A federal judge said Tuesday that she will probably strike 
down Governor Deval Patrick's emergency ban on the sale of Zohydro, 
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Super-Strong 'Zohydro' About To Hit The Street - HuffPost Live


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  1. FDA-Approved Painkiller Zohydro Concerns Critics - WebMD

    Feb 27, 2014 - A new narcotic painkiller is due to come on the market in March, and critics want the FDA to reverse its approval of the drug, Zohydro ER.
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  3. From the manufacturer
    1. Zohydro ER (hydrocodone bitartrate) Extended-Release Capsules

      Zohydro™ ER is an opioid agonist, extended-release, oral formulation of hydrocodone bitartrate indicated for the management of pain severe enough to require ...

Tuesday, April 08, 2014

Dr. C.Y. Liu OBGYN M.D. FACOG, FACS


St. Vincent’s Medical Center in New York and Chattanooga Tennessee. 
http://www.womenssurgerygroup.com
Dr. C.Y. Liu is an internationally recognized leader and pioneer in the subspecialty of gynecological endoscopic surgery (laparoscopic and hysteroscopic) surgery. For the past 15 years, Dr. Liu has devoted his work exclusively to gynecological endoscopic surgery. Recognized internationally is his pioneer work in urogynecological laparoscopic surgery (a specialty dealing with female organ prolapse and urinary and fecal incontinence).He holds the record for performing the most laparoscopic hysterectomy in the world and has extensive professional publications and presentations to his credit. Dr. Liu is one of the most sought-after surgeons for the performance of interactive live surgical demonstration at large international medical meetings both in United States and abroad. He was recognized and awarded by the European Gynecologic Endoscopic Society as one of the most achieved and excellent Gynecologic Endoscopic Surgeon in the world in September 2000, Paris, France. 
Dr. C.Y. Liu’s practice is limited to gynecological laser laparoscopic surgery, and he maintains a practice at St. Vincent’s Medical Center in New York and Chattanooga Tennessee. 
Adhesion Specialist
Dr. C.Y. Liu OBGYN M.D. FACOG, FACS
View Curriculum Vitae

ARDvark Blog Journal of Adhesion Related Disorder: A Comparative Analysis between Laparoscopic and Open Adhesiolysis at a Tertiary Care Center.

ARDvark Blog Journal of Adhesion Related Disorder: A Comparative Analysis between Laparoscopic and Open Adhesiolysis at a Tertiary Care Center.

Sunday, April 06, 2014

Recognising Dr Daniel Kruschinski ~ Twenty simple signs to spot a psychopath.

Scientist: Twenty simple signs to spot a psychopath...

" The list includes: glibness and superficial charm, grandiose sense of self-worth, cunning/manipulative, pathological lying, emotional shallowness, callousness and lack of empathy, a tendency to boredom, impulsivity, criminal versatility, behavioural problems in early life, juvenile delinquency, and promiscuous sexual behaviour."
Click link above for more insight.

Quack Doc Watch: Beware of the Claims of Dr Daniel Kruschinski of Germany

Quack Doc Watch: Beware of the Claims of Dr Daniel Kruschinski of Germany

ARDvark Blog Journal of Adhesion Related Disorder: Adhesiolysis in Germany Dr. Matthias Korell and Dr. Jens Pagel

ARDvark Blog Journal of Adhesion Related Disorder: Adhesiolysis in Germany Dr. Matthias Korell and Dr. Jens Pagel

Adhesiolysis in Germany Dr. Matthias Korell and Dr. Jens Pagel

Adhesiolysis in Germany Dr. Matthias Korell and Dr. Jens Pagel

Dr. Matthias Korell
Johanna-Etienne Hospital Neuss
On Hasenbergstraße 46 
41462 Neuss 
North Rhine-Westphalia
Germany
Phone : 02131/5295-5002 
Fax: 02131/5295-5003 

PD Dr. Matthias Korell practiced as:
  • Specialist in Obstetrics u.Geburtshilfe
  • PD Dr. Matthias Korell speaks: German.Vocational group is senior consultant or senior doctor. 
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 Dr. Jens Pagel
St. Joseph's Hospital Department of Obstetrics and Gynecology
Asberger Strasse 4 
47441 Moers 
North Rhine-Westphalia
Germany
Phone : 02841/107-2430 
Fax: 02841/107-2000 
Dr. Jens Pagels practiced as:

CryoLife Receives FDA Approval to Begin Clinical Trials for PerClot® in the U.S.

PRESS RELEASE
April 2, 2014, 8:32 a.m. EDT

CryoLife Receives FDA Approval to Begin Clinical Trials for PerClot® in the U.S.

ATLANTA, April 2, 2014 /PRNewswire/ -- CryoLife, Inc.CRY -3.24% , a leading medical device and tissue processing company focused on cardiac and vascular surgery, announced today that it has received approval of its Investigational Device Exemption (IDE) for PerClot from the United States Food and Drug Administration (FDA).  This approval allows CryoLife to begin its pivotal clinical trial to gain approval to commercialize PerClot in the U.S. The Company plans to begin enrollment in the trial in the second quarter of 2014, and could potentially receive pre-market approval from the FDA by the end of 2015.
PerClot is a unique hemostat composed of absorbable polysaccharide granules and is intended for use in surgical procedures as an adjunctive hemostatic device when control of capillary, venular and arteriolar bleeding by pressure, ligature and other conventional means is ineffective or impractical.  PerClot has CE Mark designation, and CryoLife began distributing PerClot in several international markets in the fourth quarter of 2010. 
The PerClot IDE is a prospective, multicenter, multidisciplinary, controlled clinical investigation.  The study will include 320 patients across cardiac, general and urological surgical specialties.  The primary objective of this investigation will be to collect clinical data concerning the safety and efficacy of PerClot versus C.R. Bard's Arista MPH Hemostat in multiple surgical disciplines when used as an adjunct to conventional means of achieving hemostasis such as pressure or ligature.  The primary efficacy endpoint of this investigation will be achievement of hemostasis at the site of application at five minutes following application of the prescribed hemostatic agent.  The secondary efficacy endpoint for this investigation will be hemostasis at the site of application evaluated at two minutes.  Safety endpoints will include, but are not limited to, the incidence of reoperation due to bleeding, total hospitalization and procedure time, and the incidence of procedure complications and/or adverse events through final patient follow-up at three months.
"We're pleased to have received this approval, which will allow us to begin our U.S. clinical trial for PerClot," stated Steven G. Anderson, CryoLife president and chief executive officer.  "Based on the anticipated enrollment and follow up timeline, we could potentially receive pre-market approval for PerClot by the end of 2015."
The U.S. hemostatic market is estimated to have been $780 million in 2013 growing to approximately $915 million by 2016, while the European market is estimated to have been $395 million in 2013 growing to approximately $468 million by 2016.[1]
About PerClot
PerClot is a medical device composed of absorbable polysaccharide granules and delivery applicators.  The granules are biocompatible, non-pyrogenic and derived from purified plant starch.  The granules do not contain any human or animal components.  PerClot granules have a molecular structure that rapidly absorbs water, forming a gelled adhesive matrix that provides a mechanical barrier to further bleeding and results in the accumulation of platelets, red blood cells and coagulation proteins (thrombin, fibrinogen, etc.) at the site of application.  PerClot is intended for use in surgical procedures as an adjunctive hemostatic device when control of capillary, venular and arteriolar bleeding by pressure, ligature and other conventional procedures is ineffective or impractical.
PerClot is ready to use, requiring no mixing and/or other components and does not need special handling or storage conditions.  Preclinical evaluations, clinical studies and surgical use have shown the efficacy of PerClot to be comparable to the current popular choice of surgical hemostatic materials.
About CryoLife, Inc.
CryoLife, Inc. is a leader in medical device manufacturing and distribution and in the processing and distribution of implantable living human tissues for use in cardiac and vascular surgeries.  It operates throughout the U.S. and internationally.  CryoLife manufactures and distributes BioGlue® Surgical Adhesive, an FDA-approved adjunct to sutures and staples for use in adult patients in open surgical repair of large vessels.  BioGlue is also CE marked in Europe for use in soft tissue repair and has received additional marketing approvals in several other countries throughout the world.  CryoLife's BioFoam® Surgical Matrix is CE marked in Europe for use as an adjunct in the sealing of abdominal parenchymal tissues (liver and spleen) when cessation of bleeding by ligature or other conventional methods is ineffective or impractical.  CryoLife distributes PerClot®, an absorbable powdered hemostat, in Europe and other select international countries.  CryoLife, through its subsidiary Cardiogenesis Corporation, specializes in the treatment of coronary artery disease for severe angina using a laser console system and single-use, fiber-optic handpieces to perform a surgical procedure known as Transmyocardial Revascularization (TMR).  CryoLife and its subsidiary Hemosphere, Inc. market the HeRO® Graft, which is a solution for end-stage renal disease in certain hemodialysis patients.  CryoLife's CryoValve® SG pulmonary heart valve, processed using CryoLife's proprietary SynerGraft® technology, has FDA 510(k) clearance for the replacement of diseased, damaged, malformed or malfunctioning native or prosthetic pulmonary valves.  CryoLife's CryoPatch® SG pulmonary cardiac patch has FDA 510(k) clearance for the repair or reconstruction of the right ventricular outflow tract (RVOT), which is a surgery commonly performed in children with congenital heart defects.
Statements made in this press release that look forward in time or that express management's beliefs, expectations or hopes are forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995.  Such forward-looking statements reflect the views of management at the time such statements are made and are subject to a number of risks, uncertainties, estimates, and assumptions that may cause actual results to differ materially from current expectations.  These statements include those regarding the timing, plans and expectations related to the clinical testing and pre-market approval of PerClot, as well as the estimated growth of the U.S. and European hemostatic markets by 2016.  Risks potentially impacting these statements include the following:  There is no guarantee that the FDA will approve PerClot for distribution in the U.S. in accordance with our expected timeframe, if at all.  Clinical trials are subject to a number of risks, including unanticipated reactions or results, and we may ultimately be unsuccessful in our clinical trials and/or may be unable to obtain FDA approval to market PerClot in the U.S.  Our approval efforts, including clinical testing and regulatory submissions, for PerClot in the U.S. are subject to delays and cost overages, and management plans with respect to clinical testing, regulatory submissions and regulatory approvals are subject to change at any time based on the overall needs of the Company.  Even if we receive approval, we may be unsuccessful in our attempts to sell PerClot in the U.S. as other competing products may have penetrated the market by that time.  In addition, if we ultimately sell PerClot in the U.S., we will likely end up in a patent infringement lawsuit with C.R. Bard's Medafor, Inc. subsidiary, which will be expensive.  If we lose, we may be prohibited from selling PerClot in the U.S. or may have to pay substantial royalties or damages when we sell PerClot in the U.S.  Our ability to fully realize our investment in Starch Medical, Inc. is dependent on our ability to sell PerClot in the U.S. at a reasonable rate of return, which may be materially negatively impacted by any royalty that we might be required to pay. Growth of U.S. and European hemostatic markets is subject to a number of factors, including economic conditions, government regulations, patient and physician acceptance, technology advances and competition from other products.  Our estimates regarding the growth of the hemostatic markets may be incorrect, and the markets may shrink, or fail to grow as expected, due to factors beyond our control, including general economic conditions.  To the degree that our estimates regarding the growth of the hemostatic markets are correct, there is no guarantee that we will successfully grow sales within these markets. CryoLife's business is also subject to a number of risks and uncertainties, including the risk factors detailed in our Securities and Exchange Commission filings, including our Form 10-K filing for the year ended December 31,  2013 and the Company's other SEC filings.  The Company does not undertake to update its forward-looking statements.
For additional information about the company, visit CryoLife's Web site: http://www.cryolife.com .
[1] Millennium Research Group (MRG) Report – US Markets for Surgical Hemostats, Internal Tissue Sealants and Adhesion Barriers 2013 RPUS20SA13, page 47.  Frost and Sullivan Report – European Tissue Sealants and Topical Hemostats Market M2F8-54 Oct 2008, Page 95.
Contacts: 


CryoLifeThe Ruth Group
D. Ashley LeeNick Laudico / Zack Kubow
Executive Vice President, Chief Financial Officer 646-536-7030 / 7020
 and Chief Operating Officer  nlaudico@theruthgroup.com
Phone: 770-419-3355zkubow@theruthgroup.com
SOURCE CryoLife, Inc.

Histone deacetylase inhibitors decrease intra-abdominal adhesions with one intraoperative dose by reducing peritoneal fibrin deposition pathways.

 2014 Feb;155(2):234-44. doi: 10.1016/j.surg.2013.08.018. Epub 2013 Nov 14.

Histone deacetylase inhibitors decrease intra-abdominal adhesions with one intraoperative dose by reducing peritoneal fibrin deposition pathways.

Abstract

BACKGROUND:

We previously demonstrated that postoperative peritoneal injury and inflammation contribute to adhesiogenesis. Recent evidence suggests that in addition to their role of interfering with the acetylation status of nuclear histone proteins, histone deacetylase inhibitors (HDACIs) including valproic acid (VPA) can target nonhistone proteins to resolve inflammation and modulate immune cells. We hypothesized that HDACIs could reduce adhesions.

METHODS:

Seventy-two rats underwent laparotomy with creation of 6 peritoneal ischemic buttons to induce adhesions. A single intraperitoneal (IP) dose of 50 mg/kg VPA was administered intraoperatively, whereas controls received vehicle. To evaluate the timing, 25 rats underwent ischemic button creation with either an intraoperative or a delayed IP dose of VPA at 1, 3, or 6 hours postoperatively. On postoperative day 7, adhesions were quantified. To investigate mechanisms, ischemic buttons were created in 24 rats and either VPA or saline was administered in 1 intraoperative dose. At 3 or 24 hours later, peritoneal fluid was collected and fibrinolytic activity measured. Alternatively, button tissue was collected 30 minutes postoperatively to measure tissue factor, fibrinogen, and vascular endothelial growth factor (VEGF) by real-time polymerase chain reaction or Western blot.

RESULTS:

A single intraoperative dose of VPA reduced adhesions by 50% relative to controls (P < .001). Delayed dosing did not reduce adhesions. In operated animals, peritoneal fibrinolytic activity was not different between groups. Tissue factor mRNA was downregulated by 50% (P = .02) and protein by 34% (P < .01) in animals administered VPA versus saline. VPA decreased fibrinogen protein by 56% and VEGF protein by 25% compared with saline (P = .03).

CONCLUSION:

These findings suggest that VPA rapidly reduces the extravasation of key adhesiogenic substrates into the peritoneum. A single, intraoperative intervention provides an ideal dosing strategy and indicates an exciting new role for HDACIs in adhesion prevention.
Copyright © 2014 Mosby, Inc. All rights reserved.
PMID:
 
24239397
 
[PubMed - indexed for MEDLINE]

Thursday, April 03, 2014

Preliminary study with SprayShield™ Adhesion Barrier System in the prevention of abdominal adhesions

Preliminary study with SprayShield™ Adhesion Barrier System in the prevention of abdominal adhesions


Wideochir Inne Tech Malo Inwazyjne. Dec 2013; 8(4): 301–309.
Published online May 6, 2013. doi:  10.5114/wiitm.2011.34884
 
PMCID: PMC3908634

ABSTRACT

Introduction

Peritoneal adhesions, the fibrotic bands that form between the surfaces in the peritoneal cavity following surgery, still pose a difficult clinical challenge.

Aim

To evaluate the SprayShield™ Adhesion Barrier System (PEG ester amine solution and a buffer solution) in reducing post-operative adhesion formation.

Material and methods

This was a prospective, multi-center, randomized, single blind study. A total of 11 subjects diagnosed with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) were randomized: 8 to the SprayShield™ arm and 3 to the control arm. SprayShield™ was applied on the viscera directly under the midline peritoneal incision and at the site of ileostomy. During the follow-up surgery, the incidence, extent, and severity of post-operative adhesion formation were evaluated, as well as the time required to mobilize the ileal loop.

Results

In patients who received SprayShield™ the time required to mobilize the ileal loop at the ileostomy closure was slightly shorter and the incidence and severity of adhesions were somewhat lower vs. control subjects (NS).

Conclusions

SprayShield™ was found to be easy to use, safe, and quick to apply, and performed well in adherence and conformity. The incidence and severity of adhesions were lower for SprayShield™ subjects vs. control subjects, but due to the limited number of patients there are not enough data to confirm the effectiveness of the SprayShield™ Adhesion Barrier System in prevention of adhesions.
Keywords: adhesions, adhesion prevention, laparotomy, ileostomy

Friday, March 28, 2014

Integra Buys Covidien’s Confluent Surgical Product Lines

Integra Buys Covidien’s Confluent Surgical Product Lines

By HospiMedica International staff writers
Posted on 18 Nov 2013
Integra LifeSciences (Plainsboro Township, NJ, USA) is to acquire the Covidien (Dublin, Ireland) Confluent Surgical product line, including surgical sealants, adhesion barrier, and, most significantly, DuraSeal.

The DuraSeal system technology is a synthetic, absorbable, hydrogel delivered by a dual syringe applicator. When sprayed onto the dura, a strong, adherent sealing layer is produced, which effectively seals the suture line within seconds. A feature unique to DuraSeal is the blue colorant that provides the surgeon excellent visualization of coverage and thickness of the material upon application. The addition of a dural sealant technology to Integra’s current line enables the surgeon to adopt a “one stop shop” approach to closing the Dura Mater following neurosurgical procedures, complementing the company’s dural substitute, Duragen.

The other products in the Confluent Surgical product line include DuraSeal Exact/Xact, VascuSeal, and SprayShield. The products are part of the soft tissue repair category at Covidien, and generated approximately USD 65 million in sales in fiscal 2012. Under the terms of the agreement, Covidien will receive an initial cash payment of USD 235 million from Integra. Additionally, Covidien may receive up to USD 30 million, contingent upon the achievement of certain performance measures related to the transition of the Confluent Surgical business to Integra.

“The addition of the DuraSeal product lines enables our sales force and distributor partners to provide their customers with a best-in-class dural sealant as they seek to support surgeon’s efforts to minimize cerebrospinal fluid leaks upon completion of the surgical procedure,” said Robert Davis, President of Integra’s US Neurosurgery division. “Together with our broad DuraGen product line we are fortunate to have even more options to serve our customers and the individual needs of their patients.”

“This transaction allows Covidien to better focus on its global strategic priorities,” said Bryan Hanson, group president of medical devices & US at Covidien. “Based on Integra’s presence in neurosurgery and spine surgery combined with a strong portfolio of clinical evidence, we believe these products will thrive under Integra’s ownership. We express our sincere gratitude to our dedicated employees and the clinicians who have partnered with us throughout the years.”

Related Links:

Integra LifeSciences
Covidien

Huge Ethics Breech Dr Daniel Kruschinski of Germany Marries Surgical Patient after 20 Surgeries in One Month

This is about the most egregious breech of ethics a doctor can commit.
He brags of it on his website and sees nothing wrong with this. He claims in public her poor frantic family is jealous of him!  
She is at least 20 tears his junior. Repulsive!
Take a look.

ADHESIOLYSIS #2
Some of the cases with “Frozen abdomen” are so severe that they present not only adhesions to the abdominal wall and between the bowel loops, but have all organs and bowel loops surrounded by a very dense connective tissue, glueing the organs together and causing constrictions of the bowel.
Those patients need a “Multi-Step-Adhesiolysis” according to the EndoGyn concept and are informed after the first procedure that we will work upon their symptoms in different abdominal quadrants by setting-up a multistep adhesiolysis according to their symptoms.
The first step always includes full adhesiolysis of the abdominal wall as these adhesions are often causing bowel obstructions. Also a partial interluminal adhesiolysis of the bowel loop adhesions is included in the first step.
So in January 2010 the patient was admitted again and we performed the 3rd look procedure on January 18th, 2010, followed by 7 other laparoscopic procedures due to an infection and to avoid reformation of adhesions.
We had to keep the patient for 31 days in the hospital and she had all together 8 surgeries performed.
- 18/01/2010: Gasless Lift-Laparoscopy as 3rd look
– 20/01/2010: 4th look
- 25/01/2010: 5th look
- 27/01/2010: 6th look
- 29/01/2010: 7th look
- 01/02/2010: 8th look
- 05/02/2010: 9th look
- 09/01/2010: 10th look
Please check the text under the images!
PLEASE SCROLL DOWN!
If you have a strong stomach, see her surgical photos where it appears he is combining 2 different adhesion barriers or using adept only even though everyone thinks they are getting sprayygel.
This poor woman is lucky to be alive. (IHRT opines her suffering has just begun.)

Here is some insight as to a proper patient and doctor relationship.

Opinion 8.14 - Sexual Misconduct in the Practice of Medicine

Sexual contact that occurs concurrent with the patient-physician relationship constitutes sexual misconduct. Sexual or romantic interactions between physicians and patients detract from the goals of the physician-patient relationship, may exploit the vulnerability of the patient, may obscure the physician’s objective judgment concerning the patient’s health care, and ultimately may be detrimental to the patient’s well-being.
If a physician has reason to believe that non-sexual contact with a patient may be perceived as or may lead to sexual contact, then he or she should avoid the non-sexual contact. At a minimum, a physician’s ethical duties include terminating the physician-patient relationship before initiating a dating, romantic, or sexual relationship with a patient.
Sexual or romantic relationships between a physician and a former patient may be unduly influenced by the previous physician-patient relationship. Sexual or romantic relationships with former patients are unethical if the physician uses or exploits trust, knowledge, emotions, or influence derived from the previous professional relationship. (I, II, IV)
Issued December 1989; Updated March 1992 based on the report "Sexual Misconduct in the Practice of Medicine,"PDF FIle adopted December 1990 (JAMA. 1991;266:2741-2745).