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

Showing posts with label scar tissue. Show all posts
Showing posts with label scar tissue. Show all posts

Thursday, April 17, 2014

Evaluation of the effects of hyaluronic acid-carboxymethyl cellulose barrier on ovarian tumor progression

PRESS RELEASE
Hyaluronic acid is a prognostic factor in ovarian cancers. It is also a component of Hyaluronic Acid-Carboxymethyl Cellulose (HA-CMC) barrier, an anti-adhesion membrane widely used during abdominal surgeries in particular for ovarian carcinosis.

70% of patients who undergo ovarian surgery will relapse due to the persistence of cancer cells. This study's objective was to determine the oncological risk from use of this material, in the presence of residual disease, despite the benefit gained by it decreasing post-surgical adhesions in order to provide an unambiguous assessment of its appropriateness for use in ovarian surgical management. 

Methods: We assessed the effects of HA-CMC barrier on the in vitro proliferation of human ovarian tumor cell lines (OVCAR-3, IGROV-1 and SKOV-3).

We next evaluated, in vivo in nude mice, the capacity of this biomaterial to regulate the tumor progression of subcutaneous and intraperitoneal models of ovarian tumor xenografts. 

Results: We showed that HA-CMC barrier does not increase in vitro proliferation of ovarian cancer cell lines compared to control. In vivo, HA-CMC barrier presence with subcutaneous xenografts induced neither an increase in tumor volume nor cell proliferation (Ki67 and mitotic index).

With the exception of an increased murine carcinosis score in peritoneum, the presence of HA-CMC barrier with intraperitoneal xenografts modified neither macro nor microscopic tumor growth. Finally, protein analysis of survival (Akt), proliferation (ERK) and adhesion (FAK) pathways highlighted no activation on the xenografts imputable to HA-CMC barrier. 

Conclusions: For the most part, our results support the lack of tumor progression activation due to HA-CMC barrier.

We conclude that the benefits gained from using HA-CMC barrier membrane during ovarian cancer surgeries seem to outweigh the potential oncological risks.

Author: Laetitia PicaudBenoƃ®t ThibaultEliane MeryMonia OualiAlejandra MartinezJean-Pierre DelordBettina CoudercGwenael Ferron
Credits/Source: Journal of Ovarian Research 2014, 7:40

http://7thspace.com/headlines/457665/evaluation_of_the_effects_of_hyaluronic_acid_carboxymethyl_cellulose_barrier_on_ovarian_tumor_progression.html

Wednesday, April 09, 2014

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

Sunday, April 06, 2014

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

Saturday, March 08, 2014

CollaGUARD adhesion barrier now in distributed in UK and Germany

01 Feb, 2012
ASHBURN, VA., February 1, 2012 /PRNewswire/ –– Innocoll Inc. announced it has entered into a License and Distribution Agreement with Flynn Pharma Ltd. in the United Kingdom and with Inresa Arzneimittel GmbH in Germany for CollaGUARD surgical adhesion barrier for the prevention of postoperative adhesions following abdominal and pelvic surgery.

Breaking News Seprafilm Genzyme

Attorney General J.B. Van Hollen Announces Settlement with Genzyme Corporation to Resolve Allegations of Off-Label Marketing

Targeted News Service
MADISON, Wis.March 6 -- The WisconsinAttorney General issued the following news release:
Attorney General J.B. Van Hollen announced today that Wisconsin has joined with other states and the federal government to settle allegations thatGenzyme Corp. (Genzyme) marketed and caused false claims to be submitted to federal and state health care programs for use of a "slurry" version of its Seprafilm adhesion barrier. Seprafilm is a thin film intended to reduce adhesions after surgery by forming a bio-resorbable barrier between abdominal tissue and organs. Genzyme is a biotechnology corporation based in Cambridge, Mass., and was acquired by Sanofi-Aventis SA in April 2011. As part of the settlement, Wisconsin Medicaid will receive $44,698.27 in restitution and other recoveries. Medicaid is a health insurance program for the needy and disabled jointly funded by the state and federal governments. The agreement resolves allegations that Genzyme sales representatives taught doctors and other staff to cut the Seprafilm sheets into small pieces, add saline and allow the pieces to dissolve until the desired consistency was reached. This mixture was referred to as "slurry." Genzyme sales representatives traded recipes for slurry, and trained each other in how to create it. The slurry was used in laparoscopic surgeries by inserting a catheter filled with the mixture into the body and applying it into the abdominal cavity. Seprafilm isFDA-approved for use in open abdominal surgery but not for minimally invasive surgeries, such as laparoscopic surgery. Allegedly, as a result of this conduct,Genzyme knowingly caused hospitals and other purchasers of Seprafilm to submit false and fraudulent claims to health care programs for uses that were not reimbursable.
TNS 30FurigayJof 140307-4659904 30FurigayJof
Copyright:(c) 2014 Targeted News Service
Wordcount:276

http://insurancenewsnet.com/oarticle/2014/03/07/attorney-general-jb-van-hollen-announces-settlement-with-genzyme-corporation-t-a-470833.html#.Uxr7pPldWHg

Should women with chronic pelvic pain have adhesiolysis?

Pelvic adhesions are found in up to 50% of women with CPP during investigative surgeries and adhesiolysis is often performed as part of their management although the causal or casual association of adhesions, and the clinical benefit of adhesiolysis in the context of CPP is still unclear. Our aim was to test the hypothesis of whether laparoscopic adhesiolysis leads to significant pain relief and improvement in quality of life (QoL) in patients with chronic pelvic pain (CPP) and adhesions. 

Methods: This was a double-blinded RCT.

This study was conducted in 2 tertiary referral hospitals in United Kingdom over 4 years. Women with chronic pelvic pain (CPP) were randomized into having laparoscopic adhesiolysis or diagnostic laparoscopy.

Women were assessed at 0, 3 and 6 months for Visual analogue scale scores (VAS) and Quality of Life (QoL) measures (SF-12 and EHP-30). 

Results: A total of 92 participants were recruited; 50 qualified to be randomized, with 26 in the adhesiolysis and 24 in the control group. The results are expressed in median (interquartile ranges).

In women who underwent adhesiolysis, there was a significant improvement at 6 months in VAS scores (-17.5 (-36.0 - -5.0) compared to controls (-1.5 (-15.0 - 4.5; p = 0.048); SF-12 scores physical component score (25.0 (18.8 - 43.8)) compared to controls (6.3 (-6.3 - 18.8); p = 0.021), SF-12 emotional component score 32.5 (4.4 - 48.8) compared to controls -5 (-21.3 - 15.0); p <0 -5="" -="" .0074="" 15.0="" 32.5="" 48.8="" and="" being="" compared="" controls="" domain="" ehp-30="" emotional="" nbsp="" p="" span="" the="" to="" well="">

Conclusions: This study stopped before recruitment reached the statistically powered sample size due to difficulty with enrollment and lack of continued funding. In selected population of women presenting to the gynecological clinic with chronic pelvic pain, adhesiolysis in those who have adhesions may be of benefit in terms of improvement of pain and their quality of life.Trial registration number: ISRCTN 43852269 http://www.controlled-trials.com/isrctn/pf/43852269

Author: Ying C CheongIsobel ReadingSarah BaileyKhaled SadekWilliam LedgerTin C Li
Credits/Source: BMC Women's Health 2014, 14:36


http://7thspace.com/headlines/453858/should_women_with_chronic_pelvic_pain_have_adhesiolysis.html

Men get adhesions

Do Men Get Adhesions? 
 
David Wiseman PhD, MRPharmS, Founder, International Adhesions Society 
 
It is a common myth that only women are prone to adhesions. While it is 
certainly true that women have more “internal parts” that require surgery, which 
inevitably leads to adhesions, men are not excluded from the problem of 
adhesions. 
 
A simple look at the national statistics collected from hospital discharges (ICD9 
codes) from the most recent data available (2001-2005) reveals the following: 
 
• Over 50,000 men were discharged from hospital in 2005 with a diagnosis 
of peritoneal adhesions (568.0), accounting for 28% of such diagnoses, 
compared with 72% for women. 
• Over 37,000 men were discharged in 2005 with a diagnosis that included 
the specific diagnosis of intestinal adhesions with (ie causing) bowel 
obstruction (560.81). This number accounts for 38% of cases, compared 
with 62% for women. 
• Men also accounted for 37% of discharges with a principal diagnosis (as 
opposed to an incidental diagnosis) was intestinal adhesions with 
obstruction (560.81). Their length of stay was slightly higher than that of 
women in 3 of the five years studied and their hospital charges exceeded 
those of women in every year by as much as $2500. 
• Over 2000 men and women died every year with a diagnosis of intestinal 
adhesions with obstruction, representing about 3% of the total discharges 
with that diagnosis. The contribution of males to this death rate was in 
every year slightly higher than that of women in proportion to their 
discharges, by 10-15% in the years 2002-2005, and about 2% in 2001. 
 
Overall discharges for men and women have been climbing at the same rate over 
the five year period studied.