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According to a new study now available online, and to be published in an upcoming issue of the Journal of Critical Care, bedside testing for a blood biomarker called neutrophil gelatinaseassociated lipocalin (NGAL) in patients being admitted to the intensive care unit can help to identify patients at risk for acute kidney injury (AKI). The study tested blood samples collected during the first 2 hours of ICU admission using the Triage® NGAL Test, a product trustedtablets currently sold by Inverness Medical Innovations, Inc. (NYSE IMA) outside of the United States.

Many patients admitted to the ICU will suffer from acute kidney injury, some of whom will ultimately lose kidney function entirely and develop the need for renal replacement therapy (dialysis). When this occurs mortality rates are extremely high. Today, by the time that AKI has been detected by standard clinical measures, a substantial portion of renal function may already have been lost and interventions may not have much effect on the patients outcome.

However the study suggests that a rapid test for NGAL could allow clinicians to rapidly assess if a critically ill patient is suffering from AKI perhaps in time to make meaningful interventions.

In this study, researchers at the University Hospital of ClermontFerrand, France, found that critically ill patients being admitted to the ICU with an elevated blood NGAL level were very likely to suffer from AKI. Using a cutoff level of 150ng/mL for blood NGAL, the sensitivity and specificity to predict AKI were 82% and 97%, respectively.

Measuring blood NGAL with a simple beside test allows for immediate results and early identification of AKI which was only realized by traditional clinical markers of AKI 48 hours after the NGAL increase, according to this study.

“A bedside blood test like this could be tremendously important for critically ill patients. So far therapeutic interventions for patients with AKI have been relatively unsuccessful. This is likely because they are applied late once kidney function is already lost. Knowing which patients are in trouble in advance may allow clinicians to choose therapies that will minimize further harm to the kidneys and may allow for the study of new therapeutic interventions. If further studies confirm our hypothesis, this bedside blood test could become the corner stone of a new therapeutic age,” said Dr. JeanMichel Constantin of the University Hospital of ClermontFerrand.

Considering the US, EU and Australia/New Zealand alone, Inverness estimates that in 2008 approximately 2.4 million patients at high risk of AKI were admitted to ICUs. Subject to confirmation through future trials, Inverness also expects the Triage NGAL Test to offer similar diagnostic benefits in hospital emergency rooms.

Inverness supplied the Triage NGAL Tests used in the study at no charge, but did not otherwise fund or sponsor the study.

About Inverness Medical Innovations

By developing new capabilities in nearpatient diagnosis, monitoring and health management, Inverness Medical Innovations enables individuals to take charge of improving their health and quality of life. Inverness global leading products and services, as well as its new product development efforts, focus on infectious disease, cardiology, oncology, drugs of abuse and womens health. Inverness is headquartered in Waltham, Massachusetts.

Cautionary Note Regarding ForwardLooking Statements

This press release contains forwardlooking statements within the meaning of the federal securities laws, including statements regarding the expected benefits, and the potential market for, the Triage NGAL Test. These statements reflect Inverness current views with respect to future events and are based on managements current assumptions and information currently available. Actual results may differ materially due to numerous factors, including without limitation, the potential market acceptance of the Triage NGAL Test or other NGAL tests; the ability of Inverness to successfully develop and commercialize such products; the impact of regulatory changes or developments; the development and commercialization by others of competing products or alternative technologies; the ability of Inverness to supply sufficient quantities of the product; conditions in the financial markets; the intensely competitive environment in Inverness markets it products, and the risks and uncertainties described in Inverness annual report on Form 10K, as amended, for the year ended December 31, 2008, and other factors identified from time to time in its periodic filings with the Securities and Exchange Commission. Inverness undertakes no obligation to update any forwardlooking statements contained herein.

Googles venture capital group is investing millions into Adimab, a biotech company that will construct a massive library of antibodies, some of which may yield powerful new drugs, the New York Times blog Bits reports. A Google Ventures executive said the company invests in “a variety of fields that dont necessarily directly correlate with Google products or services,” but acknowledged that because “heavyduty computation” is now a key part of biotech development, Google may collaborate with Adimab (Pollack, 10/1).

The executive also told Dow Jones VentureWire/Wall Street Journal, “Google Ventures has a pretty broad mandate.” VentureWire reports “The firm, which invests for financial return, is considering opportunities in biotech, genomics, diagnostics and health careIT, including the field of electronic medical records” (Gormley, 10/1).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

For men with type 2 diabetes, a cell type linked to allergic inflammation is closely linked to a key indicator of diabetic kidney disease (nephropathy), suggests a study in the November Clinical Journal of the American Society of Nephrology (CJASN). “Allergy is a common disease that is increasing worldwide, so our findings may have important implications for diabetic nephropathy,” comments Michiaki Fukui, MD (Kyoto Prefectural University of Medicine, Japan).

The researchers compared the eosinophil count with albumin excretion rate in nearly 800 patients with type 2 diabetes. Eosinophils are a type of white blood cell that contributes to inflammation in allergic diseases. The albumin excretion rate is a key indicator of kidney disease, one of the major complications of diabetes.

In men, a higher number of eosinophils in the blood correlates with higher urinealbumin a critical early sign of diabetic kidney disease. Surprisingly, the link between eosinophil count and albumin excretion rate was even stronger than for known risk factors like high blood pressure and poor diabetes control. The eosinophil count was unrelated to albumin excretion in diabetic women.

Previous studies have suggested that patients with asthma and other allergic diseases are at increased risk of heart disease. Heart disease is the main cause of death in diabetics, and nephropathy is a major risk factor for heart disease. If the results are confirmed by future studies, then the eosinophil count might help in estimating the risk of diabetesrelated kidney and heart disease in men.

Some of the antiinflammatory treatments used by patients with allergies can lower the eosinophil count, and its possible that these treatments could also benefit male patients with diabetes, Fukui believes. He adds, “The intriguing concept of a role for eosinophils in diabetic nephropathy holds great promise for the development of new preventive measures involving antiallergic agents.”

The study cant prove any causeandeffect relationship between eosinophil count and albumin excretion rate. More research will be needed to determine why the relationship was found only in men, and whether a similar link is also present in patients without diabetes.

The authors reported no financial disclosures. Other authors were Muhei Tanaka, Masahide Hamaguchi, Takafumi Senmaru, Kazumi Sakabe, Emi Shiraishi, Ichiko Harusato, Masahiro Yamazaki, Goji Hasegawa, all of Kyoto Prefectural University of Medicine.

The study entitled, “Eosinophil Count Is Positively Correlated with Albumin Excretion Rate in Men with Type 2 Diabetes,” appeared online at cjasn.asnjournals.org/ on Thursday, October 1, 2009, doi 10.2215/CJN.03330509.

Source
Shari Leventhal

U.S. Food Aid Declines, Despite TwoYear 53% Funding Increase

Although U.S. food aid funding has increased by 53 percent over the last two years, a Government Accountability Office report on Wednesday said that during the same time period, the “amount of food delivered to address emergencies abroad fell 5 percent,” the Washington Independent reports. “GAO is citing as a culprit a U.S. law requiring that almost all international food aid be grown domestically a boon to American agribusiness rather than purchased closer to the disaster, an approach known as local and regional procurement,” according to the publication (Lillis, 9/30).

World Bank Grants Zimbabwe $74M For Agriculture; Farmers Union Warns Of Grain Deficit

The World Bank on Wednesday said it plans to give Zimbabwe a $74 million grant to revive the countrys agriculture sector, Agence FrancePresse reports. David Rohrbach, a senior agricultural economist at the World Bank, said, “We are dealing directly with NGOs. We are following suit with what other donors have done to help Zimbabwe. We are not yet at a stage to deal with government directly but we consult them” (9/30).

In related news, “Zimbabwes farmers unions on Wednesday warned the country could face another grain deficit in the next season due to poor preparations and lack of funding, despite government projections of the biggest harvest yet,” Reuters reports. The article examines the countrys challenges in agriculture (Banya, 9/30).

Washington Times Examines U.S.Backed ITN Network

The Washington Times examines Netmark, a U.S.backed project, which “over the past decade … has sold 50 million insecticidetreated mosquito nets in African countries plagued by malaria” (Franchineau, 10/1).

Guardian Examines How To Decrease Maternal Mortality

The Guardian examines a recent Lancet study, which found that the “lives of a third of the women who die in childbirth could be saved if a cheap and common drug to prevent haemorrhage, together with antibiotics, were readily available in their villages” (Boseley, 10/1).

Japanese Drug Co. Joins Effort To Fight Chagas Disease

The Japanese pharmaceutical company Eisai Inc. on Tuesday announced it would partner with the nonprofit organization Drugs for Neglected Diseases initiative in an effort to develop new treatments for Chagas disease, “a tropical parasitic disease that threatens 100 m[illion] people in the Caribbean and Latin America,” the Financial Times reports. “European and increasingly US companies have become involved in partnerships with nonprofit groups for an increasing range of drugs and vaccines, including for malaria and tuberculosis,” the newspaper writes, adding, Eisai represents one of the first Japanese groups to join this effort (Jack, 9/29).

Vancouver Sun Examines Work Of NGO In Congo

The Vancouver Sun examines the success of a small nongovernmental organization (NGO) called HEAL Africa that delivers holistic care to the people of Congo “with Congolese staff drawn from every local tribe.” Though the “$7millionayear NGO” run by a Congolese doctor and his wife “is small by world standards,” it has gained attention for its work with local doctors and outreach to victims of rape, the newspaper writes. The NGO is supported, in part, by the Canadian International Development Agency and the Clinton Foundation (Cayo, 9/30).

This information was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

The Academy wants to hear from managed care pharmacy organizations that provide student pharmacists with experiential education. New accreditation standards for colleges and schools of pharmacy include requirements to provide Introductory Pharmacy Practice Experience (IPPE) and Advanced Pharmacy Practice Experience (APPE). To assist experiential education directors at schools and colleges place student pharmacists, the AMCP Schools of Pharmacy Relations Committee is compiling a directory of managed care pharmacy APPE and IPPE sites.

The final year of the professional program is comprised of APPEs. These are the traditional rotations that AMCP members may recall from pharmacy school. IPPEs came about when the schools and colleges of pharmacy accreditation standards were last revised. IPPEs begin early in the curriculum and prepare student pharmacists for the APPEs. The new accreditation standard requires 300 hours of IPPEs with the majority of the hours in patient care settings (primarily hospitals and community pharmacies). However, there is an option for a small amount of elective IPPE hours that would include managed care pharmacy.

Infertility refers to an inability to conceive after having regular unprotected sex. Infertility can also refer to the biological inability of an individual to contribute to conception, or to a female who cannot carry a pregnancy to full term. In many countries infertility refers to a couple that has failed to conceive after 12 months of regular sexual intercourse without the use of contraception.

Studies indicate that slightly over half of all cases of infertility are a result of female conditions, while the rest are caused by either sperm disorders or unidentified factors. According to The Mayo Clinic, USAAbout 20% of cases of infertility are due to a problem in the man. About 40% to 50% of cases of infertility are due to a problem in the woman. About 30% to 40% of cases of infertility are due to problems in both the man and the woman. According to Medilexicons medical dictionary, infertility is “Diminished or absent ability to produce offspring; in either the male or the female, not as irreversible as sterility.”

According to the Department of Health and Human Services, USA, approximately 10% to 15% of couples in the USA are infertile meaning they have not conceived after at least one year of regular, unprotected sex.

Many cases of apparent infertility are treatable. Infertility may have a single cause in one of the partners, or it could be the result of a combination of factors.

Chances of conceiving within one year

In Europe, North America and much of the world approximately 85% of couples will conceive within one year if they have regular unprotected sex. Averages in the UK are as follows (National Health Service)20% will conceive within one month70% will conceive within six months85% will conceive within 12 months90% will conceive within 18 months95% will conceive within 24 monthsTherefore, doctors in the UK will not usually diagnose a couple as infertile until 24 months have passed without conception and regular unprotected sex. Most people will see their GP (general practitioner, primary care physician) if there is no pregnancy within 12 months.

According to the National Health Service, UK, a couple that has been trying to conceive for over three years has a maximum 25% chance of conceiving over the subsequent 12 months if they continue trying.What are the risk factors of infertility?In medicine, a risk factor is something that raises the risk of developing a condition, disease or symptom. For example, obese people are more likely to develop diabetes type 2 compared to people of normal weight; therefore, obesity is a risk factor for diabetes type 2.Age a womans fertility starts to drop after she is about 32 years old, and continues doing so. A 50yearold man is usually less fertile than a man in his 20s (male fertility progressively drops after the age of 40).
Smoking smoking significantly increases the risk of infertility in both men and women. Smoking may also undermine the effects of fertility treatment. Even when a woman gets pregnant, if she smokes she has a greater risk of miscarriage.
Alcohol consumption a womans pregnancy can be seriously affected by any amount of alcohol consumption. Alcohol abuse may lower male fertility. Moderate alcohol consumption has not been shown to lower fertility in most men, but is thought to lower fertility in men who already have a low sperm count.
Being obese or overweight in industrialized countries overweight/obesity and a sedentary lifestyle are often found to be the principal causes of female infertility. An overweight man has a higher risk of having abnormal sperm.
Eating disorders women who become seriously underweight as a result of an eating disorder may have fertility problems.
Being vegan if you are a strict vegan you must make sure your intake of iron, folic acid, zinc and vitamin B12 are adequate, otherwise your fertility may become affected.
Overexercising a woman who exercises for more than seven hours each week may have ovulation problems.
Not exercising leading a sedentary lifestyle is sometimes linked to lower fertility in both men and women.
Sexually transmitted infections (STIs) chlamydia can damage the fallopian tubes, as well as making the mans scrotum become inflamed. Some other STIs may also cause infertility.
Exposure to some chemicals some pesticides, herbicides, metals (lead) and solvents have been linked to fertility problems in both men and women.
Mental stress studies indicate that female ovulation and sperm production may be affected by mental stress. If at least one partner is stressed it is possible that the frequency of sexual intercourse is less, resulting in a lower chance of conception. What are the causes of infertility? There are many possible causes of infertility. Unfortunately, in about onethird of cases no cause is ever identified.

Causes of infertility in womenOvulation disorders problems with ovulation are the most common cause of infertility in women, experts say. Ovulation is the monthly release of an egg. In some cases the woman never releases eggs, while in others the woman does not release eggs during come cycles. Ovulation disorders can be due to

Premature ovarian failure the womans ovaries stop working before she is 40.
PCOS (polycystic ovary syndrome) the womans ovaries function abnormally. She also has abnormally high levels of androgen. About 5% to 10% of women of reproductive age are affected to some degree. Also called SteinLeventhal syndrome.
Hyperprolactinemia if prolactin levels are high and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility.
Poor egg quality eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. The older a woman is the higher the risk.
Overactive thyroid gland
Underactive thyroid gland
Some chronic conditions, such as AIDS or cancer.
Problems in the uterus or fallopian tubes

The egg travels from the ovary to the uterus (womb) where the fertilized egg grows. If there is something wrong in the uterus or the fallopian tubes the woman may not be able to conceive naturally. This may be due to

Surgery pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. Cervical surgery can sometimes cause scarring or shortening of the cervix. The cervix is the neck of the uterus.
Submucosal fibroids benign or noncancerous tumors found in the muscular wall of the uterus, occurring in 30% to 40% of women of childbearing age. They may interfere with implantation. They can also block the fallopian tube, preventing sperm from fertilizing the egg. Large submucosal uterine fibroids may make the uterus cavity bigger, increasing the distance the sperm has to travel.
Endometriosis cells that are normally found within the lining of the uterus start growing elsewhere in the body.
Previous sterilization treatment if a woman chose to have her fallopian tubes blocked. It is possible to reverse this process, but the chances of becoming fertile again are not high. However, an eightyear study showed tubal reversal surgery results in higher pregnancy and live birth rates and is less costly than IVF.
Medications some drugs can affect the fertility of a woman. These include

NSAIDs (nonsteroidal antiinflammatory drugs) women who take aspirin or ibuprofen longterm may find it harder to conceive.
Chemotherapy some medications used in chemotherapy can result in ovarian failure. In some cases, this side effect of chemotherapy may be permanent.
Radiotherapy if radiation therapy was aimed near the womans reproductive organs there is a higher risk of fertility problems.
Illegal drugs some women who take marijuana or cocaine may have fertility problems. Causes of infertility in men

Semen

Semen is the milky fluid that a mans penis releases during orgasm. Semen consists of fluid and sperm. The fluid comes from the prostate gland, seminal vesicle and other sex glands. The sperm is produced in the testicles. During orgasm a man ejaculates (releases semen through the penis). The seminal fluid helps transport the sperm during ejaculation. The seminal fluid has sugar in it sugar is an energy source for sperm.

Abnormal semen is responsible for about 75% of all cases of male infertility. Unfortunately, in many cases doctors never find out why. The following semen problems are possible

Low sperm count (low concentration) the man ejaculates a lower number of sperm, compared to other men. Sperm concentration should be 20 million sperm per milliliter of semen. If the count is under 10 million there is a low sperm concentration (subfertility).
No sperm when the man ejaculates there is no sperm in the semen.
Low sperm mobility (motility) the sperm cannot “swim” as well as it should.
Abnormal sperm perhaps the sperm has an unusual shape, making it more difficult to move and fertilize an egg.
Sperm must be the right shape and able to travel rapidly and accurately towards the egg. If the sperms morphology (structure) and motility (movement) are wrong it is less likely to be able to reach the egg and fertilize it.

The following may cause semen to be abnormal
Testicular infection
Testicular cancer
Testicular surgery
Overheating the testicles frequent saunas, hot tubs, very hot baths, or working in extremely hot environments can raise the temperature of the testicles. Tight clothing may have the same effect on some people.
Ejaculation disorders for some men it may be difficult to ejaculate properly. Men with retrograde ejaculation ejaculate semen into the bladder. If the ejaculatory ducts are blocked or obstructed the man may have a problem ejaculating appropriately.
Varicocele this is a varicose vein in the scrotum that may cause the sperm to overheat.
Undescended testicle one (or both) testicle fails to descend from the abdomen into the scrotum during fetal development. Sperm production is affected because the testicle is not in the scrotum and is at a higher temperature. Healthy sperm need to exist in a slightly lowerthanbody temperature. That is why they are in the scrotum, and not inside the body.
Hypogonadism testosterone deficiency can result in a disorder of the testicles.
Genetic abnormality a man should have an X and Y chromosome. If he has two X chromosomes and one Y chromosome (Klinefelters syndrome) there will be an abnormal development of the testicles, low testosterone, and a low sperm count (sometimes no sperm at all).
Mumps this viral infection usually affects young children. However, if it occurs after puberty inflammation of the testicles may affect sperm production.
Hypospadias the urethral opening is at the underside of the penis, instead of its tip. This abnormality is usually surgically corrected when the male is a baby. If it is not the sperm may find it harder to get to the females cervix. Hypospadias occur in about 1 in every 500 newborn boys.
Cystic fibrosis Cystic fibrosis is a chronic disease that affects organs such as the liver, lungs, pancreas, and intestines. It disrupts the bodys salt balance, leaving too little salt and water on the outside of cells and causing the thin layer of mucus that usually keeps the lungs free of germs to become thick and sticky. This mucus is difficult to cough out, and it clogs the lungs and airways, leading to infections and damaged lungs. Males with cystic fibrosis commonly have a missing or obstructed vas deferens (tube connecting the testes to the urethra; it carries sperm from the epididymis to the ejaculatory duct and the urethra).
Radiotherapy radiation therapy can impair sperm production. The severity usually depends on how near to the testicles the radiation was aimed.
Some diseases the following diseases and conditions are sometimes linked to lower fertility in males

Anemia
Cushings syndrome
Diabetes
Thyroid disease

Medications

Sulfasalazine this antiinflammatory drug can significantly lower a mans sperm count. The drug is often prescribed for patients with Crohns disease or rheumatoid arthritis. Usually this side effect goes away after the patient stops taking the medication.

Anabolic steroids often taken by bodybuilders and athletes; anabolic steroids, especially after long term use can seriously reduce sperm count and mobility.

Chemotherapy some medicines may significantly reduce sperm count.

Illegal drugs consumption of marijuana and cocaine can lower a mans sperm count. Diagnosing infertilityMost people will visit their GP (general practitioner, primary care physician) if there is no pregnancy after 12 months of trying. For anybody who is concerned about fertility, especially if they are older (women over 35), it might be a good idea to see a doctor earlier. As fertility testing can sometimes take a long time, and female fertility starts to drop when a woman is in her thirties, seeing the doctor earlier on if you are over 35 makes sense.

A GP can give the patient advice and carry out some preliminary assessments. As it takes two to make a baby it is better for both the male and female to see the doctor together.

Before undergoing testing for fertility it is important that the couple be committed. The doctor will need to know what the patients sexual habits are, and may make recommendations regarding them. Tests and trials might extend over a long period. Even after thorough testing, no specific cause is ever found for 30% of infertility cases.

In some countries where universal healthcare cover does not exist, evaluation and eventual treatment may be expensive.

Tests for malesGeneral physical exam the doctor will ask the man about his medical history, medications, and sexual habits. The physician will also carry out an examination of his genitals. The testicles will be checked for lumps or deformities, while the shape and structure of the penis will be examined for any abnormalities.
Semen analysis the doctor may ask for some specimens of semen. They will be analyzed in a laboratory for sperm concentration, motility, color, quality, infections and whether any blood is present. As sperm counts can fluctuate, the man may have to produce more samples.
Blood test the lab will test for several things, including the mans level of testosterone and other male hormones.
Ultrasound test the doctor will determine whether there is any ejaculatory duct obstruction, retrograde ejaculation, or other abnormality.
Chlamydia test if the man is found to have Chlamydia, which can affect fertility, he will be prescribed antibiotics to treat it. Tests for femalesGeneral physical exam the doctor will ask the woman about her medical history, medications, menstruation cycle, and sexual habits. She will also undergo a gynecological examination.
Blood test several things will be checked, for example, whether hormone levels are correct and whether the woman is ovulating (progesterone test).
Hysterosalpingography fluid is injected into the womans uterus which shows up in Xray pictures. Xrays are taken to determine whether the fluid travels properly out of the uterus and into the fallopian tubes. If the doctor identifies any problems, such as a blockage, surgery may need to be performed.
Laparoscopy a thin, flexible tube with a camera at the end (laparoscope) is inserted into the abdomen and pelvis to look at the fallopian tubes, uterus and ovaries. A small incision is made below the belly button and a needle is inserted into the abdominal cavity; carbon dioxide is injected to create a space for the laparoscope. The doctor will be able to detect endometriosis, scarring, blockages, and some irregularities of the uterus and fallopian tubes.
Ovarian reserve testing this is done to find out how effective the eggs are after ovulation.
Genetic testing this is to find out whether a genetic abnormality is interfering with the womans fertility.
Pelvic ultrasound high frequency sound waves create an image of an organ in the body, which in this case is the womans uterus, fallopian tubes, and ovaries.
Chlamydia test if the woman is found to have Chlamydia, which can affect fertility, she will be prescribed antibiotics to treat it.
Thyroid function test according to the National Health Service (UK) between 1.3% and 5.1% of infertile women have an abnormal thyroid. What are the treatment options for infertility? This will depend on many factors, including the age of the patient(s), how long they have been infertile, personal preferences, and their general state of health. Even if the woman has causes that cannot be corrected, she may still become pregnant.

Frequency of intercourse

The couple may be advised to have sexual intercourse more often. Sex two to three times per week may improve fertility if the frequency was less than this. Some fertility experts warn that toofrequent sex can lower the quality and concentration of sperm. Male sperm can survive inside the female for up to 72 hours, while an egg can be fertilized for up to 24 hours after ovulation.

Fertility treatment for menErectile dysfunction or premature ejaculation medication and/or behavioral approaches can help men with general sexual problems, resulting in possibly improved fertility.
Varicocele if there is a varicose vein in the scrotum, it can be surgically removed.
Blockage of the ejaculatory duct sperm can be extracted directly from the testicles and injected into an egg in the laboratory.
Retrograde ejaculation sperm can be taken directly from the bladder and injected into an egg in the laboratory.
Surgery for epididymal blockage if the epididymis is blocked it can be surgically repaired. The epididymis is a coillike structure in the testicles which helps store and transport sperm. If the epididymis is blocked sperm may not be ejaculated properly. Fertility treatment for womenOvulation disorders if the woman has an ovulation disorder she will probably be prescribed fertility drugs which regulate or induce ovulation. These include

Clomifene (Clomid, Serophene) this medication helps encourage ovulation in females who do not ovulate regularly, or who do not ovulate at all, because of polycystic ovary syndrome (PCOS) or some other disorder. It makes the pituitary gland release more FSH (folliclestimulating hormone) and LH (luteinizing hormone).
Metformin (Glucophage) women who have not responded to Clomifene may have to take this medication. It is especially effective for women with PCOS, especially when linked to insulin resistance.
Human menopausal gonadotropin, or hMG, (Repronex) this medication contains both FSH and LH. It is an injection and is used for patients who dont ovulate on their own because of a fault in their pituitary gland.
Folliclestimulating hormone (GonalF, Bravelle) this is a hormone produced by the pituitary gland that controls estrogen production by the ovaries. It stimulates the ovaries to mature egg follicles.
Human chorionic gonadotropin (Ovidrel, Pregnyl) this medication is used together with clomiphene, hMG and FSH. It stimulates the follicle to ovulate.
GnRH (gonadotropinreleasing hormone) analogs for women who ovulate prematurely, before the lead follicle is mature enough during hmG treatment. This medication delivers a constant supply of GnRH to the pituitary gland, which alters the production of hormone, allowing the doctor to induce follicle growth with FSH.
Bromocriptine (Parlodel) this drug inhibits prolactin production. Prolactin stimulates milk production in breast feeding mothers. If nonpregnant, nonbreast feeding women have high levels of prolactin they may have irregular ovulation cycles and have fertility problems. Risk of multiple pregnancies

Injectable fertility drugs can sometimes be the victims of their own success and cause multiple births when the woman gets pregnant she has twins, triplets, or perhaps more babies in one go. Oral fertility drugs also raise the risk of multiple pregnancies, but much less so than injectable ones. It is important to monitor the patient carefully during treatment and pregnancy. The more babies the mother carries inside her the higher is her risk of premature labor.

If a woman needs an HCG injection to activate ovulation and ultrasound scans show that too many follicles have developed, it is possible to withhold the HCG injection. Couples may decide to go ahead regardless if the desire to become pregnant is very strong.

Multifetal pregnancy reduction is possible if too many babies are conceived one or more of the fetuses is removed. Couples will have to consider the ethical and emotional aspects of this procedure.Surgical procedures for women

Fallopian tube surgery if the fallopian tubes are blocked or scarred surgery may repair them, making it easier for eggs to pass through them.
Laparoscopic surgery a small incision is made in the womans abdomen. A thin, flexible microscope with a light at the end (laparoscope) is inserted through the incision. The doctor can then look at internal organs, take samples and perform small operations. For women with endometriosis, laparoscopy removes implants and scar tissue, reducing pain and often aiding fertility. Assisted conceptionIUI (intrauterine insemination) a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. The sperm is washed in a fluid and the best specimens are selected. This procedure must be done when ovulation occurs. The woman may be given a low dose of ovary stimulating hormones.

IUI is more commonly done when the man has a low sperm count, decreased sperm motility, or when infertility does not have an identifiable cause. The procedure is also helpful for males suffering from severe erectile dysfunction.
IVF (in vitro fertilization) sperm are placed with unfertilized eggs in a Petri dish; the aim is fertilization of the eggs. The embryo is then placed in the uterus to begin a pregnancy. Someitmes the embryo is frozen for future use (cryopreserved). Louise Joy Brown, born in England in 1978, was the worlds first IVF baby. Before IVF is done the female takes fertility drugs to encourage the ovaries to produce more eggs than normal.
ICSI (Intracytoplasmic sperm injection) a single sperm is injected into an egg to achieve fertilization during an IVF procedure. The likelihood of fertilization improves significantly for men with low sperm concentrations.
Donation of sperm or egg if there is either no sperm or egg in one of the partners it is possible to receive sperm or eggs from a donor. Fertility treatment with donor eggs is usually done using IVF. In the UK and a growing number of countries the egg donor can no longer remain anonymous the offspring can legally trace his/her biological parent when reaching the age of 18.
Assisted hatching this improves the chances of the embryos implantation; attaching to the wall of the uterus. The embryologist opens a small hole in the outer membrane of the embryo, known as the zona pellucid. The opening improves the ability of the embryo to leave its shell and implant into the uterine lining. Patients who benefit from assistant hatching include women with previous IVF failure, poor embryo growth rate, and older women. In some women, particularly older women, the membrane is hardened, making it difficult for the embryo to hatch and implant.
Electric or vibratory stimulation to achieve ejaculation ejaculation is acheived with electric or vibratory stimulation. This procedure is useful for men who cannot ejaculate normally, such as those with a spinal cord injury.
Surgical sperm aspiration the sperm is removed from part of the male reproductive tract, such as the vas deference, testicle or epididymis. What are the complications of infertility treatment? Ovarian hyperstimulation syndrome (OHSS)

The ovaries become very swollen, leaking excess fluid into the body. The ovaries produce too many follicles (small fluid sacs in which an egg develops). OHSS usually occurs as a result of taking medications to stimulate the ovaries, such as clomifene and gonadtrophins, and can also develop after IVF. Symptoms can include

BloatingConstipationDark urineDiarrheaNauseaPain in the abdomenVomiting
In most cases symptoms are mild and easy to treat. On very rare occasions the patient may develop a blood clot (thrombosis) in an artery or vein, liver or kidney problems, and respiratory distress. In very severe cases OHSS can be potentially fatal.
Ectopic pregnancy

This is a pregnancy when the fertilized egg does not implant in the womb in most cases the fertilized egg grows in the fallopian tube. If it stays in the fallopian tube the mother will usually miscarry before complications develop, such as the rupture of the fallopian tube. Women receiving fertility treatment have a slightly higher risk of having an ectopic pregnancy. An ultrasound scan can detect an ectopic pregnancy.
Coping mentally

As it is impossible to know how long treatment will go on for and how successful it will be, coping and persevering can be stressful. The emotional toll on both partners might be considerable and can have an impact on their relationship. Some people find that joining a support group helps being able to talk to others who share similar problems, aspirations and anxieties can be uplifting. It is important to tell your doctor if you are suffering mentally and/or emotionally. Most fertility doctors have access to counselors, as well as other people and professionals who can offer helpful support.

A Washington Post analysis of Virginia gubernatorial candidates Creigh Deeds (D) and Robert McDonnells (R) voting records in the state Legislature shows that both men have supported some restrictions on abortion access, though McDonnell has taken a much more severe approach. According to the Post, the candidates legislative records also demonstrate opposing philosophies on the role of government, spending of taxpayer dollars and restrictions on gay rights and guns.

Deeds supported bills that required parental notification for minors seeking abortions but did not support bills requiring parental consent or waiting periods. He voted for measures that banned socalled “partialbirth” abortion but later reversed his position, saying that he worried the bills were unconstitutional. Deeds also voted to allow pharmacists to dispense emergency contraception prior to FDAs decision allowing it to be sold over the counter.

McDonnell supported the partialbirth abortion ban, parental consent for minors and a 24hour waiting period before abortion procedures, all of which passed. He voted against the measure allowing pharmacists to dispense EC.

Planned Parenthood has criticized McDonnells voting record as extreme. The group has canvassed neighborhoods and called voters to promote its position (Kumar, Washington Post, 9/27).

Post Analyzes Campaign Ad

The Post also published an analysis of an ad Deeds released last week criticizing McDonnells stance on womens issues. According to the Post, the ad aims to appeal to women, especially in Northern Virginia, and “seems to assume its viewers have already heard about” McDonnells 1989 masters thesis, in which he called working women and feminists “detrimental” to the family. The ad states that McDonnell sponsored 35 bills on abortion issues; he was chief sponsor on eight of those, according to the Post. The ad also states that McDonnell opposes birth control for married adults. The Post reports that McDonnell supported two bills restricting birth control access but has since said that he does not oppose the use of birth control by married couples (Helderman, Washington Post, 9/27).

Reprinted with kind permission from nationalpartnership.org. You can view the entire Daily Womens Health Policy Report, search the archives, or sign up for email delivery here. The Daily Womens Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.

Abortionrights opponents are escalating their efforts to place socalled “personhood” measures on several state ballots in 2010 as a way to end legalized abortion, the Los Angeles Times reports. Their goal is to put referendums before state voters on whether states constitutions should be amended to declare that personhood and rights accorded to human beings begin at conception. According to the Times, personhoodamendment advocates believe that legally establishing personhood from conception would undo legalized abortion under the U.S. Supreme Courts 1973 Roe v. Wade decision, in which the court declared that a fetus is not legally a person.

Advocates of the personhood amendments are gathering signatures, raising funds and pressuring state legislatures to support the measures in California, Florida, Louisiana and other states. Keith Mason, cofounder of Personhood USA, said the group has “big and small efforts” under way in 30 states, adding, “Our goal is to activate the population.” Mason said, “This is an uphill battle. Even though we may not have the votes or the political equity, we have to start somewhere.”

Abortionrights supporters say personhood amendments threaten some forms of contraception, including intrauterine devices and birth control pills, as well as in vitro fertilization and embryonic stem cell research. They also say voters will reject the measures as a government intrusion into their privacy. Ted Miller, a spokesperson for NARAL ProChoice America, said that personhood measures are “a backdoor abortion ban.”

The Times reports that advocates on both sides of the debate think the logic behind the personhood movement is “farfetched,” and personhood supporters so far have been unsuccessful at changing any laws. Colorado in 2008 became the first state to put a personhood amendment before voters, who rejected it 78% to 27% after the possibility of criminalizing birth control came up in the debate. State legislatures in Montana and North Dakota rejected similar measures earlier this year, but abortionrights advocates took note of the close votes. North Dakotas House passed a bill calling for a constitutional amendment on personhood, but the Senate rejected it. The Montana Senate passed a similar bill, which died in a House committee, according to NARAL ProChoice Montanas Executive Director Allyson Hagen.

According to the Times, personhood advocates in California on Monday will announce a signaturegathering campaign for an initiative to amend the states constitution to define a person as a human beginning at conception. The proposed California Human Rights Amendment states, “The term person applies to all living human beings from the beginning of their biological development regardless of the means by which they were procreated, method of reproduction, age, race, sex, gender, physical wellbeing, function, or condition of physical or mental dependency and/or disability.” Supporters will need to obtain about 690,000 signatures to get the proposal on the 2010 ballot. The initiatives leaders are being advised by the American Life League, which is also assisting campaigns in Colorado, Florida, Missouri and Montana.

Opponents of the California amendment argue that its language goes beyond the discussion of whether a fetus is a person. Katherine Spillar, executive vice president of the Feminist Majority Foundation, said the measure is “so extreme it could literally outlaw IUDs and birth control pills.” Although she called personhood measures “so extreme that people reject them,” she said that “we take nothing for granted” and “will fight it with everything weve got” (Abcarian, Los Angeles Times, 9/28).

Reprinted with kind permission from nationalpartnership.org. You can view the entire Daily Womens Health Policy Report, search the archives, or sign up for email delivery here. The Daily Womens Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.

Eighty percent of Labour MPs believe the government should be spending more on dementia research, according to a new poll released today.

The results of the ComRes survey are revealed ahead of a dementia research fringe event being hosted by Alzheimers Society, the Alzheimers Research Trust and Age Concern and Help the Aged at the Labour Party Conference in Brighton today (Monday 28th September).

In a survey of parliamentarians, Labour MPs were found to be more in favour of an increase in investment than either the Liberal Democrats or the Conservatives although all parties showed more than 70 per cent support. The government currently spends £32.4million on dementia research compared to £248.5million on cancer research.

Results from an Alzheimers Research Trust and Alzheimers Society commissioned YouGov poll also revealed today that 59% of Labour voters believe the government should be putting more money into dementia research. The charities will make this call for an increase in funding and for a coordinated approach at the fringe event, Dementia Decade a cure by 2020?.

Broadcaster, journalist and Alzheimers Society Ambassador Fiona Phillips backed the charities call for greater investment and a coordinated plan. She will meet with Prime Minister Gordon Brown and other senior Labour officials at events during the conference. She said

To see the deterioration Alzheimers caused in first my mum and now my dad has been absolutely heart breaking. It is a cruel disease that robs a person of their dignity and places an incredible strain on the lives of their loved ones. We must do everything we can to find a cure. The only way to do this is through research and the only way research can be carried out is if the government provides the necessary investment.

Professor Simon Lovestone from Alzheimers Research Trust, said

Over the next decade we have a good chance of developing new treatments that slow down the rate of progression of Alzheimers disease and other dementias. If we fail to develop new treatments, we are in deep trouble because of the rising costs of caring for dementia in an ageing population. The government needs to increase its support for dementia research and take full advantage of the UKs worldclass scientists in the race for a cure.

Andrew Harrop, Head of Public Policy at Age Concern and Help the Aged said

Dementia is a cruel disease that robs people who are often otherwise fit and healthy of a happy retirement. Around 700,000 people currently live with dementia in the UK with many more friends and family indirectly affected by this heartbreaking disease. This is why Age Concern and Help the Aged is a major funder of dementia research, notably funding the Disconnected Mind research project and why we strongly support calls for more funding for this vital work.

Neil Hunt, Chief Executive of Alzheimers Society who will chair the fringe event, said

Even in the current economic climate there is an appreciation from MPs and the public of the necessity to do everything we can to defeat this devastating condition.

Dementia costs the UK £17billion a year yet the government spend eight times less on dementia research than cancer research. In order to see the same advancements in care and treatment as we have seen for cancer, spending on dementia research needs to be a higher priority. With the right investment and planning dementia can be defeated.

Last week leading author Terry Pratchett spoke of his experience with a rare form of Alzheimers disease and warned of the dangers of a worldwide tsunami of Alzheimers and other dementia diseases unless changes are made.

According to a recent retrospective analysis of the pivotal Phase 3 CRYSTAL study, ERBITUX® (cetuximab), when added to FOLFIRI, was shown to increase median overall survival to 19.9 months in an intenttotreat (ITT) population of firstline metastatic colorectal cancer (mCRC) patients compared to 18.6 months in those receiving FOLFIRI alone (hazard ratio [HR] 0.878; 95% CI 0.774 0.995; p=0.042). In a subset of mCRC patients with wildtype Kras tumors, median overall survival was increased to 23.5 months in patients who received ERBITUX plus FOLFIRI compared to 20 months for those taking FOLFIRI alone (HR 0. 796; 95% CI 0.670 0.946; p=0.0094).

The retrospective CRYSTAL analysis was conducted as a result of an effort to increase the tissue ascertainment rate to determine the Kras status of patients tumors. The analysis included extended patient follow up of nearly 1.5 years and doubled the tissue ascertainment rate from 45% to 89%. These data are an update from the overall survival results from CRYSTAL that were published in the April 2009 issue of the New England Journal of Medicine.

The recently completed retrospective analysis from CRYSTAL, a multinational study conducted by Merck KGaA, Darmstadt, Germany, marks the first time an overall survival benefit has been demonstrated with an epidermal growth factor (EGFR)inhibitor in the firstline treatment of mCRC in an ITT patient population and in a Kras wildtype subset of patients. An ITT analysis considers all randomized patients in a clinical trial.

In the CRYSTAL trial, the following Grade 3 or 4 adverse events were reported in the April 2009 New England Journal of Medicine as being more frequent with ERBITUX plus FOLFIRI than FOLFIRI alone in the overall patient population skin reactions (which were grade 3 only) (in 19.7% vs. 0.2% of patients, p