Health news blog

Could you be born with cells that have within them the possibility of growing into a full-blown case of endometriosis? In answering this question, researchers noted that many women do not have any classical symptoms of endometriosis while having the disease. Another dilemma involved women who had undergone abdominal surgery; there it was found that masses had developed that contained endometriosis like cells. That is, these patients appeared to have the disease, but in fact, they did not. How might this happen?

Noteworthy embryo logical studies uncovered some fascinating evidence. During intrauterine life, the fetal reproductive organs germinate from different types of cells. Vaginal tissue originates from a different set of genetic blueprints than uterine tissue, although both organs have the quality and capability of, for example, elasticity to accommodate childbearing. These embryonic studies went on to show that the tissue lining the ovaries, the endometrium, and the peritoneum—the smooth, transparent, and highly sensitive membrane that lines the pelvic and abdominal cavity—all originated from the same embryonic cell membrane.

It was then postulated that some of these cells could be transformed into endometrial cells or endometrial like cells through repeated irritation, such as pelvic infections, or by hormonal stimulation. In many cases, the physiological result is identical to having actual endometrial cells run wild and implant themselves: pain, cramps, and possible infertility. Thu mimicking of the disease posed some conclusions that interest scientists. The story that follows reveals why.

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Boils are deep infections, usually of hair follicles. They may occur at any age but are most common in adolescence. They can occur at any site except the palms and soles. Friction such as that often felt in the belt or collar areas may predispose to their development. Various diseases such as uncontrolled diabetes may aggravate boils, although very few people with boils have in fact got diabetes. The most common infective organism is the Staphylococcus.

A single boil may require no treatment other than careful washing with an antiseptic soap, causing it to spontaneously discharge. When there are multiple boils, or if one is in a potentially dangerous site, active treatment is necessary. Initially, a penicillinase-resistant semi-synthetic penicillin should be administered—such as Cloxacillin. The pus should be cultured, so that the most appropriate antibiotic can then be selected for further treatment. If boils recur, further investigations are necessary. Cultures should be taken from the infected lesion and from other sites such as the nostrils, normal skin, armpits and genital area. This will identity the reservoir or source of the infective organism. Occasionally cultures taken from other members of the immediate family may be helpful. Appropriate local treatment with an antibiotic cream can then be employed to eradicate the source. Treatment may be assisted by the taking of oral antibiotics and antiseptic baths. Further investigation to exclude possible concurrent diseases such as diabetes and immunological deficiencies may occasionally also be necessary.

Viruses are lengths of nucleic acid which carry enough information for their own replication only. They are therefore completely dependent on the host cells. Unlike bacteria, they do not grow by dividing; they assemble new virus particles by the addition of protein. There are a large number of viruses which affect man and, unfortunately, there are no antibiotics effective in their treatment.

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The specific component of carbohydrate we are seeking to increase is fibre. By selecting meals and snacks with a greater fibre content, individuals are likely to increase the intake of starches.

A gradual increase in fibre intake should be recommended. This will minimise possible side effects which include flatulence and possibly diarrhoea. When increasing fibre intake, also check fluid intake. If fluid intake is inadequate, constipation may result due to absorption of water by fibre in the large bowel.

It is also wise to caution clients against an excessive fibre intake. Besides the obvious gaseous effects, large quantities of insoluble fibre—particularly wheat bran—can interfere with the absorption of iron by the body.

Assessing dietary fibre intake. A ‘fibre count’ can be performed to identify sources of fibre and opportunities for increased intake. A greater fibre intake will result from increased consumption of fruits, vegetables, wholegrain cereals, legumes and other unprocessed plant foods. Client education should promote an eating style which includes these foods. As this list is limited to major fibre-containing foods, it can only provide a rough estimate of dietary fibre eting habits.

Reading food labels for carbohydrates. Nutrition information panels indicate carbohydrate content by showing the ‘total carbohydrate’ and the quantity of ’sugars’ per 100g. The starch content can be calculated by subtracting sugars from the total. This is a comparison between white and wholemeal bread. Both breads contain a relatively large amount of starch—44.4g and 40.7g respectively. Although technically carbohydrate, fibre content is shown separately. As you would expect, wholemeal bread contains more fibre.

In the absence of a nutrition information panel, an ingredient list can give an indication of the fibre content of a food. Names such as wholewheat, bran, wheatbran, wholegrain, wheatgerm, wheatmeal and oatbran appearing near the front of an ingredient list may indicate a generous fibre content.

An ingredient list can also provide an indication of sugar content. Sugar can be identified by numerous other names: sucrose, maltose, lactose, dextrose, fructose, glucose, sorbitol, mannitol, glucose syrup, com syrup, golden syrup, disaccharides, monosaccharides, polysaccharides, modified carbohydrate, raw sugar, brown sugar, molasses, honey and treacle.

Nutritional claims about carbohydrates. Like fat, there are requirements for manufacturers’ claims about fibre in food.

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As a result of the tests carried out your doctor will advise you as to the best course for a desired pregnancy.

If all is normal with your partner’s semen analysis it may be suggested that you are failing to ovulate and that a course of fertility drugs such as Clomiphene (Clomid) be taken to induce or increase egg production.

You will be told to start taking Clomid on either day 2 or day 5 (depending on the length of your cycle).

If a pregnancy still has not occurred after several months you may be advised to try a combination of Clomid with ultrasound scans and injections of HCG (human chorionic gonadotrophin).

The Clomid will encourage the production of an egg(s), the ultrasound scan will determine its maturity and the HCG injection will ensure it is released into the fallopian tube within 3 6 hours. You will be told to coincide intercourse during that 36 hours.

If these treatments are not successful you will need to consider your options. At this stage the options may include deciding to have no further treatment or to investigate your suitability for IVF (in vitro fertilisation) or GIFT (gamete intra fallopian transfer). However, before embarking on either of these programmes it should be noted that the success rates for full term pregnancies is 10% and 20% for IVF and GIFT respectively.

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A definite diagnosis of endometriosis is one made when a gynaecologist has actually observed endometrial implants or cysts in your pelvic cavity during a laparoscopy (a minor surgical operation using a laparoscope) or, occasionally, a laparotomy (major abdominal surgery).

In general, a laparoscopy is the preferred method of diagnosing endometriosis because it is a simpler and shorter operation and the use of the laparoscope enables better detection of small implants as it magnifies them to several times their actual size.

Classical endometrial implants and cysts can usually be easily recognised and diagnosed by a gynaecologist during a laparoscopy. However, atypical implants and microscopic endometriosis can be missed if the gynaecologist relies only on a visual impression. An increasing number of gynaecologists are using biopsies to diagnose endometriosis in doubtful cases. This involves removing a sample of tissue, known as a biopsy, from any area that the gynaecologist thinks may be the site of an endometrial implant for examination and diagnosis under a microscope.

A definite diagnosis is extremely important as it enables an accurate assessment of the severity and extent of the disease to be made and provides a guide as to the likely effect of the condition on your fertility. This is essential information if you are to think about and make informed decisions regarding the management of your endometriosis.

The Commonwealth Department of Community Services and Health, which administers the Pharmaceutical Benefits Scheme, will not subsidise the cost of some of the drugs used in the treatment of endometriosis unless a definite diagnosis has been made.

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