�BERKELEY, CA (UroToday.com) - Organized by the Pain of Urological Origin (PUGO) especial interest group of the International Association for the Study of Pain (IASP), Glasgow, Scotland August 15-16, 2008.
PUGO held a 2 day meeting in Scotland prior to the IASP twelfth World Congress on Pain to regard the past, present and future of urogenital pain. The place was to outline current practice and have a look at what the future may hold. Speakers from North America and Europe gave invited lectures, and synergistic sessions with all coming together attendees were interspersed throughout the proceeding leading to very lively discussions. The organizing commission included: Andrew Baranowski from London, John Hughes from Middlesbrough, UK, Beverly Collett from Leicester, UK, Ursula Wesselmann from Birmingham, Alabama, Leroy Nyberg from Bethesda, MD, Richard Berger from Seattle, Curtis Nickel from Kingston, Ontario, and Paul Abrams from Bristol, UK. The meeting was attended by a broad range of specialists in pain medicine, anesthesiology, psychology, neurology, neurosurgery, urology, gynecology, physical therapy, and internal practice of medicine. Patient advocates were as well enthusiastic participants. Many fantabulous presentations were given, and this report can only highlight selected ones. The proceedings will be synthesized by the organizing citizens committee and faculty and a formal publication is planned.
Curtis Nickel set the stage for the meeting with a discussion on the failure of our traditional biomedical model to successfully understand and treat urogenital chronic pelvic pain syndrome (UCPPS). He proposed a raw schema in which an initiator leads to redness or tissue damage. In some patients this results in UCPPS and can go on to develop into a regional pain in the neck syndrome and/or become a part of a systemic pain syndrome. Likewise, a systemic or regional pain sensation syndrome potty result in UCPPS in some patients. He proposed a strategy in which we attempt to identify the initiators, ameliorate the pain, treat the pelvic consequences of pelvic storey dysfunction, and tackle the associated phenotypes if diagnosed (irritable bowel syndrome, inveterate fatigue syndrome, fibromyalgia, etc.). He stressed the want to name and treat cognitive modulators including slump and catastrophizing as well as helplessness.
Fred Howard from the University of Rochester rundle on the endometriosis painfulness syndrome. Chronic pelvic botheration in women is almost commonly of gastrointestinal origin followed by the urinary tract and finally the reproductive tract. Endometriosis is a histologic finding, non a syndrome per se. We don't know the percentage of patients with endometriosis wHO also make pelvic painfulness, nor do we know the pct of women with pelvic pain wHO have endometriosis. We don't understand how it causes pelvic nuisance, why removing lesions doesn't always end the pain, or why similar symptoms are seen in patients with and without endometriosis. The common chord of symptoms associated with endometriosis includes dysmenorrhea, dyspareunia, and inveterate pelvic painful sensation. This throne be referred to as the adenomyosis pain syndrome. Dr. Howard quoted Frank Ling's report (Obstetrics and Gynecology, 93:51-58, 1999) showing the efficacy of depot leuprolide for chronic pelvic botheration in women suspected of having endometriosis, whether or not the diagnosis was borne kayoed on subsequent laparoscopy, a rather curious finding. Work by Sutton, Jones, and Abbott powerfully suggests that endometriosis lesions can cause pain and that operative treatment is more efficient than symptomatic laparoscopy in randomized, controlled trials (Fertility and Sterility, 62:696-700, 1994) (JSLS, 5:111-115, 2001) (Fertility and Sterility, 82:878-884, 2004).
Thibault Riant from Nantes, France related ground breakage surgical work in the treatment of the pudendal nerve entrapment syndrome (PNE) and the development of the Nantes criteria. The main criteria for diagnosing include all of the following: annoyance in the sensory country supplied by the pudendal nerve, hurting never awakens the patients during the night, pain increases in the seated position, no sensory loss is establish, and an immediate decreasing of botheration is noted after a pudendal anesthetic block. Therapeutic blocks, aesculapian treatment, S2 transcutaneous electrical nerve stimulation, physical therapy, and surgery were all discussed as possible forms of therapy. A multidisciplinary approach was suggested.
Maria Adele Giamberardino from the University of Chieti in Italy presented her research on the part of viscero-visceral hyperalgesia. Her studies, some in collaboration with Karen Berkley in Tallahassee, Florida, addressed patients affected with urinary calculosis and igure in 20 year old South Korean males.
Bert Messelink from Groningen, the Netherlands, spoke on pelvic storey muscles and urogenital hurting. In patients with urogenital pain, the pelvic floor muscles should be interpreted into account when talking and thinking about causative factors and possible options for treatment. Pelvic floor muscle education, physical therapy, biofeedback, and treatment of myofascial trigger points were all discussed. Possible injection of botulinum-A toxin or lidocaine into trigger points was mentioned, but information is sparse.
Eija Kalso from Finland spoke on opioids and guidelines for use in chronic pelvic pain, followed by some other talk on drug therapy by Sam Chong from the United Kingdom. Dr. Kelso illustrious that at that place are no randomized trials or regular case reports regarding the use of opioids for chronic nonmalignant pelvic hurting. Strong opioids should not be victimized as monotherapy, but rather as a part of a multidisciplinary approach. Use in combination with nonsteroidals and gabapentinoids may check tolerance. An intravenous opioid trial may be a good negative predictor of whether to consider opioids in a particular patient role. Assessing quality of sprightliness is decisive in decision making whether to continue opioids, as particular patients crataegus oxycantha find the diminished quality of life they associate with the treatment is not balanced by whatsoever perceived infliction benefit. Dr. Chong agreed that victimization cocktails and combination pain pill therapy is usually better than monotherapy.
Tony Buffington from Columbus, Ohio opened the bit day of the meeting. His presentation covered comorbidities, vulnerability factors, and familial aggregation data. Specifically he discussed variable combinations of idiopathic chronic pain syndromes including bladder pain syndrome, fibromyalgia, testy bowel syndrome, chronic pelvic pain syndrome, chronic fatigue syndrome, as well as affective disorders such as post traumatic stress disorderliness, panic disorderliness, anxiety and depression. These are ordinarily seen together in patients. They consist MUS or medically unexplained symptoms, and may strike up to 1/3rd of people seeking medical care. One candidate underlying disorder is sensitizing of the central tenseness response system and an imbalance in its production in response to stressors. Enhanced sensitiveness may result from variable combinations of familial (transmitted and environmental) factors. He hypothesizes that sensitization creates a greater vulnerability to life stressors, putting certain individuals at greater risk of development disorders characterized by painful sensation and uncomfortableness.
Andrew Baranowski presented the IASP categorisation system as it pertains to continuing pelvic pain, and noted how it embeds description of many phenotypes that are currently felt to be critical in categorizing patients with chronic pain. A resilient discussion with the audience and Dr. Nickels in particular ensued. Jose De Andres from Valencia, Spain then gave a elaborated and gripping discussion on neuromodulation techniques, concentrating on the evolving field of sacral spunk root stimulation and spinal anaesthesia cord stimulation. He accented that the level of evidence in this sphere is "low" and we are "simply treating patients". He was followed by an elegant presentation from Dr. Karen Berkeley from the University of Florida detailing her research on mechanisms of pain in a gnawer model of endometriosis - and the relationship of pain from endometriosis to other conditions via pelvic cross-talk. Central sensitization, outside central sensitization, and central hormonal modulation require a deliberate multifactorial approach to assessment and diagnosis of chronic pelvic pain.
Psychology and gender were the next topics. Anna Mandeville gave a introductory talk on the psychology of managing pain in the pelvis, highlighted by shell presentations. She described several sexual "myths" including
a. sex is to be reserved for the thoroughgoing, or at least the healthy;
b. sex must be spontaneous;
c. sex activity always should lead to intercourse;
d. each partner should instinctively know what the other wants.
Melissa Farmer from McGill University in Montreal followed Dr. Mandeville with a fascinating treatment on "sexual pain". Dyspareunia is a pain syndrome, not a sexual dysfunction. It requires biopsychosocial assessment and treatment. The motion she posed is, "Is pain sexual, or is sex painful?" In other words, does the pain in the ass occur in nonsexual or presexual situations. We would not say that depress back pain is a "work disorder" simply because the patient says it interferes with work. Likewise, we should not limit dyspareunia as a "sex disorder" because it interferes with sex. It is a pain disorder.
Dr. Farmer used the term "provoked vestibulodynia" instead of vulvovestibulitis syndrome. She famed that thither are no effective pharmacologic treatments, and that cognitive/behavioral therapy, hurting management, pelvic floor physical therapy, and vestibulectomy are efficacious in selected patients. Biomedical intervention (gynaecologist, pain specialiser), psychosocial intervention (psychologist, sexual urge therapist, psychiatrist), and phsiotherapy are all parts of successful therapy. Reducing pain does non always beggarly restoring sexual activity, nor does it necessarily lead to restoration of a relationship. Be careful how you define success in these patients.
Amanda C de C Williams from University College in London reviewed result assessment. She noted that pain is rarely adequately measured by quality of life definitions, but tone of life often approximates more closely than bother, symptom, or function measures what matters most to the affected role, and moves the focus from disease or dysfunction to the patient. She recommended falling somatization as being conceptually problematic, culturally specific, and incompatible with pain science. Likewise, cope may seem valid just is conceptually flawed. It addresses behaviour but non its setting or outcome. In a similar fashion, pain control predicts small, and is too general. Control may be an unrealistic shoot for for some pain.
The European Society for the Study of Interstitial Cystitis diagnostic approach shot was related by Jorgen Nordling from Copenhagen, and served as a model for end organ specialist rating of a chronic pain syndrome. Tim Ness from Birmingham, Alabama illustrated how the pain in the neck specialist approaches diagnosis.
Tier 1: rule out ruinous processes;
Tier 2: evaluation that guides the pick of intervention;
Tier 3: evaluation to limit discourse toxicity (imagination, laboratory testing, behavioral assessment if controlled substances are to be employed);
Tier 4: longitudinal outcome assessment;
Tier 5: use therapeutical results to help determine diagnostic information.
This comprehensive meeting ended with a presentation by this correspondent on practical considerations and algorithms for chronic pelvic pain, and also with a give-and-take led by Drs. Nickel and Baronowski to bestow the comprehensive proceedings to a close. It was agreed by all attendance that some type of clinical phenotype management strategy may help to move the field of discussion for chronic pelvic pain forward.
The management of chronic urogenital pain is a complex, but evolving field. We need standardisation of classification and valuation. We also need targeted therapies through a multidisciplinary approach, and finally, bob Hope for future benefits from translational science.
Reported by UroToday.com Contributing Editor Philip M. Hanno, MD, MPH
UroToday - the only urogenital medicine website with original substance written by global urogenital medicine key notion leaders actively ed in clinical practice.
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Friday 5 September 2008
Saturday 16 August 2008
Dmx's Rap Artist Arrested
A rapper signed to troubled rap star DMX's record label has been arrested on a series of drug and weapons charges.
Yung Berg - real name Christian Ward - has been charged with criminal possession of a weapon, criminal possession of marihuana and menacing following a police investigation on Saturday (09Aug08).
According to reports, Ward got into a dispute with a limousine driver in New York at the weekend, prompting a call to authorities.
A reference tells famous person website TMZ.com the driver reported a dispute with five passengers and when police investigated the complaints, they charged Berg.
Ward's hip-hop boss DMX pleaded not hangdog to felony charges of theft and identity larceny last month (Jul08) - the up-to-the-minute in a string of legal troubles for the star, which includes arrests for speeding, suspected drug possession and animal cruelty this year (08) alone.
More info
Thursday 7 August 2008
Singer Annie Lennox urges women to invigorate AIDS fight
MEXICO CITY - Annie Lennox says complacency threatens to slow the fight against AIDS, and is
Friday 27 June 2008
Tuesday 24 June 2008
Kim Ryder Signs �100k Coronation Street Deal
Coronation Street star Kim Ryder has signed a six-figure contract to stay on at the ITV soap for another year.
Ryder, who plays busty barmaid Michelle Connor in the long-running show, has more than doubled her �60,000 a year salary.
She has also negotiated more flexible working hours to spend more time with her children, David, 12, and 10-year-old Emily.
A source close to the former Hear'Say singer said, "When producers offered her a new contract and more money, she didn't hesitate to say yes."
Kym, 32, split with husband, former Eastenders star Jack Ryder, in March.
She has since been linked with Hollyoaks hunk Jamie Lomas, who she was seen with at her birthday party last week.
Since joining the Street in 2006, she has won a National Television Award, a British Soap Award and a TV Quick award.
See Also
Monday 9 June 2008
Spears & Gibson to holiday together?
Pop singer Britney Spears and Hollywood actor Mel Gibson are reportedly set to take a holiday together with members of their respective families.
According to People magazine, Spears and her father will spend some time with Gibson and his wife at their holiday home in Costa Rica.
A source told the magazine: "They're just going away for a few days to relax."
Spears and Gibson have previously been spotted dining together in Studio City.
A source said: "Mel and his wife Robin clearly saw a woman in crisis and wanted to extend themselves in any way possible."
According to People magazine, Spears and her father will spend some time with Gibson and his wife at their holiday home in Costa Rica.
A source told the magazine: "They're just going away for a few days to relax."
Spears and Gibson have previously been spotted dining together in Studio City.
A source said: "Mel and his wife Robin clearly saw a woman in crisis and wanted to extend themselves in any way possible."
Sunday 1 June 2008
Angelina Jolie Dismisses Birth Reports
Angelina Jolie has spoken out to dismiss a flurry of reports suggesting she has given birth to twins in the south of France.
Two false alarms on Friday sent the media into a spin, with one outlet even claiming she had delivered two baby girls and named them Isla Marcheline and Amelie Jane - honouring Jolie's late mother Marcheline and her partner Brad Pitt's mum Jane.
The coverage has prompted a spokesperson for the 32-year-old to come forward and confirm the actress is still pregnant.
The rep tells People.com, "Angelina has not given birth. She is fine, enjoying her home and her family in France."
Two false alarms on Friday sent the media into a spin, with one outlet even claiming she had delivered two baby girls and named them Isla Marcheline and Amelie Jane - honouring Jolie's late mother Marcheline and her partner Brad Pitt's mum Jane.
The coverage has prompted a spokesperson for the 32-year-old to come forward and confirm the actress is still pregnant.
The rep tells People.com, "Angelina has not given birth. She is fine, enjoying her home and her family in France."
Sunday 25 May 2008
Wednesday 21 May 2008
Rhapsody Presents Carrie Underwood With The Rhapsody Most Played Country Album Award
Rhapsody Presents Carrie Underwood With The Rhapsody Most Played Country Album Award
Rhapsody Users Listened To Carrie Underwood's Or so Hearts To a greater extent Than Any
Other Nation Album In 2007
Capital of Tennessee, Tenn., April 15 -- CMT, a division of MTV
Networks and Rhapsody(R), the digital medicine service from MTV Networks and
RealNetworks(R), INC. (National Association of Securities Dealers Automated Quotations: RNWK), compliment land artist Carrie
Underbrush, achiever of Rhapsody's To the highest degree Played State Album of 2007 award.
Announced as a part of the CMT Music Awards Red Carpet bear witness, this prize
acknowledges that Ms. Underwood's 2007 sacking Approximately Black Maria was listened to
more times Rhapsody users than any other state album in 2007.
"Rhapsody gives medicine fans unlimited memory access to millions of songs, so
it's incessantly fascinating to find which albums people come back to over and
over again," said Tim Quirkiness, frailty president of music programming, Rhapsody
USA. "Today, we're honored to be browning Carrie Undergrowth and More or less
Black Maria as Rhapsody's To the highest degree Played Country Album of 2007."
Carrie Underwood was thrilled to receive such an honor, noting, "What
an unexpected pureness. Thanks to my fans for wanting to try more music!"
As the receiver of the first ever Rhapsody's About Listened to Country
Album of the Year, Ms. Underbrush will receive a Sonos multi-room digital
music system and a full subscription to the Rhapsody Unlimited overhaul. The
compounding of Sonos summation Rhapsody lets music fans savor millions of songs
from every case of euphony throughout their home.
Rhapsody (hTTP://www.rhapsody.com) delivers pentad 1000000 songs a day to
music lovers through more consumer have-to doe with points than any other service.
Through partnerships with industry leadership like TiVo, Philips, SanDisk,
Logitech and Sonos, Rhapsody has created a complete digital euphony
experience on the PC, passim the home and on the go. Rhapsody offers
consumers unlimited access to millions of songs, professionally programmed
music channels and exclusive content from MTV Networks' premier MTV, VH1
and CMT music brands.
Nearly Rhapsody
Rhapsody(R) offers an integrated and immersive digital music go through
accessible to consumers via their figurer, portable music device and shortly
their mobile phone. Rhapsody is the scoop digital music service for
RealNetworks(R) and for MTV Networks' music and pop-culture brands in the
United States. Rhapsody is a service of Rhapsody America LLC, a joint
venture between and MTV Networks, a unit of Viacom (New York Stock Exchange: VIA) (Big board:
VIA.B) and RealNetworks (National Association of Securities Dealers Automated Quotations: RNWK).
About CMT
CMT, a unit of Viacom's MTV Networks (New York Stock Exchange: VIA and VIA.B), is the
leadership television and digital government agency on country music and
amusement, reaching more than 87 one thousand thousand homes in the U.S. CMT and its
website, CMT.com, offer an unparalleled ruffle of music, news, live concerts
and serial and is the top resource for land music on need. The
network's digital platforms include the 24-hour music channel, CMT Pure
Area, CMT Mobile and CMT VOD.
Thursday 8 May 2008
US shows shelve Heath Ledger video
US shows shelve Heath Ledger video
Plans to beam footage on US goggle box of the late worker Heath Ledger allegedly at a drug-fuelled party in Hollywood bear been pulled "come out of regard for his menage".
The footage is understood to experience been shot iI years ago following an awards ceremony in Los Angeles.
US famous person programmes Entertainment Tonight and The Insider were due to broadcast the footage and had antecedently aired a promotional clip for the proposed viewing.
Account book is non shown taking drugs in the video.
In a statement Amusement Tonight said: "Come out of respect for Heathland Ledger's family unit, Entertainment Tonight and The Insider birth decided non to race the Heathland Daybook video which has been circulating in the world media."
Vladimir Petroschoff (Conductor)
Friday 2 May 2008
"Voice" carries Bareilles up the charts
"Voice" carries Bareilles up the charts
Sara Bareilles didn’t write her make “Erotic love Song” kiss-off for an ex-boyfriend. She wrote it for Epos Records.
Bareilles (pronounced buh-RELL-is) is quick to reference that the folks at Heroic poem did a fine job of promoting her tag debut, “Little Voice” (her first CD, “Careful Confessions” was released severally). And they’ve kept her occupy with an exhausting circuit docket, opening for Mika, Paolo Nutini, Maroon 5 and James I Blunt. At present she’s playing her first base headlining Boston point on Tuesday at the Heaven.
Just her relationship with Epos got forth to a bumpy beginning.
“I was confused as to wherefore it was pickings so long to get started transcription,” the singer/songwriter/pianist said from a Milwaukee circuit stop. “They told me, ‘Keep authorship. We’ll see what happens.’ Meantime, I’d worked up a phone number of character songs and nobody on their remainder was all that impressed. I wound up touch discomfited. It made me outguess my have abilities. And then I got in truth angry at myself for lovingness too a lot about what the judge was thought process.”
She took her irritation and channeled it into on the nose what Heroic poem wanted: a hit record, love song or not.
“I finger jolly goodness around it now,” Bareilles said. “I went to my rehearsal space in L.A. and wrote it chop-chop, which tells me I was truly inspired because I’m typically a slacken ballad maker. ‘Dearest Song’ represents me well - and I know they’re happy with it.”
Of course Heroic poem is happy. Bareilles is one of alone a rattling few artists currently making the Sony foot soldier money. “Love Song” hit No. 4 on Billboard’s Hot C, prodding “Little Voice” to go gold with to a greater extent than five hundred,000 copies shipped. And that’s only in the United States. The strain is also a hit in the Nederland, New Zealand, Brazil nut, the Philippine Islands and Canada.
With its blue-eyed somebody groove and feisty spirit, “Passion Song” gained attending on its possess as a unloose iTunes download death summer. Simply when Bareilles appeared vocalizing it in a Rhapsody commercial about the holidays, it shot from No. 73 to 16 in one workweek, proving over again that TV is indeed the newly radio. Since then, the bingle has gone on to sell nearly 2 billion copies.
“I had or so reservations about doing the commercial message,” Bareilles said. “I had to curiosity if it qualified as a sellout. Was this totally a bad news program melodic theme?
“Only I decided it was a worthwhile opportunity, and it’s single I’m now real grateful to sustain had. Addition, it was for a music-related ware, and I got to be myself in the ad. If I’d been the Pantene Pro-V lady friend, that power be to a greater extent difficult for people to catch over.”
Bareilles is aware that in today’s music market, renown tooshie be fleeting. Merely she says if her concentrate with Epic poem got yanked tomorrow she’d hold open release.
“I suppose it mightiness be a relief in more or less ways,” she said. “Working with a big company like Sony tush be daunting. I’m fortunate to give come into this at my age (28). It’s yob existence your possess counsellor when you’re also thomas Young to really know wHO you ar.
“Of course, if I could do it altogether myself, I’d do it differently. Just that’s not what you polarity up for with a major label. I want to remember, I’m non doing this for blessing and credence. It’s my passion. In the end, I just make to make surely and listen to my inner ‘Little Voice.’ ”
Sara Bareilles, with Rachel Yamagata and Jacques Louis David Ford, at the Paradise, Tuesday. Tickets: $20; 617-562-8800.
Saturday 26 April 2008
Swervedriver coming together for Coachella
Swervedriver coming together for Coachella
Freshly House of York -- Swervedriver will recoil off its reunion hitch with a
freshly confirmed engagement on the final day of this month's Coachella
Vale Music & Arts Festival. The U.K. careen grouping will so
begin a North American run Crataegus laevigata 26 in Seattle.
"We've actually only had the one join at this point in a
cheap studio in North Jack London, simply it sounded surprisingly fast and
together -- and likewise to a greater extent punk rock rock and unhinged than always earlier
somehow," frontman Adam Franklin said.
"We'll be getting together around more this month and then will get a
little more intensive earlier the tour just to make sure enough we experience as
many songs and sounds consume as we want," he said.
Beforehand, John Hope Franklin has freshly music to declare oneself in the form of the
self-titled debut EP from Magnetic Morning, his band with Interpol
drummer Surface-to-air missile Fogarino. "Thither ar tunes where it's Sam's main melodic phrase
and then I've introduced a chord sequence about that strain," he
said. "So it's like sonic tag -- I chuck it back at him and he does
production things over my arrangement, (then) chucks it back to me
once more for a song melodic phrase."
The group, which has played exist only once so far, is hoping to
circuit in the fall.
Britney's cousin to launch singing career?
Britney's cousin to launch singing career?
Britney Spears' first cousin is
Housewives star dismisses baby rumours
Housewives star dismisses baby rumours
'Desperate Housewives' star Eva Longoria-Parker has denied rumours that she is pregnant.
According to People magazine, the actress dismissed the speculation at a promotion event for her freshly moving-picture show 'Over Her Dead Body'.
Longoria-Parker said: "No pregnancy, non still. I've been cooking and eating, preparation and eating. I keep singing everyone that I've gained 10 pounds just being on shine [a reference to the Hollywood writers' strickle]."
The actress sparked farther rumours when she arrived at a press day with a pink sister blanket wrapped around her.
When asked about the blanket, she said: "I know - If this isn't going to spawn pregnancy rumours, I don't know..."
She continued: "I was freezing, so I had to run down to the gift shit, and they didn't have any wraps. I grabbed this and was like, 'It's so easy, merely why is it so small?!' And they said, 'It's for a baby'."
The 'Desperate Housewives' star has spoken nigh having a family line with her basketball actor hubby Tony Yardbird Parker in the hereafter.
She said: "I intend, we're not truly on a time clock, and going away, 'Okay, this month, this clarence Shepard Day Jr.. We're variety of just going away, 'We're so happy if we get pregnant, and if we don't we're okay.' We're just letting God make up one's mind it."
Minus the Bear
Prison Break back for fourth series
Prison Break back for fourth series
Escape adventure 'Prison Break' is to return for a fourth series.
Variety reports that Fox has ordered another 22 episodes of the show.
Because of the writers' strike in the US, the third series of 'Prison Break' was cut short, with the mid-season cliffhanger becoming the season finale.
The fourth series will see Michael (Wentworth Miller) and Lincoln (Dominic Purcell) returning, with the show set to be shot in a new location.
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