Nutra Pharma’s recently launched pain reliever adjudged as the Best New Product at ECRM Conference

Nutra Pharma Corp. (OTCBB: NPHC), a biotechnology company that is developing treatments for Adrenomyeloneuropathy (AMN), HIV and Multiple Sclerosis (MS), has announced today that its recently launched pain reliever, Cobroxin, was selected as the “Best New Product” at the Efficient Collaborative Retail Marketing (ECRM) Conference. Cobroxin was chosen as the award recipient by conference attendees, including several of the leading national retailers.

“Winning this award is an exciting achievement for Nutra Pharma, as it reflects the significant amount of positive response we have received from retailers who are looking to offer their customers a safe and effective alternative to current pain relievers,” commented Rik J. Deitsch, Chairman and CEO of Nutra Pharma. “As we begin introducing Cobroxin through retailers this fall, we plan to continue our efforts educating both retailers and consumers about Cobroxin’s unique analgesic properties, which do not rely on opiates or acetaminophen for its pain relieving effects,” he concluded.

Cobroxin is the first OTC pain reliever clinically proven to treat Stage 2 (moderate to severe) chronic pain. The drug, which was developed by Nutra Pharma’s wholly-owned drug discovery subsidiary, ReceptoPharm, will be available as an oral spray (NDC47219-102-52) for treating lower back pain, migraines, neck aches, shoulder pain, cramps and neuralgia and as a topical gel (NDC47219-104-50) for treating repetitive stress, arthritis, and joint pain.

Additional benefits to Cobroxin include:

• All Natural
• Non-Addictive
• Non-Narcotic
• Non-Opiate
• More Potent than Morphine
• Long Lasting

Recently, Nutra Pharma announced a licensing agreement that grants XenaCare Holdings (OTCBB: XCHO) ongoing exclusive marketing and distribution rights for Cobroxin within the United States in return for meeting specific minimum performance requirements. In addition, the Company also announced successful submission of final Cobroxin packaging and labeling to the Food and Drug Administration (FDA), the final step required to begin selling Cobroxin.

Ardent Health Services selects Bravo Wellness for providing health assessment and wellness incentive services

Ardent Health Services has selected Bravo Wellness to provide health assessment and wellness incentive services to its 6,500 employees. In addition to improving employee health and productivity, the partnership has the potential to reduce the company’s overall health care costs, including out-of-pocket expenses for employees.

As part of the three-year agreement, Ardent will supplement its current wellness efforts by offering employees the opportunity to participate in an online health risk assessment as well as blood pressure, glucose, cholesterol, tobacco and body mass index screenings. Participating employees will receive a discount on their monthly health insurance premium contribution while those who meet certain screening criteria will qualify for additional deductions.

“As a provider of both health care and health insurance services, we see tremendous value in engaging employees in the wellness process from the very beginning,” said Neil Hemphill, Ardent’s senior vice president of human resources. “Partnering with Bravo will allow us to better manage our overall health care costs while providing a meaningful benefit that can positively impact our employees’ health as well as their wallets.”

Bravo’s corporate wellness programs provide employers with an average annual savings of nearly 10 percent. While only three in 10 employees participate in traditional wellness programs, Bravo’s programs provide financial incentives that increase employee participation. Most Bravo clients experience an average of 92 percent participation.

“We are thrilled to work with a premier provider of health services such as Ardent,” said Jim Pshock, president of Bravo Wellness. “We have found that with many companies, it is not enough to have wellness tools. With meaningful incentives, employees adopt lifestyles and behaviors to sustain good health. We are pleased to supplement Ardent’s wellness tools with our results-based wellness incentive solutions to assist them in effectively managing rising health care costs.”

Walgreens to provide flue shots faster and easier this season

Walgreens (NYSE:WAG)(NASDAQ:WAG) is making it faster and easier to get a flu shot this season. The nation’s largest drugstore chain today announced it will begin offering seasonal flu shots on Sept. 1 at more than 7,000 points of care nationwide, including nearly all of its stores in 50 states and almost 350 in-store Take Care Clinics. With more than 16,000 pharmacists, nurse practitioners and physician assistants licensed or certified to provide flu shots, Walgreens has the largest retail network of immunizers in the U.S. and can provide seasonal flu shots most hours its pharmacies and Take Care Clinics are open.

Beginning Sept. 8 through Sept. 30, all clinics and Walgreens pharmacies will have immunizing pharmacists or nurse practitioners on staff from 10 a.m. to 4 p.m. daily, offering shots on a walk-in basis or by appointment for $24.99. Shots are available outside those hours if an immunizing pharmacist or nurse practitioner is on duty. State age and health condition-related restrictions may apply.

“With a heightened awareness around this flu season, we’ve assembled the resources to be the go-to source for flu prevention, as well as general health and wellness, in every community we serve,” said Walgreens President and CEO Greg Wasson. “Walgreens was built on a long-standing history as a community pharmacy and retailer. Now, with our expansive network of health care professionals, we’re proud to also be a destination for trusted information and high quality, affordable health care.”

An integral part of the network includes Take Care Clinics at select Walgreens stores, which have board-certified nurse practitioners and physician assistants on staff seven days a week, including extended evening and weekend hours, to administer shots and other vaccines such as PPV (pneumonia). No appointment is necessary.

More Consumers Plan to Get Flu Shots

A new Walgreens survey found that more consumers, 50 percent, plan to get a seasonal flu shot this year, up from 43 percent who say they got one last season. Additionally, 27 percent say they are more concerned about getting the flu than they were a year ago.

Seasonal flu shots cost $24.99 and Take Care Clinics are again offering the FluMist nasal spray as an alternative to the shot for $29.99. Shots may be covered by insurance plans as well as Medicare Part B. Patients are encouraged to check with their insurance provider for coverage details.

For Walgreens store locations and pharmacy hours, call 1-800-WALGREENS or visit www.walgreens.com/flu, and for the nearest Take Care Clinic visit www.takecarehealth.com

Walgreens to Provide $1 Million Worth of Flu Shots to Uninsured

Walgreens also announced today that it’s providing $1 million worth of seasonal flu shots to uninsured adults. Shots will be distributed in the form of vouchers, which will go to eligible consumers who visit one of nine Wellness Tour bus locations in select markets across the continental U.S. Vouchers are available on a first come, first serve basis while supplies last.

“We’re here to help,” Wasson said. “And we’ll continue to explore ways in which Walgreens can assist consumers and government agencies throughout this flu season.”

Those uninsured wishing to find dates and the nearest Wellness Tour location are asked to call 1-866-484-TOUR or visit www.aarpwalgreens.com/tour.

H1N1

The Centers for Disease Control and Prevention (CDC) says seasonal flu vaccine will not protect against the H1N1 flu virus. The vaccine is expected to be made available around mid-October and two separate shots will be required, the center says. Walgreens is working closely with the U.S. government, which is overseeing the development and disbursement of an H1N1 vaccine. More information on the H1N1 flu virus as well as vaccine availability and prioritization can be found at the CDC Web site, www.cdc.gov.

“Pharmacists and health care professionals at Walgreens and Take Care Health Systems will actively seek out opportunities to educate patients about the differences between H1N1 and seasonal flu so they can take the best steps to protect themselves,” said Allan Khoury, MD, PhD, Chief Medical Officer, Take Care Health Systems. “While there’s certainly widespread and growing concern around H1N1, what consumers can do right now is get the seasonal flu vaccine.”

Walgreens (www.walgreens.com) is the nation’s largest drugstore chain with fiscal 2008 sales of $59 billion. The company operates 6,943 drugstores in all 50 states, the District of Columbia and Puerto Rico. Walgreens provides the most convenient access to consumer goods and services and cost-effective pharmacy, health and wellness services in America through its retail drugstores, Walgreens Health Services division and Walgreens Health and Wellness division. Walgreens Health Services assists pharmacy patients and prescription drug and medical plans through Walgreens Health Initiatives Inc. (a pharmacy benefit manager), Walgreens Mail Service Inc., Walgreens Home Care Inc., Walgreens Specialty Pharmacy LLC and SeniorMed LLC (a pharmacy provider to long-term care facilities). Walgreens Health and Wellness Division includes Take Care Health Systems, the largest and most comprehensive manager of worksite health and wellness centers and in-store convenient care clinics, with more than 700 locations throughout the country.

Effectiveness Of Surveillance Systems In Monitoring Swine Flu

Research recently published on bmj.com reports that concerns about the effectiveness of flu surveillance systems during the early phase of the swine flu pandemic were unfounded.

An investigation reviewed the samples from members of the public who called NHS Direct with cold or flu-like symptoms during June 2009. Results strongly matched local transmission rates in six regions of England.

In May 2009, laboratory confirmed cases of pandemic influenza A (H1N1) gradually increased in England. There was there was rising concern that existing surveillance systems were failing to recognize 'sustained community transmission.'

As a result, a system of self-sampling which had been piloted during the winter of 2003-2004, was resumed to improve the monitoring of local virus transmission.

In six regions of England, a total of 1,385 specimens from callers to NHS Direct during June 2009 were tested. There were two regions (London and West Midlands) where clinical diagnoses were increasing. There were also another four regions that were much less affected.

Among the participants, no one had just returned from an affected country or had had contact with a confirmed case. All were advised to self-treat their symptoms.

There was detection of Pandemic influenza A (H1N1) infections in 97 samples (7 percent). Also, eight influenza A H3 infections and two influenza B infections were found. The peak H1N1 infection rate (20 percent) was in 16 to 24 year olds.

Findings indicated that the variations in the proportion of people infected each week very much matched the rate of increase in clinical laboratory diagnoses. This suggested that there was a reliable indication of the level to which local transmission was occurring in various areas of the country.

For instance, the scheme suggested an absence of sustained community transmission in the regions where clinical diagnoses were low. Furthermore, the scheme provided corresponding and consistent evidence of increasing community transmission compared to reported laboratory diagnoses in regions where clinical diagnoses were expanding quickly.

In closing, the authors remark that if the existing pandemic influenza A (H1N1) intensifies through the coming autumn and winter, self-sampling of members of the public with cold or flu-like symptoms who phone clinical advice services should allow reasonable accurate monitoring of the milder flu-like illness attributable to particular flu types in different regions. Also, it should permit measurement of the antiviral susceptibility of strains and any antigenic drift which are random mutations in the genes of a virus that can lead to a loss of immunity.

Following the launch of the National Pandemic Flu Service (NPFS), the Health Protection Agency (HPA) began such a scheme as of 3 August 2009. It deals with callers and internet contacts to the government service. Records from this surveillance system are regularly published in the HPA online weekly epidemiological report on pandemic influenza A (H1N1).

Laser Breakthrough Opens Door To DNA Manipulation

Heralded as a breakthrough in laser technology that will benefit biomedicine by opening the door to DNA manipulation and other applications, scientists in the US have made the world's smallest semiconductor laser that can focus light in a space smaller than a single protein molecule.

The research that led to the breakthrough was done by Dr Xiang Zhang, professor of mechanical engineering and director of University of California Berkeley's Nanoscale Science and Engineering Center, and colleagues, and is described in the 30 August advanced online issue of the journal Nature.

The research breaks new ground in the field of optics because Zhang and colleagues have not only found a way to squeeze light into a tiny space but also found a way to stop it dissipating as it moves along, ie it maintains true laser properties.

For some time now optics experts have been experimenting with trying to make electromagnetic beams smaller and smaller, and it has been traditionally accepted that you can't compress such waves into spaces smaller than half their wavelength.

But as, Zhang said:

"This work shatters traditional notions of laser limits, and makes a major advance toward applications in the biomedical, communications and computing fields."

He said their achievement opens the door to the development of "nanolasers" that will be able to probe, manipulate and characterize DNA molecules. In other fields like telecommunications, it will enable data to be carried at speeds many times faster than current technology. And it will help the development of optical computers where light replaces electronic circuits, enabling huge leaps in speed and processing power.

Researchers have been trying to compress light down to the dozens of nanometers, reaching the traditionally held limit of half of its wavelenght, by binding the light to the electrons that oscillate together on the surface of metals, creating what are called surface plasmons: where light and oscillating electrons interact.

One of the problems of making lasers this small is that the natural electrical resistance of the metals cause the plasmons to dissipate very quickly, and the challenge is how to overcome this plus keep the integrity of the excitation between the light and oscillating electrons going continuously (amplification).

Zhang and colleagues created a structure capable of storing light energy in a non-metallic gap that was some 20 times smaller than its wavelength. The gap is about 5 nanometers, about the size of a single protein molecule. They made the structure out of cadmium sulfide nanowire (about 1,000 times thinner than human hair) with a silver surface.

The new structure overcame the problem of energy dissipation, now there remained the problem of amplification.

But what they found was the nanowire gap did both jobs: it was a confinement mechanism that stopped losses and it was an amplifier.

"It's pulling double duty," said lead author Dr Rupert Oulton, a research associate in Zhang's lab who first came up with the nanowire gap idea last year.

This was a real bonus because in such small spaces there is not much room to play with and by doing both jobs the new "hybrid" structure saved having to put another device in that space.

The authors wrote that holding and sustaining light in such a small space alters radically the way it interacts with matter and causes a significant increase in the spontaneous emission rate of light. Zhang and colleagues measured a six-fold increase in the spontaneous emission rate.

Biochemists are already using plasmons to look at protein to protein interaction. More conventional methods rely on labelling one protein with a fluorescent dye of one colour and another protein with a dye of another colour. This method has limits in that sometimes the dyes change the way the proteins behave, and also, when the labels sit on top of each other, you can't see if the proteins have really interacted.

So biochemists are really keen to have tools that allow them to see how proteins interact in their natural form, and devices that rely on plasmon resonance allow them to do that. They use the fact that plasmons require radiation of specific wavelengths to oscillate, and proteins attached to the surfaces that generate the plasmons change the frequency at which they resonate. By measuring changes in resonance, the scientists can tell what is happening at the protein-protein interaction level.

Now with this new breakthrough from Zhang and colleagues, the "probe" has got even smaller, making it more possible that one day, devices like plasmon nanolasers will be able to explore and manipulate at the DNA level.

For Healthy People Daily Aspirin May Do More Harm Than Good

A UK study presented at a conference last weekend found no evidence to support the idea that a daily dose of aspirin protects people who do not have artery or heart disease from developing it in the future any better than a placebo, and experts suggest given the higher risk of internal bleeding from taking aspirin routinely, for healthy people such a precaution may do more harm than good


The study reported results from the Aspirin for Asymptomatic Atherosclerosis (AAA) study, whose joint first author Professor Gerry Fowkes from the Wolfson Unit for Prevention of Peripheral Vascular Diseases in Edinburgh, presented the findings at the European Society of Cardiology (ESC) Congress 2009 in Barcelona, Spain on Sunday.

Fowkes said the study was the first placebo-controlled randomised trial to test the protective effect of aspirin in people who did not show signs of atherosclerosis as measured by a low ankle brachial index (ABI) at the start of the study, and that the results found:

"No statistically significant difference in primary endpoint events between those subjects allocated to aspirin or placebo."

ABI compares the blood pressure in the lower legs to the blood pressure in the arms and is a measure of whether peripheral artery disease might be present.

Studies have already shown that antiplatelet drugs like aspirin are effective in secondary prevention, where people who already have arterial disease, or have suffered a stroke or heart attack, use them to prevent a further event.

But as Fowkes explained, there was little evidence about how effective routine use of these drugs might be in primary prevention, that is protecting people who have not yet developed arterial or heart disease from getting it in the future, so that any benefits in this direction might be weighed up against the already known risk of bleeding.

The trial recruited 28,980 men and women who were living in central Scotlan and were aged from 50 to 75 years. Al the participants were free of clinically evident cardiovascular disease and went through ABI screening.

3,350 participants with low ABI (under or equal to 0.95) were then randomized to taking a once daily 100 mg dose of aspirin or equivalent placebo.

The researchers then followed them for an average of 8.2 years, using a mix of annual contact, looking at GP records, discharge reports from Scottish hospitals, and death notifications.

They looked for two kinds of information in the follow up, which they grouped according to whether they were primary or secondary endpoints of interest to the study.

The primary endpoints they looked for in the follow up records were: initial fatal or non-fatal coronary event or stroke, or revascularisation. They used this as a composite figure in the analysis.

They looked for two secondary endpoints: (1) all initial vascular events defined as a composite of a primary endpoint event or angina, intermittent claudication or transient ischaemic attack, or (2) death from all causes.

The results showed that:

• 357 participants had a primary endpoint event (reflecting a rate of 13.5 primary events per 1,000 person years).


• 181 of these were in the aspirin group and 176 were in the placebo group, with no statistically significant difference between them.


• 578 participants had a secondary endpoint vascular event, 288 in the aspirin and 290 in the placebo group, also with no statistically significant difference between them.


• Death from all causes was also similar in both groups (176 people died in the aspirin group and 186 in the placebo group).


• 34 (2 per cent) of the aspirin group participants had an initial event of major bleeding that required hospital admission, compared to 20 (1.2 per cent) in the placebo group.

Fowkes said:

"Although the AAA trial was not of screening per se, the results would suggest that using the ABI as a tool to screen individuals free of cardiovascular disease in the community is unlikely to be beneficial if aspirin is the intervention to be used in those found to be at higher risk."

"Other more potent antiplatelets might be considered, but only if increased effectiveness in avoiding ischaemic events is not matched by increased bleeding," he added.

The study was part funded by the British Heart Foundation, whose Medical Director, Professor Peter Weissberg said:

"We know that patients with symptoms of artery disease, such as angina, heart attack or stroke, can reduce their risk of further problems by taking a small dose of aspirin each day."

"The findings of this study agree with our current advice that people who do not have symptomatic or diagnosed artery or heart disease should not take aspirin, because the risks of bleeding may outweigh the benefits," he added.

However, other experts might suggest that the study's findings are too bound up with the issue of using ABI as the screening tool, and the question of whether these results would be different with another screening tool remains unanswered.

As Fowkes himself pointed out:

"It is possible that in the general population, aspirin could produce a smaller reduction in vascular events than this trial was designed to detect, but it is questionable whether such an effect, together with aspirin related morbidity, would justify the additional resources and health care requirements of an ABI [ankle brachial index] screening programme."

Speaking at another session the day before, Gilles Montalescot from the University Hospital of Pitié-Salpètrière in Paris, emphasized the difference between using aspirin and other NSAIDs (non-steroidal anti-inflammatory drugs) in primary and secondary prevention of strokes.

"If the net cerebrovascular benefit is in favour of aspirin in secondary prevention, it is a different story in primary prevention where the protection against ischemic stroke is offset by the risk of intracranial bleeding," said Montalescot.

Speaking at the same session, Carlo Patrono of the Catholic University School of Medicine in Rome, Italy, who worked on the AAA trial with Fowkes, said aspirin should be trialled further, as it may offer potential benefits in treating other diseases:

"Additional benefits of long-term aspirin therapy in preventing other serious outcomes, such as colorectal cancer, are not yet established by randomised clinical trials."

"However, the demonstrated efficacy of low-dose aspirin in reducing the risk of recurrence of sporadic colorectal adenomas is promising in this respect," added Patrono.

The Path to New Antibiotics

LA JOLLA, Calif., August 27, 2009 -- Researchers at Burnham Institute for Medical Research (Burnham), University of Texas Southwestern Medical Center and University of Maryland have demonstrated that an enzyme that is essential to many bacteria can be targeted to kill dangerous pathogens. In addition, investigators discovered chemical compounds that can inhibit this enzyme and suppress the growth of pathogenic bacteria. These findings are essential to develop new broad-spectrum antibacterial agents to overcome multidrug resistance. The research was published in the Cell journal Andrei Osterman, Ph.D., an associate professor in Burnham’s Bioinformatics and Systems Biology program, and colleagues, targeted the bacterial nicotinate mononucleotide adenylyltransferase (NadD), an essential enzyme for nicotinamide adenine dinculeotide (NAD) biosynthesis. NAD has many crucial functions in nearly all important pathogens and the bacterial NadD differs significantly from the human enzyme.

“It’s clear that because of bacterial resistance, we need new, wide-spectrum antibiotics,” said Dr. Osterman. “This enzyme is indispensable in many pathogens, so finding ways to inhibit it could give us new options against infection.”

According to the National Institutes of Health, drug resistance is making many diseases increasingly difficult—and sometimes impossible—to treat. They point to tuberculosis and methicillin-resistant Staphylococcus aureus (MRSA) as two pathogens that pose a serious threat to human health.

Using a structure-based approach, the team searched for low-molecular-weight compounds that would selectively inhibit bacterial NadD, but not the human equivalent, by screening, in silico, more than a million compounds. Experimental testing of the best predicted compounds against Escherichia coli and Bacillus anthracis (anthrax) led them to a handful of versatile inhibitory chemotypes, which they explored in detail. Using protein crystallography, a 3D structure of the enzyme in complex with one of the inhibitors was solved providing guidelines for further drug improvement.

“This is proof-of-concept that NadD is a good target to create antibacterial agents,” said Dr Osterman. “This knowledge will be useful for both biodefense and public health. The next step is to find better inhibitors. We do not have a silver bullet yet, but we are certainly hitting a golden target.”

This research was supported by a grant from the National Institute of Allergy and Infectious Diseases.

About Burnham Institute for Medical Research
Burnham Institute for Medical Research is dedicated to discovering the fundamental molecular causes of disease and devising the innovative therapies of tomorrow. Burnham, with operations in California and Florida, is one of the fastest-growing research institutes in the country. The institute ranks among the top four institutions nationally for NIH grant funding and among the top 25 organizations worldwide for its research impact. For the past decade (1999-2009), Burnham ranked first worldwide in the fields of biology and biochemistry for the impact of its research publications (defined by citations per publication), according to the Institute for Scientific Information.

Burnham utilizes a unique, collaborative approach to medical research and has established major research programs in cancer, neurodegeneration, diabetes, and infectious, inflammatory, and childhood diseases. The Institute is especially known for its world-class capabilities in stem cell research and drug discovery technologies. Burnham is a nonprofit public benefit corporation.

Scientific Excellence Fuels Burnham’s Growth

In its 33rd year, Burnham Institute for Medical Research has surpassed significant milestones in scientific achievement, research staffing and infrastructure development. As of July 1, 2009, the Institute exceeded 1,000 employees, including 74 full-time faculty and 800 scientific staff.

New molecular sensor could identify zinc-related diseases

Scientists have developed a new molecular sensor that can reveal the amount of zinc in cells, which could tell us more about a number of diseases, including type 2 diabetes. The research, published today in Nature Methods, opens the door to the hidden world of zinc biology by giving scientists an accurate way of measuring the concentration of zinc and its location in cells for the first time.

Zinc is involved in many processes in the body and five percent of all the proteins made by the body's cells are involved in transporting zinc. Scientists believe that zinc plays a role in many diseases; for example, it helps package insulin in pancreas cells and in people with type 2 diabetes, the gene that controls this packaging is often defective.

Previously, researchers used crude chemical techniques to get a rough idea of the concentration of zinc in cells. However, they could not produce an accurate picture of how much zinc was present in cells or where it was within them.

In today's study, researchers from Imperial College London and Eindhoven University of Technology in The Netherlands have developed a molecular sensor using fluorescence proteins that can measure the distance between zinc ions in individual cells, showing how much zinc is present.

Professor Guy Rutter, one of the authors of the study from the Division of Medicine at Imperial College London, said: "There has been relatively little biological work done on zinc compared to other metals such as calcium and sodium, partly because we didn't have the tools to measure it accurately before now. Zinc is so important in the body - studies have suggested it has roles in many different areas, including muscles and the brain."

The new sensor, called a fluorescence resonance energy transfer (FRET)-based sensor, is made up of two jellyfish proteins called green fluorescent proteins. The researchers altered the first protein to give off light at a certain wavelength, and altered the second protein to collect that light. When the proteins attached to zinc ions, the proteins became pushed apart and the transmission of light between them became weaker. The researchers used a fluorescence microscope to detect the wavelengths of light emitted by the proteins. This revealed zinc in the cell, with coloured patches visible where the proteins detected zinc.

The researchers used their new sensor to look for zinc in pancreatic cells, where insulin is packaged around zinc ions. Previous research had suggested that in people with type 2 diabetes, the gene that controls the packaging process is often defective, affecting the way insulin is stored. The researchers found a high concentration of zinc ions inside certain parts of the cells where insulin is found. They hope their new sensor could help scientists look more closely at this to find out exactly how zinc is involved in diabetes.

"We can now measure very accurately the concentration of zinc in cells and we can also look at where it is inside the cell, using our molecular measuring device. This sort of information will help us to see what is going on inside different tissues, for example in the brain in Alzheimer's disease, where we also suspect zinc may be involved. We hope this new sensor will help researchers learn more about zinc-related diseases and potentially identify new ways of treating them," added Professor Rutter.

The researchers would now like to develop their new sensor to look at zinc in a living mouse model, so they can observe the movement of zinc in different tissues, for example in diabetes.

New sleep formula unveiled at USANA Health Sciences' 17th annual international convention

USANA Health Sciences, Inc. (NASDAQ:USNA) hosted thousands of independent Associates and guests from around the world this week for its 17th annual international convention in Salt Lake City.

As part of the event, USANA unveiled its new sleep formula, Pure Rest; announced formula upgrades to its Essentials and HealthPak supplements; and introduced newly formulated super pills exclusive to USANA’s fully customizable supplement system, MyHealthPak.

Pure Rest supports healthy, restorative sleep by supplementing the body’s natural supply of melatonin and is ideal for those with age-related insomnia, jet lag, and sleep disturbances due to shift work. Pure Rest is made with high quality, pure melatonin from Switzerland.

USANA’s Essentials have been reformulated to include maximum levels of vitamin D (1800 IU per day). USANA’s Research and Development team increased levels of this highly important vitamin because of recent research showing that most Americans are not getting enough vitamin D in their diet. USANA’s HealthPak includes the reformulated Essentials and now also contains 30 mg per day of reseveratrol, the amount found in five bottles of red wine.

USANA’s new super pills, exclusive to the MyHealthPak, include double strength formulas of the company’s popular Proflavanol and Visonex products as well as a triple strength CoQuinone supplement.

“This has been an exciting week for everyone attending convention, and we are proud to have maintained outstanding attendance even during tough economic times,” USANA CEO Dave Wentz said. “The upgraded supplement formulations and addition of super pills demonstrate USANA’s commitment to providing the highest quality nutritional products, giving our dedicated Associates even more tools to change lives.”

Keynote speakers for this year’s event included:

• Dr. Myron Wentz, USANA Founder
• Robert Allen, best-selling author
• Larry King, host of CNN’s “Larry King Live”
• Les Brown, internationally renowned motivational speaker
• Tim Sales, network marketing expert and motivational speaker

USANA’s convention also served as a fundraiser for its charitable partner, Children’s Hunger Fund; the company’s annual 5K Walk for Life helped raise more than $100,000 for the international relief organization.

People who drink alcohol are likely to exercise more than teetotalers

Drinkers aren't just bending their elbows: according to a new study, the more alcohol people drink, the more likely they might be to exercise.

"Alcohol users not only exercised more than abstainers, but the differential actually increased with more drinking," said lead author Michael French, Ph.D. "There is a strong association between all levels of drinking and both moderate and vigorous physical activity. However, these results do not suggest that people should use alcohol to boost their exercise programs, as the study was not designed to determine whether alcohol intake actually caused an increase in exercise."

French is a professor of health economics at the University of Miami. The study appears in the September/October issue of the American Journal of Health Promotion.

French and colleagues analyzed data from the 2005 Behavioral Risk Factor Surveillance System, a yearly telephone survey of roughly 230,000 Americans. They uncovered a strong statistical association between measures of both alcohol use and moderate to vigorous exercise.

Among women, those currently using alcohol exercised 7.2 minutes more per week than those who abstained. Relative to abstainers, the more alcohol used, the longer the person exercised. Specifically, light, moderate and heavy drinkers exercised 5.7, 10.1 and 19.9 minutes more per week. Overall, drinking was associated with a 10.1 percent increase in the probability of engaging in vigorous physical activity. The results for men were similar.

French said that the health problems associated with heavy drinking may outweigh the benefits of more exercise. "While those who are at risk for problem drinking should minimize or curtail their consumption of alcohol, light to moderate drinking may be health-enhancing for some people. If responsible drinkers are using exercise to partially counteract the caloric intake from alcohol, that is not such as bad thing."

To Bethany Garrity, director of corporate fitness management at the National Institute for Fitness and Sport in Indianapolis, these results challenge the status quo assumption that healthy people make all the right choices.

"We don't often associate an unhealthy behavior such as moderate to heavy drinking with healthy behaviors in the same individual," she said. "Sometimes people tend to forget that we are not all healthy or all unhealthy in how we behave. This is a good reminder that people choose many kinds of health behaviors across the spectrum from healthiest to unhealthy."

High incidence of HIV infection is found among South African gays

New research from UCSF examining HIV among men who have sex with men (MSM) in the township of Soweto in South Africa has found that a third of gay-identified men are infected with HIV.

Resonant Medical To Exhibit Next Generation Clarity System At Europe's Pre-Eminent Radiation Oncology Conference

Resonant Medical, an innovator in soft tissue planning, image-guidance and adaptive radiotherapy products, today announced that the Company will be exhibiting the next generation of its multi-anatomy Clarity System at the 10th Biennial Meeting of The European Society of Therapeutic Radiology and Oncologists (ESTRO), being held in Maastricht, Netherlands.

Clarity provides cost effective soft tissue hybrid imaging, integrated within a singular point-of-care in the CT Suite. Clarity also provides structure based image-guided radiotherapy (IGRT) during daily radiation treatments. The next generation version of Clarity also supports adaptive radiotherapy by alerting physicians of changes in a target structure's precise location, shape and size and enabling them to use this information to adapt the patient's treatment plan as necessary. Additionally, the MAASTRO Clinic in Maastricht has begun offering the Clarity System for its prostate and breast treatments.

"We are honoured that the prestigious MAASTRO Clinic has adopted the Clarity System for clinical use in advanced planning and soft tissue based IGRT, thus expanding the availability of better patient care in Europe," said Tony Falco, founder and CEO of Resonant Medical. "Our continued momentum in the European market is further evidence that the radiation oncology community is recognizing the need to address the issue of tumor movement in soft tissue cancers, like breast cancer. As we unveil the latest generation of Clarity products at ESTRO, we hope to make the Clarity System available to an increasing number of cancer patients in Europe."

During the radiation treatment planning phase, Clarity allows physicians to automatically compare CT and 3D ultrasound images acquired at the same time with the patient in the same position, which can dramatically improve the treatment planning workflow when compared to CT alone. The Clarity System is based on daily auto-contouring and true 3D anatomy changes during the entire course of treatment, ensuring rapid and precise daily delivery to the intended target while sparing healthy tissue. Clarity's 3D ultrasound imaging is a gentle, non-invasive technology most often associated with pregnancy and providing images of babies. In addition to adding the Clarity System to treatment for breast and prostate cancer patients, physicians at MAASTRO will be exploring how the system may improve treatment planning and targeting in GYN, bladder and liver cancer patients.

"The MAASTRO Clinic is excited to offer this new application of 3D ultrasound technology that advances patient care by providing more accurate planning and guidance in the delivery of treatment to patients battling breast and prostate cancer," said Dr. Frank Verhaegen, Head of Physics at MAASTRO. "The Clarity System is radiation-free and with the information it provides physicians, patients can rest easier knowing that their radiation treatment can be delivered directly to the area where it is needed most. We are also excited about possible future collaborations with Resonant to develop additional applications of the Clarity System to continue addressing the issue of tumor movement in soft tissue cancers."

About the MAASTRO Clinic

MAASTRO Clinic (Maastricht Radiation Oncology Clinic) is a dedicated radiotherapy clinic, which has strategic agreements with the GROW research institute (School for Developmental Biology and Oncology), the Faculty of Health, Medicine and Life Sciences at Maastricht University and the University Hospital of Maastricht. MAASTRO Clinic offers state-of-the-art radiotherapy to more than 3500 cancer patients each year from the Limburg area in the Netherlands. One of the missions of MAASTRO Clinic is implementing and developing advanced imaging techniques for image-guided radiotherapy.

Source
Resonant Medical

ovarian cysts:symptoms

Symptoms of Ovarian Cysts Bursting
When the ovarian cyst bursts it can be dangerous. This is why you must know what the symptoms of ovarian cyst bursting are and learn to diagnose them.
An ovarian cyst is a sac-like substance filled with sundry fluids located near the ovaries of an adult female. Though cysts can occur anywhere around the vital organs of a human being and are usually benign, i.e. non-cancerous, those related to the ovaries should be carefully monitored from time to time. Sometimes, ovarian cysts rupture or burst, spilling their contents which be potentially harmful to the person, producing life-threatening symptoms that should never be ignored. A common cause of ruptured ovarian cyst is the lack of luteinizing hormones. It causes the eggs to remain attached onto the follicles, later developing into cysts and eventually turn into ruptured or burst ovarian cysts.

However, symptoms of ovarian cyst bursting may vary from person to person. With an immunostrong woman, the symptoms will be weaker as compared to one with weak immune system. Nevertheless, symptoms of ovarian cysts bursting are often ignored as they resemble pain and discomfort usually associated with menstruation. In fact, many women ignore the symptoms of ovarian cysts bursting, attributing the pain and discomfort to menstruation and related issues. However, there are some other subtle symptoms that can indicate the rupturing of the ovarian cysts. Also, if one is acquainted with the fact that she has ovarian cysts in her system, she is probably aware of its complications. Whenever such complications escalate, chances are that a cyst has ruptured. In any case, appropriate monitoring is the key to recognize the symptoms and to attribute them to the real cause. Some of the most common symptoms of ovarian cysts rupture include the following.

Some of the more recognizable symptoms of ovarian cyst bursting

(A) Bleeding that is not linked to normal menstrual bleeding is one of the surest symptoms of ovarian cyst bursting. This happens typically during a rupture. Copious blood flow that cannot be accounted for leads to a burst ovarian cyst.

(B) Exceptionally irregular periods also provide symptoms of ovarian cyst bursting. Although some irregularities are often encountered during normal periods, those in the case of bursting ovarian cysts are extremely erratic in nature. They could either be very light or become incredibly heavy and sometimes accompanied with abnormal weight gain, emotional disturbances and acne.

(C) Frequent urination or urge to urinate recurrently on account of undue pressure on the bladder is also one of the symptoms of ovarian cyst bursting. Affected women may find it difficult to relieve themselves although the urge to do so remains strong. Pain and discomfort accompanies micturition.

(D) Pain in the pelvic area also comprises on of the symptoms of ovarian cyst bursting. Although some form of pain in pelvis is often linked with menstruation, ovarian cyst bursting pain is more severe and long-lasting.

(E) Vomiting and nausea often provide symptoms of ovarian cyst bursting. Not unlike symptoms of early pregnancy in women, similar queasiness is felt by many. However, this should not be ignored as a common physical quandary.

(F) Certain forms of physical changes like abnormal weight gain, change in body structure, and tenderness in the breasts are also one of the symptoms of ovarian cyst bursting.

Working on the condition

Having understood the symptoms after diagnosis, you will now of course want to seek treatment so that the cyst can be removed. But you need to know here that often the conventional medications fail in this respect. This is because the conventional approach just treats the symptoms of ovarian cysts bursting, whereas the root causes remain unattended to. Conventional remedies also treat the condition when the cyst has ruptured – but this is too late. With conventional remedies, the ovarian cyst often makes a comeback because all the contributing factors are never analyzed and treated – and that is why some of these factors remain dormant and may lead to the formation of the cyst once more.

This is precisely why you need something that is more comprehensive – and a holistic remedy is the answer.

Symptoms of ovarian cyst bursting and the effect of holistic approach towards it

Holistic approach can organize a proper course of action after the symptoms of ovarian cysts bursting are recognized. What plan is devised will however depend a lot on how sever and intense the problem really is, and of course on the possible complications. But the fact remains, the holistic approach is more efficient, simply because it is multidimensional and it can effectively identify the problem, treat the condition and stop ovarian cyst bursting. Yes surgery may still be needed, particularly if the problem is grave, however with the holistic approach, most other cases can be successfully resolved. The fact is, in most cases surgery is not at all needed.

ovarian cancer screening

Epithelial ovarian malignancies occur in over 1000 Australian women annually, and more than 75% of these women eventually succumb to the disease.Women with early-stage ovarian cancer have a 5-year survival rate of over 80%, suggesting that early detection may improve survival. To date, it has not been established whether benign (assessed histologically as non-invasive) or borderline ovarian tumours are premalignant. In the absence of a precancerous lesion, the goal of screening is the detection of preclinical disease.
Screening tests
A number of screening tests have been evaluated or are being evaluated currently. These include bimanual pelvic examination, ultrasound examination (Box), with or without colour Doppler flow imaging, and measurement of various circulating proteins.
Bimanual pelvic examination as part of a "well-woman's screen" has not been found to be useful.Ultrasound examination alone has neither sufficient specificity nor sufficient predictive value to justify its use in community screening, and it is expensive. It is currently not known whether the addition of Doppler flow imaging substantially improves the sensitivity of ultrasound alone.The usefulness of measuring the level of high-molecular-weight glycoprotein CA 125 as a screening test depends on the screening strategy, the cut-off value used and the population of women studied. It is of more benefit when used as part of a multimodal strategy.
In particular, screening by measuring CA 125 level and performing transvaginal ultrasound examination appears to provide the highest specificity and positive predictive value for the detection of ovarian cancer.Current trials
The CA 125 plus ultrasound screening strategy is currently on trial in the United Kingdom and the United States.
In the United Kingdom, CA 125 level plus transvaginal ultrasound examination versus transvaginal ultrasound alone versus no screening is being evaluated in 200 000 postmenopausal women. Quality of life, morbidity and cost-effectiveness are included in the evaluation.In the United States, the National Cancer Institute's Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening trial is comparing 37 000 women (aged 55–74) having annual measurement of CA 125 level and transvaginal ultrasound examination, with an equal number of women receiving their usual medical care.A large European multicentre trial involves 120 000 postmenopausal women randomly allocated to no screening, transvaginal ultrasound at intervals of 18 months, or transvaginal ultrasound at intervals of 3 years, for a total of 8 years.The results of these trials will provide evidence for whether screening provides a survival advantage, and whether this is at an acceptable financial cost. Other important issues, such as age of commencing and discontinuing screening and optimal screening intervals, will need to be established before implementing population-based screening for ovarian cancer.
High-risk groups
Groups at high risk for ovarian cancer include:
Women with a strong family history of breast and/or ovarian cancer (two or more first-degree relatives and/or a relative with cancer before menopause) are a high-risk who may carry a mutation of the BRCA1 and BRCA2 genes. These women have a risk of ovarian malignancy of up to 50%.
Women with a strong family history of colon cancer (at least three affected family members in at least two successive generations, with one case below age 50 years) may be at increased risk for endometrial and ovarian malignancy because they carry a mismatch repair gene mutation. These women have a risk of up to 10% for ovarian cancer and 50% for endometrial cancer.
Studies exploring the value of screening these women for ovarian cancer are lacking and are urgently required. Even though population-based screening for ovarian cancer is not recommended, and although there is no level of evidence that this group of women should undergo screening, it seems prudent that, until evidence to the contrary is available, measurement of CA 125 levels and transvaginal ultrasound be undertaken at least on a yearly basis. Certainly, women who may have gene mutations should be referred to family cancer clinics for counselling.

Ovarian Problems:

Ovarian Problems:

Most women have two ovaries, one on each side of the womb. Ovaries are small egg-producing organs, about the size of almonds. The ovaries carry out a number of functions, including production of eggs and female sex hormones. Different problems can arise in each type of cell, in the production of each hormone, or sometimes in the egg itself. This online leaflet concentrates on the more common problems: polycystic ovaries and benign ovarian cysts. It does not give detailed information about ovarian cancer.

What do the ovaries do?

At birth our ovaries contain millions of unripe eggs, each held in a tiny fluid-filled sac or follicle. In adult life, one of these follicles matures each month, usually reaching a diameter of about two centimetres and then bursting to release its ripened egg into the fallopian tube. This is called ovulation. The fallopian tubes carry eggs from the ovaries into the womb.


The ovaries also produce female sex hormones. During the development of the follicle, increasing amounts of the main female hormone, oestrogen, are produced. After ovulation, the empty follicle (called the corpus luteum) produces the hormone progesterone. Progesterone stops the release of more eggs and thickens the lining of the uterus.

Small amounts of androgens (male hormones) are also produced in the ovaries. Hormones are carried in the blood stream and influence other organs such as the uterus and breasts.

Two other hormones, follicle stimulating hormone (FSH) and luteinising hormone (LH), play an important part in ovulation, but are not produced by the ovaries. They are produced by the pituitary gland at the base of the brain. FSH stimulates follicle development. LH triggers ovulation and helps maintain the corpus luteum.




What is Polycystic Ovary Syndrome?

Polycystic simply means 'many cysts' and describes the appearance of the ovary on ultrasound scan. On the scan a polycystic ovary is larger than normal with a ring of many cysts around the edge. The cysts are follicles, some are immature but contain an egg, and others are empty. A polycystic ovary contains at least ten cysts just below the surface, and although each cyst only measures between two and eight millimetres, together they make the ovary enlarged. The covering of the ovary (the capsule) thickens, which makes release of the egg difficult.

The diagram of the normal ovary showns a growing follicle and the empty follicle (called the corpus luteum) that is left behind after the release of the egg at ovulation. The diagram of the polycystic ovary showns the many cysts around the edge of the ovary.

Polycystic ovaries are common. About one in five women have them, and generally they present no problems. But when they are accompanied by some, or all, of the symptoms described below, you may be told that you have Polycystic Ovary Syndrome (PCOS). PCOS is sometimes called Stein-Leventhal syndrome after the doctors who first described it in 1935.


Symptoms of PCOS:
Irregular or absent periods:

Most women with PCOS do not ovulate because their follicles never ripen enough to reach the ovary's surface and burst. Some women ovulate occasionally. So you may not have any periods, or they may be very irregular and scanty. Women with PCOS may start their periods late and they may also always have irregular cycles. On the other hand some women may have heavy irregular bleeding because of the poor hormone control.

Infertility:

If you have PCOS you will only be ovulating occasionally or not at all, so getting pregnant without treatment may be difficult or impossible. Many women do not go to their doctors with irregular periods until they start trying to have a baby. You may only find out then that you have polycystic ovaries.

Miscarriage:

There may be an increased risk of miscarriage for women who do become pregnant.

Unwanted body hair

Many women with PCOS experience unwanted hair on their face, chest, abdomen, arms and legs. Hair growth might be quite thick and noticeable, especially if you have dark hair. Some women also notice a slight thinning of their head hair.

Acne:

Some women with PCOS have spots on their face, chest and back. Many women who go to their doctor with adult acne find they have polycystic ovaries.

Weight gain:

You may find that you put on weight easily. If you put on a lot of weight you may be at increased risk of developing heart disease, high blood pressure or diabetes later in life.

Pelvic discomfort:

Some women with PCOS feel occasional discomfort in their abdomen.

Feelings about having PCOS:

With the possible combination of all or some of these symptoms, it is hardly surprising that many women find living with PCOS a distressing experience.

We all experience continual daily exposure to images of female perfection, idealising smooth skinned, slim models who breeze through periods then effortlessly become mothers at the desired time.

Although not all women with PCOS experience all of the symptoms, any of them can have an effect on the way you view yourself, leaving you with feelings of low self-esteem. Thoughtless comments from others, including doctors, can be very upsetting.

If you want to talk to other women with similar experiences, contact the support group Verity. See the Resources section for their details.

Diagnosis:

PCOS may be diagnosed when you go to the doctor with one of the symptoms listed above. The doctor may then ask about other symptoms and may examine you internally to see if your ovaries are enlarged.

Your doctor may also take a blood sample to check your hormone levels, and may want you to have an ultrasound scan. Modern ultrasound is very sensitive and can detect small cysts.

If the diagnosis is unclear, for example if it is suspected that you may also have endometriosis or scar tissue due to previous pelvic infection, you may be offered a laparoscopy.

A laparoscopy allows the surgeon to look at the outside of the womb and at ovaries and fallopian tubes. It can also be used to take tissue samples. It involves making two small cuts, in the lower abdomen and near the navel. Air is passed into the pelvic cavity to lift the abdominal wall away from the internal organs, and a small viewing instrument (the laparoscope) is inserted through one of the incisions (see the diagram on the right). An instrument used to manipulate the pelvic organs is inserted through the other small cut. The operation usually takes about 30 minutes and is done in hospital. You will be given a general anaesthetic before the procedure and will have a few stitches afterwards.

Two small scars are left, and you may feel some discomfort, but you should be back to normal within a week. You should be told about what was found before you go home.




PCOS — causes and treatments:

It is not known why some women develop PCOS. But if a close family member has it, you are more likely to have it too. The immediate cause of all the various symptoms is known to be hormonal, and medical treatments are generally designed to change hormone levels.

Treatment tends to be different for each symptom and a treatment for one may not help another, so it is important to decide which symptom is troubling you most.

Treatments for PCOS symptoms:

Treating irregular or absent periods:

Since follicles don't ripen with PCOS, the corpus luteum doesn't form and progesterone isn't produced. As a result the endometrium (the lining of the uterus) does not thicken. It is the thickened endometrium which is lost with a normal menstrual period. Many women feel better for having a period each month. If a woman doesn't want to get pregnant, the usual way to manage PCOS is either a low dose combined contraceptive pill, or a progestogen only pill.

Treating infertility:

Although not ovulating is likely to be the cause of infertility, it is important to check for other possible causes in yourself or your partner before starting any treatment.

Treatment with the pill for other symptoms will stop you getting pregnant. If you want to induce ovulation, you will probably be offered fertility drugs such as clomiphene. 80% of women with PCOS ovulate on clomiphene but only 30 to 50% will conceive. If you're not pregnant after three clomiphene treatments, you may be given hormones directly by injection or a small wearable pump.

If hormone treatment doesn't work you may be offered a procedure called a laparoscopic ovarian diathermy, also known as ovarian drilling. This is similar to a laparoscopy except that, as well as looking inside, the doctor burns your ovaries slightly in several places. If this is successful it induces ovulation and corrects the hormonal balance. The recovery time is similar to that for a laparoscopy.

Fertility treatment carries risks and may take up a lot of your time in visits to the hospital or clinic and waits between visits. Possible side effects from fertility drugs range from headaches to unwanted multiple births — there is a fivefold increase in the likelihood of having twins. One potentially very dangerous unwanted effect is ovarian hyperstimulation syndrome, where too many follicles are stimulated to grow. Make sure any doctor who treats you talks this through with you. This is rare but you should be aware of the symptoms. If you have abdominal pain, bloating, nausea and vomiting following ovulation induction you should contact your doctor straight away.

You will probably want to take time to decide whether you really want these treatments, and you may want more detailed information so that you can make clear choices. If so, you should contact the appropriate organisations listed on the resources page.

Treatment concerning miscarriage:

Miscarriage associated with PCOS is thought to be due to high levels of LH. Drugs such as Buserelin may be used as injections or nasal sprays to suppress LH before using other drugs to induce ovulation. For more information concerning PCOS and miscarriage you may want to visit the following website: www.ovarian-cysts-pcos.com/miscarriage (please note: links included on these pages to external websites do not constitute an endorsement of the advice or services provided through these sites).

Treatments for unwanted body hair:

Unwanted hair growth (hirsutism) is caused by excess male hormones (androgens). Polycystic ovaries produce excess amounts of an androgen (testosterone). Although all women have some testosterone, people think of it as a male hormone because it influences male characteristics such as body hair and balding.

For women who don't want to conceive, excess hair is usually treated with the combined contraceptive pill and an anti-androgen. If you decide to use these treatments they may take several months to take effect. In the meantime, or as an alternative, you may wish to control hair growth with treatments such as waxing, electrolysis or lasers, or use bleaching and foundation creams to disguise growth.

Treatment for acne:

Like hair growth, acne is caused by high levels of androgens and may be helped by similar treatments. The combined contraceptive pill can help with acne as well as regulating your cycle. The progestogen-only pill can make acne worse. Over the counter or prescribed spot treatments might be worth trying, but they dry the skin. Antibiotics, while useful in treating some forms of acne, are not going to solve the problem when it is hormonal.

Weight gain;

The metabolism of a woman with PCOS is thought to differ from that of a woman without it. Women with PCOS use energy from food more efficiently, so relatively more is stored as fat. Advice to eat healthily and get plenty of exercise can be very frustrating for women with PCOS because it is more difficult to lose weight if you have PCOS. Try five smaller meals each day to help regulate blood sugar levels and reduce cravings for sweet or high fat foods. Loss of between 5 and 10% of body weight leads to a significant loss of symptoms.

Treating pelvic discomfort:

This may be helped by regulating periods. But if you have had investigations to make sure it is nothing more serious then you may feel it is worth trying alternative therapies such as acupuncture, aromatherapy or relaxation. Some women find that regular exercise such as walking eases aches and pains throughout the body.



What are ovarian cysts?

An ovarian cyst is a growth or swelling on, or inside, the ovary. It may be solid, or filled with fluid. If yours is solid you might hear it called a tumour. This can be frightening because it immediately brings cancer to mind, but tumour is just the medical term for any swelling. The vast majority of ovarian growths are not cancerous.

Cysts may grow inside the ovary or they may be attached by a stem to the outside. (The stem is sometimes called a pedicle).

Types of ovarian cysts:

Functional cysts:

These are the most common type of cysts. They occur as a variation of the normal function of the ovaries.

During your monthly cycle one of the follicles may not release its egg, or it may not shrink after ovulation. The follicle enlarges and fills with fluid. Follicular cysts can last for four to six weeks and grow to 5 to 6 cm in diameter. They usually go away by themselves.

A less common type of functional cyst can form in the corpus luteum. Corpus luteum cysts form when the corpus luteum fills with fluid instead of breaking down as it should. Corpus luteum cysts can become larger than follicular cysts and so may cause pelvic discomfort. Usually corpus luteum cysts go away over two or three menstrual cycles, but occasionally bleeding in the cyst can cause a strong abdominal pain similar to that of an ectopic pregnancy.

Dermoid cysts:

Dermoid cysts originate in the ovarian cells that form into different tissues as the fertilised egg develops. These cysts can grow quite large — up to 15 cm in diameter — and may contain hair, bone, teeth and cartilage. In about 12% of cases dermoid cysts may be present on both ovaries. They occur most commonly in young women and can occur in pregnancy. Large cysts are more prone to torsion, where the cyst twists on its stem, cutting off the blood supply and causing intense pain. Dermoid cysts should be removed surgically.

Serous and mucinous cystadenomas:

These can grow to be very big and heavy, and may even weigh several stone. Serous cystadenomas are filled with a watery liquid, and the mucinous ones with a thicker sticky fluid. Both types often grow outside the ovary, attached by stems. They are not always benign and should be removed as quickly as possible.

Endometriomas:

Up to 60% of women with endometriosis have endometriomas. These are cysts lined with endometrial cells similar to those lining the womb. These cells bleed during menstruation. The old blood in the cyst gives them a 'chocolate' appearance. They should be removed surgically.

Solid Ovarian Tumours:

Functional tumours (Ovarian stromal tumours)
Functional tumours are completely different and much rarer than functional cysts. They are called either masculinising or feminising because they produce either male or female hormones. Masculinising tumours tend to occur to women in their 20s and 30s. Feminising tumours can occur at any age, even before puberty. They are usually benign, but need to be removed surgically because of the small risk that they are not benign.


Fibromas:
These ovarian cysts are usually solid although they sometimes have fluid parts and may contain some bone. In some women they produce oestrogen. They should be removed surgically.


Brenner tumours:
These are rare, solid ovarian cysts that are most commonly found in women over 40. They are usually quite small and always benign.



Ovarian cysts — symptoms and diagnosis:

Symptoms:

Many women experience no symptoms when they have an ovarian cyst, particularly if it's small. Certain cysts grow large and may cause the abdomen to swell. Depending on where the cyst is and its size, it may put pressure on the bladder or bowels, making you need to go to the toilet more often. You may also notice abdominal discomfort and sex may be uncomfortable or painful. Your periods may be affected; they may become irregular or the bleeding may be heavier or lighter than usual.

Tumours which produce hormones cause more noticeable symptoms if they are active. If they are inactive, they won't produce hormones, and there probably won't be any symptoms unless the tumour is large.

If you have an active feminising tumour and have passed the menopause, you may start bleeding again. Girls who haven't reached puberty may find that their periods start early, and they may develop breasts and body hair.

If you have an active masculinising tumour, your periods may stop, you may become more masculine in shape and your clitoris may grow. You may grow more facial and body hair and your voice may get deeper.

Possible complications:

Although a woman may live with a cyst for years and not even know she has it, occasionally cysts do cause problems. If a cyst is growing on a stem, the stem may become twisted. This causes intense pain, vomiting and a rapid heartbeat. This emergency condition is called torsion (see diagram on the left) and you need to go to hospital for treatment.

Some cysts can burst (rupture). If this happens, how you feel depends on what the cyst contained, whether it is infected and whether there is any bleeding. There will usually be some pain when a cyst ruptures, but it is only as severe as the pain in torsion if there is bleeding or infection. Again you need to go to hospital for treatment.

Diagnosis:

As most cysts don't cause symptoms, they are found by chance, often on internal examination. They may also be picked up on an ultrasound scan during pregnancy or for another reason.

An internal examination is the first stage in diagnosis and if something is felt, you will be sent for an ultrasound scan and referred to a gynaecologist. How long you will wait to see the gynaecologist depends on your symptoms, age and where you live.

The gynaecologist will ask about your periods, age, previous pregnancies, and whether sex is painful. All of this information will help in determining the type of cyst and how much it is troubling you. You may then need to have another internal examination because the gynaecologist will want to check what your doctor has found.

This examination will be followed by an ultrasound scan to build up a fuller picture. There are two ways of scanning, using either an external or internal probe.

The internal probe is shaped like a tube with a rounded end which is inserted into your vagina and moved around to get a clear picture on the screen.

The external probe is flat and moved around whilst pressing on your abdomen. For this type of scan you need a full bladder so that your organs can be seen more clearly. Having such a full bladder is uncomfortable, especially if you have to wait, but it's important to hold on, otherwise your appointment may have to be rescheduled.

There are pros and cons with each method. Some women find the vaginal probe embarrassing, intrusive and/or uncomfortable, but sometimes it gives a clearer picture and allows blood flow to the ovary to be visualised, which helps with the diagnosis. Maintaining a full bladder for a long time then having someone pressing down on it can also be very uncomfortable. Unfortunately, you may not be offered a choice.

The scan results will add to the picture of which cyst it's likely to be. Because the ovaries are hidden away and are so close to other organs, problems in the bowel, the uterus or other organs may be confused with ovarian cysts, and diagnosis is a complicated procedure.

You may feel frustrated if doctors can't tell you what's wrong immediately, particularly if you have to wait between each stage.



Ovarian cysts — treatment:

If the scan shows a small cyst and you haven't yet reached your menopause and aren't on the pill, you are likely to have a functional cyst. As long as it isn't causing pain or other symptoms, most doctors will suggest waiting a month or two to see if it goes away on its own. You may also be offered the pill while you are waiting, as some doctors believe it improves the chances of the cyst disappearing. Although the pill doesn't seem to help once you have a functional cyst, it may help to prevent them in the first place.

If you keep on getting functional cysts, it might be worth considering it as a preventative measure. If your doctor suggests the pill for other types of cysts, or as treatment for an existing functional cyst, it is worth asking for an explanation or a second opinion if you're not happy.

Surgery:

Only functional cysts will disappear on their own; other cysts may need surgery. Your doctor will discuss with you the pros and cons of surgery.

If your cyst is discovered in pregnancy and is causing symptoms or is large, it will need to be removed. As with non-pregnant women, this will involve a general anaesthetic, but care will be taken to protect the baby and your other reproductive organs. You may be offered a laparoscopy at first to get a better view of the cyst. Depending on what's found, a technique called laparoscopic fenestration may follow. Using the same small cuts as an ordinary laparoscopy, the cyst is removed by draining its contents. These are sent to the laboratory for analysis. Recovery is much the same as for ordinary laparoscopy.

If there are concerns that the cyst may burst and spill during removal you may be advised to have a laparotomy, a more serious operation which involves a much larger cut across the top of the pubic hairline. This gives the surgeon better access to the cyst. The entire cyst is removed and sent for analysis during the operation to check that it isn't cancerous.

Whether the surgeon removes anything else largely depends on your age, whether she or he believes in keeping women's organs and on what you have consented to before surgery. If you are under forty, s/he is likely to recommend leaving the ovary intact, particularly if you want children. Even if the ovary is badly damaged by the cyst and only a small part remains, that part can still go on working normally. If you are over forty, the risk of developing cancer increases and, as a preventative measure, your doctor may recommend removing one ovary (oophorectomy) or both (bilateral oophorectomy) along with your fallopian tubes (salpingectomy) and your womb (hysterectomy).

Some doctors believe that even if you don't have cancer, it's worth removing all your reproductive organs to prevent the possibility of cancer developing in the future. Women who have a family history of ovarian cancer should discuss with their doctor whether they are at increased risk and if ovarian removal is justified (see the page on ovarian cancer for more information). In women not at particular risk of developing ovarian cancer it has been estimated that about 200 oophorectomies would have to be carried out to avoid one case of ovarian cancer.

It is important to remember that removing both ovaries will cause a premature menopause, if you haven't reached menopause. Even after menopause, the ovaries continue to produce small amounts of hormones that influence sexual health. A hysterectomy involves a long recovery period afterwards. You need to be quite clear about your own views and needs before the operation.

Treatment Options for Ruptured Ovarian Cysts:

The treatment you receive for a ruptured ovarian cyst will depend on the severity of your condition when you presented to hospital, the extent of damage caused by the rupture and upon whether or not there were any complications associated with the cystic rupture.

Primary treatment of your condition will be to stabilize your condition, if you have presented in an emergency situation. Doctors will need to assess your airway, breathing and circulation, and may need to start you on intravenous treatment. For very unstable patients, your first diagnostic treatment will include a culdocentesis, to determine the type and extent of fluid in your abdominal cavity.

In most cases of ovarian cyst rupture, whether there have been complications or not, you will be started on antibiotics. In the short term, you may be treated with stronger antibiotics such as Gentamycin or its variants. This drug has a narrow therapeutic window and treatment with this drug will not be extended. You will likely also receive a broad-spectrum penicillin variant as well as a drug such as Metronidazole, which acts against anaerobic bacteria and protozoa. Treatment may also include a cephalosporin drug, such as Cefotetan, which targets gram-positive cocci bacteria and gram-negative rod bacteria.

In pre-menopausal women, your doctor is likely to want to induce an anovulatory state - that is, to prevent ovulation. This will be achieved using oral contraceptive medication. It is important to use this medication to reduce stimulation of the ovaries, which also reduces the risk of further cysts. Treatment with oral contraceptives is not likely to be permanent, and you can discuss your options for falling pregnant with your doctor.

Of course, since ruptured ovarian cysts are often quite painful, your doctor will want to help you manage your pain. The type of analgesic medication you are given will depend on the other medications you are being given. Acutely, preventing infection is the primary concern, so doctors may change your pain medication as your antibiotic load changes. Typically, you may be started on a higher dose analgesic such as Fentanyl or a barbiturate such as Vicodin. A lower dose codeine derivative, such as Tylenol, will be recommended for mild to moderate pain. Newer analgesics, such as Ketorolac may also be useful therapeutic agents in certain situations.

Once your condition has been stabilized, your doctor may want to continue running tests to understand your condition more fully. You are likely to have regular abdominal examinations, both manual and by ultrasound. Your doctor may need to undertake a laparoscopic or surgical exploration to either diagnose or treat your ruptured ovarian cyst. Surgical management of a hemorrhagic cyst will probably be necessary.

If your treatment has included a surgery, your doctor will speak to you about your post-operative care. There will be things that you will need to do, such as regular foot and leg exercises to prevent blood clots if you are bed bound. You will also be advised not to undertake certain activities, such as use of tampons and sexual intercourse, until your medical team is satisfied with the way that your body has healed following surgery.

After you leave hospital, it is likely that your condition will continue to be monitored over a series of outpatient appointments. These consultations may involve further ultrasonography. You may also need to consult your gynecologist to rule out any underlying malignancy or to talk about how your condition may have impacted on your fertility.