archive-org.com » ORG » N » NEZHAT.ORG

Total: 249

Choose link from "Titles, links and description words view":

Or switch to "Titles and links view".
  • What is Endometriosis - Endometriosis faqs
    that incorrect excision surgery can potentially lead to more pain and compromised fertility And did you know that some excision experts leave endometriosis behind on your blood vessels nerves and Fallopian tubes because their excision methods can t be safely used on these delicates organs 4 Fallopian tubes destroyed by an excision expert Endometriosis often affects the Fallopian tubes Yet these organs cannot be safety treated using excisional techniques So what do many so called excision experts do in this situation Many simply leave endometriosis behind where it can continue to cause pain and interfere with fertility Others attempt to use the excision technique only to find that they ve caused severe damage to your organs There s only one way to safely remove endometriosis from thin and delicate organs like the Fallopian tubes And only the most advanced endometriosis surgeons are able to perform these difficult surgeries Make sure to ask your surgeon how he or she will treat delicate organs that cannot sustain excisional techniques 5 Did your excision expert leave endo on your blood vessels Excision surgery for deeply infiltrating endometriosis is the gold standard However did you know that traditional excisional techniques cannot be used on shallow lesions that are on top of very thin structures such as blood vessels If traditional excision techniques were used on blood vessels life threatening complications could result Because of these risks many so called excision experts leave endometriosis of the blood vessels behind where it can continue to cause pain and potentially severe complications If an excision expert has only had training with one type of method monopolar excision then he or she will not be able to remove endometriosis of the blood vessels because that requires an entirely different excisional technique Because of the complications that traditional excisional techniques caused when used on these delicate areas of the anatomy Dr Nezhat pioneered new microsurgical excisional methods that utilize non electrical devises making the procedure infinitely safer and more effective 6 Back pain Chest pain LEG PAIN Fatigue Other painful symptoms of endo You ve probably heard about the severe pelvic pain that endometriosis can cause right before or during menstruation But did you know that many women with endometriosis also report lower back pain leg hip pain acid reflux chronic fatigue upper abdominal pain and many other symptoms that don t appear to be related to the pelvic area And although very rare some even experience chest lung diaphragm and shoulder pain Confusing matters more is the fact that these symptoms are not always cyclic meaning that they may occur anytime during the month not just synchronously with menstruation READ MORE 7 Nerve pain Safest way to remove endo that HAS invaded nerves Some of the most painful endometriosis lesions are those that invade nerves Yet because the nerves cannot safely sustain traditional excision surgery an entirely different technique is required There are only a handful of surgeons in the world with the advanced skills needed to perform

    Original URL path: http://www.nezhat.org/endometriosis/most_popular.php (2016-04-24)
    Open archived version from archive

  • Back pain? Chest pain? Leg Pain? Chronic Fatigue?
    for example it can cause radiating pain throughout the region Surgically removing endometriosis from this and other nerves can help reduce these symptoms However only the most advanced laparoscopic surgeons can remove endometriosis from nerves minimally invasively without causing complications Therefore make sure to ask your surgeon how much experience he or she has with removing endometriosis from nerves using minimally invasive techniques Chest Pain Endometriosis of the diaphragm liver lungs is very rare but nonetheless should be ruled out if you are experiencing chest pain pleuritic pain shortness of breath dyspnea epigastric pain upper GI shoulder pain and right or left upper quadrant upper abdomen pain all of which may or may not be cyclic The rarer but more serious and potentially life threatening conditions of catamenial pneumothorax hemopneumothorax chest wall lesions and lung parenchyma can also cause similar symptoms and sometimes occur concomitantly with diaphragmatic endometriosis And although even rarer still with fewer than 20 cases reported in the literature liver endometriosis should also be a part of differential diagnoses as it too can cause cyclic upper abdominal pain These areas of the upper abdomen are sometimes overlooked by gynecologic surgeons who sometimes only perform diagnostic evaluations of the lower abdomen However even though these conditions are rare Dr Nezhat always makes sure to rule them out during any diagnostic investigation Articles Click here for an article about diaphragmatic endometriosis Click here for an article on thoracic endometriosis and catamenial pneumothorax Videos The following video of laparoscopic diaphragmatic stripping for ovarian cancer demonstrates several highly advanced surgical techniques Even though in this video they re applied in an oncological setting nevertheless these techniques can be used for treating diaphragmatic endometriosis as well Bottom Line If you suspect that you may have these rare forms of multi organ endometriosis make sure to discuss all of your symptoms with your doctor even if you don t think they re important Leg Pain Hip Pain Endometriosis that affects the obturator nerve which crosses through the pelvic region and innervates the inner thighs can cause pain that radiates down the leg or toward the groin area or hips Another way that endometriosis can cause leg pain is when it affects the pudendal nerve which innervates the lower vagina and external female genitalia As with the obturator nerve any areas connected to the pudendal nerve can become painful due to the endometriotic lesions Endometriosis has also been found traveling along the obturator nerve to the adductor compartment of the thigh P Waer et al Japan Journal of Radiology 2012 which can cause pain in the hips and thighs Acid Reflux The symptoms of bowel endometriosis can overlap with those of other gastrointestinal disorders such as gastroesophageal reflux disease GERD more commonly known as acid reflux Other times the patient has both endometriosis and GERD As well frequent use of certain pain medications which often goes with the territory for those with endometriosis can cause acid reflux to develop Both bowel endometriosis and acid

    Original URL path: http://www.nezhat.org/endometriosis/back-chest-pain.php (2016-04-24)
    Open archived version from archive

  • Endoscopy & Fertility Center -The best Endometriosis surgery specialist
    Surgery Urinary Incontenence Pelvic Floor Prolapse Ovarian Remnant Syndrome Uterine Artery Embolization Hysterectomy Hysteroscopy Tubal Reversal Gynecological Malignancies For Our Patients Welcome Letter Patient Forms Center Locations FAQs About Contact About News Awards Books Articles Reference Library Testimonials Physicians Physicians Fellowship Program Result Page Specialties ALL SPECIALTIES Endometriosis Infertility Fibroids Leiomyomas Ovarian Cysts Pelvic Pain Laparoscopic Surgery Robotic Surgery Urinary Incontinence Pelvic Floor Prolapse Ovarian Remnant Syndrome Uterine Artery Embolization

    Original URL path: http://www.nezhat.org/search.php (2016-04-24)
    Open archived version from archive


  • no variables received this page cannot be accessed directly

    Original URL path: http://www.nezhat.org/mailer.php (2016-04-24)
    Open archived version from archive

  • Doctor Camran Nezhat - the pioneer of Minimally Invasive Surgery
    endometriosis specialists Doctor Camran Nezhat is Director of his own private practice at the Center for Special Minimally Invasive Robotic Surgery in Palo Alto California For his outstanding contributions as the pioneer and leading practitioner in the field of laparoscopic surgery specializing in laparoscopic treatment of severe endometriosis involving multiple organs management of infertility myomas of the uterus and other pelvic diseases Dr Nezhat has received numerous awards from the

    Original URL path: http://www.nezhat.org/camran/doctors/doctor_camran_nezhat.html?iframe=true&width=85%&height=85% (2016-04-24)
    Open archived version from archive

  • Doctor Farr R. Nezhat is the Best Gynecologic oncologist in New York City, NY, US and Northeast
    City NYC Dr Nezhat is a nationally and internationally known innovator who has developed a host of minimally invasive techniques which have allowed increasingly complex procedures to be done without a major incision These include radical pelvic surgeries for ovarian cervical and endometrial cancers treatments for endometriosis and pelvic masses and hysterectomy He is a board certified gynecologic oncologist with a special focus on the treatment of cancer of the uterus cervix and ovary as well as complex ovarian cysts Dr Nezhat is a professor of obstetrics and gynecology at Columbia University College of Physicians and Surgeons and also an adjunct professor at SUNY Stony Brook School of Medicine For years he has directed a minimally invasive surgery fellowship training program helping young gynecologists to become specially qualified to perform the new techniques He has been listed in Best Doctors in America since 2003 in the New York Times Magazine s New York Super Doctors since 2007 and in the Consumer Research Council of America s Top Obstetricians and Gynecologists since 2008 Doctor Farr R Nezhat is the Best GYN oncologist in New York City NYC US Farr R Nezhat MD FACOG FACS Gynecologic Oncologist Professor of Clinical Obstetrics and

    Original URL path: http://www.nezhat.org/camran/doctors/doctor_farr_nezhat.html?iframe=true&width=85%&height=85% (2016-04-24)
    Open archived version from archive


  • 7 u OàßßÎ L û 8 ÏFóÙÅùlüÓ Û øÏñÏ ÝÅÖ¹sé ¾ºQ ý sÏ E páø ëûW Û uëù¾ ¾ ÿ l  øçÕ Á FÃÅ r àË à àë û ö Ó à ø ÐQ yì V UJØo Z ÝÎúÚÕ 2ÖÌ µ³è Ê Ï n ÕÚBí Àx W ³oçLÙÖ kó 8 ³2 Ú¼Y k Å yÕ Özm Aç ¹Zu Q ËfcÝj ã ZpW k ÃÔ Ê è 9ChµY Oº cÕ âã ¹ì â ÆßK¾ ý gµDéÞ rJ ¹ Ø Ï õ W J ã W Ó 2aÔ Y e 9ïrkàNÝ ûÆw صÀ G³ k ñV kRxïÞ s Q ö0 2ó ê d åðÐhRè F Ú³ e Õôµ ÛT õ áp m Î ç éÄì 1Q h¼ Ö 8rW Ù f à éMÅNñhØ µ 3q yát D 4 øÀð 2 0 À F y ä F 9 øÀð á ÔéÐð á à D 5Ì r ß1ñD Cq O4qeà à ÔtP Ú ä K ª ¼ ì ÿ õº ¾ c üÈ 9 à òí ÚHäùÖXùfZ ÕPùö ÑJýFZ ÓE èô ò èDÀßbø no ÞF ø íq 9 Jëx²Ò äã ü Ô Åð ¾K r û ÙJ r oO Ú ½ G îhzù x è a3 ¹ Ö Õ tõ B7Lõ 4 Gu T Ç ô J 7 5 VM öegu ë 7ýVaê A rA ºTº ý ÙHµ3Wî ò ÕÚ Ôë 1ä³W C KÌfr t Ú qÙD ÅÇ áz R² 2 óØÒSx³Ïr ÏèrÒ g4½¼Ä O æ ýÇ dBV j yßB ÐZ çèyHÈ x Î U 5 6F 8B9 a e ï U é tòÄÑNÔ SÖ³ õ rK µ µ Q w yU²b ô ù ÏXGõ èò Ô3 ß ß ãÑ Z Ég 1G êÆ G ê¹EÈÙ E Ü ê 1æP ²ÔàV yEnÕK F ¹ A ñðµ O ó u Ô O KÄݪ C õìÕ Å þ3 8ÝõÆïÔ 3 ýÚÒ ÁÇ Íl Ì Áe ðMÜ77ØJjÜ Ö ÁÈ Xf ÁÆ wºí 7ÿÔ½ËPhòÙÝ G A¾NãÚ D ðÕ nDo SööÆóì géwÙù w O é ã ¹ë çsz pSï Ñé Þ 4Ð ì Ïw Ä 1l d iàÜÑZ ÓKÕVY3Ò Ð f ²p A²AÈá å6Dî½ ¹ N p Í vÁ ¾ öRÓlE Y Ìý PUÐSú ºq ð o h F pE å æN Ó ûàIR ö ²Á ÁùLæd r Þx ìNÎÒ MƳ Þh 4v ²u Ò R Wßõ 0Öm k VCc úà õ PG XN éâ 2qîäüL pn 7² ² BK uÁ f Ç ù ¼õÕ ú á º NÂè ú6 p ÛLÍ Ä Õx y j r VC4 jÒ û Å BÝ Úµ àjEm EõR Qkw ÅÒ½Úå Ü mJº lºM b íÓö ÕîIÔâãÄr Z õA Ô0 Z T MÁj N o 84Ö j E L fá² ôð50 V º Æ ½ ÜW M ýh û º ÔàÞ THfQw ä 1ù H çÐh ØAÚ Ï ½àÎ eÒdZò2v íYþ Þ È óF¼VyîYv 84ªÎûfïà 7SÁ Þ ÌÜ ¾ Õ I Þ é C¹QjÝ ÜÏ ²óî ³Jôɺ ä N ÊÙÆìH Xïÿþë îÃÖwà ÑÅZ ñn½v kï Ñì Æ FÖ UM6 Îp Ñ 3ø K eÄôÝ Ùõø å¾ µMô 8b ½ Mè høób8ÎæÈ íJÓÜÊ áÏJ fA Òï eh töâs éÇ1 ³ Á Ä E iI íZ²c ìX 3ÔÉåÎ K 4Ê üV r k Zþó Ú Xî QJ½Nµ H vÔ J û éÇæ T q IõØÇ fï4 ê 0ê ni n OØÛºIÀ ç t ºÁ ë qÒ F ªg Ââ ÒbÕKb òê öB ÖÂåA ½ v½ ¾jÆib ÞF åù q J ½vÅiïéf ³YFö P w Ä uKH à o H 1¼ 0ö ͺR c éh m Q î N üw³ M Ì yç 1 ê1³ l ª ³æ 3 añÕµG T KØ µ Ö ÚR5 æ OA ²aÐ S GÂê TÊÂø öÔ ip Ä Èî X äß ÞʵV ½T ë I5Û Q Lµ Î JP D j vʾ f v Ï ú v ù pwZe ê â vÿ R ÝSDQã1Q À ëO rTßvhß â ºmw ûq B5v sÚ H 6 h ß ÌYþ zx â ß eÿÄ VÒÀ lE Örò X Gx Ê0² ï Ú ÿ ÌÊ ëÑ è e UàQ v v l w ÓDÑ d Z½ D ÞÕ þIB Ñ µ½rn 7 6èèß L aÃà 1N Ú Ò ÍÒö õ Æù NS H O ç ÊÅ Î0yï Õ AÒd 6á Xm EdAk czq ¾qTÄU Æã õ ç 0² ÕÊëîéÛJ P ÃÕL Ë MÆ ç æÓìèéÏ úb G î õ àXÒés¹¾ý à É Èv ¾ üÅ S Ñ üU ÃhíF ø Ü Ï rà G ôQ ÁÉ nöÎú F ê çß F ¼v î ªä7ptò ò F k Çã ÓkÌ 4E eÚ ä ÊÒ½2F p Kq W0k 4Ë64 tÃHf óE CT Q Þ¾ Z Ç èä d ñXi 0 ½T Ì ÃH aÕ 1d ÝURt eË Îè Åõ Ç 73 ã ò ÖIU8Y Í ñ à ¹q o ÇÞÅØ Å d1Ç ³K Ùm u ÖÑFu ó É tVI Gëä ²ÉziåZCå½ È w² TZçq ¹ ìU3 À Äó½o ÚÖtB XºóÄxÄ4Æ Èð Ê i ðö cAêFÛL ÒY h Î 7 8fUdä ÂÉhúx É v jk ö Ü p ½àÎw  W ³ òVE ³ÿ 0ÈÙ úzò Je SF MVT àÝ Å M ÎOÞ Âêek¾hÜ Ý n n3Ñw CÏøÝx4à D8 ¾Ù ø Ò ì3 éK m À 0 ö bµç ú É ² Nô Rm Û íÂ Þ vx ï O 9¼ ÈK Þd5ù ïöÐ þ¾ AÍÖnü¾ Ì2ã Ç ëY ½ó wcáqZxo ò ö ë LKBëý þÕÈ Á Þ Û ÊÌ z 1ý I a4G ઠÕÚ0 O eµE5 0 w JG æiézè M 9 K Ó BÎ äÈhÓ ä8½ªZ JCã Ê 5 Aº s µ ô íÁjæçÕø ìÞ ë eØUÊ Z µÐ BùaÈ õ ýQ 1z 2qÝÓGçþ D ¼S Õ x Öñ2 ß ªX3 zúð Zfc h a ª ý koî ² iæ U Ô 9 å 3n yP ¾ôÂmüh ÃÀM Ø úpkÅá Ö zÙG 2d ¹¹D ÉiÌ3c 50Ï Ik ú F 2 E ÃS ÈL Q ²¾ñ í5½Ü Ú9ÉJg ÄB SÇ p Dâ jÓípK I J þ6 ÉR ³wÐ N ìмtÁ s o U F ø Ê Í b Iâ àpñ èèa w öW vµØ JºB ³ ûWÝ V³µ8jC ÂXS 5 50 ôû Ê HVÂÜ2õ 4 â²X ßÙ n r k RAoHU Ïs B åoZ L¼qý Þʺé mS Ù XS Ó åä W g S sÞ á xåyW p rKaøo 7Rm h ÿ B ½iÂÈAöª G S F W b RÈ Fë 8 G 85Ýh Ø G½ Æ ê N jp ܪ ¾ B ãê QpÆà N êÊ ç d Ø BîºÁù x Íë ÀÓ ÅíÍJÜ ½ 3i 1 mªíc ¾ õ m d iàÜÑ Ïé j é h ÄNº i l rø ¹ ø üV ½ Áu 7Âç u0 ð ïäµ½Ô4 û ª6 E Ê éÕ b ½ h g4 W UÞf éHX f ô â ³½aECÃ1 v7 ÏP ÊÊîFÓ X Cewú5 k¾ëI Û 8Ýi ÛFøl B 1QÉRK ÿ º Ôg 8 i 6 ÿ Xá ãd íöÁ µ åp dÞ ßzÚ hÇe Ö H ö çº ßµ v zã 3ÄÆXÕ ¹í E G ÀN ªjÆê Ñp îF 4 e ÜÞ0Ö yU á 1 o 5êS G 8 W K Ã2Íaê ¼³ ¼ ³ Çî f å k7º á ðèm B ñà w ÿ 4 G a rö î î ÿ7o À² 8 ÁShÅ 4U9å ô p ø ôåô Ò Ð mÞ Óu ê ë µ ôË ÏÆ9ò ç ô h¹I 3ýß1û³Õ úN v yw ãܹ G ó þ Äþè Ú Ây õI õ Ets 9O Í ³ß fR e fù ÿ4 ïÛ HN ì ý Ö ³ ØoÈJ Æ zb6 à º a Æ IU ú³9Z 4Cvìÿgï wÛF²u EÐ f q 9èØI ì éÙ ùÕ Êb 5 eÙy ó çÉΪ x XåºQ K²XµjÝ Va Ôç Æß ûm6 ìäÏD A à Áx ó ÏO y Ë ëb X tcÖ Ò ìÐ 8È áùUJá ²t Ô wÔhHªÊ ÏÔ m ÄU õD wÓÀýÅ ØðôÊ1 yaQZÊÞÆ 4 ½I ús æªÎ wRà à F ä 2 ÀÜIà ªj ¼ N h pv p ºhÑÊÁf v¹ Çê ýâåu y6J VË9Ín E T V p h A e è  lnÇ ç Ìm åèN8Í ç W Û Q ú ê D i På ý½ ãÖ W ì ì D5uëøBN l b þp O tã i Þ Ü Ò ÂP ìðd v k j 5Å r OÎ2Q ùï k Ê GXQì Òa 9ï à ¹Å Ûë ÿlP ù ôÃàlÈ 3f TÕâV94 îó Zx ÉF ÕjªdTn HÅuèûá ÜjMUZ ö HËP j¾ÕbªD ø cÆVK ÒK ÕZN K è ¼ûúÍ JEÚYdåu V gG Õjª Ý 8 fè éÇHÈi k Í b É FZ µZwQEB J7CSñ Å Ò vï åÀ 4Yªù é Ñ Ü t Ku 8kÍN e Øfhíd ÃN À ³é ½ ô ÐrJöX K ¼é ìÉ m0 pD ü  Q µ¼õ 0Uÿq A Miüãi ÿý ô Åɳ xd K ç6 ý â¾G0êÅà â ïÝ ôÊû ºó üîhº ¼ íu éôÝ ìi²Y ç³wCømã Áá k6 gMà ÐÑå k Î ã qx àb FÞ H½ þEäúNâ º zt Ä Óï M íë o ÅE ½ Ñy oJ6  x ÕO Ö mÏ ðð x y7Eîwæ w 4K úësô Ìa Ìß ªþúh x þ² Âû  Ûð ß yd rB ã a7þ ÿ âäéö A6Ü Â àå û Êá ßAúaê ä Èjðö Á ýÀ X 9 É îW rëÉá µ ä o C sFÐGQhTyÒá ð5JMo ¼õ ß ý ðù zdú¹ÃÆ ¼ zò ü¼Î æ Yº å 0 OQ öÎ 7ðü Ù¹ Bf yøLü㪠ÙÔ ¼ ú ýëtHLåKóãÄß Îq1ø t é ºÁc01 ìã Ó ² à æv k O ö ú ç8ñÒ ¹ Þyé öÂ Ì è Ñ ás æL gr W Ǫà99 Û7 GW MF 4 Õ J G ÖË ²ÈBP j 1 î r Æ gÒ nº ÐQB ³WFnB ² g i y óh ÜvÓ ã Î2 iT eÒ KöÎêÏ ÌÂDe 41T óØ Í Ç 4 Þ dÁñ Ád i 7J Æ 8 v v MÈ ù¹ü æeD ÛäuJiã L Í á 2Wø óI Õdû ÓCêØ Ð è p WP s 3 Is ê æ áÜ VÑµÝ Å ÕSàp 2PÇÏ ls d6 Àù¹J ¼ J èËd ú y nÜûâî ³v l OuÏLÕt J 4ÝÓ Gu Xw ZC b1Ó½ UQiÀ á óD Ê É Ý T ³ bÖ kß f B 0 ì ôf º5æÓd B 2á4 ÞºÉÞu ª é AJ2 4½ á ¹ q ÂÐi Sì ko uW q ç f k ÆÊ rÖ úy ÞË dÙ õ Pß Ô e ê 1µ Êß eÛºÆ rÆN YC D ÇQ Êâ8½ Õ ¼zî d ÔÚ Ú ÊÂnBÖó Ñ þ jìzT OE 3 M Mªôëhª Q ìU Z ZKS JmBÀtXÅënÂj ÿ j p0 öQs à à âÕ ýnGî ª ø MaE äÚ bÝ ï D 7ñW õË kWé ÐWÜ Ê é RcùN ôô qþJå Ëþx Aì ï Iâª4 BÅ uþÞFp Cs Å Æ 4Xµ µ maj à âxI M7X ½Æék¹D â cG J Ì ½qE Ýáìq L îék îHZ ënLR ùÝÐýª BÏ º º KWÊE F 3ë AÅÐÝÐÝø3 Û S 7uÔ Ïú áG à¼õ Ow Y G ÁçÒ á ÖÀ dõä âW àíh Tú kïÉ Þ¼v ÿ þùî Öá òÁTµoC8 zl Þà è éç û9òV v C øp ÄËÓI Z üºbòåñ O õeî Í³Ë È ç ¼ vós TòbÖ Çw VÆz F E Ýl æÛÎws7 Ïd ãü Ý Ñj q üUË ài àM ý s Zþ çT 4æê Ô ûva 5Ù æ6 b õ8 c aÆ åzØHz 1þI ¹ù AJóäH E¹t7 8öÏMe ÅÛØ K Ë ã Ðns² Ü tFqÒØ u ÔØP xs ÌÖØÐ x ÁRñæ Ï qãDú¼ Z ËA Êó ÿÝûhL h õ8â Ò Hm V Çs G pG R È à f 4á çÁ Ði Qm Ó PXÕ V I V E I ã lÄ Z6i ó uÊÝØϲ½LÚ îz çQõÝClqV ôdû wv jz Ø 4Ö ü ½ T Ê g2ti åÖE õ Ì e ÿ e è qJ Ë 7 è 2 Ä Â Hk á á ÍOgÓÞ Í g Å ³ 8 ÜE ÒïJe þ É H e ëXÆ öÞ Ü A ár Z Å Ý ëHÏÜ LÌ qì غã ê D 7 ÝDÚv4¼Ó a r ÛÕ¼êz ð 3I1 ë Û Å t þGµgÆê HÇ R ì L ºÌì Ù L ù0m ÆOÉ Fµx Ê òCMªX µÇû àÓ èÅp Úqs  xl Ó õ fØ Y Ò L2 c ô0 Þªq T Ô mé äUF ø Ë Kç Ö L åcà óªÒk y½ØN YµOô ï ÏþÕ ½i ñQá êtì v Êh 9 v1ä ¼høýµünº Z³ ô i3 lÛt åu6 wÕÿÍ pãÞ òÒÜ Ð Ç ½ì æq ì M ª2ó0éù ¹Üc 5OµæC ¹t l 1 Á d Ø z Ç6 é Ö ËÝÔ PZ µ ÞÅÉ74Ý EÎ O ¾ z eØ ëzå µÀ AÛ îÖV R p ÉlV j ÏuÈ0P úå8 áõú û e z pÛä t QJ ç3 w ºÞÕW ÉcÍ g Å t Lº É ib k së Çn U F A8 gÙÚ t y1î SLr6ø 7IN õ VØ ½SÌ Ë Ê 6 1 R ú ñÒ NÐA Õ ü J Q ÉÚMÕÜQü é E Þ2 xÝtÿU ê0Úé Ùv ÏoKot äán 4M É ¹ u Ò Ñé ow¾Z ÂÈ ÒÕ r x KKÒ ôz o mê1p îÍ ÖYý y5 d 1SF dÿí a ÔòàN ÑK mÔÎÛ ¾j b9 8 ådzæl ª Ù n áwF o ³ ì ì ð ö 6¾ Ýã ÚíüS é92Êü u ²õq¹ô Ü µý U lÖlG7a º d S õúl æK Æ î ì ÇïÝún7¹y è Y Ý ò â ª G0 ûVs öÃPº ñàãz Ý Ðª b Ù Á Üò zqÒMÊJ 5 e SÞ Æà ªöà ö cï 5å½ 8 ¼7øhu ³MyÏi 3Ä 4æ ÞËf á b d aÊ E d½ d ÈZy ÈR ÞæÌ ê Í wö2r Ø õ ª1çl½ òSºt A ½îc mÓ Tic ôô9i þ ôêÕÈÞõU F ÝÍ 3 ÉÚ n ô ä² Rq ü Mç Ø t ä V NÈÎ ÝÒ 55 g MÍÅÔ P N Ý kgç Wý ¹TnÅ9ªF o f54 æbj ³ëZªPQäÖÇø 4Iþ æÖ Õ EX X Ü ï 6 8 ÿ8 7 ¾ ÔÅ Ëë é ìË Ò Ò S Îâ B Ú º ãªo sA ³ ÌO â h ñE Âpýß Ü ½ õ ý ÇE ç ºêÿñ4 ÿþ ÁlØ Ø³ ¼ c ñ áÜÆ KÜ èÖ Åà â ïÝ ôÊû ºó üîhº ¼ c ï xiï Íb A0 R GÊäP 08 ÅÅHp ³yðìý ñÏøhäO² h û µ 1 cÆ 1w c tÔ Ï º Ù Ï 5 ²î W¹ J kä ³YL r Xý ½J Àv2ÍÝ 2 J9ð Jëb ½ßlxÚØè cÈ3 äù ¹7õ ó¹û n aJ½ DCrü Õ No TlÉc T bR æÛà L³óÚFÅ µ D ê jw¼ ft 9 O iw żâØIÚ o qúDí TJí D 0ï çÒ Ä Ã GÒqð ç ãÑµÓ g Æ WJ â ñ ó î à ½ ¾ á ÿÓÁ ËÑPöʳ GÙ7½ Ë ¾ û5 ïáó FÆg ï ösä îàçuè ß ç Og tGÄ ì h ÿ¾ y ø B WþRåÞâ æ Ñg ù CcíÝ g âM M í þ å 0Z¹Q ïóï F  ý0B Ë Ü I T¾4 7ü Ù µ Á gò t Çèz O Û 5 1ly Ãh2M ns ÛÄ ÁI Z Í MP 1 UÕà io ÉËÎb ÚUWBõn k ½lJ pW ¹E 7 þí x v Se2Ù 6 Åô à dz fâAÆ Ò GÎÓI J Gc ñó îÂIo1 âá ñSrcSkzp²û BI g Uì S U½ y8 WàdS 5¹ÌÊ g GõÐê Ùë ci dÖ z èl2jWºëASã aýÖu ulÏF M4 Å Å I ñ Ä p èg i ï f sÔö qï ÙßS oÆÑÅqnomRÝÈ e b Ý W Ä Ö JAsä˳AíwÀ B ÊúYsíñ7Ùë ÉÊf Âsµ aL5Ø Ð i g I¾f ²4 Yw ÅI F ÓDcPR 5 ³igù XÐ µ àþ EZÝ Fv ÒÍh Lã f1 J 7 3X 0 êí r ¾ N Ñ 8 Ò µ r 5²ËÊ Ç I N úz Ú ¾û Õý ÑQÛ î ãJWx t Ý rí fk Ù BIj7Q Õ0ÖDÿª9a f þ ãi 0 d º ó øÒ àZÑÌ H äg9þ 3 D³ tiúït kjØ Q Xó² î 0 Zí ÙË ô FÄúÚi Ó LçQ¹óÈ l Å0Ú AÕvÊ ß sHQ Ô za ó8Ëÿ0 8èüðb 1w 5 ú xÔBí W B ÙÞÄ 0Ò ÕÈÿ äý ² Ñ N RWÃD uwï L¾ ÒT ÿð uwß O ê Ãaºî ü r ÿÆ5 íÝ ôÇ àõQ ÎÚz é q Þ L à 2M ¹q õ³Ñ ë0 ôðëÝ Á fÏ Û ø û ãÿî X Ö Ë l ð ô èÍ x OI ätó ½ ßÎ 8 x ð Ö e i oÃøª ë 2Ç ÿèqD ä c O 7hÎ 5ç½Û ìt Wó²ï x8Nü0dC³Ü þLÎ ïÄÉ77 ÎvW Cä X û3á U WZ 9 2ÀÚK Ó9 ç X²¹ èÊ ò WHyÄ 4 Ç Äb b Ò Ëq zî ½ í V ت þCÜ Ôh aA¾ xÈ à Ê Vèª à ¼èÌ ãµ ÆqTBN ÜLóÚL Ýá ¹UÉd¹Ùãu0 s p U ç ªÉæ 3 é º ç² J î É8 åJREèf8 É uù 2 ÍTR527à uVÀv þ ó 8ÛÀzkÒÛvÒ4Ú ä ¼ ì Dîf8 z º k ³ N B ZAäþ I Ê ß â S 5 PÐ dt ü ÎT ä æ d u 1S û ûS9 å H u J Äq Tg mÝ ýÅÍ Æp ²ý7 ì Ø êÿæ Üöebe¾ Då ÌR ÄsïÙ c W úU Bârõ Öh ç q m ïØVüZ nÁ U½ m Ô Ð à 5 Ã Ï F ªÓàð hç³óXI qÔû Íó tËoÀ Gò6 O ² ¼³gôT õñìK å8 0ð7 6À Oä r P ÒÜ ½ê 0 ð X p t È e ú D w ò6N Õ É FÛVÁMqt¼è ÆÞUê R Ké ê Ë ÊÇ 8 A Pí ïhQ s ² µ9 Ïa Nà7u4ÎN Ç M J åIÓÑX R û Xx Í Ô 6 J BÀ ² P² gJÄ ìöµ ðm M P ²Q æ ²ä ÚÝÉcHÆj¹HõM 5ô é Pi J t tÔ â J Çà Nø ñÐ D Rí³æ DæÞé f õz Í0 é Ð3 È 0èãÊPD Ö 8 óg åd g ñòmç bú ùõBá J È x y X ép ñ Eöþ ÄbÓ õR Q ù J à u¹q m rIÇ ç 7èõDJ zY m áÈëaa q ä éå ÿµ Nºíø ä 3RKdá Ú KNt Övõ Z àe ²ÒÿJS 2Ò ² Ð Ô Ä è ̹w ñ r E 7 ÕùIbf ÑK B ý 9 wJr Ïbú ú ½³ ëî9Þèvräjçû ÎëF Ö øXÖ ma ñï Ãj ¹wg8A ò ûçÜ g T è k ¹ H L ÿÒ H Âñkà àUäa Ù Þ w ã Ä çóã ËiíQeù ½t1ãÿû ½ ÄÁè îå ãÂÇÑ 1 Ü Àæ½ ÛãtT ç ç V åÛãtVê7 T Ïå Þ R9 Î Ì üê e Ä ÂI SÎ ÓåkÙ Nå6¹Z 1ó å6K BF9B Zn þrÞ2 Kî9 n Aã 6 J Oàtæ zRÁÙ À l el Å Ô ÿè ÏÛ 2É Öqò ÒR ùl ÊÑ O t öwõ ÏñÙKh zV Jøl о ÉoÈ P éØêó È ãD Ø ï 7m4 4 aJ ÉÙÀ ù UeÅ Ü z 5 MÒR ˼ ²t d NÖ T Lvr É S é qiµ õæ ö o jé ð ½ ý BN QQ 6à NäV æ Dàü Ú RiEî¹ A øÚ Fé 5 à XC à KABín íO ³ ½úD2 CäÌ A ß MÜ M 4e 6kfk P þÙ LÞ7íÅLÛ3Ú5ipRø ù Ï K4i º9l ºs Û XëOÝ W uØ H á vrô ²Ý í pa7 òFäF uïÙD ÝsÀïzú uEÖÙ4 Yç ë çsz M Ò Ç½³I3i 1 Oà ymYÿ t ig Tm 5åy R ÄNº jPlàBüs È Ð Âèok o EE i b ¼ BM²UÞLH pÃi ÝÎ A t W ²C z ér ñ4 ßô ÙHæxà Ãy k hè Ct U ë³9 Î U c p Îêc V Ë Æú ïïÊ É u Þ Rg Ýeò5 Îgÿh ã Ï é0â Ø 8 îlï¾ ÙÛC i8 ã á ø ä þ g lïþé NÂíU î éo a Wý ²à ¾ N ú l gåFWýYúë aÀøá Í àcø t îá3î v ÿ J Y ¼ ø Ø 1à ô á â Çz p D ð ÒkeSJ9 ü Ö ó ÖWÿÎ ò wqò dÿ X Þ n Âp lö ï ùÜ Ì uîÜ ëÜ ë ûï D Ê q Ç î ÌÑï èÎ ð é6É ¹XL wsx x Ù f ð ã X ñ Ñ Þùq Çà k N ï âð øÅ ¼ ÀT ¹¾ x îb õèF ß ï Xº¾ Õ kÏ Øò X ¾ Ùô áýU ÅìY Å r XÂà ð ö T ñ Ò SÉÁ VAÛðá F ÇÁþWT r Sº ÒÛf åä Z 3 Ö FË d7 p úáuÁ îî8zÞî ³ÌÚ äzó PA O ð Y Æ â Aþ SoAoB É Æ 4¼Û G¹ ÿÊ ÚÏ ÉïÎ1Ù ç Lßr zÆ C 8 ÍÉÙO ÏG V N çß Ãrh UÒ Ã bïªÿ àƽ î¾W Üö øjp eÕ âí Ö N2SoPEVñ w XW ÐvKg IBÙîù ¹ ïñR 2õÚN Ë2n Ä ï qVv ñ1 ¼Èé4ê¹î mìÙ 7² GÈ xC Û qV 6²ûrAH¾ª Ã8 3 U úÝ Z AµÿAÈL ÇJn t ð Å2Á ô Ô0 ð x Á C åÒ Z øÕy wÉá µ ä o Ô yè TyÖá Djz zl ÞÃç õ ôÈôs ý y ôä øy ñ ÃÑ4 ñòt AÀ WÇÖ üâüû Æ µ Pa J è3 Á 7 ú Áå N óGå Ä µÌ6 Ì ï þª Ë a 3 Wþ½ ç ûÍ S ö T ü Hü Ì ³ Ú ú ýë YùÒüÜð f BÇp þ Ý Z Ò ºå q ÎÎ ÝRZ Í1 R ÒÚ ãx9 tå C Å Îõ Tñ¹ s Æ 2 ûªN gì à ä ù Ä äyÏ Û ¼ DÍ B v Á è ¾abï T É væ RÊcµ zÕ W ß ¼ 1Ö bW c 6 W Ñë y M3hb É 0z ö² Õ ² Û ñ î ô 5Þ 9 ³Û¼ F 5 oô ÎèxT² ñv ǺiÐ º lã5 û 7 9 Ü ÎL Â¾Æ Ê ÉfáB1 J ªù1n XÈÊ íâ Éëà µ Ëi ÛJË Àë ³ 3ÿTÓ Oã Rr úìä R ôí Gué ²C E d É DïóZ VÖzË Ë Ç åü ÖÇÀ 6ËàR Ùuï ª¾ n ôY A¾ Ä U e ª ïM jøl Æ Ö ûð6þ¹ÛY Iê ú³ òWv AñÖçÊË1Dsm o Ûè Ûá ³Ç i A ë z Ô õùx ÜäúÒ RHé µI êvG Úb y FJDPÇküã ÿ ÁÅS à ñ E½ËºÆ Nó UF QâÐ AÀûe Aúg dóe À è Zåwq ÿ Á Bý ça z Y 0jÄÏ ëÀ d åv à ák Òch GøÙ Ewò ßnóaÝï ÿT 6à þ sÜ ç î ñùA Ò 29 oW Aà cØ ²ø m ñ ñ ë ù o ÄËå QÙÆ t¾kû ø õÛð p ý áÏUCKFÐ ß²dÁxþ þ½H Õ Ã z 0zùx WÇ YÝà Ö ÑË V w ã Ú Å lnv BÌ ¾ª öø0 Àoµ s¾ ï Wµ 0 ÖPþ S À ßpvðÖ MüíË ÿö H Ï è åO K u Í2 Wkaï P ônÒÁ ê ýêì J ZÏÄ jL Gu ÊËÞC eL æ zÙó²7 ö g µm Ê Éé yÓ úÜ Õ ª Ï Y 81 S C Õ P Æ a ²øÔÔÉ 3DÜi ÒKW 7X 3 ÕóB ýÀ Ó YÝ ¹ þbö ÿßfO G ê ü ò ½r ÇÖ b 14 Úcy 1Ë D Q ØÚË 28 a ³ a Î Ó ç ÐÌ0 Õ 2ëNTñ HôÃç Äôx hÏG Idè1 ÒêKD Á êM ù ÍÚ µ Ô ½ ªòst ÅF ³ù Ò Pá Kݼ Gò Ùs m é TEgØ B üÌ çt Âî½ v íà çc dc ìûa0N5Õ ÿ ¾ ðS9ú ÃÊÏýL 6Jiw ÇÔÏÄéâ qcç Ùó 9z îD à Ú4 Z zÛø mÄí ÃäÓÏ º ÉbÓ Gâ KÒ q b äñWݼ ² åò nNÃÍ Dý ½Ê ß c 4 F eÒ ÿ ñ ï Bn³ U NHe ÆSêeï 1 ýz Ø Ñm Æ ÆMB õ ì ¾¾P ÜÕžHæ Øy ö ïPø H5 ôèÄÏEcµ r CSMð äÙÃî6 x i L î eé jÌ Zî ² 5 N Ê ð 9 Ìäó 9 ø ÜB Û Á áÅò9üÔÿ v 5á Ñ9 ÂúÛìÄ 2Ô ªÀt øzÄtñ ö a Ä È vÐ g jXo Ó sËY þº P öc J Y Õ ýX õÕåA þÙ07Ð02 l1bó ½H õ4ìwF aæ úp â ¼s ñ l v ÜD ÍD ÝCqû Yþ i b ã õH Ðz UáÞ Û uÙ Û¼ 2½Í nlûêG ìv Qzb öÍ KÓ W Ë W r ³èöc eE òè Þq Fdÿ 7u í ³vs Y XEFÌc8â ò Z7 U b vÀª hð q iMdcÃíEÔQ n g ºu Ö ³ãS ÃÂbú s7 õB Z Ø iCMK¼ n a á D ù UEè h xÞUQB âlnØ aëMDÞjþõ ª ¼ à h ¹Ú ác7ºX j º8ô À Ybìù Ói¾qÙ 5 FÆ Vjÿ Ï zk ikpv ÛÈpy ÆJ t pTýt Õ5 ò6 6ÑôõñË 3ß åÛáA Zx Z sÁª ý ÇÄ PQsü k wt³ I BP ÃlKÓ h ¾DÅ y ½Q ÙH 0L sýój é åÆ ô êâv ò v4iÏ jG7 r þÁû Dé³Ä è 0íf Y W µÃè³a M K å ÐÞRF ë ö cµ½ M C 4å hÇ 9è ÿj Âzä ÉÆa Úmî³ ³ î º Çã ³ æé2 à  ÿOiñ ä a äQÕ v Ǿ b S Ó EK ù 1 1 Ôn UÝL ¾ ØæÅP úv Æ l o o àyç Õ 75 ñÖ ¾  ZüµÉ ÉõMñv O½ âä ï ã R Õ KI íÂU ªÅ ÿvÁ ÿ w6A Ü ý E o jG É â µ kFBo ì AÜy OS m êã 0í kÒ vîëä ú m ÐC Ä ÂÝ ²çQ u0 qäQ ýÈp 5È ç û ònë Ï ä p ê þayþ YbØí0Gh N Ø ºÈ ½þ ý JÍÏ ósÃÐ ¾ Ö aý ßDKR ÇAúö¼fÿ Pç¾N K 8 ïÿösÃÀ1é Á ñKr yü úÈCö Ãæ E yÈÞ ½² Øòøk zß ²o Áú ÎÓ ù ÆööÊWc S Ü íí32x9v m Îù zjÔÃjn ÝAE i g ÐðÄ8 o µk4AR ã äb7é½Ñ ä 1wh ý 9 ÓÔÖgÉ ã î 5 Nc m Î ã ÿ ü àýÅ Çu ï P 2 zg c ª G þø f²½EÙ Õ Fùþp jà oQJOä ³ ÿýºøÇd Òs çã Ò kg ãã oe ÖA½ Ë ½F ² K ÑDnD ÿß ÅC OúÀ ò4 ï ó OÉm ïâ ï Ü Ò½M æ å 8 x ÑÎÍ ² ¹ i9 wAÃV N GR È uë C S ù ËGeeöîÎpª ó 9g ÕSSGDô à PÖDaÚ Y V éÅ ô kSz K Ád ïjdüñ 1 ù Q S ûrO 1 Cë ½ Lâ Ô Â EÎÓ 8y³w íf Îà2 Î v F B0 k I T Ð O a0ÿ J ª³ ØÕ ü T sUKÛ Ê é íz óà½m Úo çJò Âåµ h 0 ö u øp ÄEg HtYU Õ¾ ã yÏ ²Æ ÿÝ oLÛN üÑ K Ú ÂøtÊjb eñ Ü æé cý5oê óx áAUÝ Ó Ý Wã P9 r Ä ¼ 1Ù óÉ À Ù 7 cí a Y çàã ¾ þõüãó ÏÅ Ô ³ ÃÑócøé N o ³Élöü ½ûí FüõìÙäh ËâeT â³5 ² È ÉUIo 0 3ø Êe ïÊfr l6 º½ ÃÓ ta Ï Å ¾ ½¼ zõ rÛ áEºnç 3ú 8 j Ï W Á q Û iÝ c ÞtÀü ñÙVVJ ù n ô w Q ½ Q ²ÞÇn O e Gå 3o vÍ y Dø³ Îþ Õ Ö Ìð é½go G Y Ý 0y5ô1es Çhê ¹7 r yï Iâ xÐÞ³ Q9ª 0²nNa ÁÌÍ XÓûD²n ñ ½ U üBÒõÒÄñ½n ýô u ïÍ Û þª Ý ýyß Ä Y gBl ð î 4 8 ï s i s NED ¾ N Ã É MN½¼Ôº ¹úêÉx ޵Πwñ P ó å è ò l ½1àlËR Y ó Ô 8 ùºíç f ø Æe Πì I irº¾àý X ½ ½ßv ½ Gù à Ê À ü Ö Ú Ê é Ý ðgª ñbûæ ôW S ûVÖ Òù²í Û úÞ óà íü öµiú ² ß²dÁ¾ù þ½Ø6B Ϫãá 9 O µÚÅ 9 lX Mü5 Z ÜdvÒ Uó óò çõ Îë ³ ßj Ñü 4 ²å p J Õ S ÙöŪQ óÙæ v Ì þð åOÕÉØWµ é ª¾ Í ã h³ 8ÔVa I ÜIÕ ÇÁ ë kZ ë üA ng9Ãau ù æ W S¾ P ü pË ö ª S5Ý beà ªN Û jÉÞ æ sw Õ ñçqð à Ô µ ÒÓ l Ot ªO È 1æ sY ¾Aa6 Ä è UÃCãò L o w m µ V Óî ùNY eRk éºÛa ò ì F 7Õ õ Q Ñ jQ Î7L γ XKÀ À1ñK³úczR 4îo Üt0éN í T ifØ k ó Ü Á B ÞS o ÊÕ l 5 Ø dKÏ 3çc ô òûpÀ¾p HÝl J µgÀ 5ÇM Aô A jÀ 2 ùä G ¼ R Îü Ë ÏqÐéþV Ä AÙn tí mO w þz M 5ôÐ Ùpg ï P 4N1k k ÇKÌÛÈ X ýSÁà ۵ Û³îa áõ ÛÀ µ ÃæpGèË4ÎWÿï ýo7K FÕU Ár l F CA U Bt n e ÇÁÝM¼ Þ C ÑHì C 6 à æ Ý K¹Xìf Â Ë h ØLf Gfò Ç É ªÕ K n ÀÒMÕ2 ö ã Ûð ¹ I iOÍ O3 v Ú f a ³ z½Å ÒbNOýÌ ï åakI3 ÝÄ j êTâU Q aµ Z Ëd ÍÌB MñG³íàT i¼ ÁúY9 ß jQS ² øR ïéÕ D ìO³ Á O ÜDKÖ µ ÂÅítús D²Fw8 PÙ ï ÑÔÞæ F Kè² ü²Ê9k j Üci ÇY ãÀ F ç Î DOTuCYÀQíÍç íl Ò µ M F ÉC µùÀ Y j WWY X T ãx W AK Ø 7n ò  ¹ 6 ÝûÝ ê Ãø ßâ 3 v M H u655 aè ÔÚ î æµúR µ k 8 Øç Çú 0Ôc v W ½¼kFöÝñ Ò Àyl á Û 89 ö º ãºþ NÆ õ8Sôòøè Óá ÇSm m ̹¹ p Mb jGb Lú ð ª Êè úçMd Oï èËÝ Á ²í1 ÀèDù 7M ï Í Ä0æ Uiõ Ø Xóz Y ôÝ æ¹zÿN ø ý Yµ ªàù Ø þ oùÐ RÔ²íÀ Ók7Ó 2NÇ TÖ nn èYâÀke µòô ö̼Vn S ² Òf½ üU µ Ê E y íÔÊUîÜûÊà Ô w y S v SJ rg¹µÃ ÌW ³² ÊVjåÉô L Á IÍ7ÿ 6ñ þ³öt3 5 Øy2GäFª PÙÔ Ô yd ½ È ÏÞ Ôö aïp Ç Q G 8k Û ë 3 äþXÏ ïÛ 5Ä ØÁ ¹Ev Ê uo g9 õ Á¹O ëK S Z g ç ³f är Eñª ZÎp åæ ô Ñ Ç ò øÃf Ä azrµwowðËTY³ à 7 ñ 5ìM Éê Ýó j7Dõê Ú ¼ íõzkØ ÆRÚU vò þK7 ¼ v hÔ ºÞ ÞGO IÛgÕ ÌÀÀË77¾ h º F l ÞwøF ÄÇ ª í E1ËÎ i í9R Ö 9 u k úK D ô Çñ Lk M dÍaÇïÓ w ͪl áëDí QP¹lVÉwÀ ê ÑeÎ 7Á u V² 9ôa J þh Ò üõ ÃGå ôÇÓá Q f º 6XBö ô RÂfc éXU Øá ÎÛÖ Ú Õ ÙÜQkg¹3 f9Nt SÌc wò ÙÊ ðê 8 ÿ ¼ gÔ²í¾òu ãüÑ õÁòÓ X Nk1 ÜwX ²8Ç á Ng ÏéVrú ª 1ðû ª øÚ Â ²ùµ ªfâs ái HUà ÍL Ë Hù Í Ù²Ê o ú ÌÁÝùÁÄ ½µ ý 5²üY I3 ö C Ö ãÛ â³ Z8dè ñÌ4ßh é 8 KÔ c ¾ ãÇ ß ñrü tE I q M C µ²1é k åT q8g ý RÈÊ Ú bNF ½ Y Cí HVG ñð û4Ã Æ ¼a ÿØ Çl ü I ³ ã 5 K k Nf ðp1 Ä 5 ÐX ¼Înr³àc µIÓù GÓ íâ u j sôÝ me M êdæët ºwÉ ½ HWEfxý Ó íÝ iQ P çà e sª w më i 1 Ì ª ß Y ºákl c qÆ êâ Ì fþ Dc 6 D øOݾ W û ªÔf í¹ l ðÙ0 ÓÍÉÿ 2ìbìëd 8H Ìjc 2v³n¾ ð ÏÏÛ ÓÚË î Ù jÂá 1 ëó CpU Ë Ôô õ¾ 2 HÏÁ æç Mgµ M Ú 34 ¼ îðÐ4Ó sï Ë N ¹ wUÀNÓ Ó ñ rhÖq² P0í Ü óeZÜ â 8þÖÆ È Ù ÉÐ M e Z ² Î dE Ý ÈybÇ ß gI Å E ½U V Ó ÊW A J Ê ó ó äTA é å Ê Ú ïÛR Ó1 B N ñ6 mÁªà H Ð ÎuT ñU Åç þ Ì ¼ñhH Id u 0 ã OVð ÓÑ ª Ú Hv u Ô ýS ÅòHM0 i 1 ã s ½ê Ü Ï xlå 9d Ù g ÕÖÌ ãßxðÏN O OJ Ô b ö ½â ðò ð Øi äJ ½Õ ÏÒ ª ÖJ ºdM T v0mek âÚoé Ìð nò ÓÉΪ ùyY Í W pû 5 V ³²xÆÛq 3 ² Th N lCî àax Ê åC Qzò n BÈ q ö O Ü çÉ 4oë y Ô¾þÓö HÒYyð06Çi ìiöm ûai ²Z0 Awïø ȹ yºL³ ÍÏuÿóÝÙ Þ Ï d 3 úõ8Ö 4ª l è ¹ g kDå RwiHi s Läß ÅËbYUÛøúÏ ÑaR¹ ¼ÿèb r 3úëß Úm ý K Í ô88æý5ª²p ìëBBÆ çÎ 14ReÛ þ r ÿ û âW8 Ç Ñ ômúLúZRÆ Æ Î Í q ÉÙ2pO iBlÅÔv Ú 9 F ³ éÛ²Ý Z3ã êP ç Ñ ñáèpÂPÉåK ã µ wÊß Ý ôî Yºl LõÀòÇ Û½n à ªöþ êüÑcóðÇ Î þvÜ½ß ½ V n YåÉùÁ ³ e he ð LÞÃÓ ½ 8 k á k¾1aAñMQ OQÐ8µëÇ Æq ij ö m úÓH kîÓU ñ½ Ø Ã HâV 4 ò ³PZ D 47ok Jã Rwmâ 2 Ú a ü pG ùj òø CÉl U èfâÉ y Z aÂv0 ÅG ëò ½ HóÔïØ m äÄ Í 4 ªn Â8É zK 6R dàû Às Ø U 8 ÀHóÝSQ Ö ý òÎFï d ÉûJál ªPLcó9 p Ð ÄPÁÌ nDDÅ À 2 F Í XÍ ÒÈ½Û g Éû ë vÆm Ͻ S k V D áÇs õ xfå ÝÈÙ IÌ Ýb³ O x Qí Î u Z û áÊÝR Q b Ð á m ä Iº 2ï Zì ÿ ½o n É ü ª J ÞD ò Ù Ê Ü ÛûR 2 P ü û ó8oó ó ó 2 L ò Ñ Ä ph HJ 1 C 0löÕ6 à a ö í xR ç l e Ú c Yùè ÐC áT éb4 ¹VÖ tA h Ó ÃÞ Ý SÄT Ö 1Z 1 ÅÙ ET¹ É7ÉPî Ê É Ð G1 y rñ Ä ä tÛL l4 XJ VP Ê Õ e ª á V48 t0µ f 04æÂäA Î j âlJ þ ¹ L5H åËGûô YÎG R0Õ aH Æ5Ð ûþà Z 2ÿk WÞÝ ùLË6 ÿ¼ Ý û Fîyopl6 l 0 ë I0 4ml ÚJ Þb7 ÍIçJ Kç ÆG¹ 4Kuøj7 í ³Ù³ 2 a X JÍhaN I G 5Û ÜdalÞ óºe² T B ùyoÒ Íê Ö Q ëu Nÿ ²éªÁ Ç C vGýQZ 6ÌM ã Þ Ç D 7 e ò ù 1UXaP 0 9qÿÍ û RÓ Ê rmY ðp þÆu uÐô x ËJ ªfM ÚU ÿ vGE 3  g wÞûZp à Å ù úÒ H ¾Àº ÂðöC Áw OKh ä ÒZ Q vº b29 p vùPk þ ÁÒ ñl ÇI ï éùá æ n Ø ½ J ù µ Ú ½ÏG ü qÆ iV t v Åþ q äÓVÚ YR S ü ùô Ë TÌw 4à ÚJR â Æa D Æ3lã Bô ¾  JN Ä Ãê º ³X ÓÌÆa cþf Öb8¼ 9e k 7YKРʾd í 0Vko c Û7G iÉtôðú þ A²1TsnÆ g¹ Üÿ ¹ZÖ ²i a fû5 EÍ S xP RÎ ú k ÅnB õrjqP ĺ O Y Ý ½ lQ Ç 0Õ ê K1 v ÓXcrÑAÿDVè Y B ²H Ò Á ÿbÒº uj XZb7 f gÔ ¾ ÎË Wç JØ ñö ºõ Ýùæà whÓ Úû²Í K½ óXnü E¾6 Áó ² ò és Ø ¼9 Ð éðô8S ÌÛÓÑizhæÝA Töð ͽ M 3Ñf TR 3EJ bh Æ ñ ÕMõÿ aá µh³Oæ âä X ¾ûá Ùôƽ 4x 2 M AB0 k ah Ì y Ääôþ Í ê éÁÊ U Ñ ï K þk r s wî7ô È 0bøÓðg 8 xp ÊG 5Í ÔðûcË 6 ß Yv QT Bp hv6 Ë P29 iFdå ½ 0 exBT ï în2 f Ó ²7FÁ h TYuÃN í dÕó eà Õ ÇßÄ s Ó å dÁdÉ pÓÇæt L²dÜ Ä Ê ko CD sÊ Dæ É ôöí I ÿ yny iaò eqº w 3jƽ٠Bõ À 4 ç dMVÌ ä LÌ ê 1ã 4 5³ ÓKSI 1ý¹Uñõç ¹ Ý ÛV ÐÄN Á½ yë Æ8 h S i mü ìî ïaØÕ 5ßGa bM ¼ Æ Æ ï È h û W þ i ÿ¼aj ÀHlL Ø o 6i IñÝÜÎñ q Ï ½ nKø 9r Ϲñ ipLb X2 Í ûå ªÝàDÁ Î9¹ hp ád õ Nì 0 æ ãjBfÏÒ Ç58Õ p N hpPZá áÚ ³ r ô0 ¼9 tc qåø äW 0 eúøh oÀ ACÁKEÄ ÜôUP à öfF âtÌv1 ¼WACR èJÃTc 50 ùö h rñê eMËî4 ôÛë ªïP h à z t½ ô ¾ eÕTHmÛf õ ÜGg 4Ó³fÐkÐ áñú ³ j ûÄ 6ÐmV 1 ÍP Î Lª 8 9Þp ín8 Ýt L Zù 3ú æ Ìa ï Ý à hÔvW Õ Í² ³ð 6 OPÖ Á z l È z88 ª q Å tuz î 99 ½ ð7ü P b xZº ß èÌ Ïó ½H Õ ñ Î ÐÕ o Âå ú9ø ½ sM é0 ðK7 C9 öà r df1Påa ² Í t Ix Þ UWð2 m I ÎÜ Î ÙËÛ0 â w ¾Ì¾ ² M ² qÿµrü ¼y çêÓ3Ãcð 9r c ß Ññ  à Ò Sàé K çd é ÒèûÚ ë ÀGô t Hvü G ç tOªVè w ³dcJv Î ÇYá Î îp F Búý ÜgÇ ÂË oÓ ÍÞó 8¹r 2w éܹ D ó o

    Original URL path: http://www.nezhat.org/file/Patient_History_Form.docx (2016-04-24)
    Open archived version from archive

  • How Does Endometriosis Occur?
    As a result of this continued battle between endometriosis and your body s immune system the cytokine prostaglandin response inflammation and other immune system factors appear to become chronically dysregulated It s a classic vicious cycle Partially as a result of this immune response and other factors severe pain with menstruation chronic pain independent of menstruation inflammation subfertility infertility tissue necrosis and scar tissue adhesions can develop In severe cases endometriosis causes such extensive damage that serious complications ensue like life threatening bowel obstruction bladder dysregulation kidney dysfunction silent loss of kidney collapsed lungs and destruction of the ovaries and fallopian tubes Meanwhile scar tissue formation also damages organs by encasing them together in abnormal ways in a sense strangling them which in severe cases leads to the so called frozen pelvis which can cause chronic pain and even loss of organ function Like the rogue agents that they are it appears that these clever little endometriotic growths can also reprogram genetic pathways allowing them to continue migrating throughout the body and even produce their own hormones nerves and blood supply It s as if endometriosis is determined to live and will do anything to ensure its own survival In this sense endometriosis behaves in similar ways as cancer even though it s classified as a benign condition Endometriosis is however associated with an increased risk of certain cancers A combination of genetic predisposition epigenetic mutations stem cell dysregulation immune system dysfunction and environmental triggers have all been proposed as potential factors in the pathogenesis of endometriosis Through all of these potential pathways endometriosis can be a progressive disease that is it can continue to grow throughout the body and become worse despite medical and or surgical interventions and even if the uterus and ovaries have been surgically removed Did you know Did you know that teenage girls can develop endometriosis as soon as they start menstruating Why Does Endometriosis Occur Despite centuries of research the cause of endometriosis is still unknown However several theories have been proposed including the retrograde menstruation hypothesis which was reported over 300 years ago in the 17th century The most widely proposed theories of pathogenesis include Retrograde Menstruation Theory also called Sampson s Theory Mullerian Embryologic Theory Coelomic Metaplasia Theory Lymphatic or Hematologic Spread Theory Stem Cell Theory Iatrogenic Implantation Theory Environmental Triggers Genetic and or Epigenetic Triggers Hybrid Theories Why Is It Often So Painful Unlike normal endometrial cells found in the lining of the uterus these errant endometriotic growths do not get expelled from your body each month as a period Instead they implant and begin reacting to the monthly hormones that trigger menstruation causing them to bleed and shed and grow month after month and year after year if left untreated Although these endometriotic growths are benign not cancer it appears that the body still recognizes that they shouldn t be growing outside of the uterus and therefore usually launches an inflammatory response in order to try to destroy them As

    Original URL path: http://www.nezhat.org/endometriosis/endometriosis_occur.php (2016-04-24)
    Open archived version from archive