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Objective: This review discusses the general principles on which classic and novel approaches in the pharmacotherapy of endometriosis are based and presents the types of drugs involved. Design: Review article. Data sources: Relevant studies were retrieved from Pubmed, Scopus and ISI -Web of knowledge databases. Eligibility criteria: All articles in English, French, German and Danish languages that contained the following keywords: endometriosis, pharmacotherapy, pain relief, chronic pelvic pain & infertility, were retrieved and read and all relevant data were included in this review. Results: Endometriosis is an estrogen-dependent, benign gynaecologic disorder, characterized by the presence of tissue morphologically and biologically similar to normal endometrium outside its normal location. The underlying aetiology and pathophysiology are poorly understood. Dyspareunia, dysmenorrhea, chronic pelvic pain and infertility are characteristic and debilitating manifestations of the disease. Several pharmacotherapeutic approaches are available. Currently available pharmacotherapies are not curative but symptomatic and aim either at decreasing ovarian estrogen production or at antagonizing estrogen action. Recurrence is the rule after cessation of treatment while pharmacotherapy is not suitable for women seeking conception. Conclusions: No curative pharmacotherapeutic options for treating endometriosis are currently available and most options complicate the course of treatment due to adverse events and short-term results. Novel approaches aim to take advantage of recent advances in endometriosis research but limited data are available regarding chronic use and long-term safety and efficacy.

Objective: We review the surgical modalities used in the treatment of endometriosis, including ablative, excisional and denervating. Design: A systematic review of the literature referring to the surgical treatment of endometriosis with emphasis on articles published since 2000. Data sources: Medline, MeSH and Cochrane library searches for terms including “endometriosis”, “ablation”, “excision”, “denervation”, “pelvic pain” and “infertility”. Eligibility criteria: Trials assessing the short, medium and longer-term efficacy of surgical modalities employed in the treatment of endometriosis were considered. Studies published prior to 2000 and small power trials were included only if commonly referenced in the literature. Results: 114 articles were considered with 53 referenced in the final review. Conclusions: Excisional treatment provides more favourable outcomes than drainage and ablation with regards to pain relief, endometrioma recurrence, symptom control and fertility rates. Ancillary surgical procedures such as presacral neurectomy and laparoscopic uterine nerve ablation can prove helpful in the management of dysmenorrhoea. Radical surgery in the form of hysterectomy remains end-stage treatment for endometriosis. The role of medical treatment remains unclear.

The purpose of this study was to evaluate the effects of the anti-inflammatory hormone α-melanocyte-stimulating hormone (α-MSH) treatment on renal function and expression of aquaporins (AQPs) and Na-K-ATPase in the kidney in response to 24 h of bilateral ureteral obstruction (BUO) or release of BUO (BUO-R). In rats with 24-h BUO, immunoblotting revealed that downregulation of AQP2 and AQP3 was attenuated (AQP2: 38 ± 5 vs. 13 ± 4%; AQP3: 44 ± 3 vs. 19 ± 4% of sham levels; P< 0.05), whereas downregulation of Na-K-ATPase was prevented by α-MSH treatment (Na-K-ATPase: 94 ± 7 vs. 35 ± 5% of sham levels; P< 0.05). Immunocytochemistry confirmed the changes in AQP1 and Na-K-ATPase expression. Renal tubular cell apoptosis was confirmed in BUO kidneys, and α-MSH treatment virtually completely abolished apoptosis. Furthermore, we measured glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), respectively. Forty-eight hours after BUO-R demonstrated that α-MSH treatment almost completely prevented the decrease in GFR (nontreated: 271 ± 50; α-MSH: 706 ± 85; sham: 841 ± 105 μl·min−1·100 g body wt−1, P< 0.05) and ERPF (nontreated: 1,139 ± 217; α-MSH: 2,598 ± 129; sham: 2,633 ± 457 μl·min−1·100 g body wt−1, P< 0.05). α-MSH treatment also partly prevented the downregulation of AQP1 and Na-K-ATPase expression in rats after BUO-R for 48 h. In conclusion, α-MSH treatment significantly prevents impairment in renal function and also prevents downregulation of AQP2, AQP3, and Na-K-ATPase during BUO or AQP1 and Na-K-ATPase after BUO-R, demonstrating a marked renoprotective effect of α-MSH treatment in conditions with urinary tract obstruction.

Lung cancer is still diagnosed at a late stage due to a lack of symptoms. Although there are novel therapies, many patients are still treated with chemotherapy. In an effort to reduce adverse effects associated with chemotherapy, inhaled administration of platinum analogs has been investigated. Inhaled administration is used as a local route in order to reduce the systemic adverse effects; however, this treatment modality has its own adverse effects. In this mini review, we present drugs that were administered as nebulized droplets or dry powder aerosols for non-small-cell lung cancer. We present the adverse effects and methods to overcome them.

Ehlers–Danlos syndrome (EDS) is a heterogeneous group of connective tissue disorders involving various organ systems. We report the case of a female patient with Ehlers–Danlos syndrome type III (EDS III) presenting with a recurrent rectocele in whom porcine small intestinal submucosa mesh was used successfully to correct the defect in the rectovaginal fascia.