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The literature suggests that misoprostol can be offered to patients for off-label use as it has reasonable efficacy, risk/benefit ratio, tolerance and patient satisfaction, according to the criteria for evidence-based medicine. Both the vaginal and sublingual routes are more effective than the oral route for first-trimester cervical dilatation. Vaginal misoprostol 800μg, repeated if necessary after 24 or 48h, is a possible alternative for management after early pregnancy failure. However, misoprostol has not been demonstrated to be useful for the evacuation of an incomplete miscarriage, except for cervical dilatation before vacuum aspiration. Oral mifepristone 200mg, followed 24-48h later by vaginal, sublingual or buccal misoprostol 800μg (followed 3-4h later, if necessary, by misoprostol 400μg) is a less efficacious but less aggressive alternative to vacuum aspiration for elective or medically-indicated first-trimester terminations; this alternative becomes increasingly less effective as gestational age increases. In the second trimester, vaginal misoprostol 800-2400μg in 24h, 24-48h after at least 200mg of mifepristone, is an alternative to surgery, sulprostone and gemeprost. Data for the third trimester are sparse. For women with an unripe cervix and an unscarred uterus, vaginal misoprostol 25μg every 3-6h is an alternative to prostaglandin E2 for cervical ripening at term for a live fetus. When oxytocin is unavailable, misoprostol can be used after delivery for prevention (sublingual misoprostol 600μg) and treatment (sublingual misoprostol 800μg) of postpartum haemorrhage. The use of misoprostol to promote cervical dilatation before diagnostic hysteroscopy or surgical procedures is beneficial for premenopausal women but not for postmenopausal women. Nonetheless, in view of the side effects of misoprostol, its use as a first-line treatment is not indicated, and it should be reserved for difficult cases. Misoprostol is not useful for placing or removing the types of intra-uterine devices used in Europe, regardless of parity., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Two butterfly species living in the Alps, Parnassius apollo and P. phoebus, frequently hybridize in certain localities of this region. The features of this phenomenon have been previously studied by biometry and starch gel electrophoresis, but some points remained obscure. We present them in a study combining results from cellulose acetate electrophoresis and wing pattern biometry with a determination of the mitochondrial haplotype by a PCR-RFLP analysis in a sample of butterflies from the southern French Alps. It was already known that the male hybrids are fecund and thus that interspecific gene exchange could take place via backcrosses with the parent species. In the present case, combining the identification of mtDNA with the analysis of nuclear genotypes allows us to demonstrate that hybridization can involve both sexes of both species. Moreover, it suggests that at least some female hybrids are not sterile. The impact of Haldane's rule is therefore not very strong in the present case. However, although the prerequisites for introgression between the concerned species are fulfilled, at the level of both nuclear and mitochondrial genomes, no indication of such a phenomenon could be gathered in the studied sample.

Traumatisms of the genito-urinary apparatus may be due to road or work accidents as well as mishaps occurring in surgery. Whatever be their cause, such after-effects may quite possibly not only perturb genital functioning, but also be detrimental to everyday life, if not survival itself. Such sequels are then open to legal redress, when making an estimate of the attendant damage, it behooves one to take into account the initial lesions, the gesture carried out in surgery, the evolution of such lesions as regards each particular organ and, last but not least, the way after-effects effectively impact upon the subject's everyday life. Such widespread considerations are integrally linked to equally widespread medical knowledge, to which one must necessarily add legal notions pertaining to juridical compensation for the type of corporeal injury which any surgeon, whatever be his degree of expertise, has got to know.

As part of urinary tract transitional cell carcinoma, inverted papilloma deserves a particular place owing to its histologic features, rarity and prognosis. These tumors are usually located in the bladder and their location in the upper urinary tract is quite exceptional. This is the reason why we were prompted to report 4 new cases.