Experimental treatments of endometriosis

Endometriosis is defined as the presence of endometrial gland and stroma outside the uterine cavity. It is an estrogen-dependent disease and is associated with chronic pelvic pain, dysmenorrhea, dyspareunia and infertility. The treatment of endometriosis is conservative or radical surgery, medical therapies or their combination. All currently used hormonally active treatments are effective in the treatment of endometriosis; however, the adverse effects of these hormonal treatments limit their long-term use. Moreover, recurrence rates are high after cessation of therapy, and the treatments have no benefit in endometriosis-associated infertility. Therefore, researchers are working on new treatment modalities with improved side effects, mainly focusing on the molecular targets involved in etiopathogenesis of endometriosis. Here we summarized these novel treatments modalities

Use of hematopoietic stem cells in obstetrics and gynecology

Stem cells can be used in different areas of obstetrics and gynecology. Adult stem cells are specialized cells found within many tissues of the body where they function in tissue homeostasis and repair. In vitro they have been shown to differentiate into a wide variety of cell types. Hematopoietic stem cells (HSC) have been used to set up therapeutic strategies for the treatment of gynecological solid tumors such as ovarian cancer. Stem cells can be used for prenatal transplantation and in utero gene therapy. Also stem cells can be used in infertility and IVF for research and treatment. (C) 2008 Elsevier Ltd. All rights reserved

Experimental treatments of endometriosis.

Endometriosis is defined as the presence of endometrial gland and stroma outside the uterine cavity. It is an estrogen-dependent disease and is associated with chronic pelvic pain, dysmenorrhea, dyspareunia and infertility. The treatment of endometriosis is conservative or radical surgery, medical therapies or their combination. All currently used hormonally active treatments are effective in the treatment of endometriosis; however, the adverse effects of these hormonal treatments limit their long-term use. Moreover, recurrence rates are high after cessation of therapy, and the treatments have no benefit in endometriosis-associated infertility. Therefore, researchers are working on new treatment modalities with improved side effects, mainly focusing on the molecular targets involved in etiopathogenesis of endometriosis. Here we summarized these novel treatments modalities

Enhanced recovery pathways in gynecology

Objective: Enhanced recovery after surgery (ERAS) is a multimodal approach to improving outcomes surrounding perioperative care. Recommendations are regulation of intake fluids and foods, nausea, vomiting management and encouraging a regular diet, and early mobilization. In this article, ERAS rules and regulations for better perioperative outcome and comfort are discussed.Materials and Methods: This article discusses major reviews and recommendations of medical societies for ERAS.Results: Prompt removal of drains, catheters, and lines and using laxatives on routine basis are inevitable landmarks of ERAS protocol. Hypothermia, decreased perfusion of peripheral organs, fluid and electrolyte imbalances, and insulin resistance all can lead to the release of counter regulatory hormones, including cortisol, growth hormone, glucagon, and catecholamines. Hormonal changes around surgery can trigger the release of inflammatory cytokines that eventually may lead to adverse outcomes.Conclusions: The main goal of ERAS is to prevent and decrease this negative cascade in the context of perioperative care

Aromatase inhibitors: the next generation of therapeutics for endometriosis?

Objective and Design: To review the role of aromatase inhibitors (AIs) in the treatment of endometriosis

Association of interleukin 1beta gene (+3953) polymorphism and severity of endometriosis in Turkish women

Endometriosis is regarded as a complex trait, in which genetic and environmental factors contribute to the disease phenotype. We investigated whether the interleukin (IL) 1beta (+3953) polymorphism is associated with the severity of endometriosis. Diagnosis of endometriosis was made on the basis of laparoscopic findings. Stage of endometriosis was determined according to the Revised American Fertility Society classification. 118 women were enrolled in the study. 78 women didnot have endometriosis, 6 women had stage I, 3 had stage II, 13 had stage III and 18 had stage IV endometriosis. Polymerase Chain Reaction (PCR), Restriction Fragment Length Polymorphism (RFLP), and agarose gel electrophoresis techniques were used to determine the IL 1beta (+3953) genotype. Frequencies of the IL-1beta (+3953) genotypes in the control group were: CC, 0.397; TT, 0.115; CT, 0.487. Frequencies of the IL-1beta (+3953) genotypes in cases were: CC, 0.375; TT, 0.225; CT, 0.400. We found a 2.22 fold increase in TT genotype in the endometriosis group. However, the difference was not statistically significant (P > 0.05). We also observed an increase in the frequency of IL-1beta (+3953) T allele in the endometriosis group. However, the difference was not statistically significant. We also investigated the association between IL-1beta (+3953) polymorphism and the severity of endometriosis. The frequencies of CC+CT genotypes in stage I, III and IV endometriosis patients were 83.3, 84/6 and 72.2%, respectively; and TT genotypes were 16.7, 15.4 and 27.8%, respectively. We observed a statistically insignificant increase in TT genotype in stage IV endometriosis (P > 0.05). We suggest that IL-1beta (+3953) polymorphism is not associated with endometriosis in Turkish women