Diagnosis and treatment of endometriosis.

Endometriosis is a chronic and progressive disease that affects approximately 10% of women of reproductive age. Its aetiology remains unknown, however, factors such as retrograde menstruation, heredity, impaired immune function and environmental toxins have been implicated. Laparoscopy is still considered the mainstay for diagnosis, however non-invasive diagnostic methods such as transvaginal ultrasound and MRI may also be complementary. Treatment should be individualised and current treatment options include medical treatment and surgery, however, disease recurrence is common following treatment. Hormonal therapy induces atrophy of endometriotic lesions. Conservative surgery may be successful in removing visible lesions, however in cases of severe or incapacitating illness, removal of the uterus and ovaries may be necessary. In such cases, extreme care must be taken to remove all traces of disease. Experimental treatments for endometriosis show promising preliminary results and include GnRH antagonists, aromatase inhibitors, selective oestrogen receptor modulators and mifepristone.

Brasofensine treatment for Parkinson's disease in combination with levodopa/carbidopa.

OBJECTIVE: To investigate the safety, tolerability, pharmacokinetic, and pharmacodynamic properties of the dopamine transporter antagonist brasofensine (BMS-204756) in patients with Parkinson's disease receiving levodopa/carbidopa treatment. METHODS: A 4-period crossover study was performed in 8 men (mean age 66 y) with moderate Parkinson's disease (Hoehn-Yahr stage II-IV). A dose escalation study was used in which each patient was given a single oral dose of brasofensine 0.5, 1, 2, or 4 mg, which was coadministered with the patient's usual dose of levodopa/carbidopa. RESULTS: The maximum concentration (Cmax) values of brasofensine observed in plasma after oral administration were 0.35, 0.82, 2.14, and 3.27 ng/mL for the 0.5-, 1-, 2-, and 4-mg doses, respectively; these concentrations occurred 4 hours (time to Cmax) after administration in all cases. Exposure to brasofensine (based on AUC0-infinity) increased at a rate greater than proportional to dose. Based on the motor performance subscale of the Unified Parkinson's Disease Rating Scale, no change in patient disability was observed at any dose level. CONCLUSIONS: Brasofensine was safe and well tolerated in the patient cohort studied at daily doses of up to 4 mg. Adverse events were generally mild in intensity, and included headache, insomnia, phlebitis, dizziness, ecchymosis, and vomiting.

Risperidone in the treatment of Hispanic inpatients with schizophrenia: a pilot study.

A growing body of scientific evidence over the last two decades suggests that certain ethnic groups may require lower dosages of standard antipsychotics for the treatment of schizophrenia symptoms. Recent studies have implicated the role of genetic and environmental factors in the metabolism of these drugs as the basis for this differential response. In this pilot study, 10 Hispanic and 8 non-Hispanic patients with schizophrenia were enrolled in a double-blind, parallel-group, inpatient risperidone dosing (daily versus twice daily) trial with the novel antipsychotic risperidone. The result of repeated measures ANOVA reveals a significant interaction effect for race, indicative of a faster rate of symptom improvement (PANSS General) in Hispanic patients. The findings suggest that this novel agent may be preferable for certain ethnic groups. A trend toward more frequently occurring extrapyramidal symptoms among Hispanics was also found, which suggests that dosages lower than those typically recommended may be necessary in Hispanic schizophrenics.